DASS-21 Scale Research Articles

Exploring the Effects of a Calming Herbal Tea Blend on Perioperative Anxiety: A Randomized Clinical Trial.

This research aimed to explore the effectiveness of consuming a calming herbal tea blend, comprising Matricaria recutita, Passiflora incarnata L., and Pimpinella anisum L., in comparison to a placebo tea infused with lemon, to ascertain whether the herbal blend possesses anxiety-reducing properties capable of alleviating perioperative anxiety. The study adopted a clinical randomized, double-blind design and collected data from volunteers undergoing elective surgery at Hospital Unimed Erechim in the northern region of Rio Grande do Sul, Brazil. A total of 210 participants were enrolled and randomly allocated into two groups: one receiving the placebo tea and the other the sedative herbal tea. All participants completed a questionnaire postoperatively to assess anxiety levels, employing the adapted Portuguese version of the DASS-21 Scale (Depression, Anxiety, and Stress Scale). Results revealed no significant difference in anxiety levels between the group consuming the calming herbal tea and the group consuming the placebo tea. However, consumption of the anxiolytic herbal tea was associated with a notable increase in positive sentiments toward the surgical procedure (P = .0009). Furthermore, the study demonstrated that the DASS-21 questionnaire exhibited a preoperative profile comparable to the clinical scenarios depicted by the scale. Both the calming herbal tea and the placebo tea were found to effectively mitigate perioperative anxiety. This suggests that both options-soothing herbal tea and placebo tea-can be considered safe, efficacious, and pleasant methods for reducing preoperative fasting requirements.

Prevalence and Level of Depression, Anxiety and Stress Among Frontliners Using the Depression, Anxiety and Stress Scale (DASS)-21 in a Tertiary Hospital in Manila, Philippines During the COVID-19 Pandemic: a Cross-Sectional Study

Background: COVID-19 was declared as a pandemic by the World Health Organization (WHO) in March 2020. It has affected millions globally and remains as a public health concern until today. Objectives: The study aims to identify the prevalence of depression, anxiety and stress among UST hospital frontliners during the COVID-19 pandemic using the Depression, Anxiety and Stress Scale (DASS)-21 scale. Methods: A cross-sectional study was conducted among 272 frontliners in a tertiary hospital in Manila, Philippines using the DASS-21 scale. Results: Based on data gathered from the responses of participants using the DASS-21 scale, the prevalence of depression, anxiety and stress among the frontliners were 28.68%, 35.66% and 14.71%, respectively. Being single, living alone, higher degree of educational attainment (postgraduate), trainees (residents and fellows) and those having pulmonary comorbidities were associated with increasing level of depression and stress. Respondents who had less work experience (less than 5 years) had significant depression; being single presented with higher anxiety; and those who had a previous COVID-19 infection had higher degree of stress. Conclusion: Several demographic and occupational characteristics, in accordance to the COVID-19 pandemic, yielded significant results regarding the presence of depression, anxiety and stress. The study recommends closer follow-up of participants which recorded high severity scores in the DASS-21 scale as well as regular psychological briefing and counseling to assess if there are other contributory factors to such responses. Ultimately, this may enlighten us on how to provide holistic care to our own hospital staff. Keywords: COVID-19, Depression, Anxiety, Stress, DASS-21 scale

Online compulsive buying behavior and its association with internet addiction, self-esteem, impulsiveness, and emotional distress among nursing students

ABSTRACT Background: Compulsive buying behavior [CBB] or pathological buying (PB) is a psychiatric disorder of growing recognition and many psychosocial factors have been proposed to predispose or precipitate this predicament. Aim: To find out the association of compulsive buying behavior, emotional distress, self-esteem, internet addiction, and impulsiveness among nursing students. Materials and Methods: A web-based cross-sectional, online survey was conducted among nursing undergraduates to assess the association of compulsive buying behavior, emotional distress, self-esteem, internet addiction, and impulsiveness using total enumerative sampling from February 2024 to April 2024. Data were collected using self-administered PBS, IAT, Rosenberg self-esteem scale, BIS-Brief, and DASS-21 scales. Descriptive and inferential statistics were used. Frequency distribution, Bivariate correlation, and Multiple regression analysis were also used. Results: There were 410 participants with valid responses, and 207 [50.5%] fell into the category of pathological buying. The participant group “with pathological buying” was comparable with the group “not having pathological buying” in terms of sociodemographic statistics, preferred modality of purchasing stuff, and the “duration of daily internet use”. However, the DASS-21 and IAT scores were significantly higher among the participants “with pathological buying”. On regression analysis, both DASS and IAT scores were predicting the PBS scores. Conclusion: There is a significant association between pathological buying with internet addiction and psychological distress, but not with self-esteem, and impulsivity.

