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Surwill DL, Pharr JR. Socioecological Predictors of Resilience in Sexual and Gender Minority Individuals. J Community Health 2024:10.1007/s10900-024-01398-7. [PMID: 39235544 DOI: 10.1007/s10900-024-01398-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/06/2024]
Abstract
Many factors affect an individual's resilience. Low resilience has been attributed to increased stress, anxiety, depression, and suicidality within the LGBTQIA + population, which is heightened compared to different populations. This study identifies predictors of resilience in the LGBTQIA + population and aims to identify predicting factors at all levels of the socioecological model. This was a cross-sectional study of data from a web-based survey that was conducted from January to February 2022. A national sample of 1033 LGBTQIA + adults was utilized for hierarchical regression analysis. Hierarchical regression analyses were performed for total resilience, which had an average score of 143.66 (SD = 33.88) and accounted for 53.4% of resiliency variance. Factors that were found to decrease an individuals resiliency score were depression, stress, suicidality, and isolation discrimination distress. Factors found to increase an individuals resiliency scores are college graduate 4 years+, married, outness, personal comfortability with being SGM, gender expression discrimination distress, and vicarious discrimination distress. Understanding the factors that influence resilience is vital to improving the resilience of the LGBTQIA + communities. Interventions that focus on decreasing depression, stress, and suicidality may be particularly impactful for all types of resilience.
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Affiliation(s)
- Dana L Surwill
- Department Environmental and Occupational Health, School of Public Health, University of Nevada, 4700, South Maryland Parkway, Las Vegas, NV, 89119, USA.
| | - Jennifer R Pharr
- Department Environmental and Occupational Health, School of Public Health, University of Nevada, 4700, South Maryland Parkway, Las Vegas, NV, 89119, USA
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Wang Q, Zhou Y, Wang G, Pan X, Sha S, Wang Z, Liu Y, Tian T, Liang S. The mediation effects of COVID-19-related traumatic stress symptoms and mentalization on the relationship between perceived stress and psychological well-being in healthcare workers transitioning to a post-pandemic world. PLoS One 2024; 19:e0309561. [PMID: 39231148 PMCID: PMC11373818 DOI: 10.1371/journal.pone.0309561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 08/13/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND In context of COVID-19 as a collective trauma and the intense involvement of healthcare workers (HCWs) in the pandemic, perceived stress continues to have a tremendous impact on their psychological well-being. However, few studies have attempted to delineate the underlying mechanisms. This study examined whether COVID-19-related traumatic stress symptoms and mentalization act as mediators. METHODS A sample of HCWs (N = 2610) from 22 hospitals in Beijing, China participated in this cross-sectional investigation. Data on their perceived stress, psychological well-being, the impact of event, and reflective function during the COVID-19 pandemic were collected using self-report questionnaires. Different mediating models were tested. RESULTS COVID-19-related stress symptoms and mentalization independently mediate the association between perceived stress and psychological well-being. These two mediators also compose a serial mediation model. In particular, higher perceived stress inhibits the psychological well-being of HCWs through increased severity of traumatic stress symptoms, which in turn is associated with hypomentalizing. CONCLUSION These findings shed light on the mechanisms underlying the relationship between perceived stress and psychological well-being in HCWs. We strongly recommend incorporating a mentalization framework with trauma-informed practice in prevention and intervention work with this population during this and future healthcare crisis.
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Affiliation(s)
- Qian Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - You Zhou
- New York Psychoanalytic Society & Institute, New York, New York, United States of America
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xinyu Pan
- The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zhe Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yinqi Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Tengfei Tian
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Sixiang Liang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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Letourneau N, McManus C, Novick J, Silverstone A. Impacts of Peer Support on Coping and Cortisol Levels for Women Affected by Domestic Violence and Coercive Control. Can J Nurs Res 2024:8445621241272723. [PMID: 39149993 DOI: 10.1177/08445621241272723] [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: 08/17/2024] Open
Abstract
PURPOSE Gendered domestic violence and coercive control are prevalent public heath concerns in Canada with dire consequences for survivors. Peer support groups may address and reduce negative impacts of domestic violence and coercive control on women's stress, coping, safety, and alliances with social support network members, the focus of this study. METHODS A one-group, pre-test/post-test quasi-experimental study was undertaken to evaluate the effectiveness of Growth Circle, a 14-week peer support program offered at an agency serving women affected by domestic violence in a major western Canadian city. Through convenience sampling, women 18 years and older who experienced domestic violence were recruited and provided data on stress, coping, safety-related empowerment, and social support/alliances. Thirty-five participants provided all pre-test and post-test data, with a subsample of 14 providing repeated hair samples. Hair was employed to determine stress hormone (cortisol) levels. RESULTS A significant reduction in self-reported levels of perceived stress and stress hormone levels following completion of the Growth Circle program was revealed. Participants also reported a significant increase in safety-related empowerment, and supportive alliances with group members. CONCLUSIONS The Growth Circle peer support program was demonstrated to be effective. Further implementation and research into the Growth Circle program across Canada is recommended.
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Affiliation(s)
- Nicole Letourneau
- Professor, Faculty of Nursing and Cumming School of Medicine (Pediatrics, Psychiatry, Community Health Sciences), University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Carrie McManus
- Director of Innovation and Programs, Sagesse Domestic Violence Prevention Society, Calgary, Alberta, Canada
| | - Jason Novick
- Research Assistant, Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta, Canada, T2N 1N4
| | - Andrea Silverstone
- Chief Executive Officer, Sagesse Domestic Violence Prevention Society, Calgary, Alberta, Canada
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Rost K, Ziegenhain U, Fegert JM, Buchheim A, Köhler-Dauner F. Maternal insecure attachment representation as a long-term risk factor for disrupted mother-child-interaction and child mental health. BMC Psychol 2024; 12:385. [PMID: 38982522 PMCID: PMC11234699 DOI: 10.1186/s40359-024-01874-8] [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: 02/08/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Maternal childhood maltreatment (CM) represents an important factor in the transmission of trauma that may lead to impaired child mental health. Apart from childhood maltreatment insecure attachment has been identified as a risk factor for insensitive caregiving behavior, which may affect child's mental health. The aim of this study is to identify the working mechanisms in the relationship between maternal CM and child mental health, considering maternal attachment representation, mother-child-interaction und maternal helplessness and fear. N = 103 mother-child-dyads from a longitudinal cohort study were examined at four different measuring points. Data was assessed using self and external report questionnaires as well as the AMBIANCE scales during the Strange Situation Procedure and the Adult Attachment Projective Picture System (AAP). Maternal CM experience did not predict an insecure attachment representation (OR = 2.46 [0.98, 6.53], p = .060). Maternal insecure attachment was associated with higher AMBIANCE scores (F(8, 94) = 11.46, p < .001), which indicates more disrupted communication between mother and child. AMBIANCE scores in turn predicted higher self-perceived helplessness (F(9, 93) = 8.62, p < .001) and fear (F(9, 93) = 7.40, p < .001) in mothers. Helplessness and fear both were associated with higher SDQ-scores, indicating more mental health problems in children (F(10, 92) = 3.98, p < .001; F(10, 92) = 3.87, p < .001). The results of this study highlight how even insecure attachment in a low-risk sample has a long-term impact on parenting behavior and child mental health, therefore underlining the need of early intervention programs in affected and at-risk families.
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Affiliation(s)
- Katharina Rost
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany.
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany
- German Center for Mental Health (DZPG), partner site Ulm, Ulm, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Ulm, Germany.
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Garces-Arilla S, Fidalgo C, Mendez-Lopez M, Osma J, Peiro T, Salvador A, Hidalgo V. Female students' personality and stress response to an academic examination. ANXIETY, STRESS, AND COPING 2024; 37:460-472. [PMID: 37771236 DOI: 10.1080/10615806.2023.2264208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/23/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Women are vulnerable to stress-related disorders. Examinations are a source of stress, triggering emotional, cognitive, and hormonal responses. We examined women's psychological and hormonal stress responses and academic performance according to personality during a real-life examination. METHODS Female students (N = 66) were divided into two groups based on hierarchical cluster analysis: one cluster characterized by high neuroticism and moderate extraversion (HN-ME; n = 42) and the other by low neuroticism and high extraversion (LN-HE; n = 24). Academic performance, perceived stress, and emotional dysregulation were analyzed. State anxiety, affect, and cortisol release were measured before and on the examination day. RESULTS The HN-ME cluster was high in perceived stress, emotional dysregulation, and negative affect. This cluster also had higher state anxiety levels two days before and shortly after the examination compared to the LN-HE cluster. Students' cortisol levels were higher on the examination day, and there was a marginal significance of the Cluster factor in the cortisol release regardless of the day of measurement. CONCLUSIONS Women with high neuroticism and moderate extraversion may be more vulnerable to psychological stress in academic settings but similar to other women in their cortisol response.
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Affiliation(s)
- Sara Garces-Arilla
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Camino Fidalgo
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Magdalena Mendez-Lopez
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Jorge Osma
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Teresa Peiro
- Department of Nursing, University of Valencia, Valencia, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, University of Valencia, Valencia, Spain
- Spanish National Network for Research in Mental Health CIBERSAM, Madrid, Spain
| | - Vanesa Hidalgo
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, University of Valencia, Valencia, Spain
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Thomas TA, Schmid AM, Kessling A, Wolf OT, Brand M, Steins-Loeber S, Müller A. Stress and compulsive buying-shopping disorder: A scoping review. Compr Psychiatry 2024; 132:152482. [PMID: 38603938 DOI: 10.1016/j.comppsych.2024.152482] [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: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Theoretical frameworks of behavioral addictions mostly acknowledge the role of stress in the development and maintenance of these disorders, models of compulsive buying-shopping disorder (CBSD) however rarely incorporated stress. The association between stress and CBSD has not been reviewed yet. METHODS A scoping review was conducted to evaluate empirical results on the association between stress and CBSD. A comprehensive search string was employed in three databases. RESULTS 16 studies were included. Correlative studies suggested significant correlations between general perceived stress and CBSD symptom severity. Studies involving mean comparisons found higher general perceived stress levels in persons with problematic buying-shopping behavior/CBSD compared to control participants (large effects). Mixed results were found in studies involving regression/structural equation models and ecological momentary assessments. One study with a stress/negative mood induction observed more CBSD symptoms in a high stress group compared to a low stress group. DISCUSSION The studies are heterogeneous concerning design, samples and measures. Only very few studies surpass the level of cross-sectional correlative data which limits the ability to draw clear conclusions. Future research should study the impact of experimentally induced stress on CBSD symptoms, examine the relationship between stress and CBSD longitudinally and assess objective stress markers.
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Affiliation(s)
- Tobias A Thomas
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany.
| | - Anna M Schmid
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Annica Kessling
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Matthias Brand
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
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Terry E, Pharr JR, Batra R, Batra K. Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. LGBT Health 2024; 11:392-405. [PMID: 38324060 DOI: 10.1089/lgbt.2023.0003] [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: 02/08/2024] Open
Abstract
Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.
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Affiliation(s)
- Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Ravi Batra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Tryfonos C, Pavlidou E, Vorvolakos T, Alexatou O, Vadikolias K, Mentzelou M, Tsourouflis G, Serdari A, Antasouras G, Papadopoulou SK, Aggelakou EP, Giaginis C. Association of Higher Mediterranean Diet Adherence With Lower Prevalence of Disability and Symptom Severity, Depression, Anxiety, Stress, Sleep Quality, Cognitive Impairment, and Physical Inactivity in Older Adults With Multiple Sclerosis. J Geriatr Psychiatry Neurol 2024; 37:318-331. [PMID: 38018355 DOI: 10.1177/08919887231218754] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
A good nutritional status and healthy diets may decelerate disease disability and symptom severity and quality of life of peoples with multiple sclerosis (MS). Mediterranean diet (MD) can prevent several chronic diseases, including neurodegenerative disease. This is an observational, cross-sectional study on 279 older adults with MS, aiming to investigate the effects of MD against several aspects of mental health. Qualified questionnaires were used to assess disability and symptom severity, depression, anxiety, stress, sleep quality, cognitive status, physical activity, and MD adherence. Multivariate analysis showed that enhanced MD adherence was independently associated with lower prevalence of disability and symptom severity (P = .0019), depression (P = .0201), anxiety (P = .0287), perceived stress (P = .0021), inadequate sleep quality (P = .0033), cognitive impairment (P = .0018) and physical inactivity (P = .0028). Adopting MD may ameliorate mental health disturbances in older adults with MS. Future public health policies should inform older adults with MS for the favorable impacts of MD in improving the mental health MS comorbidities.
