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Li R, Zhao Q, Cui Y, Fan S. What exacerbates and what eases Chinese rural residents' depression during the COVID-19? Heliyon 2024; 10:e35110. [PMID: 39170387 PMCID: PMC11336448 DOI: 10.1016/j.heliyon.2024.e35110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/13/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
During the COVID-19 pandemic, there has been a growing prevalence of mental disorders, particularly in China, where anti-epidemic measures have been more stringent compared to other countries. This has resulted in a heightened psychological burden on individuals. However, the actual psychological impacts of COVID-19 on Chinese residents have not been clearly established. In this study, we aimed to investigate the effects of various factors, including personal and household characteristics, social networks, and epidemic-related variables (such as rural residents' knowledge of COVID-19 virus transmission and prevention), on rural residents' depression. Using a two-year balanced panel dataset encompassing 152 villages and 676 samples in both 2019 and 2020, we employed the Ordinary Least Squares (OLS) model to estimate the influence of these factors and compare their coefficients to examine the changes in rural residents' depression between the pre-epidemic and during-epidemic periods. Our study highlights significant factors contributing to rural residents' depression during the COVID-19 pandemic, including isolation (2.063, p < 0.01) and concern about COVID-19 infection (0.128, p < 0.05). Conversely, factors such as health status (-0.714, p < 0.01) and the number of friends (-0.017, p < 0.01) were found to significantly alleviate depression among rural residents. Moreover, we identify key moderators that mitigate the negative impact of infection concerns on mental health. Specifically, the health status of rural residents (-0.166, p < 0.01), the size of their family network (-0.036, p < 0.05), and their knowledge of COVID-19 transmission and prevention (-0.184, p < 0.05) significantly moderated the relationship between infection concerns and depression. These findings contribute to a better understanding of the psychological implications of the pandemic and provide valuable insights for the development of targeted interventions to address mental health challenges in rural populations.
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Affiliation(s)
- Ruotong Li
- College of Economics and Management, China Agricultural University, Beijing, 100083, China
- Academy of Global Food Economics and Policy, China Agricultural University, Beijing, 100083, China
| | - Qiran Zhao
- College of Economics and Management, China Agricultural University, Beijing, 100083, China
- Academy of Global Food Economics and Policy, China Agricultural University, Beijing, 100083, China
| | - Yi Cui
- College of Economics and Management, China Agricultural University, Beijing, 100083, China
| | - Shenggen Fan
- College of Economics and Management, China Agricultural University, Beijing, 100083, China
- Academy of Global Food Economics and Policy, China Agricultural University, Beijing, 100083, China
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2
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Shi Y, Wang C, Sevick MA, Bao H, Xu X, Jiang Y, Zhu Z, Wei A, Feldman NM, Hu L. Diabetes Distress and Associated Factors Among Chinese Americans with Type 2 Diabetes in New York City. Diabetes Metab Syndr Obes 2024; 17:2845-2853. [PMID: 39100965 PMCID: PMC11296360 DOI: 10.2147/dmso.s459478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose The purpose of this study is to describe diabetes distress and related factors among Chinese Americans with type 2 diabetes in New York City (NYC). Methods We conducted a secondary data analysis of the baseline data from three research studies conducted among community-dwelling Chinese American adults with type 2 diabetes. Diabetes Distress Scale (DDS) was used to measure sources of diabetes distress including emotional-, regimen-, interpersonal-, and physician-related distress. A score of 2 or greater indicates moderate diabetes distress or higher. Patient Health Questionnaire-2 (PHQ-2) was used to measure depressive symptoms. Participants' sociodemographic information was also collected. Descriptive statistics were used to describe diabetes distress, and logistic least absolute shrinkage and selection operator (LASSO) regression was used to examine factors associated with diabetes distress level. Results Data from 178 participants (mean age 63.55±13.56 years) were analyzed. Most participants were married (76.40%), had a high school degree or less (65.73%), had a household annual income < $25,000 (70.25%), and reported limited English proficiency (93.22%). About 25.84% reported moderate or higher overall distress. The most common sources of distress were emotional burden (29.78%), followed by regimen- (28.65%), interpersonal- (18.54%), and physician-related distress (14.04%). Participants who were younger, female, limited English proficient, and had elevated depressive symptoms were more likely to have higher diabetes distress. Conclusion Diabetes distress is prevalent among Chinese immigrants with type 2 diabetes, especially emotional- and regimen-related distress. Given the known link between diabetes distress and poor glycemic control, it is critical to screen for diabetes distress at primary care clinics and incorporate psychological counseling in diabetes care in this underserved population.
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Affiliation(s)
- Yun Shi
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Chan Wang
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Mary Ann Sevick
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Han Bao
- Jacobi Medical Center, New York, NY, USA
| | - Xinyi Xu
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Yulin Jiang
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Ziqiang Zhu
- Wellsure Medical Practice, New York, NY, USA
| | - Ashley Wei
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | | | - Lu Hu
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
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Shi Y, Wu B, Islam N, Sevick MA, Shallcross AJ, Levy N, Tamura K, Bao H, Lieu R, Xu X, Jiang Y, Hu L. Characterizing Mental Health Status and Service Utilization in Chinese Americans With Type 2 Diabetes in New York City: Cross-Sectional Study. JMIR Form Res 2024; 8:e59121. [PMID: 38954806 PMCID: PMC11252619 DOI: 10.2196/59121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/14/2024] [Accepted: 06/05/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Emerging evidence indicates that individuals with type 2 diabetes (T2D) are more prone to mental health issues than the general population; however, there is a significant lack of data concerning the mental health burden in Chinese Americans with T2D. OBJECTIVE The aim of this study was to explore the comorbid mental health status, health-seeking behaviors, and mental service utilization among Chinese Americans with T2D. METHODS A cross-sectional telephone survey was performed among 74 Chinese Americans with T2D in New York City. We used standardized questionnaires to assess mental health status and to gather data on mental health-seeking behaviors and service utilization. Descriptive statistics were applied for data analysis. RESULTS A total of 74 Chinese Americans with T2D completed the survey. Most participants (mean age 56, SD 10 years) identified as female (42/74, 57%), were born outside the United States (73/74, 99%), and had limited English proficiency (71/74, 96%). Despite nearly half of the participants (34/74, 46%) reporting at least one mental health concern (elevated stress, depressive symptoms, and/or anxiety), only 3% (2/74) were currently using mental health services. Common reasons for not seeking care included no perceived need, lack of information about Chinese-speaking providers, cost, and time constraints. The cultural and language competence of the provider was ranked as the top factor related to seeking mental health care. CONCLUSIONS Chinese Americans with T2D experience relatively high comorbid mental health concerns yet have low service utilization. Clinicians may consider team-based care to incorporate mental health screening and identify strategies to provide culturally and linguistically concordant mental health services to engage Chinese Americans with T2D.
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Affiliation(s)
- Yun Shi
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, NY, United States
| | - Nadia Islam
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
| | - Mary Ann Sevick
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Department of Medicine, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
| | - Amanda J Shallcross
- Department of Wellness and Preventive Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Natalie Levy
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
| | - Kosuke Tamura
- Socio-Spatial Determinants of Health Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Han Bao
- Jacobi Medical Center, Bronx, NY, United States
| | - Ricki Lieu
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Creighton University School of Medicine, Omaha, NE, United States
| | - Xinyi Xu
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
| | - Yulin Jiang
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
| | - Lu Hu
- Department of Population Health, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
- Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York University Langone Health, New York, NY, United States
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4
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Wang QK, Wang X, Qiu YJ, Bao WX, Chen XC, Xu JJ. The attitudes of nonpsychiatric nurses towards mental disorders in China. Front Psychiatry 2024; 15:1420632. [PMID: 38993389 PMCID: PMC11236610 DOI: 10.3389/fpsyt.2024.1420632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
Background Few studies have explored the associated factors of attitudes of nonpsychiatric nurses towards mental disorders. Therefore, this study is aimed to evaluate the attitudes of nonpsychiatric nurses towards mental disorders and especially explore the association between psychiatric clinical practice and these attitudes. Methods A total of 1324 nonpsychiatric nurses and students majoring in nursing were recruited through an online questionnaire from December 2021 to March 2022 in Sichuan Province, China. Demographic information, personal care experience, psychiatric nursing education and the Community Attitudes towards the Mentally Ill (CAMI) were collected. A higher score indicates a stigmatizing attitude in the authoritarianism and social restrictiveness (SR) subscales and a positive attitude in the benevolence and community mental health ideology (CMHI) subscales. Multivariate linear regression was employed to analyze associated factors of attitudes towards mental disorders, and hierarchical linear regression was used to analyze the association between psychiatric clinical practice and the attitudes towards mental disorders. Results Under the control of confounders, high education level, long residence in urban and personal care experience were positively correlated with score of authoritarianism and SR (p < 0.05), and negatively correlated with score of benevolence (p < 0.05). Long residence in urban and personal care experience were negatively correlated with score of CMHI (p < 0.05). Hierarchical linear regression analysis showed that after adjusting for demographic information, psychiatric clinical practice was associated with lower score of benevolence (B = -0.09, 95%CI = -0.17 ~ -0.003, p = 0.043) and CMHI (B = -0.09, 95%CI = -0.17 ~ -0.01, p = 0.027), but the initial associations between psychiatric clinical practice and authoritarianism, SR disappeared. Conclusions High education level, long residence in urban, personal care experience and the psychiatric clinical practice were associated with the discrimination of nonpsychiatric nurses towards mental disorders. Further exploring practical strategies to optimize the psychiatric clinical practice experience of nonpsychiatric nurses could help improve their attitudes towards mental disorders.
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Affiliation(s)
- Qi-Kai Wang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Xu Wang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ya-Jing Qiu
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Wen-Xin Bao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xia-Can Chen
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jia-Jun Xu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
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5
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Yang X, Hu J, Zhang B, Ding H, Hu D, Li H. The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma. Front Psychol 2024; 15:1356435. [PMID: 38939229 PMCID: PMC11208703 DOI: 10.3389/fpsyg.2024.1356435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction Mental health literacy is viewed as a significant factor that may facilitate an individual's pursuit of professional psychological assistance. However, it is important to explore further influencing factors that might underlie this association. This study, employing the framework of the Theory of Planned Behavior (TPB), aims to examine the relationship between mental health literacy and the behavior of seeking professional psychological help, with a focus on the potential mediating roles of perceived stigma and social support in this context. Methods We surveyed 911 college students in seven regions of China (406 males and 505 females, aged between 19 and 25 years old; M age = 19.65, SD = 1.41) utilizing self-report measures, including the Mental Health Literacy Questionnaire, Professional Psychological Help-Seeking Behavior Scale, Professional Psychological Help-Seeking Stigma Scale, and Perceived Social Support Scale. A chain mediation model was developed to analyze the interconnections between mental health literacy, stigma related to seeking psychological help, perceived social support, and professional psychological help-seeking behaviors. Results The mediation effect analysis indicates that: (1) mental health literacy significantly positively correlates with professional psychological help-seeking behaviors; (2) both perceived social support and professional psychological help-seeking stigma significantly mediate the relationship between mental health literacy and professional psychological help-seeking behavior; (3) perceived social support and the stigma associated with seeking professional psychological help play a chained mediating effect between mental health literacy and the behavior of seeking professional psychological help. Discussion This study found that mental health literacy indirectly facilitates professional psychological help-seeking behaviors by enhancing the perception of social support and reducing the stigma associated with seeking such help. These findings help in understanding how improving mental health literacy and perceived social support while reducing stigma can increase the likelihood of individuals seeking professional psychological assistance. The results are significant for enhancing the utilization of mental health services and implementing mental health education programs in universities.
