Depression , Anxiety And Stress Scale Research Articles

Perfect Enough to Sleep? Perfectionism and Actigraphy-Determined Markers of Insomnia

ABSTRACT Objectives Perfectionism is an important factor in insomnia development and maintenance. Previous studies exploring the relationship between perfectionism and insomnia have predominantly relied on self-reported sleep measures. Therefore, this study sought to assess whether actigraphy-measured sleep parameters were associated with perfectionism. Methods Sixty adults (85% females, mean age 30.18 ± 11.01 years) were sampled from the Australian general population. Actigraphy-derived objective sleep measures, subjective sleep diary measures, the Frost Multidimensional Perfectionism Scale (FMPS), Hewitt-Flett Multidimensional Perfectionism Scale (HFMPS) and Depression, Anxiety and Stress Scale 21 (DASS-21) were collected. Results High perfectionism levels were associated with poor sleep, but these relationships differed between objective and subjective measures. Perfectionism via FMPS total score and subscales of Concern over Mistakes, Doubts about Actions, Personal Standards and Self-oriented Perfectionism correlated with subjective sleep onset latency and sleep efficiency with moderate effects (r = .26 to .88). In contrast, perfectionism via HFMPS total score and subscales of Socially Prescribed Perfectionism and Parental Expectations predicted objective sleep onset latency and sleep efficiency. Additionally, stress mediated the relationships between objective sleep efficiency and Concern over Mistakes and Doubts about Actions. Conclusions Perfectionism demonstrated stronger associations with subjective than objective sleep measures. Higher Parental Expectations and Socially Prescribed Perfectionism may increase one’s vulnerability to objectively measured poor sleep. Therefore, perfectionism may be important in preventing and treating insomnia.

Necessity of assessment and how it affects students' psyche and desire to learn: innovative digital technologies for assessment of art and music teaching in China

ABSTRACT This paper studies the use of innovative digital technologies to assess art and music creative works in China. The authors of the paper conducted an experimental study of the influence of various types of assessment, such as formative and summative, on the academic motivation and mental health of artists and musicians. The study involved second-year students from Xihua University (N = 548). The researchers used the Academic Motivation Scale (AMS) and the Depression, Anxiety and Stress Scale (DASS) as psychometric tools of the standardized methods. Summarizing the results obtained, they can conclude that summative assessment stimulates external motivation, while formative assessment contributes to the development of internal motivation of students. These results allow teachers to offer different types of assessment to strengthen a certain type of students’ motivation. The researchers also found that summative assessment could result in a higher level of amotivation. However, they did not confirm the assumption about the negative impact of summative assessment on the mental state of students.

Workplace Bullying and Depression, Mediating Role of Insomnia Among Employees

Background: Workplace bullying is characterized by unpleasant and unethical behavior, which can manifest directly or indirectly, affecting individuals' mental health. Insomnia is also a known consequence of workplace bullying, which can lead to depression. Objective: To explore the association between workplace bullying, insomnia, and depression among employees in Lahore, and to determine the mediating role of insomnia in the relationship between workplace bullying and depression. Methods: This study employed a correlational research design with a purposive sample of 200 employees, both male and female, from Lahore, Pakistan. Data were collected using a demographic form, a 21-item Workplace Bullying Scale, the Insomnia Severity Index (ISI), and the Depression, Anxiety, and Stress Scale-21 (DASS-21). The study followed the principles outlined in the Declaration of Helsinki, and statistical analysis was conducted using SPSS version 25, including descriptive statistics, correlation analysis, and regression analysis. Results: The mean score for workplace bullying was 42.54 (SD = 15.8), for insomnia was 9.88 (SD = 6.26), and for depression was 18.97 (SD = 13.69). There were significant positive correlations between workplace bullying, insomnia, and depression, with correlation coefficients of 0.53, 0.62, and 0.61, respectively (all p < 0.01). Both workplace bullying (B = 0.36, p < 0.001) and insomnia (B = 0.84, p < 0.001) were significant predictors of depression. Insomnia also mediated the relationship between workplace bullying and depression, with an indirect effect of 0.1714 (95% CI: 0.1105, 0.2393). Conclusion: Workplace bullying contributes to higher levels of depression among employees, with insomnia serving as a mediator. Both workplace bullying and insomnia are significant predictors of depression. These findings highlight the importance of addressing workplace bullying to improve employee mental health.

