Parental intention on getting children COVID-19 vaccinations: Invariance evaluation across parenting roles and COVID-19-like symptoms experiences among Iranians during the pandemic period

Countries worldwide are facing challenges with increasing the COVID-19 vaccination rates for children. This study examined associations between perceived knowledge, coping appraisal, threat appraisal, adaptive response, maladaptive response, and intention, and possible variance across parents (mother or father) and COVID-19-like symptoms experiences regarding parental intentions to vaccinate their children. A total of 836 Iranian parents with children between the ages of 6 and 12 y completed measures assessing perceived knowledge, coping appraisals, threat appraisals, intentions, adaptive responses, and maladaptive responses. Multigroup structural equation modeling revealed that perceived knowledge was positively associated with both coping and threat appraisals, coping appraisals positively associated with adaptive responses, maladaptive responses, and intentions to vaccinate, threat appraisals positively associated with adaptive and maladaptive responses, and adaptive responses positively associated with intentions to vaccinate. The invariance evaluation revealed no differences across parents or COVID-19-like symptoms experiences in parental intentions to get their children vaccinated. The findings suggest that cogent information regarding childhood COVID-19 vaccination may boost parents' knowledge influencing their appraisals, adaptive responses and intentions to vaccinate their children. Specifically, coping appraisals and adaptive responses appeared to be important mediators between knowledge and intentions to vaccinate. Furthermore, intentions to vaccinate children may not be strongly influenced by parental roles or COVID-19-like symptoms experiences. These findings may help multiple stakeholders promote COVID-19 vaccination rates among children, and countries should further examine ways of increasing rates based on their specific needs.

Association of quality of life with internet use and weight stigma across individuals with obesity and those without obesity: Role of self-perception

Weight status, weight stigma, and internet use are important factors impacting quality of life (QoL). However, little is known regarding how these factors interact in their association with QoL, and it is important to understand how self-perceived obesity and body mass index (BMI)-defined obesity may differentially impact QoL. We aimed to assess the associations between weight status (obesity vs. non-obesity, including both self-perceived and BMI-defined), weight stigma, internet use, and QoL. Cross-sectional data from the Taiwan Social Change Survey (N = 1604; mean age = 49.22; 52.93 % women) were used. All participants were classified as having obesity or not having obesity according to both self-perceived (self-perceived as 'too fat') and BMI-defined (≧27 kg/m2 as obesity) weight status. Results showed that the group with obesity (both BMI-defined and self-perceived) had significantly more internet time and lower physical QoL than the group without obesity. Those with self-perceived obesity, but not those with BMI-defined obesity, sought health information via the internet and used social media significantly more than the group without obesity. More internet time was associated with worse physical and mental QoL for the group with obesity regardless of BMI-defined or self-perceived status. Moreover, weight stigma was associated with worse mental QoL for the group with self-perceived obesity, but not for the group with BMI-defined obesity. Accordingly, being a person with obesity (self-defined, or based upon BMI) was associated with more internet time and poorer QoL. People with self-perceived obesity may have increased experience of weight stigma and greater internet use, factors that may contribute to their impaired QoL.

The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) - A psychometric evaluation of adolescents in Sweden during the COVID-19 pandemic

The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) is effective in assessing positive aspects of mental health. Despite its advantages, little is known about group differences in the interpretation of SWEMWBS items across age groups, especially during the adolescence period. Hence, this study examined the psychometric properties of the SWEMWBS through Confirmatory Factor Analysis (CFA), Rasch analysis and network analysis of Swedish adolescents during the COVID-19 pandemic. A total of 5548 participants from the south of Sweden (i.e., Jönköping County) took part in this cross-sectional study through an online platform between September 2020 and October 2020. The CFA, Rasch (including differential item functioning, DIF) analysis and network analysis were used to examine the psychometric properties and measurement invariance of the SWEMWBS. The SWEMWBS had a unidimensional structure with robust psychometric properties. The CFA demonstrated measurement invariance across gender, school year and country of birth, which was also confirmed by Rasch DIF. Furthermore, considerable associations between the items of the SWEMWBS, general health and COVID-19 impact items were observed in network analysis. The SWEMWBS showed robust psychometric properties capable of assessing positive aspects of mental health and well-being among adolescents.

Meta-analysis with systematic review to synthesize associations between oral health related quality of life and anxiety and depression

OBJECTIVES

The present systematic review aimed to investigate how oral health related quality of life (OHQOL) associates with anxiety and depression. The study protocol was registered prospectively in the PROSPERO database (CRD42023389372).

MATERIALS AND METHODS

Studies investigating associations between OHQOL and depression and/or anxiety were included. Fisher's Z scores were used to summarize associations between OHQOL and depression/anxiety. Funnel plots and Begg's Tests were used to assess publication bias. Meta-regression was conducted to examine potential moderator effects in the associations. Academic databases including the ISI Web of Knowledge, Scopus, ProQuest and PubMed were systematically searched. The quality of included studies was checked with the Newcastle Ottawa Scale (NOS).

RESULTS

All 15 included studies were cross-sectional (14,419 participants from nine countries; mean age=43.74 years). The pooled estimates showed weak associations between OHQOL and depression (Fisher's z-score of 0.26 [95% CI = 0.17, 0.35; I2 = 96.2%; τ2 = 0.03]) and anxiety (Fisher's z-score of 0.22 [95% CI = 0.001, 0.43; I2 = 97.9%; τ2 = 0.06]). No severe problems in methodology quality, publication biases, or moderator effects were observed.

CONCLUSION

Both depression and anxiety were weakly associated with individuals' OHQOL. Although the synthesized associations were not strong, they were significant, indicating that depression and anxiety are potential factors influencing individuals' OHQOL.

Problematic Use of Internet Associates with Poor Quality of Life via Psychological Distress in Invididuals with ADHD

Background

Problematic use of internet (PUI) may have negative impacts on psychological distress and quality of life (QoL). This situation might be more profound in people with attention-deficit/hyperactivity disorder (ADHD) due to poorer behavioral control and regulatory capacity. However, there is little evidence regarding mediated effects in the associations between PUI, psychological distress, and QoL in people with ADHD.

Aims

To investigate mediating effects of psychological distress in the associations of problematic smartphone use (PSPU), problematic use of social media (PUSM), and problematic gaming (PG) with QoL in individuals with ADHD.

Methods and Procedures

PUI behaviors of participants with ADHD (n = 99) were assessed using the Smartphone Application-Based Addiction Scale, Bergen Social Media Addiction Scale, and Internet Gaming Disorder-Short Form. Psychological distress was assessed using the Depression, Anxiety, Stress Scale and QoL using the Kid-KINDL.

Outcomes and Results

Psychological distress mediated the associations between PUI and different domains of QoL, except for self-esteem QoL. There were also positively direct effects between PG and physical QoL, PUSM and friends' QoL, and PSPU and physical QoL.

Conclusions and Implications

PUI may associate with poor QoL in people with ADHD via psychological distress. Programs on reducing PUI for people with ADHD are needed.

Exploring health literacy categories among an Iranian adult sample: a latent class analysis

General and electronic health literacy are important factors engaging in healthy behaviors and maintaining good health. The present study explored demographic factors associated with general and electronic health literacy in the Iranian adult population. Via stratified cluster sampling, trained interviewers visited adult residents in Qazvin Province, Iran between January, and April 2022. The participants (N = 9775; mean age = 36.44 years; 6576 [67.3%] females) completed the Health Literacy Instrument for Adults (HELIA) assessing health literacy and the eHealth Literacy Scale (eHEALS) assessing electronic health literacy. Demographic data, including age, gender, educational level, marital status, and living location (city or rural), were collected. Latent class analysis (LCA) was used to classify the participants into different health literacy/electronic health literacy levels. The relationships between health literacy/electronic health literacy levels and demographic factors were examined using χ2 or analysis of variance. The LCA used HELIA scores to suggest five classes of health literacy and eHEALS scores to suggest three classes of electronic health literacy. For general and electronic health literacy, similar relationships were with demographic factors: females as compared with males had better general/electronic health literacy; younger people as compared with older people had better general/electronic health literacy; higher educational level was associated with better general/electronic health literacy; and city residents as compared with rural residents had better general/electronic health literacy. In conclusion, Iranian governmental agencies may wish to target on males, older adults, people with low educational level, and rural residents to improve their health literacy.