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Affiliation(s)
- Christina Tryfonos
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Greece
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Greece
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Greece
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, Athens, Greece
| | - Aspasia Serdari
- Department of Geriatric Psychiatry, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | | | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, Myrina, Greece
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Pintro K, Sanchez SE, Rondon MB, Gelaye B. Fourteen-item perceived stress scale assessment using item response theory among pregnant women. Scand J Psychol 2024; 65:443-451. [PMID: 38123342 PMCID: PMC11088525 DOI: 10.1111/sjop.12993] [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: 04/19/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
The current study aimed to assess the psychometric properties of the Spanish language version of the 14-item Perceived Stress Scale (PSS-S) in a population of pregnant women who speak Spanish in Peru using item response theory (IRT). Our study consisted of 5,435 pregnant women who participated in the Pregnancy Outcomes Maternal and Infant Study (PrOMIS) cohort in Peru. Exploratory and confirmatory factor analyses were conducted to determine dimensionality of the scale in this population, and item response theory was conducted to determine the applicability of the PSS. The PSS consisted of a 2-factor questionnaire measuring perceived stress and coping capacity accounting for 77% of variability. The IRT analysis showed differences in item difficulty and discrimination. Item difficulty represents the level of the latent construct where 50% of respondents endorse a particular response, and item discrimination determines the rate of change of the probability of endorsing an item for differing ability levels. For the first factor, perceived stress, item 12 was the least difficult and item 2 was the most difficult. For the second factor, coping capacity, item 9 was the least difficult and item 6 was the most difficult. The Spanish version of the 14-item PSS can be a useful assessment tool for perceived stress, but more IRT should be done to delve further into the psychometric properties of the questionnaire to inform clinicians and policy makers more appropriately.
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Affiliation(s)
- Kedie Pintro
- Department of Epidemiology, Harvard T. H. Chan School of Public Health
| | - Sixto E. Sanchez
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Instituto de Investigacion, Lima, Peru
| | - Marta B. Rondon
- Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health
- The Chester M. Pierce, M.D. Division of Global Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Weiss SJ, Xu L. Postpartum symptoms of anxiety, depression and stress: differential relationships to women's cortisol profiles. Arch Womens Ment Health 2024; 27:435-445. [PMID: 38214755 PMCID: PMC11116185 DOI: 10.1007/s00737-024-01421-9] [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: 07/07/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE Women are at high risk of stress, anxiety, and depression during the postpartum but the ways in which these different types of psychological distress are related to cortisol regulation is not clear. We examined the distinct association of each type of distress with women's average cortisol level, cortisol awakening response (CAR), cortisol decline across the day (diurnal slope), and overall amount of cortisol secretion across the day (AUCG). METHODS At 6 months postpartum, a diverse group of 58 women completed measures of depression, anxiety, perceived stress, and life stressors. Each woman provided 4 salivary samples for cortisol assay from waking to bedtime on each of 2 consecutive days. Linear regressions were used to examine associations of stress, anxiety and depression to each of the 4 cortisol measures, controlling for number of stressful life events. RESULTS Depressive symptoms were associated with less of a rise in the CAR (β = -.46, p = 0.01), steeper diurnal slope (β = .51, p = 0.006), and higher average cortisol level (β = .42, p = .01). Women who met the clinical cutoff for an anxiety disorder had lower overall cortisol output (β = -.29, p = 0.03). Stress was not related to any cortisol metric. CONCLUSIONS Findings suggest that stress is less associated with cortisol alterations in the postpartum than are more severe types of psychological distress. Anxiety and depression may have distinct and opposite profiles of cortisol dysregulation. Results indicate that mental health assessment is critical even in the later postpartum so that interventions can be initiated to reduce emotional suffering and the risk of impaired cortisol regulation.
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Affiliation(s)
- Sandra J Weiss
- Department of Community Health Systems, University of California, San Francisco, CA, USA.
| | - Ling Xu
- Department of Community Health Systems, University of California, San Francisco, CA, USA
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11
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Hoteit R, Bou-Hamad I, Hijazi S, Ayna D, Romani M, El Morr C. A cross-sectional study of university students' mental health and lifestyle practices amidst the COVID-19 pandemic. PLoS One 2024; 19:e0302265. [PMID: 38626105 PMCID: PMC11020786 DOI: 10.1371/journal.pone.0302265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/31/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVES University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students' mental health, specifically depression, anxiety, and stress, during Lebanon's extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it. METHODS An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05. RESULTS Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the "poor" and "fair" overall-reported health groups having higher odds than the "Excellent" group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours. CONCLUSION Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.
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Affiliation(s)
- Reem Hoteit
- Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Imad Bou-Hamad
- Department of Business Information and Decision Systems, Suliman S. Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Sahar Hijazi
- Faculty of Social Sciences, Lebanese University, Saida, Lebanon
| | - Dinah Ayna
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Romani
- Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christo El Morr
- School of Health Policy and Management, York University, Toronto, Canada
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Volkos P, Kritsotakis EI, Symvoulakis EK. Psychotropic medicine use without current or prior medical advice, storage at home and association with perceived stress in a primary health care setting in Greece. Semergen 2024; 50:102150. [PMID: 38064767 DOI: 10.1016/j.semerg.2023.102150] [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: 07/31/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 04/01/2024]
Abstract
OBJECTIVE Psychotropic medicines use alters according to socio-economic factors and perceived stress. The study aimed to assess the prevalence of use of psychotropic medicines and supplements (PMS) without medical advice, including storage at home, and its relationship with socio-demographic characteristics and perceived stress in primary care patients. MATERIALS AND METHODS A cross-sectional sample of adult attendees in an urban primary care unit in Crete, Greece, were surveyed during regularly scheduled appointments during a three-week period in October 2020. A questionnaire was distributed to investigate PMS use during the last 12 months. The validated Greek version of Perceived Stress Scale (PSS-14) was adopted to measure perceived stress. RESULTS Of 263 respondents (mean age 46.3±14.5 years; 66.5% females), 101 (38.4%; 95%CI 33.1-43.7%) recalled having psychotropic medicines stored at home cabinets and 72 (27.4%; 95%CI 22.4-32.3%) reported using PMS without medical advice in the last 12 months. CONCLUSIONS This study revealed a high prevalence of PMS use without medical advice, including storage at home. People>59 years of age, experiencing irregular sleep and scoring high in PSS, displayed increased prevalence of storing PMS at home or using them without medical advice. The findings could potentially inform primary care providers to focus on patients most likely to be users of PMS without medical advice.
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Affiliation(s)
- P Volkos
- 4th Local Health Team-Academic Unit of Heraklion, Heraklion, Crete, Greece.
| | - E I Kritsotakis
- Division of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - E K Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
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13
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Rost K, Gossmann E, Fegert JM, Ziegenhain U, Köhler-Dauner F. Long-term consequences of childhood emotional abuse in mothers on parental load and child mental health. Acta Psychol (Amst) 2024; 244:104169. [PMID: 38341882 DOI: 10.1016/j.actpsy.2024.104169] [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: 08/02/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Childhood emotional maltreatment can be associated with long-term consequences on mental health. In addition, transgenerational transmission of adverse childhood experiences to the next generation can occur and thus have an impact on the mental health of one's own children. OBJECTIVE The purpose of this study was to examine the role of stress on the association between childhood emotional maltreatment and parental load what is referred to in this study as limitations in parental functioning that affect the resources available to parents to cope with the demands of raising, caring for, and providing for their child. Furthermore the effect of parental load on the mental health of one's own children will be examined. PARTICIPANTS AND SETTING N = 237 mother-child dyads (age mother M = 33.76, SD = 4.07 years; age child M = 11.91 months, SD = 0.89 months) from a longitudinal cohort study were examined at two different measuring points. METHODS Emotional abuse, perceived stress, parental load and child mental health were assessed using self and external report questionnaires. RESULTS The calculation of a mediation showed that the association of emotional abuse and parental load was completely mediated by perceived stress (indirect effect ab = 0.44, 95 %-CI[0.17, 0.78]). In addition, effects of parental load on the child's mental health (β = 0.13, 95%CI [0.07;0.20]), mainly hyperactivity (β = 0.06, 95%CI [0.03;0.11]) and prosocial behavior (β = -0.04, 95%CI [-0.07; -0.01]), were evident. CONCLUSIONS The results of this study provide evidence that the mental health of children can be influenced in the long term by increased parental load.
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Affiliation(s)
- Katharina Rost
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.
| | - Emily Gossmann
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
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14
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Toor IK, Rastogi K, Ajmani S. Integrating spiritual disposition intervention into behavioral medicine: A case report on systemic lupus erythematosus from India. Lupus 2024; 33:420-429. [PMID: 38166465 DOI: 10.1177/09612033231225895] [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: 01/04/2024]
Abstract
Background: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory systemic autoimmune disease. The disease manifests as the body's immune cells start attacking healthy connective tissue, which affects the skin, kidneys, blood vessels, brain, and other vital organs. As with any other chronic illness, the disease has psychological implications.Purpose: Literature suggests patients with SLE experience anxiety, depression, anger, and stress along with physiological symptoms. There is a strong association between the occurrence of stress and the onset of the disease. These psychological symptoms can be ameliorated through spiritual activities such as meditation, mindfulness, journaling, and reading.Mehtod: This case report is based on the importance of spirituality in the healthcare system. The study focuses on the concept of a whole-person-centered approach to the medical care industry. Spirituality has been proven to have a positive effect on health and illness. Hence, a 10-week intervention with 30 sessions focusing on spiritual dispositions was provided to the patient for this study, along with regular pharmacological treatment. The present case report is of a 56-year-old woman from New Delhi, India, who was diagnosed with SLE 2 years ago.Results: The results reveal the positive effect of the intervention, as it led to a significant decrease in stress levels and depressive symptoms; it also resulted in improved quality of life, an enhanced coping style, and bolstered health hardiness. There was an increase in the score of a spiritual personality.Conlcusion: Spiritual Disposition as an intervention was sucessfull in reducing psychological implications of the disease thus leading to overall positve growth in the patient.
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Affiliation(s)
- Ishanpreet Kaur Toor
- Department of Psychology, CHRIST (Deemed to be University) Delhi-NCR, Ghaziabad, India
| | - Kritika Rastogi
- Department of Psychology, CHRIST (Deemed to be University) Delhi-NCR, Ghaziabad, India
| | - Sajal Ajmani
- Rheumatology Department at BLK-Max Super Speciality Hospital, New Delhi, India
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15
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Varela P, Zervas I, Vivilaki V, Lykeridou A, Deltsidou A. Validity and reliability of the Greek version of Wijma delivery expectancy/experience questionnaire (Version A) among low-risk pregnant women. BMC Psychol 2024; 12:165. [PMID: 38504313 PMCID: PMC10953171 DOI: 10.1186/s40359-024-01662-4] [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: 10/23/2022] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Fear of childbirth is a frequent health issue for pregnant women. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is a widely used instrument to measure the fear of childbirth during the antenatal period. The aim of the study was to assess the psychometric properties of the W-DEQ (version A) in a sample of Greek pregnant women. METHODS Low-risk pregnant women in the second or third trimester of pregnancy (N = 201) were invited to participate in the study and to complete a booklet of questionnaires including the Greek versions of W-DEQ-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Exploratory (EFA) and confirmatory factor analysis (CFA) was performed. RESULTS The mean age of participants was 34.2 years (SD = 4.3 years). EFA yielded six factors ("Lack of self-efficacy", "Lack of positive anticipation", "Lack of feeling lonely", "Concerns about delivery and losing control", "Calmness", and "Concern for the child") of 33 items of W-DEQ-A. CFA confirmed the multidimensionality of the instrument. All Cronbach's alpha were over 0.7, indicating acceptable reliability of the factors. All factors were significantly correlated with each other, and convergent validity was demonstrated by a significant association with stress, anxiety, and depression among low-risk pregnant women. CONCLUSION The Greek version of W-DEQ-A proved to be a valid and reliable instrument of fear of childbirth among Greek low-risk pregnant women.
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Affiliation(s)
- Pinelopi Varela
- Department of Midwifery, University of West Attica, Athens, Greece.
| | - Ioannis Zervas
- National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, MD, Greece
| | | | | | - Anna Deltsidou
- Department of Midwifery, University of West Attica, Athens, Greece
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16
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Wang J, Wen Y, Zhou J, Zhao N, Zhu T. Identifying stress scores from gait biometrics captured using a camera: A cross-sectional study. Gait Posture 2024; 109:15-21. [PMID: 38241963 DOI: 10.1016/j.gaitpost.2024.01.013] [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: 04/08/2022] [Revised: 09/17/2023] [Accepted: 01/13/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Stress is a critical risk factor for various health issues, but an objective, non-intrusive and effective measurement approach for stress has not yet been established. Gait, the pattern of movements in human locomotion, has been proven to be a valid behavioral indicator for recognizing various mental states in a convenient manner. RESEARCH QUESTION This study aims to identify the severity of stress by assessing human gait recorded through an objective, non-intrusive measurement approach. METHODS One hundred and fifty-two participants with an average age of 23 years old (SD = 1.07) were recruited. The Chinese version of the Perceived Stress Scale with 10 items (PSS-10) was used to assess participants' stress levels. The participants were then required to walk naturally while being recorded with a regular camera. A total of 1320 time-domain and 1152 frequency-domain gait features were extracted from the videos. The top 40 contributing features, confirmed by dimensionality reduction, were input into models consisting of four machine-learning regression algorithms (i.e., Gaussian Process Regressor, Linear Regression, Random Forest Regressor, and Support Vector regression), to assess stress levels. RESULTS The models that combined time- and frequency-domain features performed best, with the lowest RMSE (4.972) and highest validation (r = 0.533). The Gaussian Process Regressor and Linear Regression outperformed the others. The greatest contribution to model performance was derived from gait features of the waist, hands, and legs. SIGNIFICANCE The severity of stress can be accurately detected by machine learning models using two-dimensional (2D) video-based gait data. The machine learning models used for assessing perceived stress were reliable. Waist, hand, and leg movements were found to be critical indicator in detecting stress.
