Feelings Of Despair Research Articles

Effect of Combination of Facial Acupuncture Therapy with Lavender Aromatherapy on Reducing Postpartum Maternal Anxiety Levels in Medan Tuntungan District

Following childbirth, moms will undergo emotional fluctuations characterized by mood swings, anxiety, dizziness, and feelings of despair. Impaired maternal understanding of infant care can lead to psychological issues that impact the mother's physical well-being, including disrupted sleep patterns and reduced appetite. Failure to promptly manage anxiety in postpartum mothers can lead to the development of baby blues syndrome and postpartum depression. This study employs a Quasi Experiment design with a pre-posttest not include a control group to quantitatively investigate the impact of combining facial acupressure therapy with lavender aromatherapy on anxiety reduction in postpartum mothers. The investigation was conducted in Medan Tuntungan District, located in Medan City. One hundred postpartum women constituted the sample in this study. The data collection process involved administering treatment (facial acupressure therapy with lavender aromatherapy), followed by observation and interviews conducted using the HARS instrument. The analysis conducted using the Wilcoxon Signed Ranks Test revealed a negative ranks value of 94. This indicates that out of the 100 postpartum women who participated in the study, 94 mothers reported a reduction in anxiety levels. The positive rankings index is 0, indicating that none of the 100 postpartum moms who participated in the study reported a rise in anxiety levels. The tie value of 6 indicates that among the 100 postpartum moms who participated in the study, 6 mothers did not show any significant difference in anxiety levels before and after undergoing a combination of Facial Acupressure Therapy with Lavender Aromatherapy. Moreover, it is established that the significance value at this stage of analysis is 0.000 or greater than ? (0.05). Therefore, it can be inferred that there is a significant impact of the combination of Facial Acupressure Therapy with Lavender Aromatherapy on the reduction of anxiety levels in postpartum mothers.

Swinging Between Hope and Despair: Experiences of Patients with Behçet's Disease: A Phenomenological Research Study

Background: Behçet's disease (BD) can severely impact the psychosocial and emotional aspects of patients, significantly disrupting their quality of life. Objectives: The purpose of this study was to describe the psychosocial and emotional experiences of patients with BD and their coping strategies. Methods: This study was conducted using a qualitative method with a hermeneutic phenomenological approach. Data were collected through unstructured and in-depth interviews (9 conducted face-to-face and 6 via WhatsApp video calls) until data saturation was reached. Face-to-face interviews took place at the rheumatology clinic and the rheumatologist’s office from April to July 2023. Data analysis was performed using Diekelmann's seven-step method. The trustworthiness of the study was ensured based on the criteria of Lincoln and Guba, as well as Sim and Sharp. Results: By analyzing the data, 580 codes were extracted, leading to the identification of 12 sub-themes and 2 main themes. The first theme, "emotional, mental, and communicative instability," included the sub-themes of indecisiveness and uncertainty, moving away from desires and wishes, feelings of despair and demise, fears caused by the disease outcomes, sadness and mental anguish, isolationism, and reluctance to seek support. The second theme, "psychological and communicative strengthening strategies," comprised the sub-themes of having an occupation, seeking support, hoping for miracles and healing, doing mental exercises, and engaging in hobbies. Conclusions: This study revealed numerous emotional, psychological, and communicative challenges faced by patients with BD, as well as the strategies they use to cope with these problems. It is recommended that the findings of this study be used to enhance the care team's understanding of the mental and communicative issues experienced by these patients and to improve their skills in teaching psychological strengthening strategies.

Online occupational therapy group training for mothers of children with feeding problems: A randomized controlled trial.