Does Socioeconomic Status Moderate the Association Between Screen Time, Mobile Phone Use, Social Networks, Messaging Applications, and Mental Health Among Adolescents?

The aim of this study was to examine the relationship between different screen time (ST)-related behaviors and mental health conditions such as depression, anxiety, and stress. In addition, this study aimed to determine the moderating role of socioeconomic status (SES). This was a cross-sectional study and included data from 620 adolescents, aged 12-17 years, from the Valle de Ricote, Region of Murcia, Spain. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Overall ST, mobile phone use, social network use, and messaging application use were measured using validated questionnaires. SES was assessed using the Family Affluence Scale-III. The results indicated that overall ST was significantly associated with symptoms of depression at the mean SES (unstandardized beta coefficient [B] = 0.005, p = 0.023) and 1 standard deviation (SD) below the mean (B = 0.007, p = 0.011), and with stress only 1 SD below the mean (B = 0.006, p = 0.011). No significant associations were found for anxiety and stress across all socioeconomic levels. Mobile phone use exhibited a strong positive association with symptoms of depression (B = 0.891, p < 0.001), anxiety (B = 0.530, p = 0.014), and stress (B = 0.790, p < 0.001) at 1 SD below the mean SES. Similar patterns were observed for mean SES, albeit with slightly weaker associations. Conversely, social network use was positively associated with all three DASS-21 scales, particularly at 1 SD below the mean SES, with the strongest associations found for symptoms of depression (B = 0.327, p < 0.001), anxiety (B = 0.325, p < 0.001), and stress (B = 0.318, p < 0.001). Furthermore, messaging application use did not show significant associations with symptoms of depression, anxiety, or stress across any SES levels. In conclusion, social inequalities may influence the associations between various ST-related behavior and symptoms of depression, anxiety, and stress among adolescents. These findings may have implications for the design of effective interventions to improve symptoms of depression, anxiety, and stress in this population.

Depression, anxiety, and stress in the Chilean Educational System: children and adolescents post-pandemic prevalence and variables

The mental health of children and adolescents in the Chilean Educational System (ChES) has become a severe post-pandemic public health problem. This cross-sectional study, which included 1,174 children and adolescents from five Chilean regions, used the DASS-21 scale, focusing on determining the prevalence of depression, anxiety, and stress, as well as identifying associated risk factors. The results exposed a high prevalence of depression, anxiety, and stress (60.2%, 63.6%, and 50.2%, respectively). Risk factors for depression involve being female, having separated parents, being in high school, having a cell phone, difficulty sleeping, ruminative thoughts, and low self-esteem. For anxiety, factors included being female, being 12 years old, owning a cell phone, having sleep problems, having ruminations, having low self-esteem, and being an atheist. For stress, factors were identified as being female, owning a cell phone, sleep problems, ruminations, low self-esteem, being atheist, as well as extensive use of social networks. The research underscores the urgent need for intervention by educational authorities, given the marked deterioration in the mental health of children and adolescent students in the ChES, to prevent long-term consequences.

The impact of cancer prevention education on the mental health of college students based on the difference-in-differences method.

