Child Care Worker Psychological Distress: The Role of Parental Protective Behavior Under COVID-19

PurposeThe novel coronavirus disease 2019 (COVID-19) caused psychological distress and changed human living styles. However, rare studies have examined the psychological distress and protective behaviors across different populations. Therefore, the present study aimed to assess psychological distress, protective behaviors, and potential predictors of psychological distress and protective behaviors across the Hong Kong general population, Taiwan healthcare workers, and Taiwan outpatients.MethodsA cross-sectional design was used to recruit participants from Hong Kong and Taiwan. Telephone interviews were carried out for Hong Kong participants (n = 1,067; 30.2% male participants); online surveys were used for Taiwan healthcare workers (n = 500; 8.0% male participants) and Taiwan outpatients (n = 192; 32.8% male participants). All the participants completed questions on psychological distress and protective behaviors. Multiple linear regressions and multivariable logistic regressions were employed to explore the potential predictors of psychological distress and protective behaviors, respectively.ResultsHong Kong participants had significantly lower levels of psychological distress than Taiwan participants [mean (SD) = 0.16 (0.39) vs. 0.47 (0.59) in healthcare workers and 0.46 (0.65) in outpatients; p < 0.001]. Hong Kong participants (51.7%) and Taiwan outpatients had more people showing fear of COVID-19 (52.0%) than Taiwan healthcare providers (40.8%; p < 0.001). Moreover, Hong Kong participants engaged the most in protective behaviors, followed by Taiwan healthcare providers and Taiwan outpatients (p < 0.001). Moreover, being a female, fear of COVID-19 and worry about personal savings were associated with protective behaviors in general.ConclusionsDespite the greater COVID-19 severity and fear of COVID-19 in Hong Kong, the general population in Hong Kong experienced less psychosocial distress with higher compliance to protective behaviors than the other groups in Taiwan.

Patients with shoulder and rotator cuff pathology who exhibit greater levels of psychological distress report inferior preoperative self-assessments of pain and function. In several other areas of orthopaedics, higher levels of distress correlate with a higher likelihood of persistent pain and disability after recovery from surgery. To our knowledge, the relationship between psychological distress and outcomes after arthroscopic rotator cuff repair has not been similarly investigated. (1) Are higher levels of preoperative psychological distress associated with differences in outcome scores (visual analog scale [VAS] for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) 1 year after arthroscopic rotator cuff repair? (2) Are higher levels of preoperative psychological distress associated with less improvement in outcome scores (VAS for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) 1 year after arthroscopic rotator cuff repair? (3) Does the prevalence of psychological distress in a population with full-thickness rotator cuff tears change when assessed preoperatively and 1 year after arthroscopic rotator cuff repair? Eighty-five patients with full-thickness rotator cuff tears were prospectively enrolled; 70 patients (82%) were assessed at 1-year followup. During the study period, the three participating surgeons performed 269 rotator cuff repairs; in large part, the low overall rate of enrollment was related to two surgeons enrolling only two patients total in the initial 14 months of the study. Psychological distress was quantified using the Distress Risk Assessment Method questionnaire, and patients completed self-assessments including the VAS for pain, the Simple Shoulder Test, and the American Shoulder and Elbow Surgeons score preoperatively and 1 year after arthroscopic rotator cuff repair. Fifty of 85 patients (59%) had normal levels of distress, 26 of 85 (31%) had moderate levels of distress, and nine of 85 (11%) had severe levels of distress. Statistical models were used to assess the effect of psychological distress on patient self-assessment of shoulder pain and function at 1 year after surgery. With the numbers available, distressed patients were not different from nondistressed patients in terms of postoperative VAS for pain (1.9 [95% confidence interval {CI}, 1.0-2.8] versus 1.0 [95% CI, 0.5-1.4], p = 0.10), Simple Shoulder Test (9 [95% CI, 8.1-10.4] versus 11 [95% CI, 10.0-11.0], p = 0.06), or American Shoulder and Elbow Surgeons scores (80 [95% CI, 72-88] versus 88 [95% CI, 84-92], p = 0.08) 1 year after arthroscopic rotator cuff repair. With the numbers available, distressed patients also were not different from nondistressed patients in terms of the amount of improvement in scores between preoperative assessment and 1-year followup on the VAS for pain (3 [95% CI, 2.2-4.1] versus 2 [95% CI, 1.4-2.9], p = 0.10), Simple Shoulder Test (5.2 [95% CI, 3.7-6.6] versus 5.0 [95% CI, 4.2-5.8], p = 0.86), or American Shoulder and Elbow Surgeons scale (38 [95% CI, 29-47] versus 30 [95% CI, 25-36], p = 0.16). The prevalence of psychological distress in our patient population was lower at 1 year after surgery 14 of 70 (20%) versus 35 of 85 (41%) preoperatively (odds ratio, 0.36; 95% CI, 0.17-0.74; p = 0.005). Mild to moderate levels of distress did not diminish patient-reported outcomes to a clinically important degree in this small series of patients with rotator cuff tears. This contrasts with reports from other areas of orthopaedic surgery and may be related to a more self-limited course of symptoms in patients with rotator cuff disease or possibly to a beneficial effect of rotator cuff repair on sleep quality or other unrecognized determinants of psychosocial status. Level I, prognostic study.