The aim of this study was to scrutinize how online occupational therapy group training for mothers influenced their attitudes and stress levels relating to feeding their children and the eating behaviours of the children. The secondary purpose of the study is to evaluate the satisfaction of the participants of this program. Twenty-nine mothers of children aged 3-6 years, experiencing feeding issues, were randomly allocated to either an intervention or control group. Feeding problems including selective eating, loss of appetite, and mealtime behaviour problems are prevalent during childhood. Parents play a fundamental role in acquiring knowledge about feeding. Problems in the feeding process may lead to parental stress, feelings of despair, and incorrect attitudes. The mothers in the research group participated in the 4-week training. Results indicated positive effects on both maternal attitudes and their children's eating behaviours (p < 0.05). No significant change was found in mothers' state and trait anxiety levels (p > 0.05). Participants were asked to score their satisfaction level with the program between 1 and 10, and the average of the scores was 9.78 ± 0.42. This study shows that online group education for mothers can support existing treatments and guide clinicians working with children with feeding problems.

“I Thought That We Could Nurture the Nature Out of Our Son”: Making Meaning of Parenting in the Narratives of Parents of Children in Residential Treatment

ABSTRACT Enrolling a child in residential treatment for behavioral or emotional disorders is often considered a last resort for parents and can be accompanied by feelings of desperation and failure. Coupled with social discourse inexorably linking parenting with mental health outcomes, parents might experience stigma as they seek support for themselves and their children. Thus, this study implements relational dialectics theory to explore the meaning of parenting from the perspective of parents who have enrolled a child in a residential treatment program. Contrapuntal analysis of six interviews revealed two discourses competing to make meaning of parenting, the Discourse of Demanding Parenting Ideals (DDPI), consisting of two themes: relentless sacrifice and complete responsibility, whereas themes of boundary-setting and acceptance compose the Discourse of Realistic Best Effort (DRBE). Discursive interplay between these discourses occurred in the forms of diachronic separation, synchronic interplay, and discursive transformation to make meaning of parenting.

Molecular mechanism of basolateral amygdala involved in electroacupuncture-induced amelioration of cancer pain and concomitant depression based on transcriptomics techniques.

To observe the effect of electroacupuncture (EA) of "Zusanli" (ST36) and "Sanyinjiao" (SP6) on cancer pain and concomitant negative emotion in cancer pain model mice, and to explore its molecular mechanisms in the basolateral amygdala (BLA) by using transcriptomics techniques. C57BL/6 mice were randomized into sham operation, model and EA groups, with 10 mice in each group. The cancer pain model was established by injecting PBS suspension containing Lewis lung cancer cells into the femur. The mice in the EA group received EA stimulation(1 mA, 2 Hz) on ST36 and SP6 from the 10th day after modeling, 20 min per day for 12 successive days. The bone damage of the distal femur was observed with X-ray and H.E. staining, respectively. The mechanical pain threshold (MPT) was detected by using von Frey. The depression-like behavior was detected by using sucrose-preference test (sucrose preference index in 12 h), and the immobility (feeling of despair) duration of forced swimming within 4 min. The BLA tissue was extracted for RNA sequencing (RNA library construction, and screening differential gene profiling by transcriptomic sequencing) and bioinformatics analysis. The real-time PCR was used to validate the mRNA expression of differentially expressed genes：tumor necrosis factor superfamily 8 (Tnfsf8), bone marrow stromal cell antigen 1 (Bst1), prodynorphin (Pdyn) and voltage-gated sodium channelβ4 (Scn4b). H.E. staining and X-ray showed significant bone damage in the distal femur in cancer pain mice. In contrast to the sham operation group, the MPT on the 1st , 4th, 7th , 10th, 14th and 21st day after modeling and sucrose preference index were significantly decreased (P<0.001, P<0.000 1), and the immobility time of the forced swimming was considerably increased in the model group (P<0.001). In contrast to the model group, the MPT values on the 14th and 21st day and sucrose preference index were obviously increased (P<0.000 1, P<0.05), and the immobility time was strikingly decreased in the EA group (P<0.01). RNA sequencing showed that a total of 404 differentially expressed genes (205 up-regulated, 199 down-regulated) were screened in the model group compared with the sham operation group, and a total of 329 differentially expressed genes (206 up-regulated and 123 down-regulated) were screened in the EA group compared with the model group. Venn diagram analysis of the differentially expressed genes showed that 45 up-regulated and 28 down-regulated genes in the model group were completely reversed by EA. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the screened differentially expressed genes revealed that the above differential genes were mainly enriched in the ligand receptor activity, cytokine receptor binding, and cytokine activity related to neuro-inflammation, as well as in neuropeptide signaling pathways related to neuronal excitability, and calcium ion mediated signal transduction. The analysis of KEGG pathway showed that the differentially expressed genes were mainly enriched in the inflammation-related pathways, such as interleukin-17 pathway. Validation analysis of the differentially expressed genes showed that the expression levels of Tnfsf8 and Bst1 were significantly up-regulated in the model group compared with the sham operation group (P<0.01, P<0.05), and down-regulated by EA (P<0.01, P<0.05), while the expression levels of Pdyn and Scn4b were down-regulated in the model group in comparison with the sham operation group (P<0.01), and up-regulated by EA (P<0.05, P<0.01), which was consistent with the changing trend of the gene sequencing results. Acupuncture of ST36 and SP6 can significantly relieve cancer pain and concomitant negative emotion in cancer pain mice, which may be related to its functions in alleviating neuro-inflammation and relieving the abnormal activities of specific neurons in the BLA.

Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana

IntroductionPeople with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana.MethodsA sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis.ResultsMost PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes.ConclusionThe study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.

When a Poem Hits You in the (White) Face

AbstractThis article seeks to acknowledge the issue of problematic whiteness in listening to Black experiences through reflecting on the poem “Mirroring” by the womanist theologian Doreen Hazel and in the writing of a poem by the author as an artistic piece. Against a feeling of despair about xenophobia, racism, sexism, homophobia, and the way people talk about refugees, the poem seeks to find the light of hope and to imagine the kingdom and how to participate in it.

COVID-19 IMPACT ON MENTAL HEALTH AND STRESS LEVELS: A STUDY TWO YEARS LATER

Amidst the contemporary challenges, the profound impact of Covid-19 on mental health and stress levels among students in Malaysia, particularly in the context of pharmacy education, requires urgent consideration. Historically marginalized, mental health issues are gaining recognition for their critical significance. This study explores the psychological repercussions of the Covid-19 pandemic on the stress and mental well-being of Diploma in Pharmacy students at Universiti Teknologi MARA (UiTM) Cawangan Pulau Pinang. The research, encompassing 116 respondents, predominantly female (85.3%), aims to elucidate students' self-awareness of their health status. Results reveal notable instances of fatigue, sleep difficulties, and heightened stress during online learning. Specifically, 50.9% of students experience occasional stress during assignments, and 16.4% report constant stress. Despite feelings of despair among 54.3% of students, no significant gender-based differences emerge. The study emphasizes the imperative to address mental health and stress levels among pharmacy students and underscores students' awareness of their well-being. In conclusion, proactive measures and support are essential for students at UiTM Cawangan Pulau Pinang, Kampus Bertam, navigating the challenges of mental health and stress in the post-Covid era.

Bombay cinema’s mapping impulse: Location, suspense and atmosphere

This article examines the use of locations in a cross-section of contemporary Bombay films. The complicated workings of various kinds of production infrastructures typically shape cinema’s topographical motivations and sense of scale. Through a comparative analysis of films shot in and around Bombay with a film shot in a location outside India, I establish how the aesthetic drives of vertical, horizontal and atmospheric urbanism have generated a cartographic diversity in the cinematic imagination of contemporary India. The focus is on suspense films and their creative use of location shooting to invoke physical and psychological expressions of space. These are small-budget films where scale and navigational possibilities are managed carefully. In Anurag Kashyap’s Ugly (2013), the hunt for a kidnapped child unveils a gritty urban terrain and the failed dreams of its damaged protagonists. Vikramaditya Motwane’s Trapped (2016) showcases the slow breakdown of a man who inadvertently gets locked into an apartment on the 35th floor of an empty, half-constructed, high-rise building with no electricity, food or water. Unlike Ugly and Trapped, which speak to Bombay’s constant play with feelings of desperation and survival, Badla (2019) transports us to the cold, wintry landscape of Scotland to create an atmosphere for a psychological exposition of crime and revenge.

