Depression Coping Research Articles

The Mediating Effect of Coping Style in the Relationship Between Depression and Disordered Eating Among Chinese Female Undergraduates.

The aim of the current study was to explore the relationship between depression and disordered eating in female undergraduates and the mediating role of coping style between depression and disordered eating. Self-report questionnaires assessing coping style, disordered eating, and depression were completed in 646 Chinese female undergraduates. The results illustrated that there were obvious differences in disordered eating among the undergraduates with various majors. The disordered eating in female undergraduates majoring in art was more serious than those in other majors. Depression and coping style were effective indicators to predict disordered eating. Moreover, depression could not only directly predict disordered eating, but also predict disordered eating through the mediating effect of coping style. These findings indicate that depression and negative coping style are associated with disordered eating. Coping style could mediate the effect of depression on disordered eating, as these may be an important target for early intervention programs for eating disorder (ED).

Maternal HIV status disclosure to young uninfected children: psychological variables of the mother

Mothers living with HIV are faced with the dilemma of when and how to disclose their HIV-positive status to their young uninfected children. In this study, a South African sample of mothers living with HIV, with young uninfected children (6–10 years) in the city of Tshwane was studied. In the sample of 406 mothers, 11.6% reported that they disclosed their HIV status to their young uninfected children. The research compared 47 mothers who disclosed (29 full disclosure and 18 partial disclosure) and a random sample of 50 mothers who did not disclose to their children, in terms of depression symptoms, parenting stress and coping strategies. The results showed that single and widowed mothers disclosed significantly more to their uninfected young children than mothers who had partners or were married. Mothers in the three disclosure groups did not differ in their experience of depression symptoms, parental distress and coping styles. Mothers who disclosed partially reported less parent–child dysfunctional interaction. Time since disclosure did not influence level of disclosure and was not significantly related to psychological outcome of mothers. Mothers who disclosed reported significantly more emotional and instrumental support as coping strategies than mothers who did not disclose. Mothers thus mostly disclose their status to their children to gain support and family closeness. Mothers who disclosed and had not disclosed did not differ in terms of psychological variables. Some mothers perceived partial disclosure as age-appropriate for young children. It is recommended that HIV-positive mothers receive psychosocial support services to equip them to disclose their health status in an age-appropriate way to their children, as it is documented that maternal disclosure benefits both mother and child.

Intervention targets for people living with HIV and depressive symptoms in Botswana

Background: The prevalence of HIV in Botswana is high. Many people living with HIV (PLWH) suffer from depressive symptoms and have inadequate coping skills. Most PLWH do not receive adequate psychological treatment. Empirically based interventions for PLWH with depressive symptoms in Botswana should be developed, with a focus on improving coping skills. The present study was a first step towards this goal, by trying to identify targets for intervention. The study aimed to provide prevalence rates of depression among PLWH in Botswana, to assess their mental health treatment needs and wishes as expressed by themselves, and to study the relationships between cognitive and behavioural coping strategies and depressive symptoms.Method: A cross-sectional study was conducted. The sample consisted of 291 participants (73% female) from 8 HIV treatment centres from Botswana. Participants completed standardized questionnaires on depressive symptoms (CES-D) and coping skills (CERQ, BERQ). They also answered questions regarding their mental health care needs and wishes.Results: In total 43.4% of participants reported clinically significant depressive symptoms. The majority of participants indicated that they needed help with the following topics: feelings of depression, physical tension, finding new goals and coping with HIV. In addition, they indicated preferring a self-help programme in booklet format. Multiple regression analyses showed that the following coping strategies had significant relationships with depressive symptoms: rumination, catastrophising, withdrawal, positive refocusing and refocus on planning (the latter two negatively).Conclusion: Almost half of the PLWH reported depressive symptoms that were clinically significant. The findings suggested that an intervention for PLWH with depressive symptoms in Botswana should preferably be a self-help programme presented in booklet format. With regard to content, the results confirmed that the intervention should focus on specific coping skills. In addition, elements like goal finding and strategies to reduce physical tension should be added.

What factors influence feeling competent as a parent with multiple sclerosis?