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Affiliation(s)
- Jingying Wang
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA; Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yeye Wen
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing, China
| | - Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA
| | - Nan Zhao
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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17
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Symvoulakis EK, Stachteas P, Smyrnakis E, Volkos P, Mantadaki AE, Karelis A, Petraki C, Nioti K, Mastronikolis S, Antoniou AM, Linardakis M. Multiple Behavioral Risk Factors As Assets for Chronic Disease Prevention: Observations From Urban Primary Care Settings in Crete, Greece. Cureus 2024; 16:e56711. [PMID: 38646332 PMCID: PMC11032647 DOI: 10.7759/cureus.56711] [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] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
AIM This study aimed to assess the health profile of patient-attendees visiting primary healthcare (PHC) practice settings in the midst of the COVID-19 pandemic and to explore the relationships between multiple behavioral risk factors (MBRFs) and consultation-driven health information. Multiple behavioral risk factors involve a variety of unhealthy behaviors that are associated with an increased prevalence of non-communicable diseases (NCDs). SUBJECTS AND METHODS The study design was based on a dataset analysis, afterward exploring the feasibility and diagnostic capacity of respiratory morbidity aspects from a study previously conducted. The study dataset contained information regarding socio-demographic characteristics, health habits, clinical information, and reported comorbidities from 183 primary care patient-attendees. A categorical regression analysis was performed, using as a numeric variable the multiple MBRFs (clustering of 0 to four factors) in order to examine relationships with the basic and clinical characteristics of the patient-attendees. RESULTS Based on this secondary analysis, it was found that the prevalence of MBRFs is quite common among patient-attendees visiting urban PHC facilities. The prevalence of current smoking, sleep deprivation, increased body weight, and medium/high perceived stress levels were 33.9%, 52.5%, 83.1%, and 35.0%, respectively. An increased occurrence of MBRFs might be significantly predicted by the lower age of patient-attendees (b = -0.221, p = 0.05), by the absence of gray hair at an early age (b = -0.144, p = 0.042), by the physical discomfort during activities (b = 0.191, p = 0.017), or by the lower oxygen saturation (b = -0.184, p = 0.004). Diabetes mellitus (25.1%) was the most prevalent condition, followed by bronchial asthma (18.6%) and depression (15.8%). CONCLUSIONS Lower age, absence of premature hair whitening, physical discomfort during activities, and lower oxygen saturation are linked with an increased occurrence of MBRFs, leading to a neglected way of living. Those factors could be used to alert researchers, policymakers, and PHC professionals to act accordingly in order to prevent or early diagnose NCDs.
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Affiliation(s)
- Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Panagiotis Stachteas
- Laboratory of Primary Health Care, General Practice and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Panagiotis Volkos
- Fourth Local Health Team, Academic Unit of Heraklion, Heraklion, GRC
| | - Aikaterini E Mantadaki
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Andreas Karelis
- Department of Family Medicine, Private Primary Care Facilities, Heraklion, GRC
| | - Chrysi Petraki
- Department of Family Medicine, Private Primary Care Facilities, Heraklion, GRC
| | - Kadiani Nioti
- Department of Family Medicine, Private Primary Care Facilities, Heraklion, GRC
| | | | - Aikaterini M Antoniou
- Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, GRC
| | - Manolis Linardakis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Heraklion, GRC
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Booker LA, Spong J, Hodge B, Deacon-Crouch M, Bish M, Mills J, Skinner TC. Differences in shift and work-related patterns between metropolitan and regional/rural healthcare shift workers and the occupational health and safety risks. Aust J Rural Health 2024; 32:141-151. [PMID: 38063243 DOI: 10.1111/ajr.13075] [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: 04/30/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES To explore if there are differences in shift patterns and work-related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents. DESIGN A cross-sectional study. SETTING An anonymous online survey of healthcare shift workers in Australia. PARTICIPANTS A total of 403 nurses, midwives and paramedics completed the survey. MAIN OUTCOME MEASURES Sample characteristics, employment location, shift work-related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift. RESULTS Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on-call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on-call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression. CONCLUSION Differences in work-related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Brad Hodge
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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Yavropoulou MP, Filippa MG, Vlachogiannis NI, Fragoulis GE, Laskari K, Mantzou A, Panopoulos S, Fanouriakis A, Bournia VK, Evangelatos G, Papapanagiotou A, Tektonidou MG, Chrousos GP, Sfikakis PP. Diurnal production of cortisol and prediction of treatment response in rheumatoid arthritis: a 6-month, real-life prospective cohort study. RMD Open 2024; 10:e003575. [PMID: 38233075 PMCID: PMC10806498 DOI: 10.1136/rmdopen-2023-003575] [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: 08/03/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES A reduced adrenal reserve-associated cortisol production relative to the enhanced needs of chronic inflammation (disproportion principle) has been observed in rheumatoid arthritis (RA). We examined the possible clinical value of diurnal cortisol measurements in active RA on treatment response prediction. METHODS Diurnal cortisol production (measured at: 08-12:00/18:00-22:00) was assessed by electrochemiluminescence immunoassay in 28 consecutive patients with moderately/highly active RA, as well as 3 and 6 months after treatment initiation or/escalation. Twenty-eight COVID-19 patients and 28 age-matched healthy individuals (HC) served as controls. RESULTS Saliva diurnal cortisol production in patients with RA was similar to that of HC, despite 12-fold higher serum C reactive protein (CRP) levels, and lower than COVID-19 patients (area under the curve: RA: 87.0±37.6 vs COVID-19: 146.7±14.3, p<0.001), having similarly high CRP. Moreover, a disturbed circadian cortisol rhythm at baseline was evident in 15 of 28 of patients with RA vs 4 of 28 and 20 of 28 of HC and COVID-19 patients, respectively. Treatment-induced minimal disease activity (MDA) at 6 months was achieved by 16 of 28 patients. Despite comparable demographics and clinical characteristics at baseline, non-MDA patients had lower baseline morning cortisol and higher adrenocorticotropic hormone (ACTH) levels compared with patients on MDA (cortisol: 10.9±4.0 vs 18.4±8.2 nmol/L, respectively, p=0.005 and ACTH: 4.8±3.3 vs 2.4±0.4 pmol/L, respectively, p=0.047). Baseline morning cortisol <13.9 nmol/L predicted non-MDA at 6 months (75% sensitivity, 92% specificity, p=0.006). Prospective measurements revealed that individualised diurnal cortisol production remained largely unchanged from baseline to 3 and 6 months. CONCLUSIONS An impaired adrenal reserve is present in patients with RA. Further studies to confirm that assessment of diurnal cortisol production may be useful in guiding treatment decisions and/or predicting treatment response in RA are warranted. TRIAL REGISTRATION NUMBER NCT05671627.
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Affiliation(s)
- Maria P Yavropoulou
- First Department of Propaedeutic and Internal Medicine, Endocrinology Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria G Filippa
- First Department of Propaedeutic and Internal Medicine, Endocrinology Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos I Vlachogiannis
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - George E Fragoulis
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
- Institute of Infection, Immunity and Inflammation, University of Glasgow School of Medicine, Glasgow, UK
| | - Katerina Laskari
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - Aimilia Mantzou
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stylianos Panopoulos
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Fanouriakis
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki-Kalliopi Bournia
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Evangelatos
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - Aggeliki Papapanagiotou
- Department of Biological Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria G Tektonidou
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic and Internal Medicine and Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Athens, Greece
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20
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Njoroge WFM, Tieu T, Eckardt D, Himes M, Alexandre C, Hall W, Wisniewski K, Popoola A, Holloway K, Rodriguez Y, Kornfield S, Momplaisir F, Wang X, Gur R, Waller R. The impact of the pandemic on mothers and children, with a focus on syndemic effects on black families: the "Prenatal to Preschool" study protocol. Front Psychiatry 2024; 14:1281666. [PMID: 38260788 PMCID: PMC10801187 DOI: 10.3389/fpsyt.2023.1281666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Racism, a known social determinant of health, affects the mental health and well-being of pregnant and postpartum women and their children. Convincing evidence highlights the urgent need to better identify the mechanisms and the ways in which young children's development and mental health are adversely impacted by their mothers' experiences of racism. With the additional stressor of the COVID-19 pandemic, the criticality of improving knowledge of these domains has never been starker. The proposed project will address these questions and move the field forward to create targeted, culturally informed preventative interventions, thus achieving mental health equity for all children and families. Methods This prospective research is a cohort study that will longitudinally observe the outcomes of a cohort of mothers and their children recruited during the initial phase of the COVID-19 pandemic. Data will be parent/caregiver questionnaires assessing mental health, racism, support, and resilience at multiple time points with the first beginning at 24 months, clinical interviews with mothers, electronic medical records of mothers, and videotaped dyadic interactions at child age 24 and 48 months. A subset of Black participants will be asked to participate in qualitative interviews at child age 36 months. Results Analyze will be performed within and across Black and Non-Latino/a/e/x white (NLW) groups, and comparing mothers and fathers/secondary caregivers. Descriptive and multivariate analyzes will be run to better characterize how young children's development and mental health may be adversely impacted by their caregiver's experiences of racism. Discussion This prospective longitudinal mixed-methods study evaluates the simultaneous effects of the COVID-19 pandemic and racism on mothers and their developing children to characterize cross-racial differences, providing insight into risk and resilience factors in early development and the peripartum period.
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Affiliation(s)
- Wanjikũ F. M. Njoroge
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Tiffany Tieu
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Devlin Eckardt
- Clinical Research Support Office, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Megan Himes
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Christina Alexandre
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Waynitra Hall
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kate Wisniewski
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Ayomide Popoola
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kayla Holloway
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, United States
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
| | - Sara Kornfield
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Penn Center for Women’s Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Florence Momplaisir
- Perelman School of Medicine, Division of Infectious Diseases, University of Pennsylvania, Philadelphia, PA, United States
| | - Xi Wang
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Raquel Gur
- Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rebecca Waller
- Lifespan Brain Institute (LiBI), Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, United States
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21
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Messineo L, Tosto C. Evaluation of the psychometric properties of the Italian version of the 10-item perceived stress scale in a sample of teachers. Front Psychol 2024; 14:1330789. [PMID: 38259559 PMCID: PMC10801019 DOI: 10.3389/fpsyg.2023.1330789] [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: 11/10/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
Background The 10-item Perceived Stress Scale is a widely used questionnaire for measuring perceived stress. Aim This study aimed to assess the psychometric properties of the Italian version of the 10-item Perceived Stress Scale in a sample of Italian teachers during the COVID-19 pandemic. Methods A cross-sectional study was performed. A sample of 1,179 teachers of pre-primary, primary, and secondary schools anonymously completed an online questionnaire. A Confirmatory Factor Analysis was performed to compare the fit of a two-factor model against a one-factor solution of the scale. Multigroup CFA was run to test the measurement invariance of the two-factor PSS-10 solution across gender. The internal reliability of the scale was evaluated using Cronbach's alpha and McDonald' omega coefficients. Convergent validity with measures of subjective well-being and self-reported health was evaluated. Results The results of the Confirmatory Factor Analysis showed that the two-factor structure of the 10-items Perceived Stress Scale provided a better fit to the data and supported the adequacy of the Italian version of the scale. The two-factor model showed measurement invariance across female and male groups, as result of the multigroup CFA. The scale proved to have good internal reliability. Correlation analyses with measures of the Positive Affect and Negative Affect Schedule and self-reported health supported convergent validity. Conclusion These results suggest that the Italian version of the 10-item Perceived Stress Scale has good psychometric properties and can be considered a valid and reliable instrument to assess perceived stress.
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Affiliation(s)
- Linda Messineo
- Istituto per le Tecnologie Didattiche, Consiglio Nazionale delle Ricerche, Palermo, Italy
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22
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Vage A, Spence AD, Gormley GJ, McKeown G, Murphy P, Hamilton PK. Untapped resource: the simulation-based healthcare environment as a means to study human stress. THE ULSTER MEDICAL JOURNAL 2024; 92:157-166. [PMID: 38292502 PMCID: PMC10824135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
The effects of 'stress' within the healthcare professions are wide-reaching, not least of all within the field of simulation-based healthcare education. Whilst this popular method of experiential learning offers a 'safe space' for participants to develop their skillset, it also has a more surreptitious action; namely, the incubation of simulation-related stress. Currently, research concerning the complex relationship between stress, learning, and performance is ambiguous, leaving fertile ground for simulationists to debate what level of stress is appropriate for an optimised educational experience. In this narrative review, we examine the human response to stress and outline the various methods that have been used by researchers to measure stress in a quantifiable and standardised way. We then provide a brief overview of simulation-based healthcare education before describing why stress responses have been of interest to healthcare educationalists for some time. Finally, we outline how simulation education environments might provide an ideal environment for studying the human response to stress generally, with ramifications extending beyond the field of medical education.