Cancer, as the second leading cause of death worldwide, poses significant challenges to human health and socio-economic development. In recent years, the incidence of cancer has shown a trend toward younger populations, drawing attention to cancer prevention education among college students. However, research on the specific impact of cancer prevention education on the mental health of college students is limited. This study aims to explore the impact of cancer prevention education on the mental health of college students, revealing the mediating role of disease awareness and the moderating roles of psychological resilience and cultural differences. A difference-in-differences (DID) approach was used, involving 1,670 freshmen from a Chinese university, divided into an experimental group (n = 835) and a control group (n = 835). The experimental group received a semester-long cancer prevention education program. Data were collected monthly from November 2022 to June 2023 using the Depression Anxiety Stress Scales (DASS-21) and a custom Disease Awareness Scale. The study found a significant improvement in mental health scores among the experimental group, with an average increase of 14.738 points on the DASS-21 scale (p < 0.001), representing a 23% reduction in stress, anxiety, and depression levels compared to the control group. Disease awareness in the experimental group improved by 17%, as measured by the Disease Awareness Scale, with a mediation effect of 3.563 points (p < 0.001). Furthermore, psychological resilience and cultural differences moderated the impact of the education program, with those scoring higher in resilience showing an additional 8% improvement in mental health scores (moderation effect = 0.892, p < 0.001), and cultural differences accounting for a 5% variance (moderation effect = 0.756, p < 0.001) in the outcomes. This study demonstrates that systematic and scientific cancer prevention education has a significant positive impact on the mental health of college students. Universities should promote comprehensive and personalized health education strategies to improve disease awareness, foster psychological resilience, and emphasize cultural differences, thereby enhancing the overall physical and mental health of college students and promoting their holistic development. This finding provides important empirical support and theoretical basis for the design and implementation of health education in universities.

CORRELATION BETWEEN PSYCHOLOGICAL PARAMETERS SUCH AS DEPRESSION, ANXIETY, AND STRESS AND AFFECT SCORE AMONG MEDICAL STUDENTS

Objectives: In the modern era, internet use has turned out to be a significant arena for day-to-day life activities. Proper use of the internet is harmless, but misuse of this tool might lead to disruptions in psychological health and social relationships, yet available reports about the association between internet use and affect are inconsistent. Hence, the objective is to assess and correlate the psychological parameters with the affect score among medical college students using the depression anxiety stress scale (DASS)-21 questionnaire and positive and negative affect schedule (PANAS) scale. Methods: The present study was a cross-sectional study conducted on medical students in the age group of 17–22 years. 150 participants were recruited by random sampling. DASS-21 scale was used to assess depression, anxiety, and stress, consisting of 21 items designed to measure emotional states of depression, anxiety, and stress. PANAS is designed to assess individuals’ positive and negative moods. Results: Pearson’s correlation of these psychological parameters with affect scores had a significant negative correlation with the positive affect score (depression [p=0.003], anxiety [p=0.01], and stress [p&lt;0.04]) and a significant positive correlation with negative affect score (depression [p&lt;0.02], anxiety [p=0.0009], and stress [p=0.01]). Students should be closely monitored with regard to their use of the internet, and also, internet addiction and psychological behaviors can be reduced by providing early counseling and interventional therapy. Conclusion: Awareness about the harmful effects of excessive internet use should be provided so as to enhance the academic performance of students.

Estrés, ansiedad y depresión como factores asociados a la procrastinación académica en estudiantes universitarios peruanos

The influence of stress, anxiety, and depression (SAD) on academic procrastination (AP) in the context of COVID-19 was analyzed; a predictive study in 1069 Peruvian students aged 18 to 25 from a public university recruited by non-probabilistic sampling and assessed using the Academic Procrastination Scale and the DASS-21 Scale. The results reflect significant differences in academic procrastination in favor of non-scholarship holders; likewise, for stress, anxiety, and depression in favor of: a) women, b) non-scholarship holders, c) without COVID-19 infection, and d) with family losses due to COVID-19; likewise, a positive correlation between AP and SAD (with emphasis on depression); this correlation is strengthened in the network analysis for the scholarship holder condition. Finally, regarding the analysis of structural equations: anxiety and stress are related at 0.83; both variables explain depression at 63%. On the other hand, depression is presented as a cause of PA at 0.41 and this model has an explanatory value of 17% (with adjustment indices of CMIN/df = 0.305, CFI = 1.000, SRMR = 0.006, RMSEA = 0.000 and PClose = 0.974). The study reflects the predictive capacity of the E-A-D in the behavior of higher education students regarding their academic responsibility.

