Public Sector Workers' Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale

Psychometric properties of the Perceived Stress Scale (PSS-10) in silica-exposed workers from diverse cultural and linguistic backgrounds

BACKGROUND

The Perceived Stress Scale (PSS-10) has been used in a range of occupational cohorts, but only recently in stone benchtop workers undergoing screening for silicosis. The aim of this study was to compare psychometric properties of the PSS-10 in stone benchtop workers amongst those born overseas or who used an interpreter.

METHODS

Stone benchtop workers in Melbourne, Australia completed the PSS-10 as part of their occupational screening for silicosis. Internal consistency was assessed with Cronbach's α for the total score and the positive and negative subscales. Validity was assessed using confirmatory factor analysis (CFA). Analysis was performed for the total group and for subgroups according to sex, interpreter use, overseas-born, and language spoken at home.

RESULTS

The results of 682 workers with complete PSS-10 scores were included in analysis. Most participants were male (93%), with mean age 36.9 years (SD 11.4), with just over half (51.6%) born in Australia, 10.1% using an interpreter, and 17.5% using a language other than English at home. Cronbach's α for the overall group (α = 0.878) suggested good internal consistency.

DISCUSSION

CFA analysis for validity testing suggested PSS-10 performance was good for both sexes, moderate for country of birth and language spoken at home categories, but poorer for those who used an interpreter. Whilst professional interpreters provide a range of benefits in the clinical setting, the use of translated and validated instruments are important, particularly in cohorts with large numbers of migrant workers.

CONCLUSION

This study describes the psychometric properties of the PSS-10 in a population of stone benchtop workers, with good internal consistency, and mixed performance from validity testing across various subgroups.

Reliability and validity of a widely-available AI tool for assessment of stress based on speech

Cigna's online stress management toolkit includes an AI-based tool that purports to evaluate a person's psychological stress level based on analysis of their speech, the Cigna StressWaves Test (CSWT). In this study, we evaluate the claim that the CSWT is a "clinical grade" tool via an independent validation. The results suggest that the CSWT is not repeatable and has poor convergent validity; the public availability of the CSWT despite insufficient validation data highlights concerns regarding premature deployment of digital health tools for stress and anxiety management.

COVID-19-related stress in postpartum women from Argentina during the second wave in 2021: Identification of impairing and protective factors

Objective

Postpartum women are a vulnerable population to pandemic stressors that challenge their psychological well-being. Thus, reliable and valid instruments are necessary to measure pandemic-related stress and to identify risk and protective factors. This work aimed to assess psychometric properties of the COVID-19 Pandemic-Related Stress Scale (PSS-10-C) and associations of maternal pandemic stress with demographic, reproductive and pandemic factors of Argentinian postpartum women during the second COVID-19 wave.

Design

An online cross-sectional survey was conducted from April to June 2021.

Setting

Online recruitment of postpartum women was carried out during the second wave of COVID-19 in Argentina. This study was conducted in accordance with the Declaration of Helsinki and had the corresponding ethical approval.

Participants

This study was performed on 300 women, aged 18–49 years, up to 12 months postpartum in Argentina.

Measurements and findings

Stress was assessed with PSS-10-C, with a sociodemographic questionnaire being used to collect demographic, reproductive and pandemic variables. Statistical analysis included psychometric procedures, structural equation modeling, and multiple regressions. PSS-10-C was a reliable and structurally valid instrument with two subscales, with entire scale, Stress and Coping subscales scoring 17.31 (6.52), 9.70 (4.61) and 7.61 (2.77), respectively. History of mood disorders, pregnancy loss, and unhealthy child during the pandemic predisposed to increased stress (β > 0.10, p < 0.05), whereas having work and practicing breastfeeding promoted coping to face it (β < -0.13, p < 0.05). This situation was impaired by mood changes, loss of happiness, economic changes, fear of contracting COVID-19 -own or by a loved one- (β > 0.11, p < 0.05).

Key conclusions

The study highlighted the vulnerability of postpartum women's mental health in the pandemic context, with PSS-10-C being a useful instrument for clinicians and researchers to assess perceived stress. Targeting interventions toward women at higher risk can be highly beneficial for maternal and child health.

Triggering of postpartum depression and insomnia with cognitive impairment in Argentinian women during the pandemic COVID-19 social isolation in relation to reproductive and health factors

Objective

The 2019 coronavirus disease pandemic (COVID-19) required strict confinement measures that differentially impacted the individual's daily life. Thus, this work aimed to study postpartum women's mental health in Argentina during mandatory social isolation.