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Affiliation(s)
- Aaron Vage
- Centre for Medical Education, Queen’s University Belfast, Whitla Medical Building, Lisburn Road, Belfast, BT9 7BL
| | - Andrew D Spence
- Centre for Medical Education, Queen’s University Belfast, Whitla Medical Building, Lisburn Road, Belfast, BT9 7BL
| | - Gerard J Gormley
- Centre for Medical Education, Queen’s University Belfast, Whitla Medical Building, Lisburn Road, Belfast, BT9 7BL
| | - Gary McKeown
- School of Psychology, Queen’s University Belfast, David Keir Building, Malone Road, Belfast, BT9 5BN
| | - Paul Murphy
- School of Arts, English and Languages, Queen’s University Belfast, University Square, Belfast, BT7 1NN
| | - Paul K Hamilton
- Centre for Medical Education, Queen’s University Belfast, Whitla Medical Building, Lisburn Road, Belfast, BT9 7BL
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El Morr C, Jammal M, Bou-Hamad I, Hijazi S, Ayna D, Romani M, Hoteit R. Predictive Machine Learning Models for Assessing Lebanese University Students' Depression, Anxiety, and Stress During COVID-19. J Prim Care Community Health 2024; 15:21501319241235588. [PMID: 38546161 PMCID: PMC10981228 DOI: 10.1177/21501319241235588] [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: 12/26/2023] [Revised: 01/28/2024] [Accepted: 02/10/2024] [Indexed: 04/01/2024] Open
Abstract
University students are experiencing a mental health crisis. COVID-19 has exacerbated this situation. We have surveyed students in 2 universities in Lebanon to gauge their mental health challenges. We have constructed a machine learning (ML) approach to predict symptoms of depression, anxiety, and stress based on demographics and self-rated health measures. Our approach involved developing 8 ML predictive models, including Logistic Regression (LR), multi-layer perceptron (MLP) neural network, support vector machine (SVM), random forest (RF) and XGBoost, AdaBoost, Naïve Bayes (NB), and K-Nearest neighbors (KNN). Following their construction, we compared their respective performances. Our evaluation shows that RF (AUC = 78.27%), NB (AUC = 76.37%), and AdaBoost (AUC = 72.96%) have provided the highest-performing AUC scores for depression, anxiety, and stress, respectively. Self-rated health is found to be the top feature in predicting depression, while age was the top feature in predicting anxiety and stress, followed by self-rated health. Future work will focus on using data augmentation approaches and extending to multi-class anxiety predictions.
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Affiliation(s)
| | | | | | | | - Dinah Ayna
- American University of Beirut, Beirut, Lebanon
| | - Maya Romani
- American University of Beirut, Beirut, Lebanon
| | - Reem Hoteit
- American University of Beirut, Beirut, Lebanon
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24
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Pavlidou E, Papadopoulou SK, Antasouras G, Vorvolakos T, Alexatou O, Tsourouflis G, Angelakou EP, Serdari A, Grammatikopoulou MG, Psara E, Vadikolias K, Dakanalis A, Lefantzis N, Giaginis C. Association of COVID-19 Infection with Sociodemographic, Anthropometric and Lifestyle Factors: A Cross-Sectional Study in an Older Adults' Population Aged over 65 Years Old. Diseases 2023; 11:165. [PMID: 37987276 PMCID: PMC10660554 DOI: 10.3390/diseases11040165] [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: 10/20/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to unfavorable disruptions to daily living routines by exerting deleterious effects on several aspects of human mental and physical health and quality of life worldwide. The purpose of the current survey is to explore the potential association of COVID-19 infection with multiple sociodemographic, anthropometric, and lifestyle factors of community-dwelling older adults. METHODS This is a cross-sectional survey including 5197 older adults aged over 65 years old from 10 geographically diverse regions of Greece. Relevant questionnaires were used to record study the population sociodemographic factor, while anthropometric parameters were also measured. Validated questionnaires were also applied to assess several lifestyle factors such as depression, anxiety, stress, cognitive status, sleep quality, health-related quality of life, physical activity levels, and Mediterranean diet (MD) adherence. RESULTS In multivariate regression analysis, COVID-19 infection was significantly, independently related with urban residence (p = 0.0107), regular smoking (p = 0.0218), overweight status and obesity (p = 0.0036), as well as abdominal obesity (p = 0.0008), higher risk of depression (p = 0.0027), anxiety (p = 0.0045), stress (p = 0.0038), inadequate sleep quality (p = 0.0108), lower physical activity levels (p = 0.0012), reduced MD compliance (p = 0.0009), and poor health-related quality of life (p = 0.0002). In univariate analysis, older adults' age (p = 0.0001), male gender (p = 0.0015), living alone (p = 0.0023), lower educational and economic level (p = 0.0175 and p = 0.0294, respectively), and cognition decline (p = 0.0032) were also related with the presence of COVID-19 infection; however, these associations were considerably attenuated at a non-significant level by adjustment for several confounders in multivariate analysis. CONCLUSIONS This is one of the few available studies supporting evidence that COVID-19 infection may be associated with diverse sociodemographic, anthropometric, and lifestyle factors in an older adults' population in Greece. This study highlights the strong demand to provide psychological and nutritional counselling and support to older adults diagnosed with COVID-19 infection in order to ameliorate disease symptoms and severity, emphasizing the adaptation of healthy dietary and lifestyle habits as preventing and supplementary therapeutic factors against COVID-19.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandoupoli, Greece;
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupoli, Greece;
| | - Maria G. Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupoli, Greece;
| | - Antonios Dakanalis
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Nikolaos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, Chaidari, 12462 Athens, Greece;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
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Alonso Lloret F, Gil Domínguez S, Fontecha Merino VM, Rodríguez Ferreiro C, Mendoza Soto A. Perioperative stress and anxiety in parents of children operated on for congenital heart disease. ENFERMERIA INTENSIVA 2023; 34:205-217. [PMID: 37775435 DOI: 10.1016/j.enfie.2023.07.001] [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: 05/26/2022] [Accepted: 03/24/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION Levels of stress and anxiety suffered by parents of children with congenital heart disease (PCUCS) during their children's admission for cardiac surgery may be higher than those suffered by other parents who go through the same experience. OBJECTIVE General objective of this study was to measure the stress and anxiety suffered by PCUCS and parents of children undergoing renal surgery (PCURS) in relation to the intervention of their children. The specific objective of the quantitative study was to compare global stress and anxiety according to sex, time of the perioperative period, and cohort. The general objective of the qualitative section is to explore the experience that PCUCS and PCURS have during their hospital stay and to identify the specific factors that influence the genesis of stress and anxiety. METHOD A cohort study was carried out in which PCURS and PCUCS were included. The quantitative part was performed by comparing the scores of three questionnaires that measure stress levels (PSS-14), state anxiety (STAIE) and trait anxiety (STAIR) throughout three perioperative moments. At the same time, a qualitative study was carried out with semi-structured interviews and collection of diaries on which a descriptive phenomenological analysis was carried out, according to Munhall. The analysis of the text was carried out according to Colaizzi. RESULTS Stress and anxiety levels were significantly higher in PCUCS compared to PCURS. Mothers in the cardiac cohort were those with the highest scores on all scales. In the qualitative study, four themes emerged: "stress and anxiety from the moment of diagnosis", "surgical intervention as a critical moment", "harshness of the postoperative period in the Intensive Care Unit" and "joy and gratitude versus dependence and fear for the future". CONCLUSIONS PCUCS suffer higher levels of stress and anxiety than PCURS, being the mothers of the cardiac cohort those who suffer these disorders with greater intensity. This study can constitute a starting point to develop strategies that cover these parental needs.
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Affiliation(s)
- F Alonso Lloret
- Unidad de Cuidados Intensivos Pediátricos - Reanimación pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - S Gil Domínguez
- Unidad de Cuidados Intensivos Pediátricos - Reanimación pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - V M Fontecha Merino
- Unidad de Cuidados Intensivos Pediátricos - Reanimación pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Rodríguez Ferreiro
- Unidad de Soporte Científico, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Mendoza Soto
- Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Sanitaria 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
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Jiang C, Ma H, Luo Y, Fong DYT, Umucu E, Zheng H, Zhang Q, Liu X, Liu X, Spruyt K, Meng R. Validation of the Chinese version of the Perceived Stress Scale-10 integrating exploratory graph analysis and confirmatory factor analysis. Gen Hosp Psychiatry 2023; 84:194-202. [PMID: 37572467 DOI: 10.1016/j.genhosppsych.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/02/2023] [Accepted: 07/28/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE The study aimed to initially assess the measurement properties of the 10-item simplified Chinese version of the Perceived Stress Scale (PSS-C-10) and as a first, assess a longitudinal measurement invariance (LMI). METHODS A longitudinal survey was conducted with a convenient sample of healthcare students using the PSS-C-10. We assessed the PSS-C-10 mainly using composite analytical approaches, including exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) to suggest the best-fit factor structure and assess measurement invariance. RESULTS The EGA identified a two-factor structural solution with an accuracy of 98.6% at baseline and 100% at a 7-day follow-up. The CFA subsequently confirmed this structure, with a comparative fit index of 0.963 at baseline and 0.987 at follow-up, Tucker-Lewis index of 0.951 at baseline and 0.982 at follow-up, and root mean square error of approximation of 0.111 at baseline and 0.089 at follow-up. The LMI was supported by the goodness-of-fit indices, and their changes fell within the recommended cut-off range. Additionally, Cronbach's alpha (0.885 at baseline and 0.904 at follow-up), McDonald's omega (0.885 at baseline and 0.902 at follow-up), and an ICC value of 0.816 for 7 days demonstrated the robust reliability of the PSS-C-10. CONCLUSION The PSS-C-10 exhibited a stable two-factor structure with promising LMI and measurement properties.
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Affiliation(s)
- Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China; Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou 311121, Zhejiang, China.
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo 315100, Zhejiang, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Emre Umucu
- College of Health Sciences, University of Texas at El Paso, El Paso, Texas TX 79968, USA
| | - Huiqiu Zheng
- Department of Child and Adolescent Health and Health Education, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China
| | - Qiran Zhang
- School of Medicine, Xiangyang Polytechnic, Xiangyang 441021, Hubei, China
| | - Xiao Liu
- School of Medicine, Xiangyang Polytechnic, Xiangyang 441021, Hubei, China
| | - Xiaoxue Liu
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Karen Spruyt
- Université de Paris, NeuroDiderot, INSERM, Paris 75019, France
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China; Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou 311121, Zhejiang, China.
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Badacho AS, Mahomed OH. Prevalence of hypertension and diabetes and associated risk factors among people living with human immunodeficiency virus in Southern Ethiopia. Front Cardiovasc Med 2023; 10:1173440. [PMID: 37680566 PMCID: PMC10482101 DOI: 10.3389/fcvm.2023.1173440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023] Open
Abstract
Background Access to antiretroviral therapy (ART) allows people living with HIV (PLWH) to live longer. Consequently, non communicable diseases (NCD) have emerged as the main drivers of ill health, disability, and premature death. This study assessed the magnitude of hypertension and diabetes and risk factors among PLWH receiving ART in Ethiopia. Methods A cross-sectional study was conducted using an analytical component. Data were collected through face-to-face interviews, physical measurements, and chart reviews of the 520 adults. Associations between the demographic and clinical attributes of hypertension and diabetes were assessed using logistic regression models. Results Prevalence of hypertension was (18.5%) (95% CI: 15.2%-21.7%), and diabetes was (6.9%) (95% CI: 4.8%-9.2%). More than two-thirds (70.8%) and 61% were newly diagnosed with hypertension and diabetes, respectively. Age > = 45 years [adjusted odds ratio (AOR) = 2.47], alcohol consumption (AOR = 4.51), Insufficient physical activity (AOR = 3.7), BMI ≥25 (AOR = 3.95), family history of hypertension (AOR = 7.1), and diabetes (AOR = 4.95) were associated with hypertension. Age ≥45 years [adjusted odds ratio (AOR) = 2.47], BMI ≥25 (AOR = 1.91), Central obesity (AOR = 3.27), detectable viral load (AOR = 4.2), hypertension (AOR = 4.95) and duration of ART >10 years (AOR = 3.12) were associated with diabetes. Conclusions A combination of modifiable and nonmodifiable factors increased the risk of hypertension and diabetes. Primary prevention strategies, regular screening for hypertension and diabetes and integration with HIV care in primary health care are the recommended intervention measures.
