Anxiety In People Research Articles

“A man who was a hospital” CYBERCHONDRIA: ONLINE HEALTH INFORMATION AND ESCALATION OF HEALTH ANXIETY

World Wide Web provides massive amount of health oriented information. The inclination of using internet to get information on health is also all-embracing. Particularly women are found to be the heavy users of online health information (OHI) both for ‘Curative health information’ (CHI) and ‘Preventive health information’ (PHI). This trend is reported to escalate in pandemic like situations due to many factors including increased dependency on online sources. Online health information helps people to have an idea of the health issues and diseases which they probably can be diagnosed with on the basis of their symptoms. Additionally, it can also assist people to have a better understanding of health and illness and provide them with possible explanations for symptoms. Contrariwise, using symptoms as indicators leading to online search can also have undesirable consequences, for example; increase in the anxiety in people. This phenomenon is called cyberchondria, which has recently gained substantial attention from scholars in health communication field. From among the other featured variables in studies on OHI, eHealth literacy is a significant one. There is a huge amount of literature available on established relationship between eHealth literacy and certain aspects of OHI including trust. However, the aspect that how and to what extent factors (eHealth literacy, age and health status of the user) can marginalize the Cyberchondria effects has had little scholarly attention. This study attempts to fill this gap. A survey from 1000 female users of OHI measured eHealth literacy using eHEALS scale and the relationship between the selected variables. Results showed insignificant positive association between ehealth literacy and Cyberchondria (Kendall’s Tau-b= 0.044, p-value=0.294) at 5% level of significance. Negative insignificant association was observed between age of respondents and cyberchondria (Kendall’s Tau-c= -0.057, p-value=0.123). Similarly, the association between health status of respondents and cyberchondria was also found insignificantly negative (Kendall’s Tau-c= -0.065, p-value=0.081). The study showed that eHealth literacy was not found to have association with cyberchondria among users whereas; it established the association of age and health status with cyberchondria. Although the difference was found in direction and signigicance of this relationship. Keywords: Online health information (OHI), eHealth Literacy, Cyberchondria. Online health research (OHR).

Evaluation of serum hepcidin level in acne vulgaris patients

Background: Acne vulgaris is a pilosebaceous unit inflammatory condition. Although acne is not life-threatening, it can cause psychological issues such as low self-esteem and anxiety in people who suffer from it. Acne scarring is a common and unpleasant consequence of acne vulgaris. Predicting scarring liability can modify treatment protocol and aid in the prevention of such disfigurement. Methods: This study included 82 participants divided into 3 groups: 26 patients with acne vulgaris without scars, 36 patients with acne vulgaris with scars and 20 control. Serum hepcidin level was assessed by a commercially available double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) kit. Results: Serum hepcidin is significantly higher in patients suffering from acne without acne scars than patients suffering from acne with acne scars (p < 0.05). serum hepcidin is significantly higher in the control group than patients with active acne with scars (p < 0.05). There was a statistically significant difference between serum hepcidin level in control versus severe acne scars (p < 0.05). Serum hepcidin level acts as a predictor of occurrence of acne scars and occurrence of severe acne scars. Serum hepcidin level can be used as an indication for beginning aggressive and specific acne treatment as systemic retinoid.

Investigating the Extent of Coronaphobia and some Related Psycho-Social Variables in Iran

Investigating the Extent of Coronaphobia and some Related Psycho-Social Variables in Iran

Virtual Reality Exposure Therapy for Treating Social Anxiety: A Scoping Review of Treatment Designs and Adaptation to Stuttering.

Virtual Reality Exposure Therapy (VRET) has been shown to be an effective technique for reducing social anxiety. People who stutter are at greater risk of developing heightened social anxiety. Cognitive behavior therapy protocols have shown promise in reducing social anxiety in people who stutter, but no studies have investigated VRET targeting social anxiety associated with stuttering. The aim of the current review is to provide an overview of VRET techniques used to treat social anxiety and insights into how these techniques might be adopted in the case of comorbid stuttering and social anxiety. Twelve studies were reviewed to understand key distinctions in VRET protocols used to treat social anxiety. Distinctions include exercises targeting public speaking vs. general social anxiety, computer-generated virtual environments vs. 360° video, and therapist guided vs. automated VRET. Based on the review findings, we propose how certain features could be applied in the case of stuttering. Virtual therapists, inhibitory learning techniques and integration into speech therapy may be suitable ways to tailor VRET. Regardless of these different techniques, VRET should consider the situations and cognitive-behavioral processes that underlie the experience of social anxiety amongst people who stutter.

