Impact of Caring for Mentally Ill Patient on Caregivers

Introduction: In the COVID-19 pandemic, the implementation of the lockdown led to the closure of dental practices. Restricting treatment to emergency patients, having to use Personal Protective Equipment and the fear of contracting the virus led to modifications in the techniques and methods used to provide efficient dental care to the patients. However, it caused a significant psychological and financial impact on the dental community. The purpose of this research was to evaluate dentists’ perceptions regarding the psychological, financial, and general impact of the COVID-19 pandemic on the reopening of their dental practices. Methods: This cross-sectional analytical study was conducted using a validated questionnaire, which was distributed among 257 dental practitioners working in Karachi through the social media app (WhatsApp®) from May 2021 to May 2022. The questionnaire included four sections and 26 items, recording data for demographics, psychological effects on resumption of dental practices, workplace disinfection, and precautionary measures along financial impacts. Data were analyzed using SPSS, version 21.0. p-value ≤ 0.05 was taken as statistically significant Results: A total of 200 filled questionnaires were received, making the response rate 77%. The majority of respondents were females (67%). More than half of the respondents (55.5%) were working in dental OPDs. Most participants affirmed that they did not have a COVID-19 screening area nor patient triage was being done in dental OPDs. Closure of dental practices caused financial problems for all dental practitioners, more specifically for those that were associated with both public and private types of practices (84.9%). The majority of the dentists in private practice (94.4%) declared that their workplaces were being disinfected, while 47.7% of dental practitioners working in the dental OPD affirmed that they had enough financial stability to keep using Personal Protective Equipment. Approximately 64.9% of professionals practicing in dental OPDs and 33.3% in private practice believed that the reopening of dental practices was responsible for the re-spread of the coronavirus Conclusion: Significant anxiety and stress related to COVID-19 were seen among dental practitioners. Some CDC-recommended guidelines such as the use of Personal Protective Equipment were being implemented whereas COVID-19 screening and patient triage were found deficient.

IntroductionThe COVID-19 pandemic has caused major impacts to social and financial status for many people, including those living in the vulnerable US-Mexico border region. This study examined relationships between changes in sleep and perceived impacts to social and financial stability due to the pandemic.MethodsParticipants were 155 individuals who completed the Nogales Cardiometabolic Health and Sleep (NOCHES) and were contacted about completing a COVID sub-study (95% Hispanic/Latino). Participants were asked if the COVID-19 pandemic was causing them to feel more socially isolated, negatively impacting their finances, causing increased worry about finances, affecting their primary job, causing a job loss, and impacting their belief life will one day return to normal. In addition, they were asked to report the degree to which they experienced pandemic-related changes to sleep, including a regularity, overall improvement/worsening, initial and middle-of-the-night insomnia, daytime sleepiness, and napping. Logistic regression analyses were adjusted for age, sex, socioeconomics, and mental health (PHQ4).ResultsThose who kept a more regular schedule had lower odds of endorsing isolation (OR=0.32,p<0.0005) and higher odds of believing things will return to normal (OR=1.67,p=0.041). Those whose sleep improved also had lower odds of feeling isolated (OR=0.40,p=0.005). Those with worsened sleep had increased odds of feeling isolated (OR=2.14,p=0.023), experiencing a financial impact (OR=1.85,p=0.016) and increased financial worry (OR=1.71,p=0.033), and lower odds of believing things will return to normal (OR=0.53,p=0.012). More initial insomnia was associated with isolation (OR=3.62,p=0.001), financial impact, (OR=1.89,p=0.015), financial worry (OR=1.87,p=0.016) and job impact (OR=1.95,p=0.010). More middle-of-the-night insomnia was associated with financial worry (OR=1.82,p=0.016) and job impact (OR=1.93,p=0.009). More sleepiness was associated with job loss (OR=1.84,p=0.043). More napping was associated with financial impact (OR=1.89,p=0.017) and worry (OR=1.88,p=0.017), impact to job (OR=1.89,p=0.016) or lost job (OR=1.81,p=0.041), and decreased likelihood of believing things will return to normal (OR=0.45,p=0.003).ConclusionPandemic-related stress was linked with sleep disturbances. Worse sleep was indicative of increased social isolation, greater financial fears, more job-related impacts and less of a general sense that things would return to normal.Support (if any)Supported by T32HL007249, R01MD011600, R01DA051321

Correlates of Perceived Need for Mental Health Care Among Active Military Personnel

