High Levels Of Distress Research Articles

Health-related quality of life and fear of progression in individuals with Li-Fraumeni syndrome.

Li-Fraumeni syndrome (LFS) is a rare autosomal dominant cancer predisposition syndrome associated with a highly elevated lifetime cancer risk. This and the recommended intense surveillance program represent a large psychological burden on families. In order to develop targeted psychosocial interventions, we conducted a needs assessment. Adults (≥18 years) with LFS were included via regular hospital visits and online support groups and newsletters. Individuals filled out a questionnaire addressing among others: fear of progression (FoP-questionnaire, short-form), health-related quality of life (HRQoL, Short-Form Health Survey-12), distress (National Comprehensive Cancer Network distress thermometer), perceived cancer risk, and aspects of surveillance adherence. Collecting data over a 14-month period (March 2020 - June 2021), 70 adults were recruited (female = 58, 82.9%; mean age = 41.53 years). With mean mental component scores (MCS) of 42.28 (SD = 10.79), and physical component scores (PCS) of 48.83 (SD = 10.46), HRQoL was low in 34.8% (physical) and 59.4% (mental) of individuals when applying a mean cut-off of 45.4 (PCS) and 47.5 (MCS) to indicate poor HRQoL. High levels of FoP and distress were present in 68.6% and 69.1% of the participants, respectively. Performing a multiple linear regression on MCS and PCS, no sociodemographic variable was shown to be significant. FoP (β = -0.33, p < 0.05) and distress (β = -0.34, p < 0.05) were significantly associated with MCS. Individuals in our sample were burdened more than expected, with the majority reporting low levels of (mental) HRQoL, high distress, and FoP. Psychosocial support is necessary to help individuals with LFS (survivors as well as "previvors") increase their HRQoL, as it is crucial to survival.

Spiritual Surrender: Initial Appraisals of Cancer Diagnoses in Black Christian Women

The basis of the meaning-making model is that distress results from discrepancies between one’s global meaning system and one’s situational appraisals of negative life events. This model suggests a preventative function for religion when religious global beliefs inform situational appraisals in ways that minimize distress. Using consensual qualitative research, we evaluated the initial reactions to a cancer diagnosis of 29 Black Christian women. We examined how the women appraised the cancer diagnosis and how this appraisal was related to reported distress. Our results indicated that lower levels of distress were related to believing that God was faithful, while higher levels of distress were related to beliefs in retributive justice and cancer as a death sentence. Lower distress was further related to spiritual surrender, a religious coping practice that combines entrusting the outcome of one’s cancer experience to God and actively pursuing treatment. We discuss spiritual surrender as a collaborative religious coping strategy and highlight its importance in informing culturally sensitive psychological interventions.

The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study

BackgroundThe COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries.MethodsData were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption.ResultsA total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50−59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%).ConclusionsSmoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.

ICare – a self-directed, interactive online program to improve health and wellbeing for people living with upper gastrointestinal or hepato-pancreato-biliary cancers, and their informal carers: the study protocol for a Phase II randomised controlled trial

BackgroundUp to 70% of people diagnosed with upper gastrointestinal (GI) tract or hepato-pancreato-biliary (HPB) cancers experience substantial reductions in quality of life (QoL), including high distress levels, pain, fatigue, sleep disturbances, weight loss and difficulty swallowing. With few advocacy groups and support systems for adults with upper GI or HPB cancers (i.e. pancreas, liver, stomach, bile duct and oesophageal) and their carers, online supportive care programs may represent an alternate cost-effective mechanism to support this patient group and carers. iCare is a self-directed, interactive, online program that provides information, resources, and psychological packages to patients and their carers from the treatment phase of their condition. The inception and development of iCare has been driven by consumers, advocacy groups, government and health professionals. The aims of this study are to determine the feasibility and acceptability of iCare, examine preliminary efficacy on health-related QoL and carer burden at 3- and 6-months post enrolment, and the potential cost-effectiveness of iCare, from health and societal perspectives, for both patients and carers.Methods and analysisA Phase II randomised controlled trial. Overall, 162 people with newly diagnosed upper GI or HPB cancers and 162 carers will be recruited via the Upper GI Cancer Registry, online advertisements, or hospital clinics. Patients and carers will be randomly allocated (1:1) to the iCare program or usual care. Participant assessments will be at enrolment, 3- and 6-months later. The primary outcomes are i) feasibility, measured by eligibility, recruitment, response and attrition rates, and ii) acceptability, measured by engagement with iCare (frequency of logins, time spent using iCare, and use of features over the intervention period). Secondary outcomes are patient changes in QoL and unmet needs, and carer burden, unmet needs and QoL. Linear mixed models will be fitted to obtain preliminary estimates of efficacy and variability for secondary outcomes. The economic analysis will include a cost-consequences analysis where all outcomes will be compared with costs.DiscussioniCare provides a potential model of supportive care to improve QoL, unmet needs and burden of disease among people living with upper GI or HPB cancers and their carers.Australian and New Zealand Clinical Trials RegistryACTRN12623001185651. This protocol reflects Version #1 26 April 2023.

