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Khurram SS, Aga IZ, Karim M, Muzzamil M, Lakhani A, Ahmed S. Electronic health records as a window into telehealth: exploring service utilisation and mental health outcomes in Pakistan. Gen Psychiatr 2024; 37:e101609. [PMID: 39258116 PMCID: PMC11381653 DOI: 10.1136/gpsych-2024-101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/08/2024] [Indexed: 09/12/2024] Open
Affiliation(s)
- Sara Saeed Khurram
- Public Health & Digital Health, Sehat Kahani C/O Community Innovation Hub, Karachi, Sindh, Pakistan
- Health Policy and Management, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Iffat Zafar Aga
- Public Health & Digital Health, Sehat Kahani C/O Community Innovation Hub, Karachi, Sindh, Pakistan
- Global Health, The University of Edinburgh Centre for Global Health Research, Edinburgh, Edinburgh, UK
| | - Mahek Karim
- Public Health & Digital Health, Sehat Kahani C/O Community Innovation Hub, Karachi, Sindh, Pakistan
- Epidemiology and Biostatistics, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Muhammad Muzzamil
- Public Health & Digital Health, Sehat Kahani C/O Community Innovation Hub, Karachi, Sindh, Pakistan
- Public Health, Health Services Academy, Islamabad, Punjab, Pakistan
| | - Alina Lakhani
- Public Health & Digital Health, Sehat Kahani C/O Community Innovation Hub, Karachi, Sindh, Pakistan
| | - Sanaa Ahmed
- Mental Health, British Asian Trust, Karachi, Sindh, Pakistan
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Baig KB, Sadia H, Rauf U, Abbas Q, Ramzan Z, Tabassum U, Aljhani S. Reliability and validity estimation of Urdu version of Children Emotion Management Scales (CEMS) in Pakistan. Front Psychiatry 2024; 14:1214708. [PMID: 38605884 PMCID: PMC11008575 DOI: 10.3389/fpsyt.2023.1214708] [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: 04/30/2023] [Accepted: 10/11/2023] [Indexed: 04/13/2024] Open
Abstract
Introduction The present study aimed to translate and validate Children's Emotion Management Scales into Urdu, the national language of Pakistan. Method The current study comprised three different phases, i.e., phase I: Cross-language validation over a sample of (N = 169) school children, estimated at a 1-week interval. Results The results indicate a significant correlation (r = 0.846-0.891) at p < 0.01. In phase II, the internal consistency reliability (r = 0.808-0.904) and split-half reliability (r = 0.737-0.898) of the scale were assessed (N = 683) at p < 0.01. Furthermore, significant results for test-retest reliability analysis (N = 168) were obtained (r = 0.736-0.917 at p < 0.01), following the confirmatory factor analysis (CFA) (N = 1,083). Exploratory factor analysis (EFA) was conducted on the same sample chosen for CFA. EFA resulted in the retention of original inhibition (INH), dysregulated expression (DYS), and emotional coping (EMO) factors. CFA findings suggest a good model fit. In phase III, convergent validity and divergent validity were checked (N = 385, 255, and 213). Convergent validity of INH and DYS subscales and divergent validity of EMO subscales were established, with SBI (r = 0.217-0.609; 0.210-0.445; -0.026 to -0.553), SHS (r = 0.417-0.441; 0.480-0.546; -0.338 to -0.582), and suppression subscale of ERQ (r = 0.430-0.480; 0.468-0.522; -0.245 to -0.369) at p < 0.01. For divergent validity of INH and DYS subscales and convergent validity of EMO subscales, their scores were correlated with the SPS (r = -0.204 to -0.350; -0.318 to -0.459; 0.191-0.531), RSE Scale (r = -0.226 to -0.351; -0.279 to -0.352; 0.255-0.507), DTS (-0.290 to -0.617; -0.369 to -0.456; 0.246-0.680), and reappraisal subscale of ERQ (r = -0.456 to -0.541; -0.329 to -0.544; 0.446-0.601) at p < 0.01. Discussion It is concluded that the scale is reliable and valid with sound psychometric properties.