To identify factors that influence the perception parents with multiple sclerosis have of their competence in parenting. Subjects were parents of a child with a maximum of 18 years of age recruited through a national multiple sclerosis organization's social media channels. Data on demographic and disease information, mood, coping, quality of life and perceived social support were collected using an anonymous online questionnaire. Univariate and multivariate analyses were performed to assess associations between these variables and subjects' perception of parenting sense of competence. The sample consisted of 285 parents with multiple sclerosis, with a mean age of 41 years and a mean disease duration of 10.4 years. In the multivariate analysis, independent determinants of lower parenting sense of competence were anxiety (p = 0.012), depression (p = 0.001) and dysfunctional coping (p = 0.005). Problem-focused coping (p = 0.029) and higher physical and mental scores on the SF-12 (p = 0.006, p < 0.001, respectively) were related to a higher parenting sense of competence. Higher parent age correlated with a lower sense of parenting competence (p = 0.002). The perception parents with multiple sclerosis have of their parenting competence was most strongly correlated with mood, coping strategies and health-related quality of life, factors that are potentially modifiable.

Long-Term Effects of Smoking Cessation on Depressive Symptoms, Resilience, Coping Skills, and Serotonin.

There are many studies on how smoking cigarettes is harmful to health, but research on how smoking cessation improves mental health is insufficient. The purpose of this study was to examine long-term effects of smoking cessation on depressive symptoms, resilience, coping skills, and serotonin levels in Korean adults. This was a longitudinal study that followed up on periodically participants for 2years after the initial smoking cessation intervention. A total of 164 smokers participated within this study. Of these, 15 maintained smoking cessation for 504.93 ± 182.82days. On the other hand, 148 participants failed to maintain smoking cessation. Depressive symptoms decreased and resilience increased significantly over 2years in the 15 abstainers. Smoking cessation, in total, decreased depressive symptoms by 32.9% (p = .015) and also increased resilience by 37.5% (p = .012). Smoking cessation also explained for 9% of total positive interpretation at the 1-year follow-up, and 7.3% of total self-criticism at the 2-year follow-up. Serum serotonin did not change over the course of 2years in both abstainers and smokers but did decrease in the short-term for those who maintained smoking cessation. Platelet serotonin increased over 6months among smokers.

The Effect of a Nurse-Led Cognitive Behavioral Protocol on Depressive Symptoms and Coping Strategies of Dementia Caregivers.

Family caregivers of patients with dementia (PWD) often experience depressive symptoms and use poor coping strategies. Cognitive behavioral interventions may enhance positive appraisals of caregiving-related issues and the utilization of active coping strategies among caregivers, which may help prevent caregiver depression. However, there is a shortage of primary, community-based mental health services in China, and little research has been conducted on the effect of nurse-led mental health programs in this population. This study explored the effect of a nurse-led cognitive behavioral intervention on depressive symptoms and coping strategies among family caregivers of PWD in China. This randomized controlled trial used data from a sample of 112 caregivers screened from 276 potential participants in a city in southeastern China. The sample was randomly assigned to an intervention group (n = 56) and a control group (n = 56). The intervention group received five monthly in-home, nurse-led cognitive behavioral sessions and telephone consultations after each session. The control group received five monthly, short, general conversations with nurse interventionists at the participants' homes, in the hospital, or via telephone. Depressive symptoms, coping strategies, and the demographics of caregiving dyads were collected at Time 1 (baseline), Time 2 (the end of the 5-month intervention), and Time 3 (2-month follow-up). IBM SPSS Statistics Version 19.0 was used for data analysis. Eighty-two participants (intervention group: n = 47, control group: n = 35) completed the three evaluations. No significant group differences were found in baseline characteristics between the two groups. The general linear model repeated-measures analysis of variance indicated a significant difference in depressive symptoms and active coping between groups over time, with p < .001 for the interaction between depressive symptoms and groups and p < .01 for the interaction between active coping and groups. A similar result did not occur for passive coping. The t tests further supported a significant interventional effect on participants' depressive symptoms and active coping. This nurse-led cognitive behavioral intervention was effective in decreasing depressive symptoms and improving active coping among study participants. The findings suggest the improvement of mental health services and social policies in China to support family caregivers of PWD.