Between loss and restoration: The role of liminality in advancing theories of grief and bereavement

A recent national survey of bereaved partners found high levels of complicated grief and psychological distress, with evidence that loneliness and isolation may contribute to these outcomes. However, the mechanisms of action for this have not been explored. To advance grief theory this paper reports analysis of the survey free-text data to examine the relationship between social support and emotional responses to bereavement. Individuals bereaved of a civil partner or spouse 6–10 months previously were identified through death registration data. 569/1945 (29 %) completed surveys were received. Of those, 311 participants (55 %) provided responses to two free-text questions which asked about their ‘feelings since the death of their partner or spouse’, and ‘about the support around’ them. Data were analysed using corpus-assisted discourse analysis and the discourse dynamics approach for figurative language. Participants described diverse emotional responses to the bereavement (e.g. sadness, anger, denial, acceptance), and the value of formal and informal bereavement support. Although many of the experiences described are accounted for in existing grief theory, some participants described a liminal experience not recognised within these theories. They felt trapped, unable to engage with loss or restoration, and unable to move forward as their planned future no longer existed. They sought out ‘communitas’ (solidarity in experiences), but often found support from their social networks had diminished. Metaphors were used to describe this liminality, with partner grief expressed as a dark agentic force, a monster, an abyss, and as water. The findings of this study offer original insights into experiences and trajectories of bereavement, and our understandings of prolonged or complicated grief. A novel model ‘Between Loss and Restoration’ is presented to include these experiences. Recognition of the place for liminality within the spectrum of grief experiences could enhance grief literacy and improve formal and informal bereavement support provision.

A Positive Psychology Intervention for Caregivers of Hematopoietic Stem Cell Transplantation Survivors (PATH-C): Initial Testing and Single-Arm Pilot Trial

Caregivers of patients with hematologic malignancies undergoing allogeneic hematopoietic stem cell transplantation (HSCT) play a crucial role in supporting their loved ones through physical, emotional, and practical challenges. This role has been associated with high levels of psychological distress and low levels of positive psychological well-being (PPWB). Positive psychology interventions for caregivers in other disease groups (eg, breast cancer) have been associated with improved outcomes. However, positive psychology interventions that specifically address HSCT caregivers' psychological needs are currently lacking. The goal of this single-arm open-pilot trial was to determine the feasibility and acceptability of the Positive Affect in the Transplantation of Hematopoietic Stem Cells (PATH) intervention for HSCT Caregivers to identify caregiver preferences to tailor PATH for HSCT caregivers. Adult caregivers of HSCT recipients were eligible for PATH during the HSCT recipient's first 100 d post-transplant. We defined, a priori, feasibility as >60% of participants who start the intervention completing ≥6/9 intervention sessions and acceptability as weekly ratings of ease and utility of the PP exercises ≥7/10 on a 10-point Likert Scale (0 = very difficult/not helpful; 10 = very easy/very helpful). We conducted semistructured qualitative exit interviews (n = 15) to explore HSCT caregivers' perception of PATH's content, benefits of PATH, as well as facilitators and barriers to engaging with the intervention. Transcribed interviews were analyzed using framework-guided rapid analysis by 2 coders. The intervention was feasible with 83% (15/18) of caregivers who started the intervention completing ≥6/9 intervention sessions. Among caregivers who completed ≥6/9 intervention sessions, ratings of ease (mean = 8.1; 95% CI: 7.4, 8.7) and utility (mean = 8.3; 95% CI: 7.8, 8.9) also exceeded our a priori threshold of ≥7/10. Caregivers identified benefits of PATH, including identifying and responding to emotions, dedicating time to self-care, and cultivating important relationships. Sociodemographic factors (eg, being retired) and the manualized structure of PATH were cited as facilitators to intervention engagement. Barriers to PATH engagement included lack of time and competing caregiving responsibilities. Caregivers preferred remote intervention delivery within the first 100 d post HSCT. This is the first study to show a 9-wk, phone-delivered positive psychology intervention is feasible in caregivers of allogeneic HSCT recipients. Our findings also underscore the specific preferences of this population for positive psychology interventions. Larger studies are warranted to establish the efficacy of these interventions in addressing persistent unmet psychological needs for HSCT caregivers.