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Affiliation(s)
- Khawer Bilal Baig
- Department of Professional Psychology, Bahria University Lahore Campus, Lahore, Pakistan
| | - Haleema Sadia
- Department of Applied Psychology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Umara Rauf
- Department of Psychology, Government College Women University Sialkot, Sialkot, Pakistan
| | - Qasir Abbas
- Department of Applied Psychology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Zoobia Ramzan
- Department of Psychiatry, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Urooj Tabassum
- Department of Psychiatry, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Sumayah Aljhani
- Department of Psychiatry, College of Medicine, Qassim University, Buraydah, Saudi Arabia
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Younas A, Zeb H, Tejada-Garrido CI, Durante A. Social suffering in individuals with chronic obstructive pulmonary disease: a secondary analysis of interpretative phenomenological study. PSYCHOL HEALTH MED 2024; 29:236-241. [PMID: 36154546 DOI: 10.1080/13548506.2022.2128195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/16/2022] [Indexed: 10/14/2022]
Abstract
Individuals with chronic obstructive pulmonary disease experience suffering that affects their families and community relationships. However, no studies provide an explicit account of social suffering among these individuals. This secondary analysis was conducted to understand the lived experiences of social suffering in individuals with chronic obstructive pulmonary disease. The theory of social suffering guided the analysis of an interpretative phenomenological study. Thirteen individuals were recruited using purposive sampling. Data were analyzed using reflexive thematic analysis. Three themes were generated: a) prevailing hopelessness and burden, b) progressing relational adversities, and c) struggling with co-dependency. Social suffering is a complex entity experienced by the patients and the family caregivers. For enhanced caregiving, health professionals could prepare patients to tackle the suffering through collective actions.
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Affiliation(s)
- Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, Canada
| | - Hussan Zeb
- Swat College of Nursing, Mingora, Pakistan
| | | | - Angela Durante
- Department of Nursing, University of La Rioja, Logroño Spain
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Hassan W. Mandatory mental health education in Pakistan: a proposal. Lancet Psychiatry 2023; 10:318-319. [PMID: 37059483 DOI: 10.1016/s2215-0366(23)00108-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 04/16/2023]
Affiliation(s)
- Waseem Hassan
- Institute of Chemical Sciences, University of Peshawar, Peshawar 25120, Khyber Pakhtunkhwa, Pakistan.
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Valkovskaya M, Hassan A, Zartaloudi E, Hussain F, Umar M, Khizar B, Khattak I, Gill SA, Khan SUDA, Dogar IA, Mustafa AB, Ansari MA, Qalb I Hyder S, Ali M, Ilyas N, Channar P, Mughal N, Channa S, Mufti K, Mufti AA, Hussain MI, Shafiq S, Tariq M, Khan MK, Chaudhry ST, Choudhary AR, Ali MN, Ali G, Hussain A, Rehman M, Ahmad N, Farooq S, Naeem F, Nasr T, Lewis G, Knowles JA, Ayub M, Kuchenbaecker K. Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan. Psychiatr Genet 2023; 33:69-78. [PMID: 36538573 PMCID: PMC9997631 DOI: 10.1097/ypg.0000000000000333] [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] [Received: 08/31/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500 cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research.