The impact of anxiety levels on destination visit intention in the context of COVID-19: the mediating role of travel intention

PurposeThis study aims to investigate the effect of tourists' anxiety levels regarding pandemic on their intention to travel and intention to destination visit as a reflection of risk perception.Design/methodology/approachThis study employed a quantitative research design. Multivariate statistical methods were used because they predict cause and effect relationships. The data collection process was completed in 32 days between March 20 and April 20, 2020. Smart-PLS software was used for data analysis.FindingsAccording to the study results, the level of concern tourists have about the COVID-19 outbreak directly affected their intention to travel and indirectly affected their intention to visit destinations.Research limitations/implicationsAccording to the results of the study, people's anxiety levels about COVID-19 will negatively affect their travel behavior after the pandemic. Such results suggest that when potential travelers' pandemic-induced anxiety levels increase, their travel intention after the pandemic will decrease. In addition, there is a positive relationship between people's intention to travel and post-COVID-19 touristic visit intentions. Therefore, as people's travel intentions increase, so do their destination visit intentions. Another important theoretical implication of this research is that people's pandemic-induced anxiety levels have been shown to negatively affect their destination visit intention through the mediating variable of travel intention.Practical implicationsA multidimensional and stakeholder engagement process needs to be followed to decrease the influences of the pandemic on destinations. Destination management organizations (DMOs) can take an active role in crisis periods to encourage stakeholder participation while attracting tourism demand in the post-COVID-19 era.Originality/valueThis study is important for its topical relevance and for providing specific theoretical and practical implications concerning tourists' travel behavior.

Intolerance of Uncertainty Moderates the Relationship between Catastrophizing, Anxiety, and Perceived Pain in People with Chronic Nononcological Pain.

Substantial empirical evidence has shown that intolerance of uncertainty is a central transdiagnostic feature in psychopathology and it has been suggested to be a pain-related psychological factor contributing to the experience of chronic pain. However, research in this area is virtually nonexistent. The objective of this study was to investigate associations between pain severity, catastrophizing, and anxiety in people with chronic nononcological pain, while assuming that intolerance of uncertainty moderates these relationships. A convenience sample of 188 individuals with nononcological chronic pain (157 women and 32 men) participated in the study. We investigated the moderated mediation of intolerance of uncertainty between anxiety and catastrophizing and between catastrophizing and pain intensity. The full moderated mediation model accounted for significant variance in pain intensity (R2 = 0.148, P< .001). Intolerance of uncertainty significantly moderated the interaction between anxiety and catastrophizing (B = 0.039, SE = 0.012, 95% CI [0.015, 0.063]) and between catastrophizing and pain intensity (B = -0.034, SE = 0.010, 95% CI [-0.054, -0.014]). Anxiety and intolerance of uncertainty did not interact in predicting catastrophizing, although an interaction effect was found between intolerance of uncertainty and catastrophizing in predicting pain intensity. This study is the first to address the interrelationship of intolerance of uncertainty, catastrophizing, and anxiety in relation to perceived pain intensity. The current findings support intolerance of uncertainty as a relevant psychological variable that is distinct from other relevant constructs in the setting of pain research and treatment.