Residential mobility restrictions and adverse mental health outcomes during the COVID-19 pandemic in the UK

During the COVID-19 pandemic, several governments tried to contain the spread of SARS-CoV-2, the virus that causes COVID-19, with lockdowns that prohibited leaving one’s residence unless carrying out a few essential services. We investigate the relationship between limitations to mobility and mental health in the UK during the first year and a half of the pandemic using a unique combination of high-frequency mobility data from Google and monthly longitudinal data collected through the Understanding Society survey. We find a strong and statistically robust correlation between mobility data and mental health survey data and show that increased residential stationarity is associated with the deterioration of mental wellbeing even when regional COVID-19 prevalence and lockdown stringency are controlled for. The relationship is heterogeneous, as higher levels of distress are seen in young, healthy people living alone; and in women, especially if they have young children.

Mental Health in Swiss Veterinary Medicine Students: Variables Associated with Depression Scores.

Mental health and wellbeing in veterinary students have become an important area of study, given the high levels of mental distress compared to other professions. Although research has identified poor mental health of veterinary students, few studies have examined positive factors such as self-compassion, which can have a favorable effect on mental health. The aim of this study was to examine self-reported symptoms of depression and factors influencing this construct, such as loneliness, self-compassion, and various demographic aspects in Swiss veterinary students. A sample of 374 Swiss veterinary students completed online measures including a demographic questionnaire, the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), a short form of the University of California Loneliness Scale (UCLA-9), and the short form of the Self-Compassion Scale (SCS-SF). Results showed that 54.3% of the students were above the CESD-R cut-off score for depression, indicating a higher likelihood to suffer from depression. Results from the backward selection linear regression showed loneliness to be a risk factor, while self-compassion and rural upbringing were protective of depression. Findings suggest that Swiss veterinary students are highly burdened and may benefit from interventions aimed at reducing loneliness and improving self-compassion.

Preliminary evidence for the acceptability, safety, and efficacy of the flash technique.

This study reports on four similar studies intended to explore the acceptability, safety, and efficacy of the flash technique (FT), a method of rapidly reducing the intensity of a disturbing memory or image, with minimal subjective disturbance for subjects during the process. Of the four studies, two were conducted during FT trainings in the United States, one in Australia, and one in Uganda. The studies involve pre-, post-, and follow-up repeated-measures design to determine the effectiveness of a 15-min FT intervention. A total of 654 subjects were asked to think of a disturbing memory and then participate in a structured experience of an FT. The purpose of this investigation was to determine whether a brief application of an FT would be safe and effective in significantly reducing their disturbance. In each study, subjects rated their disturbing memories on a 0-to-10 scale, with zero representing no disturbance at all and 10 representing the worst they could imagine. Then, they took part in a 15-min group practicum where they were guided in a self-administering FT with no individual supervision or support. In all four studies, the mean reduction in disturbance exceeded two-thirds, the results were significant (p < 0.001), and the effect size was very large. Of the 813 sessions (654 subjects) represented in these studies, only two subjects reported slight increases in disturbances, and both of these subjects reported reductions in disturbance in their second FT experiences 2 h later. At a 4-week follow-up, mean disturbance levels in all four studies indicated maintenance of benefit or slightly further reduction of mean disturbance levels. An 18-month follow-up study with a subgroup of subjects who initially reported a high level of memory-related distress found similar maintenance of gains as well as symptom reduction. These findings provide preliminary evidence of acceptability, safety, and efficacy of FT; therefore, further study is warranted.