Irruption of Network Analysis to Explain Dietary, Psychological and Nutritional Patterns and Metabolic Health Status in Metabolically Healthy and Unhealthy Overweight and Obese University Students: Ecuadorian Case.

The association between dietary nutritional patterns, psychological factors, and metabolic health status has not been investigated in university students. There are studies that include numerous variables to test hypotheses from various theoretical bases, but due to their complexity, they have not been studied in combination. The scientific community recognizes the use of Gaussian graphical models (GGM) as a set of novel methods capable of addressing this. To apply GGMs to derive specific networks for groups of healthy and unhealthy obese individuals that represent nutritional, psychological, and metabolic patterns in an Ecuadorian population. This was a quantitative, non-experimental, cross-sectional, correlational study conducted on a sample of 230 obese/overweight university students, selected through a multi-stage random sampling method. To assess usual dietary intake, a Food Frequency Questionnaire (FFQ) was used; to evaluate psychological profiles (anxiety, depression, and stress), the DASS-21 scale was employed; blood pressure and anthropometric data were collected; and insulin levels, lipid profiles, and glucose levels were determined using fasting blood samples. The International Diabetes Federation (IDF) criteria were applied to identify metabolically healthy and unhealthy individuals. Statistical analysis relied on univariate methods (frequencies, measures of central tendency, and dispersion), and the relationships were analyzed through networks. The Mann-Whitney U test was used to analyze differences between groups. In metabolically unhealthy obese individuals, GGMs identified a primary network consisting of the influence of waist circumference on blood pressure and insulin levels. In the healthy obese group, a different network was identified, incorporating stress and anxiety variables that influenced blood pressure, anthropometry, and insulin levels. Other identified networks show the dynamics of obesity and the effect of waist circumference on triglycerides, anxiety, and riboflavin intake. GGMs are an exploratory method that can be used to construct networks that illustrate the behavior of obesity in the studied population. In the future, the identified networks could form the basis for updating obesity management protocols in Primary Care Units and supporting clinical interventions in Ecuador.

Loneliness and Mental Health During the First Covid-19 Lockdown in Romania

During the spring of 2020, Romania entered its first lockdown in response to the growing Covid-19 pandemic. The pandemic’s impact on mental health was thus superimposed on an already epidemic risk of loneliness in developed countries. The purpose of this article was thus to measure the impact of perceived social isolation during the national lockdown on emotional distress among the general population, while also considering potential risk or buffering factors like social media usage, and romantic relationships. Featuring a cross-sectional design, data was collected from 180 participants, aged 20 – 60 years using an online questionnaire which included the DASS-21 scale, the UCLA Loneliness Scale and the Intimate Relationships Scale. Our results indicated that loneliness significantly predicted depressive, anxious and stress symptoms even when correcting for gender and age. Distancing measures had no significant effect on couples, though differences in depression and loneliness were found between those with no partner, and those who described minimal impact of social distancing measures. Number of social media sites used predicted greater depressive and anxious symptoms, even when correcting for age and gender, whereas partner intimacy presented as a protective factor for loneliness. Given the many public, individual and dyadic factors involved in mental health during a pandemic, the implications for further studies are discussed.

Depression, anxiety, stress, and current e-cigarette use: Results from the Truth Longitudinal Cohort of youth and young adults (2022−2023)

ObjectiveTo examine associations between depression, anxiety, and stress, as measured by the Depression, Anxiety and Stress Scale (DASS-21) scale, with current e-cigarette use. MethodsData from the Truth Longitudinal Cohort – a nationally representative sample of youth and young adults – was collected between October 2022 to February 2023. The analytic sample was comprised of participants who provided information on e-cigarette use and the DASS-21 scale (N = 4198). Chi-square statistics were used to determine differences by current e-cigarette use across covariates and DASS-21 items. Logistic regression analyses were applied to the cross-sectional data to determine which scales predicted current e-cigarette use, adjusted for the effects of age, gender identity, race and ethnicity, parental educational attainment, perceived financial situation, and current use of alcohol, marijuana, and other tobacco use. ResultsThose who had severe/extremely severe levels of depression, anxiety, and stress had greater odds of current e-cigarette use, relative to those who had normal levels of depression, anxiety, and stress, even after adjusting for covariates. Results also demonstrated associations between age, race/ethnicity, parental education, and current use of alcohol, marijuana, and other tobacco products with current e-cigarette use. LimitationsCross-sectional analyses of self-reported data limit the ability to determine directionality of effects between depression, anxiety, stress, and current e-cigarette use. DiscussionMore severe levels of depression, anxiety, and stress were associated with a greater likelihood of current e-cigarette use. Future research is needed to evaluate changes in e-cigarette use, in response to depression, anxiety, and stress symptomatology.