Qualitative Analysis of Decision to Pursue Electrical Brain Stimulation by Patients With Drug-Resistant Epilepsy and Their Caregivers.

To understand why patients with drug-resistant epilepsy (DRE) pursue invasive electrical brain stimulation (EBS). We interviewed patients with DRE (n = 20) and their caregivers about their experiences in pursuing EBS approximately 1 year post device implant. Inductive analysis was applied to identify key motivating factors. The cohort included participants aged from teens to 50s with deep brain stimulation, vagus nerve stimulation, responsive neurostimulation, and chronic subthreshold cortical stimulation. Patients' motivations included (1) improved quality of life (2) intolerability of antiseizure medications, (3) desperation, and (4) patient-family dynamics. Both patients and caregivers described a desire to alleviate burdens of the other. Patient apprehensions about EBS focused on invasiveness and the presence of electrodes in the brain. Previous experiences with invasive monitoring and the ability to see hardware in person during clinical visits influenced patients' comfort in proceeding with EBS. Despite realistic expectations for modest and delayed benefits, patients held out hope for an exceptionally positive outcome. Our findings describe the motivations and decision-making process for patients with DRE who pursue invasive EBS. Patients balance feelings of desperation, personal goals, frustration with medication side effects, fears about surgery, and potential pressure from concerned caregivers. These factors together with the sense that patients have exhausted therapeutic alternatives may explain the limited decisional ambivalence observed in this cohort. These themes highlight opportunities for epilepsy care teams to support patient decision-making processes.

“I just want to stay here and sleep forever”: South African patients’ lived experiences of chronic fatigue in endometriosis

Chronic fatigue is a distressing symptom for endometriosis patients but is not widely investigated in the literature. Our aim was to explore patients’ lived experiences of chronic fatigue and how they make meaning of it. We analysed a subset of data from seven severely fatigued endometriosis patients, drawn from a broader qualitative study in South Africa, using an interpretive phenomenological analysis. Three superordinate themes and eight subordinate themes were developed. The three superordinate themes were powerlessness, which was a core aspect of the chronic fatigue experience among participants; struggle and anguish, as their lives had become a daily struggle resulting in feelings of despair and anger; and otherness, as they felt different from their peers due to the fatigue. The findings demonstrate the far-reaching effects that chronic fatigue has in the lives of endometriosis patients, including on their self-perception, and highlights the critical need for fatigue management strategies within treatment protocols.

The Effect of Educational Religious Intervention on Improving Life Expectancy in Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Clinical Trial

Background and Purpose: The main problem of cancer patients is the feeling of despair and hopelessness. Religious beliefs can boost the morale of cancer patients. This study aimed to determine the effect of religious interventions on life expectancy in cancer patients undergoing chemotherapy. Materials and Methods: The present clinical trial study was conducted on 128 patients with cancer undergoing chemotherapy referred to the oncology unit of a teaching hospital in Khorramabad, Iran. After selecting the sample size, the patients were randomly divided into intervention and control groups. In addition to routine care, religious intervention sessions were performed for the intervention group, and the control group received only routine care. For the intervention group, training sessions focused on trust in God, good morals, patience, gratitude, and remembrance of God. After 3 weeks and 6 sessions (after finishing the sessions), the post-test was done. Data collection tools were the demographic and Miller’s standard life expectancy questionnaires. Analysis of covariance was used to compare life expectancy after the intervention. SPSS software, version 23 was employed for data analysis. A significance level of 0.05 was considered for all tests. Results: There were 64 men and 64 women in both groups. Also, 111 people were married in both groups. The most frequent cancer seen in both intervention and control groups was gastric cancer (n=37). The mean life expectancy scores of the experimental and control groups before the intervention were not statistically significant (P&lt;0.05). There was a statistically significant difference in life expectancy scores before and after the intervention in the experimental group (P&lt;0.05). There was a statistically significant difference in life expectancy scores after the intervention in the experimental and control groups (P=0.000). Conclusion: Religious intervention increases the life expectancy of cancer patients undergoing chemotherapy. Medical staff, especially nurses, can, along with other routine care, guide patients undergoing chemotherapy to spirituality and help them accept the disease and its complications better.