Perspectives Matter: Insecure Residency Status Accounts for Aggressive Emotions in Adolescent Refugees

Unaccompanied refugees are a high-risk group for trauma-induced psychiatric disorders. Besides traumatic experiences pre- and during migration, post-migration stressors such as insecure residency status affect refugees’ mental health and foster aggressive emotions. High levels of psychological distress and psychopathology distort time perspectives. Consequently, an insecure residency status linked to distress may influence a refugee’s time perspective. This study investigated psychological distress, PTSD symptoms, aggressive emotions, and time perspectives in 33 unaccompanied adolescent refugees with and without secure residency status in Germany. Refugees with precarious residency status showed higher levels of overall distress and aggression than individuals with secure residency status. Both groups revealed a distorted time perspective profile, but individuals with a residence permit showed a stronger orientation toward the present hedonistic perspective than those without a permit. Higher aggressive emotions were related to insecure status, higher levels of psychological distress, more pronounced PTSD symptoms, and lower orientation to future time perspective. Distorted time perspectives among refugees may be caused by traumatic experiences and having been uprooted, independently of their residency status in the host country. A higher future orientation may buffer the association between distorted time perspectives and aggressive emotions in the highly stressed group of unaccompanied adolescent refugees.

The moderating effect of psychological distress in the association between temperaments and dark future among young adults

ObjectiveThe aim of the current study is to evaluate the moderating effect of psychological distress variables, depression, anxiety and stress on the relationship between affective temperaments and future anxiety, assessed with the Dark Future scale.MethodsLebanese adults from all districts/governorates of Lebanon participated in this cross-sectional study. The data was collected through a questionnaire including: a section about sociodemographic characteristics, the Dark Future scale (DFS), the Depression Anxiety Stress Scale (DASS-8) and the Affective Temperament Scale (TEMPS-M).ResultsThe interaction irritable temperament by psychological distress (p = .007) was significantly associated with dark future; at low levels of psychological distress, more irritable temperament (Beta = 0.16) was significantly associated with more dark future. The interaction anxious temperament by psychological distress (p = .010) was significantly associated with dark future; at low (Beta = 0.34), moderate (Beta = 0.25) and high (Beta = 0.15) levels of psychological distress, more anxious temperament was significantly associated with more dark future.ConclusionThe nature of the associations among depression, anxiety and stress, specific temperaments and anxiety towards the future in a sample of Lebanese individuals was clarified. This is especially significant as Lebanese people live in circumstances that promote psychological distress and future anxiety such as dramatic economic and political crises, instability and lack of security in different aspects of life.

Intent to stay, moral distress, and nurse practice environment among long-term care nurses: A cross-sectional questionnaire survey study.

Many long-term care facilities in the United States face significant problems with nurse retention and turnover. These challenges are attributed, at least in part, to moral distress and a negative nurse practice environment. The purpose of the study was divided into two parts: first, to investigate the relationships among nurse practice environment, moral distress, and intent to stay; second, to explore the potential mediating effect of the nurse practice environment on the intent to stay among those with high levels of moral distress. This study was a descriptive, cross-sectional survey using targeted sampling. A total of 215 participants completed the surveys. Participants were nationally representative of long-term care nurses by age, years of experience, employment status, and type of health setting. This study was an online national survey of long-term care nurses' perceptions of their intent to stay, moral distress level (Moral Distress Questionnaire), and nurse practice environment (Direct Care Staff Survey). Structural equation modeling analysis explored intent to stay, moral distress, and the nurse practice environment among long-term care nurses. The mean moral distress score was low, while the mean nurse practice environment and intent to stay scores were high. Moral distress had a significant, moderately negative association with the nurse practice environment (β = -0.41), while the nurse practice environment had a significant, moderately positive association with intent to stay (β = 0.46). The moral distress had a significant, moderately negative association with intent to stay (β = -0.20). The computed structural equation modeling suggested a partially mediated model (indirect effect = -0.19, p = 0.001). Since the nurse practice environment partially mediates the relationship between moral distress and intent to stay, interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession. Our study demonstrated that the nurse practice environment mediates moral distress and intent to stay. Interventions to improve the nurse practice environment are crucial to alleviating moral distress and enhancing nurses' intent to stay in their jobs, organizations, and the nursing profession.