To explore the relationship between psychological distress and social support and examine its association with various socio-demographic and clinical characteristics. Psychological distress is a common experience in patients after limb fractures. In this regard, a lower level of psychological distress is associated with better social support among patients with various types of diseases. However, there is a paucity of studies examining the relationship between social support and psychological distress among patients with limb fractures. More so, no such study has been conducted in the Chinese population. A cross-sectional and correlational design. A convenience sample of participants with upper limb fractures (n = 43) or lower limb fractures (n = 43) was recruited from two orthopaedic wards of a regional acute public hospital in Hong Kong. Data were obtained through face-to-face interview. The Impact of Event Scale was used to measure the level of psychological distress, while the Social Support Questionnaire Short-Form (SSQ6) was used to measure social support. Approximately two-thirds of the participants (n = 54) suffered from medium to high level of psychological distress. Majority of them were fairly satisfied with their social support, with their children being the most common support persons. Furthermore, there was no significant difference in the level of distress between the participants with lower or upper limb fractures. No significant correlation was found between psychological distress and social support. Those who were women, had lower education level and lower monthly income were significantly associated with a higher level of psychological distress. Patients with fractured limb suffered from a high level of psychological distress. Therefore, a comprehensive assessment of psychological distress should be incorporated as routine assessment. Also, assessing the socio-demographic characteristics of patients should enable nurses to identify patients at risk of developing a high level of psychological distress.

Parents of children with type 1 diabetes (T1D) often experience distress and worries, which may negatively impact their parenting behaviors. The current study investigates parental mindfulness (i.e., an enhanced attention to and awareness of current experiences or present reality) as a resilience mechanism. Using a daily diary approach, the predictive role of parental mindfulness for daily diabetes-related worries was examined, its impact upon protective parenting behaviors, and its buffering role in the relationship between daily worries and protective parenting behaviors. Participants were 56 parents of 40 children with T1D (2-12 years). Trait mindfulness was assessed with the Mindful Attention Awareness Scale. Subsequently, parents completed a diary for 14 consecutive days, assessing parental worries about hypo- and hyperglycemia and general and diabetes-specific parental protective behavior. Multilevel analyses showed that parental diabetes-related worries fluctuated substantially across days and positively predicted daily protective behavior. Higher levels of parental mindfulness predicted less daily worries about hypoglycemia and lower engagement in general protective behavior and hypoglycemia avoidance behavior. In addition, the relationship between worries about hyperglycemia and general protective behavior was moderated by parental mindfulness. The present findings highlight the importance of daily parental worries in explaining parental protective behaviors on a daily basis. Mindfulness emerged as a promising resilience factor in parents of children with T1D, resulting in less daily worries and protective parenting. These results have important clinical implications and point to the promising role of mindfulness interventions in this context.