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Affiliation(s)
- Abebe Sorsa Badacho
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- School of Nursing and Public Health, Public Health Medicine Discipline, University of KwaZulu-Natal, Durban, South Africa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Ozayr Haroon Mahomed
- School of Nursing and Public Health, Public Health Medicine Discipline, University of KwaZulu-Natal, Durban, South Africa
- Dasman Diabetes Institute, Kuwait City, Kuwait
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Melnyk BM, Hsieh AP, Tan A, McAuley JW, Matheus M, Larson B, Dopp AL. The State of Health, Burnout, Healthy Behaviors, Workplace Wellness Support, and Concerns of Medication Errors in Pharmacists During the COVID-19 Pandemic. J Occup Environ Med 2023; 65:699-705. [PMID: 37217830 PMCID: PMC10417224 DOI: 10.1097/jom.0000000000002889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES The aims of the study were to describe the well-being and lifestyle behaviors of health-system pharmacists during the COVID-19 pandemic and to determine the relationships among well-being, perceptions of workplace wellness support, and self-reported concern of having made a medication error. METHODS Pharmacist ( N = 10,445) were randomly sampled for a health and well-being survey. Multiple logistic regression assessed associations with wellness support and concerns of medication error. RESULTS The response rate was 6.4% ( N = 665). Pharmacists whose workplaces very much supported wellness were 3× more likely to have no depression, anxiety, and stress; 10× more likely to have no burnout; and 15× more likely to have a higher professional quality of life. Those with burnout had double the concern of having made a medication error in the last 3 months. CONCLUSIONS Healthcare leadership must fix system issues that cause burnout and actualize wellness cultures to improve pharmacist well-being.
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Mourouti N, Michou M, Lionis C, Kalagia P, Ioannidis AG, Kaloidas M, Costarelli V. An educational intervention to improve health and nutrition literacy in hypertensive patients in Greece. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:234. [PMID: 37727406 PMCID: PMC10506746 DOI: 10.4103/jehp.jehp_14_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/19/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Suboptimal control of blood pressure (BP) is a public health challenge in Greece. This educational intervention attempts to improve health literacy (HL) and nutrition literacy (NL) in primary healthcare (PHC) patients with hypertension (HTN). MATERIALS AND METHODS This was a proof-of-concept (PoC) educational intervention. Twenty-four patients with HTN and low or medium levels of HL agreed to participate in this 6-week educational intervention. The program was delivered by a general practitioner (GP) in group A and by a qualified nurse in group B. Group C was the control group. The levels of HL of NL, adherence to the Mediterranean diet, and perceived stress were assessed using the European Health Literacy Survey Questionnaire 16 (HLS_EU_Q16) and part B (reading a medication label) of the High Blood Pressure-Health Literacy Scale (HBP-HLS), the Nutrition Literacy Scale-Greek (NLS-Gr), the Mediterranean Diet Adherence Screener (MEDAS), and the Perceived Stress Scale (PSS-14), respectively, together with certain socioeconomic, dietary, and lifestyle characteristics. The Kruskal-Wallis and Wilcoxon nonparametric, the Chi-square, and the McNemar-Bowker tests were used. The analysis was done with the STATA software, version 14 (MP & Associates, Sparta, Greece). RESULTS No statistically significant differences were found in the total score of HL and NL before and after the intervention; however, the results indicate a slight improvement in HL and NL levels in the two intervention groups, together with small improvements in knowledge and behaviors related to HTN and dietary salt. A trend of improvement in the MEDAS levels in the GP's group and the HBP-HLS levels in the nurse's group was also reported. CONCLUSION A slight improvement in HL and NL levels in the two intervention groups has been reported, and the changes, however, were not statistically significant.
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Affiliation(s)
- Niki Mourouti
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, Athens, Greece
| | - Maria Michou
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion 71003, Crete, Greece
| | | | | | | | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, Athens, Greece
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Bou-Hamad I, Hoteit R, Hijazi S, Ayna D, Romani M, El Morr C. Coping with the COVID-19 pandemic: A cross-sectional study to investigate how mental health, lifestyle, and socio-demographic factors shape students' quality of life. PLoS One 2023; 18:e0288358. [PMID: 37471388 PMCID: PMC10358926 DOI: 10.1371/journal.pone.0288358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE The high prevalence of COVID-19 has had an impact on the Quality of Life (QOL) of people across the world, particularly students. The purpose of this study was to investigate the social, lifestyle, and mental health aspects that are associated with QOL among university students in Lebanon. METHODS A cross-sectional study design was implemented using a convenience sampling approach. Data collection took place between November 2021 and February 2022, involving 329 undergraduate and graduate students from private and public universities. Quality of life was assessed using the Quality-of-Life Scale (QOLS). Descriptive statistics, Cronbach's alpha, and linear regression-based methods were used to analyze the association between QOL and socio-demographic, health-related, lifestyle, and mental health factors. The significance level for statistical analysis was predetermined at α = 0.05. RESULTS The study participants' average (SD) QOL score was 76.03 (15.6) with a Cronbach alpha of 0.911. QOL was positively associated with importance of religion in daily decisions (β = 6.40, p = 0.006), household income (β = 5.25, p = 0.017), general health ratings (β Excellent/poor = 23.52, p <0.001), access to private counseling (β = 4.05, p = 0.020), physical exercise (β = 6.67, p <0.001), and a healthy diet (β = 4.62, p = 0.026); and negatively associated with cigarette smoking (β increased = -6.25, p = 0.030), internet use (β ≥4 hours = -7.01, p = 0.005), depression (β = -0.56, p = 0.002) and stress (β = -0.93, p <0.001). CONCLUSION In conclusion, this study reveals the key factors that positively and negatively influence students' quality of life (QOL). Factors such as religion, higher income, and a healthy diet improve QOL, while depression, stress, excessive internet use, and cigarette smoking negatively impact it. Universities should prioritize initiatives like physical activity promotion, affordable nutritious options, destigmatizing mental health, counseling services, and self-help interventions to support student well-being and enhance their QOL.
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Affiliation(s)
- Imad Bou-Hamad
- Department of Business Information and Decision Systems, Suliman S. Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Reem Hoteit
- Department of Internal Medicine, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Sahar Hijazi
- Faculty of Social Sciences, Lebanese University, Saida, Lebanon
| | - Dinah Ayna
- Faculty of Medicine, Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Romani
- Faculty of Medicine, Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christo El Morr
- School of Health Policy and Management, York University, Toronto, Canada
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Zwönitzer A, Rost K, Fegert JM, Ziegenhain U, Köhler-Dauner F. Emotional problems in young children during the SARS-CoV-2-pandemic and child attachment. Front Pediatr 2023; 11:1191032. [PMID: 37534198 PMCID: PMC10392938 DOI: 10.3389/fped.2023.1191032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023] Open
Abstract
Background Restrictions imposed by national governments during SARS-CoV-2-pandemic have impacted the mental health of children around the world. Studies have already proven the importance of secure attachment acting as a protective factor in child development. Therefore, children with secure attachment have a higher chance of developing and using appropriate coping mechanisms. Objective The goal of this study was to explore the possible connection between the pandemic, as well as child attachment, and young children's emotional health. The general hypothesis assumes a lower rate of emotional problems among children with secure attachment and a higher rate of emotional problems among children with insecure-disorganized attachment, as well as an increase of these problems during the pandemic. Method The analysis included N = 129 mothers (M = 39.98 years) and their children (M = 5.19 years). Via an online survey, which was held at different time points during the pandemic, information on the children's emotional problems was retrieved. The survey used the Strengths and Difficulties Questionnaire (SDQ). Data regarding the quality of attachment was collected via the Strange Situations Test (SST). At this point the participating children were approximately 12 months old. Results The calculation of a mixed ANCOVA showed, that attachment quality had a significant influence on children's emotional problems [F(2, 121) = 4.01, p = .021]. The interaction effect between time and child attachment reached significance [F(3.45, 208.42) = 3.58, p = .011]. The calculation of an additional mixed ANCOVA showed, that the reported emotional problems of girls were higher than those of boys F(1, 118) = 4.56, p = .035). Conclusions Our study shows that there is an association between attachment security and emotional problems and the impact of the SARS-CoV-2 pandemic on the mental health of preschool children in Germany. The emotional problems of all children increased, especially the disorganized attached children had been reported as emotionally stressed in the first lockdown. The results indicate the need for preventive services (for children and parents) to promote and maintain stress coping skills in order to maintain children's mental health in times of crisis.
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Eichenauer H, Huss M, Brander M, Bernauer T, Ehlert U. Effects of improved on-farm crop storage on perceived stress and perceived coping in pregnant women-Evidence from a cluster-randomized controlled trial in Kenya. PLoS One 2023; 18:e0288446. [PMID: 37440562 DOI: 10.1371/journal.pone.0288446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Food insecurity can be harmful to pregnant women, as pregnancy is a challenging period with increased maternal nutritional requirements to ensure optimal fetal development and health of the mother. Whether food insecurity negatively affects maternal health may depend on how stressful pregnant women perceive this food insecurity to be and how strongly they believe they can cope with it. In Sub-Saharan Africa (SSA), pregnant women from smallholder households suffer from food insecurity due to post-harvest losses (PHL), i.e., loss of crops because of inadequate storage. An agricultural intervention that improves crop storage has been shown to reduce food insecurity. However, it remains to be determined whether this agricultural intervention (treatment) has an additional positive effect on pregnant women's perceived stress levels and coping abilities. This study examines whether pregnant women from treatment households experience lower perceived stress levels and higher perceived coping abilities compared to pregnant women from control housholds. METHODS AND FINDINGS In a randomized controlled trial (RCT), short message service (SMS)-based mobile phone surveys were conducted to assess the causal effect of a food security intervention (improved on-farm storage of maize) on perceived stress and coping in pregnant women from smallholder households. Pregnant women were identified through these monthly surveys by asking whether someone in their household was currently pregnant. The significant results revealed that pregnant women from treatment households experienced more perceived stress but better perceived coping abilities compared to pregnant women from control households. Uncertainty due to lack of experience, this might have contributed to the higher perceived stress, as the women could not easily judge the benefits and risks of the new storage technology. However, the technology itself is a tangible resource which might have empowered the pregnant women to counteract the effects of PHL and thus food insecurity. CONCLUSION Our findings indicate that pregnant women from treatment households had higher perceived coping abilities but experienced more perceived stress. More research is needed on how this technology impacts maternal mental health in a broader sense and whether biological mechanisms, such as epigenetics, may underlie this association.
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Affiliation(s)
- Heike Eichenauer
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Matthias Huss
- Institute of Science, Technology and Policy (ISTP), ETH Zurich, Zurich, Switzerland
- Zurich Knowledge Center for Sustainable Development & Informatics and Sustainability Research Group, University of Zurich, Zurich, Switzerland
| | - Michael Brander
- Institute of Science, Technology and Policy (ISTP), ETH Zurich, Zurich, Switzerland
- Zurich Knowledge Center for Sustainable Development & Informatics and Sustainability Research Group, University of Zurich, Zurich, Switzerland
| | - Thomas Bernauer
- Institute of Science, Technology and Policy (ISTP), ETH Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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Symvoulakis E, Vasarmidi E, Linardakis M, Tsiavos A, Mantadaki A, Pitsidianakis G, Karelis A, Petraki C, Nioti K, Mastronikolis S, Tzanakis N, Eraclion Crete AK. Assessing feasibility of targeted primary care referrals for patients with clinical suspicion of interstitial lung disease using lung ultrasound: a prospective case finding study. The potential benefits of LUS utilization. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2023; 40:e2023022. [PMID: 37382071 PMCID: PMC10494744 DOI: 10.36141/svdld.v40i2.14017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND In Primary Health Care (PHC) many interstitial lung disease (ILD) cases may remain at diagnostic delay, due to their challenging presentation and the limited experience of general practitioners (GPs) in recognizing their early symptoms. OBJECTIVE We have designed a feasibility study to investigate early ILD case-finding competency between PHC and tertiary care. METHODS A cross-sectional prospective case-finding study was launched at two private health care centers of Heraklion, Crete, Greece, during nine months (2021-2022). After clinical assessment by GP, PHC attenders, who agreed to participate in the study, were referred to the Respiratory Medicine Department, University Hospital of Heraklion, Crete, underwent Lung Ultrasound (LUS) and those with an overall suspicion for ILDs underwent high resolution computed tomography (HRCT) scan. Descriptive statistics and chi-square tests were used. Multiple Poisson regression analysis was performed to explain positive LUS and HRCT decision with selected variables. RESULTS One hundred and nine patients out of 183 were finally included (54.1% females; mean age 61, SD: 8.3 years). Thirty-five (32.1%) were current smokers. Overall, two out of ten cases were assessed to need HRCT due to a moderate or high suspicion (19.3%; 95%CI 12.7, 27.4). However, in those who had dyspnea in relation to counterparts, a significantly higher percentage of patients with LUS findings (57.9% vs. 34.0%, p=0.013) was found, as in those who had crackles (100.0% vs. 44.2%, p= 0.005). Detected possible ILD provisional labelling cases were 6, and most importantly, 5 of those cases were considered highly suspicious for further evaluation based on LUS findings. CONCLUSIONS This is a feasibility study exploring potentials by combining data of medical history, basic auscultation skills, as crackles detection, and inexpensive and radiation-free imaging technique, such as LUS. Cases of ILD labeling may be hidden within PHC, sometimes, much before any clinical manifestation.