THE USE OF TRANSCUTANEOUS SUPRAORBITAL NERVE STIMULATION IN THE TREATMENT OF ASTHENIC SYNDROME AFTER COVID-19

Resume. Aim: to assess the efficacy of Transcutaneous Supraorbital Nerve Stimulation (t-SNS) with the Cefaly® Device on the parameters of asthenia and anxiety, as the main components of psychosomatic changes after suffering COVID-19. Materials and methods: an open prospective study in parallel groups was conducted. 60 patients, 30 men and 30 women, average age (61,3 ± 4,1) years, after a coronavirus infection (COVID-19) more than 6 months ago, meeting the following criteria: age from 60 to 75 years old, presence of asthenic syndrome, no contraindications to supraorbital neurostimulation was included. By the envelope method, patients were randomized into two groups. In the Cefaly® group (30 people), patients underwent 10 procedures (3 times a week) of t-SNS with the Cefaly® Device (Cefaly Technology sprl, Herstal, Belgium) in combination with restorative treatment according to temporary methodological guidelines for medical rehabilitation for a new coronavirus infection (COVID-19), in the control group (30 people), patients received only rehabilitation treatment. The results were evaluated using the Multidimensional Fatigue Inventory (MFI-20) and the Hamilton Anxiety Rating Scale (HAM-A) at baseline and after 24 days of therapy. Results: Cefaly® in addition to the standard rehabilitation program effectively reduces the severity of asthenia symptoms -in the Cefaly® group it was 33,6 %, in the control group - 14,4 %. The use of Cefaly® affects all components of the asthenic syndrome (reduced activity, reduced motivation, physical and mental asthenia). The standard rehabilitation program had an effect only on physical asthenia and reduced activity, but not on parameters of reduced motivation and mental asthenia. The reduction in total score from baseline on the HAM-A anxiety scale in the Cefaly® group was 55,16%, in control group -19,74 %. Cefaly® therapy had the greatest effect on insomnia and tension. It should be noted that the standard rehabilitation program has little effect on anxiety scores. However, after treatment, both groups maintained a high mean total asthenia score (MFI-20 - 42,5 points in the Cefaly® group, 63 points in the control group), which once again confirms that post-COVID changes (Long COVID) are long-term in nature even with availability of adequate therapy. Conclusions: The use of transcutaneous supraorbital nerve stimulation can more effectively reduce the severity of symptoms of asthenia and anxiety in people who have recovered from COVID-19.

The Correlation between Coping Strategies and Anxiety in Hypertension Patients in Malang Regency, Indonesia

ABSTRACT Good self-management in hypertension patients will reduce the risk of complications. This study’s aim was to analyse the correlation of coping strategies on anxiety levels in hypertension patients. The study uses a crosssectional study approach. The research has been conducted in Malang district, Indonesia, wherein a total sample of 108 participants was taken using simple random sampling. Research variables include anxiety and coping strategies. The data are collected using a questionnaire. The statistical test used is multiple linear regression analysis. The results show that there was a significant correlation of active coping (p-value = 0.005), planning (p-value = 0.041), suppression of competing activities (p-value = 0.007), restraint (p-value = 0.026), and the use of social support (p-value = 0.004) for anxiety in patients with hypertension. These results illustrate that improving coping strategies by focusing on problems through the use of active coping, planning, suppression of competing activities, restraint, and the use of social support influence is reducing anxiety in people with hypertension.

Government Public Health Interventions: Crucial Steps in COVID-19 Pandemic in Iran

In the face of the global coronavirus disease 2019 (COVID-19) pandemic, governments worldwide have taken on the immense responsibility of implementing public health interventions to curb the spread of the virus. These interventions, ranging from social distancing to widespread diagnostic testing and vaccination, have played a pivotal role in safeguarding public health and mitigating the impact of this unprecedented crisis.Government intervention in controlling the spread of COVID-19 has been critical. In this respect, governments have showed their commitment to protecting citizens, promoting community well-being, and minimizing the strain on healthcare systems through implementing various measures. These interventions not only have saved many lives but also provided a sense of security and stability during the uncertain pandemic times, considering the unprecedented and invasive waves of infodemics and conspiracies. Various policies and approaches to fight the virus have been adopted in different countries based on cultural, social, economic, and health system conditions. (1,2) The most common and important government actions include public awareness campaigns, (3) prevention measures, (4) contact tracing, (5) diagnostic and treatment interventions, vaccination, and specialized care. In the context of Iran, despite the extensive and severe global sanctions imposed on the country, multifaceted interventions were carried out in the framework of Iran's primary healthcare system within a very short period after the onset of the global COVID-19 pandemic. The documentation and dissemination of these interventions can serve as valuable lessons for the present and future health systems. Some of these interventions included educating the community, promoting social distancing, establishing verbal screening structures, contact tracing, identifying and breaking the chain of disease transmission, engaging the public and community in disease control efforts, establishing specialized COVID-19 diagnostic laboratories, expanding nationwide diagnostic testing, setting up designated COVID-19 centers to accept referrals from public and private sectors at the primary level, developing and reviewing diagnostic and treatment protocols for COVID-19, establishing quarantine centers, and implementing general vaccination programs through prioritizing vulnerable and at-risk groups. Despite the remarkable success of the interventions undertaken to combat COVID-19, numerous challenges persist. Public concerns, fueled by the prevalence of infodemics and various rumors, act as a flood that threatens to dismantle the structures, dams of prevention, and public health interventions, eroding trust in healthcare authorities. Moreover, the emergence of different and novel virus strains further exacerbates people's anxieties, demanding increased efforts within the healthcare system. Therefore, it is necessary to enhance communication strategies to ensure public understanding and compliance with preventive measures. Considering the role of scientific research journals in promoting participatory decision-making and disseminating evidence-based information, these journals play a vital role in fostering trust between the public and the healthcare system.(6) Accordingly, the role of local scientific research journals in non-English language speaking countries is vital in the distribution of evidence-based data, clarification of national programs to battle the pandemic, as well as correcting misinformation and rumors among the general public. Considering the mentioned issues, the Depiction of Health journal, as a journal published in Persian language by the Health Services Management Research Center of Tabriz University of Medical Sciences, decided to release a special issue in collaboration with the Deputy Minister of Health, Ministry of Health and Medical Education (MOHE), and the Director of Iran's Primary Healthcare Management Network. This special issue covers policies, executive and preventive measures related to COVID-19 in the primary healthcare system based on evidence, government documents, field studies, and performance data conducted in primary healthcare systems during the time frame of 2019-2021. All articles in this special issue have undergone a rigorous peer review process in accordance with the standards set by the journal under the supervision of the journal's editor-in-chief.