Diabetes distress is the emotional and mental burden of living with diabetes. It can include feelings of frustration, guilt, anxiety, and worry. Understanding the factors contributing to psychological distress and how it affects glycemic control can be crucial for improving patient outcomes. Therefore, this study investigated the association between psychological distress levels and glycemic control in patients with diabetes. It also identified factors associated with severity of psychological distress. A multicentre cross-sectional study was conducted among patients with diabetes at selected hospitals in Northwest Ethiopia. Psychological risk distress was measured using the Kessler 10 (K10) questionnaire, validated for this population. Glycemic control was categorized as poor and good based on patients' current glucose records and following recommended guidelines. Logistic regression examined the association between psychological distress levels and glycemic control. Linear regression assessed the association between psychological distress score and other independent variables. p-value <0.05 was considered statistically significant. More than half (218, 54.2%) of the participants had severe psychological distress with a 27.4 (±4.6) mean score. Patients with moderate [AOR = 1. 85, 95% CI: 1.05-3.76] and severe [AOR = 2.84, 95% CI: 1.32-7.31] distress levels significantly had poor glycemic control compared to those with no distress. BMI [β = 0.61, 95% CI: 0.42, 71], monthly salary [β = -0.41, 95% CI: -67, -0.25], source of healthcare cost [β = -0.75, 95% CI: -2.36, -0.03], SMBG practicing [β = -0.85, 95% CI: -1.93, -0.25], lifestyle modifications [β = -1.66, 95% CI: -3.21, -0.18], number of medical conditions [β = 0.72, 95% CI: 0.57, 2.81], number of medications [β = 2.26, 95% CI: 1.05, 4.57], hypoglycaemia perception [β = 2.91, 95% CI: 1.32, 7.01], and comorbidity and/or complications [β = 3.93, 95% CI: 1.08, 6.72] were significantly associated with severity of psychological distress. Most patients reported having moderate to severe psychological distress, which in turn, negatively impacted their glycemic control. Interventions incorporating mental health and psychosocial support should be implemented to relieve psychological distress and improve glycemic control.

Introduction: The COVID-19 pandemic has influenced the whole world, thus also affecting the high school graduates in Croatia. Aims: The purpose of the study was to examine the psychological distress high school graduates experienced during the COVID-19 social distancing measures, more precisely to investigate gender and school type differences and to examine the relationship between psychological distress and self-regulated learning. Methods: In this cross-sectional study, an online questionnaire was administered to 13,037 high school graduates across Croatia. Results: The results show that girls exhibit higher levels of psychological distress compared to the boys, while the art school graduates show the highest distress, followed by gymnasium (i.e., secondary grammar school, prep school) graduates, and lastly vocational school graduates. Furthermore, a moderate negative correlation was found between self-efficacy and psychological distress, and significant, but small correlations were found between regulation of effort, management of work, time and environment, self-handicapping as well as elaboration and psychological distress. These results show that higher levels of self-regulation are connected to lower levels of psychological distress. Conclusions: These findings demonstrate that a need exists for greater accessibility of mental health care for adolescents.

Introduction This study adds to the existing international evidence on psychological distress in the student population by focusing on student nurses. It quantitatively assesses psychological distress with comparative norms and investigates service uptake in a single study. Aim The aim of this study was to investigate the level of psychological distress in students and compare this with population norms and highlight potential facilitators and barriers to help seeking. Methods This study recruited N=121 student nurses from one university in a cross-sectional design. Data were analysed using descriptive statistics, independent t tests and one-way ANOVAs. Findings The key findings show high levels of psychological distress, which is above levels seen in the general population. The main barriers to seeking support were fear of disclosure and the perceived impact on their suitability as a student nurse. Discussion The study highlights that high levels of distress identified in the literature are seen in student nurses and that fear of disclosure may account for some not seeking support. Relevance The fear of disclosure and low levels of seeking support suggest there is a need for mental health nurses and academics to play a key role in mental health literacy and evidence-based interventions such as mindfulness to combat these issues.

