General Self-Efficacy Scale Scores Research Articles

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery

BACKGROUND Esophageal cancer is one of the most common malignant tumors. The three-dimensional quality structure model is a quality assessment theory that includes three dimensions: Structure, process, and results. AIM To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery. METHODS In this prospective study, the control group received routine nursing, and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care. Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale (GSES) and Exercise of Self-Care Agency scale, respectively. IBM SPSS Statistics for Windows, version 17.0, was used for the data processing. RESULTS This study recruited 112 patients who were assigned to the control and experimental groups (n = 56 per group). Before the intervention, there was no significant difference in GSES scores between the two groups (P > 0.05). After the intervention, the GSES scores of both groups increased, with the experimental group showing higher values (P < 0.05). At the time of discharge and three months after discharge, the scores for positive attitudes, self-stress reduction, and total score of health promotion in the experimental group were higher than those in the control group (P < 0.05). CONCLUSION The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

The relationship between clinical decision-making levels and self-efficacy levels of operating room nurses

BackgroundClinical decision-making and self-efficacy levels of operating room nurses are critical for patient care quality and safety. ObjectiveThis study aims to examine the relationship between clinical decision-making levels and self-efficacy among operating room nurses and to identify factors influencing these two key components of nursing practice. MethodsA cross-sectional descriptive design was used to survey 94 nurses working in surgical wards at Ankara University Medical Faculty Hospital. Data were collected using the Clinical Decision Making in Nursing Scale (CDMNS), General Self-Efficacy Scale (GSES), and a demographic information form. Data were analyzed using descriptive statistics, correlation analysis, and group comparisons. ResultsA significant positive correlation was found between clinical decision-making ability and self-efficacy (r = 0.355, p < .0001). Nurses with higher education levels demonstrated significantly greater clinical decision-making skills (p < .005). Nurse managers reported significantly higher self-efficacy levels compared to scrub/circulating nurses (p < .05). Age was positively correlated with self-efficacy (r = 0.373, p < .0001) but not with clinical decision-making ability. ConclusionThe research indicated that self-efficacy levels correspond with clinical decision-making capabilities of the operating room nurses. Higher education levels of the practitioners enhanced their clinical decision-making abilities. Nurse managers had higher self-efficacious beliefs than the scrub or circulating nurses. Age was positively associated with self-efficacy, but not with the scores on clinical decision-making abilities. The results of this study nurse leaders have higher GSES and CDMNS scores because they are experienced nurses with higher education degrees.

Temporal binding and sense of agency in major depression.

Alterations in the experience of controlling oneself and one's environment are of high relevance to understanding the psychopathology of depression. This study investigated the relationship between Temporal Binding for action-event sequences, sense of agency, self-efficacy and symptom severity in Major Depressive Disorder. We employed the Sense of Agency Scale (SoAS) and the General Self-Efficacy Scale (GSE) to assess explicit Sense of Agency and self-efficacy in a group of 42 persons diagnosed with Major Depressive Disorder (MDD) [20 identifying as female, 19 as male; mean age 37.8 years (± 13.3)] and 40 control persons without a psychiatric diagnosis (CG) [22 identifying as female, 20 as male; mean age 38.0 years ( ± 13.3)]. Depressive symptom severity was measured using the BDI-II. We additionally performed a temporal binding paradigm as a potential correlate to Sense of Agency. Participants partook in a time estimation task judging three intervals (250ms, 450ms, 650ms) while either observing or causing stimulus presentations. The underestimation of intervals following intentional actions causing stimulus presentations (compared to merely observing the stimulus presentation) is interpreted as temporal binding. SoAS scores demonstrated an inverse correlation with depressive symptoms (CG: p=.032, R2=.113; MDD: p<.001, R2=.260) and a positive correlation with GSE scores (CG: p<.001, R2=.379; MDD: p<.001, R2=.254). We found distinct differences in temporal binding between healthy participants and the Major Depressive Disorder group without significant correlation between temporal binding and the SoAS or GSE scores. The data suggest group differences in time estimation particular pertaining to time intervals involving intentional action and increasingly complex multisensory stimuli. We investigated parameters of subjective control, namely Sense of Agency and Self Efficacy. Here, we were able to reveal their inverse relationship with depressive symptoms in patients with major depressive disorder, highlighting a profound experience of loss of control with increasing symptom load. Deficits in experiencing control, particularly involving intentional motor actions (and more complex multisensory stimuli), appear to be more pronounced in Major Depressive Disorder, involving not only negative self-efficacy expectations but also an altered Sense of Agency and temporal binding. Temporal binding and SoAS scores did not correlate, adding to the growing evidence that the two measures may not be directly related. We propose that future research be directed at this contiguous relationship between Sense of Agency and Self Efficacy in Major Depressive Disorder.