Ameliyathane Çalışanlarında Pandemi Sonrası Normalleşme Sürecinde Kaygı ve Anksiyete Durumunun Değerlendirilmesi

Objective: The COVID-19 pandemic, which is a rapidly spreading infection, has caused serious stress and anxiety in people, primarily healthcare workers. In our study, we aimed to determine the anxiety of loss of professional skills that may be caused by staying away from operations for a long time due to the pandemic in operating room workers and the reasons that may cause anxiety caused by working under the threat of coronavirus infection during the normalization process. Methods: The population of this cross-sectional study consists of doctors, nurses, technicians, and auxiliary personnel working in the operating room of our hospital. Sociodemographic form, health histories, Worry and Anxiety Questionaire (WAQ) and occupational skill loss anxiety questionnaire were applied to the researchers. Results: Worry and Anxiety (WA) scores and occupational anxiety scores of female healthcare workers were found to be statistically significantly higher than males. It was determined that the WA scores of the anesthesia assistants and operating room nurses were statistically significantly higher than the scores of the surgeons and assistants. It was determined that the WA scores of the participants with chronic disease were statistically significantly higher than those without chronic disease. Conclusion: Psychological support should be continued for health workers who work under intense working conditions and high risk, especially for health workers on the front line, and their family members when necessary. It has been determined that anesthetists and health workers who have previously had psychological disorders and chronic diseases carry a high risk of worry and anxiety, and psychological support should be prioritized. Keywords: COVID-19, anxiety, healthcare workers

Kemampuan Koping Dengan Tingkat Kecemasan Klien Hipertensi

Hypertension is often called the silent killer because it is often asymptomatic and causes complications in other organs, this often causes anxiety in people with hypertension. Coping is an attempt to overcome psychological stress, including anxiety. The purpose of this study was to determine the relationship between coping abilities and anxiety levels in patients with hypertension. The design of this study was a correlational study with a cross-sectional study approach with a sample of 100 respondents taken using a total sampling technique. The results showed that the description of hypertension sufferers in the Grogol Health Center Work Area, Cilegon City, the majority aged 45 years (63%), the majority were male (67%), the majority suffered from hypertension 5 years (60%), the majority had coping skills. maladaptive (65%) and the majority experienced moderate anxiety (43%). There is a significant relationship between coping abilities and anxiety in patients with hypertension in the Grogol Health Center Work Area, Cilegon City in 2021 (p value: 0.000).&#x0D; Keywords: hypertension, anxiety, coping

The Correlation between Enjoying Fictional Narratives and Empathy in Japanese Hikikomori