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Affiliation(s)
- Xiao Yang
- Mental Health Education and Counseling Center, Hangzhou Normal University, Hangzhou, China
| | - Jun Hu
- School of Marxism, Hangzhou Normal University, Hangzhou, China
| | - Bingren Zhang
- Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou, China
| | - Hua Ding
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Danying Hu
- Mental Health Education and Counseling Center, Ningbo Polytechnic, Ningbo, China
| | - Hangdong Li
- Mental Health Education and Counseling Center, China Jiliang University, Hangzhou, China
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Ji C, Nagata DK. Mental health help-seeking intentions & coping strategies of Chinese international students in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-12. [PMID: 38848325 DOI: 10.1080/07448481.2024.2361309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 05/19/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Chinese international students (CIS) in the United States may face unique mental health challenges that are often overlooked in discussions about mainstream college student needs. OBJECTIVE This study aims to investigate the predictors of mental health (MH) professional help-seeking intentions among CIS at a large public Midwestern university, as well as the obstacles that hinder their use of professional MH services. METHODS The study used quantitative and qualitative approaches to gather data on CIS' help-seeking attitudes. Quantitative analysis focused on the association between specific factors and help-seeking intentions. Qualitative coding of open-ended questions provided additional insights into obstacles and suggestions for improving mental health support. RESULTS The study identified several factors influencing the mental health help-seeking intentions of Chinese international students. Two primary negative predictors were a preference for emotional self-control and concerns about the questionable quality of treatment. Conversely, having previous experience with professional mental health services, both in China and the United States, was found to be a positive predictor of help-seeking intentions. Additionally, qualitative analysis of open-ended responses revealed further obstacles to seeking help and provided useful suggestions for enhancing mental health support for Chinese international students in college settings. CONCLUSIONS The study identifies key factors that influence CIS' attitudes toward seeking professional mental health services. Understanding these factors can help in developing strategies to better support the mental health of CIS in college settings. LIMITATIONS Several limitations must be acknowledged in this study. The cross-sectional design limits the ability to draw causal inferences from the data. Additionally, the sample may not be fully representative of the broader population of Chinese international students, which may affect the generalizability of the findings. Self-reported data may also introduce response biases. Future research should consider longitudinal approaches and a more diverse sample to validate and expand on these findings.
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Affiliation(s)
- Carolyn Ji
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Donna K Nagata
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
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7
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Ning X, Huang S, Hilario C, Yamanda J, Vahabi M, Poon ML, Yao Z, Fung KP, Cheng S, Gao J, Jia C, Li AT, Wong JP. Chinese university students' help-seeking behaviors when faced with mental health challenges. J Ment Health 2024; 33:386-393. [PMID: 38845178 DOI: 10.1080/09638237.2024.2361259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 03/22/2024] [Accepted: 04/18/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Mental illnesses and mental health challenges have become increasingly pervasive among Chinese university students. However, the utilization rate of mental health services is low among students. AIMS We aimed to explore Chinese university students' help-seeking behaviors to understand how they deal with mental health challenges and use the results to inform the development of effective mental health promotion initiatives. METHODS In this study, we conducted 13 focus group interviews with students in six universities in Jinan, China, including 91 (62%) female students and 56 (38%) male students. We drew on the Theory of Planned Behaviors to guide our thematic analysis to gain a contextual understanding of participants' accounts on help-seeking. RESULTS Our results have depicted the help-seeking patterns of Chinese university students and show that there are four major behaviors which are self-reliance, seeking support from peers and families, seeking professional support, and accessing virtual mental health care. CONCLUSION Results from this study can be used to inform the development of mental health literacy programming for students in universities that share similar contexts, and the study has also opened up a new space for using qualitative approaches to study mental health needs and access to care in diverse populations.
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Affiliation(s)
- X Ning
- Department of Social Sciences, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - S Huang
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
| | - C Hilario
- School of Nursing, The University of British Columbia, Vancouver, Canada
| | - J Yamanda
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
| | - M Vahabi
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
| | - M L Poon
- School of Social Work, York University, Toronto, Canada
| | - Z Yao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - K P Fung
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - S Cheng
- Department of Social Work, Shandong University, Jinan, China
| | - J Gao
- Department of Social Work, Shandong University, Jinan, China
| | - C Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - A T Li
- Regent Park Community Health Center, Toronto, Canada
| | - J P Wong
- Daphne Cockwell School of Nursing, Faculty of Community Services, Toronto Metropolitan University, Toronto, Canada
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8
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Bu D, Zhang CQ, Liu JD, Han Z, Wang X, Huang Z. Mental health literacy, mental health experiences and help-seeking behaviours of Chinese elite athletes: a qualitative study. Front Public Health 2024; 12:1391597. [PMID: 38813417 PMCID: PMC11133729 DOI: 10.3389/fpubh.2024.1391597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/15/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Elite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach. Methods Face-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis. Results Seven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours. Conclusion Support for Chinese elite athletes' mental health and help-seeking requires improvement.
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Affiliation(s)
- Danran Bu
- School of Physical Education, Hubei University, Wuhan, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jing-Dong Liu
- Department of Physical Education, Sun Yat-sen University, Guangzhou, China
| | - Zhe Han
- Key Laboratory of General Administration of Sport of China, Hubei Institute of Sport Science, Wuhan, China
| | - Xiang Wang
- The Department of Sport, Physical Education and Health, Faculty of Social Science, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Zhijian Huang
- School of Physical Education, Hubei University, Wuhan, China
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9
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Tan J, Shi W, Yuan GF, Lowe SR, Liu J. Perceived barriers and influencing factors of psychological help-seeking amongst Chinese nurses exposed to COVID-19. J Res Nurs 2024; 29:203-213. [PMID: 38883255 PMCID: PMC11179599 DOI: 10.1177/17449871241236387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
Background The COVID-19 pandemic has caused psychological problems among nurses worldwide. However, their willingness to seek professional help is relatively low, due to perceived barriers that have remained unknown. Aims This study analysed the potential barriers and influencing factors of psychological help-seeking among nurses participating in community COVID-19 epidemic prevention work. Methods Five variables - depression, anxiety, post-traumatic stress syndrome, social support and mental health literacy - were measured from a sample of 667 nurses. Latent class analysis identified homogeneous classes about psychological help-seeking barriers and multinomial logistic regression identified factors associated with potential grouping outcomes. Results Three categories were identified: major barriers (N = 17, 2.5%), stigma and accessibility barriers (N = 132, 21.2%) and low barriers (N = 518, 76.4%). Mental health literacy was significantly correlated with the 'low barriers' class (OR = 0.953, B = -0.047, p = 0.03), whereas depression (OR = 1.091, B = 0.085, p = 0.011) had a slightly positive effect on being in the 'stigma and accessibility barriers' class. Conclusions During pandemics or other social health crises, nurses may experience psychological barriers to help seeking. Communities and hospitals should consider increasing the resources available for psychological counselling services, improving mental health awareness and literacy that may help reduce depression levels and promote mental health.
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Affiliation(s)
- Jiani Tan
- Research Student, Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Wei Shi
- Associate Professor, Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Guanzhe Frank Yuan
- Associate Professor, School of Education Science, Leshan Normal University, Leshan, China
| | - Sarah R Lowe
- Associate Professor, Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jiahe Liu
- Research Student, School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
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10
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White M. Commentary: Perceived barriers and influencing factors of psychological help-seeking amongst Chinese nurses exposed to COVID-19. J Res Nurs 2024; 29:214-215. [PMID: 38883254 PMCID: PMC11179602 DOI: 10.1177/17449871241246795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Affiliation(s)
- Mark White
- Executive Dean of the Faculty of Nursing & Midwifery in the RCSI University of Medicine and Health Sciences, Dublin, Ireland
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11
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Wang X, Weng W, Li M, Xue J, Chen S. Understanding the intention and behavior of psychological help-seeking among Chinese college students using theory of planned behavior: a three-month follow-up study. PSYCHOL HEALTH MED 2024; 29:765-777. [PMID: 37220277 DOI: 10.1080/13548506.2023.2217379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/18/2023] [Indexed: 05/25/2023]
Abstract
Underutilization of mental health services is common and associated with substantial suffering, mental disorders and death. The present study aimed to explore factors significantly affecting the professional psychological help-seeking behavior based on the Theory of Planned Behavior (TPB). A sample of 597 Chinese college students recruited online completed the questionnaires, which measured four constructs of TPB including help-seeking intention, attitude, subjective norm and perceived behavioral control in December 2020. Help-seeking behaviors were evaluated three months later in March 2021. A two-step structural equation modeling procedure was used to test the TPB model. Findings show that partially consistent with TPB, more positive attitudes about seeking professional help (Β = .258, p = .001) and higher perceived behavioral control (Β = .504, p < .001) directly predicted higher intention to seek mental health services, and perceived behavioral control (Β = .230, p = .006) directly predicted help-seeking behavior. However, behavioral intention (Β = -.017, p = .830) did not statistically significantly predict help-seeking behavior, while subjective norm (Β = .047, p = .356) did not predict help-seeking intention as well. The model accounted for 49.9% of the variance modeling help-seeking intention and 12.4% of the variance modeling help-seeking behavior. The results revealed the importance of attitude and perceived behavioral control in predicting help-seeking intention and behavior among Chinese college students and indicated that there existed a gap between intention and actual help-seeking behavior.
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Affiliation(s)
- Xuanyi Wang
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenqi Weng
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Mei Li
- Mental Health Education and Counseling Center, Hangzhou Normal University, Hangzhou, China
| | - Jiang Xue
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shulin Chen
- Department of Psychology and Behavioral Science, Zhejiang University, Hangzhou, Zhejiang, China
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Sun KS, Lam TP, Wu D, Chan TH, Browne G, Chan SWC. A Chinese help-seeking model for psychological distress in primary care: An adaptation of Andersen's Behavioral Model of Health Services Use. Transcult Psychiatry 2024; 61:182-193. [PMID: 38233734 DOI: 10.1177/13634615231225130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Help-seeking for depression and anxiety disorders from primary care physicians in Western countries is at three times the rate of China. Western help-seeking models for common mental disorders have limitations in the Chinese settings. This article argues that an adapted model based on Andersen's Behavioral Model of Health Services Use could be an appropriate tool to better understand patients' help-seeking behaviors and improve outcomes. We applied a narrative review approach to integrate research findings from China into Andersen's model to generate a model that fits the Chinese context. We found 39 relevant articles in PubMed, MEDLINE, and Chinese journal databases from 1999 to 2022. Findings were mapped onto predisposing, enabling, and need factors of the model. This model emphasizes that predisposing factors including demographics, social norms, and health beliefs influence help-seeking preferences. Mental health service users in China tend to be older and female. Chinese generally have high concern about psychotropic medications, and social norms that consider psychological distress a personal weakness may discourage help-seeking. However, help-seeking can be enhanced by enabling factors in the health system, including training of primary care physicians, longer consultation time, and continuity of care. Need factors for treatment increase with the severity of distress symptoms, and doctor's skills and attitudes in recognizing psychosomatic symptoms. While predisposing factors are relatively hard to change, enabling factors in the health system and need factors for treatment can be targeted by enhancing the role of family doctors and training in mental health.