A study on the correlations of PRL levels with anxiety, depression, sleep, and self-efficacy in patients with prolactinoma.

The purpose of this study was to explore the factors influencing PRL levels in patients with prolactinoma and to investigate the correlations between anxiety, depression, sleep, self-efficacy, and PRL levels. This retrospective study included 176 patients with prolactinoma who received outpatient treatment at the Affiliated Hospital of Zunyi Medical University from May 2017 to August 2022. The general information questionnaire, Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS), and General Self-Efficacy Scale (GSES) were used for data collection. A generalized estimating equation (GEE) model was used to analyze the factors influencing PRL levels in patients with prolactinoma. GEE single-effect analysis was used to compare PRL levels at different time points between anxiety group and nonanxiety group, between insomnia group and normal group, and between low, medium, and high self-efficacy groups. The median baseline PRL level and the PRL levels at 1, 3, 6, and 12 months of follow-up were 268.50 ng/ml, 122.25 ng/ml, 21.20 ng/ml, 19.65 ng/ml, and 16.10 ng/ml, respectively. Among patients with prolactinoma, 59.10% had anxiety (HADS-A score = 7.35 ± 3.34) and 28.98% had depression (HADS-D score = 5.23 ± 3.87), 9.10% had sleep disorders (AIS score = 6.10 ± 4.31) and 54.55% had low self-efficacy (GSES score = 2.13 ± 0.83). Educational level, tumor size, number of visits, sleep quality, anxiety level, and self-efficacy level were found to be factors influencing PRL levels in patients with prolactinoma (P<0.05). Higher PRL levels were observed in the anxiety group compared to the non-anxiety group (P<0.001), in the insomnia group compared to the normal group (P<0.05), and in the low self-efficacy group compared to the medium and high self-efficacy groups (P<0.05). PRL levels in patients with prolactinoma are related to education level, tumor size, number of visits, anxiety, self-efficacy, and sleep but not depression. PRL levels were higher in patients with anxiety, low self-efficacy, and sleep disorders.

Perception of Polish pharmacy students on simulation exercise in pharmaceutical care for diabetes—a pilot study

BackgroundThe transformation of a pharmacist’s role from that of a drug dispenser to an advisor and patient educator, partially accelerated by the COVID-19 pandemic, requires a thorough change in the pharmacy curriculum. Preparation for the provision of modern pharmaceutical services requires the use of the most advanced teaching methods, such as pharmaceutical simulation. Knowledge alone does not guarantee students’ readiness and motivation to take on new challenges in their professional work, but it seems crucial that graduates of medical faculties have the ability to practically apply their knowledge, including in new and nonstandard situations. Therefore, in our study, we proposed an intervention using a simulation method (peer role play) in teaching pharmaceutical care, and we assessed its impact on students’ levels of self-perceived confidence and self-efficacy in accordance with Bandura’s theory. The aim of the study was to verify whether the introduction of these types of classes could be a useful element of pharmacy curriculum renewal.MethodsThe questionnaire-based study was conducted during pharmaceutical care peer role-playing classes in a simulation environment with a debriefing session among 85 final-year pharmacy students at Poznan University of Medical Sciences, Poland. The questionnaire consisted of two surveys: the General Self-Efficacy Scale (GSE) and a pre-post self-assessment and self-efficacy questionnaire.ResultsThere was a positive correlation between the GSE score and self-efficacy (R = 0.52, p < 0.0001). A statistically significant increase in the post-self-assessment of all the skills and competencies included in the survey in the field of pharmaceutical care of a patient with diabetes compared to the pre-values was also observed (p < 0.001). Additionally, the students’ self-efficacy in terms of communicating with patients was greater following the class than before the class (p < 0.001).ConclusionsThe peer role-play active teaching method was found to be a cost-effective method allowing for an increase in the self-assessment and self-efficacy of pharmacy students in diabetic patient pharmaceutical care. However, further in-depth research is needed to fully confirm the effectiveness of simulation exercises for teaching pharmacy undergraduates.