Supporting a mentally healthy place of study: Examining the relationship between mental well-being, stress, and protective factors among university students.

Students can expect to experience stressors associated with their studies that can have detrimental effects on their mental well-being if not properly managed. Drawing on a positive psychology paradigm, protective factors can help students to counter study-related stressors and contribute to their mental well-being and academic success. The relationship between protective factors, such as maintaining perspective and building networks, with stress severity and positive mental well-being was examined in a sample of Australian university students undertaking postgraduate coursework. Students completed a survey measuring stress from the Depression, Anxiety and Stress Scale (DASS), positive mental well-being from the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), and seven protective factors from the Resilience at University (RAU) scale. Bivariate correlations were calculated for the RAU protective factors with stress and mental well-being. ANOVA examined the RAU protective factors in relation to mental well-being and stress severity groupings. All seven protective factors had a positive and significant relationship with positive mental well-being, and six of the seven protective factors had a negative and significant relationship with stress. A statistically significant difference was found for six of the seven RAU protective factors according to mental well-being group, and three of the seven RAU protective factors group according to stress severity group. A linear effect emerged between level of protective factor and mental well-being group, with participants in the high well-being group having the highest level of protective factors. Universities should focus on the development of protective factors to support students' well-being and help them to flourish in their studies.

Decoding the impact of night/day shiftwork on well-being among healthcare workers

This study delved into the complex effects of work schedules on the well-being of healthcare professionals, spotlighting Nigeria’s medical landscape. A diverse cohort of 387 participants, spanning doctors, nurses, pharmacists, and laboratory technicians or scientists, formed the research base, with the majority being women (67.7%), with a mean age of 34.67 years. Professionals self-reported their predominant schedules to gauge work patterns, classifying them as day or night shifts. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) tool assessed the quality of life across the physical, psychological, social relationship, and environmental domains. Psychological distress was measured using the Depression, Anxiety, and Stress Scales (DASS), and perceived social support was evaluated via the Multidimensional Scale of Perceived Social Support (MSPSS). A cross-sectional design was adopted, and the study employed moderated mediation analysis using SmartPLS 4.0. The results underscored the significant ramifications of night shifts on environmental and physical well-being. Psychological health and social relationships were better among day shift than night shift workers. There was a pronounced correlation between night shifts and heightened levels of anxiety, stress, and depression. The mediating role of psychological distress and the moderating influence of social support in these relationships were evident. This study offers invaluable insights into the role of work schedules in shaping the well-being of healthcare professionals, emphasising the protective role of social support and the unique challenges faced by migrant health workers.

Psychological distress among low-vision patients

Purpose: The purpose of the study was to measure the mental well-being of patients suffering from low vision using the Depression, Anxiety, and Stress Scale (DASS). Methods: Low-vision patients who visited the low-vision clinic of CL Gupta Eye Institute were studied using the DASS. Patients were excluded if they were <18 years old or could not understand the questionnaire due to an intellectual disability. Sociodemographic characters (such as age, gender, marital status, and education) were recorded before the administration of the study questionnaire. Results: In this study of 60 low-vision patients, high rates of psychological distress were observed, with 85% experiencing depression, 81.7% anxiety, and 75% stress. Demographic variables such as age, gender, marital status, and education did not significantly affect these rates. However, individuals with severe visual impairment (VI) or blindness had significantly higher prevalence rates for depression (P = 0.003), anxiety (P = 0.001), and stress (P = 0.013). Conclusion: This study reveals a high prevalence of depression, anxiety, and stress among low-vision patients, with the most pronounced impact seen in individuals with severe VI or blindness. These findings underscore the urgent need for targeted mental health interventions to improve the well-being of low-vision patients, especially those with severe VI. Tailored support can significantly enhance their overall quality of life and psychological health.