Analisis Swot dalam Perspektif Al-Qur’an

The aim of this research is that the Al-Qur'an is a holy book that contains various solutions to all problems in life. Thousands of verses in it can be used as a guide to life, in accordance with the name of the Al-Quran, namely "al-Huda" which means guidance. Guidelines for humans in dealing with various kinds of problems in everyday life. Sticking to the Koran can keep people away from feelings of despair and distress. In order for humans to be able to control themselves, it is appropriate for us to be able to understand the contents and contents of the verses of the Koran by studying them. By using the maudlu'I method, namely understanding the Al-Qur'an based on a theme. This can make it easier to connect the verses of the Koran with everyday life. The type of research used is library research, where the data is mostly sourced from literature, books and scientific works related to the theme. Based on the research results, it can be concluded that humans have four components inherent in them. Namely strengths, weaknesses, exploiting opportunities and awareness of threats. If humans are aware and can control the four components above, then they will live this life well.

Association between social withdrawal and suicidal ideation in patients with major depressive disorder: The mediational role of emotional symptoms

BackgroundThe study was designed to investigate the associations between social withdrawal, emotional symptoms, and suicide ideation in patients with major depressive disorder (MDD). MethodsThis cross-sectional study included 2678 MDD patients from the National Survey on Symptomatology of Depression (NSSD). Differences in the sociodemographic factors, clinical characteristics, suicide ideation, and emotional symptoms were compared in patients with different frequencies of social withdrawal. Pearson correlation, multiple linear regression analysis, and mediation analysis were employed to assess the contribution of social withdrawal to suicide ideation. ResultsMDD patients with a higher frequency of social withdrawal were prone to have a higher frequency of suicide ideation (p for trend <0.001) and history of suicide behavior (p for trend <0.001). Multiple linear regression analysis showed that there was a dose–response relationship between social withdrawal and suicide ideation in MDD patients, but this association became insignificant after adjusting for emotional symptoms. Mediation analysis suggested that all of the emotional symptoms had significant mediating effects on the association between social withdrawal and suicide ideation in MDD patients (p < 0.05). The magnitude of mediation varied between 4.3 % and 64.3 %, with the largest mediating effect in the feeling of despair (64.3 %), helplessness (41.2 %), and loneliness (40.0 %). ConclusionOur study provides evidence that social withdrawal was a common clinical presentation and it may increase the risk for suicide through emotional symptoms in MDD patients. LimitationsCausal conclusions could not be drawn between social withdrawal, emotional symptoms, and suicide ideation because of the cross-sectional design of the study.

Bereavement Experiences of Families of Elderly Individuals Who Died Due to COVID-19.

This study was conducted to evaluate the bereavement experiences of families of elderly individuals who died due to the COVID-19 pandemic. One of the qualitative research methods, the case study method, was used in the study. The sample of the research consisted of 19 people who agreed to participate in the research between April and July 2022. The research data were collected using a Personal Information Form and a Semi-Structured Interview Form, which was created to conduct individual in-depth interviews. As a result of the descriptive analysis, four main themes, the ability to perform religious rituals related to the bereavement experience, feelings and thoughts about death, attitudes of those around after death, and coping strategies in the COVID-19 process. It was determined that individuals had difficulty accepting death, felt inadequate about spirituality due to limited religious rituals, had feelings of despair and guilt, and limitedly utilized social support systems.