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Affiliation(s)
- Kai Sing Sun
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK
| | - Tak Hon Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Graeme Browne
- Faculty of Health, Southern Cross University, Sydney, Australia
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Li J, Luo R, Guo P, Zhang D, Mo PKH, Wu AMS, Xin M, Shang M, Cai Y, Wang X, Chen M, He Y, Zheng L, Huang J, Xu RD, Lau JTF, Gu J, Hall BJ. Effectiveness of a WHO self-help psychological intervention to alleviate stress among healthcare workers in the context of COVID-19 in China: a randomised controlled trial. Epidemiol Psychiatr Sci 2024; 33:e11. [PMID: 38450478 PMCID: PMC10940054 DOI: 10.1017/s2045796024000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 09/19/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
AIMS To examine the effectiveness of Self-Help Plus (SH+) as an intervention for alleviating stress levels and mental health problems among healthcare workers. METHODS This was a prospective, two-arm, unblinded, parallel-designed randomised controlled trial. Participants were recruited at all levels of medical facilities within all municipal districts of Guangzhou. Eligible participants were adult healthcare workers experiencing psychological stress (10-item Perceived Stress Scale scores of ≥15) but without serious mental health problems or active suicidal ideation. A self-help psychological intervention developed by the World Health Organization in alleviating psychological stress and preventing the development of mental health problems. The primary outcome was psychological stress, assessed at the 3-month follow-up. Secondary outcomes were depression symptoms, anxiety symptoms, insomnia, positive affect (PA) and self-kindness assessed at the 3-month follow-up. RESULTS Between November 2021 and April 2022, 270 participants were enrolled and randomly assigned to either SH+ (n = 135) or the control group (n = 135). The SH+ group had significantly lower stress at the 3-month follow-up (b = -1.23, 95% CI = -2.36, -0.10, p = 0.033) compared to the control group. The interaction effect indicated that the intervention effect in reducing stress differed over time (b = -0.89, 95% CI = -1.50, -0.27, p = 0.005). Analysis of the secondary outcomes suggested that SH+ led to statistically significant improvements in most of the secondary outcomes, including depression, insomnia, PA and self-kindness. CONCLUSIONS This is the first known randomised controlled trial ever conducted to improve stress and mental health problems among healthcare workers experiencing psychological stress in a low-resource setting. SH+ was found to be an effective strategy for alleviating psychological stress and reducing symptoms of common mental problems. SH+ has the potential to be scaled-up as a public health strategy to reduce the burden of mental health problems in healthcare workers exposed to high levels of stress.
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Affiliation(s)
- Jinghua Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen University Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Health Informatics, Guangzhou, China
- Research Center of Health Informatics, Sun Yat-sen University, Guangzhou, China
| | - Rui Luo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pengyue Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin District, Hong Kong, China
| | - Phoenix K. H. Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin District, Hong Kong, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Anise M. S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Taipa, Macao, China
| | - Meiqi Xin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Menglin Shang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuqi Cai
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xu Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Mingyu Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiling He
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Luxin Zheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinying Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Roman Dong Xu
- Acacia Lab for Health Systems Strengthening and Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, China
| | - Joseph T. F. Lau
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
- Centre for Health Behaviors Research, The Chinese University of Hong Kong, Shatin District, Hong Kong, China
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen University Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Health Informatics, Guangzhou, China
- Research Center of Health Informatics, Sun Yat-sen University, Guangzhou, China
| | - Brian J. Hall
- Center for Global Health Equity, New York University (Shanghai), Shanghai, People’s Republic of China
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Wu Z, Shi W, Chen Y, Lowe SR, Liu J. Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach. J Community Health Nurs 2024:1-13. [PMID: 38368504 DOI: 10.1080/07370016.2024.2314076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
PURPOSE This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach. DESIGN A cross-sectional design including an online self-reported questionnaire survey was used. METHODS A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS. FINDINGS Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences. CONCLUSIONS Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses' perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses' help-seeking preferences and behaviors to reduce mental illness during public health emergencies. CLINICAL EVIDENCE Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.
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Affiliation(s)
- Zhihong Wu
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Yueran Chen
- Department of Psychology, University of Hong Kong, Hong Kong, China
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, USA
| | - Jiahe Liu
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
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15
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Suen YN, Leung CM, Wan YS, Chan KT, Wong MTH, Hui CLM, Chan KWS, Lee EHM, Chen EYH. Evaluation of a Low-Intensity Online Intervention (LiON) for Reducing Distress and Mental Health Symptoms in Young People. J Adolesc Health 2024; 74:89-97. [PMID: 37815770 DOI: 10.1016/j.jadohealth.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/12/2023] [Accepted: 08/14/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Enhancing young people's mental health is crucial given that most adult mental disorders develop before age 24 years. However, it is unclear whether low-intensity interventions delivered online can be effective. This study aimed to provide preliminary evidence on whether a low-intensity online intervention (LiON) can effectively lower young people's distress levels and mental health symptoms. METHODS We compared the preintervention and postintervention changes in distress level and severity of depression and anxiety symptoms in 137 young people aged 15-24 years who used the LiON service with the three-month changes in a 1:1 propensity score-matched control group of community young people who did not use the service. They participated in one of the following modules for the first time: (1) sleep and relaxation, (2) stress-coping, and (3) problem-solving. RESULTS Participants who received LiON intervention (mean age 22.88 [standard deviation 3.67] years, 65.7% female) showed significantly greater reductions in distress level (Cohen's f2: 0.079), as well as the severity of depressive symptoms (Cohen's f2: 0.056) and anxiety symptoms (Cohen's f2: 0.044) compared to the control group. DISCUSSION The findings suggest that the LiON intervention has the potential to effectively reduce distress and mental health symptoms in young people. Future research should aim to confirm these findings through randomized controlled trials and explore the cost-effectiveness of the intervention.
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Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
| | - Chung Ming Leung
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Yau Sum Wan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Kai Tai Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | | | | | - Kit Wa Sherry Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China
| | - Edwin Ho Ming Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
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16
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Yang J, Li Y, Gao R, Chen H, Yang Z. Relationship between mental health literacy and professional psychological help-seeking attitudes in China: a chain mediation model. BMC Psychiatry 2023; 23:956. [PMID: 38129805 PMCID: PMC10734200 DOI: 10.1186/s12888-023-05458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Mental health literacy is considered an important factor in promoting professional psychological help-seeking attitudes. However, it is important to clarify the emotional and behavioral factors that underlie this association. Drawing from the ABC model of attitudes and the Health Disclosure Decision-Making Model, this study aimed to examine the mediating role of psychological help-seeking stigma and distress disclosure in the relationship between mental health literacy and professional psychological help-seeking attitudes. METHODS We collected data from 827 participants in seven regions of China (597 female; Mage = 26.019, SD = 5.592 years old) using self-report measures, including the Mental Health Literacy Scale, Questionnaire of Stigma for Seeking Professional Psychological Help, Distress Disclosure Index, and Attitudes Toward Seeking Professional Psychological Help-Short Form. A chain mediation model was built to examine the relationships among mental health literacy, psychological help-seeking stigma, distress disclosure, and professional psychological help-seeking attitudes. RESULTS The results of the analyses showed a positive association between mental health literacy and professional psychological help-seeking attitudes, with psychological help-seeking stigma and distress disclosure playing mediating roles in this relationship. Furthermore, even after controlling for participants' age, gender, and education, the chain mediation effect of psychological help-seeking stigma and distress disclosure on the relationship between mental health literacy and professional psychological help-seeking attitudes was observed among the Chinese population. CONCLUSIONS These findings underscore the significance of mental health literacy in shaping professional psychological help-seeking attitudes, while emphasizing the need to account for psychological help-seeking stigma and distress disclosure when examining this association. Additionally, the model proposed in this study provides a valuable framework for promoting the utilization of professional mental health services.
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Affiliation(s)
- Jingyuan Yang
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Tsinghua East Road, Haidian District, Beijing, 100083, P. R. China
| | - Yunjia Li
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Tsinghua East Road, Haidian District, Beijing, 100083, P. R. China
- Center for Strategic Studies, Qiyuan Laboratory, Building 1st, Yard 58th, Yinhua Road, Zhongguancun Environmental Protection Science and Technology Park, Haidian District, Beijing, 100095, P. R. China
| | - Rui Gao
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Tsinghua East Road, Haidian District, Beijing, 100083, P. R. China
| | - Hui Chen
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Tsinghua East Road, Haidian District, Beijing, 100083, P. R. China.
| | - Zhihui Yang
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Tsinghua East Road, Haidian District, Beijing, 100083, P. R. China.
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17
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An S, Sun S. Serial multiple mediation of perceived professional healthcare support and social structural factors in the relationship between care-seeking behavior and perinatal mental health in Chinese mothers. BMC Public Health 2023; 23:2386. [PMID: 38041013 PMCID: PMC10691162 DOI: 10.1186/s12889-023-17310-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND In previous studies, it has been observed that mother's perinatal mental health (PMH) problems can be improved by engaging in appropriate health care-seeking behaviors. However, the exact mechanism that influences the relationship between these two factors is still not fully understood. This cross-sectional study aims to examine the serial multiple mediating effects of perceived professional healthcare support (PPHS) and social structural factors on the association between care-seeking behavior and PMH. METHODS The cross-sectional study evaluated 1705 Chinese mothers (pregnancy 12 to 41 weeks) through questionnaires from October 2021 to November 2022. These mothers were selected from three hospitals in Wuxi, with an annual delivery volume of at least 5000. We conducted a structural equation model (SEM) analysis to examine the multiple mediating effect of PPHS and social structural factors (social stigma or social trust) between care-seeking behavior and PMH. After analyzing the results of the SEM, we used bootstrapping to further test the mediating effect. RESULTS Among the 1705 Chinese mothers surveyed, 636 (37.3%) sought help from professionals. It was observed that more women tended to seek professional help during the early stages of pregnancy (12 to 28 weeks) compared to the later stages (28 to 41 weeks) (t = 1.47, p < 0.05). The results of the SEM analysis indicated that the mother's care-seeking behavior did not have a significant direct effect on PMH. However, it was identified as a crucial distal variable, with its significant effect being fully mediated by PPHS and social structural factors. The mediation effect of PPHS and social stigma on the pathway from care-seeking behavior to PMH was found to be 92.9% (direct effect = 0.002; indirect effect = 0.026). Additionally, the mediating effect of stigma contributed to 21.9% of the association between care-seeking behavior and PPHS (direct effect = 0.405; indirect effect = 0.114). Similarly, the mediation effect of PPHS and social trust on the pathway from care-seeking behavior to PMH was 73.3% (direct effect = 0.008; indirect effect = 0.022). Moreover, the mediating effect of social trust contributed to 22.0% of the association between care-seeking behavior and PPHS (direct effect = 0.407; indirect effect = 0.115). The proposed model showed a good fit with the collected data. CONCLUSION This study examines the serial multiple mediation effect, in which PPHS and social structural factors mediate the relationship between PMH and professional care-seeking behavior. We suggest three levels of intervention: implementing mental health in all policies, providing training for healthcare providers, and establishing healthcare channels with easily accessible information.
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Affiliation(s)
- Shanshan An
- Department of Social Medicine, Jiangnan University, Wuxi, 214122, China
| | - Sheng Sun
- Department of Social Medicine, Jiangnan University, Wuxi, 214122, China.
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18
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Zhan Z, Yang Y, Huang H, Mai H, Guo X, Lv X. Improving mental health care among patients with cancer in China. Lancet Psychiatry 2023; 10:831-832. [PMID: 37863521 DOI: 10.1016/s2215-0366(23)00297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Zejiang Zhan
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, Guangdong, China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Haoyang Huang
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, Guangdong, China
| | - Haiqiang Mai
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, Guangdong, China
| | - Xiang Guo
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, Guangdong, China
| | - Xing Lv
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, Guangdong, China.