Mediators of Intervention Effects on Depressive Symptoms Among People Living With HIV: Secondary Analysis of a Mobile Health Randomized Controlled Trial Using Latent Growth Curve Modeling.

BackgroundAlthough several studies have investigated the effects of mobile health (mHealth) interventions on depression among people living with HIV, few studies have explored mediators of mHealth-based interventions to improve mental health in people living with HIV. Identifying influential mediators may enhance and refine effective components of mHealth interventions to improve mental health of people living with HIV.ObjectiveThis study aimed to examine mediating factors of the effects of a mHealth intervention, Run4Love, designed to reduce depression among people living with HIV using 4 time-point measurement data.MethodsThis study used data from a randomized controlled trial of a mHealth intervention among people living with HIV with elevated depressive symptoms in Guangzhou, China. A total of 300 patients were assigned to receive either the mHealth intervention (n=150) or a waitlist control group (n=150) through computer-generated block randomization. Depressive symptoms, coping, and HIV-related stigma were measured at baseline, 3-, 6-, and 9-month follow-ups. The latent growth curve model was used to examine the effects of the intervention on depressive symptoms via potential mediators. Mediating effects were estimated using bias-corrected 95% bootstrapped CIs (BCIs) with resampling of 5000.ResultsEnhanced positive coping and reduced HIV-related stigma served as effective treatment mediators in the mHealth intervention. Specially, there was a significant indirect effect of the mHealth intervention on the slope of depressive symptoms via the slope of positive coping (beta=–2.86; 95% BCI –4.78 to –0.94). The indirect effect of the mHealth intervention on the slope of depressive symptoms via the slope of HIV-related stigma was also statistically significant (beta=–1.71; 95% BCI –3.03 to –0.40). These findings indicated that enhancement of positive coping and reduction of HIV-related stigma were important mediating factors of the mHealth intervention in reducing depression among people living with HIV.ConclusionsThis study revealed the underlying mediators of a mHealth intervention to reduce depression among people living with HIV using latent growth curve model and 4 time-point longitudinal measurement data. The study results underscored the importance of improving positive coping skills and mitigating HIV-related stigma in mHealth interventions to reduce depression among people living with HIV.

Problem-focused coping and depression among adolescents: Mediating effect of self-esteem

Adolescence is a developmental phase marked by a high risk of depressive symptoms. The Diathesis-Stress Model of Depression proposed that different types of coping strategy can determine depression level in individuals differently. It was found that low self-esteem is linked with greater depressive symptoms among adolescents. Although past studies have discovered the effects of problem-focused coping on depression, there are limited studies examining the underlying mechanism among Malaysian adolescents. Thus, the present study investigated the intervening role of self-esteem on the association between problem-focused coping and depression among adolescents. A total of 852 secondary school students in Kuala Lumpur, Malaysia were recruited through multi-stage cluster sampling. Participants filled out self-reported questionnaires on depression, self-esteem, and problem-focused coping. SPSS macro was used to analyze the mediation model. The findings showed both self-esteem and problem-focused coping negatively correlated with adolescents’ depression. Self-esteem in turn partially mediated the association between problem-focused coping and adolescents’ depression. Thus, it is recommended that intervention on reducing depressive symptoms should focus on providing adolescents with the skills to use problem-focused coping. Workshops could be conducted to heighten adolescents’ self-esteem through the help of teachers, parents and school counselors in reducing depressive symptoms among adolescents.

A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study

Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner's relationship quality and anxiety, stress, and depression over time. One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping. Patient-perceived supportive dyadic coping was positively associated with both partners' relationship quality but was negatively associated with spouses' stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners' relationship quality and positively associated with patients' depression and spouses' depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses' depression at baseline and patients' depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner's anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model. As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners' relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.

High Prevalence of Diabetes Distress in a University Population.

