Resilience and perceived social support among family Caregivers of patients with mental illness : what links ?

Introduction

Burden among family caregivers of patients with mental illness can be mediated by resilience and perceived social support.

Objectives

The present study aimed to explore the relationship between perceived social support and resilience levels among caregivers of patients with mental illness and to identify its associated factors.

Methods

This was a cross-sectional, descriptive and analytical study conducted on caregivers of patients followed in the outpatient psychiatry department at the university hospital of Sfax (Tunisia), during septembre 2021. Resilience was assessed with the Connor–Davidson Resilience Scale and the social support with the social provisions scale. High scores indicate high resilience and support.

Results

We have involved 34 family caregivers with an average age of 47.47 years(SD=12.4 years). The mean resilience score of caregivers was 42.85 and the mean social support score was 28.09(SD=5.54). The score of resilience correlated positively with the score of social support among family caregivers of patients (r= 0.76 ; p=0.0001). Furthermore, resilience and social support were significantly lower among caregivers with a history of chronic illness (p=0.0001 and 0.002 respectively). Regarding clinical factors, the scores of social support and resilience decreased significantly with the duration of providing care to patients (r=-0.60; p=0.0001 and r=-0.75; p=0.0001 respectively). Similarly, they decreased significantly with the number of hospitalizations of patients (r=-0.53; p=0.001 and r=-0.62; p=0.0001 respectively).

Conclusions

The findings suggests that high social support promotes better resilience among family caregivers of patients with mental illness. So, a better adjustement to the role of caregiver can be effectively achieved by improving the perceived social support.

Disclosure

No significant relationships.

Resilience in Family caregivers of Tunisian patients with psychiatric disorders

Introduction

Resilience has been described as an individual’s ability to adjust or adapt to significant adverse or traumatic circumstances.

Objectives

The aims of this study were to assess the resilience of caregivers of patients with mental disorders and to identify its associated factors.

Methods

We conducted a descriptive and analytical cross-sectional study among caregivers of patients followed in the outpatient psychiatry department at the university hospital of Sfax(Tunisia), during septembre 2021. Resilience was assessed using Connor–Davidson Resilience Scale(CD‑RISC).The total scores range from zero to 100. The cut-off scores for this questionnaire is 50, with higher score indicating higher resilience.

Results

Our sample included 34 family caregivers. The mean age was 47.47 years (SD=12.4 years)and the sex ratio (M/F) was 1.42. They were the parents of patients in 35.3% of cases. The mean duration of providing care to patients was 8.62 years. The mean resilience score of caregivers was 42.85 and 26.5% of them were resilients. The Caregivers with low socioeconomic level (p=0.004), a history of chronic illness (p=0.0001), a long duration of providing care (p=0.001), a stressful events (0.002) and those victims of agressive behaviors committed by patients (p=0.0001) were more likely to have a low resilience score.

Conclusions

Our results stated that three out four cargivers have low level of resilience. Interventions targeting stress related to social events and burden of care, and violence committed by patients in their family environment should be integrated to increase the caregivers’resilience.

Disclosure

No significant relationships.

Quality of sleep in Tunisian patients with Multiple Sclerosis during the COVID-19 pandemic

Introduction

COVID-19 pandemic has affected human communities around the world, and there is fear that people with chronic diseases such as Multiple sclerosis(MS) are more vulnerable to negative psychological effects.

Objectives

The aim of the present study was to assess the quality of sleep in patients with (MS) in comparison with healthy controls(HCs), during the COVID-19 pandemic and to identify its associated factors.

Methods

This was a cross-sectional survey study conducted with patients followed at the neurology department of Hbib bourguiba university hospital in sfax(Tunisia), during the month of november2020. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI). The PSQI is a questionnaire assessing participants’ sleep quality, sleep duration, and sleep disturbances and their severity during the past month.Participants with a PSQI ≤5 are classified as ‘good sleepers’.

Results

Fifty two patients were included in the study. The mean age was 33.69 years(SD=9.21 years)and the sex ratio(F/H)was 4.77. Overall, our patients had higher scores of(PSQI)compared to HC and these différences were statistically significant(p < 0.05). The mean score of(PSQI)was 11.04(SD=3.003)and 11.53%were classified as ‘good sleepers’. Unemployment was related to a poor sleep quality(p=0.0001). Patients with high EDSS(r=0.7;p=0.0001), high number of relapses(r=0.58 ;p=0.0001)were more likely to have sleep disturbance. There was a positive correlation between a poor sleep quality and the duration of disease(r=0.38;p=0.005).

Conclusions

We identified that during the COVID-19pandemic patients with(MS)had a worse sleep quality. The COVID-19pandemic poses a challenge to psychological resilience. More studies are warranted to better understand the long-term consequences of the pandemic on mental health of vulnerable people.

Disclosure

No significant relationships.

Self-esteem in women experienced intimate partner violence : a tunisian cross-sectional study

Introduction

Intimate partner violence (IPV) and psychological distress are major public health concerns among emerging adult women.

Objectives

To study the self-esteem of women victims of domestic violence and to determine its associated factors .