The effects of an incivility-based virtual simulation on nursing students perceived self-efficacy

BackgroundIncivility is an established, well-known problem within the nursing culture. The purpose of this study was to determine the effect of participating in an incivility-based virtual simulation on undergraduate nursing students’ perceived self-efficacy. Aim(1) Describe the GSE scores of the study cohort and examine the association between pre-and post-intervention scores. (2) Explore students’ perceptions of how participation affected their ability to identify and address incivility. MethodsA mixed-methods research design was utilized to determine the relationship between students' completion of an incivility-based virtual simulation and their self-efficacy in identifying and addressing incivility. The study compared pre- and post-intervention General Self-Efficacy Scale (GSE) scores and identified significant findings and themes among qualitative data collected. IRB approval was obtained for the study. ResultsPaired t-test results indicated a significant association between pre- and post-GSE scores with participants in the post-intervention group having significantly higher scores (Mean = 34.6, SD = 4.1).The themes that emerged from the qualitative data collected included communication, self-confidence, conflict resolution, and vicarious learning. ConclusionFindings from this study showed a significant increase in participants’ self-efficacy in identifying and addressing incivility in nursing after completing the intervention.

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months.

To explore distinct longitudinal trajectories of resourcefulness among initial ischemic stroke patients from diagnosis to 12 months, and to identify whether sociodemographic factors, disease-related factors, self-efficacy, family function, and social support can predict patterns in the trajectories of resourcefulness. A prospective longitudinal study was conducted. Initial ischemic stroke patients who met inclusion and exclusion criteria were followed up when still in hospital (Preparing for discharge, Baseline, T1), at 1 month (T2), at 3 months (T3), at 6 months (T4), at 9 months (T5) and 12 months (T6) (±1 week) after discharge. General information, National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), General Self-Efficacy Scale (GSES), General Family Functioning Subscale (FAD-GF), and Social Support Rate Scale (SSRS) were used in T1. The Resourcefulness Scale© was evaluated at 6 time points. Growth mixture modeling was used to identify trajectory patterns of resourcefulness. Logistic regression was used to identify predictors of resourcefulness trajectories. Three longitudinal trajectories of resourcefulness were identified and named as the high-stable class (38.9%, n=71), fluctuation class (41.2%, n=75), and low-stable class (19.9%, n=36), respectively. Dwelling areas (x2=6.805, P=0.009), education (x2=44.865, P=0.000), monthly income (x2=13.063, P=0.001), NIHSS scores (x2=44.730, P=0.000), mRS scores (x2=51.788, P=0.000), Hcy (x2=9.345, P=0.002), GSES (x2=56.933, P=0.000), FAD-GF (x2=41.305, P=0.000) and SSRS (x2=52.373, P=0.000) were found to be statistically significant for distinguishing between different resourcefulness trajectory patterns. Lower education (OR=0.404), higher NIHSS(OR=6.672) scores, and higher mRS(OR=21.418) scores were found to be risk factors for lower resourcefulness, whereas higher education(OR=0.404), GSES(OR=0.276), FAD-GF(OR=0.344), and SSRS(OR=0.358) scores were identified as protective factors enhancing resourcefulness. This study obtained three patterns of trajectories and identified their predictive factors in initial ischemic stroke. The findings will assist health care professionals in identifying subgroups of patients and when they may be at risk of low resourcefulness and provide timely targeted intervention to promote resourcefulness.

Mediation effect of self-efficacy on the relationship between perceived social support and resilience in caregivers of patients with first-stroke in China: a cross-sectional survey