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El-Hachem SS, Lakkis NA, Osman MH, Issa HG, Beshara RY. University students' intentions to seek psychological counseling, attitudes toward seeking psychological help, and stigma. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1661-1674. [PMID: 37037916 DOI: 10.1007/s00127-023-02470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/30/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Mental health problems are prevalent among university students worldwide. Studies have shown that most students do not disclose and do not get the psychological help and support they need. OBJECTIVES This survey aims to investigate the intentions to seek psychological counseling (ISC) among university students, their attitudes toward seeking professional psychological help (ATSPPH), and the predictors of those intentions and attitudes including stigma. DESIGN AND METHODS a cross-sectional survey was conducted among 420 students at the American University of Beirut (AUB). RESULTS Depression, test anxiety, and difficulty sleeping are the three main reasons students would seek psychological help. The source the students most preferred to ask for help was one's family followed by psychologists and psychiatrists. Students' ATSPPH is a positive predictor of their ISC, while students' self-stigma of seeking help (SSOSH) is a negative predictor of their ATSPPH. Moreover, students' awareness of the psychological help system available on campus, free of charge, is a positive predictor for both ISC and ATSPPH. CONCLUSION Different interventions are needed to reduce stigma and enhance students' mental health literacy and awareness of the available professional psychological help on campus.
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Affiliation(s)
- Saria S El-Hachem
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Najla A Lakkis
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon.
- Department of Family Medicine, Faculty of Medicine, American University of Beirut, Riad El Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon.
| | - Mona H Osman
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Hanane G Issa
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ranin Y Beshara
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
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Ma R, Wang Y, Wang XQ, Yu K, Zhang CC, Zhou YQ. Analysis of hindering and facilitating factors of help-seeking behavior in schizophrenia based on COM-B model: a descriptive qualitative study. BMC Psychiatry 2023; 23:770. [PMID: 37867190 PMCID: PMC10591348 DOI: 10.1186/s12888-023-05226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Timely and systematic professional treatment is crucial in schizophrenia prognosis, but the global rate of mental health service, now, use or help-seeking behavior is low. METHODS In-depth semi-structured interviews were conducted with 13 participants with the diagnosis of schizophrenia between October to December 2021. The participants were purposively sampled from a psychiatric hospital's. Interviews were recorded and transcribed verbatim into NVivo 12.0. RESULTS The findings were summarized under 3 themes and 12 subthemes: (1) capability (lack of knowledge due to insufficient mental health literacy or lack of insight, inability to access disease information due to a lack of mental health literacy, and symptoms-related barriers); (2) opportunity (lack of disease information sources, inability to balance work and study during prolonged hospitalization, accessibility and convenience of medical resources, and the acquisition and utilization of social support); and (3) motivation (awareness of the disease and professional treatment, negative experiences of disease episodes, past medical experience, confidence in tcuring the disease, and the fulfillment of daily life and self-worth). CONCLUSION The medical help-seeking behavior of people with the diagnosis of schizophrenia is the result of the interaction of many barriers and facilitators, and challenges persist today. Interventions can be implemented with the BCW framework and our results to precisely eliminate delays in the diagnosis and treatment of mental problems.
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Affiliation(s)
- Rui Ma
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Yu Wang
- Department of Nursing, Fu Wai Central China Cardiovascular Hospital, Zhengzhou, 451460, Henan, China
| | - Xiao-Qing Wang
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Kai Yu
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Chen-Chen Zhang
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University, Harbin, 150081, Heilongjiang, China.
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Rochelle TL, Lo CH. Predictors of Attitude Toward Seeking Professional Psychological Help in Hong Kong. Behav Med 2023; 49:374-380. [PMID: 35862491 DOI: 10.1080/08964289.2022.2077293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 04/20/2022] [Accepted: 05/04/2022] [Indexed: 11/02/2022]
Abstract
The present study examined predictors of attitude toward professional psychological help-seeking in Hong Kong. A cross-sectional approach was adopted and a total of 166 participants (120 female) ranging in age from 20 to 60 years were recruited online. The relationship between attitudes toward professional help-seeking, self-stigma, and perceived accessibility and affordability of services were examined, gender differences were also examined. Findings revealed that self-stigma was significantly negatively associated with attitude toward professional psychological help-seeking, while perceived affordability was positively associated with attitudes. The current study demonstrates that stigma is still an ever-present obstacle, which could contribute to low utilization of services in Hong Kong.
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Affiliation(s)
- Tina L Rochelle
- Department of Social & Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Chung Huen Lo
- Department of Social & Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong
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22
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Lim YS, Quek JH, Ching XW, Lim DTR, Lim KG, Thuraisingham C, George PP. Efficacy of a Text-Based Mental Health Coaching App in Improving the Symptoms of Stress, Anxiety, and Depression: Randomized Controlled Trial. JMIR Form Res 2023; 7:e46458. [PMID: 37738081 PMCID: PMC10559195 DOI: 10.2196/46458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Stress, anxiety, and depression are major mental health concerns worldwide. A wide variety of digital mental health interventions have demonstrated efficacy in improving one's mental health status, and digital interventions that involve some form of human involvement have been shown to demonstrate greater efficacy than self-guided digital interventions. Studies demonstrating the efficacy of digital mental health interventions within the Asian region are scarce. OBJECTIVE This study aimed to investigate the potential efficacy of the digital mental health intervention, ThoughtFullChat, which consists of one-on-one, asynchronous, text-based coaching with certified mental health professionals and self-guided tools, in improving self-reported symptoms of depression, anxiety, and stress. The study also aims to examine the potential differences in efficacy among occupational subgroups and between sexes. METHODS A randomized controlled study was conducted among housemen (trainee physicians), students, faculty members, and corporate staff at International Medical University, Malaysia. A total of 392 participants were enrolled and randomized to the intervention (n=197, 50.3%) and control (n=195, 49.7%) groups. Depression, anxiety, and stress symptoms were measured using the Depression, Anxiety, and Stress Scale-21 items at baseline and after the 3-month intervention period. The Satisfaction with Life Scale and Brief Resilience Scale were also included, along with a questionnaire about demographics. RESULTS Significant decrease was observed in depression (P=.02) and anxiety (P=.002) scores in the intervention group. A subgroup (corporate staff) also demonstrated significant decrease in stress (P=.005) alongside depression (P=.006) and anxiety (P=.002). Females showed significant improvements in depression (P=.02) and anxiety (P<.001) when compared with males. CONCLUSIONS This study provides evidence that the ThoughtFullChat app is effective in improving the symptoms of depression, anxiety, and stress in individuals, particularly among corporate staff from the educational field. It also supports the notion that mobile mental health apps that connect users to mental health professionals in a discreet and cost-efficient manner can make important contributions to the improvement of mental health outcomes. The differential improvements among occupational subgroups and between sexes in this study indicate the need for future digital mental health app designs to consider an element of personalization focused on systemic components relating to occupation. TRIAL REGISTRATION Clinicaltrials.gov NCT04944277; https://classic.clinicaltrials.gov/ct2/show/NCT04944277.
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Affiliation(s)
- Yee Siew Lim
- International Medical University (IMU), Seremban, Malaysia
| | - Jia Hui Quek
- International Medical University (IMU), Seremban, Malaysia
| | - Xiu Wei Ching
- International Medical University (IMU), Seremban, Malaysia
| | | | - Kean Ghee Lim
- International Medical University (IMU), Seremban, Malaysia
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Cao H. Analyzing Chinese parents' and teachers' perception of play, children's emotional needs and therapy: implications for seeking help. Front Psychol 2023; 14:1219901. [PMID: 37744607 PMCID: PMC10516295 DOI: 10.3389/fpsyg.2023.1219901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Before going through play therapy with children, parents' consent is usually needed. Thus, Parents' perception of play therapy can be a very important variable that influences the extent to which children are exposed to play therapy. Previous research has demonstrated the significant influence of social-cultural factors on people's perceptions of play therapy. This may in turn influence parents' decision about whether their children will participate in play therapy. This study explores the factors that influence Chinese parents' decisions on their children's engagement in play therapy from a social-cultural perspective. Methods This small-scale research includes the following: a questionnaire with 16 parents; three one-to-one semi-structured interviews with three parents; and one focus group with 3 teachers. Results The results showed that Chinese parents' perceptions of therapy are mostly negative, which may reduce the desire of parents to let their children become involved with play therapy. The children's academic stress and the parents' economic pressures indicate a barrier for families to commit time and money to play therapy. Parents' confidence in their ability to recognize children's emotions, their lack of knowledge about play therapy, and the process of obtaining help from mental health services for children could be another barriers preventing engagement with play therapy. Discussions Even though the research is conducted with a very limited sample size and the results cannot represent the wider population, this research provides some insights into this issue that can be explored in detail in future research, to re-evaluate the results and form a more concrete theory within a wider population in China.
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Affiliation(s)
- Huiting Cao
- Institute of Education, University College London, London, United Kingdom
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24
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Hilberdink CE, Ghainder K, Dubanchet A, Hinton D, Djelantik AAAMJ, Hall BJ, Bui E. Bereavement issues and prolonged grief disorder: A global perspective. Glob Ment Health (Camb) 2023; 10:e32. [PMID: 37854407 PMCID: PMC10579660 DOI: 10.1017/gmh.2023.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 10/20/2023] Open
Abstract
The death of a loved one - bereavement - is a universal experience that marks the human mental health condition. Grief - the cognitive, emotional, and behavioral responses to bereavement - is thus experienced by virtually everyone at some point in life, while mourning is a process through which grievers come to terms with the loss envisioning life without the deceased. Although distress subsides over time among most bereaved individuals, a minority will develop a condition recently identified as prolonged grief disorder (PGD). The present review provides a global perspective on bereavement, grief reactions, and PGD. Although the loss of a loved one and grief reactions are in general experienced consistently across different cultures, differences and variations in their expression may exist across cultures. Especially within specific populations that may be more at risk for PGD, possibly due to risk factors associated with the mechanisms of loss (e.g., refugees, migrants, and conflict survivors). The diagnostic criteria for PGD are mostly based on Western grieving populations, and cultural adaptations of PGD treatments are limited. Therefore, cross-cultural development and validation of PGD screening/assessment is critical to support future research on grief reactions and PGD, especially in non-Western contexts, and concerning the potential future global changes and challenges that appear to have a major impact on PGD. More transcultural research on PGD is needed to contextualize and will lead to culture-bound symptom identification of PGD, and the adaptation of current treatment protocols, which may ultimately improve health at the individual level, and health-care systems.
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Affiliation(s)
- Charlotte E. Hilberdink
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders”, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), GIP Cyceron, Caen, France
| | - Kevin Ghainder
- Centre Hospitalier Universitaire Caen Normandie, Caen, France
| | | | - Devon Hinton
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Brian J. Hall
- Center for Global Health Equity, New York University, Shanghai, 200122 People’s Republic of China
| | - Eric Bui
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders”, NEUROPRESAGE Team, (Institut Blood and Brain @ Caen-Normandie), GIP Cyceron, Caen, France
- Centre Hospitalier Universitaire Caen Normandie, Caen, France
- Massachusetts General Hospital, Boston, MA, USA
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25
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Oguro S, Ojio Y, Matsunaga A, Shiozawa T, Kawamura S, Yoshitani G, Horiguchi M, Fujii C. Mental health help-seeking preferences and behaviour in elite male rugby players. BMJ Open Sport Exerc Med 2023; 9:e001586. [PMID: 37265779 PMCID: PMC10231004 DOI: 10.1136/bmjsem-2023-001586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/03/2023] Open
Abstract
Objectives Mental health symptoms and mental illnesses are common in elite athletes. There is an urgent need to develop care systems to support the mental health of elite athletes. Understanding elite athletes' preferences in mental health help seeking can help explore strategies to develop such systems. Therefore, this study aims to investigate with whom/where elite athletes feel comfortable discussing mental health concerns and seeking help. Methods We analyse data from 219 Japanese male rugby players out of 612 players (565 Japanese, 47 foreigners) aged 18 and over who belong to the Japan Rugby Players Association using a cross-sectional design and an anonymous, web-based, self-administered questionnaire. In the questionnaire, the players are asked to rate on a 5-point Likert scale how comfortable they feel talking about their mental health concerns with affiliation/team staff, family/relatives, friends, mental health professionals, rugby-related seniors and teammates. Analysis of variance and Dunnett's test are performed to detect differences in their preferences for sources of help. Results Dunnett's test shows that the mean scores for preferring to consult affiliation/team staff are significantly lower than for all the other groups (p<0.001), indicating that players are reluctant to seek help for mental health concerns from affiliation/team staff. Fewer players sought help from affiliation/team staff or mental health professionals than from other groups. Conclusion Regarding mental health concerns, for elite male rugby players as elite athletes, it can be difficult to ask for help or talk to team staff.