Caffeine Consumption, Sleep Quality and Mental Health Outcomes Among Malaysian University Students

Background: Recognizing the scarcity of data on caffeine consumption among university students in Malaysia, this study was designed to first characterize the habitual caffeine intake within this group. This study further investigated the potential association between these caffeine consumption patterns and sleep quality and mental health status. Methodology: The study employed an online self-administered questionnaire to assess habitual caffeine intake from various products. Sleep quality and mental health were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale-21 (DASS-21), respectively. Results: 78% of the respondents consumed caffeinated products daily within the safe level recommended by the European Food Safety Authority (£400mg/day). Only 2.6% of the students consumed caffeine exceeding the recommended limit. The median total daily caffeine intake was 100mg/day. Most students had poor sleep quality (77.3%), with 43.5%, 49.5%, and 33.0% reporting varying levels of depression, anxiety, and stress, respectively. Odds ratio calculations revealed respondents consuming less than or more than 400 mg/day of caffeine did not show significantly different odds of poor sleep quality, depression, anxiety, or stress compared to non-consumers. Conclusions: This study highlights the need for further localized research on caffeine's effects among Malaysian university students regarding caffeine consumption, sleep, and mental health.

Depression, Anxiety and Stress among Nursing Students in Selected Colleges of Eastern India: A Descriptive Study

Background: Nursing students after enrolling themselves into nursing profession experiences high level of stress and anxiety which later shows signs and symptoms of depression at early age. The present study is undertaken to study the level of stress, anxiety and depression among undergraduate nurses. The objective of the study was to assess the level of stress, anxiety and depression among nursing undergraduates.Methods: A total of 201 sample were selected using non probability sampling technique. The three domains of mental status was assessed using depression, anxiety and stress scale-21 (DASS-21).Findings & Conclusion: Majority of the nursing students showed 60.2% of mild anxiety followed by milddepression (57.7%) and mild stress (55.2%). The present study revealed significant presence of anxiety, stress and depression among the nursing undergraduates. These findings are alarming in nature as it may have negative impacts on the mental health of the students. Stress, anxiety and depression among nursing students will adversly affect the academic performance and the quality of care they give to their patients. Students must be made aware to employ different coping strategies, different communication skills, campus connectdness, to deal with the stress,anxiety and depression during their clinical training. Mental health screening is another important preventive strategies to avoid mental disorders.

Screening psychological symptoms in Filipino university students during the COVID‐19 pandemic: Translation and structural validation of the Filipino version of the DASS‐21

AbstractCulturally appropriate tools are necessary to aid in objective screening for psychological symptoms among students in university settings. This study aimed to translate and validate the Depression Anxiety and Stress Scale‐21 (DASS‐21). The instrument underwent forward translation and was reviewed by representatives from the target population, field experts, and an external auditor. The translated version of the DASS‐21, together with the International Positive and Negative Affect Schedule Short Form (I‐PANAS‐SF), Patient Health Questionnaire (PHQ‐9), Generalized Anxiety Disorder‐7 (GAD‐7), Satisfaction with Life Scale (SWLS), was administered to 681 university students. Through confirmatory factor analysis, results supported the intercorrelated three‐factor model with correlated errors for the DASS‐21 Filipino. Results also demonstrated the criterion validity of the depression and anxiety subscales through significant correlations with PHQ‐9 and GAD‐7, respectively, and a stringent z‐score test to examine the difference between two dependent correlations with one variable in common. The convergent validity of all three subscales was established through significant correlations with I‐PANAS‐SF and SWLS. All DASS‐21 Filipino subscales which includes depression (α = .89), anxiety (α = .84), and stress (α = .85), showed high internal consistency. The current findings offer initial evidence on the structural validity of the DASS‐21 Filipino, which can be utilized as a tool to screen for depression, anxiety, and stress symptoms among Filipino speakers during a global health crisis. Implications for psychological assessment and school and clinical interventions are discussed.