Validity, reliability, and the factorial structure of bangla version depression, anxiety, and stress scale (DASS-21) among Bangladeshi healthcare professionals

ObjectiveThe objective of this study was to assess the validity, reliability, and factorial structure of the Bengali-translated Depression, Anxiety, and Stress Scale—21 (DASS-21) among Bangladeshi health professionals.MethodsThis study incorporated the cross-sectional study design, conducted among 312 health professionals from 28 health facilities in 18 districts across Bangladesh. The internal consistency and intraclass correlation coefficient of the DASS-21 was assessed. The confirmatory factor analyses was done to assess the fitness of different structural models of DASS-21. The concurrent validity was estimated by using the PHQ-9 and GAD-7 scales.ResultsIn total, 258 healthcare professionals (82.7%) out of 312 completed the whole survey questionnaire and were included in the study. The internal consistency of the DASS-21 exhibited satisfactory internal consistency (α = 0.93) and ICC = 0.92). The conventional three-factor model appeared to best fit the Bengali-translated DASS-21 scale. The discriminant validity has been affirmed by strong evidence. The convergent validity of Bengali DASS-21 was confirmed by the PHQ-9 and GAD-7 scales.ConclusionsThis study found good validity, reliability, and suitability of the DASS-21 used among the Bangladeshi healthcare professionals. We warrant future research to explore the validity of this tool in other cohorts in Bangladesh.

Assessment of cfDNA levels in saliva samples of stressed young adults: Preliminary study

Purpose: The aim of this pilot study was to examine the levels of cell-free DNA (cfDNA) in the saliva samples of second-year medical students before and after a stress-inducing event, exams. Materials and Methods: Saliva samples were collected from 20 students, whose stress profiles were assessed using the DASS-21 scale, both before and after the exams. Cell-free DNA were isolated from these samples, and measured using spectrophotometry and automated electrophoresis system. Results: Spectrophotometric analysis revealed a significant decrease in cfDNA levels in the saliva samples collected after the exams (p ≤ 0.05). This difference was confirmed by the automated electrophoresis system, particularly showing a reduction in cfDNA amounts in the 40-200 bp range with the reduction of stress (p ≤ 0.05). Conclusion: Psychosocial stress affects the release of cell-free DNA. This study reports that the amount of cfDNA found in saliva samples significantly changes in relation to stress. This preliminary study suggests that cfDNA in saliva samples could potentially serve as a biological marker for stress in healthy individuals.

Positive mental health, depression and burnout in healthcare workers during the second wave of COVID-19 pandemic.

INTRODUCTION: Few studies focused on healthcare workers' positive mental health (i.e. high levels of psychological well-being) and its association with anxiety, depression and burnout in the second wave of the pandemic. To evaluate the protective role of well-being in buffering burnout and psychological distress. We evaluated 173 Italian healthcare workers with indicators of psychological distress (Depression Anxiety Stress Scales [DASS]-21), burnout (Copenhagen Burnout Inventory [CBI]) and positive mental health (Mental Health Continuum) and we cross-classified them according to their levels of mental health (flourishing, languishing and moderate mental health) and their levels of anxiety, depression and burnout. Forty-eight per cent of health workers were classified as flourishing, 10% as languishing and 42% as moderate mental health. Flourishing individuals presented lower scores on DASS and CBI scales, whereas no differences emerged between languishing and moderate mental health groups. More than 80% of health workers with clinically significant symptoms of anxiety, depression and risk of burnout were classified as not flourishing. This investigation documented the presence of flourishing mental health in almost half of the sample of Italian healthcare workers. However, those with moderate or languishing mental health manifested higher levels of anxiety, depression and higher risks of burnout. The study confirms the importance of maintaining and/or promoting the well-being of this population, with a crucial role of mental health nurses who can easily approach other healthcare workers and provide them informational (training, guidelines) and emotional support programmes (psychoeducation, mental health support team, peer support and counselling) when facing adverse working conditions.