Diabetes distress is an affective condition that addresses an individual's frustrations, worries, and concerns about living with diabetes. It is associated with fewer self-care behaviors, suboptimal glycemic control, and lower quality of life (QOL). For these reasons, diabetes care guidelines recommend routine assessment of diabetes distress. To assess diabetes distress in a university population. This study was conducted using a descriptive, cross-sectional design. Researchers assessed diabetes distress and other psychosocial factors via an electronic anonymous survey among students, faculty, and staff at a large university in the Midwest. A total of 173 participants completed the survey (mean [SD] age, 35.1 [16.7] years), with 108 [62.4%] female and 142 [82.1%] white participants). Eighty-five participants had type 1 diabetes mellitus (T1DM), and 88 had type 2 diabetes mellitus (T2DM). Of the 85 T1DM participants, 23 (27.4%) reported high diabetes distress, and 27 (30.7%) T2DM participants reported high diabetes distress. Sixteen T1DM (18.8%) and 15 T2DM (17.0%) participants screened positive for severe depression. Severe depression was associated with high distress for both T1DM and T2DM participants (T1DM: χ2=28.845, P<.001; T2DM: χ2=20.679, P<.001). Participants with T1DM reported more frequent self-care behaviors (mean [SD], 62.3 [17.1] vs 52.2 [19.2]; P<.001), but lower diabetes QOL (63.3 [14.1] vs 68.5 [15.5]; P=.021) compared with T2DM participants. No differences were observed in depressive symptoms, diabetes self-efficacy, and coping styles. Linear regression models showed that high diabetes distress scores (standardized β=.323, P=.025; standardized β=.604, P<.001) were independently associated with higher hemoglobin A1C levels and lower diabetes QOL after controlling for depressive symptoms, age, and gender in T1DM participants. Similarly, high diabetes distress scores (standardized β=.434, P<.001) were associated with lower diabetes QOL in T2DM participants after controlling for the same variables. High diabetes distress levels were associated with lower diabetes QOL for both T1DM and T2DM participants. These findings suggest that attending or working at a university may be associated with high diabetes distress scores and lower diabetes QOL. Additional research with a larger, more diverse sample from multiple universities is needed to confirm these findings.

Burden in Family Caregivers of Cancer Patients: The Association with Depression, Religiosity and Religious Coping

Introduction: Cancer caregiving is challenging and often associated with significant burden in family caregivers. Yet, the healthcare providers often overlook the needs of the caregivers. Local data on cancer caregiving is still lacking. In line with the increasing cancer cases worldwide, there is a need to examine factors influencing the caregiver burden, and to find ways to improve the quality of life of the caregivers.&#x0D; Objectives: The study aimed to determine the caregiver burden rate among the local family caregivers of cancer patients, and to examine the associations between the caregiver burden and their sociodemographic factors, clinical factors, levels of depression, religiosity, and religious coping patterns.&#x0D; Methods: 127 family caregivers of cancer patients in a government tertiary hospital in Sarawak, Malaysia were recruited cross-sectionally using non-random sampling method. The associations between the variables were examined through bivariate analyses (Chi-Square test), followed by multivariate analysis to determine the factor(s) that were significantly associated with the caregiver burden.&#x0D; Results: The caregiver burden rate among local cancer caregivers was 55.6%. Two factors remained significant after adjusted in multivariate analysis. Caregivers who were the offspring of cancer patients experienced significantly fewer burden than non-offspring caregivers (OR 0.41, CI 0.18 – 0.94, p = 0.035). Also, the caregiver depression was significantly associated with the caregiver burden (OR 4.26, CI 1.87 – 9.72, p = 0.001). There were no significant associations found between the religiosity and religious coping with the caregiver burden on multivariate level.&#x0D; Conclusion: Caregiver burden is common among family caregivers of cancer patients. Caregivers who are the children or grandchildren of cancer patients are less likely to experience caregiver burden, whereas caregivers who have probable depression are more likely to experience caregiver burden. Future studies should assess the effects of specific intervention strategies in helping these caregivers.

The Predictive Value of Emotional Intelligence for Internet Gaming Disorder: A 1-Year Longitudinal Study.