ABSTRACT Background Self-efficacy, perceived social support, and resilience in caregivers of first-stroke patients are closely related, while the interaction mechanism remains unclear. This research explores the mediation effect of self-efficacy in the relationship between perceived social support and resilience in caregivers of first-stroke patients in China. Methods Convenience sampling was designed and used to recruit participants from the General Hospital of Northern Theater in Shenyang, Liaoning Province, China, from February to October 2022, in which 207 self-reported participants completed the Connor-Davidson Resilience Scale (CD-RISC), Multidimensional Scale of Perceived Social Support (MSPSS) and General Self Efficacy Scale (GSES). In addition, the mediation effect of self-efficacy between perceived social support and resilience was determined by the PROCESS macro for SPSS. Result Among the 207 caregivers of patients with first-stroke, the mean CD-RISC, MSPPS and GSES scores were (72.17 ± 11.28), (71.17 ± 8.99), and (29.64 ± 5.03) respectively. Caregivers’ self-efficacy was positively correlated with perceived social support (r = 0.439, p < 0.01) and resilience (r = 0.730, p < 0.01). Self-efficacy served a mediation function partially between perceived social support and resilience, whose effect accounted for 52.90% of the total. Conclusion Both simple and mediation roles of perceived social support and self-efficacy are established in the relationship of resilience among caregivers of first-stroke patients. Positive social support and self-efficacy are two important targets for future interventional studies, and interventions on them may synergistically improve resilience. Hence, the nurses and community workers should correctly evaluate social support and self-efficacy, confirm the health education requirements, and implement counseling intervention to protect and improve the health of first-stroke patients and their families.

Anxiety, mindfulness and self-efficacy association among university healthcare specialties students in Al Qassim, Saudi Arabia: a cross-sectional study

BackgroundAnxiety is a widely recognized topic in medical education. Previous studies have found that medical students experience higher levels of anxiety than other students. An increasing corpus of research indicates a major association between mindfulness and mental wellness.ResultsThis study included 418 respondents, of whom 394 were included in the final sample. Most were female (55.3%), while male participants comprised 44.7%. The mean age of the population was 22.4 years. Our results showed only 7.2% of the participants in the sample were diagnosed with mental health disorders. Moreover, 26% of the study population had minimal anxiety, and the proportions of those with mild, moderate, and severe anxiety ranged from 20.3% for mild, to 22.7% for moderate, to 31.1% for severe. The most commonly observed severe symptoms were fear of the worst happening, nervousness, and inability to relax. The mean score on the General Self-Efficacy Scale (GSE) was 27.7 (SD: 5.1) on a scale of 10–40. According to the short-form Five Facet Mindfulness Questionnaire (FFMQ-15) evaluation of participants’ mindfulness, the average score was 41.6 (SD: 9.5) on a scale of 15–75. Gender, college attended, and presence of psychiatric diagnosis were the independent factors potentially influencing Beck Anxiety Inventory (BAI) scores.ConclusionOur findings revealed the prevalence of anxiety and mindfulness among healthcare students at Qassim University, Saudi Arabia. Weak correlations were found among the GSE, FFMQ-15, and BAI scores.

The effect of the Ankle Pump Exercise (APE) counter system assisted ankle pump motion in patients after femoral neck fracture

ObjectiveTo explore the effect of the Ankle Pump Exercise (APE) counter system on moderate to high-risk Venous thromboembolism (VTE) after femoral neck fracture surgery.MethodsFrom June 2021 to June 2022, a total of 140 patients with moderate and high-risk VTE after femoral neck fracture surgery treated at the Department of Orthopedics of a tertiary hospital in Zhejiang were included and divided into observation (70 cases) and control (70 cases) groups according to whether APE counter system was used or not. The control group was given routine oral propaganda, and the observation group was given a comprehensive nursing intervention with APE counter system on the basis of the control group’s treatment. The compliance rates of the two groups on the postoperative 3st, 5rd, and 7th days were compared. Moreover, the General self-efficacy scale (GSES) was used to evaluate self-efficacy before and after exercise.ResultsThe compliance rates of the control group and the observation group on the postoperative 3st, 5rd, and 7th days were 74.3% vs. 85.7%, 67.1% vs. 85.7%, and 61.4% vs. 82.9%. On the 5rd and 7th days, the compliance of the observation group was obviously higher than that of the control group. Moreover, the mean postoperative GSES score was also significantly higher than that in the control group (23.20 ± 3.516 vs. 25.31 ± 4.583, P < 0.05, values are expressed in mean ± standard).ConclusionAPE counter system can significantly improve the compliance and self-efficacy of patients with moderate and high-risk VTE after lower limb fracture surgery.