The effect of self-hypnosis on anxiety level and self-efficacy of pregnant women in dealing with childbirth during the COVID-19 pandemic

The COVID-19 pandemic has become a multidimensional disaster, affecting various countries, including Indonesia. Adaptation is crucial in addressing the physical and mental health challenges within communities, which includes the adaptation of pregnant women who are preparing for childbirth amidst the pandemic with the aim of reducing maternal mortality rates in Indonesia. This research aimed to assess the impact of self-hypnosis on the anxiety levels and self-efficacy of pregnant women preparing for childbirth during COVID-19. The study utilized a quasi-experimental design with pre-test and post-test measures. It involved 30 respondents in both the control and intervention groups, who were selected through consecutive sampling. Anxiety levels were measured using the Depression, Anxiety, and Stress Scale (DASS), while self-efficacy was assessed with the New General Self-Efficacy Scale. Data analysis employed paired t-tests and independent t-tests, with the significance level set at p<0.05. The results indicated a significant difference in anxiety levels and self-efficacy between the control and intervention groups, with a p-value of 0.000. Regular self-hypnosis practice positively influenced both anxiety levels and self-efficacy among pregnant women preparing for childbirth during the COVID-19 pandemic.

Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students.

The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.

Psychiatric Co-Morbidities and Profile of Patients with Irritable Bowel Syndrome in Northern India.

To study sociodemographic and clinical variables, including psychiatric co-morbidities, in patients with irritable bowel syndrome. A total of 158 patients attending a medical gastroenterology clinic in a tertiary care center in Northern India were screened, from whom 100 were selected for the study. Rome IV criteria were used to diagnose IBS, and the severity of symptoms was assessed by the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS). Psychiatric co-morbidities were screened via clinical evaluation, and if present, a diagnosis was made as per DSM-5. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and Somatic Symptom Scale-8 (SSS-8) were used to assess depression, anxiety, stress, and somatic symptoms. The mean age of cases was 35.6 years' old, and the majority of cases (i.e., 38.0%) were between 18 and 29 years' old. Males comprised 62.0% of the sample and females 38.0%. Moderate IBS was present in 61.0% of the cases. Evaluation via DASS-21 revealed that 53.0% were in the moderate category of depression, 43.0% had moderate anxiety, and 36.0% had moderate stress. The somatic symptom scale revealed that 48.0% patients were in the high category. Psychiatric co-morbidities were present in 29.0% of cases. Depressive disorders were the most common psychiatric co-morbidity. Patients with IBS presenting to a tertiary care center in Northern India were primarily young males living in semi-urban areas who belonged to the Hindu religion, were married, and had a nuclear family. Patients with IBS commonly have associated psychiatric disorders; anxiety disorders and depression are most common.

IJCM_342A: Nomophobia and its Relationship with Depression, Anxiety and Stress among Undergraduate Medical Students Of Murshidabad Medical College, West Bengal: A Cross Sectional Study