PurposeParents of children with cancer experience treatment-related employment disruptions. Most significant shifts occur during diagnosis and treatment. However, challenges can persist into survivorship. We explored employment changes during diagnosis and treatment among parents of children with cancer, and professional and financial impact during long-term survivorship. We investigated (1) if and what kind of employment changes occurred, (2) reasons for the changes, (3) differences between mothers and fathers, and (4) if parents experience long-term professional or financial impacts from their child’s past illness.MethodsA questionnaire survey assessed employment changes during diagnosis and treatment and long-term professional and financial impacts. We described changes and reasons thereof and conducted logistic regression analyses to predict long-term impacts.ResultsWe included 469 parents (59% female) of childhood cancer survivors (mean = 24 years after diagnosis). At time of treatment, 21% of parents reported employment changes: e.g., work time reduction (52%), quitting (27%), and taking unpaid leave (21%). Mothers were more likely to experience changes (OR = 2.00; p = .005). Most parents (87%), especially mothers, reported caring for their sick child to be one of the reasons for change. Some parents reported professional (5%) or financial long-term impact (5%). Financial impact was mainly associated with survivors experiencing late effects (OR = 10.51; p < .001), cancer relapse (OR = 3.96; p = .007), and survivors’ financial dependence (OR = 3.64; p = .005). Professional impact was associated with female sex (OR = 3.26; p = .029) and employment changes (OR = 2.39; p = 0.050).ConclusionsAlthough most parents do not experience lasting effects on employment or finances, some continue to face challenges well into survivorship. Providing sustained, long-term support for these parents is essential.

Social Banking: Products and Services

&lt;p&gt;This research is focused on the discussion of (1) integration between traditional and conventional medicine in the RSJ (Mental Hospital) of Bali, (2) the form of a combination of traditional medicine with conventional medicine for mental disorder patients at Mental Hospital of Bali, (3) the impact of integrating traditional medicine and conventional in mental patients at Mental Hospital of Bali. The theory used in analyzing the three problem formulations in this study, namely: (1) psychoanalytic theory, (2) ethnomedicine theory, and (3) perception theory. This research uses the method of documentation, literature study, observation and interviews. The results of this study indicate the following points. First, the factors that cause psychiatric rehabilitation patients at RSJ Bali integrate traditional and conventional medicine consisting of internal factors, e.g., beliefs, needs for holistic nursing care, religion, social, and culture, and also external factors, e.g., state legitimacy towards traditional medicine and western biomedical weakness. Second, the form of traditional medicine for mental illness patients at RSJ Bali Province consists of traditional forms, e.g., diagnosis (nengerin), peruwatan (bhuta Yajna) and spells, speech, dharma wacana (spiritual ceremony), prayer, and text-based handling (manuscripts) of medicine and a combination of traditional and modern techniques, and also conventional forms of treatment for psychoanalysis, cognitive behavioral approaches (cognitive behavior), humanistic approaches, and other types of therapy. The form of combining traditional and modern techniques consists of diagnosis, improvement of mental development, the use of drugs, and treatment by spiritual means. Third, traditional and conventional treatments for mental patients at RSJ Bali have an individual impact, social impact, psychological impact on patients, the impact of power, and the impact of community culture.&lt;/p&gt;

Financial, resource, and psychological impacts of COVID-19 on U.S. College students: Who is impacted and what are the implications for adjustment and well-being?