Impact of Psychoeducation Applied to The Spouses of Bipolar Patients on Their Emotional Expression, Stigmatization, and Loneliness Levels

Objective: Bipolar disorder (BD) is a serious burden for patients and family members due to recurrent mood episodes, hospitalizations, and loss of productivity. The goal of this study is to examine how psychoeducation affected the caregivers of bipolar patients' levels of emotional expression, stigmatization, loneliness, and mood symptoms. Method: This research is a quasi-experimental intervention study applied as a pretest-posttest design with a control group. The study included 20 patients with bipolar diagnosis and 20 caregiver spouses who were followed up in our outpatient clinic. Participants were divided into 2 groups as study and control group. The spouses in the control group were interviewed only to evaluate their situation. The study group received a 6-session (15 hours) psychoeducation intervention. We administered the Emotion Expression Scale (EES), Self-Stigma Scale-Family (SSI-F), UCLA Loneliness Scale (UCLA-LS), and DASS-21 Scale to the spouses of bipolar patients in the study and control groups before and after the psychoeducation program. Results: The mean age of the spouses in the study group was 43.4±7.04 years, the mean age of the spouses in the control group was 39±8.29 years and all of them were female. There was no significant difference between the mean scores of the SSI-F, EES, and DASS-21 scales of the spouses in the study and control groups before the training (p&gt;0.05). After the psychoeducation program was applied to the spouses in the intervention group, a significant decrease was observed in the SSI-F, EES, and DASS-21 scale scores (p

Factors associated with mental health and quality of life among Brazilian medical students: a three-year longitudinal study

Background Despite several studies on the mental health of medical students, there is insufficient research on long-term follow-ups. Aims To investigate the associated factors and changes in the quality of life and mental health of a group of medical students followed-up for three years. Methods An observational, prospective cohort study was conducted. Four classes were followed during the first three years of the medical course. The study included sociodemographic data, mental health data using the DASS-21 scale, and quality-of-life data using the WHOQOL-BREF scale. Linear regression models were used for analysis. Results A total of 201 (66.1%) medical students responded to both data collection waves after a three-year follow-up. Depressive symptoms(p < 0.001), anxiety(p = 0.037), and stress(p < 0.001) increased. Additionally, physical(p < 0.001), psychological(p < 0.001), and social(p = 0.003) quality of life decreased. Worse mental health at baseline and being a woman were associated with worse mental health after three years, while higher income at baseline was associated with better quality of life after three years. Conclusions The mental health and quality of life of the medical students worsened after three years, being influenced by gender, income, and mental health at baseline. Educators and managers must be aware of these factors to minimize suffering in medical schools.

Construct validity and reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science students

BackgroundDASS-21 is the common and widely used tool for assessing depression, anxiety and stress. However, its validity and Reliability in Ethiopian Amharic language is not assessed.ObjectiveTo translate the DASS-21 and assess its validity and reliability among Ethiopian Defense University college of health science students in Bishoftu, Ethiopia.MethodAn institutional based cross-sectional study was conducted using a self-administered questionnaire. A total of 435 students from different departments in accordance with their proportional size were participated in this study. As to the sampling technique, the study units were selected from each department and year of study using simple random sampling proportional to size. Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the DASS-21. Cronbach alpha coefficient and corrected item total correlation was calculated to assess the internal consistency of Amharic version of DASS-21.ResultAmong 435 undergraduate students who participated in the study, 246(56.6%) were the age of 18–25 year and majority 347(79.8%) were males. Regarding their year of study; 200 (46.0%) were first year students. Confirmatory factor analysis indicates a good model fit of the three correlated factors (Comparative fit index (CFI) = 0.92 with root mean square error of approximation (RMSEA) = 0.059[0.052–0.066] and standardize root mean residual SRMR = 0.045). The internal consistency of overall DASS-21 and each sub scale were in acceptable range (0.91, 0.82, 0.77 and 0.77) respectively.ConclusionAmharic version of DASS-21 was found to be a valid and reliable instrument to measure the mental problem especially, Depression, Anxiety and Stress among university students.