Background: The study aimed to estimate the magnitude of nomophobia, prevalence and degree of depression, anxiety and stress; the relationship between nomophobia and different mental health status; and also finding the correlates of nomophobia among undergraduate medical students. Methodology: This descriptive cross-sectional study was undertaken in Murshidabad Medical College during September-November 2023, among a calculated sample of 222 undergraduate medical students selected through stratified random sampling. A self-reported English questionnaire comprising background characteristics, smartphone use related characteristics; and validated nomophobia questionnaire (NMP-Q) and depression, anxiety and stress scale (DASS) were used to collect the data. Data were analyzed using SPSS 20.0. Results: Among the study participants 13.1%, 72.1% and 14.8% had mild, moderate and severe nomophobia respectively. The prevalence of depression, anxiety and stress were 54.5%, 69.4% and 37.4% respectively. Multivariable binary logistic regression revealed that students aged less than 21 years (AOR: 6.088; 95% CI: 2.053- 18.055), students belonging to joint family (AOR: 6.836; 95% CI: 2.392-19.537) and daily average time spent on smartphone more than 5 hours (AOR:5.314; 95% CI: 1.919-14.721) were at higher risk of developing severe nomophobia. Correlation analysis revealed depression was significantly correlated with Nomophobia (Spearman rho:0.200, p value:0.003). Conclusion: Nomophobia is quite prevalent among medical students with varying degree of severity. Mental health status specially depression is correlated with nomophobia. Findings suggests the need for supporting the holistic well-being of medical students through proper health education strategies and workshops on mental health.

Characteristics of Tinnitus and its Association with Clinico-Demograhic Factors & Mental Health

Objectives: To determine the characteristics of tinnitus and its association with clinical and demographic variables including psychological health. Methodology: This cross-sectional study recruited 80 tinnitus cases from ENT outpatients of District Head Quarter Hospital Chakwal from over a period of 6 months from 1st Jan 2019 to 31st June, 2019, using convenience sampling. Sample included both genders, aged 18-75 years with tinnitus for at least three months. Tinnitus Handicap Inventory (THI) & Depression Anxiety and Stress Scale 21 (DASS-21) were used for data collection & analysis done using SPSS-version 20. Anova statistics & Pearsons correlation was determined for THI and DASS-21. Chi-square test was used to see any association with clinic-demographic variables. P<0.05 was considered significant. Results: Study revealed 30(37.5%) cases with mild, 20(25%) each with moderate and severe while least 4(5%) catastrophic tinnitus. Tinnitus severity was significant associated with gender (p=0.005), age (p=0.035), educational level (p=0.049), occupation (p=0.002), duration of tinnitus (p=0.038), site of tinnitus (P<0.001) and type of tinnitus sound (P=0.003). Duration of tinnitus was associated with anxiety (p=0.024), site of tinnitus was associated with THI (p=0.016), anxiety (p=0.021), stress (p<0.001) and depression (p=0.02) and total DASS-21 (p=0.005). A significant positive correlation was present between tinnitus handicap, Anxiety, stress, depression and DASS-21 total score (P<0.001). Conclusion: Mild tinnitus was most prevalent (37.5%) with Tinnitus severity having significant association with gender, age, educational level, occupation, duration of tinnitus, site of tinnitus, and type of tinnitus sound. Duration of tinnitus was also associated with anxiety while site of tinnitus has association with THI, anxiety, stress, depression and total DASS-21. Significant positive correlation is present between THI and Anxiety, stress, depression and DASS-21 total score.

Psychological Impact of COVID-19 on Speech and Language Therapists Working with Adults in Dysphagia.