Psychological Distress, Adaptive Coping Mechanism, and Well-Being of Junior High School Students in Public Schools

This study investigated various aspects of psychological distress, adaptive coping mechanisms, and well-being among junior high school students in public schools within General Santos City. The researchers employed a descriptive-correlational research design, administering a researcher-developed questionnaire to students from four prominent public high schools. Statistical analyses included the use of mean, standard deviation, and Pearson's r correlation. The findings indicate that junior high school students experience high levels of psychological distress. Although the overall impact of contributing factors is low, specific factors such as excessive use of technology or social media and concerns about post-junior high school futures were notably significant. Despite experiencing high levels of psychological distress, students reported using adaptive coping mechanisms and maintaining a high level of well-being. A significant relationship was also identified between psychological distress and student well-being. Based on these findings, the researchers recommend the implementation of tailored mental health intervention programs to address the specific challenges faced by students in public high schools. Such programs could enhance student well-being, mitigate long-term issues, and provide support for school counselors, teachers, and mental health advocates. The study's results offer a foundation for developing practical interventions to improve the mental well-being of junior high school students in public schools, thereby promoting a healthier and more supportive educational environment.

Adapting amidst waves: Psychological symptoms and coping in Israeli pandemic

This paper aims to present research findings on psychological symptoms and coping strategies concerning the COVID-19 pandemic in Israel. The aim of the study was to compare distress levels and coping strategies among Israeli citizens during the first (W1) and third (W3) COVID-19 waves, hypothesizing that distress and concern about contracting the virus would decline over time, reflecting more adaptive coping strategies. A cross-sectional study using online surveys involved two groups of Israelis (n=558 in W1 and n=501 in W3). Higher levels of distress and concern about contracting the virus were found among W3 participants compared to W1. Regression analysis indicated that female sex, financial concerns, and younger age were predictors of distress. Emotion-focused coping was lower in W3 but more strongly associated with distress than in W1, while problem-focused coping increased. The findings highlight the need to support individuals before future lockdowns to reduce distress. Vulnerable groups, such as females, younger individuals, and those with financial concerns, require targeted interventions during ongoing and future public health crises.

Applying the Z-Score Model to Predict Corporate Financial Distress: An Empirical Research on the Listed Firms in Vietnam Stock Market

Assessing the risk of financial distress is an important component of effective management because it helps companies make right financial decisions, avoid potential risks and improve business operations. This study provides more empirical evidence on the role of the Z-Score model in predicting financial distress of companies in emerging markets like Vietnam. This research paper uses data from 30 companies that delisted on UPCOM due to financial distress and 30 companies with Z-score greater than 4.35 on Ho Chi Minh City Stock Exchange (HoSE) for 5 years from 2018 to 2022, corresponding to 300 observations. The selected companies have enough audited financial statement data during the research period which are collected from websites such as cafef.vn, vietstock.vn, and websites with data on companies’ financial statements. The financial factors are taken from the balance sheet and income statement by the authors to calculate the Z-Score. The authors use the Independent-samples T-test with data collected delisted companies due to financial distress and stably listed firms on the Vietnam Stock Market to test whether there is a difference in Z-score and independent variables in the Z-score model between these two groups of companies. The research results show that, there is a significant difference in the Z-score and the factors in the Z-Score model between the group of listed companies and the group of delisted companies, and between companies with low level of financial distress and those with high level of financial distress. From the findings obtained, the authors have made suggestions and recommendations for relevant parties such as the State Securities Commission of Vietnam, users of financial statements, and companies in order to contribute to preventing and limiting the risk of corporate financial distress in the most effective way.