Forgotten and Exploited: The Plight of Migrant Female Domestic Workers Interrelated to Human Rights Violation in Ethiopian Towns

This study aims to investigate the experiences of migrant female domestic workers (FDWs) in relation to social exclusion, policy exclusion, and human rights violations in the studied area. The pragmatic paradigm, with an embedded design, was employed as the dominant approach. Convenience sampling was used to gather a sample of domestic workers who are not officially recorded. A total of 130 participants took part in the quantitative study, and 28 participated in the qualitative study. Quantitative data were analyzed using the SPSS software, while qualitative data were analyzed thematically. The results indicate that migrant FDWs are marginalized and excluded from the country’s labor laws, and the Council of Ministers has delayed issuing laws to protect them. As a result, most respondents do not have legally binding work contracts and instead have contractual arrangements that are drafted by brokers and favor employers. This leads to various human rights abuses, including the denial of the right to education and access to health care. In addition, employers were found to be reluctant to send their employees to school, and some even fired employees due to their illnesses. These experiences have led to mental health issues such as low self-esteem, feelings of despair and insecurity, and resentment toward employers and society at large. Therefore, it is recommended that the government and stakeholders take steps to advocate for the rights of FDWs and initiate programs to raise social awareness and inclusion in labor laws.

Functional improvement of patients with Parkinson syndromes using a rehabilitation training software.

Individuals with Parkinsonian disorders often face limited access to specialized physiotherapy and movement training due to staff shortages and increasing disease incidence, resulting in a rapid decline in mobility and feelings of despair. Addressing these challenges requires allocating adequate resources and implementing specialized training programs to ensure comprehensive care and support. Regarding these problems, a computer software was invented that might serve as an additional home-based extension to conventional physiotherapy. The trial took place in a rehabilitation center where every patient received equivalent treatment apart from the training program that was set up to be investigated over 3 weeks. Seventy four Patients were included and randomized between two intervention and one control group. Intervention group 1 (IG1) trained with the computer-based system two times a week while Intervention group 2 (IG2) received five training sessions a week. Using the markerless Microsoft Kinect® camera, participants controlled a digital avatar with their own body movements. UPDRS-III and Clinical measurements were performed before and after the three-week period. Patients in all groups improved in UPDRS-III pre and post intervention whereas reduction rates were higher for IG1 (-10.89%) and IG2 (-14.04%) than for CG (-7.74%). Differences between the groups were not significant (value of ps CG/IG1 0.225, CG/IG2 0.347). Growth rates for the arm abduction angle were significantly higher in IG1 (11.6%) and IG2 (9.97%) than in CG (1.87%) (value of ps CG/IG1 0.006 and CG/IG2 0.018), as was the 5-steps-distance (CG 10.86% vs. IG1 24.5% vs. UG2 26.22%, value of ps CG/IG1 0.011 and CG/IG2 0.031). The study shows the beneficial effects of computer-based training and substantiates the assumption of a similar impact in a home-based setting. The utilized software is feasible for such interventions and meets with the patient's approval. Group dynamics seem to have an additional supporting effect for the aspired objective of improving mobility and should be seen as an essential aspect of video games in therapy.

Complex post-traumatic stress disorder (cPTSD) and suicide risk: A multigroup mediation analysis exploring the role of post-traumatic symptomatology on hopelessness

Complex post-traumatic stress disorder (cPTSD) is a clinical condition that features not only PTSD symptoms, but also disturbances in self-organization. Patients with cPTSD have a higher incidence of psychiatric comorbidities, including suicidality. A key construct tightly related to suicidality is hopelessness, described as a feeling of despair, with a state of mind giving low or negative expectancies regarding one's future. Since there is a paucity of studies investigating the link between cPTSD and hopelessness as a risk factor for suicidality, the aim of this study was to examine the role of post-traumatic symptomatology as the primary driver of suicidality, as measured by hopelessness.211 patients were enrolled and divided into two groups: PTSD (143 patients) and cPTSD (78 patients). A set of standardized measures was administered to study post-traumatic symptomatology, depression, and hopelessness.The results showed that compared to PTSD, cPTSD patients experienced more severe symptoms in all clinical outcomes (p < 0.001). The mediation analysis revealed a significant positive association between post-traumatic symptomatology and hopelessness in the cPTSD group, which was not significant in the PTSD group. Among PTSD patients, depression mediated 43.37% of the impact of post-traumatic symptomatology on suicidal ideation.Our results contribute to a better understanding of complex post-traumatic symptomatology, further highlighting its role in the pathogenesis of suicidality. Hence, these findings have important clinical implications, suggesting that targeted, trauma-focused interventions might effectively prevent hopelessness and therefore suicide risk in patients with cPTSD.