Background: The COVID-19 pandemic has imposed unprecedented challenges on healthcare systems worldwide, with significant attention to the mental health of healthcare workers. Speech and Language Pathologists (SLPs) working with dysphagia patients represent a unique subgroup, whose psychological well-being during the pandemic has been less explored. Understanding the psychological impact on these professionals is crucial for developing targeted support mechanisms. Objective: This study aims to investigate the psychological impact of the COVID-19 pandemic on SLPs working with adult dysphagia patients in Punjab, Pakistan, identifying key factors influencing their mental health and providing insights into their experiences and perceptions regarding the pandemic. Methods: A cross-sectional study design was employed, utilizing a non-probability convenience sampling technique to recruit 87 SLPs from various hospitals and rehabilitation centers across Punjab. Participants completed an online survey, which included demographic questions and standardized instruments: the Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Impact of Event Scale-Revised (IES-R). Data were analyzed using SPSS version 25.0, focusing on descriptive and inferential statistics. Results: The majority of respondents were female (81.6%), with a significant proportion aged between 23 to 29 years. Qualifications predominantly were MS SLP (43.7%), and experience ranged mostly between 1 to 2 years (26.4%). The DASS-21 results indicated mean scores of 6.67 (SD=4.02) for depression, 7.71 (SD=3.4) for anxiety, and 7.87 (SD=4.4) for stress, suggesting elevated levels of psychological distress among participants, particularly regarding anxiety and stress. Conclusion: The findings highlight the substantial psychological impact of the COVID-19 pandemic on SLPs working with dysphagia patients, emphasizing the need for comprehensive mental health support for these professionals. Enhancing support mechanisms can contribute to the resilience and effectiveness of SLPs in managing dysphagia patients during and beyond the pandemic.

Quality of life among residents of Gaza, Palestine: the predictive role of mental distress, fear of COVID-19, and social support

BackgroundLiving under siege and deteriorated health, social, educational, and economic conditions and isolation with scarce opportunities to fulfil basic needs and aspirations affect the civil population's mental health and perceived quality of life. In this cross-sectional investigation, we explored the consequences of mental distress, fear of COVID-19, and social support for QoL in the Gaza strip.MethodsNine hundred seventy nine (32.9% males; 67.1% females; mean age was 35.2 years; s.d. = 11.4) adults were recruited in the Gaza strip. We used the Fear for COVID-19 scale (FCS-19), The WHOQOL-BREF Scale, Berlin Social Support Scale (BSSS), Depression Anxiety and Stress Scale (DASS). Pearson correlation coefficient was computed to assess relationships between quality of life, fear of COVID19, mental distress, and social support; a hierarchical regression analysis was used to assess the association between QoL as the dependent variable and demographic variables and fear of COVID19, mental health, and social support as the independent variables.ResultsQoL was positively associated with perceived emotion, instrumental, and support seeking. Depression, anxiety, stress, and fear of COVID19 were negatively associated with quality of life. Gender was significantly associated with lower QoL. The study highlighted that the level of fear of COVID-19 was negatively influencing individuals' quality of life (QoL). This fear was negatively associated to psychological distress, gender, place of residence, and family type. Lower-educated and poorer participants had lower QoL scores. Conversely, female gender was notably linked to a lower QOL. The hierarchical regression confirmed that COVID-19 was an added burden for the Palestinian population. The fear of COVID-19 term added a 6.2% variance in QoL. In the final analysis, all predictors were statistically significant, with the fear of COVID-19 term recording a higher contribution of 22.5%, followed by depression term with 21.5%, perceived emotional 18.5%, income at 15.4%, and perceived instruments at 14.8% towards QoL.ConclusionsPractitioners and policymakers must consider the severe violation of human rights when developing psychosocial programs to intervene in the COVID-19 crisis.

Fatigue and mental health among patients with heart failure in an outpatient setting