A cross- sectional study of refugees in Norway and Serbia: Levels of mental distress and social-demographic risk factors

This cross-sectional study has assessed and compared symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) among one refugee group during flight (in Serbia) and another refugee group after flight (in Norway). Results indicate high levels of mental distress in both samples of refugees (Serbia: N = 100, Norway: N = 78). Participants in Serbia reported higher levels of symptoms than the participants in Norway. Moreover, the study found that female gender, low education, refused asylum, high age, and concerns about family correlated with mental distress among the participants.

Study of socio-clinical risk factors and assessment of metabolic syndrome and Risk of Cardiovascular Events in Patients With polycystic ovary syndrome

Background and Aims: More than 1.55 million women of reproductive age have polycystic ovary syndrome (PCOS) in the world; PCOS is an important disease threatens public health, linked to psychological, metabolic, and reproductive problems. The aim of our work was an evaluation of some risk factors, oxidative stress and Cardiovascular Risk among PCOS Women in El-Oued region. Methods: Our risk factor study was conducted on a group of 200 women who were diagnosed by specialized doctors (100 healthy and 100 polycystic ovaries), with 50 women volunteering to provide blood and saliva samples to study the blood glucose, Atherogenic index, lipids profile, hematological and oxidative stress markers. Results: About risk factors study, our results showed that the high levels of Psychological distress, Menstrual fluctuation and year of taking pills are the most dangerous factors (OR=3.11; OR=9.205; OR=5.940) respectively. Our result demonstrated a significant increase (P &gt; 0.05) in blood glucose, total cholesterol, Triglycerides, VLDL, Atherogenic index and sedimentation rate, MDA and SOD levels and a significant decreased (P &gt; 0.01) in HDL, WBC (P &lt; 0.000), MCV (P &lt; 0.05) HGB, RBC, CMH, CMH level in women with PCOS patients as compared to controls. Conclusions: In conclusion, several social and nutritional factors contributed to the spread and development of PCOS in El-Oued region. In addition to a change in blood components, lipid profile Atherogenic index and their relationship to oxidative stress, which contributes to metabolic syndrome development and the occurrence of cardiovascular complication in women with PCOS.

Effectiveness of group problem management plus in distressed Syrian refugees in Türkiye: a randomized controlled trial.

Despite high levels of psychological distress, mental health service use among Syrian refugees in urban settings is low. To address the mental healthcare gap, the World Health Organization developed group problem management plus (gPM+), a scalable psychological intervention delivered by non-specialist peer facilitators. The study aimed to evaluate the effectiveness of gPM+ in reducing symptoms of depression and anxiety among Syrian refugees in Istanbul, Türkiye. A randomized controlled trial was conducted among 368 distressed (Kessler Psychological Distress Scale, K10 > 15) adult Syrian refugees with impaired functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16). Participants were recruited between August 2019 and September 2020 through a non-governmental organization providing services to refugees. Participants were randomly allocated to gPM+ and enhanced care as usual (gPM+/E-CAU) (184 participants) or E-CAU only (184 participants). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist (HSCL-25)) at 3-month follow-up. Secondary outcomes were post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5; PCL-5), functional impairment (WHODAS 2.0), and self-identified problems (psychological outcome profiles). Intent-to-treat analyses showed no significant effect of gPM+ on symptoms of anxiety, depression, PTSD and self-identified problems. Yet, there was a significant reduction in functional impairment in gPM+/E-CAU compared to E-CAU at 3-month follow-up (adjusted mean difference 1.66, 95 % CI 0.04, 3.27, p = 0.045, d = 0.19). Post-hoc subgroup analyses among participants with probable baseline depression or anxiety showed that there was a small but significant reduction in depression (adjusted mean difference -0.17, 95 % CI -0.32, -0.02, p = 0.028, d = 0.27) and anxiety (adjusted mean difference -0.21, 95 % CI -0.37, -0.05, p = 0.009, d = 0.30) symptoms comparing gPM+/E-CAU to E-CAU only at 1-week post assessment, but not at 3-month follow-up. There was a significant difference between conditions on functional impairment at 3-month follow-up, favouring gPM+/E-CAU condition (adjusted mean difference -1.98, 95 % CI -3.93, -0.02, p = 0.048, d = 0.26). In this study in an urban setting in Türkiye, gPM+ did not alleviate symptoms of depression and anxiety among Syrian refugees experiencing psychological distress and daily living difficulties. However, participants with higher distress at baseline seemed to benefit from gPM+, but treatment gains disappeared in the long term. Current findings highlight the potential benefit of tailored psychosocial interventions for highly distressed refugees in volatile low-resource settings.