359 Background: Healthcare providers’ ability to successfully engage in patient-centered communication (PCC) and shared decision making (SDM) is critical for prioritizing patient values and needs given the diversity of cancer treatment options available. This study aims to examine the impact of PCC and SDM on urologic cancer patients’ perceived knowledge and preparedness in treatment decision-making. Methods: Participants in Cancer Support Community’s Cancer Experience Registry reported sociodemographic and clinical information, decision-making style (provider-led, patient-led, shared), knowledge about cancer treatment options and financial impact as well as preparedness to make treatment decisions (on 5-pt scale, dichotomized for analysis), and PCC (6-item PCC short form). We ran three logistic regression models adjusting for sociodemographic and clinical factors, with outcomes: (1) knowledge of treatment options, (2) knowledge of financial impact, (3) and preparedness for treatment decisions. Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 254 U.S. adults (75% men; ages 24-90 [Mean = 68, SD = 11]) with urologic cancer (54% prostate, 29% bladder, 15% kidney, 2% testicular), 48% in remission, 24% localized, 20% metastatic; 3yr Median time since diagnosis; 85% non-Hispanic White, 58% held a Bachelor’s degree or higher, and 58% had income ≥$40K. Decision-making styles were 58% patient-led, 31% shared, and 12% HCP-led. 54% felt quite a bit or very much knowledgeable about treatment options, 34% about financial impacts, and 56% prepared for treatment decisions. PCC scores were negatively skewed, indicating strong communication; a median split (Mdn = 4) was used in regressions. Higher PCC significantly predicted greater knowledge of treatment options (OR = 1.74[1.02-2.95]) and financial impact (OR = 2.02[1.10-3.70]) as well as feeling prepared to make treatment decisions (OR = 2.86[1.62-5.03]), adjusting for controls. Further, SDM (OR = 5.63[1.98-16.06]) and patient-led decision-making (OR = 5.53[1.85-16.55]) predicted greater preparedness than HCP-led decisions. Conclusions: Among urologic cancer patients, more than half reported good treatment knowledge and treatment preparedness, while only a third felt well informed of financial impacts of treatment. PCC was high and predicted greater perceived knowledge about treatment and finances, even when accounting for key sociodemographic and clinical factors. Additionally, both PCC and SDM predicted feeling prepared to make treatment decisions. Findings suggest that PCC and SDM play a critical role in patient experiences and strengthening these approaches in clinical settings may help ensure that care is more aligned with patients’ values, preferences, and needs.

This study aims to evaluate perceived social support (SS) in inpatients with mental disorders, its association with sociodemographic and clinical characteristics, and its impact on hospitalization patterns, highlighting the importance of evaluating and enhancing SS. This hospital-based study, using a cross-sectional design, was conducted at the Psychiatric Clinic of University Hospital Larissa, Greece and included 280 consecutive admitted patients. SS was assessed with short form social support questionnaire SSQ-6, and sociodemographic and clinical characteristics were examined along with possibility of reentry during a 32-month period. Most respondents reported low SS levels, with significant differences in SS quantity across diagnostic categories. Sociodemographic factors, including age, work status, housing conditions, medical insurance and the number of cohabitants, were significantly associated with both SS quantity and satisfaction. Clinical factors, including diagnosis, illness duration and prior admissions also showed significant associations with both dimensions of SS. Multivariate analysis identified increasing age, urbanicity, homelessness, retirement, and unemployment as independent risk factors for lower SS quantity, while cohabitation and affective disorder diagnoses were protective factors. Regarding SS satisfaction, homelessness, retirement, and prolonged illness duration, emerged as risk factors, while medical adherence was protective. Notably, SS quantity was marginally negatively associated with involuntary type of admission. Low SS significantly increased the likelihood of readmission during the 32- month follow-up period. The study highlights the critical role of assessing and enhancing SS in hospitalized patients with mental disorders. Sociodemographic and clinical factors significantly influence SS, with poor SS contributing to a higher risk of involuntary admission and increased readmission likelihood.

The aim of this study was to estimate the relationship between the financial impact of a new drug and the recommendation for reimbursement by the Australian Pharmaceutical Benefits Advisory Committee (PBAC). Data in the PBAC summary database were abstracted for decisions made between July 2005 and November 2009. Financial impact-the upper bound of the values presented in the PBAC summary database-was categorized as ≤A$0, >A$0 up to A$10 million, A$10 million up to A$30 million, and >A$30 million per year. Descriptive, logistic, survival, and recursive partitioning decision analyses were used to estimate the relationship between the financial impact of a new drug indication and the recommendation for reimbursement. Multivariable analyses controlled for other clinical and economic variables, including cost per quality-adjusted life-year gained. Financial impact was a significant predictor of the recommendation for reimbursement. In the logistic analysis, the odds ratios of reimbursement for drug submissions with financial impacts ≥A$10 million to ≥A$30 million or >A$0 to <A$10 million compared with ≤A$0 were 0.12 (95 percent confidence interval [CI]: 0.03-0.51) and 0.16 (95 percent CI: 0.04-0.60), respectively. In the recursive partition decision analysis, the first split of the data was for submissions with a positive financial impact compared with those with a zero or negative financial impact. In Australia, financial impact on the drug budget is an important determinant of whether a new drug is recommended for reimbursement when cost-effectiveness estimates and other clinical and economic variables are controlled.