Background: Heart failure is a health problem that occurs in the cardiovascular system which globally is the highest cause of death in the world. Heart Failure is a complex clinical syndrome in which the heart cannot pump blood to meet the body's blood circulation needs for tissue metabolism in certain conditions, due to structural or functional damage to the heart chambers. It is usually characterized by excessive blood volume, inadequate tissue perfusion, poor activity tolerance, and usually easily feels tired, orthopnea and edema. The emergence of various clinical symptoms in heart failure patients will cause nursing problems and interfere with basic human needs, one of which is fatigue. Heart failure sufferers have problems with the heart system which results in a lack of blood and oxygen supply to the brain and muscles, so sufferers often experience fatigue to the point of fainting. Purpose: To determine the relationship between the level of fatigue and the mental health of heart failure patients. Method: This type of quantitative research with a design using a cross sectional approach. Carried out at the heart clinic dr. Moewardi Surakarta, Central Java of the regional general hospital from October to December 2023. The population of heart failure sufferers in this study was 186 people, however by using a purposive sampling technique in sampling, a sample of 148 patients was obtained. The inclusion criteria in this study were patients aged >18 years, New York Heart Association (NYHA) class II and class III heart failure patients, while the exclusion criteria were heart failure patients who were unwilling or unable to take part in this study. The instruments used were the fatigue assessment scale (FAS) and depression anxiety and stress scale 21 (DASS-21) questionnaires. Data analysis used univariate and bivariate with the chi square test. Results: The majority of respondents experienced mild fatigue with anxious conditions, 53 people (53.0%). Meanwhile, 47 patients (47.0%) who complained of severe fatigue showed anxiety, 24 people (85.7%), and 12 people (60.0%) felt stressed. The results of the analysis obtained a significant value with a p-value of 0.001 (<0.05) which indicates that H0 was rejected. So there is a relationship between the level of fatigue and mental health conditions in heart failure sufferers. Conclusion: There is a relationship between the level of fatigue and mental health in heart failure patients. The nursing implication that can be implemented is providing education about fatigue so that patients understand the impact it has on heart failure sufferers so that it does not cause mental health problems.

The Effects of Resilience Training on Mental Health Among Students

Background: Research indicates that certain demographic groups, including girls, often experience lower-than-average levels of mental well-being. Therefore, it appears that one approach to enhancing mental health is by teaching resilience skills. Objectives: This study aimed to investigate the effects of resilience training on the mental health dimensions of sixth-grade female students in Qaynat city during the academic year 2021 - 2022. Methods: The study employed an experimental design with a control group, conducting pre- and post-tests. The statistical population comprised female sixth-grade students from an elementary school in Qaynat City. Thirty female students exhibiting high scores on measures of depression, anxiety, and stress were selected and randomly divided into two experimental groups, with 15 participants in each group. The experimental group underwent resilience training consisting of 8 sessions. The desired variables were measured using Lovibond and Lovibond's Depression, Anxiety, and Stress Scale (DASS). The data were analyzed using SPSS 25 software through independent samples t-tests and paired t-tests. Results: The findings revealed that the resilience training intervention significantly reduced symptoms of depression (F = 11.542), anxiety (F = 13.67), and stress (F = 6.01) in the experimental group (P = 0.001). Conclusions: The results suggest that participation in a resilience training program can improve students' mental health. Therefore, implementing such intervention programs in the form of workshops and establishing counseling and support groups may be beneficial for enhancing students' mental well-being.

Effect of vitamin E with and without saffron on the sexual function in women of reproductive age with sexual dysfunction: a randomized controlled trial