Problematic Use of Internet Among Indonesia University Students: Psychometric Evaluation of Bergen Social Media Addiction Scale and Internet Gaming Disorder Scale-Short Form

OBJECTIVE

Social media addiction and internet gaming disorder may cause mental health problems among a minority of university students. The Bergen Social Media Addiction Scale (BSMAS) and the 9-item Internet Gaming Disorder Scale-Short Form (IGDS9-SF) are commonly used worldwide. However, they have not been translated or validated into Indonesian. The present study aimed to translate and validate the BSMAS and IGDS9-SF in an Indonesian context among young adults.

METHODS

A multi-center, web-based cross-sectional study was conducted among 458 university students (74% female; mean age 22.5 years) in Indonesia from June to December 2021. The BSMAS and IGDS9-SF were translated into Indonesian. Internal consistency (using Cronbach's α and McDonald's ω) and factor structure (using confirmatory factor analysis) of the two instruments were examined. Concurrent validity of BSMAS and IGDS9-SF was examined using their correlations with two external concepts: nomophobia and psychological distress.

RESULTS

Internal consistency of the Indonesian BSMAS and IGDS9-SF were both acceptable (Cronbach's α=0.80 and 0.90; McDonald's ω=0.86 and 0.92). Both instruments were unidimensional with good factor loadings (0.54-0.78 for BSMAS; 0.63-0.79 for IGDS9-SF). Moreover, BSMAS and IGDS9-SF had stronger associations with nomophobia (r=0.58 and 0.12; p<0.001) than with psychological distress (r=0.43 and 0.15; p<0.001).

CONCLUSION

The Indonesian versions of the BSMAS and IGDS9-SF had good psychometric properties in terms of linguistic validity, unidimensionality, and reliability. The findings indicate the tools are appropriate for assessing the risk of social media addiction and internet gaming disorder among university students in Indonesia.

Problematic smartphone use and two types of problematic use of the internet and self-stigma among people with substance use disorders

BACKGROUND AND AIMS

Guided by the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and a self-stigma framework, this study aimed to investigate relationships between cognitive and affective self-stigma and behavioral self-stigma, problematic use of internet (PUI), and problematic smartphone use (PSU) among people with substance use disorders (SUDs). It also examined mediating roles for affective self-stigma in the relationships between cognitive self-stigma and behavioral self-stigma/PUI/PSU.

METHODS

Using a cross-sectional design, 530 participants diagnosed with SUDs in Taiwan were recruited from a psychiatric center in Taiwan. Mediation models were investigated using the Hayes' Process Macro Model 4.

RESULTS

Mediation analyses indicated that cognitive self-stigma was directly associated with behavioral self-stigma (p < 0.001), but not with either types of PUI or PSU (p-values ranging from 0.41 to 0.76). Affective self-stigma was directly related to behavioral self-stigma (p < 0.001), two types of PUI, and PSU (β = 0.24-0.30; all p < 0.001); cognitive self-stigma was indirectly associated with behavioral self-stigma (β = 0.53; 95  % bootstrapping CI = 0.46, 0.60), two types of PUI, and PSU (β = 0.20-0.25; 95  % bootstrapping CI = 0.08-0.14, 0.31-0.37) via a mediating effect of affective self-stigma.

DISCUSSION AND CONCLUSION

Findings support the I-PACE model in a self-stigma context. The findings also suggest that addressing affective self-stigma may help prevent or reduce behavioral self-stigma, PUI, and PSU among people with SUDs. Longitudinal studies are warranted to investigate over time relationships between self-stigma and PUI/PSU in people with SUDs.

Sleep hygiene behaviours mediate the association between health/e-health literacy and mental wellbeing

BACKGROUND

Health literacy and e-health literacy are important factors helping people shape awareness of health behaviours in different aspects, including sleep hygiene behaviours. Good sleep hygiene behaviours promote sleep quality and are beneficial to overall mental wellbeing.

OBJECTIVE

We aimed to examine if sleep hygiene behaviours may mediate the association between health literacy/e-health literacy and mental wellbeing.

METHODS

Adult Iranian subjects (n = 9775; mean [SD] age = 36.44 [11.97] years; 67.3% females) completed the Health Literacy Instrument for Adults, eHealth Literacy Scale, three items on sleep hygiene behaviour that have been used in prior research and the Short Warwick Edinburgh Mental Wellbeing Scale. Data were then subjected to structural equation modelling (SEM) including 500 bootstrapping resampling to examine whether sleep hygiene is a mediator in the relationship between health literacy/e-health literacy and mental wellbeing.

FINDINGS

Both health literacy and e-health literacy were significantly associated with mental wellbeing (r = .63 for health literacy and .39 for e-health literacy; p < .001) and sleep hygiene behaviours (r = .58 for health literacy and .36 for e-health literacy; p < .001). Sleep hygiene behaviours were significantly associated with mental wellbeing (r = .42; p < .001). Moreover, SEM that incorporated bootstrapping approaches indicated that sleep hygiene behaviours were significant mediators in the association between health literacy/e-health literacy and mental wellbeing.

CONCLUSIONS

We conclude that health literacy and e-health literacy are associated with mental health wellbeing in the Iranian population. Additionally, the association could be mediated via sleep hygiene behaviours.

PATIENT OR PUBLIC CONTRIBUTION

The study was co-designed with healthcare providers from the vice-Chancellor's Office for Health Affairs of Qazvin University of Medical Sciences as equal partners. Moreover, the women's health volunteers were involved in the design of the study.

Validation of the Thai Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) among young adults

BACKGROUND

The Assessment of Criteria for Specific Internet-use Disorders (ACSID-11) is a consistent and comprehensive instrument to assess symptoms of specific internet-use disorders including those related to gaming, shopping, pornography use disorder, social networks use and gambling considering criteria in the eleventh revision of the International Classification of Diseases (ICD-11). However, to date, there is little evidence supporting instruments assessing major types of specific internet use disorders in Thailand. The aim of this present study was to assess the psychometric properties of the ACSID-11 among Thai young adults.

METHODS

A total of 612 participants were recruited. A confirmatory factor analysis (CFA) examined construct validity of the ACSID-11. Cronbach's α and McDonald's ω were used to assess reliability of the ACSID-11. Pearson correlations examined relationships between ACSID-11 domains and Internet Gaming Disorder Scale-Short Form (IGDS9-SF) scores.

RESULTS

The CFA supported validity of the Thai version of the ACSID-11 and a four-factor structure. Specific domains of the Thai ACSID-11, particularly gaming, were positively and significantly correlated with IGDS9-SF scores.

CONCLUSIONS

Data indicate that the Thai version of the ACSID-11 is a valid and reliable instrument to assess major types of specific internet use disorders. Additional studies are needed to further examine the validity and reliability of the Thai ACSID-11.

Validation of two brief instruments (the SURE and CollaboRATE) to measure shared decision-making in patients with restless legs syndrome

Restless legs syndrome (RLS) is a common neurological disorder characterised by an urge to move arms and legs, usually associated with discomfort, pain, motor restlessness, and sleep disturbance. An individually adapted treatment is needed but difficult to optimise, which makes shared decision-making (SDM) important. However, brief validated instruments on how patients with RLS perceive their involvement in treatment decisions are lacking. Therefore, the aim was to validate two instruments, SURE (Sure of myself, Understand information, Risk-benefit ratio, Encouragement, i.e., to assess decisional conflict) and CollaboRATE (brief patient survey focused on SDM, i.e., to assess SDM), in patients with RLS. A cross-sectional design, including 788 participants with RLS (65% females, mean [SD] age 70.8 [11.4] years) from a national patient organisation for RLS, was used. A postal survey was sent out to collect data regarding weight, height, comorbidities, demographics, and RLS-related treatment data. The following instruments were included: the SURE, CollaboRATE, Restless Legs Syndrome-6 Scale, and eHealth Literacy Scale. Confirmatory factor analysis and Rasch models were used to assess the validity and reliability of the SURE and CollaboRATE. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age, gender, and medication groups were assessed. The SURE and CollaboRATE were both identified as unidimensional instruments with satisfactory internal consistency. No DIF across age and gender was identified, while significant DIF was observed for both the SURE and CollaboRATE regarding medication use categories. However, both the SURE and CollaboRATE are potential instruments to be used in research, but also as reflection tools by healthcare professionals, patients, and students to explore and assess SDM, and support its development in clinical care.