Background:Hikikomori is a Japanese social withdrawal phenomenon which, in recent years, is spreading in western developed countries as well. Spending a lot of time secluded indoors, watching and playing with fictional narratives may be relatively commonfor Hikikomori peopleand may represent a protective factor for their psychological well-being. Method:Weevaluatedthe role of enjoying fictional narratives onempathy, relaxation, depression, and anxietyinpeople withHikikomoriexperience,in relation to their daily consumption of fictional narratives and their emotional transportation toward fictional narratives. Hikikomori from one psychiatric clinic andthreedifferent support facilities were enrolled in this study. Multidimensional empathy scale, CES-D, STAI questionnaire,andrelaxation inventory self-report scale were used as outcome measures. Results:We found a significant correlation between empathy and emotional transportation toward fictional narratives and between relaxation during watching and reading fictional narratives and consumption frequency of fictionalnarratives.Wefailed, however,to find any significant correlation with depression and anxiety. Conclusions:These findingssuggestapossiblecorrelationbetween fiction andempathy/relaxation response; however, any causal relationship is not proven, consequently we deem that further investigations with a larger sample size are required for a better understanding.

Anxiety, “Concerned Consciousness” and Their Manifestation in the COVID-19 Pandemic in China

The article examines the specifics of the Chinese containment measures of the COVID-19 pandemic and their social consequences at the beginning of 2021. The author analyses empirical psychological research results on distress and anxiety of people in times of the first wave of the COVID-19 pandemic in China, and explores to what degree the individual feelings of anxiety in contemporary China are conditioned by the traditionally prevailing absence of faith in higher transcendent forces on the one hand, and social isolation on the other. It proceeds from Xu Fuguan’s interpretation of the origins of a traditional Chinese concept of “concerned consciousness” (youhuan yishi 憂患意識). The author shows that this concept can be compared to the feeling of anxiety, but highlights important differences which separate it from the anxiety as developed and understood in the framework of modern Western philosophy. The paper aims to provide some preliminary answers to the questions of whether and in what way such a traditional feeling of anxiety in the sense of a “concerned consciousness” manifested itself in the period of social isolation that was implemented as a part of the government measures for the COVID-19 pandemic in China. These questions are being investigated through an analysis of philosophical studies on concerned consciousness on the on hand, and a contemporary case study on the other. The results show that the specifically Chinese kind of anxiety, which is rooted in concerned consciousness, is tightly linked to the relational nature of Chinese ethics and the corresponding understanding of individual identity. In addition, it is connected with the traditional understanding of human destiny, which is not fatalistic or determinist, but rather based on autonomous decisions based on the social responsibilities of a free human self.

Impacts of acupressure treatment on depression: A systematic review and meta-analysis.

BACKGROUNDDepression is recognized as a major public health problem with a substantial impact on individuals and society. Complementary therapies such as acupressure may be considered a safe and cost-effective treatment for people with depression. An increasing body of research has been undertaken to assess the effectiveness of acupressure in various populations with depression, but the evidence thus far is inconclusive.AIMTo examine the efficacy of acupressure on depression.METHODSA systematic literature search was performed on PubMed, PsycINFO, Scopus, Embase, MEDLINE, and China National Knowledge (CNKI). Randomized clinical trials (RCTs) or single-group trials in which acupressure was compared with control methods or baseline in people with depression were included. Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression. The primary outcome measures were set for depression symptoms. Subgroups were created, and meta-regression analyses were performed to explore which factors are relevant to the greater or lesser effects of treating symptoms.RESULTSA total of 14 RCTs (1439 participants) were identified. Analysis of the between-group showed that acupressure was effective in reducing depression [Standardized mean differences (SMDs) = -0.58, 95%CI: -0.85 to -0.32, P < 0.0001] and anxiety (SMD = -0.67, 95%CI: -0.99 to -0.36, P < 0.0001) in participants with mild-to-moderate primary and secondary depression. Subgroup analyses suggested that acupressure significantly reduced depressive symptoms compared with different controlled conditions and in participants with different ages, clinical conditions, and duration of intervention. Adverse events, including hypotension, dizziness, palpitation, and headache, were reported in one study. CONCLUSIONThe evidence of acupressure for mild-to-moderate depressive symptoms was significant. Importantly, the findings should be interpreted with caution due to study limitations. Future research with a well-designed mixed method is required to consolidate the conclusion and provide an in-depth understanding of potential mechanisms underlying the effects.