Effects of combined spinal-epidural anesthesia on anxiety, labor analgesia and motor blocks in women during natural delivery

BACKGROUND The background of this study was analgesia in natural delivery. The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor, and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases. AIM To study the effects of combined spinal-epidural anesthesia on anxiety, labor analgesia, and motor blocks in parturients during natural delivery. METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included; a random number table approach was employed to divide the women into a control group and a joint group, with each group consisting of 60 women. The control group was given epidural anesthesia, while the joint group was given combined spinal-epidural anesthesia. The visual analog scale (VAS) was used to evaluate the degree of maternal pain. Comparisons were made between the two groups’ conditions of childbirth and the duration of labor. Apgar scores were used to evaluate the status of the newborns at birth; Self-rating Anxiety Scale (SAS) and General Self-Efficacy Scale (GSES) scores, umbilical artery blood gas analysis indices and stress indices were compared between the two groups; and the frequencies of motor block and postpartum complications were analyzed. RESULTS In comparison to the control group, in the joint group, the VAS scores for the first, second, and third stages of labor were lower (P &lt; 0.05). The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group (P &lt; 0.05). No significant differences were observed in the Apgar score, the duration of the first stage of labor, or the total duration of labor between the two groups (P &gt; 0.05). The second and third stages of labor in the joint group were shorter than those in the control group (P &lt; 0.05). When compared to the control group, the postpartum SAS score of the joint group was lower, while the GSES score was greater (P &lt; 0.05). Between the control group and the joint group, the differences observed in pH, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, or arterial hydrogen ion concentration were not significant (P &gt; 0.05). Nitric oxide, cortisol, and adrenaline levels were lower in the joint group than in the control group (P &lt; 0.05). There were no substantial differences in Bromage grade or rate of complications between the two groups (P &gt; 0.05). CONCLUSION For parturients during natural delivery, combined spinal-epidural anesthesia can reduce anxiety, provide labor analgesia, shorten labor time, and reduce postoperative stress levels but did not result in a motor block.

Combining lamotrigine tablets on students with bidirectional emotional disorders in the context of educational psychology in higher education teaching reform

BackgroundThe potential of comprehensive educational reforms, backed by principles of educational psychology, to positively impact bipolar disorder students is underexplored. Combining such strategies with medical treatment, such as risperidone, might further enhance positive psychological effects. This study hypothesizes that such a synergistic approach can optimize teaching methods and improve the mental health landscape in higher institutions.Subjects and MethodsWe utilized a mixed-methods approach in this non-randomized controlled trial. Study participants included students diagnosed with bipolar disorder across different universities and currently under risperidone treatment. Our research tools included standardized measures such as the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), as well as the General Self-Efficacy Scale (GSES). Data were collected and analyzed using SPSS23.0.ResultsA statistically significant improvement was observed in the student participants’ psychological well-being signs, attributed to the educational reform combined with risperidone treatment. These alterations demonstrated substantial improvements in YMRS and HDRS scores, manifesting reduced manic and depressive symptoms. Furthermore, higher GSES scores reflected enhanced self-efficacy.ConclusionsEducational reform that accommodates the unique learning needs of students with bipolar disorder, combined with risperidone treatment, seems to result in significant positive psychological effects. This study underscores the potentially valuable cross-disciplinary approach to addressing mental health issues within higher education institutions.

INVESTIGATION OF THE RELATIONSHIP BETWEEN PARAMEDICS' PERCEPTIONS OF SELF-EFFICACY AND MANAGEMENT OF PATIENTS WITH COPD IN THE PRE-HOSPITAL PERIOD

Objective: In this study, it was aimed to examine the relationship between paramedics' COPD (Chronic Obstructive Pulmonary Disease) patient management and their self-efficacy perceptions in the prehospital period. Methods: The research was conducted between October and November 2022 in descriptive-relational type. The sample of the study consisted of 130 students studying in the First and Emergency Aid Departments of two universities. Socio-Demographic Information Form, COPD knowledge level questionnaire and General Self-Efficacy Scale (GSE) were used in the study. Results: 63.3% of the students were women and 70.8% of them received training on chronic diseases. The mean score of COPD knowledge level of the students was found to be 8.20±2.60, and the mean total score of GSE was found to be 46.20±13.28. It was determined that the COPD knowledge level and the school variable had a significant positive effect on GSE (p&amp;lt;0.001). Conclusion: In our study, it was found that the COPD knowledge of the students was moderate and their self-efficacy was low. It was determined that the COPD knowledge level of the students was an important predictor of the GSE (p&amp;lt;0.001).

Mentorship and self-efficacy are associated with lower burnout in physical therapists in the United States: a cross-sectional survey study.