The Fear of COVID-19 Scale: A meta-analytic structural equation modeling approach

The widespread administration and multiple validations of the Fear of COVID-19 Scale (FCV-19S) in different languages have highlighted the controversy over its underlying structure and the resulting reliability index. In the present study, a meta-analysis based on structural equation modeling (MASEM) was conducted to assess the internal structure of the seven-item, 5-point Likert-type FCV-19S version, estimate an overall reliability index from the underlying model that best reflected the internal structure (one τ-equivalent factor, one congeneric factor, or two-factor models), and perform moderator analyses for the model-implied interitem correlations and estimated factor loadings. A Pearson interitem correlation matrix was obtained for 48 independent studies, from which a pooled matrix was calculated following a random-effects multivariate meta-analysis. The results from the one-stage MASEM analysis showed that the two-factor model properly fitted the pooled matrix, while the τ-equivalent and congeneric one-factor models did not. Even though, the use of a bifactor model exhibited the predominance of the general factor over the domain-specific ones. High omega coefficients were obtained for the entire scale (.91) and the psychological (.83) and physiological (.83) symptoms subscales. Moderator analyses evidenced an increase in the estimated factor loadings, as well as in the reliability of the FCV-19S, when the standard deviation of the total scores increased and when the FCV-19S was administered to specific (vs. general) populations. The FCV-19S can be therefore considered as a highly related two-factor scale whose reliability makes it suitable for applied and research purposes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A phubbing scale tested in Bangladesh, Iran, and Pakistan: confirmatory factor, network, and Rasch analyses

BACKGROUND

Phubbing, a phenomenon of ignoring others in face-to-face conversations due to mobile phone use, can be assessed using a Phubbing Scale (PS). Recently, the PS has been shortened into an eight-item version, the PS-8. However, psychometric properties of the PS-8 among Iranian, Bangladeshi and Pakistani individuals remain understudied, especially using advanced psychometric testing, such as Rasch and network analyses.

METHODS

Participants residing in Iran, Bangladesh, and Pakistan (n = 1902; 50.4% females; mean age = 26.3 years) completed the PS-8 and the Internet Disorder Scale-Short Form (IDS9-SF) via an online survey. Network analysis was used to examine if PS-8 items were differentiated from IDS9-SF items; confirmatory factor analysis (CFA) was used to examine the factor structure and measurement invariance of the PS-8; Rasch modeling was used to examine the dimensionality of the PS-8 and differential item functioning (DIF).

RESULTS

Network analysis showed that PS-8 items were clustered together with a distance to the IDS9-SF items. The CFA results supported a two-factor structure of the PS-8, and the two-factor structure was found to be invariant across countries and women and men. Rasch model results indicated that the two PS-8 subscales were both unidimensional and did not display DIF across countries and gender/sex.

CONCLUSION

The PS-8 is a feasible and robust instrument for healthcare providers, especially mental health professionals, to quickly assess and evaluate individuals' phubbing behaviors.

Psychometric properties of the Persian Gaming Disorder Test and relationships with psychological distress and insomnia in adolescents

BACKGROUND

Gaming Disorder (GD) was recently included by the World Health Organization (WHO) as a psychiatric condition in the eleventh revision of the International Classification of Diseases (ICD-11) and is a concern worldwide, including in Iran. Thus, based on the ICD-11 criteria, a Persian version of the Gaming Disorder Test (GDT) was developed to facilitate assessment of GD.

METHODS

The present study used classical test theory and Rasch analysis to examine the psychometric properties of the Persian GDT. Iranian adolescents (n = 3837; 2171 [56.6%] males; mean [SD] age = 16.02 [1.4] years) completed the GDT and other instruments assessing disordered gaming, psychological distress, and insomnia.

RESULTS

Overall, the psychometric properties of the Persian GDT were satisfactory based on classical test theory (i.e., confirmatory factor analysis corroborated the unidimensional structure of GDT) and Rasch analysis (i.e., fit statistics suggested that all items were embedded in the concept of GD). Moreover, the Persian GDT was found to be sex-invariant, displaying no items with substantial differential item functioning across sexes. Additionally, it was found that GD mediated associations between time spent gaming and measures of psychological distress and insomnia.

CONCLUSION

The Persian GDT is a convenient and short instrument for assessing GD among Iranian adolescents. The mediating roles of GD in the associations between time spent gaming and psychological distress and between time spent gaming and insomnia suggest that targeting features of GD may reduce psychological distress and improve sleep for Iranian adolescents.

Psychometric properties of the Depression, Anxiety, and Stress Scale (DASS-21) among different Chinese populations: A cross-sectional and longitudinal analysis

Given that there is limited evidence concerning the psychometric properties of DASS-21 when applied to primary school students, the present study undertook a comprehensive exploration of the psychometric evidence supporting the use of the DASS-21 within this demographic. The research comprised three studies. In Study 1, the basic psychometric properties of internal consistency and construct validity were examined. A total of 3138 primary school students from three provinces in mainland China participated. The internal reliability of the overall scale was 0.93, and for all the subscales, it was higher than 0.80. Construct validity was partially supported. Both exploratory and confirmatory factor analyses upheld the factorial validity of the original three-factor structure. While convergent validity was established, the results showed unsatisfactory discriminant validity. The bifactor model showed that DASS-21 raw scores predominantly indicated the general factor, evidenced by the high explained common variance and omega-hierarchical values. However, the contributions from the three specific factors were minimal, with their omega hierarchical values all below 0.15. In Study 2, a longitudinal design was adopted, tracking 1366 primary school students from Southwest China over a three-month interval. The results further confirmed that the DASS-21 exhibited scalar time-invariance. The latent mean analysis showed that there were no statistically significant differences in the latent means of depression, anxiety, and stress between Time 1 and Time 2. In Study 3, which included 364 college students and 483 enterprise workers, the results demonstrated that the DASS-21 had measurement invariance across different populations. The latent mean analysis further confirmed that, in terms of the latent mean of all three subscales, both college students and enterprise workers had significantly higher scores than primary school students. Overall, the findings indicated that the DASS-21 is a suitable tool for screening schoolchildren for general psychological distress, but it is not suitable for discerning distinct negative mood state disorders.

Cross-Cultural Adaptation and Psychometric Properties of the Swahili Version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 among Breast Cancer Patients in Tanzania

Breast cancer is the most frequent cancer in women in Africa and contributes to premature death and poor quality of life. This study aimed to determine the validity, reliability, and psychometric properties of the Swahili version of EORTC QLQ-BR45 among women with breast cancer in Tanzania. A cross-sectional study design with non-probability convenience sampling was employed. Data were collected in two tertiary hospitals and one national cancer institute; 414 participants completed the EORTC-QLQ-C-30 and EORTC-QLQ-BR45. The reliability of QLQ-BR45 was measured using Cronbach's alpha and McDonald's Omega coefficients. The factor structure of EORTC QLQ-BR45 was assessed using confirmatory factor analysis. The internal consistencies for the five dimensions were all above 0.7 indicating satisfaction, except for systemic therapy side effects with a marginal value of 0.594 and significant correlations between the dimensions of QLQ-C30 and BR45. The final model fit well to the data, with the comparative fit index = 0.953, Tucker-Lewis index = 0.947, root mean square error of approximation = 0.041 (90% CI: 0.035, 0.046), and standardized root mean square residual = 0.072. In conclusion, the QLQ BR45 Swahili version displayed good reliability, validity, and psychometric properties and can be used in Swahili-speaking Sub-Saharan countries.

Nurses' and medical doctors' attitudes towards exercise for people with chronic kidney disease in Denmark

BACKGROUND

Implementation of exercise training in people with kidney failure may be affected by clinicians' attitudes.

OBJECTIVES

To investigate Danish nephrology nurses' and medical doctors' attitudes towards: exercise for people undergoing dialysis; use of physical activity interventions in chronic kidney disease; and to compare Danish and previously reported Australian nurse attitudes.

DESIGN

Cross-sectional survey.

PARTICIPANTS

Nurses and medical doctors from the nephrology field in Denmark.

MEASUREMENTS

The questionnaire attitudes towards exercise in dialysis, and questions about exercise advice, counselling and interventions.

RESULTS

Nephrology nurses (n = 167) and 17 medical doctors (women 92%, age 47 ± 11 years) from 19 dialysis units participated. There were no differences between nurses' and medical doctors attitudes about training. Ninety-five % and 88% of nurses and medical doctors, respectively, agreed that most people undergoing dialysis could benefit from exercise. Exercise training was offered to people undergoing haemodialyses in 88% of 17 departments. Danish nurses reported more positive attitudes than Australian towards exercise (p < 0.05). Ninety-five % and 86% of the Danish and Australian nurses, respectively, agreed/strongly agreed that most people undergoing dialysis could benefit from exercise. Six % and 35% of the Danish and Australian nurses, respectively, agreed/strongly agreed that most people with dialysis were too sick to exercise.