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Affiliation(s)
- Saki Oguro
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yasutaka Ojio
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Asami Matsunaga
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Mental Health and Psychiatric Nursing, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takuma Shiozawa
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | | | | | | | - Chiyo Fujii
- Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Krstanoska-Blazeska K, Renzaho A, Blignault I, Li B, Reavley N, Slewa-Younan S. A Qualitative Exploration of Sources of Help for Mental Illness in Arabic-, Mandarin-, and Swahili-Speaking Communities in Sydney, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105862. [PMID: 37239588 DOI: 10.3390/ijerph20105862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Despite being disproportionately affected by poor mental health, culturally and linguistically diverse (CaLD) individuals seek help from mental health services at lower rates than others in the Australian population. The preferred sources of help for mental illness amongst CaLD individuals remain poorly understood. The aim of this study was to explore sources of help in Arabic-, Mandarin-, and Swahili-speaking communities in Sydney, Australia. Eight focus-group discussions (n = 51) and twenty-six key informant interviews were undertaken online using Zoom. Two major themes were identified: informal sources of help and formal sources of help. Under the informal sources of help theme, three sub-themes were identified: social, religious, and self-help sources. All three communities strongly recognised the role of social sources of help, with more nuanced roles held by religion and self-help activities. Formal sources of help were described by all communities, although to a lesser extent than informal sources. Our findings suggest that interventions to support help-seeking for all three communities should involve building the capacity of informal sources of help, utilising culturally appropriate environments, and the collaboration between informal and formal sources of help. We also discuss differences between the three communities and offer service providers insights into unique issues that require attention when working with these groups.
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Affiliation(s)
| | - Andre Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2571, Australia
| | - Ilse Blignault
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2571, Australia
| | - Bingqin Li
- Social Policy Research Centre, University of New South Wales, Sydney 2052, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
| | - Shameran Slewa-Younan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2571, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
- School of Medicine, Western Sydney University, Campbelltown 2571, Australia
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27
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Crompton D, Kohleis P, Shakespeare-Finch J, FitzGerald G, Young R. Opportunistic Mental Health Screening: Is there a Role Following a Disaster? Lessons from the 2010-2011 Queensland (Australia) Floods and Cyclones. Prehosp Disaster Med 2023; 38:223-231. [PMID: 36691688 PMCID: PMC10027488 DOI: 10.1017/s1049023x23000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Following the 2010-2011 floods and cyclones that affected 78% of Queensland, Australia, a State-wide mental health response was established. The response plan included a 24-hour access line. This study examines the effectiveness of the mental health screening program conducted via the State-wide health call center (13HEALTH) in 2012. METHODS Callers to the 13HEALTH line were screened to assess the impact of the disaster. The 13HEALTH clinicians administered the Primary Care-Posttraumatic Stress Disorder Scale (PC-PTSD) screening measure. Those scoring more than two on the PC-PTSD Scale were provided information on the emotional impact of disasters and a referral to the post-disaster specialist mental health program (SMHP). For calls related to those under 18, a single-item question assessed behavioral or emotional changes since the natural disasters. Those with identified changes were offered a referral to a post-disaster SMHP.The study evaluates the relationship between disaster exposure and the likelihood of 13HEALTH callers experiencing physical health concerns and unacknowledged mental health symptoms. The program's cost for the 12 months of 2012 was assessed using data from the financial contract. RESULTS In 2012, there were 205,064 calls to 13HEALTH: 19,708 identified as residing in a flood or cyclone-affected area, 7,315 adults indicated they were personally affected, and 907 scored more than two on the PC-PTSD Scale. Only 700 agreed to a referral to the SMHP. There were 290 children under 18 assessed as at risk; 207 accepted a referral to a SMHP.Regions that experienced a greater impact from the floods and cyclones were 1.3-2.3 times more likely to report being personally affected by the floods and cyclones. Similarly, these regions had more callers scoring more than two on the PC-PTSD Scale. The total cost of the 13HEALTH program for 2012 was $53,284 (AU) across all age groups. CONCLUSION The 13HEALTH general health post-disaster screening program demonstrates opportunistic screening may assist identification of those with unmet mental health needs. The data indicate an increased likelihood of personal exposure in the more affected regions with an increased risk of unrecognized psychological symptoms as assessed by the PC-PTSD Scale. However, more than 20% declined referral to a SMHP.
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Affiliation(s)
- David Crompton
- Queensland University of Technology, Brisbane, Queensland, Australia
- Griffith University, Nathan, Queensland, Australia
| | - Peter Kohleis
- Metro South Hospital and Health Service, Woolloongabba, Queensland, Australia
| | | | - Gerard FitzGerald
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ross Young
- Queensland University of Technology, Brisbane, Queensland, Australia
- Griffith University, Nathan, Queensland, Australia
- University Sunshine Coast, Maroochydore DC, Queensland, Australia
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28
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Chan CS, Wong CYF, Yu BYM, Hui VKY, Ho FYY, Cuijpers P. Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: a parallel-group randomized controlled trial. Psychol Med 2023; 53:1799-1813. [PMID: 37310329 DOI: 10.1017/s0033291721003421] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Despite its efficacy in treating comorbid insomnia and depression, cognitive behavioral therapy for insomnia (CBT-I) is limited in its accessibility and, in many countries, cultural compatibility. Smartphone-based treatment is a low-cost, convenient alternative modality. This study evaluated a self-help smartphone-based CBT-I in alleviating major depression and insomnia. METHODS A parallel-group randomized, waitlist-controlled trial was conducted with 320 adults with major depression and insomnia. Participants were randomized to receive either a 6-week CBT-I via a smartphone application, proACT-S, or waitlist condition. The primary outcomes included depression severity, insomnia severity, and sleep quality. The secondary outcomes included anxiety severity, subjective health, and acceptability of treatment. Assessments were administered at baseline, post-intervention (week 6) follow-up, and week 12 follow-up. The waitlist group received treatment after the week 6 follow-up. RESULTS Intention to treat analysis was conducted with multilevel modeling. In all but one model, the interaction between treatment condition and time at week 6 follow-up was significant. Compared with the waitlist group, the treatment group had lower levels of depression [Center for Epidemiologic Studies Depression Scale (CES-D): Cohen's d = 0.86, 95% CI (-10.11 to -5.37)], insomnia [Insomnia Severity Index (ISI): Cohen's d = 1.00, 95% CI (-5.93 to -3.53)], and anxiety [Hospital Anxiety and Depression Scale - Anxiety subscale (HADS-A): Cohen's d = 0.83, 95% CI (-3.75 to -1.96)]. They also had better sleep quality [Pittsburgh Sleep Quality Index (PSQI): Cohen's d = 0.91, 95% CI (-3.34 to -1.83)]. No differences across any measures were found at week 12, after the waitlist control group received the treatment. CONCLUSION proACT-S is an efficacious sleep-focused self-help treatment for major depression and insomnia. TRIAL REGISTRATION ClinicalTrials.gov, NCT04228146. Retrospectively registered on 14 January 2020. http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT04228146.
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Affiliation(s)
| | | | | | | | | | - Pim Cuijpers
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Yonemoto N, Kawashima Y. Help-seeking behaviors for mental health problems during the COVID-19 pandemic: A systematic review. J Affect Disord 2023; 323:85-100. [PMID: 36435398 PMCID: PMC9684094 DOI: 10.1016/j.jad.2022.11.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the nature of communication has changed dramatically owing to lockdowns and the need for social distancing with ongoing outbreaks. As a result, patient's help-seeking behavior for mental health may have changed. We summarized the research on help-seeking behavior for mental health during the COVID-19 pandemic and investigated changes that have occurred. METHODS This study was a systematic review. We searched four literature databases: MEDLINE, EMBASE, CHINAHL, and PsycINFO. We included the following in the review: 1) studies conducted during the COVID-19 pandemic, and 2) studies that dealt with help-seeking behavior for mental health. Eligible studies were summarized according to characteristics such as research participants and study type. RESULTS In total, 41 studies (38 observational studies 2 qualitative studies and 1 randomized trial) were eligible for the review. Most studies reported delays, decreases, or deficits in help-seeking behavior. The study participants included medical professionals, local residents, hospitals, children and adolescents, online participants, pregnant women, people who experienced intimate partner violence, those with eating disorders, and other individuals. LIMITATIONS Findings from observational studies may have bias as confounder. Meta-analysis could not be performed, because the studies had variations of design. CONCLUSION During the COVID-19 pandemic, delay in seeking help from mental health services may have resulted in lost opportunities to link patients with appropriate treatment and care. The COVID-19 pandemic is ongoing as of 2022. Therefore, it is important to examine the impact of the pandemic on mental health in future research.
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Affiliation(s)
- Naohiro Yonemoto
- Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan; Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yoshitaka Kawashima
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Clinical Psychology Course, Department of Psycho-Social Studies, School of Arts and Letters, Meiji University, Tokyo, Japan
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30
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Huang S, Xiao M, Hu Y, Tang G, Chen Z, Zhang L, Fu B, Lei J. Attitudes toward seeking professional psychological help among Chinese pregnant women: A cross-sectional study. J Affect Disord 2023; 322:163-172. [PMID: 36400148 DOI: 10.1016/j.jad.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND There exists a gap between the high prevalence of mental health problems and negative attitudes toward seeking professional psychological help among Chinese pregnant women. This study aimed to investigate the attitudes and factors toward seeking professional psychological help among Chinese pregnant women to provide some suggestions for improving pregnant women's psychological help-seeking behaviors. METHODS A total of 1024 pregnant women were recruited. The Chinese version of the Attitude Toward Seeking Professional Psychological Help Scale (ATSPPH) was used to assess the attitudes toward professional psychological help-seeking. Demographic and socio-psychological factors were collected by self-developed questionnaire, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Patient Health Questionnaire-9 Scale. RESULTS 1006 pregnant women were included in the final analysis. Only 3.7 % of participants chose professionals as their first choice for psychological help-seeking. The attitudes toward seeking professional psychological help were relatively positive, with the highest score of stigma tolerance among four subscales in ATSPPH. Education level, perceived social support, and positive coping style had a positive predictive effect on the four subscales of ATSPPH. Women with prenatal depressive symptoms had a lower score in the subscales of recognition of need for psychotherapeutic help and confidence in mental health practitioner; women with higher scores of negative coping style had a lower score in the subscales of stigma tolerance and interpersonal openness. History of professional psychological help-seeking behaviors was only associated with the subscale of recognition of need for psychotherapeutic help; Maternal age was only associated with the subscale of interpersonal openness. CONCLUSION The attitudes toward seeking professional psychological help were relatively positive among Chinese pregnant women, and stigma tolerance was the significant barrier to professional psychological help-seeking. More attention should be paid to those women with older age, negative coping style, and women with prenatal depressive symptoms.
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Affiliation(s)
- Sasa Huang
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Meili Xiao
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Ying Hu
- Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Guanxiu Tang
- Department of Geriatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Zhihong Chen
- Pediatric Intensive Care Unit, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Lijuan Zhang
- Department of Emergency Pediatrics, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Bing Fu
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China.