This study investigated the prevalence of burnout in physical therapists in the United States and the relationships between burnout and education, mentorship, and self-efficacy. This was a cross-sectional survey study. An electronic survey was distributed to practicing physical therapists across the United States over a 6-week period from December 2020 to January 2021. The survey was completed by 2,813 physical therapists from all states. The majority were female (68.72%), White or Caucasian (80.13%), and employed full-time (77.14%). Respondents completed questions on demographics, education, mentorship, self-efficacy, and burnout. The Burnout Clinical Subtypes Questionnaire 12 (BCSQ-12) and self-reports were used to quantify burnout, and the General Self-Efficacy Scale (GSES) was used to measure self-efficacy. Descriptive and inferential analyses were performed. Respondents from home health (median BCSQ-12=42.00) and skilled nursing facility settings (median BCSQ-12=42.00) displayed the highest burnout scores. Burnout was significantly lower among those who provided formal mentorship (median BCSQ-12=39.00, P=0.0001) compared to no mentorship (median BCSQ-12=41.00). Respondents who received formal mentorship (median BCSQ-12=38.00, P=0.0028) displayed significantly lower burnout than those who received no mentorship (median BCSQ-12=41.00). A moderate negative correlation (rho=-0.49) was observed between the GSES and burnout scores. A strong positive correlation was found between self-reported burnout status and burnout scores (rrb=0.61). Burnout is prevalent in the physical therapy profession, as almost half of respondents (49.34%) reported burnout. Providing or receiving mentorship and higher self-efficacy were associated with lower burnout. Organizations should consider measuring burnout levels, investing in mentorship programs, and implementing strategies to improve self-efficacy.

Effects of the online and offline hybrid continuous group care on maternal and infant health: a randomized controlled trial

BackgroundThe group care is a well-established maternal care model that has been widely used in many developed countries, but in China, it is confined to prenatal care services. In addition, affected by traditional birth culture, Chinese women tend to focus more on their fetuses and newborns but lack attention to their own intrapartum and postpartum care. The aim of this study was to construct and implement a prenatal, intrapartum, and the postpartum continuous group care model that combines online and offline service in Hainan Province, China, and to evaluate the effect on maternal women and newborns.MethodsThis study was a randomized controlled trial involving 144 pregnant women in a first-class tertiary general hospital in Hainan Province, China. Women were divided into an intervention group and a control group using the random number table, with 72 women in each group. The control group received routine maternal care services, and the intervention group received the continuous group care based on the routine maternal care services. Count data such as rate of cesarean section and incidence rate of fetal macrosomia were analyzed with the chi-square test or Fisher’s exact test, and the General Self-efficacy Scale scores were analyzed by repeated measures ANOVA. P < 0.05 was considered statistically significant, with two-sided probability values.ResultsCompared with the control group, the rate of excessive prenatal weight gain, cesarean section, and 42-day postpartum depression were significantly lower in the intervention group (P < 0.05), and higher General Self-efficacy Scale scores (in the expectant period and 42 days postpartum) and exclusive breastfeeding rate (42 days postpartum) (P < 0.05). The incidence of fetal macrosomia was significantly lower in the intervention group (P < 0.05). But there was no significant difference in birth weight, preterm birth, the incidence of low-birth-weight infants and 1-min Apgar score (P > 0.05).ConclusionThe continuous group care with online and offline service can effectively control the gestational weight gain, reduce the rate of cesarean section, macrosomia, and postpartum depression. It can improve the self-efficacy of women and the rate of exclusive breastfeeding effectively.Trial registrationChinese Clinical Trial Regestry (ChiCTR2200065765, 04/11/2022, Retrospectively registered).

Smartphone video games improve cognitive function in patients with chronic schizophrenia: a randomized controlled trial.

This study aimed to examine the efficacy of video games in improving cognitive function in chronic patients with schizophrenia and to evaluate the biomarker of video games for cognitive function. The patients in the game group were requested to play single-player video games on their smartphones for 1h per day, five times a week for 6weeks. Those in the control group watched television for 1h per day, five times a week for 6weeks. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Stroop Color and Word Test (SCWT). Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), General Self-Efficacy Scale (GSE), Problematic Mobile Gaming Questionnaire (PMGQ), and Patient Health Questionnaire-9 (PHQ-9). The game group demonstrated improved RBANS total score during the trial. There were no significant group effects among all SCWT scores. The game group demonstrated greater improvement on the PANSS Negative Scale, and global function (GAF score). The PMGQ scores were lower than the cutoff score at all time points in both groups. There were no significant group differences in the PHQ-9 and GSE scores. The serum BDNF levels were significantly higher in the game group following 6weeks of video game intervention. The BDNF serum levels of all participants were positively associated with the RBANS total scores. This preliminary study suggested that video games can improve cognitive function in schizophrenia patients. Serum BDNF levels may be a suitable biomarker for predicting an improvement in cognitive function in schizophrenia patients.Trial registration: This study was registered on March 11, 2021 (ChiCTR2100044113).Clinical trials: Smartphone video games improve cognitive function in patients with chronic schizophrenia; https://www.chictr.org.cn/hvshowproject.aspx?id=95623 ; ChiCTR2100044113.