CONCLUSION

Danish nephrology nurses and medical doctors had mostly positive attitudes to exercise training to people undergoing dialysis, and exercise to people with dialysis was offered frequently. Danish and Australian nurses had positive attitudes to exercise to people undergoing dialysis, it was however more positive in Danish nurses.

Prevalence of COVID-19 vaccine acceptance among migrant and refugee groups: A systematic review and meta-analysis

Objectives

Understanding COVID-19 vaccine hesitancy among migrant and refugee groups is critical for achieving vaccine equity. Therefore, we aimed to estimate the prevalence of COVID-19 vaccine acceptance among migrant and refugee populations.

Methods

A systematic review (PROSPERO: CRD42022333337) was conducted (December 2019-July 2022) using PubMed, Scopus, Web of Science, ProQuest and Google Scholar.

Results

Nineteen studies from 12 countries were included. The pooled estimated prevalence of COVID-19 vaccine willingness among migrant and refugee groups was 70% (19 studies, 95% CI: 62.3-77.4%, I2: 99.19%, τ2: 0.03). Female and male participants did not differ significantly with each other (p = 0.64). Although no individual variable contributed statistically significantly in multivariable meta-regression analysis, the multivariable model that considered methodological quality, mean age of participants, participant group and country of origin explained 67% of variance.

Discussion

Proportions of migrant/refugee groups receiving COVID-19 vaccinations approximated those observed among general populations. Additional studies are needed to examine factors relating to vaccine willingness to identify the most significant factors that may be targeted in interventions.

Mediating Roles of Psychological Distress, Insomnia, and Body Image Concerns in the Association Between Exercise Addiction and Eating Disorders

Purpose

Exercising can promote good health. However, excessive exercising may have downsides. This study examined the association between exercise addiction and eating disorders and whether the identified association was mediated by psychological distress, insomnia (including sleep quality), and body image concern.

Methods

A total of 2088 adolescents (mean age of 15.3 years) participated in this cross-sectional study by questions assessing exercise addiction, eating disorders, psychological distress, insomnia, sleep quality, and body image concern.

Results

There were significantly positive relationships between the variables (r=0.12-0.54, p<0.01) with effect sizes from small to large. The four potential mediators (ie, insomnia, sleep quality, psychological distress, and body image concern), individually and in total, significantly mediated the association between exercise addiction and eating disorders.

Conclusion

The findings suggest that exercise addiction in adolescents may influence eating disorders through multiple pathways, such as insomnia, psychological distress, and body image concerns. Future research should examine these relationships longitudinally and use gathered information to inform intervention development. Clinicians and healthcare workers are encouraged to assess exercise addiction when treating individuals with eating disorders.

Translation and Validation of the Gaming Disorder Test and Gaming Disorder Scale for Adolescents into Chinese for Taiwanese Young Adults

PURPOSE

To translate and cross-culturally adapt the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) for use in Taiwan and to validate their internal consistency, construct validity, measurement invariance, and convergent validity in Taiwanese young adults.

METHODS

The GDT and GADIS-A were translated into traditional (unsimplified) Chinese characters and culturally adapted according to standard guidelines. A sample of 608 Taiwanese university students were recruited online. All participants completed the GDT, GADIS-A, Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and Depression Anxiety Stress Scale-21 (DASS-21). Internal consistency was assessed using Cronbach's α and McDonald's ω. Factor structure was examined using Confirmatory Factor Analysis (CFA). Measurement invariance in gender was assessed by three nested models in CFA. Convergent validity was determined by calculating Pearson's r among the GDT, GADIS-A, IGDS9-SF, and DASS-21.

RESULTS

The GDT and GADIS-A showed adequate internal consistency (both α and ω = 0.90). The CFA results supported a one-factor structure for the GDT and a two-factor structure for the GADIS-A. Measurement invariance across gender was supported for both the GDT and GADIS-A. The convergent validity of the GDT and GADIS-A were acceptable.

CONCLUSIONS

The Chinese versions of the GDT and GADIS-A are valid and reliable tools that can be used to assess gaming disorder in Taiwanese young adults. Measurement invariance across genders was supported for both tools. The convergent validity of the GDT and GADIS-A were also satisfactory.

Collection of smartphone and internet addiction

The enigma of smartphone and internet addiction has plagued academics for the last decade, now scholars believe this behavior might have a substantial effect on human health and social issues. However, there are literature gaps. Thus, BMC Psychiatry works with us to launch the special collection "Smartphone and Internet Addiction".

Large-scale dataset on health literacy, sleep hygiene behaviors, and mental well-being in the general population of Qazvin, Iran

The collected data included socio-demographic information and measurements of health literacy, e-health literacy, mental well-being, and sleep hygiene behaviors. The study aimed to provide insights regarding health literacy status and related factors in the general population residing in Qazvin province, Iran. The findings of the study will assist health authorities and policy makers in developing and implementing effective interventions, which in turn, improving health literacy in the community. Additionally, the findings can also aid health sector workers, including non-communicable disease researchers, public health experts, health education specialists, epidemiologists, and sociologists, in their work to improve health literacy and overall health outcomes among general population. Therefore, the present study used paper-pencil method with multi-stage cluster sampling to collect data. Trained research associates (n=25) collected data from 9775 people living in Qazvin province between January and April 2022. All the participants completed the study questionnaires using self-reported paper-pencil mode.

Validation and psychometric evaluation of the Swedish version of the Nasal Obstruction Symptom Evaluation scale

Objectives

The Nasal Obstruction Symptom Evaluation (NOSE) scale is a symptom-specific quality-of-life questionnaire for patients suffering from nasal obstruction. The instrument is designed specifically for patients with septal deviation and for the evaluation of the outcome of septoplasty. The aim of this study was to validate a Swedish version of the NOSE instrument for use in clinical practice and research.

Methods

A Swedish version of the NOSE was tested in a case group consisting of 125 subjects with nasal obstruction (of which 31 underwent septoplasty) and a control group consisting of 65 healthy subjects. Base line data for the case and control groups were used to evaluate face validity, known groups validity, construct validity, internal consistency and factor structure analysis. Fifty participants in both the case groups and control groups were assessed both at baseline and after 2 weeks to evaluate test-retest reliability. The participants who underwent septoplasty were assessed at baseline and after 3-6 months to evaluate responsiveness.

Results

The S-NOSE was found to be reliable, valid, and responsive. Both Cronbach's α and McDonald Omega coefficients were >0.7, and the intra class coefficient was 0.942. The S-NOSE scores were significantly correlated with nasal patency VAS in both the case group and the control group (p < .001 and p = .018, respectively). After septoplasty, the mean S-NOSE score were significantly improved (p < .001). Furthermore, the S-NOSE was shown to have excellent and robust psychometric properties.

Conclusion

The S-NOSE can be recommended in both clinical practice and research to evaluate the outcome of septoplasty in Swedish-speaking populations.

Level of Evidence

NA.

The effect of time spent sitting and excessive gaming on the weight status, and perceived weight stigma among Taiwanese young adults

Background

During the COVID-19 pandemic, physical inactivity and sedentary behaviors (i.e., longer sitting time and excessive gaming) increased because governments across the globe adopted stringent mitigation strategies such as social distancing and lockdowns to curb the spread of the virus. Excessive gaming was one of the coping mechanisms used to deal with the pressure associated with the pandemic. Moreover, perceived weight stigma (PWS) and weight status became more salient concerns among young adults during the COVID-19 pandemic. The current study sought to investigate the relationship between time spent sitting, excessive gaming, weight status, and PWS of Taiwanese Young adults. Additionally, weight status and PWS were examined as mediators between both sedentary behaviors.

Methods

This cross-sectional study involved 600 participants who were recruited through Taiwan universities. All participants completed a demographic questionnaire (including weight and height) and self-report measures including the International Physical Activity Questionnaire short form (IPAQ-SF), the Perceived Weight Stigma Scale (PWSS), and the Internet Gaming Disorder Scale-short form (IGDS9-SF). PROCESS model was performed to test the potential mediation roles of weight status and PWS. Moreover, we categorized participants into two groups based on the sitting-time item in the IPAQ-SF: students whose sitting time was less than 8 h daily, and those more than 8 h daily.