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Affiliation(s)
- Emmanouil Symvoulakis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Greece .
| | - Eirini Vasarmidi
- Department of Respiratory Medicine, School of Medicine, University of Crete, Greece.
| | - Manolis Linardakis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Greece .
| | | | - Aikaterini Mantadaki
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Greece .
| | | | - Andreas Karelis
- Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, Greece .
| | - Chrysi Petraki
- Private Primary Care Facilities, Heraklion, Crete, Greece.
| | - Kadiani Nioti
- Private Primary Care Facilities, Heraklion, Crete, Greece.
| | | | - Nikolaos Tzanakis
- Department of Respiratory Medicine, School of Medicine, University of Crete, Greece.
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Nwanaji-Enwerem JC, Cardenas A, Gao X, Wang C, Vokonas P, Spiro A, Osborne AD, Kosheleva A, Hou L, Baccarelli AA, Schwartz J. Psychological Stress and Epigenetic Aging in Older Men: The VA Normative Aging Study. TRANSLATIONAL MEDICINE OF AGING 2023; 7:66-74. [PMID: 37576443 PMCID: PMC10416788 DOI: 10.1016/j.tma.2023.06.003] [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] [Indexed: 08/15/2023] Open
Abstract
Psychological stress remains an important risk factor for morbidity and mortality throughout the life course. However, there have been counterintuitive findings reported in previous studies of older persons that examine the relationships of perceived psychological stress with DNA methylation-based markers of aging, which also serve as predictors of morbidity and mortality (epigenetic age/clocks). We aimed to replicate and expand findings from existing work by examining relationships of self-reported stress with nine epigenetic clocks: Hannum, Horvath, Intrinsic, Extrinsic, SkinBloodClock, PhenoAge, GrimAge, DNAm Telomere Length, and Pace of Aging. We analyzed data from 607 male participants (mean age 73.2 years) of the VA Normative Aging Study with one to two study visits from 1999 to 2007 (observations = 956). Stress was assessed via the 14-item Perceived Stress Scale (PSS). Epigenetic age was calculated from DNA methylation measured in leukocytes with the HumanMethylation450 BeadChip. In linear mixed effects models adjusted for demographic/lifestyle/health factors, a standard deviation (sd) increase in PSS was associated with Horvath (β = -0.35-years, 95%CI: -0.61, -0.09, P=0.008) and Intrinsic (β = -0.40-years, 95%CI: -0.67, -0.13, P=0.004) epigenetic age deceleration. However, in models limited to participants with the highest levels of stress (≥ 75th-percentile), Horvath (β = 2.29-years, 95%CI: 0.16, 4.41, P=0.04) and Intrinsic (β = 2.06-years, 95%CI: -0.17, 4.28, P=0.07) age acceleration associations were observed. Our results reinforce the complexity of psychological stress and epigenetic aging relationships and lay a foundation for future studies that explore longitudinal relationships with other adult stress metrics and factors that can influence stress such as resilience measures.
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Affiliation(s)
- Jamaji C. Nwanaji-Enwerem
- Gangarosa Department of Environmental Health, Emory Rollins School of Public Health, Atlanta, GA, USA
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, USA
| | - Xu Gao
- Department of Occupational and Environmental Health Sciences, Peking University, Beijing, China
| | - Cuicui Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, and MD/PhD Program, Harvard Medical School, Boston, MA, USA
| | - Pantel Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System and the Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Avron Spiro
- Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Anwar D. Osborne
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Anna Kosheleva
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, and MD/PhD Program, Harvard Medical School, Boston, MA, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, and MD/PhD Program, Harvard Medical School, Boston, MA, USA
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Mendis BILM, Palihaderu PADS, Karunanayake P, Satharasinghe DA, Premarathne JMKJK, Dias WKRR, Rajapakse IH, Hapugalle AS, Karunaratne WRSA, Binendra AGYN, Kumara KBPP, Prabhashwara GSD, Senarath U, Yeap SK, Ho WY, Dissanayake AS. Validity and reliability of the Sinhalese version of the perceived stress scale questionnaire among Sri Lankans. Front Psychol 2023; 14:1152002. [PMID: 37397314 PMCID: PMC10313401 DOI: 10.3389/fpsyg.2023.1152002] [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: 01/27/2023] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Despite the availability of validated psychometrics tools to assess depression, there has not been any validated and reliable tool established to test perceived stress among Sri Lankans. The objective of this study is to test the validity and reliability of the Sinhalese Version of the Sheldon Cohen Perceived Stress Scale. Materials and methods Standard and systematic procedures were adopted to translate the original English version of the Perceived Stress Scale-10 questionnaire into Sinhalese. Consecutive sampling was employed to recruit the Type 2 Diabetes mellitus (T2DM) sample (n = 321), and a convenient sampling was used to recruit the Age and Sex matched Healthy Controls (ASMHC) (n = 101) and the Healthy Community Controls (HCC) groups (n = 75). Cronbach alpha was used to assess internal consistency and reliability was determined using test-retest method utilizing Spearman's correlation coefficient. Sensitivity was evaluated by comparing the mean scores of the Sinhalese Perceived Stress Scale (S-PSS-10) and Sinhalese Patient Health Questionnaire (S-PHQ-9) scores. Post-hoc comparisons were done using Bonferroni's method. Mean scores were compared between the T2DM, ASMHC, and HCC groups using the independent t-test. Explanatory Factor Analysis (EFA) was conducted using the principal component and Varimax rotation while the Confirmatory Factor Analysis (CFA) was performed to assess the goodness-of-fit of the factor structure extracted from the EFA. Concurrent validity was assessed using the Pearson correlation between the S-PSS-10 and Patient Health Questionnaire measured by S-PHQ-9 (p < 0.05). Results Cronbach alpha values of the three groups T2DM, ASMHC and HCC were 0.85, 0.81, and 0.79, respectively. Results of the ANOVA test suggested that there was a significant difference in the mean scores between groups (p < 0.00). EFA analysis revealed the existence of two factors with eigenvalues greater than 1.0. The factor loadings for the items ranged from 0.71-0.83. The CFA analysis demonstrated a good model fit for the two-factor model S-PSS-10. The S-PSS-10 significantly correlated with S-PHQ-9, indicating an acceptable concurrent validity. Conclusion Findings revealed that the S-PSS-10 questionnaire can be used to screen perceived stress among the majority of the Sri Lankan Sinhalese-speaking population specially with chronic illnesses. Further studies with higher sample sizes across different populations would enhance the validity and reliability of S-PSS-10.
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Affiliation(s)
| | | | - Panduka Karunanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Dilan Amila Satharasinghe
- Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka
| | | | | | | | - Avanti Sulochana Hapugalle
- Department of North Indian Music, Faculty of Music, University of the Visual and Performing Arts, Colombo, Sri Lanka
| | | | | | | | | | - Upul Senarath
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Swee Keong Yeap
- China-ASEAN College of Marine Sciences, Xiamen University Malaysia, Sepang, Selangor, Malaysia
| | - Wan Yong Ho
- Division of Biomedical Sciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia
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Lee SG, Song YD, Lee EC. Experimental Verification of the Possibility of Reducing Photoplethysmography Measurement Time for Stress Index Calculation. SENSORS (BASEL, SWITZERLAND) 2023; 23:5511. [PMID: 37420678 DOI: 10.3390/s23125511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 07/09/2023]
Abstract
Stress is a direct or indirect cause of reduced work efficiency in daily life. It can damage physical and mental health, leading to cardiovascular disease and depression. With increased interest and awareness of the risks of stress in modern society, there is a growing demand for quick assessment and monitoring of stress levels. Traditional ultra-short-term stress measurement classifies stress situations using heart rate variability (HRV) or pulse rate variability (PRV) information extracted from electrocardiogram (ECG) or photoplethysmography (PPG) signals. However, it requires more than one minute, making it difficult to monitor stress status in real-time and accurately predict stress levels. In this paper, stress indices were predicted using PRV indices acquired at different lengths of time (60 s, 50 s, 40 s, 30 s, 20 s, 10 s, and 5 s) for the purpose of real-time stress monitoring. Stress was predicted with Extra Tree Regressor, Random Forest Regressor, and Gradient Boost Regressor models using a valid PRV index for each data acquisition time. The predicted stress index was evaluated using an R2 score between the predicted stress index and the actual stress index calculated from one minute of the PPG signal. The average R2 score of the three models by the data acquisition time was 0.2194 at 5 s, 0.7600 at 10 s, 0.8846 at 20 s, 0.9263 at 30 s, 0.9501 at 40 s, 0.9733 at 50 s, and 0.9909 at 60 s. Thus, when stress was predicted using PPG data acquired for 10 s or more, the R2 score was confirmed to be over 0.7.
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Affiliation(s)
- Seung-Gun Lee
- Department of AI & Informatics, Graduate School, Sangmyung University, Hongjimun 2-Gil 20, Jongno-Gu, Seoul 03016, Republic of Korea
| | - Young Do Song
- Department of AI & Informatics, Graduate School, Sangmyung University, Hongjimun 2-Gil 20, Jongno-Gu, Seoul 03016, Republic of Korea
| | - Eui Chul Lee
- Department of Human-Centered Artificial Intelligence, Sangmyung University, Hongjimun 2-Gil 20, Jongno-Gu, Seoul 03016, Republic of Korea
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Maté-Muñoz JL, Hernández-Lougedo J, Ruiz-Tovar J, Olivares-Llorente R, García-Fernández P, Zapata I. Physical Activity Levels, Eating Habits, and Well-Being Measures in Students of Healthcare Degrees in the Second Year of the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11111570. [PMID: 37297711 DOI: 10.3390/healthcare11111570] [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: 04/15/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND When the first cases of COVID-19 (caused by SARS-CoV-2 virus infection) were discovered, exceptional norms to fight the spread of the virus were established by applying movement restrictions (lockdown) in many countries. These unprecedented norms led to sedentary behaviours and less healthy diets which could persist for much longer after lockdown. The aim of this study was to analyse the physical activity, eating habits, self-perceived well-being, and toxic habits, as well as the perceived changes of these habits with respect to the pre-pandemic period, in a population of university students in the second year of the COVID-19 pandemic. METHODS A single-centre, cross-sectional study was conducted in a population of university students of healthcare degrees. A total of 961 students (639 (66.5%) women and 322 (33.5%) men) signed the informed consent and completed the questionnaire. The study was conducted through an anonymous survey, which was voluntarily self-completed by the students on an online platform. The questionnaire was based on the Spanish Health Survey and it was divided into six main parts: demographic and anthropometric characteristics, physical activity, eating habits, well-being measures (sleeping habits, health state, and stress), toxic habits, and perception of the influence of the COVID-19 pandemic on the variables described. RESULTS AND CONCLUSIONS The results showed that, during the second year of the pandemic, statistically significant dependence was identified for those students that showed higher levels of physical activity with greater perceived physical activity (p < 0.05), healthier eating habits (p < 0.05), and a better self-perceived health state (p < 0.05), with respect to the 12 months before the COVID-19 pandemic. On the other hand, there was a negative correlation between the sedentary students and greater perceived physical activity (p < 0.05). With regard to toxic habits and physical activity, a significant correlation was only detected between sedentary behaviour and cocaine consumption (p < 0.05). Analysing eating habits, it was observed that the students who smoked, consumed alcohol, and binge drank had low adherence to the Mediterranean diet (p < 0.05). In addition, those students with high stress levels slept less than 7 h (p < 0.05).
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Affiliation(s)
- José Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Juan Hernández-Lougedo
- Department of Physiotherapy, Faculty of Health Sciences, Camilo José Cela University, 28692 Madrid, Spain
| | - Jaime Ruiz-Tovar
- Department of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Rafael Olivares-Llorente
- Department of Physical Activity and Sports Science, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Irene Zapata
- Department of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
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Chen G, Leary S, Niu J, Perry R, Papadaki A. The Role of the Mediterranean Diet in Breast Cancer Survivorship: A Systematic Review and Meta-Analysis of Observational Studies and Randomised Controlled Trials. Nutrients 2023; 15:2099. [PMID: 37432242 DOI: 10.3390/nu15092099] [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: 03/10/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
Female breast cancer is the most frequently diagnosed cancer. The long-term survival rates for this disease have increased; however, the unique demand for high-quality healthcare to improve breast-cancer survivorship are commonly unmet. The Mediterranean diet (MD) is associated with reduced breast-cancer risk and various health-related benefits in the general population, but its effect on breast-cancer survivors remains uncertain. The objective of this systematic review and meta-analysis was to assess current evidence from randomised controlled trials (RCTs) and observational studies (cohort, cross-sectional and case-control) regarding the effect of the MD on survival, quality of life (QoL) and health-related outcomes in female breast-cancer survivors. MEDLINE, EMBASE, Web of Science and the Cochrane library were searched for studies published before and including April 2022. Two reviewers independently screened the literature and completed the data extraction and risk-of-bias assessment. Eleven studies (fifteen reports) were included, including two RCTs, four cohort and five cross-sectional studies. The meta-analysis of the cohort studies showed strong evidence of an inverse association between high adherence to the MD and all-cause mortality (hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.66-0.93, I2: 0%, Grading of Recommendations Assessment, Development and Evaluation (GRADE) = low certainty of evidence) and non-breast-cancer mortality (HR 0.67, 95% CI 0.50-0.90, I2: 0%, GRADE = very low certainty of evidence). The associations between high adherence to the MD and QoL and health-related parameters were not consistent. These findings highlight the potential of adherence to the MD to reduce the risk of mortality. Future research with better study designs, as well as more consistent measurements of QoL and MD adherence, taking into account changes in MD adherence over time and population subgroups, is needed to provide more robust evidence on the survival, QoL and health-related outcomes in BC survivors.