Prevalence of Depression and Subjective Job Stress Among Men who have Sex with Men and Transgender Community Health Workers in Pakistan.

To determine the prevalence of depression, subjective work-related stress and associated factors among men who have sex with men and transgender people working in community-based organisations in Pakistan. Cross-sectional descriptive study. Place and Duration of the Study: Community-based organisations in Lahore, October 2022. Community-based organisations were contacted and link of the study tool in the Urdu language was shared. The study tool consisted of sociodemographic questions, substance abuse history, Patient Health Questionnaire (PHQ) 9, the General Self-Efficacy Scale (GSE), and the Subjective job stress scale (SJSS). The composite score for each scale was calculated and compared. A total of 91 men participated in the study. Of them, 52.1% were below 30 years of age. The mean PHQ-9 score was 7.62 (range 0-27), mean GSE score was 32.38 (range 12-40), and mean SJSS score was 10.48 (4-14). While 41.7% of the participants were not depressed, 31.77% had depression of at least moderate severity. About 56.52% of the study participants had an SJSS score of more than ten showing a high level of work-related stress. There is a high frequency of depression among MSM and TG community health workers. High degree of self-efficacy may protect against depression. There is a need of developing comprehensive referral systems with psychiatric units for these community workers. Community health workers, Homosexual men, Transgender, Depression.

Willingness to practice medicine and related influential factors among medical undergraduates during COVID-19: a cross-sectional study

BackgroundAs the medical undergraduates constitute the future workforce in China, their career preferences hold a significant bearing on the quality of healthcare services, particularly in light of the ongoing COVID-19 pandemic. We aim to understand the current state of the willingness to practice medicine among medical undergraduates and to analyze the related influential factors.MethodsDuring the COVID-19 epidemic, we conducted a cross-sectional survey via an online platform from February 15, 2022, to May 31, 2022, to collect participants’ demographic information, psychology, and factors influencing their career choices. The general self-efficacy scale (GSES) was used to evaluate medical students’ perceptions of their self-efficacy. Futhermore, we conducted multivariate logistic regression analyses to explore the influencing factors of medical undergraduates’ willingness to pursure a caree in medicine.ResultsA total of 2348 valid questionnaires were included, and 1573 (66.99%) were willing to practice medicine for medical undergraduates after graduation. The mean GESE scores in the willingness group (2.87 ± 0.54) were significantly higher than those of the unwillingness group (2.73 ± 0.49). The multiple logistic regression showed that several factors were positively associated with willingness to practice medicine as a career, including students’ GSES score (OR = 1.87), current major, household income, personal ideals (OR = 1.97), family support (OR = 1.44), high income (OR = 1.77), and social respect (OR = 2.19). Compared with those who were very afraid of COVID-19, students who did not express any fear towards the COVID-19 pandemic had a higher preference for choosing the medical profession as a career. Conversely, students thinking of high tension in the doctor-patient relationship, heavy workload, and long training were less likely to choose medical work after graduation.ConclusionsThe study highlights a noteworthy prevalence of medical undergraduates who expressed their willingness to pursue medicine as a career post-graduation. Several factors, including but not limited to current major, household income, psychological factors, personal preferences, and career needs or preferences, were significantly associated with this willingness. Moreover, the impact of the COVID-19 pandemic on medical students’ career choices cannot be overlooked.

Efficacy of Mobile-Based Cognitive Behavioral Therapy on Lowering Low-density Lipoprotein Cholesterol Levels in Patients With Atherosclerotic Cardiovascular Disease: Multicenter, Prospective Randomized Controlled Trial.