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Pan Q, Hao Z. Chinese college students' help-seeking behavior: An application of the modified theory of planned behavior. Psych J 2023; 12:119-127. [PMID: 36174984 DOI: 10.1002/pchj.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/24/2022] [Indexed: 02/04/2023]
Abstract
Chinese college students have a high incidence of psychological problems but rarely seek professional psychological help. Despite this fact, there have been few studies of the help-seeking behavior of Chinese college students with mental health problems. This research aims to use a modified model based on the theory of planned behavior (TPB) to explore the intentions and behaviors of Chinese college students with psychological problems in seeking professional psychological help. A total of 319 Chinese college students were recruited to measure attitude, stigma, coping efficiency, help-seeking intention, help-seeking behavior, and demographic variables. The results showed that attitudes were the most powerful predictor of intentions to seek help, followed by coping effectiveness and stigma. In addition, a multigroup analysis showed that the model was valid across genders. Our research results show that the TPB-based model can effectively explain the intentions and behaviors of college students with psychological problems in seeking professional help. Using our results, families, schools, and society could design intervention measures to enhance students' help-seeking intentions and behaviors.
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Affiliation(s)
- Qi Pan
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zhihong Hao
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
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32
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Xu RH, Bao XL, Shi LSB, Wang D. Associations between eHealth literacy, mental health-seeking attitude, and mental wellbeing among young electronic media users in China during the COVID-19 pandemic. Front Public Health 2023; 11:1139786. [PMID: 36908426 PMCID: PMC9998951 DOI: 10.3389/fpubh.2023.1139786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/09/2023] [Indexed: 03/14/2023] Open
Abstract
Objective This study aimed to examine the associations among mental health related eHealth literacy (eHL), mental health-seeking attitude, and wellbeing among Chinese young electronic media users during the COVID-19 pandemic. Methods A web-based cross-sectional survey was conducted in Guangzhou, China. The modified eHealth literacy Scale, Mental Help-Seeking Attitudes Scale, and Short Warwick-Edinburgh Mental Wellbeing Scale were used. Structural equation modeling (SEM) examined the associations between them and was adjusted by several controlled variables. Results Totally, 1,008 participants completed the questionnaire and provided valid responses. The eHL showed a statistically significant and direct effect on mental wellbeing in this sample. The higher the level of eHL, the better wellbeing of the participants. The mental health-seeking attitude is also positively correlated with mental wellbeing, indicating that the more positive attitude toward seeking mental health services, the better the wellbeing participants reported. The higher level of eHL is significantly associated with a more positive attitude toward seeking mental health services. Conclusion Training to improve eHL may optimize young electronic media users' mental health outcomes. Development and use of a mental health specific eHL instrument in future studies should be encouraged.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xiao-Lu Bao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lu-Shao-Bo Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
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Leung D, Lee C, Wang AH, Guruge S. Immigrants' and refugees' experiences of access to health and social services during the COVID-19 pandemic in Toronto, Canada. J Health Serv Res Policy 2023; 28:34-41. [PMID: 35971256 PMCID: PMC9382571 DOI: 10.1177/13558196221109148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE In 2020, the World Health Organization reported that immigrants were the most vulnerable to contracting COVID, due to a confluence of personal and structural barriers. This study explored how immigrants and refugees experienced access to health and social services during the first wave of COVID-19 in Toronto, Canada. METHODS This study analyzed secondary data from a qualitative study that was conducted between May and September 2020 in Toronto that involved semi-structured interviews with 72 immigrants and refugees from 21 different countries. The secondary data analysis was informed by critical realism. RESULTS The vast majority of participants experienced fear and anxiety during the COVID-19 outbreak but through a combination of self-reliance and community support came to terms with the realities of the pandemic. Some even found the lifestyle changes engendered by the pandemic a positive experience. CONCLUSIONS Self-reliance may hinder help-seeking and augment the threat of COVID-19. This is particularly a concern for the most vulnerable immigrants, who experience multiple disruptions in their health care, have limited material resources and social supports, and perhaps are still dealing with the challenges of settling in the new country.
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Affiliation(s)
- Doris Leung
- School of Nursing,
The Hong
Kong Polytechnic University, Kowloon,
Hong Kong
| | - Charlotte Lee
- Daphne Cockwell School of Nursing,
Toronto
Metropolitan University, Canada
| | - Angel He Wang
- Daphne Cockwell School of Nursing,
Toronto
Metropolitan University, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing,
Toronto
Metropolitan University, Canada,Sepali Guruge, The Daphne Cockwell Health
Sciences Complex, Toronto Metropolitan University, Room DCC-579C, 288 Church St,
Toronto, OA M5B 2K3, Canada.
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Wu T, Dong S, Yang L, Qiu H, Qiu H, Mellor D, Chen J, Xu Y. Investigation of the pharmacological treatment patterns of Chinese patients with major depressive disorder under real-world settings using multi-channel sequence analysis. Front Psychiatry 2023; 14:1089504. [PMID: 37091706 PMCID: PMC10115953 DOI: 10.3389/fpsyt.2023.1089504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
Background Despite many treatment guidelines available now, the treatment patterns of major depressive disorder (MDD) in China haven't been well-understood due to complexity and diversity. Aim To describe pharmacological treatment patterns of MDD patients in real-world settings using electronic health records from a major psychiatric hospital in China. Methods MDD patients (18-65 years, ICD-10: F32.x, F33.x) newly initiated single antidepressant (AD) in 2015 were enrolled, the date of first AD prescription during the study period was defined as index date, and eligible patients were followed up to 1 year. Treatment patterns were revealed and analyzed using multi-channel sequence analysis (MCSA), considering patients' chronological sequences (in days) of AD prescription, cumulative treatment step(s), and polypharmacy usage during the follow-up. Results This study (n = 5,003) identified four types of MDD treatment patterns. The first type (1-time treatment) represents the largest proportion of patients (73.6%, n = 3,686), followed by the second type (6-month consistent treatment) and third type (long-term, consistent treatment) collectively accounted for 20.6% (n = 1,031) of patients, by contrast the last type (long-term, inconsistent treatment) made up the rest 5.7% (n = 286) of patients while exhibiting the most complicated treatments patterns. The choice of AD was dominated by selective serotonin reuptake inhibitors (SSRIs), while treatment duration spent in polypharmacy spanned at 2.8%, 16.4%, 2.0%, and 36.5% over the four types, respectively. Conclusion Treatment patterns reflecting real-world pharmacological treatment practices of MDD in China were revealed using MCSA. The observed discrepancies between real-world practice and treatment guidelines provided additional insights in improving the clinical management of MDD.
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Affiliation(s)
- Tao Wu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Beijing, China
| | - Sijia Dong
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Shanghai, China
| | - Lu Yang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Qiu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Qiu
- Global Epidemiology, Office of Chief Medical Officer, Johnson & Johnson, Titusville, NJ, United States
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Jun Chen
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- *Correspondence: Jun Chen
| | - Yifeng Xu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Yifeng Xu
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35
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Zhou W, Xiao S, Feng C, Yu Y, Wang D, Hu C, Liu X. Measuring the quality of mental health services from the patient perspective in China: psychometric evaluation of the Chinese version of the World Health Organization responsiveness performance questionnaire. Glob Health Action 2022; 15:2035503. [PMID: 35289731 PMCID: PMC8928838 DOI: 10.1080/16549716.2022.2035503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Despite the large population of patients with mental disorders and the rapid development of mental health services in China, there are few evaluations of Chinese mental health services from the patient perspective. Relevant instruments with robust psychometric properties are lacking. Objective This study aimed to translate, adapt and validate the WHO responsiveness performance questionnaire for measuring the quality of hospital mental health services among Chinese patients. Methods The adaption of the translated questionnaire incorporated experts’ and patients’ opinions. For psychometric testing, 193 outpatients and 168 inpatients completed outpatient and inpatient modules, respectively. Results The adapted questionnaire adhered to the WHO framework of responsiveness domains, and just four items had some wording changes. Item missing rates were below 6%. Both the outpatient and inpatient modules had acceptable internal reliability (Cronbach’s α = 0.837 and 0.730) and most domains had desirable average inter-item correlation coefficients. The confirmatory factor analysis indicated an acceptable model fit for the inpatient module, while some goodness-of-fit indices for the outpatient module were a little outside of the recommended ranges. Except for ‘talking privately’ from the domain of confidentiality (both outpatient and inpatient modules) and ‘waiting time’ from the domain of prompt attention (the inpatient module), factor loadings of all other items were above 0.5. Conclusions The Chinese version of the responsiveness performance questionnaire has acceptable feasibility, reliability, and validity in general and it can be used to measure, assess and improve the quality of mental health services in China.
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Affiliation(s)
- Wei Zhou
- Research Center for Public Health and Social Security, School of Public Administration, Hunan University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Caixia Feng
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Teaching Department, Liuzhou People's Hospital, Liu Zhou, China
| | - Yu Yu
- Division of Prevention and Community Research & the Consultation Center, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Dan Wang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Cheng Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Department of Public Health, Zhuzhou Central Hospital, Zhuzhou Central Hospital, Zhuzhou, China
| | - Xiang Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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36
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Crespo-Gonzalez C, Dineen-Griffin S, Rae J, Hill RA. Mental health training programs for community pharmacists, pharmacy staff and students: A systematic review. Res Social Adm Pharm 2022; 18:3895-3910. [PMID: 35778317 DOI: 10.1016/j.sapharm.2022.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Primary care is often the first point of contact for people living with mental disorders. Community pharmacists, pharmacy staff and students are increasingly being trained to deliver mental health care. However, there is still a gap in the literature exploring the characteristics of all available mental health training programs and their components and their influence on pharmacists, pharmacy staff and students' outcomes. OBJECTIVES To summarize the evidence evaluating mental health training programs completed by community pharmacists, pharmacy staff and students. More specifically, to explore the components of mental health training programs and identify those that facilitate significant improvements in outcomes. METHODS A systematic review was conducted following the Cochrane handbook and reported according to PRISMA guidelines. A search for published literature was conducted in three databases (PubMed, Scopus, and Web of Science) in July 2021. Eligible studies were included if they described and evaluated the impact of mental health training programs delivered to community pharmacists, pharmacy staff and pharmacy students regardless of design or comparator. The methodological quality of included studies was appraised using both the NIH quality assessment, to evaluate studies with an uncontrolled pre-post design, and the Cochrane EPOC risk of bias assessment, to evaluate studies with a controlled (randomized and non-randomized) study design. RESULTS Thirty-three studies were included. Most of the identified mental health training programs contained knowledge-based components and active learning activities. Changes in participants' attitudes, stigma, knowledge, confidence and skills were frequently assessed. An extensive range of self-assessment and observational instruments used to evaluate the impact of the training programs were identified. Positive improvements in participants' attitudes, knowledge and stigma were frequently identified following participation in training programs. CONCLUSIONS This systematic review highlights the importance of mental health training programs in increasing pharmacists', pharmacy staff and pharmacy students' skills and confidence to deliver mental health care in community pharmacy. Future research should build upon this basis and further focus on finding the most efficient measures to evaluate these training programs and assess their long-term effectiveness, allowing comparison between programs.
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Affiliation(s)
- Carmen Crespo-Gonzalez
- School of Dentistry and Medical Sciences, Charles Sturt University, Panorama Avenue, Bathurst, New South Wales, Australia
| | - Sarah Dineen-Griffin
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - John Rae
- School of Dentistry and Medical Sciences, Charles Sturt University, Panorama Avenue, Bathurst, New South Wales, Australia
| | - Rodney A Hill
- School of Biomedical Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, Australia.