BackgroundSexual satisfaction is a crucial part of a fulfilled life, and the ability to have satisfying sexual function is crucial to one’s sexual health. This study investigated the effect of the combined administration of saffron and vitamin E and vitamin E alone on the sexual function of women in their reproductive years.MethodsA triple-blind randomized controlled trial was conducted with 50 participants experiencing sexual dysfunction without comorbid sleep disorders or severe depression. They were allocated into two groups using a block randomization method (stratified based on the severity of moderate or mild/normal depression). During the 8-week intervention period, participants in the experimental group were administered a 15 mg saffron capsule (safrotin) in the morning and a combination capsule containing 15 mg saffron and 50 mg vitamin E (safradide) in the evening. During the same period, the control group consumed one saffron placebo capsule in the morning and one capsule containing 50 mg of vitamin E and saffron placebo in the evening (in identical appearance to safradide). The Female Sexual Function Index was used to assess sexual function, and the Depression, Anxiety, and Stress Scale-21 (DASS-21) was used to measure levels of depression, anxiety, and stress. These measures were administered at baseline as well as four and eight weeks post-intervention, with an additional measurement taken four weeks after the intervention ceased. The repeated measures ANOVA, ANCOVA, and Mann-Whitney U tests were used to compare the groups.ResultsFollowing the intervention, the experimental group (saffron and vitamin E) demonstrated a statistically significant increase in the overall mean score of sexual function compared to the control group (placebo of saffron and vitamin E) (adjusted mean difference (AMD): 4.6; 95%CI: 3.1 to 6.1; p < 0.001). The mean scores for sexual function dimensions, namely libido, arousal, orgasm, and satisfaction, except for pain, were consistently higher than those of the control group across all time points (p < 0.001). Additionally, the mean score for lubrication was significantly higher only at the eighth-week measurement (p = 0.004). The mean depression score in the experimental group was significantly lower than in the control group at all-time points, i.e., four (p = 0.011) and eight weeks after the intervention (p = 0.005), and four weeks after the end of the intervention (p = 0.007). The experimental group exhibited a statistically significant decrease in mean anxiety score compared to the control group at four weeks into the intervention (p = 0.016) and four weeks following the end of the intervention (p = 0.002). At eight weeks post-intervention, however, there was no significant difference between the groups (p = 0.177). Additionally, the experimental group exhibited a significant reduction in the overall mean stress score compared to the control group after the intervention (AMD: -2.3; 95%CI: -3.1 to -1.5; p < 0.001).ConclusionUsing the combination of saffron and vitamin E is more effective in improving sexual function and its domains compared to vitamin E alone in women of reproductive age with sexual dysfunction without severe depression. Also, it diminishes the degree of depression, anxiety, and stress more compared to vitamin E alone. However, further research is required to arrive at a more definitive conclusion.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20100414003706N36. Date of registration: 17/05/2020; URL: https://en.irct.ir/trial/45992; Date of first registration: 21/05/2020.

Psychological Disorders and Coping among Undergraduate College Students: Advocating for Students' Counselling Services at Kuwait University.

Objectives: The objectives of the current study are twofold. First, it aimed to explore the prevalence of depression, anxiety and stress symptoms (i.e., psychological disorders) among Kuwait University students. Second, it sought to identify and quantify the associated risk factors as well as the students' coping strategies utilized to address these psychological disorders. Methods: We used a cross-sectional study at Kuwait University and selected students using a multistage stratified cluster sampling design among the 15 faculties of Kuwait University. To serve the study purposes, two cross-cultural and validated instruments were used, including the Depression, Anxiety and Stress Scale 21 (DASS-21) and the Brief-COPE scale. Descriptive statistics, as well as logistic regression analysis, were used to analyze the study findings. Results: A sample of 1142 students from various faculties participated in this study. We found that 681 (59.6%), 791 (69.3%) and 588 (51.5%) of the participants had depression, anxiety and stress symptoms, respectively. The highest coping strategies for stressors and challenges faced were moderate and high emotion-based coping strategies (n = 1063, 93.1%). Students from the Faculty of Allied Health Sciences as well as students from the Faculty of Engineering had significantly higher stress levels compared with students from other faculties (p < 0.05). Our results demonstrated that family problems were consistently a significant predictor of depression, anxiety and stress symptoms among Kuwait University students (p < 0.05). We further found that students who presented with stress and anxiety symptoms and those who practiced avoidant-focused coping strategies were substantially more likely to experience depression (ORs ≥ 2.7, p < 0.01). Conclusions: Our findings inferred that the majority of Kuwait University students have a remarkably high prevalence of mental health problems, mainly anxiety, depression, and stress symptoms along with inconsistent coping strategies toward the faced challenges during their studies. Therefore, the most important recommendation of the current study is the establishment of counselling centers in all faculties at Kuwait University. In turn, doing so facilitates the integration of wellness programs and the provision of comprehensive educational seminars, specialized training sessions and self-management techniques for Kuwait University students, leading to desired academic outcomes.