Results

The group that had less than 8 h had significantly higher PWS and IGDS9-SF scores than the other group. Sitting time was negatively associated with weight status, PWS, and IGDS9-SF. Additionally, we found a significantly direct effect between time spent sitting and excessive gaming. Both weight status and PWS were significant mediators in the association between time spent sitting and excessive gaming.Conclusions: The present study demonstrated important negative correlates of excessive sedentary behaviors. Prevention efforts should focus on promoting physical activity and providing information to decrease sedentary behavior among university students.

Sleep duration during the COVID-19 pandemic in Bangladesh: A GIS-based large sample survey study

Although several studies have been conducted in Bangladesh regarding sleep problems during the COVID-19 pandemic, none have utilized a large nationwide sample or presented their findings based on nationwide geographical distribution. Therefore, the aim of the present study was to explore the total sleep duration, night-time sleep, and daily naptime and their associated factors as well as geographic information system (GIS) distribution. A cross-sectional survey was carried out among 9730 people in April 2020, including questions relating to socio-demographic variables, behavioral and health factors, lockdown, depression, suicidal ideation, night sleep duration, and naptime duration. Descriptive and inferential statistics, both linear and multivariate regression, and spatial distribution were performed using Microsoft Excel, SPSS, Stata, and ArcGIS software. The results indicated that 64.7% reported sleeping 7-9 h a night, while 29.6% slept less than 7 h nightly, and 5.7% slept more than 9 h nightly. 43.7% reported 30-60 min of daily nap duration, whereas 20.9% napped for more than 1 h daily. Significant predictors of total daily sleep duration were being aged 18-25 years, being unemployed, being married, self-isolating 4 days or more, economic hardship, and depression. For nap duration, being aged 18-25 years, retired, a smoker, and a social media user were at relatively higher risk. The GIS distribution showed that regional division areas with high COVID-19 exposure had higher rates of non-normal sleep duration. Sleep duration showed a regional heterogeneity across the regional divisions of the country that exhibited significant associations with a multitude of socioeconomic and health factors.

Worldwide Estimation of Parental Acceptance of COVID-19 Vaccine for Their Children: A Systematic Review and Meta-Analysis

Currently, the best method to well control the spread of COVID-19 without severe mental health problems is to reach herd immunity. Therefore, the vaccination rate of the COVID-19 vaccine is critical. Among the populations, children are the vulnerable ones to get vaccinated; therefore, it is important to assess parents’ and guardians’ willingness to have their children vaccinated. The present systematic review and meta-analysis synthesized evidence to estimate the parents’ acceptance rate of COVID-19 vaccination toward their children. Additionally, factors explaining the acceptance rate were investigated. Four academic databases (PubMed, Scopus, Web of Science, and ProQuest) together with Google Scholar were searched, and the references of the included publications were searched as well. Using the PECO-S framework (population, exposure, comparison, outcome, and study design), observational studies of cross-sectional, cohort, or case-control studies were included. The outcome was parents’ or guardians’ willingness to let their children be vaccinated. The studies included in the present review were restricted to English and peer-reviewed papers published between December 2019 and July 2022. A total of 98 papers across 69 different countries with 413,590 participants were included. The mean age of the parents was 39.10 (range: 18–70) years and that of their children was 8.45 (range: 0–18) years. The pooled estimated prevalence of parental acceptance to vaccinate their children with the COVID-19 vaccine was 57% (98 studies, 95% CI: 52–62%, I2: 99.92%, τ2: 0.06). Moreover, data collection time was a significant factor explaining parental willingness in the multivariable meta-regression, with a 13% decrease in parental willingness by each month increase in time, explaining 11.44% of variance. Qualitative synthesis results showed that parents’ COVID-19 vaccine knowledge, trust in theCOVID-19 vaccine, and facilitators in vaccination (e.g., low cost, good vaccine accessibility, and government incentive) were significant factors for higher willingness, while mental health problems (e.g., having worries and psychological distress) were significant factors for lower willingness. Given that the acceptance rate was relatively low (57%) and does not achieve the requirement of herd immunity (i.e., 70%), governments and healthcare authorities should try to elevate parents’ knowledge and trust in the COVID-19 vaccine, facilitate in vaccination, and reduce their mental difficulties to improve the overall vaccination rate among children.

Mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life among women of reproductive age: An Iranian cross-sectional study

OBJECTIVES

This study aimed to determine the mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life (QoL) among Iranian women of reproductive age.

METHODS

A cross-sectional study comprising 324 married women was conducted. Online convenience sampling was used to collect data. SPSS PROCESS macro was used for the mediation analysis. The direct and indirect effects of the fear of COVID-19 on sexual QoL and marital satisfaction were estimated comprising a 95% CI using 5000 bootstrap samples. Pairwise comparisons between the mediators were calculated by Hayes' macros.

RESULTS

A positive/negative or suspected history of COVID-19 infection had marginally significant relationship with marital satisfaction (p=0.049). The total effect of fear of COVID-19 on sexual QoL was significant (b=-1.31, SE=0.20, p<0.001). Fear of COVID-19 had no significant direct effect on sexual QoL (b=-0.22, SE=0.19, p=0.24) but it had an indirect effect on sexual QoL via mediation of psychological distress (b=-0.34, SE=0.09, 95% CI: -0.53 to -0.19) and domestic violence (b=-0.75, SE=0.18, 95% CI: -1.12 to -0.40). The total effect of fear of COVID-19 on marital satisfaction was significant (b=-1.91, SE=0.32, p<0.001). Fear of COVID-19 had no significant direct effect (b=0.20, SE=0.25, p=0.42) on marital satisfaction but it had an indirect effect on marital satisfaction via mediation of psychological distress (b=-0.59, SE=0.13, 95% CI: -0.86 to -0.36) and domestic violence (b=-1.51, SE=0.29, 95% CI: -2.08 to -0.92).

CONCLUSION

The fear of COVID-19 during the pandemic indirectly decreased women's marital satisfaction and sexual QoL via increased psychological distress and domestic violence. Consequently, in critical situations such as the COVID-19 pandemic, improving couples' psychological health and reducing domestic violence are likely to improve women's sexual QoL and marital satisfaction.

Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD

BACKGROUND

Several studies have linked the problematic use of the Internet (PUI) to psychological distress. Youth with attention deficit hyperactivity disorder (ADHD) are considered a particular disadvantaged population with a high risk of developing PUI, psychological distress, and self-stigma. Nonetheless, the interrelationships of PUI, self-stigma, and psychological distress in adolescents with ADHD are not well understood.

AIMS

This study investigated whether self-stigma mediates relationships between different forms of PUI, such as problematic gaming (PG), problematic social media use (PSMU), problematic smartphone use (PSPU), and psychological distress (i.e., depression, anxiety, and stress), in children with ADHD.

METHODS AND PROCEDURES

We recruited 100 youth with ADHD (mean age=10.80 [SD=3.07] years; 84 boys) from psychiatric outpatient clinics in Taiwan. All participants were assessed for PUI (via Internet Gaming Disorder-Short Form for PG, Bergan Social Medica Addiction Scale for PSMU, and Smartphone Application-Based Addiction Scale for PSPU), self-stigma (via Self-Stigma Short-Scale), and psychological distress (via Depression, Anxiety, Stress Scale).

OUTCOMES AND RESULTS

The results of path and bootstrapping analyses indicated that self-stigma mediated the associations between PSMU and PSPU, but not PG, and depression, anxiety, and stress.

CONCLUSIONS AND IMPLICATIONS

This study expands the extant literature by revealing that self-stigma mediates the association between specific forms of PUI and psychological distress in adolescents with ADHD. Interventions aimed at reducing self-stigma and PUI, particularly PSMU and PSPU, may help decrease psychological distress among adolescents with ADHD.

Estimation of moral distress among nurses: A systematic review and meta-analysis

BACKGROUND

Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction.

AIM

To estimate moral distress among nurses.

METHODS

This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its' 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg's Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis.

ETHICAL CONSIDERATION

The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773.

RESULTS

Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0-10 scale [95% Confidence Interval: 2.27-2.84, I²: 98.4%, Tau²:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance.

CONCLUSION

The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare.