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Affiliation(s)
| | - Arsalan Hassan
- Department of Pharmacy, University of Peshawar, Peshawar, Pakistan
| | - Eirini Zartaloudi
- Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Fahad Hussain
- Lahore Institute of Research and Development, Lahore
| | - Muhammad Umar
- Lahore Institute of Research and Development, Lahore
| | - Bakht Khizar
- Lahore Institute of Research and Development, Lahore
| | | | | | | | | | - Ali Burhan Mustafa
- Department of Psychiatry and Behavioural Sciences, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan
| | - Moin Ahmed Ansari
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Syed Qalb I Hyder
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Muhammad Ali
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Nilofar Ilyas
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Parveen Channar
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Nazish Mughal
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | - Sumera Channa
- Sir Cowasjee Jehangir Institute of Psychiatric and Behavioral Sciences, Hyderabad
| | | | | | | | | | | | | | | | | | | | - Gohar Ali
- Department of Psychiatry, Saidu Teaching Hospital
| | | | | | - Noman Ahmad
- Punjab Institute of Mental Health (PIMH), Lahore, Pakistan
| | - Saeed Farooq
- School of Medicine, Keele University, Keele
- Innovation Department, Midlands Partnership NHS Foundation Trust, Staffotdshire, UK
| | - Farooq Naeem
- Department of Psychiatry, University of Toronto
- Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tanveer Nasr
- Lahore Institute of Research and Development, Lahore
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - James A. Knowles
- Human Genetics Institute of New Jersey (HGINJ), Rutgers University, New Brunswick, New Jersey, USA
| | - Muhammad Ayub
- Division of Psychiatry, University College London, London, UK
| | - Karoline Kuchenbaecker
- Division of Psychiatry, University College London, London, UK
- UCL Genetics Institute, University College London, London, UK
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Imran N, Hamdan QU, Thomson S, Hermans M, Javed A, Ng R. Training beyond borders: A WPA pilot project for Child and Adolescent Mental Health course in Pakistan. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.19337.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The World Psychiatric Association (WPA) strives to close the gap between expertise in high income countries (HICs) and low- and middle-income countries (LMICs). WPA volunteering programme is a project framework wherein area specific experts from HICs volunteer to support local experts in the LMICs in training their own professionals. This paper reports on the outcome of a collaborative project on Child and Adolescent Mental Health (CAMH) training in Pakistan. Methods: Thirty participants from twenty three different institutions across Pakistan were selected on the basis of their interest in CAMH. Two volunteers (ST and MH) met online with the Pakistani representatives (NI and QUH) to develop a programme. They also regularly met online between the sessions to evaluate adjustments in order to increase appropriateness of the offered content according to participants‘ feedback and suggestions. Results: The pre- and post-course evaluation revealed statistically significant improvement in knowledge and skills gained in different topics covered in the course (P-value<0.001) as well as improvement in confidence in applying the theoretical knowledge of CAMH problems in their daily clinical practice (P-value<0.001) Conclusions: The WPA volunteering programme is a valuable strategy to deliver effective and much needed training in low resource settings. Long-distance learning via live online sessions is effective and worthwhile, especially when they provide opportunities for participants to learn from interactive sessions.
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Shah SM, Sun T, Xu W, Jiang W, Yuan Y. The mental health of China and Pakistan, mental health laws and COVID-19 mental health policies: a comparative review. Gen Psychiatr 2022; 35:e100885. [PMID: 36506889 PMCID: PMC9676995 DOI: 10.1136/gpsych-2022-100885] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/16/2022] [Indexed: 11/18/2022] Open
Abstract
Mental health is one of the major causes of disability worldwide, and mental health problems such as depression and anxiety are ranked among the top 25 leading causes of disease burden in the world. This burden is considerable over the lifetime of both men and women and in various settings and ages. This study aims to compare the mental health status of people in China and Pakistan and to highlight the mental health laws and policies during COVID-19 and afterwards. According to the literature on mental health, before the COVID-19 pandemic, mental health problems increased gradually, but during and after the COVID-19 pandemic, an abrupt surge occurred in mental health problems. To overcome mental health disorders, most (but not all) countries have mental health laws, but some countries ignore mental health disorders. China is one such country that has mental health laws and policies and, during the COVID-19 pandemic, China made beneficial and robust policies and laws, thereby succeeding in defeating the COVID-19 pandemic. The mortality rate and financial loss were also lower than in other countries. While Pakistan has mental health laws and general health policies, the law is only limited to paperwork and books. When it came to COVID-19, Pakistan did not make any specific laws to overcome the virus. Mental health problems are greater in Pakistan than in China, and China's mental health laws and policies are more robust and more widely implemented than those in Pakistan. We conclude that there are fewer mental health issues in China than in Pakistan both before and since the COVID-19 pandemic. China has strong mental health laws and these are robustly implemented, while the mental health law in Pakistan is not applied in practice.
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Affiliation(s)
- S Mudasser Shah
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Taipeng Sun
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wei Xu
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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