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Affiliation(s)
- Ge Chen
- Bristol Dental School, University of Bristol, Bristol BS2 8AE, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2BN, UK
| | - Sam Leary
- Bristol Dental School, University of Bristol, Bristol BS2 8AE, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2BN, UK
| | - Jizhao Niu
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
| | - Rachel Perry
- Bristol Medical School (Cardiovascular Surgery and Vascular Biology), University of Bristol, Bristol BS2 8HW, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
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Varela P, Lykeridou A, Zervas I, Deltsidou A. Psychometric properties of the Greek Version of the Traumatic Event Scale (TES) (Version A) among low-risk pregnant women. BMC Psychol 2023; 11:105. [PMID: 37029446 PMCID: PMC10082481 DOI: 10.1186/s40359-023-01152-z] [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: 02/08/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The Traumatic Event Scale (TES) is one of the most often used instruments for the assessment of the Posttraumatic Stress Disorder (PTSD) symptomatology during pregnancy which is linked with adverse effects. The aim of the study was to assess the psychometric properties of the TES (version A) in a sample of Greek pregnant women. METHODS Two hundred one low risk pregnant women in their second or third trimester were invited to participate in the study. Participants completed a number of questionnaires including the Greek versions of TES-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Confirmatory factor analysis (CFA) was conducted in order to test how well the already TES-A five-factor model fits the data from Greece. RESULTS Participants' average age was 34.2 years (SD = 4.3 years). Through CFA the already five-factor structure of the TES-A (Anticipation of trauma, Intrusion, Avoidance, Resignation, Hyperstimulation) was applied to our sample. All five factors were significantly and positively correlated with each other. All Cronbach's alpha were over 0.7, indicating acceptable reliability of the factors. Relatively convergent validity, all factors of the Greek version of the TES-A were significantly associated with stress, anxiety, depression and coping strategies. CONCLUSION The Greek version of TES-A is detected to be a valid and reliable instrument of prenatal Posttraumatic Stress Disorder (PTSD) symptomatology among low-risk Greek pregnant women.
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Affiliation(s)
- Pinelopi Varela
- General Hospital of Athens "Alexandra", Department of Midwifery, University of West Attica, Athens, Greece.
| | | | - Ioannis Zervas
- Professor of Psychiatry and Psychosomatic Medicine, Head of the Women's mental health and reproductive psychiatric clinic, National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece
| | - Anna Deltsidou
- Department of Midwifery, University of West Attica, Athens, Greece
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Heath J, Wiggins AT, Meador D, Kennison M, Woodall M, Pendleton M, MacCallum T, Butler KM. The State of Health and Intentions for Action to Advance Mental Health and Well-being for the Nursing Workforce. J Nurs Adm 2023; 53:220-227. [PMID: 36951949 DOI: 10.1097/nna.0000000000001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The aims of this study were to explore the health of nurse leaders and assess intentions to integrate workplace mental health/wellness practices. BACKGROUND National efforts address high rates of poor mental health and lifestyle behaviors among nurses. Few studies describe the extent to which nurse leaders in academic and clinical environments can influence a strategic mission for health/well-being among the nursing workforce. METHODS Two hundred seventeen email invitations were distributed to nurse leaders from 5 Kentucky nursing organizations to complete a 1-time 46-item online survey assessing individual health behaviors and intentions to build a culture of workplace health/well-being. RESULTS Most respondents reported positive physical health (86%), positive mental health/intentions for action to change behaviors (80%), improved self-care practices (86%), integration of self-care practices in the workplace (79%), and commitment to integrate suicide prevention training (55%). CONCLUSIONS Overall, nurse leaders reported positive healthy behaviors. The finding that the highest intentions were reported to integrate, sustain, and/or advance lifestyle behaviors for self-care practices as well as to integrate practices for mental health and well-being in the work environment is encouraging. Enhanced strategies and efforts are needed to prioritize workplace cultures of wellness to benefit nurses and further promote well-being among nurse leaders.
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Affiliation(s)
- Janie Heath
- Author Affiliations: Dean and Warwick Professor of Nursing (Dr Heath) and Lecturer and Biostatistician (Dr Wiggins), University of Kentucky, Lexington; President (Meador), Kentucky Nurses Association, Louisville; Susan V. Clayton Baccalaureate Nursing Chair and Professor (Dr Kennison), Berea College; and Past Co-Chair (Dr Kennison), Kentucky Nursing Deans and Directors, Richmond; Director of Nursing (Dr Woodall), Madisonville College; and Past Co-Chair (Dr Woodall), Kentucky Nursing Deans and Directors, Madisonville; President (Dr Pendleton), Kentucky Organization of Nurse Leaders, Louisville; Assistant Assessment Director (MacCallum), University of Kentucky, Lexington; and Associate Dean of Academic and Student Affairs and Professor of Nursing (Dr Butler), University of Kentucky, Lexington, Kentucky
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Aydin R, Aktaş S, Kaloğlu Binici D. Examination of the effect of the perceived stress in the coronavirus-19 pandemic on marital adjustment, sexual life and intimate partner violence. J Adv Nurs 2023; 79:1513-1524. [PMID: 35841330 PMCID: PMC9349524 DOI: 10.1111/jan.15368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/18/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
AIMS The aim of the study was to explore the effects of perceived stress during the pandemic on marital adjustment, sexual life and intimate partner violence. DESIGN A cross-sectional design was employed in this study. METHODS The data were collected with an online survey between October and December 2020 from 901 participants in Turkey. Participants completed the Descriptive Information Form, the Marital Adjustment Scale and the Perceived Stress Scale. Multivariate analysis of variance and moderation analysis were used in the analysis of the data. RESULTS The pre-pandemic marital adjustment scores of the participants significantly decreased during the pandemic. The marital adjustment and sexual life of those with high perceived stress levels were found to be negatively affected, and they were exposed to violence during the pandemic. In the moderation analysis, a non-standardized coefficient of the marital adjustment variable in the model turned out to be significant, and the perceived stress decreased as marital adjustment increased. The marital adjustment was low, and the stress level was high in individuals exposed to violence. Besides, perceived stress was found to be effective in being exposed to intimate partner violence. CONCLUSION The stress perceived by individuals during the COVID-19 pandemic negatively affected their marital adjustment and sexual life. Besides, perceived stress was found to be effective in being exposed to intimate partner violence, and marital adjustment decreased during the pandemic compared to the pre-pandemic period. IMPACT During the pandemic period, health care providers should routinely screen the psychosocial health of individuals. Continuous, accessible, free psychosocial support services should be available in order to increase the psychosocial health and marital adjustment of people with high-stress levels and prevent exposure to violence. PATIENT OR PUBLIC CONTRIBUTION The conduct of this study is based on an online survey with participants living in the same house with their spouses during the pandemic.
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Affiliation(s)
- Ruveyde Aydin
- Department of Nursing, Faculty of Health SciencesOndokuz Mayıs UniversitySamsunTurkey
| | - Songül Aktaş
- Department of Midwifery, Faculty of Health SciencesKaradeniz Technical UniversityTrabzonTurkey
| | - Dilek Kaloğlu Binici
- Department of Nursing, Faculty of Health SciencesArtvin Çoruh UniversityArtvinTurkey
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Sergooris A, Verbrugghe J, Matheve T, Van Den Houte M, Bonnechère B, Corten K, Bogaerts K, Timmermans A. Clinical phenotypes and prognostic factors in persons with hip osteoarthritis undergoing total hip arthroplasty: protocol for a longitudinal prospective cohort study (HIPPROCLIPS). BMC Musculoskelet Disord 2023; 24:224. [PMID: 36964541 PMCID: PMC10039547 DOI: 10.1186/s12891-023-06326-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Large heterogeneity exists in the clinical manifestation of hip osteoarthritis (OA). It is therefore not surprising that pain and disability in individuals with hip OA and after total hip arthroplasty (THA) cannot be explained by biomedical variables alone. Indeed, also maladaptive pain-related cognitions and emotions can contribute to pain and disability, and can lead to poor treatment outcomes. Traumatic experiences, mental disorders, self-efficacy and social support can influence stress appraisal and strategies to cope with pain, but their influence on pain and disability has not yet been established in individuals with hip OA undergoing THA. This study aims (1) to determine the influence of traumatic experiences and mental disorders on pain processing before and shortly after THA (2) to identify preoperative clinical phenotypes in individuals with hip OA eligible for THA, (3) to identify pre- and early postoperative prognostic factors for outcomes in pain and disability after THA, and (4) to identify postoperative clinical phenotypes in individuals after THA. METHODS This prospective longitudinal cohort study will investigate 200 individuals undergoing THA for hip OA. Phenotyping variables and candidate prognostic factors include pain-related fear-avoidance behaviour, perceived injustice, mental disorders, traumatic experiences, self-efficacy, and social support. Peripheral and central pain mechanisms will be assessed with thermal quantitative sensory testing. The primary outcome measure is the hip disability and osteoarthritis outcome score. Other outcome measures include performance-based measures, hip muscle strength, the patient-specific functional scale, pain intensity, global perceived effect, and outcome satisfaction. All these measurements will be performed before surgery, as well as 6 weeks, 3 months, and 12 months after surgery. Pain-related cognitions and emotions will additionally be assessed in the early postoperative phase, on the first, third, fifth, and seventh day after THA. Main statistical methods that will be used to answer the respective research questions include: LASSO regression, decision tree learning, gradient boosting algorithms, and recurrent neural networks. DISCUSSION The identification of clinical phenotypes and prognostic factors for outcomes in pain and disability will be a first step towards pre- and postoperative precision medicine for individuals with hip OA undergoing THA. TRIAL REGISTRATION ClinicalTrials.gov: NCT05265858. Registered on 04/03/2022.
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Affiliation(s)
- Abner Sergooris
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium.
| | - Jonas Verbrugghe
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
| | - Thomas Matheve
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Maaike Van Den Houte
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
- Laboratory for Brain-Gut Axis Studies (LABGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, University of Leuven, Leuven, Belgium
| | - Bruno Bonnechère
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
| | - Kristoff Corten
- Department of Orthopaedics - Hip Unit, Ziekenhuis Oost-Limburg, Genk, Belgium
- Centre for Translational Psychological Research (TRACE), Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Katleen Bogaerts
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Annick Timmermans
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
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Xiao Y, Brown TT, Snowden LR, Chow JCC, Mann JJ. COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States. JAMA Netw Open 2023; 6:e232716. [PMID: 36912834 DOI: 10.1001/jamanetworkopen.2023.2716] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
IMPORTANCE The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects. OBJECTIVES To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19-related worry, and sleep. DESIGN, SETTING, AND PARTICIPANTS This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023. EXPOSURES Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling). MAIN OUTCOMES AND MEASURES Perceived stress scale, National Institutes of Health (NIH)-Toolbox sadness, NIH-Toolbox positive affect, COVID-19-related worry, and sleep (latency, inertia, duration). RESULTS In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19-related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep. CONCLUSIONS AND RELEVANCE To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children's mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.
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Affiliation(s)
- Yunyu Xiao
- Weill Cornell Medicine, NewYork Presbyterian, Department of Population Health Sciences, New York
| | | | | | | | - J John Mann
- Departments of Psychiatry and Radiology, Columbia University Irving Medical Center, Columbia University, New York
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York
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Khodabandeh Shahraki S, Adelian H, Miri S, Farokhzadian J. Using mindfulness-based stress reduction group therapy to reduce perceived stress of vulnerable women in south of Iran. PSYCHOL HEALTH MED 2023; 28:582-594. [PMID: 35313769 DOI: 10.1080/13548506.2022.2055771] [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] [Indexed: 11/17/2022]
Abstract
Provision of educational and health services to vulnerable women in drop-in centers can reduce their traumas. Mindfulness-Based Stress Reduction (MBSR) group therapy is a psychological intervention to reduce perceived stress these women. This quasi-experimental study aimed to evaluate the effectiveness of MBSR group therapy in the perceived stress of 63 vulnerable women who referred to two drop-in centers in southeastern Iran. The participants were assigned into the intervention (n = 30) and control (n = 33) groups. The intervention group members were required to attend the MBSR intervention held in eight 90-minute sessions. Perceived Stress Scale (PSS) was administered to collect data before and one month after the MBSR. Based on the findings, the pre-test scores of perceived stress were not significantly different between the intervention (38.16 ± 6.04) and control (39.06 ± 5.30) groups (t = -0.62, p = 0.53). However, the perceived stress scores reduced significantly in the intervention group (30.20 ± 2.89) than the control group scores (37.96 ± 4.18) in the posttest (t = -8.35, P = 0.001). Given the significant reduction of perceived stress in participants after attending the MBSR group therapy, expert counselors, psychologists, and psychiatrists are recommended to conduct this therapy to reduce perceived stress in vulnerable women.