This one-year longitudinal study examined trait emotional intelligence as a predictor of Internet gaming disorder (IGD). To date, only cross-sectional research has been conducted to test the protective effects of emotional intelligence against IGD tendency. Based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study aimed to address the research gap by examining not only the direct effects of trait emotional intelligence, but also its indirect effects (via depressive symptoms and coping flexibility) on IGD, with both a cross-sectional and longitudinal design. The participants were 282 Chinese university students (mean age = 20.47; 39.4% males) who voluntarily completed an anonymous questionnaire at both baseline (W1) and one-year follow-up (W2). Path analysis results revealed that trait emotional intelligence had a protective but indirect effect on IGD tendency in both our cross-sectional and longitudinal data. Depression was found to have a significant, full mediating effect on the relationship between: (i) trait emotional intelligence and IGD tendency (W2) and (ii) coping flexibility and IGD tendency (W2), after adjusting for IGD tendency at the baseline (W1). Gender invariance of the path coefficient was also observed in the prospective model. This study provided longitudinal evidence to support the I-PACE model. Interventions should address both IGD and depressive symptoms, and school-based workshops to increase emotional intelligence and coping flexibility are also recommended.

Coping behaviors and depressive status in individuals with type 2 diabetes mellitus

ObjectiveType 2 diabetes mellitus (T2DM) is associated with a high prevalence of depression, which is influenced by personality traits and coping style. However, these psychological factors have not been well studied in individuals with T2DM. The association between coping behaviors and the reported levels of depressive symptoms was examined in individuals with T2DM.MethodsThe subjects were 435 T2DM patients (mean age 63.1 ± 12.6 years). Depressive status, personality traits and coping behaviors were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Brief Scale for Coping Profile (BSCP). Lifestyle factors and glycated hemoglobin A1c (HbA1c) levels in the patients were also included in the analyses.ResultsAmong the 435 subjects with T2DM, 130 (29.9%) exhibited possible depression, and 68 (15.6%) displayed probable depression. After adjustment for confounders, logistic and multiple regression analyses revealed that certain coping profile scores, such as Changing one’s point of view, Emotional expression involving others and Avoidance and suppression, were consistently and significantly associated with the presence and severity of depression. No relationship was found between depression and HbA1c.ConclusionThese findings indicate that Maladaptive emotion-focused coping strategies, such as Emotional expression involving others and Avoidance and suppression, are protective factors and that Adaptive emotion-focused coping, such as Changing one’s point of view, is a risk factor for depression in T2DM patients. Psychological intervention focusing on the coping profile may reduce depressive symptoms. Additional studies are needed to examine the relationships between psychological factors and depressive symptoms using a longitudinal study design.

Associations Among Depressive Symptoms, Childhood Abuse, Neuroticism, Social Support, and Coping Style in the Population Covering General Adults, Depressed Patients, Bipolar Disorder Patients, and High Risk Population for Depression.

BackgroundExposure to childhood abuse has been identified as a salient risk factor for the development of depression. However, the mediating factors between childhood abuse and depressive symptoms have not been sufficiently elucidated. This study aims to investigate the mediating effects of neuroticism, social support, and coping style between childhood abuse and depressive symptoms in population covering general adults, depressed patients, bipolar disorder patients, and high risk population for depression.MethodsThis is a cross-sectional study. Five validated questionnaires were used to measure the psychological outcomes (Childhood Trauma Questionnaire CTQ-SF, Eysenck Personality Questionnaire EPQR-S, Social Support Rating Scale SSRS, Simplified Coping Style Questionnaire SCSQ, and Patient Health Questionnaire-9 PHQ-9) of 312 participants. Multiple regressions and structural equation modeling (SEM) were used to conduct data analysis.ResultsMultiple regression analysis and SEM showed a significant association between childhood emotional abuse and depression symptoms. Neuroticism, use of social support, and active coping style were important mediating variables of this association. The R2 for our model was 0.456, indicating that 45.6% of the variability in depressive symptoms can be explained by the model.Conclusion:This study suggested that neuroticism, active coping, and use of social support play important role in mediating the effects of childhood abuse on adult depressive symptoms.