Effectiveness of Acceptance and Commitment Therapy in Depression and Anxiety in People with Substance Use Disorder

Background: The comorbidity of substance use, mood disorders, and anxiety has been proven in various studies, leading to many clinical implications. Objectives: This study aimed to evaluate the effectiveness of acceptance and commitment therapy (ACT) in depression and anxiety in individuals with substance use disorder. Methods: This quasi-experimental study utilized a pretest-posttest design with a control group. The statistical population consisted of all people with substance abuse in Urmia in 2019, including 220 subjects. The sample consisted of 50 individuals with substance use disorders selected by purposive sampling and randomly assigned to experimental and control groups. The experimental group was trained in eight sessions, each lasting 90 min, based on the ACT protocol by Hayes et al. (2004), while the control group did not receive any intervention. The data were obtained using the Beck Depression Inventory and Beck Anxiety Inventory. Pretest and posttest were performed in both groups. The collected data were analyzed by multivariate analysis of covariance (MANCOVA) using SPSS23 software. Results: The results showed that after controlling for the pretest effects, a significant difference was observed between the mean posttest scores of the two groups in both depression and anxiety (P &lt; 0.05). Conclusions: Acceptance and commitment therapy is an appropriate strategy to effectively improve depression and anxiety in people with substance use disorder.

Effect of Music on Stress Parameters in Dogs during a Mock Veterinary Visit.

Simple SummaryVisits to the vet are stressful for many pet dogs, but less is known about how measures of stress change over the course of a visit. Identifying appropriate measures of canine stress, along with successful interventions which alleviate stress in dogs during a veterinary visit, will be of great benefit to dogs and people. Music therapy has been successfully used to reduce stress and anxiety in people and other animals. Specifically, a process called entrainment, which involves playing music at a particular tempo aimed at synchronizing physiological responses, has been implemented with success in humans. The aim of this study was to examine a range of behavioral and physiological measures in dogs over the duration of a veterinary visit and to establish if bespoke music, which mimicked the tempo of their resting heart rate, could improve wellbeing. The results indicated that certain measures increased over time, indicating that dogs became increasingly stressed. Music was not shown to have a demonstrated effect across measures, suggesting that the stressor may be too extreme for this type of intervention to have a positive effect, or that music therapy requires modification before it can be successful in alleviating stress in dogs during a veterinary visit.Veterinary visits can be stressful for dogs, but how their wellbeing changes during a visit is not well understood. Music therapy has been successfully used in clinical practice to alleviate stress and anxiety in people. The present study aimed to understand how canine stress changes during a veterinary visit, establish the effect of music, and highlight measures which may be of practical use. In a randomized crossover design, dogs were exposed to no music and a bespoke piece of classical music at a tempo designed to match their resting heart rate during a mock veterinary visit. Dogs were scored as more “afraid” during the physical examination compared to when they were in the hospital kennel (p < 0.001). Salivary cortisol, IgA, and infrared temperature all increased significantly (p < 0.05) from baseline to post-kennel and post-examination, with no effect of music treatment. Core body temperature (p = 0.010) and the odds of ‘relaxed’ lips (p = 0.020) were lower when dogs were exposed to music compared to control visits. Overall, dogs experienced changes in physiology and behavior, indicative of increased stress, over the course of the visit. Additional research is required to further understand the effect that bespoke music may have in alleviating canine stress during veterinary visits.

Physiotherapists perceived role in managing anxiety in patients with relapsing-remitting multiple sclerosis: a mixed-methods study

BackgroundAnxiety is common for people with Multiple Sclerosis (PwMS) and is higher in those with relapsing-remitting MS (RRMS) and in community-based samples. Anxiety can impact self-efficacy, pain, fatigue, engagement in physical activity and treatment adherence, all of which influence the rehabilitation process. Little is known about how physiotherapists manage anxiety in PwMS and the challenges associated with anxiety throughout the rehabilitation process, in community and outpatient settings.MethodsA mixed-methods design, combining a cross-sectional survey and semi-structured interviews with UK-physiotherapists, was used to answer the research question. To inform the qualitative study, a cross-sectional survey collected data from physiotherapists working in neurology to understand the impact and management of anxiety in people with MS (PwMS) during rehabilitation. Analysis used descriptive statistics and the findings formed the interview guide. Semi-structured interviews with specialist physiotherapists explored barriers and facilitators to managing anxiety in PwMS in community and outpatient settings, identified perceived physiotherapy training needs and offered suggestions to develop physiotherapy research and practice. Themes were derived inductively.ResultsThe survey suggested how PwMS present with anxiety, its impact during rehabilitation, physiotherapy management practices, and physiotherapist skills and training needs. Five semi-structured interviews with specialist physiotherapists expanded on the survey findings and identified five main themes: Understanding the MS journey, modifying assessment and treatment, anxiety management toolbox, lagging behind Musculoskeletal Physiotherapy, and gaining knowledge and skills.ConclusionPhysiotherapists encounter anxiety in PwMS in community and outpatient rehabilitation and perceive they have a role in managing it as it presents. Facilitators included communication, listening skills and opportunities to develop strong therapeutic relationships. Poor training and support, lack of clinical guidelines and limited research evidence were considered barriers. Clinically relevant learning opportunities, interprofessional working, and greater support through clinical supervision is recommended to better develop physiotherapy practice.