Patient Outcomes of a Virtual Reality-Based Music Therapy Pilot in Palliative Care.

Hospitalized patients with palliative care needs often have high levels of physical and psychological symptom distress. Virtual reality (VR) with a music therapy intervention may improve physical and psychological symptoms. To assess symptom distress and quality of life (QOL) among hospitalized palliative care patients who participated in a virtual reality-based music therapy (VR-MT) intervention, and to explore VR-MT from the perspectives of health care professionals involved in their care. Single-arm pilot study of a two-day VR-MT intervention. Patients seen by an inpatient palliative care consultation service at a U.S. hospital could participate in the VR-MT intervention. Participants created a customized soundtrack with a music therapist and then listened to it while experiencing a 360-degree VR nature-based environment of their choice. Patients completed the Edmonton Symptom Assessment System, revised version (ESAS-r) and McGill Quality of Life, revised version (MQOL-R) before and after VR-MT. Members of the participants' health care teams were interviewed. Seventeen patients completed VR-MT (range 20-79 years of age, 59% women). Moderate clinical improvements were observed for total ESAS-r score (Cohen's d effect size, 0.68), physical distress subscale (0.52), and psychological distress subscale (0.60); small improvements were observed in total MQOL-r score (0.26) and the existential subscale (0.27). Health care team members described the value of VR-MT as facilitating meaningful conversations. This pilot study of VR combined with a music therapy intervention for hospitalized patients with palliative care needs supports opportunities for future study of potential improvements in symptom distress and QOL.

Factors Associated with Psychological Distress, Fear, and Coping Strategies during the COVID-19 Pandemic in Thailand: A Cross-Sectional Study.

Despite being initially perceived as a local infectious disease, COVID-19 has emerged as one of the most perilous global health threats, significantly impacting the psychological well-being of individuals worldwide. This cross-sectional descriptive study investigates the psychological distress, fear, and coping mechanisms among Thai people residing in Thailand during the COVID-19 pandemic. This online cross-sectional survey targeted Thai individuals during the first and third waves of the COVID-19 pandemic. Participants aged 18 and above who provided consent self-reported their responses to the Kessler Psychological Distress Scale, Fear of COVID-19 Scale, and Brief Resilient Coping Scale. Data collection occurred between November 2020 and January 2021 across four regions of Thailand. Univariate and multivariate logistic regression analyses explored associations between contextual factors and the variables of interest. Out of 498 survey respondents, with an average age of 43.07 (SD = 13.69) years, 81.9% were female, and 61.6% self-identified as healthcare workers, with 47.59% identified as frontline healthcare workers. Findings revealed that 46% of participants experienced moderate-to-very high levels of psychological distress, 14.3% reported high levels of fear of COVID-19, and 35.1% exhibited low resilient coping. Factors such as changes in employment status or financial situations, comorbidities, contact with known or suspected COVID-19 cases, recent healthcare utilization for COVID-19-related stress, and elevated fear of COVID-19 were associated with higher levels of psychological distress. Conversely, being nurses and perceived better mental health status were linked to more effective coping strategies. These results emphasize the critical importance of government interventions to safeguard the psychological well-being of healthcare workers and the broader Thai population. Urgent measures to bolster resilience among these groups during and after the pandemic are imperative.