Kematangan Emosi, Problem-Focused Coping, Emotion-Focused Coping dan Kecenderungan Depresi pada Mahasiswa Tahun Pertama

This research aimed to examine the correlation between emotional maturity, problem-focused coping, and emotion-focused coping in depression among first year college students. It was hypothesized that emotional maturity, problem-focused coping, and emotion-focused coping correlate with the tendency of depression among first year college students. Participants were 214 college students in Yogyakarta (male=66; female=148). Multiple regression analysis showed that emotional maturity and emotion-focused coping contribute significantly to first year college students depression with 19% contribution (R² = 0,19; p &lt; 0,05). Emotional maturity negatively correlated with depression tendency (t = -6,026; p &lt; 0,05), while emotion-focused coping positively correlated with first year college students depression tendency (t = 2,265; p &lt; 0,05). Result showed that problem-focused coping has no significant relationship with depression tendency (t = -0,557; p &gt; 0,05).

Perceived fatigue and cognitive performance change in multiple sclerosis: Uncovering predictors beyond baseline fatigue

BackgroundFatigue is a common and disabling symptom in multiple sclerosis (MS) with a variety of direct and indirect influences, but remains poorly understood. Perceived fatigue and cognitive performance fatigability may only be weakly correlated and may have independent predictors. We adopted a multifactorial approach, utilising a measure of concurrent cognitive performance change in order to examine the clinical, psychological, and cognitive factors influencing perceived and cognitive performance fatigability in MS. MethodsIndividuals with adult-onset MS were identified from a regional patient database and invited to complete an assessment battery during a home visit. Baseline perceived fatigue was measured using the Modified Fatigue Impact Scale, Fatigue Assessment Instrument, and a Visual Analogue Scale (VAS). The Conners Continuous Performance Test 3 (CCPT3) and VAS were administered before and after our intervention of roughly 2.5 hours of assessment, which represented a period of cognitive effort. The differences in scores formed measures of cognitive performance fatigability and perceived fatigue change, respectively. We examined differences across baseline fatigue, fatigue change and performance change classifications, using regression analysis to uncover predictors of perceived fatigue and performance change. ResultsThe sample comprised 61 participants who were recruited from an existing cohort of MS patients. Positive relationships with depression and emotion-focused coping, and a negative one with sleep, each predicted baseline perceived fatigue with the model explaining 53.5% of variance. Increased perceived fatigue change was not associated with baseline fatigue, cognitive impairment, disease variables or levels of disability, but was linked with higher anxiety, lower self-efficacy and gender. Most CCPT3 performance change variables did not show significant correlations with baseline clinical, psychological, or fatigue variables. However, two variables were predicted by positive relationships with estimated intelligence, whilst a negative relationship with self-efficacy and a positive one with post-intervention fatigue predicted one each. ConclusionFatigue in MS is a multifactorial construct, with perceived fatigue and cognitive performance fatigability largely influenced by indirect psychological and cognitive factors. Future studies need to take these influences into account when developing fatigue assessment tools. Further, targeting influential fatigue drivers such as psychological variables may improve the burden of fatigue and quality of life of people with MS.

Physical and Psychological Impairments Associated with Mucositis after Oral Cancer Treatment and Their Impact on Quality of Life

Background: Posttherapeutic mucositis is a common secondary effect of oral cancer treatment. Mucositis affects the oral mucosa, which leads to specific physical impairments in oral function and a negative impact on quality of life. Objective: To evaluate the impairments associated with oral mucositis and their impact on posttherapeutic quality of life. Methods: A retrospective analysis was conducted on 1,652 patients treated for oral cancer during the multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK), which included 43 clinics from Germany, Austria, and Switzerland. The analysis was based on questionnaires filled out by patients following treatment. Results: Approximately 10% of 1,652 patients included in our study had physical or psychological impairments due to increased posttreatment oral mucositis; this was mainly due to adjuvant radiotherapy or radiochemotherapy administered. Oral mucositis was significantly associated with specific physical impairments, especially xerostomia and pain (p = 0.000), which required supportive care and analgesia (p = 0.000). Additionally, impaired ingestion and speech significantly led to psychological disorders such as public avoidance behavior and social isolation (p = 0.001). Depressive coping of disease (p = 0.001) and concomitant depressive tendencies (p = 0.004) were highly associated with mucositis, which was accompanied by diminished general condition (p = 0.001), bleak future prospects (p = 0.006), and a reduction in quality of life (p = 0.002). Conclusion: Minimizing mucositis-related impairments should be a main effort in oral cancer treatment to optimize patient outcome and improve quality of life after therapy.