Design

A cross-sectional survey was conducted from May to July 2020, which included five validated questionnaires to assess postpartum depression (Postpartum Depression Screening Scale‐Short Form), insomnia (Insomnia Severity Index), memory complaints (Memory Complaint Scale), metacognition (Brief Metamemory and Metaconcentration Scale), and breastfeeding self-efficacy (Breastfeeding Self-Efficacy Scale-Short Form). Sociodemographic variables, social isolation characteristics, and breastfeeding practices were also collected. This study was conducted in accordance with the Declaration of Helsinki. Statistical analysis included zero-order correlations, multiple logistic regressions, and a set of structural equation models (SEM) to test direct and indirect effects. Goodness-of-fit indices were calculated for SEM.

Setting

Postpartum women were recruited from public hospitals, private health clinics, and online community recruitment in the Cordoba province (Argentina).

Participants

305 postpartum women from Argentina.

Measurements and findings

37% of women reported postpartum depression, 46% insomnia, 42% memory impairment, 60% low metaconcentration, 50% low metamemory, and 23% low breastfeeding efficacy. Also, significant associations were found demonstrating that social isolation promoted postpartum depression and insomnia were reciprocally related, which compromised female cognition and efficacy. This situation was aggravated in women during late postpartum, with previous children, and by low social support (e.g., family, health professionals), with non-exclusive breastfeeding being increased.

Key conclusions

This is the first study addressing postpartum women's mental status during social isolation in Argentina, which was a promoting factor for postpartum depression and insomnia that were reciprocally related. This situation was also aggravated by reproductive factors, such as late postpartum, multiparity, breastfeeding frequency, and non-exclusive breastfeeding. Additionally, breastfeeding self-efficacy depended on mental health status, and euthymia therefore favoured the practice of exclusive breastfeeding.

Memory enhancement in Argentinian women during postpartum by the dietary intake of lignans and anthocyanins

Due to their polyphenolic content, vegetable foods have neuroprotective effects which provide health benefits for specific human groups. Thus, they may be a useful dietary component for women who experience mnesic variations during postpartum, and here we examined the hypothesis that polyphenols can differentially enhance memory functioning. In particular, we aimed to associate the dietary intake of polyphenols with different memory systems in Argentinian postpartum women. The daily intakes of polyphenol groups were calculated using a validated food frequency questionnaire and the Phenol-Explorer database. Short-term memory (STM), long-term memory (LTM), learning (L), lexical-semantic memory (LSM), and working memory (WM) were assessed. Partial Least Squares (PLS) regression models were used to analyze the dietary polyphenols (predictors) and memory domains (responses), taking into account demographic, obstetric, and psychological factors. The sample included 71 women, with an average age of 29.59 years (SE = 0.73). Most of these women lived in a couple (91%), were unemployed (63%), and had ≥12 years of formal education (72%). STM, LTM, L, and LSM correlated with lignans and anthocyanins, with LTM also being correlated with flavanones, flavonols, and tyrosols, and L and LSM also being associated with flavonols. A significant correlation was also found between WM and lignans. In conclusion, a cognitive improvement was demonstrated, mainly associated with the intake of lignans and anthocyanins, in the STM, LTM, WM, L, and LSM systems of postpartum women. This is the first study to our knowledge suggesting a role of polyphenolic effects on memory functioning during postpartum.

Insomnia is associated with worry, cognitive avoidance and low academic engagement in Argentinian university students during the COVID-19 social isolation

An increment in mental health problems related to social isolation strategies was evinced in several populations, however few investigations address this problem in students. This study aimed to analyze the relationship between insomnia, worry, coping strategies, and academic engagement in subjects pursuing a university degree in Argentina during the first month of compulsory social isolation against the COVID-19 pandemic. Self-report online questionnaires were administered to 584 participants: Insomnia Severity Index, Penn State Worry Questionnaire, Coping Responses Inventory, Utrecht Work Engagement Scale for Students. Demographic data was recorded. Statistics included bivariate and multivariate techniques. Prevalences of 45% for subthreshold insomnia, 23% for moderate insomnia, and 4% for severe insomnia were found. The severe insomnia group presented higher levels of worry and cognitive avoidance strategies. Insomnia was also associated with daytime concerns. The group without insomnia was more vigorous in their academic engagement. Being physically active was associated with lower sleep problems. Insomnia prevalence is high in socially isolated university students. Cognitive avoidance coping strategies are associated with worry, which leads to an alert state that makes sleep difficult. These findings should be taken into account by academic institutions to define their pedagogic strategies.