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Qin S, Sheehan L, Yau E, Chen Y, Wang Y, Deng H, Lam C, Chen Z, Zhao L, Gan S, Mao H, Mo X, Yang L, Zhang F, Corrigan P. Adapting and Evaluating a Strategic Disclosure Program to Address Mental Health Stigma Among Chinese. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00911-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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38
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Huang W, Li X, Wu Z, Jiang N, Zhang X. Psychometric properties of the Postpartum Depression Literacy Scale (PoDLiS) among Chinese perinatal women: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:737. [PMID: 36184620 PMCID: PMC9526904 DOI: 10.1186/s12884-022-05067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the present work was to cross-culturally adapt the Postpartum Depression Literacy Scale (PoDLiS) and use a descriptive cross-sectional design to evaluate its psychometric properties in Chinese perinatal women. Methods Brislin’s translation theory was applied to translate the PoDLiS, with subsequent cultural adaptation. The reliability and validity of the PoDLiS were determined using a questionnaire in 635 Chinese perinatal women. Results Good internal consistency was found (omega coefficient, 0.894) for the Chinese version of the Postpartum Depression Literacy Scale (PoDLiS-C), with omega coefficients of the six dimensions of 0.865, 0.870, 0.838, 0.777, 0.837 and 0.794, and a test–retest reliability coefficient of 0.874. The item-level content validity index (CVI) ranged from 0.8 to 1 while the scale-level CVI was 0.968. Moreover, confirmatory factor analysis (CFA) determined satisfactory construct validity of the PoDLiS-C, with the six-factor model explaining 60.76% of the total variance, demonstrating good model fit (likelihood ratio χ2/df, 1.003; goodness-of-fit index, 0.916; adjusted goodness-of-fit index, 0.901; comparative fit index, 0.999; incremental fit index, 0.999; root mean square error of approximation, 0.003; and standardized root mean square error of approximation, 0.0478). Conclusions The PoDLiS-C has adequate psychometric properties. This tool could be used to assess the postpartum depression literacy of perinatal women in Chinese-speaking populations.
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Affiliation(s)
- Weijian Huang
- Eastern Operating Room, Yantai Yuhuangding Hospital, No.20 Yantai Yuhuangding Eastern Road, Zhifu Area, Yantai, Shandong Province, P. R. China.,School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
| | - Xiaohan Li
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China.
| | - Zijing Wu
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
| | - Nan Jiang
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
| | - Xu Zhang
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, P.R. China
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39
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Shi W, Yuan GF, Hall BJ, Zhao L, Jia P. Chinese adolescents' depression, anxiety, and family mutuality before and after COVID-19 lockdowns: Longitudinal cross-lagged relations. FAMILY RELATIONS 2022; 72:FARE12761. [PMID: 36246205 PMCID: PMC9538438 DOI: 10.1111/fare.12761] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 07/11/2022] [Accepted: 07/24/2022] [Indexed: 05/30/2023]
Abstract
Objective This study aimed to investigate the longitudinal cross-lagged association between family mutuality, depression, and anxiety among Chinese adolescents before and after the COVID-19 lockdown in 2020. Background Limited attention has been paid to the longitudinal links between family mutuality, depression, and anxiety in the context of the COVID-19 pandemic. Method We used self-administered questionnaires to collect data from three high schools and two middle schools in Chengdu City at two time points: Time 1 (T1), December 23, 2019-January 13, 2020; Time 2 (T2), June 16-July 8, 2020. The sample consisted of 7,958 participants who completed two wave surveys before and after the COVID-19 lockdown. We analyzed the data using cross-lagged structural equation modeling. Results The longitudinal cross-lagged model showed family mutuality at T1 significantly predicted depression, anxiety, and family mutuality at T2. We observed a decreasing prevalence of depression and anxiety after the COVID-19 lockdown. Conclusion Family mutuality plays an important role in mitigating long-term mental health disorders, such as depression and anxiety. More family-centered psychological interventions could be developed to alleviate mental health disorders during lockdowns. Implications Improving family mutuality (e.g., mutual support, interaction, and caring among family members) could be beneficial for reducing mental health disorders among Chinese adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR)Sichuan UniversityChengduSichuanChina
| | - Guangzhe Frank Yuan
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public HealthUniversity of South CarolinaColumbia, SC
| | | | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth HospitalSichuan UniversityChengduSichuanChina
| | - Peng Jia
- Institute for Disaster Management and Reconstruction (IDMR)Sichuan UniversityChengduSichuanChina
- School of Resource and Environmental SciencesWuhan UniversityWuhanChina
- International Institute of Spatial Lifecourse Health (ISLE)Wuhan UniversityWuhanChina
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40
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Wang C, Havewala M, Cheong Y, Chen J. Cybervictimization, Mental Health literacy and depressive symptoms among College students: a cross-cultural investigation. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03357-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Deng K, Tsuda A, Horiuchi S, Aoki S. Processes of change, pros, cons, and self-efficacy as variables associated with stage transitions for effective stress management over a month: a longitudinal study. BMC Psychol 2022; 10:122. [PMID: 35549766 PMCID: PMC9102284 DOI: 10.1186/s40359-022-00822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background The transtheoretical model of intentional health behavior change categorizes people into experiencing five stages in understanding the process of initiating and maintaining effective stress management (i.e., engagement in any form of healthy activity that is practiced for at least 20 min per day). The first purpose of this study was to observe whether any cases would disclose stage misclassification over one month. The second was to examine whether different model's variables are associated with the stage transitions for effective stress management at different stages. Methods Data from 946 Chinese students and workers were subjected to analyses. This study is a part of a larger, longitudinal web-based study in which three surveys were conducted in March, April, and September 2014. This study analyzes the data of demographic variables, perceived stress, stages of change, processes of change, pros, cons, and self-efficacy at the point of the first survey and stages of change at the point of the second survey. Results Of 144 participants who progressed from the pre-Action stages to the post-Action stages, 44 then progressed to Maintenance (practicing effective stress management for six months or longer). These patterns could not technically occur, and thus, these participants were excluded from the following analyses. Data from the remaining 902 participants were subject to a series of logistic regression analyses. Generally, the model’s variables failed to predict the stage transitions. Exceptions were found that higher experiential processes (the cognitive activities required to progress through stages) and lower self-efficacy (the confidence that one can engage in effective stress management despite barriers to it) predicted the forward and backward stage transitions from Precontemplation (with no intention to initiate effective stress management in the next six months) and Action/Maintenance (practicing effective stress management). Conclusions Evidence of stage misclassification indicated the limitations of the model’s stage classification. Experiential processes and self-efficacy as predictors at different stages were in line with the model’s assumption that different variables are assumed to be predictors of stage transitions at different stages, partially supporting the utility of the stage classification.
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Affiliation(s)
- Ke Deng
- Institute of Comparative Studies of International Cultures and Societies, Kurume University, Fukuoka, Japan
| | - Akira Tsuda
- Graduated School of Medical Sciences, Teikyo University of Science, Tokyo, Japan
| | - Satoshi Horiuchi
- Department of Social and Clinical Psychology, Hijiyama University, Hiroshima, Japan.
| | - Shuntaro Aoki
- Center for Medical Education and Career Development, Fukushima Medical University, Fukushima, Japan.,Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
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Gearing RE, Brewer KB, Leung P, Cheung M, Chen W, Carr LC, Bjugstad A, He X. Mental health help-seeking in China. J Ment Health 2022:1-8. [PMID: 35532046 DOI: 10.1080/09638237.2022.2069703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 01/21/2022] [Accepted: 02/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In China, mental health disorders are considered the leading causes of disability, yet treatment-seeking behaviors among individuals with mental health problems are deficient. AIMS This study sought to examine attitudes and participant characteristics associated with help-seeking among adults residing in China's Shanghai metropolitan area. METHODS This study employed a convenience cross-sectional sampling strategy and recruited 500 participants in public places in Shanghai. The survey administered in Mandarin was comprised of two sections: a series of demographic questions and standardized instruments measuring stigma and help-seeking attitudes. RESULTS Findings indicate that beliefs about seeking professional help for mental health are influenced by knowing someone with a mental health problem. In addition, men who were older, had a child, and were married endorsed more openness to help-seeking for mental health needs, underscoring the importance of life experience as an essential variable when considering attitudes toward help-seeking. CONCLUSIONS Findings support future research identifying the mechanisms by which these life experiences impact individuals' help-seeking attitudes.
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Affiliation(s)
- Robin Edward Gearing
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Kathryne B Brewer
- University of New Hampshire Institute for Policy and Social Science Research, Durham, NH, USA
| | - Patrick Leung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Monit Cheung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Wanzhen Chen
- East China University of Science and Technology, Shanghai, China
| | - L Christian Carr
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Arlene Bjugstad
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Xuesong He
- East China University of Science and Technology, Shanghai, China
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Chang WH, Lai AG. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers. Nat Med 2022; 28:860-870. [PMID: 35347280 PMCID: PMC9018408 DOI: 10.1038/s41591-022-01740-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Cancer is a life-altering event causing considerable psychological distress. However, information on the total burden of psychiatric disorders across all common adult cancers and therapy exposures has remained scarce. Here, we estimated the risk of self-harm after incident psychiatric disorder diagnosis in patients with cancer and the risk of unnatural deaths after self-harm in 459,542 individuals. Depression was the most common psychiatric disorder in patients with cancer. Patients who received chemotherapy, radiotherapy and surgery had the highest cumulative burden of psychiatric disorders. Patients treated with alkylating agent chemotherapeutics had the highest burden of psychiatric disorders, whereas those treated with kinase inhibitors had the lowest burden. All mental illnesses were associated with an increased risk of subsequent self-harm, where the highest risk was observed within 12 months of the mental illness diagnosis. Patients who harmed themselves were 6.8 times more likely to die of unnatural causes of death compared with controls within 12 months of self-harm (hazard ratio (HR), 6.8; 95% confidence interval (CI), 4.3-10.7). The risk of unnatural death after 12 months was markedly lower (HR, 2.0; 95% CI, 1.5-2.7). We provide an extensive knowledge base to help inform collaborative cancer-psychiatric care initiatives by prioritizing patients who are most at risk.
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Affiliation(s)
- Wai Hoong Chang
- Institute of Health Informatics, University College London, London, UK
| | - Alvina G Lai
- Institute of Health Informatics, University College London, London, UK.
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Hagström J, Woodford J, von Essen A, Lähteenmäki P, von Essen L. Opt-out rates and reasons for non-participation in a single-arm feasibility trial (ENGAGE) of a guided internet-administered CBT-based intervention for parents of children treated for cancer: a nested cross-sectional survey. BMJ Open 2022; 12:e056758. [PMID: 35365530 PMCID: PMC8977820 DOI: 10.1136/bmjopen-2021-056758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Difficulties with recruitment into clinical trials are common. An opt-out recruitment strategy, whereby potential participants can decline further contact about a study (opt-out), and non-responders are contacted, may facilitate participation. Primary objectives examined opt-out and consent rates, mode and time point of opt-out, and sociodemographic characteristics of those who opted out versus those who chose to participate in a single-arm feasibility trial (ENGAGE) of a guided, internet-administered, cognitive-behavioural therapy-based intervention for parents of children treated for cancer. Secondary objectives examined reasons for non-participation. DESIGN A cross-sectional survey nested within the ENGAGE feasibility trial. SETTING The intervention was delivered from Uppsala University, with parents located throughout Sweden. PARTICIPANTS Potential participants were recruited 3 months-5 years following their child ending treatment for cancer and were identified via their personal identification number (via the Swedish Childhood Cancer Registry and Swedish Tax Agency) and invited via postal invitation packs and could opt out via post, online, telephone or email. Those who did not opt out or consent, within 4 weeks, received up to five telephone calls and/or one postal reminder. RESULTS Of 509 invited, 164 (32.2%) opted out, 78 (47.6%) via post, 53 (32.3%) via telephone, 24 (14.6%) online, and 6 (3.7%) via email, 88 (53.7%) opted out after at least one telephone call and/or postal reminder. There was a trend for parents with lower educational levels to opt out. No need of psychological support, lack of time, and no interest in internet-administered self-help were frequently reported reasons for non-participation. CONCLUSIONS Results emphasise the importance of using different opt-out modes and suggest future research should consider how to widen study participation for parents with lower education levels. Self-identifying a need for psychological support and the acceptability of internet-administered self-help are important factors for participation and should be considered in future research to increase recruitment. TRIAL REGISTRATION NUMBER ISRCTN57233429.