Evaluation of the English Version of the Fear of COVID-19 Scale and Its Relationship with Behavior Change and Political Beliefs

The COVID-19 pandemic has many individuals around the world fearing for their lives. The constant news coverage, rapid transmission, and relatively high mortality rate, make fearfulness a natural response. To assess the fear of COVID-19, the Fear of COVID-19 Scale (FCV-19S) was developed. The primary aim of the present study was to conduct the first psychometric assessment and validation of the English version of the FCV-19S. Two samples were collected in New Zealand. Sample 1 comprised 1624 participants of which 1397 completed all questions and were used in the analyses. Sample 2 comprised 1111 participants of which 1023 completed all questions and were used in the analyses. Several psychometric tests were conducted to ascertain the scale's reliability and validity. Across both samples, the FCV-19S had high internal consistency. Consistent with the earlier validation studies, the FCV-19S displayed a moderately strong relationship with the perceived infectability and germ aversion subscales of the perceived vulnerability to disease scale (PVDS). Furthermore, FCV-19S scores were negatively correlated with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) scores. With respect to the motivating role of fear, there was a significant relationship between FCV-19S scores and adherence to the lockdown rules that were implemented in New Zealand. Finally, consistent with recent reports on the politicization of the COVID-19 pandemic, an exploratory question found that participants who rated themselves as more conservative tended to report lower FCV-19S scores. The English version of the COVID-19S is a sound unidimensional scale with robust psychometric properties and can be used with confidence among English-speaking populations.

Temporal associations between physical activity and three types of problematic use of the internet: A six-month longitudinal study

Background and aims

Internet use has become an important part of daily living. However, for a minority it may become problematic. Moreover, problematic use of the Internet/smartphone (PUIS) has been associated with low physical activity. The present study investigated the temporal associations between three types of PUIS (i.e., problematic smartphone use [PSPU], problematic social media use [PSMU] and problematic gaming [PG]) and physical activity among Taiwanese university students.

Methods

A six-month longitudinal survey study comprising three time points for assessments was conducted. From the original 974 participants, a total of 452 completed all three waves of an online survey comprising the International Physical Activity Questionnaire Short Form (IPAQ-SF) assessing physical activity level, Smartphone Application-Based Addiction Scale (SABAS) assessing PSPU, Bergen Social Media Addiction Scale (BSMAS) assessing PSMU, and Internet Gaming Disorder Short Form (IGDS9-SF) assessing PG.

Results

The linear mixed effects model found positive temporal associations of PSMU and PG with physical activity level (PSMU: B = 85.88, SE = 26.24; P = 0.001; PG: B = 36.81, SE = 15.17; P = 0.02). PSPU was not associated with physical activity level (B = 40.54, SE = 22.99; P = 0.08). Additionally, the prevalence rates were 44.4% for at-risk/PSPU, 24.6% for at-risk/PSMU, and 12.3% for at-risk/PG.

Discussion and Conclusions

PSMU and PG unexpectedly demonstrated correlations with higher physical activity level. The nature of these relationships warrants additional investigation into the underlying mechanisms in order to promote healthy lifestyles among university students.

Burdens on caregivers of patients with stroke during a pandemic: relationships with support satisfaction, psychological distress, and fear of COVID-19

BACKGROUND

Caregivers have faced unprecedented circumstances throughout the COVID-19 pandemic, but previous research only minimally addresses the caregivers' burden. Therefore, this study aimed to investigate the relationship between caregiver burden, psychological stress, satisfaction with support, and fear of COVID-19 in caregivers of patients with stroke during the pandemic.

METHODS

A cross-sectional survey study with total of 171 caregivers of patients with stroke in a community hospital in Taiwan. All participants completed the Zarit Burden Interview, Depression, Anxiety, Stress Scale (DASS-21), satisfaction of support survey, and Fear of COVID-19 Scale. Pearson correlations were used to examine the bivariate correlations between study variables. Then, with the control of demographic confounders, a multiple linear regression model was applied with significant variables to construct and explain caregiver burden.

RESULTS

The proposed model significantly explained the caregiver burden of caregivers of patients with stroke. Specifically, the caregiver burden was negatively correlated with satisfaction with family support, but positively with psychological distress and the fear of COVID-19.

CONCLUSIONS

Caregivers of patients with stroke will suffer a greater burden if they have lower satisfaction with family support, experienced higher psychological distress, and perceived more fear of the COVID-19 pandemic. Health professionals must address these concerns, support caregivers, and enhance available resources.

Comparisons of psychological distress and self-stigma among three types of substance use disorders receiving treatment-as-usual approaches: real-world data from a 9-month longitudinal study

BACKGROUND

Substance use is an important issue worldwide and people with substance use disorders (SUDs) have been reported to have high levels of psychological distress and self-stigma. Therefore, psychological distress and self-stigma in people with SUDs are considerable.

OBJECTIVE

The present study used a longitudinal design to examine whether treatment-as-usual approaches in Taiwan improve psychological distress and self-stigma among people with three types of SUDs (heroin, amphetamine, and alcohol use disorders).

DESIGN

A 9-month longitudinal design involving four assessments spaced 3 months apart.

METHODS

Convenience sampling was used to recruit people with heroin (n = 112), amphetamine (n = 151), and alcohol (n = 56) use disorders from outpatient psychiatric center in Southern Taiwan. Psychological distress was assessed using the Depression, Anxiety, Stress Scale (DASS-21), and self-stigma was assessed using the Self-Stigma Scale-Short (SSS-S). Generalized estimating equation (GEE) models were constructed to understand between-group differences in psychological distress and self-stigma over time.

RESULTS

Patients with heroin and amphetamine use disorders had lower levels of psychological distress as compared with those with alcohol use disorder. Levels of psychological distress were lower at Time 2 to Time 4 as compared with Time 1. Patients with heroin and amphetamine use disorders had higher levels of self-stigma as compared with those with alcohol use disorder. Self-stigma levels remained stable over time. The dropout rate of receiving treatment-as-usual approach in the 9-month study was 60%.

CONCLUSION

Treatment as usual for SUDs among outpatients in Taiwan may decrease psychological distress but not self-stigma. However, such effects need to be further examined given the high drop-out rates and absence of a control condition. The findings suggest that self-stigma may warrant additional treatment for patients with SUDs.

Associations between fear of COVID-19, dental anxiety, and psychological distress among Iranian adolescents

Objectives

The present study evaluated the association of fear of COVID-19 with dental anxiety, oral health-related quality of life (OHRQoL), and psychological distress (depression, anxiety and stress), as well as exploring the mediating role of dental anxiety in the association of fear of COVID-19 with OHRQoL and psychological distress.

Methods

A cross-sectional study was conducted among adolescents in high schools of Qazvin city (Iran) from March-June 2021, recruited through a two-stage cluster sampling method. All the adolescents completed a self-administered survey assessing (i) fear of COVID-19, (ii) depression, anxiety and stress, (iii) OHRQoL, and (iv) dental anxiety. Structural equation modelling was used to evaluate all the hypothesised associations, and the model fit was estimated.

Results

A total of 2429 adolescents participated in the study. The conceptual model fitted the data well. Fear of COVID-19 had a direct effect on dental anxiety (B = 0.316; bias-corrected bootstrapping 95% CI = 0.282, 0.349), depression (B = 0.302; bias-corrected bootstrapping 95% CI = 0.259, 0.347), anxiety (B = 0.289; bias-corrected bootstrapping 95% CI = 0.246, 0.334), stress (B = 0.282; bias-corrected bootstrapping 95% CI = 0.237, 0.328), and OHRQoL (B = −0.354; bias-corrected bootstrapping 95% CI = −0.530, −0.183). Also, dental anxiety mediated the association of fear of COVID-19 with depression, anxiety stress, and OHRQoL.

Conclusions

High levels of fear of COVID-19 were associated with high levels of dental anxiety and poorer OHRQoL. Moreover, fear of COVID-19 was positively associated with anxiety, depression and stress. Increased levels of dental anxiety were also associated with increased anxiety, stress, depression, and poorer OHRQoL.

Temporal associations between problematic use of the internet and self-stigma among people with substance use disorders: A cross-lagged model across one year

Self-stigma is a common experience for people with substance use disorders (SUDs). Understanding factors associated with self-stigma may aid in intervention development. This study investigated the reciprocal relationship between three types of problematic use of the internet [PUI; i.e. problematic use of social media (PUSM), problematic smartphone use (PSPU), and problematic gaming (PG)] and self-stigma among people with SUDs. This longitudinal study involved five waves of a survey given to individuals with SUDs in Taiwan. A total of 319 participants (85% male), with a mean age of 42.2 years (SD = 8.9), were recruited. The Smartphone Application-Based Addiction Scale, Bergen Social Media Addiction Scale, Internet Gaming Disorder-Short Form, and Self-Stigma Scale-Short Form were used. No significant associations between PUI and self-stigma were found in early waves (i.e., Waves 1 and 2). The earliest significant finding was identified between Wave 2 PSPU (smartphone) and Wave 3 self-stigma. Additionally, Wave 3 PSPU (smartphone) and PG (gaming) were associated with Wave 4 self-stigma, and Wave 4 PSPU (smartphone), PG (gaming), and PUSM (social media) were associated with Wave 5 self-stigma. Therefore, all three types of PUI (internet) may elevate self-stigma at different time points for individuals with SUDs. However, the reciprocal effects between self-stigma and PUI (internet) only occurred in PUSM (social media) at a later stage (i.e., from Wave 4 to Wave 5). In conclusion, people with SUDs who have PUI (internet) are at increased likelihood of developing more self-stigma, which may then increase subsequent PUSM (social media), forming a vicious cycle.