(223) Sexual Therapy: Patient-reported Barriers to Care

Abstract Introduction Sexual therapy for male sexual dysfunction has been used to help patients address a variety of sexual dysfunction-related conditions. While this intervention is frequently recommended for patients by male sexual health experts, the rate of adherence to the recommended therapy and associated factors is unknown. Objective To understand factors leading to completion of sex therapy consultations and barriers that prevent it. Methods A survey was developed by experts in the management of male sexual dysfunction and sex therapy at our institution. The survey included questions focusing on the decision to pursue sex therapy (or not), barriers or facilitating factors, patient perceptions regarding the referral, and treatment success. A retrospective chart review was performed to identify those patients who were referred for sexual therapy after undergoing evaluation for male sexual dysfunction at an academic Men’s Health urology clinic from 2017 - present. The survey was mailed out to these patients, and respondent survey data was compiled to evaluate survey responses. Results To date, 23 patients completed the survey (20% response rate). Sixty-five percent of survey respondents were ≥ 50 years of age, 87% were straight, and 71% were married. Reasons for sex therapy referral were frequently multi-factorial and included erectile dysfunction (65%, n=15), low libido (43%, n=10), ejaculatory dysfunction (39%, n=9), performance anxiety (30%, n=7), relationship problems (30%, n-7), and genital pain (14%, n=3). Seventy-eight percent of patients (n=18) felt that sex therapy consultation was a reasonable part of their treatment plans. Six (26%) patients did not attend their recommended sex therapy consultations. Reported barriers included sense of shame (n=2), embarrassment (n=2), scheduling conflicts (n=1), lack of anticipated benefits (n=1), and feeling dismissed by the referring provider (n=2). Those who attended sex therapy frequently reported the perception that referral made sense based on their symptoms (n=10, 59%) and/or a feeling of desperation to “do anything do get better” (n=11, 65%). Seventy-eight percent of patients who attended sex therapy found it helpful and would recommend it to a friend with a similar concern. Conclusions The majority of male patients who are referred to sexual therapy feel it is beneficial. However, one in four men choose not to pursue this line of treatment despite recommendations from their treating physicians. Future work is needed to address barriers to pursuing sex therapy. Disclosure No

Subjective Perceptions of Occupational Fatigue in Community Pharmacists.

Community retail pharmacists are experiencing unsafe levels of stress and excessive demands within the workplace. One aspect of workload stress that has been overlooked among pharmacists is occupational fatigue. Occupational fatigue is a characteristic of excessive workload including increased work demands and reduced capacity and resources to complete the work. The goal of this study is to describe the subjective perceptions of occupational fatigue in community pharmacists by using (Aim 1) a previously developed Pharmacist Fatigue Instrument and (Aim 2) semi-structured interviews. Wisconsin community pharmacists were eligible to participate in the study and recruited via a practice-based research network. Participants were asked to complete a demographic questionnaire, a Pharmacist Fatigue Instrument, and semi-structured interview. Survey data were analyzed using descriptive statistics. Interview transcripts were analyzed using qualitative deductive content analysis. Totally, 39 pharmacists participated in the study. From the Pharmacist Fatigue Instrument, 50% of the participants stated they had times where they were not able to go above and beyond standard patient care on more than half of the days they worked. A total of 30% of the participants reported that they found it necessary to take short-cuts when providing patient care on more than half of the days they worked. Pharmacist interviews were separated into overarching themes including mental fatigue, physical fatigue, active fatigue, and passive fatigue. The findings highlighted the pharmacists' feelings of despair and mental fatigue, fatigue's connectedness to interpersonal relationships, and the complex nature of pharmacy work systems. Interventions aimed at improving occupational fatigue in community pharmacies should consider key themes of fatigue that pharmacists are experiencing.