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Affiliation(s)
- Josefin Hagström
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Agnes von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Päivi Lähteenmäki
- Department of Paediatrics and Adolescent Medicine, TYKS Turku University Hospital, Turku, Finland
- Pediatric Oncology and Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Perceived mental illness stigma among family and friends of young people with depression and its role in help-seeking: a qualitative inquiry. BMC Psychiatry 2022; 22:107. [PMID: 35144565 PMCID: PMC8832742 DOI: 10.1186/s12888-022-03754-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Depressive disorders are a serious public health concern. Left untreated, further clinical distress and impairment in important life domains may arise. Yet, the treatment gap remains large. Prior research has shown that individuals with depressive disorders prefer seeking help from informal sources such as family and friends ahead of formal sources. However, this preference has its disadvantages such as experiencing actual, perceived and internalized stigmatizing responses from them which may delay or deter help-seeking. This paper aimed to determine the role of perceived stigma among family and friends in an individual's help-seeking behavior. METHODS Data were collected using semi-structured interviews with patients with depressive disorders from a tertiary psychiatric hospital in Singapore to capture individuals' self-reported experience with depression and stigmatization among family and friends. Interviews were audio recorded and transcribed verbatim. Data of 33 young adults (mean age = 26 years, SD =4.6; 18 female, 15 male) were analyzed using thematic analysis. RESULTS In all, four broad themes were developed: (1) absence of support, (2) provision of unhelpful support, (3) preference for non-disclosure, and (4) opposition towards formal help-seeking. Lack of awareness of depression and perpetuation of stigma manifests as barriers towards help-seeking in the form of absence of support and provision of unhelpful support which subsequently leads to a preference for non-disclosure, as well as opposition by family and friends towards formal help-seeking. CONCLUSIONS Data from this study can contribute to the development of public health programs aimed at improving awareness and support from family and friends and facilitating earlier help-seeking among young people with depressive disorders.
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Chan CS, Hazan H. The Health Hexagon Model: Postulating a holistic lifestyle approach to mental health for times and places of uncertainty. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Wu X, Xu L, Li P, Tang T, Huang C. Multipurpose Mobile Apps for Mental Health in Chinese App Stores: Content Analysis and Quality Evaluation. JMIR Mhealth Uhealth 2022; 10:e34054. [PMID: 34982717 PMCID: PMC8767465 DOI: 10.2196/34054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/30/2021] [Indexed: 01/05/2023] Open
Abstract
Background Mental disorders impose varying degrees of burden on patients and their surroundings. However, people are reluctant to take the initiative to seek mental health services because of the uneven distribution of resources and stigmatization. Thus, mobile apps are considered an effective way to eliminate these obstacles and improve mental health awareness. Objective This study aims to evaluate the quality, function, privacy measures, and evidence-based and professional background of multipurpose mental health apps in Chinese commercial app stores. Methods A systematic search was conducted on iOS and Android platforms in China to identify multipurpose mental health apps. Two independent reviewers evaluated the identified mobile apps using the Mobile App Rating Scale (MARS). Each app was downloaded, and the general characteristics, privacy and security measures, development background, and functional characteristics of each app were evaluated. Results A total of 40 apps were analyzed, of which 35 (87.5%) were developed by companies and 33 (82.5%) provided links to access the privacy policy; 21 (52.5%) apps did not mention the involvement of relevant professionals or the guidance of a scientific basis in the app development process. The main built-in functions of these apps include psychological education (38/40, 95%), self-assessment (34/40, 85%), and counseling (33/40, 82.5%). The overall quality average MARS score of the 40 apps was 3.54 (SD 0.39), and the total score was between 2.96 and 4.30. The total MARS score was significantly positively correlated with the scores of each subscale (r=0.62-0.88, P<.001). However, the user score of the app market was not significantly correlated with the total MARS score (r=0.17, P=.33). Conclusions The quality of multipurpose mental health apps in China’s main app market is generally good. However, health professionals are less involved in the development of these apps, and the privacy protection policy of the apps also needs to be described in more detail. This study provides a reference for the development of multipurpose mental health apps.
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Affiliation(s)
- Xiaoqian Wu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - Lin Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
| | - PengFei Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - TingTing Tang
- The Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng Huang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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Tao X, Chen D, Fan Y, Zhang L, Shan H, Wei Y, Yu X, Zhong T, Wang L, Chung SK, Yu Y, Xiao Y. A cross-sectional study for the mental health status and sleep quality among college students in Macao during the COVID-19 pandemic. PeerJ 2021; 9:e12520. [PMID: 34966578 PMCID: PMC8663623 DOI: 10.7717/peerj.12520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/29/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives The main focus of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic on the mental health condition and sleep quality of college students in Macao. In addition, the students’ behaviours during the pandemic, such as drinking alcohol, taking sleeping pills, and seeking psychological counselling were analyzed. Method A cross-sectional survey of mental health and sleep quality status, as well as the possible behavioral risk factors, was conducted among the college students of Macao in August, 2020 during the COVID-19 pandemic. An online self-report questionnaire survey method was applied to assess the general demographics and related lifestyle behaviors of students. The general mental health condition and sleep quality were evaluated through the General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Index (PSQI) questionnaires, respectively. The main statistical methods included the Chi-square test, Bonferroni correction, and Pearson correlation. Data analysis was performed using SPSS Version 24.0. Results A total of 980 students were investigated in the study, of which 977 completed the survey. During the COVID-19 pandemic period, overall college students in Macao were psychologically well adjusted and reported good quality of sleep. However, female students were in poorer psychological condition than males (P < 0.05). Moreover, the students over 20 years of age had poorer sleep quality than students aged less than or equal to 20 (P < 0.05). The significant differences were found among the students in different study majors for the mental health status and sleep quality (both P < 0.05), which were associated with certain behaviors, such as drinking alcohol, taking sleeping pills, and seeking for help in psychological counselling during the COVID-19 pandemic period. Conclusions Poor mental health status could be either the consequence or cause of sleep disturbance, which might further affected physical health. Therefore, regular assessment of mental health condition and sleep quality of college students is particularly necessary during public health emergencies, such as the COVID-19 pandemic, and appropriate intervention should be provided to the students.
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Affiliation(s)
- Xiaoyu Tao
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Dong Chen
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Yawen Fan
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Lanxin Zhang
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Houqian Shan
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Yi Wei
- School of Public Administration, Jilin University, Changchun, Jilin, China
| | - Xi Yu
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Tian Zhong
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Ling Wang
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Sookja Kim Chung
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
| | - Yaqin Yu
- Faculty of Health Sciences, Zhuhai College of Science and Technology, Zhuhai, Guangdong, China
| | - Ying Xiao
- Faculty of Medicine, Macau University of Science and Technology, Macao, China
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Shi W, Yuan GF, Hall BJ, Liu X, Su Y, Zhao L, Jia P. Mental Disorders and Emotional Competence Among Chinese Adolescents Before and During COVID-19 Pandemic: A Longitudinal Mediation Model. Front Public Health 2021; 9:767004. [PMID: 34957019 PMCID: PMC8702639 DOI: 10.3389/fpubh.2021.767004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The outbreak of the COVID-19 pandemic has had a profound influence on the mental health and well-being of individuals across the globe. Emotional competence, defined as one's ability to recognize, understand, and manage their emotions, has been found linked with mental health problems (e.g., depression and anxiety) in previous studies. However, there is limited knowledge about the direction of the association between these factors among populations exposed to COVID-19. This study examined the possible mediation relationships between depression, anxiety, emotional competence, and COVID-19 exposure among Chinese adolescents. Methods: Responses from 7,958 Chinese adolescents who had previously taken part in a two-wave study before (December 23, 2019-January 13, 2020) and during COVID-19 (June 16, 2020-July 8, 2020) were analyzed (51.67% males, mean age = 11.74, SD = 2.15). Structural equation modeling with three covariates (i.e., age, gender, and ethnicity) was used to test the longitudinal mediation relationships between COVID-19 exposure and depression, anxiety via emotional competence. Results: Results indicated that the prevalence of depression (38.67 to 36.74%) and anxiety (13.02 to 12.77%) decreased from Time 1 to Time 2. The T2 emotional competence significantly mediated the relationship between T2 COVID-19 exposure and T2 anxiety (indirect effect [95% CI] = 0.011 [0.004-0.019], p < 0.05). T2 emotional competence also significantly mediated the relationship between T2 COVID-19 exposure and T2 depression (indirect effect [95% CI] = 0.013 [0.005-0.022], p < 0.05). The results indicated that T2 emotional competence had a significant and negative influence on T2 anxiety (β = -0.266, SE = 0.005, p < 0.001), and T2 depression (β = -0.326, SE = 0.029, p < 0.001). Conclusions: This longitudinal research study demonstrated the crucial role of emotional competence in influencing the severity of long-term mental health problems, and suggested that emotional competence interventions can be conducted to improve mental well-being among Chinese adolescents exposed to COVID-19.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Guangzhe Frank Yuan
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau SAR, China
| | - Brian J. Hall
- Global and Community Mental Health Research Group, New York University, Shanghai, China
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Xiaoli Liu
- Office of Humanities and Social Sciences Administration, Sichuan University, Chengdu, China
| | - Ya Su
- Department of Sociology, Dickinson College, Carlisle, PA, United States
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Health Emergency Management Research Center. China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China
| | - Peng Jia
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
- School of Resources and Environmental Science, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan University, Wuhan, China
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Hathorn SK, Lochner C, Stein DJ, Bantjes J. Help-Seeking Intention in Obsessive-Compulsive Disorder: Predictors and Barriers in South Africa. Front Psychiatry 2021; 12:733773. [PMID: 34630184 PMCID: PMC8497739 DOI: 10.3389/fpsyt.2021.733773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction: Many individuals with obsessive-compulsive disorder (OCD) delay seeking help, leading to greater illness severity, additional comorbidity, and increased functional impairment. Patterns of help-seeking for OCD have however not yet been described in South Africa, a low-and middle-income country with many health service challenges. Using the health belief model as a conceptual framework, study aims were to identify predictors of and barriers to help-seeking among South Africans with OCD. Methods: Fifty adults with OCD completed an online survey to assess (1) socio-demographic characteristics, (2) OCD symptom severity, (3) treatment barriers, (4) perceived treatment benefits, (5) self-efficacy, and (6) help-seeking intention. Multiple linear regression analysis was used to establish predictors of help-seeking intention. Descriptive statistics were used to determine the most endorsed help-seeking barriers. Results: 42.6% of the variance in help-seeking intention was explained by the investigated constructs (R 2 = 0.426, F = 4.45 and p < 0.01). Perceived treatment benefits were the only significant predictor of help-seeking intention (B = 1.37, t = 5.16, and p < 0.01). More than a third (36%) of the sample endorsed wanting to handle the problem independently as a significant barrier, followed by treatment concerns (26%), affordability (22%), and shame (20%). Conclusion: An innovative analysis of help-seeking patterns suggested that perceived treatment benefits were the only significant predictor of help-seeking intention among South African adults with OCD. Psychoeducation and mental health literacy programmes may be useful in increasing public appreciation of the benefits of OCD treatment, and in mitigating key help-seeking barriers.
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Affiliation(s)
- Sarah Kate Hathorn
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Christine Lochner
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Dan J. Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jason Bantjes
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
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