Methods

This was a cross-sectional descriptive study carried out at the National Health Fund of Sfax among women who consulted during the months of October and November 2019. The sociodemographic and clinical characteristics of the consultants were collected using a pre-established form. Women’s Experience with Battering Scale” (WEBS) was used to screen (IPV). The Rosenberg Self-Esteem Scale (RSE), was used for evaluating individual self-esteem. It uses a scale of 0–4 where a score less than 25 may indicate a problematic very low self esteem.

Results

The sample comprised 110 women. More than half (66.7%) of women had a primary school level and 69% had a median socioeconomic level. (IPV) was estimated at 57.3% in our population. The mean (WEBS) score was 30.92(SD=9.8) and the mean (RSE) score was 31.26 (SD=3.5) among abused women self-esteem was very low in15.5% and low in 42.7% Abused women were more likely to have a low self-esteem (r= -0.528 ;p=0.012) The score of self-esteem decreased with age (r=-0.685 p=0.0001) and previous history of violence(p=0.04).

Conclusions

The findings suggests that Women who experienced (IPV) were more likely to have a low self-esteem. Therefore, the role of the physician is essential not only in the care of the victims but also in the detection of psychological repercussions.

Disclosure

No significant relationships.

A Multicenter Prospective Registry Study of Lung Transplant Recipients Hospitalized with COVID-19

Purpose

Outcomes of lung transplant recipients (LTR) hospitalized for COVID-19 and comparisons to non-lung solid organ transplant recipients (SOTR) are incompletely described.

Methods

Using a multicenter prospective registry of SOTR, we examined 28-day outcomes (mortality [primary outcome], intensive care unit (ICU) admission, mechanical ventilation, and bacterial pneumonia) among both LTR and non-lung SOTR hospitalized with laboratory-confirmed COVID-19 diagnosed between March 1, 2020 and September 21, 2020. Data were analyzed using Stata (StataCorp, College Station, TX); chi-square tests were used to compare categorical variables and multivariable logistic regression was used to assess risk factors for mortality.

Results

The cohort included 72 LTR and 392 non-lung SOTR (Table 1). Overall, 28-day mortality trended higher in LTR vs. non-lung SOTR (27.8% vs. 19.9%, P=0.136). Other 28-day outcomes were similar between LTR and non-lung SOTR: ICU admission (45.8% vs. 39.1%, P=0.28), mechanical ventilation (32.9% vs. 31.1%, P=0.78), and bacterial pneumonia (15.3% vs. 8.2%, P=0.063). Congestive heart failure, diabetes, age >65 years, and obesity (BMI >= 30) were independently associated with mortality in non-lung SOTR, but not in LTR (Table 2).

Conclusion

In this large prospective cohort comparing lung and non-lung SOTR hospitalized for COVID-19, there were high but not significantly different rates of short-term morbidity and mortality. Baseline comorbidities appeared to drive mortality in non-lung SOTR but not LTR. Further studies are needed to identify risk factors for mortality among LTR.

Serine protease inhibitor-6 differentially affects the survival of effector and memory alloreactive CD8-T cells

The clonal expansion of effector T cells and subsequent generation of memory T cells are critical in determining the outcome of transplantation. While cytotoxic T lymphocytes induce direct cytolysis of target cells through secretion of Granzyme-B (GrB), they also express cytoplasmic serine protease inhibitor-6 (Spi6) to protect themselves from GrB that has leaked from granules. Here, we studied the role of GrB/Spi6 axis in determining clonal expansion of alloreactive CD8-T cells and subsequent generation of memory CD8-T cells in transplantation. CD8-T cells from Spi6(-/-) mice underwent more GrB mediated apoptosis upon alloantigen stimulation in vitro and in vivo following adoptive transfer into an allogeneic host. Interestingly, while OT1.Spi6(-/-) CD8 T cells showed significantly lower clonal expansion following skin transplants from OVA mice, there was no difference in the size of the effector memory CD8-T cells long after transplantation. Furthermore, lack of Spi6 resulted in a decrease of short-lived-effector-CD8-cells but did not impact the pool of memory-precursor-effector-CD8-cells. Similar results were found in heart transplant models. Our findings suggest that the final alloreactive CD8-memory-pool-size is independent from the initial clonal-proliferation as memory precursors express low levels of GrB and therefore are independent of Spi6 for survival. These data advance our understanding of memory T cells generation in transplantation and provide basis for Spi6 based strategies to target effector T cells.

Reading Saedi's Ahl-e Hava: pattern and significance in spirit possession beliefs on the southern coasts of Iran

Based on Saedi's description of spirit possession beliefs and practices on the southern coasts of Iran, this paper attempts to isolate the culturally and psychologically significant categories through which the possessed define and differentiate their possessing spirits or "Winds." It examines the play of these categories in the complex of relationships between the possessing spirits, the possessed, ritual specialists, "symptoms" of possession, and their "negotiations" in rituals of possession or exorcism. It examines from a semiotic perspective the double transformations of spirit and host which in the beliefs and practices of the People of the Air constitute "therapy." It points out areas for further research and analysis.