Elevated low-density lipoprotein cholesterol (LDL-C) is an established risk factor for atherosclerotic cardiovascular disease (ASCVD). However, low adherence to medication and lifestyle management has limited the benefits of lowering lipid levels. Cognitive behavioral therapy (CBT) has been proposed as a promising solution. This trial aimed to evaluate the efficacy of mobile-based CBT interventions in lowering LDL-C levels in patients with ASCVD. This multicenter, prospective, randomized controlled trial enrolled 300 patients with ASCVD, who were randomly assigned to the mobile-based CBT intervention group and the control group in a ratio of 1:1. The intervention group received CBT for ASCVD lifestyle interventions delivered by WeChat MiniApp: "CBT ASCVD." The control group only received routine health education during each follow-up. The linear regression and logistic regression analyses were used to determine the effects of a mobile-based CBT intervention on LDL-C, triglyceride, C-reactive protein, the score of General Self-Efficacy Scale (GSE), quality of life index (QL-index), and LDL-C up-to-standard rate (<1.8 mmol/L) at the first, third, and sixth months. Finally, 296 participants completed the 6-month follow-up (CBT group: n=148; control group: n=148). At baseline, the mean LDL-C level was 2.48 (SD 0.90) mmol/L, and the LDL-C up-to-standard rate (<1.8 mmol/L) was 21.3%. Mobile-based CBT intervention significantly increased the reduction of LDL-C change (%) at the 6-month follow-up (β=-10.026, 95% CI -18.111 to -1.940). In addition, this benefit remained when baseline LDL-C <1.8 mmol/L (β=-24.103, 95% CI -43.110 to -5.095). Logistic regression analysis showed that mobile-based CBT intervention moderately increased the LDL-C up-to-standard rates (<1.8 mmol/L) in the sixth month (odds ratio 1.579, 95% CI 0.994-2.508). For GSE and QL-index, mobile-based CBT intervention significantly increased the change of scores (%) at the 1-, 3-, and 6-month follow-up (all P values <.05). In patients with ASCVD, mobile-based CBT is effective in reducing LDL-C levels (even for those who already had a standard LDL-C) and can improve self-efficacy and quality of life. Chinese Clinical Trial Registry ChiCTR2100046775; https://www.chictr.org.cn/showproj.aspx?proj=127140.

Abstract 720: Implementation and evaluation of a mental health app with comedy content for women living with advanced cancer

Abstract Introduction: Metastatic cancer patients report elevated stress levels and unique stressors compared to other adults. This study tested the feasibility and efficacy of a mental health app with comedy content delivered to women living with advanced cancer (WLAC). Methods: The mental health platform Neolth was used as a self-guided intervention for WLAC, ages 18+ years. WLAC were recruited by The Comedy Cures Foundation through a press release, social media posts, an email newsletter, and a video call for participants on the foundation’s website. No compensation was provided to participants. After using the Neolth platform, which included watching comedy content for eight weeks, researchers evaluated engagement, and stress levels using The Perceived Stress Scale -10 (PSS-10), self-efficacy using The New General Self-Efficacy Scale (GSES), and anxiety and depression using The Hospital Anxiety and Depression Scale (HADS-A and HADS-D). Results: 54 WLAC (M = 52.2 years, R = 31-74) from 10 countries and 24 states participated by completing the baseline questionnaire. 20.5% identified as BIPOC and 33.0% had previous experience with a mental health app. 57.4% (N=31) completed the study surveys at Week 4 and Week 8. At Week 8, HADS-D scores decreased 18.1%, PSS-10 scores decreased 15.1%, HADS-A scores decreased by 9.7%, and GSES scores increased 7.6%. Participants spent an average of 116 minutes per week on Neolth with an average of 3.15 logins per week. 43.6% of time spent was completing self-guided relaxation practices and 17.2% watching Comedy Cures Foundation videos from cancer survivor Saranne Rothberg. The 30-day retention on Neolth was 100%, with 60-day retention 83%. Conclusion: This study demonstrated the ability of a mental health app with comedy content to engage and support the mental health of WLAC, presenting a cost-effective intervention. Further examination with a larger sample size is needed to conduct multivariate analyses for enhanced understanding of the role of mobile apps and comedy content in reducing stress, anxiety, and depression for WLAC. Citation Format: Saranne Rothberg, Katherine B. Grill, Claire Wheeler. Implementation and evaluation of a mental health app with comedy content for women living with advanced cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 720.