Evaluating a cross-lagged panel model between problematic internet use and psychological distress and cross-level mediation of school administrator support on problematic internet use: The serial mediating role of psychological needs thwarting of online teaching and psychological distress

Background

To reduce the transmission of COVID-19, many teachers across the globe, including teachers in China, were required to teach online. This shift to online teaching can easily result in psychological need thwarting (PNT) of teachers' psychological basic needs (autonomy, competence, and relatedness), leaving them vulnerable to negative psychological outcomes. Resulting negative emotional state may lead to problematic internet use (PIU), which can lead to further psychological distress, forming a vicious cycle.

Methods

The present study was conducted using a cross-lagged panel model (with longitudinal data) and hierarchical linear modeling (HLM) (with cross-sectional data). The aims were to investigate (i) the reciprocal relationships between two specific forms of PIU [problematic social media use (PSMU) and problematic gaming (PG)] and psychological distress among schoolteachers, and (ii) the influence of administrators' support on schoolteachers' PIU through a cross-level serial mediation model (PNT of online teaching was the first mediator and psychological distress was the second mediator affected by PNT of online teaching). Primary and secondary schoolteachers (N = 980; mean age = 34.76; 82.90% females) participated in two surveys (Time 1: mid-November 2021; Time 2: early-January 2022).

Results

Results indicated that (i) high psychological distress at Time 1 was associated with increased levels of PSMU and PG at Time 2. Inversely, PG at Time 1 was associated with increased psychological distress at Time 2, although PSMU at Time 1 did not have a significant influence on psychological distress at Time 2; (ii) during Time 1, increased administrative support contributed to alleviating teachers' psychological needs thwarting of online teaching, thereby lowering their psychological distress which, in turn, resulted in a decrease in PG.

Conclusion

PG had a stronger negative influence on teachers' psychological distress than PSMU. To relieve teachers' PG, administrative support can alleviate teachers' psychological needs thwarting of online teaching and psychological distress. Based on this finding, school managers must consider effective ways to support teachers during mandatory online teaching.

Quality of life and care burden among family caregivers of people with severe mental illness: mediating effects of self-esteem and psychological distress

BACKGROUND

Family caregivers are important allies for healthcare providers in facilitating the recovery process among people with mental illness (PWMI). The present study examined the factors associated with quality of life (QoL) among family caregivers of PWMI.

METHODS

A multi-center cross-sectional survey was conducted. Family caregivers of people with schizophrenia, major depressive disorder, and bipolar disorder were recruited using convenience sampling. A survey assessing their QoL, depression, anxiety, and self-esteem was completed with self-rated psychometric scales including the Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, Beck Anxiety Inventory, and World Health Organization Quality of Life Instrument Short Form. A mediation model was constructed with QoL as the dependent variable, care burden as the independent variable, and psychological distress (including depression and anxiety) with self-esteem as mediating variables.

RESULTS

Family caregivers of people with schizophrenia had worse QoL compared with counterparts of people with major depression and bipolar disorder. The sociodemographic of both caregivers and PWMI had less impact on QoL when psychological factors were considered. Caregivers with lower self-esteem, higher levels of psychological distress, and heavier care burdens had poorer QoL. Care burden had a significant total effect on QoL. Both self-esteem and psychological distress were significant mediators.

CONCLUSION

The findings indicated that caregivers' psychological health and care burden influenced their QoL. Interventions that target family caregivers' self-esteem and psychological distress may attenuate the effect from care burden, and further improve their QoL.

The Mediating Roles of Anxiety, Depression, Sleepiness, Insomnia, and Sleep Quality in the Association between Problematic Social Media Use and Quality of Life among Patients with Cancer

The present study examined the mediating role of anxiety, depression, sleepiness, insomnia, and sleep quality in the association between problematic social media use and quality of life (QoL) among patients with cancer. This cross-sectional survey study recruited 288 patients with cancer to respond to measures on anxiety, depression, sleepiness, insomnia, sleep quality, problematic social media use, and QoL. Structural Equation Modeling was used for the mediation analysis. There were significant relationships between all of the variables used in the study. It was revealed that problematic social media use did not directly influence the QoL of patients with cancer except via anxiety, depression, sleepiness, and insomnia. Sleep quality did not mediate the association between problematic social media use and QoL. Healthcare workers managing cancer should pay attention to the mental health needs of their patients even as they treat their cancer so as to improve their quality of life. Future studies may examine other variables that affect the QoL of patients with cancer as well as other mediating and moderating variables.

Home care assistants' attitudes and perceptions of caring for people at the end of life in their homes in Sweden

The ageing population is increasing worldwide, with older people often having multimorbidity and a need for help with activities and personal care. Home Care Assistants (HCAs) are central to the provision of care in the home. They meet older people approaching the end of life and their relatives. Little is known about HCAs attitudes towards caring for a dying person and how aspects such as education, age, earlier care experiences, care education and experience of caring for dying older people affect their attitudes. The aim was to describe HCAs' attitudes towards the care of dying persons living in their ordinary homes. This cross-sectional study used the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) for data collection during December 2017 and January 2018, and descriptive statistics and regression analysis for data analysis. The participants were HCAs (n = 127, 96% of those eligible) in a municipality in central Sweden. An overall positive attitude was reported. About 32% lacked formal HCA education although 93% had experience of interacting with a dying person. Age, HCA education, internal palliative care education, number of years' experience and previous experience of caring for a dying person were independently associated with HCAs' attitudes. In the multivariate regression analysis, age and years of experience were the only significant predictors of HCAs' attitudes towards caring for dying care recipients. Young employees without HCA education and experience of a dying person might be vulnerable in situations involving caring for a dying person. Communicating about death and dying, forming a relationship with the care recipient and the family, and providing care when a person is dying can be challenging. Implications: Young employees without HCA education and experience of interacting with a dying person needs to be prepared for the situation. This needs to be considered by stakeholders and social and healthcare organisations.

Binge-Watching and Mental Health Problems: A Systematic Review and Meta-Analysis

BACKGROUND

Binge-watching, the viewing of online videos or streamed content, may be associated with different types of mental health problems. The present study aimed to investigate the associations between binge-watching and five mental health concerns including depression, loneliness, sleep problems, anxiety, and stress.

METHODS

Academic databases of PubMed, Scopus, Web of Science, ProQuest, PsycINFO, and Psych Articles were systematically searched through February of 2022. The Newcastle-Ottawa Scale was used to assess the methodological quality. A meta-analysis was performed on Fisher's z values as effect sizes, using a random effect model. Publication bias, small study effect, and moderators in this association were assessed.

RESULTS

Binge-watching was significantly associated with the five types of mental health concerns with the most robust correlations found with stress (0.32) and anxiety (0.25). Stronger associations between binge-watching and two types of mental health problems (depression and sleep problems) were found during the COVID-19 pandemic than before the pandemic. Moreover, stronger associations between binge-watching and two types of mental health problems (stress and sleep problems) were found in developing countries than in developed countries.

CONCLUSIONS

The associations between binge-watching and mental health concerns were significant and positive. Programs and interventions to reduce binge-watching should be considered and tested.

Relationships of familial sexual stigma and family support with internalized homonegativity among lesbian, gay and bisexual individuals: The mediating effect of self-identity disturbance and moderating effect of gender

Background

The mediators of the association between familial attitudes toward sexual orientation and internalized homonegativity among lesbian, gay, and bisexual (LGB) individuals have not been well examined.

Methods

A cross-sectional survey study was carried out to examine the (i) associations of familial sexual stigma and family support with internalized homonegativity among young adult LGB individuals in Taiwan, and (ii) mediating effect of self-identity disturbance and the moderating effect of gender. Self-identified LGB individuals (N = 1000; 50% males and 50% females; mean age = 24.6 years) participated in the study. Familial sexual stigma, family support, self-identity disturbance, and internalized homonegativity were assessed. Structural equation modeling was used to examine relationships between the variables.