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Affiliation(s)
| | - Hamideh Adelian
- Student Research Committee, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Sakineh Miri
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Vargová L, Kačmár P, Lačný M, Baník G. Measuring various aspects of coronavirus anxiety: a psychometric evaluation of Pandemic anxiety and Coronophobia scales from the latent and network perspective. CURRENT PSYCHOLOGY 2023:1-14. [PMID: 36776147 PMCID: PMC9905769 DOI: 10.1007/s12144-023-04277-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/11/2023]
Abstract
Since the outbreak of COVID-19, understanding and describing the changes in experiences related to the pandemic and its correlates have become crucial. The current study aims to provide a psychometric evaluation and examination of the relationship of two COVID-related anxiety scales through the latent and network approach. The data was collected from the same participants at two time points (Nwave 1 = 1283; Nwave 2 = 1326). The study examined the psychometric properties of the Pandemic Anxiety Scale and Coronaphobia scale. It also examined the factor structure, invariance and relationship with selected variables through both the latent and network approach. The results revealed that both scales provided good fit and psychometric properties-PAS (wave1: CFI = 0.97, TLI = 0.95, RMSEA = 0.05 [0.04, 0.07], SRMR = 0.048; wave2: CFI = 0.97, TLI = 0.95, RMSEA = 0.05 [0.04, 0.07], SRMR = 0.049), and Coronaphobia scale (wave1: CFI = 0.99, TLI = 0.98, RMSEA = 0.05 [0.03, 0.07], SRMR = 0.027; wave2: CFI ~ 1, TLI = 0.99, RMSEA = 0.03 [0.002, 0.06], SRMR = 0.015). The results also indicated that distinguishing between them is crucial as they were related differently to various variables. The global network models provided a more complex insight in their connections with the set of selected variables. The PAS and Coronaphobia scales are brief and valid measures that can be used in research looking at mental health issues related to the pandemic. The present study shows a unique pattern of relationships of these scales with other variables, extending previous studies into the topic of COVID-related anxiety.
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Affiliation(s)
- Lenka Vargová
- Institute of Psychology, Faculty of Arts, University of Presov, 17. Novembra 1, 080 01 Presov, Slovakia
| | - Pavol Kačmár
- Department of Psychology, Faculty of Arts, Pavol Jozef Safarik University in Kosice, Moyzesova 9, 040 59 Kosice, Slovakia
| | - Martin Lačný
- Institute of Political Science, Faculty of Arts, University of Presov, 17. Novembra 1, 080 01 Presov, Slovakia
| | - Gabriel Baník
- Institute of Psychology, Faculty of Arts, University of Presov, 17. Novembra 1, 080 01 Presov, Slovakia
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Kyriakaki ED, Detorakis ET, Bertsias AK, Markakis G, Tsakalis NG, Volkos P, Spandidos DA, Symvoulakis EK. Ocular trauma, visual acuity related to time of referral and psychosocial determinants, during COVID‑19 pandemic: A prospective study. Exp Ther Med 2023; 25:130. [PMID: 36845962 PMCID: PMC9947913 DOI: 10.3892/etm.2023.11829] [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] [Received: 11/29/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
The aim of the present study was to explore the associations between visual outcomes of ocular injury patients in a tertiary hospital unit with clinical and demographic variables and to evaluate the psychosocial impact of the injury on the patients. An 18-month prospective study of 30 eye-injured adult patients was conducted in the General University Hospital of Heraklion, Crete, a tertiary referral hospital. All severe eye injury case information was prospectively collected between February 1, 2020 and August 31, 2021. Best corrected visual acuity (BCVA) was labelled not poor (>0.5/10 or >20/400 on the Snellen scale, <1.3 in LogMAR scale) and poor (≤0.5/10 or ≤20/400 on the Snellen scale, ≥1.3 on the LogMAR equivalent). Data regarding participants' perceived stress levels, by using Perceived Stress Scale 14 (PSS-14), were collected prospectively, one year after study end. Out of 30 ocular injury patients selected, 76.7% were men and most of them were self-employed and private or public sector workers (36.7%). Not poor final BCVA was related to not poor initial BCVA [odds ratio (OR) 1.714; P=0.006]. No statistical associations were found between visual outcome and demographic or clinical factors, but not poor final BCVA was associated with improved self-reported psychological condition of the sufferers, as examined by a questionnaire sheet developed to collect information for study purpose (8.36/10 vs. 6.40/10; P=0.011). No patient reported job loss or changed work status following the injury. Not poor initial BCVA was a significant predictor for not poor final visual outcomes (OR 1.714; P=0.006). Patients with not poor final BCVA expressed higher levels of positive psychology (8.36/10 vs. 6.40/10; P=0.011) and less fear of eye injury repetition (64.0 vs. 100.0%; P=0.286). Not poor final BCVA was associated with low PSS-14 scores one year after study end (77.3 vs. 0.0%, P=0.003). Collaboration between ophthalmologists, mental health professionals and primary care team may be important in order to help patients to cope with the psychosocial burden sequel to eye trauma.
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Affiliation(s)
- Elli D.O. Kyriakaki
- Department of Ophthalmology, University Hospital of Heraklion, 71500 Heraklion, Greece,Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece,Correspondence to: Ms. Elli D.O. Kyriakaki, Clinic of Social and Family Medicine, School of Medicine, University of Crete, Andrea Kalokerinou 13, Giofirakia, 71500 Heraklion, Greece
| | | | - Antonios K. Bertsias
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Georgios Markakis
- Department of Social Work, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Nikolaos G. Tsakalis
- Department of Ophthalmology, University Hospital of Heraklion, 71500 Heraklion, Greece,Department of Ophthalmology, General Hospital of Ierapetra, 72200 Ierapetra, Greece
| | - Panagiotis Volkos
- 4th Local Health Team, Academic Unit of Heraklion, 71303 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece
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Ncitakalo N, Sigwadhi LN, Mabaso M, Joska J, Simbayi L. Exploring HIV status as a mediator in the relationship of psychological distress with socio-demographic and health related factors in South Africa: findings from the 2012 nationally representative population-based household survey. AIDS Res Ther 2023; 20:6. [PMID: 36747255 PMCID: PMC9901137 DOI: 10.1186/s12981-022-00498-5] [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: 01/16/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Psychological distress as measured by mental disorders like depression and anxiety is more prevalent in people living with HIV (PLHIV) than in the general population. However, the relationship between mental disorders and HIV is complex and bidirectional. Improved understanding of the relationship between mental disorders and HIV is important for designing interventions for this group. This paper explores the interrelationships of psychological distress with HIV and associated socio-demographic and health-related factors. METHODS This secondary data analysis used the 2012 South African population-based household survey on HIV collected using a cross-sectional multi-stage stratified cluster sampling design. Generalized structural equation modelling (G-SEM) path analysis was used to explore the direct and indirect relationships of socio-demographic, health and HIV-related factors with psychological distress as measured by Kessler 10 scale using HIV status as a moderator variable. RESULTS A total of 20,083 participants were included in the study, 21.7% reported psychological distress, of whom (32.6%) were HIV positive. In the final path model with HIV status as a moderator, psychological distress was significantly more likely among age group 25-49 years (AOR: 1.4 [95% CI 1.3-1.6]), age 50 years and older, (AOR: 1.4 [95% CI 1.2-1.6]), females (AOR: 1.6 [95% CI 1.4-1.8]), high risk drinkers (AOR: 1.9 [1.6-2.2]) hazardous drinkers (AOR: 4.4 [95% CI 3.1-6.3]), ever tested for HIV (AOR: 1.2 [95% CI 1.1-1.3]). Psychological distress was significantly less likely among the married [AOR: 0.8 (0.7-0.9)], other race groups [AOR: 0.5 (0.5-0.6)], those with secondary level education (AOR: 0.9 [95% CI 0.8-0.9]), and tertiary level education (AOR: 0.7 [95% CI 0.6-0.9]), those from rural informal [AOR: 0.8 (0.7-0.9)], and rural formal [AOR: 0.8 (0.7-0.9)] areas and those who rated their health as excellent/good [AOR: 0.4 (0.4-0.5)]. CONCLUSION The findings highlight the importance of designing tailored interventions targeted at psychological distress among PLHIV especially the elderly, females, those with no education and / or low education attainment and those residing in informal urban areas.
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Affiliation(s)
| | - Lovemore Nyasha Sigwadhi
- grid.11956.3a0000 0001 2214 904XDivision of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Musawenkosi Mabaso
- grid.417715.10000 0001 0071 1142Human and Social Capabilities Research Division, Human Sciences Research Council, Durban, South Africa
| | - John Joska
- grid.7836.a0000 0004 1937 1151HIV Mental Health Research Unit, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Leickness Simbayi
- grid.7836.a0000 0004 1937 1151HIV Mental Health Research Unit, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa ,grid.417715.10000 0001 0071 1142Human Sciences Research Council, Cape Town, South Africa ,grid.7836.a0000 0004 1937 1151Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
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Papini NM, Jung M, Kang M, Lopez NV, Herrmann SD. Development and Rasch Analysis of the 18-Item Health Resilience Profile (HRP). Nutrients 2023; 15:nu15040807. [PMID: 36839165 PMCID: PMC9962227 DOI: 10.3390/nu15040807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Existing resilience measures have psychometric shortcomings, and there is no current gold-standard resilience measure. Previous work indicates adults enrolled in a health coaching program may benefit from a resilience measure that is tailored and contextualized to this sample. This two-part study aimed to develop and evaluate a resilience instrument focused on health behavior change in adults in a health coaching program. Two studies were conducted to (1) create a resilience instrument (Health Resilience Profile; HRP) specific to adults attempting health behavior change (n = 427; female = 83.8%; age = 44.5 ± 11.9 years) and to (2) optimize the instrument performance using Rasch analysis (n = 493; female = 62.1%; age = 49.8 ± 12.5 years). Study 1 identified two issues: (1) four unacceptable misfit items and (2) inappropriate rating scale functioning. Study 2 evaluated an improved instrument based on the outcome of study 1 resulting in one more misfit item, and unidimensionality was supported. The new four-category rating scale functioned well. The item-person map indicated that item difficulty distribution was well matched to participants' resilience level, and items were free from measurement error. Finally, items did not show differential item functioning across age, sex, alcohol use, and obesity status. The 18-item HRP is optimized for adults in a health coaching program.
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Affiliation(s)
- Natalie M. Papini
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
- Correspondence:
| | - Myungjin Jung
- Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, MS 38677, USA
| | - Minsoo Kang
- Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, Oxford, MS 38677, USA
| | - Nanette V. Lopez
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Stephen D. Herrmann
- Department of Internal Medicine, University of Kansas Medical Center, Kansas, KS 66160, USA
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Soria-Reyes LM, Cerezo MV, Alarcón R, Blanca MJ. Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients. Stress Health 2023; 39:115-124. [PMID: 35657280 PMCID: PMC10084090 DOI: 10.1002/smi.3170] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/23/2022] [Accepted: 05/29/2022] [Indexed: 02/05/2023]
Abstract
Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.
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Affiliation(s)
| | | | - Rafael Alarcón
- Faculty of Psychology, University of Malaga, Malaga, Spain
| | - María J Blanca
- Faculty of Psychology, University of Malaga, Malaga, Spain
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Dagnall N, Denovan A, Drinkwater KG. Longitudinal assessment of the temporal stability and predictive validity of the Revised Paranormal Belief Scale. Front Psychol 2023; 13:1094701. [PMID: 36778162 PMCID: PMC9911539 DOI: 10.3389/fpsyg.2022.1094701] [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: 11/10/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
The Revised Paranormal Belief Scale (RPBS) is the prevailing measure of supernatural credence. However, there exists only limited evidence to support the temporal stability and predictive validity of the instrument over time. Acknowledging this, the present study assessed the test-retest reliability of the RPBS using a large, heterogeneous sample across multiple trials. In addition, predictive validity was tested using a longitudinal statistical model, which focused on allied health outcomes (Perceived Stress and Somatic Complaints). A sample of 1,665 (M age = 54.40, 853 females, 804 males, five non-binary and three not disclosing of gender) completed study measures at three time points separated by 2 month intervals. Prior to assessing temporal stability, assessment of structural validity and longitudinal invariance occurred. Test-retest reliability of the RPBS was in the moderate to high range across time intervals, and good internal consistency was observed. Furthermore, satisfactory stability coefficients existed for RPBS subfactors. Data-model fit for the predictive model was acceptable. Belief in the paranormal explained low variance over time in Perceived Stress and Somatic Complaints (between 2.4 and 4.2%). Findings supported the stability and reliability of the RPBS. In addition, they aligned with the notion that paranormal belief in the absence of high scores on cognitive-perceptual factors (e.g. transliminality and schizotypy), has a benign influence on perceived health.
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Affiliation(s)
- Neil Dagnall
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom,*Correspondence: Neil Dagnall, ✉
| | - Andrew Denovan
- Department of Psychology, University of Huddersfield, Huddersfield, United Kingdom
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