Assessment of Psychological Well-being of Doctors Working in Public and Private Hospitals of Gilgit-Baltistan, Pakistan

Healthcare workers are prone to develop psychological distress due to overwhelming responsibilities. This can lower their job performance as well as patient satisfaction. Objectives: To assess the psychological well-being of doctors who were working in public and private hospitals of Gilgit-Baltistan, Pakistan. Methods: A cross-sectional study was conducted for six months, during which data were gathered from a sample of 214 participants chosen through non-probability convenient sampling at various public and private hospitals in the region. Data were analyzed using SPSS version 26.0. An Independent sample t-test was applied to compare the psychological well-being of doctors working in the public and private sectors. DASS scale and self-rated held were used to assess the mental health of doctors. Results: Among the 214 respondents, the majority were male doctors. Moreover, the study population’s majority was working in the public sector. It was noted that the majority of the study population lies in the normal to mild range of depression, anxiety, and stress. Results also revealed that there was no significant difference in the psychological health of doctors in public and private hospitals. Conclusion: It was concluded that the psychological health of doctors working in public and private hospitals of Gilgit Baltistan has no significant difference.

Is Having Urban Green Space in the Neighborhood Enough to Make a Difference? Insights for Healthier City Design.

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose: This study delves into whether merely having green space in the neighborhood is sufficient to impact residents' mental health in Brazilian metropolitan regions. Method: Utilizing a cross-sectional survey, data were collected from 2136 participants. The analyzed variables included the intensity, duration, and frequency of nature engagement, suitability of UGS for visitation and physical activities, and mental well-being indicators measured by the DASS-21 scale. Multivariate statistical analyses and multiple regression models were employed to verify hypothetical relationships. Results and conclusions: Higher intensity, duration, and frequency of nature engagement in UGS were significantly associated with lower depression, anxiety, and stress scores. Notably, having urban UGS in the neighborhood alone was not enough to reduce mental health issues. Practical implications: The findings point out the need for urban planning policies that prioritize the development of high-quality, accessible green spaces to maximize mental well-being benefits. These insights could inform city designs that foster healthier urban environments. Future directions: Longitudinal studies are needed to establish causality between nature engagement and mental health improvements. Further research should incorporate objective measures of nature engagement and explore more aspects of green space quality, such as biodiversity and amenities.

Consequences of the COVID-19 pandemic on the mental health of nurses in the Spanish out-of-hospital Emergency Service

ObjectiveTo analyse the impact of the COVID-19 pandemic on the mental health of nurses in Spanish out-of-hospital Emergency Services, identifying predictor factors of greater severity. MethodA multicentre cross-sectional descriptive study was designed, including all nurses working in any Spanish out-of-hospital Emergency Services between 01/02/2021 and 30/04/2021. The main outcomes were the level of depression, anxiety and stress assessed through the DASS-21 scale. Sociodemographic, clinical, and occupational information was also collected. Univariate and multivariate analyses were conducted to determine possible associations between variables. ResultsThe sample included 474 nurses. 32.91%, 32.70% and 26.33% of the participants had severe or extremely severe levels of depression, anxiety and stress, respectively. Professionals with fewer competencies to handle stressful situations, those who had used psychotropic drugs and/or psychotherapy on some occasion before the pandemic onset, or those who had changed their working conditions presented more likelihood of developing more severe levels of depression, anxiety and/or stress. ConclusionNurses in Spanish out-of-hospital Emergency Services have presented medium levels of depression, anxiety and stress during the pandemic. Clinical and occupational factors have been associated with a higher degree of psychological distress. It is necessary to adopt strategies that promote professionals’ self-efficacy and mitigate the triggers of negative emotional states.