Results

The results indicated that familial sexual stigma was directly associated with increased internalized homonegativity, and indirectly associated with increased internalized homonegativity via the mediation of self-identity disturbance among LGB individuals. Family support was indirectly associated with decreased internalized homonegativity via the mediation of low self-identity disturbance. The direct association between family support and internalized homonegativity was only found among lesbian and bisexual women but not among gay and bisexual men.

Conclusions

Program interventions for familial sexual stigma, family support, and self-identity disturbance are warranted to help reduce internalized homonegativity among LGB individuals.

Rasch Modeling and Differential Item Functioning of the Self-Stigma Scale-Short Version among People with Three Different Psychiatric Disorders

Self-stigma is prevalent in individuals with psychiatric disorders and can profoundly affect people. A unified assessment with sound psychometric properties is needed for evaluating self-stigma across psychiatric conditions. The aim of this study was to examine the psychometric properties of the Self-Stigma Scale-Short version (SSS-S) using Rasch modeling. Six-hundred and twelve participants with substance use disorders (n = 319), attention-deficit/hyperactivity disorder (n = 100), and schizophrenia (n = 193) completed the SSS-S. Rasch results confirmed the unidimensionality of the nine items of the SSS-S. The four-point Likert scale of the SSS-S reflected monotonical increases along the self-stigma continuum. No ceiling or floor effects were detected. Among the three subdomains of the SSS-S, cognitive items appeared to be the most robustly endorsed, and behavioral items were the least endorsed. Two items in the SSS-S displayed differential item functioning across the three diagnoses. Additionally, SSS-S scores showed weak to moderate correlation with depression, anxiety, and stress scale scores. The SSS-S had overall satisfactory psychometric properties. Healthcare professionals may use this assessment to assess self-stigma in multiple psychiatric groups, and information gained may facilitate improved care.

Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan

The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State–Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants’ sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.

Psychometric evaluation of a short-form version of the Swedish "Attitudes to and Knowledge of Oral Health" questionnaire

BACKGROUND

Healthcare professionals' attitudes to and knowledge of oral health are fundamental to providing good oral health care to older adults. One instrument that assesses healthcare professionals' attitudes to and knowledge of oral health in a Swedish context is the "Attitudes to and Knowledge of Oral health" (AKO) questionnaire. Two of the three item-groups of the AKO have previously been validated in a Swedish context. However, it is crucial that all three item-groups are validated, and beneficial to design a shorter, easy-to-use questionnaire for healthcare professionals while maintaining adequate integrity of its reliability and validity. Therefore, the present study aims to develop a short-form version of AKO and to secure its psychometric properties.

METHODS

Psychometric evaluation with Classical Test Theory and Item Response Theory to validate and shorten AKO with 611 healthcare professionals from a population of 1159 working in a municipality in an urban area in western Sweden.

RESULTS

Of the original 16 items in the AKO, 13 were shown to warrant retention in the abbreviated/shortened form. These showed acceptable validity and reliability for assessing healthcare professionals' attitudes to and knowledge of oral health.

CONCLUSION

This validated short-form version of AKO shows acceptable validity and reliability after being reduced to 13 items, structured in a 3-part scale. The items are consistent with the total scale, indicating that the internal consistency is acceptable. Future studies should be performed to evaluate AKO in other groups of healthcare professionals, across cultures, languages, and so on, to investigate its use and strengthen its validity and reliability.

Adaptation and validation of the Online-Fear of Missing Out Inventory into Turkish and the association with social media addiction, smartphone addiction, and life satisfaction

Background

In online environments, fear of missing out (FoMO) is where individuals become constantly preoccupied with what others are doing online and feel unable to log off in case they miss something. FoMO is a concept associated with the use of online social media (OSM; e.g., Facebook use, Instagram use) and various scales have been developed to assess the concept. One such scale is the Online Fear of Missing Out (On-FoMO) Inventory. The present study translated the On-FoMO Inventory into Turkish and its main aim was to test the validity and reliability of the scale. The secondary aim was to investigate the relationships between FoMO, social media addiction, smartphone addiction, and life satisfaction.

Methods

A total of 419 participants (289 females and 130 males, mean age = 25.43 years, SD = 6.37) completed a self-report questionnaire including the On-FoMO Inventory, Fear of Missing Out Scale, Bergen Social Media Addiction Scale, Smartphone Addiction Scale-Short Version, and Satisfaction with Life Scale. In the adaptation process of the On-FoMO Inventory, confirmatory factor analysis, concurrent validity, and reliability analyses were performed.

Results

The four-factor structure of the On-FoMO Inventory was confirmed and the Turkish version of the scale demonstrated good reliability. Online FoMO was positively related to social media addiction and smartphone addiction, and negatively related to life satisfaction.

Conclusion

The results showed that the Turkish version of the On-FoMO Inventory has strong psychometric properties.

A network analysis of the Internet Disorder Scale-Short Form (IDS9-SF): A large-scale cross-cultural study in Iran, Pakistan, and Bangladesh

The Internet Disorder Scale-Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03284-8.

Prevalence of gaming addiction and its impact on sleep quality: A cross-sectional study from Pakistan

Background

Gaming addiction has become a topic of increasing research interest worldwide but little research has been carried out in Pakistan.

Aims

The present study assessed the prevalence of gaming addiction among a Pakistani sample of adults in the general population. It also explored the effects of online gaming addiction upon sleep quality.

Method

A cross-sectional survey was carried out during a national lockdown due to the COVID-19 pandemic in Pakistan. Using a convenience sampling technique, an online survey comprising demographic information, the Game Addiction Scale (GAS), and the Pittsburgh Sleep Quality Index (PSQI) was completed by 618 participants (67.5% male) aged 18–56 years (M = 24.53 years, SD = ±5.016).

Results

Out of 618 participants, 57.0% (n=352) played online games. Among gamers, 12.5% (n = 44) were classed as addicted to the gaming based on GAS scores. Compared to those not addicted to gaming, participants with gaming addiction had significantly poorer subjective sleep quality, higher sleep disturbance, lesser sleep duration, and higher daytime dysfunction. Gaming addiction was also more prevalent among males compared to females.

Conclusion

Gaming addiction among the Pakistani general population is significantly associated with poor sleep quality. This problem needs to be addressed at both individual and societal levels to avoid adverse long-term health impacts.

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Problematic gaming behavior has been identified as one of the emerging public health issues, especially among adolescents and young adults.

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Gaming addiction in the Pakistani population affected a significant minority (based on GAS scores) and was associated with poor sleep quality.

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Gaming addiction was found to be more prevalent among males compared to females.

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Psychoeducation on the knowledge of gaming for general population of Pakistan may be used to be a preventive method to improve their sleep.

Association between COVID-19 preventive behavioral changes and anxiety in Karachi, Pakistan: A cross-sectional pilot study

Background

COVID-19 has turned into emergent psychological impacts across cohorts with devastating consequences related to preventive measures. Health organizations recommended some preventive measures (e.g., wearing masks, frequent handwashing, etc.) to overcome the COVID-19 pandemic. However, performing these behaviors may increase anxiety among populations. Thus, the present study aimed to investigate the role of behavioral changes to prevent COVID-19 infection and anxiety during the COVID-19 pandemic in Pakistan.

Subjects and methods

The present cross-sectional study was conducted for 10 days during July 2020 among the general public of Karachi after the imposition of lockdown amid the COVID-19 pandemic, with a sample size of 331 participants. The questionnaire consisted of three parts i.e., (i) socio-demographics, (ii) perception and preventive behaviors towards COVID-19, and (iii) anxiety-related questions using the Urdu Generalized Anxiety Disorder (GAD-7). The data was analyzed using logistic regression to investigate the association between behavior change and anxiety.

Results

Almost half of the participants (i.e., 48.9%) reported being anxious. Although most of the participants were compliant with preventive behavioral changes in their daily lives but no associations between preventive behaviors and anxiety were found. There were significant associations between anxiety and some of the socio-demographic variables (i.e., gender: females were more anxious; age group and marital status single participants were more anxious).

Conclusion

Based on the present findings, it is clearly evident that Pakistani people are suffering psychiatric problems during the COVID-19 pandemic. Hence, appropriate initiatives should be adopted as soon as possible. Besides, COVID-19 related preventive behavioral measures are highly recommended to practice without putting anything back for psychological fears.