GERIATRIC DEPRESSION AND COPING STRATEGIES OF PENALIZED OLDER ADULTS

The older adult prisoners are the most vulnerable to the pressures and the harsh conditions in the prison environment which may be deteriorating and compromising both to their physical and mental health conditions. We have turned our attention towards this research to learn about both physical and psychological status of the older adult prisoners. Using a descriptive design, we gathered data through face-to-face interview using the questionnaires: Geriatric Depression Scale Short Form and Coping Strategies Inventory. The researchers also assessed the physical condition through review of systems. Results revealed that there are physical issues experienced by the older prisoners which are common in old age. There is mild to severe depression among 80% of the participants. Despite the remarkable physical and mental situations, they are in, there are several positive coping strategies used by the older prisoners in dealing with their everyday challenges inside prison. Nursing as a profession are non-selective and non-discriminatory in caring even to these neglected yet vulnerable group. The results of the study may be utilized in understanding the current situation of this sector to provide appropriate interventions and strategies catering to their needs in health and well-being

(109) Aging Back Clinics – A Geriatric Syndrome Approach to Treating Low Back Pain in Older Adults: Results of a Preliminary Randomized Controlled Trial

Treating chronic low back pain (CLBP) with spine-focused interventions is common, potentially dangerous, and often ineffective. We posit that CLBP in older adults is a geriatric syndrome – a final common pathway for the expression of multiple contributors. We have published evidence and expert consensus-based algorithms to guide evaluation and treatment of key biopsychosocial CLBP contributors in older adults – hip osteoarthritis, myofascial pain, fibromyalgia, sacroiliac joint syndrome, lumbar spinal stenosis, leg length inequality, lateral hip/thigh pain, anxiety, depression, insomnia, and maladaptive coping. This preliminary trial tests the feasibility and efficacy of care based on these algorithms in Aging Back Clinics (ABC). Fifty-five English-speaking Veterans age 60-89 with CLBP and no red flags, prior back surgery, dementia, impaired communication, or uncontrolled psychiatric illness were randomized to ABC care or usual care (UC) over 6 months. ABC care was implemented by geriatricians trained in CLBP assessment who: 1) performed a structured history and physical examination to identify pain contributors, 2) provided structured education to participants about their contributors, and 3) recommended additional care using collaborative decision making. Primary outcomes were low back pain severity (0 to 10 current, and 7-day average and worst pain) and pain-related disability (Roland Morris [RM] questionnaire). Follow up data were collected monthly by telephone. ABC participants experienced significantly greater reduction in 7-day average (-1.22 points; p=0.023) and worst pain (-1.70 points; p=0.003) at 6 months. Neither present pain nor RM score at 6-months was statistically significant but favored ABC in magnitude. Descriptively, participants randomized to UC were more likely to experience pain-related emergency room visits (45.8 vs 30.8%; p=0.5136) and be exposed to Beers’ list medications, specifically non-COX2 nonsteroidal anti-inflammatory drugs (73.1% vs. 54.2) and muscle relaxants (42.3% vs. 16.7) . These preliminary data suggest that ABC care reduces pain and exposure to other potential morbidity.

Living with HIV/AIDS: Stigma and Social Discrimination

&lt;em&gt;&lt;span&gt;The diagnose HIV/AIDS in Melayu community is often experience social discrimination and stigma. This situation could lead to mental health disorders among people with HIV/AIDS. This study explores the perceived stigma and social discrimination among people with HIV/AIDS, how they adapt with the situation. Using phenomenological approach, in-depth interview was conducted with seven participants, then analyzed using Collaizi approach. The result showed that most of the participants experienced stigma and lead to received social discrimination from community members such as neighbor, colleagues, relatives, close friend, and even the health professionals. Some of them can adapt well, however, most of them felt anger, depressed, and negative coping such as lying and anti-social. It is recommended to increase social awareness of this situation especially for providing support for people with HIV/AIDS, to improve their quality of life especially their mental health status.&lt;/span&gt;&lt;/em&gt;