The aim of this longitudinal study was to explore both levels of and factors predictive of psychological and cancer-specific distress in women with demonstrated BRCA1 mutations belonging to families with hereditary breast/ovarian cancer (HBOC). We included 214 women from HBOC families who had BRCA1 testing, and who were examined with a mailed questionnaire at pre-test (T1), 6 weeks after getting the test result (T2) and 18 months later (T3). Self-rating instruments for psychological distress, cancer-specific distress and personality traits were used. Hardly any significant changes were observed concerning the levels of psychological and cancer-specific distress from T1 via T2 to T3 for the total group or those with carrier or non-carrier status, while women with cancer had a significant reduction of cancer-specific distress over time. The pre-test levels of psychological and cancer-specific distress were significant and strong predictors of these types of distress at T3. The personality trait of neuroticism made a significant contribution to both types of distress at pre-test, and a small separate contribution to distress at T3. Carrier status, history of personal cancer, pre-test levels of optimism or multidimensional health locus of control did not significantly predict distress at T3. Genetic testing or test results were not found to induce psychological or cancer-specific psychological distress at long-term. Neuroticism had a decisive influence at both pre-test and long-term levels of distress.

BackgroundThere is limited information about psychological distress in adults who underwent kidney replacement therapy (KRT) during childhood. This study aimed to describe psychological distress in adults after KRT during childhood in comparison to the Swiss general population and to evaluate associations with sociodemographic and clinical characteristics.MethodsWe sent a questionnaire to 143 people from the Swiss Pediatric Renal Registry (SPRR), who were alive, over 18 years old, started KRT before the age of 18 years, and were German speakers. We measured psychological distress using the Brief Symptom Inventory 18 (BSI-18) and evaluated the Global Severity Index 18 (GSI-18), reflecting the overall level of distress, and the three subscales: depression, somatization, and anxiety. We compared levels of psychological distress to normal data from the Swiss general population and used regression models to identify associations with sociodemographic and clinical characteristics.ResultsEighty persons with a mean age of 39 years (SD 10.1) responded to the questionnaire (response rate 56%). Overall, the GSI-18 and all subscales of the BSI-18 were similar. Unemployed participants (25%) reported higher levels of somatization and were more likely to experience psychological distress. Participants using psychotropic drugs (14%) reported higher levels of overall psychological distress (10%), depression (13%) and somatization (9%).ConclusionsAdults after KRT during childhood showed good long-term psychological well-being. These results are encouraging and underline the favorable outcome of these patients. So besides the excellent somatic outcome, these patients can achieve a psychological healthy life after diagnosis of chronic kidney disease.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

Introduction: Medical profession has been associated with high level of burnout leading to severe psychological problems among the medical students. With the emerging demand of health care facilities during a pandemic, medical students do face high exhaustion which may result in dissatisfaction in life. Aims and Objectives: To assess the level of burnout, the level of satisfaction and the level of distress in post graduate medical students in relation to covid 19 work load. Materials and Methods: A cross-sectional study was conducted in s tertiary health care centre. A total of 100 post graduate medical students who actively participated in covid 19 duty were recruited for the study. A standardized and structured questionnaire for Oldenburg Inventory scale (OLBI-S), the Satisfaction with Life Scale (SWLS) and Kessler Psychological Distress Scale (K10) were used to briefly assess the burnout level, life satisfaction and psychological distress respectively among the participants. A Self semi-structured proforma for socio-demographic details was given to study subjects to fill up. Statistical Analysis: Both qualitative and quantitative measures of data were calculated. Statistical significance was kept at p-value of &lt;0.05 using Fisher’s t-test and Chi-square test wherever applicable. Analysis of data was done by using SPSS version 21. Results: Majority (85%) of the participants reported low burnout of which 62.3% (n=53) were male and 37.6% (n=32) were female. The level of exhaustion when compared with gender was found to be statistically significant (p-value=0.037). Most of the participants (n=55) reported to be slightly satisfied with their life of which 67% (n=37) were male and 32.7% (n=18) were female. Most of the participants(n=63) reported to be psychologically well while 34 of them reported mild distress of which 29 were male and 5 of them were female. The level of psychological distress when compared with gender was found to be statistically significant (p-value=0.002). No positive correlation was found between burnout level and level of satisfaction, neither between burnout level and level of psychological distress. Conclusion: Our study found an overall low burnout, low psychological distress and low level of dissatisfaction with life in the postgraduate medical students working in covid 19 pandemic.