Disability self-worth relates to lower anxiety and depression in people with visual impairment.

Visual impairment (VI) has been associated with depression and anxiety. Although researchers have identified several relevant individual differences associated with risk for depression and anxiety, researchers have not considered the role of personal disability identity (PDI) in depression and anxiety for people with VI. The purpose of this study isto examine the association between two aspects of PDI, perceived self-worth and personal meaning, and depression and anxiety among people with VI. Hierarchical linear regressions assessed the relative contribution of PDI and disability characteristics to anxiety and depression in an international sample of adults with VI (N = 390). Lower disability self-worth, but not lower personal meaning, was significantly associated with higher depression and anxiety, explaining more variance than demographic or disability-related factors. By introducing disability self-worth as a correlate of depression and anxiety in VI, study findings suggest that considering and cultivating PDI for people with VI may be useful for improving clinical outcomes.

The relationship between social isolation and anxiety in people with cognitive impairment in the United States.

Social isolation among older adults with cognitive impairment is understudied. The purpose of this study is to examine the relationship between social isolation and anxiety in people with cognitive impairment in the United States. Secondary data analyses were conducted using the National Social Life, Health, and Aging Project (NSHAP) Wave 2 (2010-2011) dataset which includes a nationally representative sample of American older adults living at home. A total of 1343 people who had probable cognitive impairment measured by a Montreal Cognitive Assessment (MoCA) score of 22 or less were selected. Anxiety was measured using the anxiety measure of Hospital Anxiety and Depression Scale (HADS-A) and social isolation was measured using Perceived Social Isolation Scale. A weighted multivariable linear regression analysis and weighted F tests were used to examine the relationship between social isolation and anxiety. We observed that greater social isolation was related to increased anxiety in people with cognitive impairment (coefficients=0.7242, t=2.51, p=0.015), adjusting for severity of cognitive impairment, race, pain, depression, activities of daily living, and instrumental activities of daily living. Weighted F tests showed that persons with clinically significant anxiety (HADS-A≥8) had higher levels of loneliness, including feeling a lack of companionship, feeling left out, and greater social isolation. The results of our study suggest that people with cognitive impairment can feel social isolation and it may contribute to their anxiety. Health care professionals, family, and friends of people with cognitive impairment should pay greater attention to social isolation of their loved ones.

Validity of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) in Patients With Dizziness.

The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) will be a valid and reliable combined measure of depression and anxiety in people with vertigo and dizziness. Co-occurrence of depressive, anxiety, and somatic symptoms are common. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7) measure symptoms of depression and anxiety respectively, although measuring them separately may be suboptimal in people who have illness-related distress. There is some evidence that these scales can be combined in long-term conditions resulting in the PHQ-ADS, but validity is yet to be determined in people with vertigo and dizziness. Two separate datasets from a tertiary vestibular clinic were analyzed where the PHQ-ADS was completed at initial clinical assessment (n = 624) and while on a waiting list (n = 185). A cross-sectional design was used to examine the factor structure (confirmatory factor analysis), internal consistency (omega index), and construct validity (Pearson correlation coefficient) of the PHQ-ADS. Construct validity was determined against the dizziness handicap inventory (DHI). A bi-factor PHQ-ADS model had good fit to the data (χ2 = 397.163, 249.763; comparative fit index [CFI] = 0.954, 0.919; Tucker-Lewis index [TLI] = 0.938, 0.892; root mean squared error of approximation [RMSEA] = 0.076, 0.098). The general distress factor explained 81 to 85% of the common variance between items. There were moderate to large significant positive correlations between the PHQ-ADS and DHI. The PHQ-ADS appears to have good structural validity in patients with vertigo and dizziness. Clinicians and researchers can use this scale where a composite psychological measure is desired.