Support persons of haematological cancer survivors may be faced with unique challenges due to the course of these diseases and the treatments required. This study aimed to examine the social and financial impacts associated with their role. Eight hundred adult survivors of haematological cancer within 3 years of diagnosis were invited via an Australian state population-based cancer registry to complete a survey. Survivors were mailed two questionnaire packages, one for themselves and one for their primary support person. Non-respondents were mailed reminders via the survivor after 3 weeks. One hundred and eighty-two support persons completed the questionnaire (85% response rate). Of these, 67 (46%) support persons reported having at least one personal expense and 91 (52%) experienced at least one financial impact. Male support persons and support persons of survivors in active treatment reported experiencing more personal expenses than other support persons. Older participants reported fewer financial consequences. A greater number of social impacts were reported by those born outside Australia, those who had to relocate for treatment and support persons of survivors in active treatment. Future research should focus on practical solutions to reducing these impacts on support persons.

Background: Losing a baby to IUFD has a profound emotional impact on mothers. This not only affects their mental health and quality of life but also emphasizes the importance of psychological support in the recovery process. Objectives: This review aims to explore recent evidence on the biological, psychological, and social impact of intrauterine fetal death (IUFD) on mothers in developing countries. Methods: This review involved searching databases from 2015 to 2023 through sources such as PubMed, ScienceDirect, and Wiley, as well as search engines such as Google Scholar and Research Rabbit. Articles were selected with the help of Mendeley and evaluated using the JBI Critical Appraisal Guidelines for Qualitative Research. Of the 314 articles found, 5 articles met the inclusion criteria. Results: This review identified three main themes: biological impact (disturbing physical changes and danger warning signs), psychological impact (mothers' emotional responses), and social impact (moral support, negative stigma, health workers' misbehavior, and the need for better social protection). Conclusions: To provide adequate emotional support as well as clear and comprehensive information about the causes and next steps after fetal death, health workers need to be equipped with skills and knowledge. In situations that require difficult information delivery, midwives also need to have the sensitivity and skills to help parents manage and respond appropriately to their emotions.ABSTRACT Background: Losing a baby to IUFD has a profound emotional impact on mothers. This not only affects their mental health and quality of life but also emphasizes the importance of psychological support in the recovery process. Objectives: This review aims to explore recent evidence on the biological, psychological, and social impact of intrauterine fetal death (IUFD) on mothers in developing countries. Methods: This review involved searching databases from 2015 to 2023 through sources such as PubMed, ScienceDirect, and Wiley, as well as search engines such as Google Scholar and Research Rabbit. Articles were selected with the help of Mendeley and evaluated using the JBI Critical Appraisal Guidelines for Qualitative Research. Of the 314 articles found, 5 articles met the inclusion criteria. Results: This review identified three main themes: biological impact (disturbing physical changes and danger warning signs), psychological impact (mothers' emotional responses), and social impact (moral support, negative stigma, health workers' misbehavior, and the need for better social protection). Conclusions: To provide adequate emotional support as well as clear and comprehensive information about the causes and next steps after fetal death, health workers need to be equipped with skills and knowledge. In situations that require difficult information delivery, midwives also need to have the sensitivity and skills to help parents manage and respond appropriately to their emotions.

Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

Introduction Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment. Objective Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples. Methods A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected. Results 1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000. Conclusions Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples. Disclosure No.

This study explored the psychosocial experience of caregiving on the family caregiver of patients with prostate cancer in the Cape Coast metropolis of Ghana. A descriptive phenomenological study was conducted through in-depth face-to-face semi-structured interviews. Twelve family caregivers of prostate cancer patients were selected through purposive sampling. Interviews were conducted until data saturation. All interviews were taped, transcribed verbatim and analysed thematically. The family caregiver's psychosocial experience associated with caregiving uncovered two significant themes with 13 sub-themes. 'Psychological impact' emerged as the first central theme, with anxiety, care as an obligation and feelings of inadequacy, hopelessness, uncertainty, denial and concealment as the sub-themes. The second central theme was 'Social impact' with sexual concerns, role adjustment, loss of livelihood, turmoil and reduced leisure activities emerging as sub-themes. The findings demonstrated that caring significantly impacts the psychological and social well-being of the caregivers of prostate cancer patients. Therefore, there is a need for holistic assessment to include the psychosocial well-being of family caregivers to improve quality of life. Therefore, psychiatric nurses support family caregivers through education and psychosocial interventions to improve their quality of life and enable them to care for their loved ones more effectively.