Despite the effectiveness of social distancing policies in preventing the spread of Coronavirus Disease 2019 (COVID-19), their impact on mental health remains a concern. Longitudinal studies investigating the psychological effects of social distancing are limited. Longitudinal data on psychological variables were collected eight times between May 2020 and November 2021 through online surveys in South Korea. The participants in the study reported a worsening of depressive and anxiety symptoms, suicide risk, and psychological distress with increasing levels of social distancing. Specifically, during the third wave, when social distancing levels peaked, the highest levels of depression, anxiety, and psychological distress were observed, and the second-lowest levels of vitality were reported. Furthermore, psychological risk factors, such as depressive symptoms, anxiety symptoms, and suicidal risk, were closely associated with vitality levels in daily life. During the pandemic, although social distancing helped prevent the spread of COVID-19, it also led to increased depression, anxiety, suicide risk, psychological distress, and decreased vitality. Engagement at a personal level in fundamental daily activities is important to cope with psychological distress. Our results indicate that commitment to fundamental daily activities and following routines is an important protective factor against psychological distress, notwithstanding COVID-19.

Background: A growing body of scientific literature indicates that risk factors for COVID-19 contribute to a high level of psychological distress. However, there is no consensus on which factors contribute more to predicting psychological health. Objectives: The present study quantifies the importance of related risk factors on the level of psychological distress and further explores the threshold effect of each rick factor on the level of psychological distress. Both subjective and objective measures of risk factors are considered in the model. Methods: We sampled 937 individual items of data obtained from an online questionnaire between 20 January and 13 February 2020 in China. Objective risk factors were measured in terms of direct distance from respondents’ housing to the nearest COVID-19 hospital, direct distance from respondents’ housing to the nearest park, and the air quality index (AQI). Perceived risk factors were measured in regard to perceived distance to the nearest COVID-19 hospital, perceived air quality, and perceived environmental quality. Psychological distress was measured with the Kessler psychological distress scale K6 score. The following health risk factors and sociodemographic factors were considered: self-rated health level, physical health status, physical activity, current smoker or drinker, age, gender, marital status, educational attainment level, residence location, and household income level. A gradient boosting decision tree (GBDT) was used to analyse the data. Results: Health risk factors were the greatest contributors to predicting the level of psychological distress, with a relative importance of 42.32% among all influential factors. Objective risk factors had a stronger predictive power than perceived risk factors (23.49% vs. 16.26%). Furthermore, it was found that there was a dramatic rise in the moderate level of psychological distress regarding the threshold of AQI between 40 and 50, and 110 and 130, respectively. Gender-sensitive analysis revealed that women and men responded differently to psychological distress based on different risk factors. Conclusion: We found evidence that perceived indoor air quality played a more important role in predicting psychological distress compared to ambient air pollution during the COVID-19 pandemic.

Differential responsiveness to a parenting intervention for mothers in substance abuse treatment

K. Karos is a postdoctoral researcher supported by the Research Foundation, Flanders, Belgium (grant 1244820N). F. P. Kapos is a PhD candidate who is supported by the Patrick-Beresford Fellowship in Social Epidemiology and the P.E.O. International Peace Scholarship. H. Devan is a Postdoctoral Fellow supported by the Centre for Health, Activity and Rehabilitation Research (CHARR) Postdoctoral Fellowship at the School of Physiotherapy, University of Otago, New Zealand. This review was an initiative of the Social Aspects in Pain Special Interest Group (SocSIG) of the International Association of Pain (IASP).

This study was designed to assess the level of psychological distress in a heterogeneous group of patients with chronic obstructive pulmonary disease (COPD), and compare them with the general population and psychiatric outpatients. A total of 118 patients with COPD, a random sample of 500 subjects from the general population and 500 psychiatric outpatients participated in this study. The Dutch version of the Symptom Checklist-90-Revised was used to assess general psychological distress. The sample of patients with COPD experienced significantly more psychological distress than the general population and significantly less than psychiatric outpatients. Furthermore, no significant association was found between the severity of the pulmonary disease and the level of psychological distress, although patients with severe or very severe COPD appeared to be at increased risk of depression. Lastly, the pattern of psychological complaints seems comparable in depressed patients with COPD and psychiatric outpatients. Once patients with COPD report suffering from depressive symptoms, the level of distress seems to increase to that found in psychiatric outpatients. In conclusion, in clinical settings in which psychological complaints are not routinely assessed, the Beck Depression Inventory and Symptom Checklist-90-Revised are very useful for drawing attention to depression and psychological distress.