High Levels Of Distress Research Articles

The Effect of Emotional Techniques in Reducing Psychological Distress among Orphan Female Secondary School Students

The current research aims to verify the ineffective effects in removing psychological distress among orphan female secondary school students in schools in Basrah Governorate. In order to apply these goals to the field of study and application, and to achieve the objectives of this study, the two researchers built a scale of psychological distress based on the definition of Pearlin (1983) and built a counseling program based on emotional techniques to reduce psychological distress, taking into account the scientific steps to build measurement tools and verify the face validity and construct validity as well as the validity of the confirmatory factor analysis and extracting psychometric properties and calculating reliability in two ways. It was found that the value of the Cronbach’s alpha reliability coefficient was (0.72) and by the retest method was (0.84).After applying the scale to the final sample of (267) and analyzing the data using the statistical package (SPSS), the results of the study showed that there was high psychological distress among the research sample. Based on this result, a purposive sample of (20) female students who obtained the highest scores on the scale was drawn. And according to the type of experimental design adopted in the research, the experiment sample was distributed into two groups, experimental and control, in a random manner, with (10) female students in each group. The experimental group was then subjected to treatment using emotional techniques, and the treatment was withheld from the control group. After the end of the experiment period, (14) sessions were provided, two sessions per week. The researchers processed the pre- and post-measurement data for the two groups by adopting the Wilcoxon rank-sum test for two correlated samples and the Kruskal-Wallis test. The results of the post-measurement for the experimental group showed a noticeable decline compared to the results of the pre-measurement for the same group and the results of the post-measurement for the control group whereas the control group maintained a high level of psychological distress in the pre- and post-measurements. The results of the scientific experiment demonstrated the effect of emotional techniques in making change in reducing psychological distress among the experimental group, achieving the general goal of the program. In light of these results, the research concluded with a set of recommendations and suggestions.

Prevalence and Correlates of Depressive Symptoms among Patients with Cancer: A Cross-Sectional Study.

The purpose of this study was to identify the correlates of depressive symptoms and the prevalence of depression, distress, and demoralization among patients with cancer in Taiwan in relation to their sociodemographics. A cross-sectional study design with convenience sampling was used to recruit 191 consecutive patients with cancer from the Cancer Center of a teaching hospital in northern Taiwan. Multiple linear regression was applied to analyze the determinants of depressive symptoms. The prevalence rates of depression (including suspected cases), distress, and demoralization were 17.8%, 36.1%, and 32.5%, respectively. The regression model explained 42.2% of the total variance, with significant predictors including marital status, life dependence, comorbidity, demoralization, and distress. The results demonstrated that higher levels of distress and demoralization were associated with more depressive symptoms. Demoralization and distress played vital roles in moderating depressive symptoms among patients with cancer. Nursing interventions should integrate appropriate mental health services, such as alleviating distress and demoralization, to prevent the occurrence of depression in patients with cancer.

Feasibility of Early Assessment for Psychological Distress: HRV-Based Evaluation Using IR-UWB Radar.

Mental distress-induced imbalances in autonomic nervous system activities adversely affect the electrical stability of the cardiac system, with heart rate variability (HRV) identified as a related indicator. Traditional HRV measurements use electrocardiography (ECG), but impulse radio ultra-wideband (IR-UWB) radar has shown potential in HRV measurement, although it is rarely applied to psychological studies. This study aimed to assess early high levels of mental distress using HRV indices obtained using radar through modified signal processing tailored to reduce phase noise and improve positional accuracy. We conducted 120 evaluations on 15 office workers from a software startup, with each 5 min evaluation using both radar and ECG. Visual analog scale (VAS) scores were collected to assess mental distress, with evaluations scoring 7.5 or higher classified as high-mental distress group, while the remainder formed the control group. Evaluations indicating high levels of mental distress showed significantly lower HRV compared to the control group, with radar-derived indices correlating strongly with ECG results. The radar-based analysis demonstrated a significant ability to differentiate high mental distress, supported by receiver operating characteristic (ROC) analysis. These findings suggest that IR-UWB radar could be a supportive tool for distinguishing high levels of mental stress, offering clinicians complementary diagnostic insights.

Comparison of outcomes from a university counselling service before and during COVID‐19: Exploring the use of remote therapy

AbstractBackgroundResearch pooling data from UK university counselling services (UCSs) has allowed UCSs to compare their outcomes and demonstrate their effectiveness in improving student mental health. During the COVID‐19 pandemic, UCSs moved to remote delivery. Consequently, it was necessary to understand how this impacted students' outcomes.AimsThis evaluation aimed to (1) understand how the therapeutic outcomes of a UCS compared with established norms in UK UCS literature, and (2) understand whether delivering therapy online affected student outcomes compared with UK norms from in‐person therapy.MethodSessional outcome data from 627 students who attended the UCS in the 2020/2021 academic year were gathered. Descriptive analyses of students' initial clinical data (determined by the CCAPS‐34) were conducted. Paired sample t‐tests determined differences between the pre‐ and post‐therapy scores. The effect size of this difference was derived.ResultsStudents presented with high levels of academic distress, social anxiety, generalised anxiety and depression. The initial severity of mental health concerns was lower than that reported in previous literature. The largest improvements were evidenced for depression and general anxiety and 25% (n = 112) of students achieved reliable reductions in distress. Compared with existing literature, the UCS showed similar levels of improvement over therapy. It is suggested that remote therapy increased service accessibility.ConclusionThe delivery of remote therapy produced results consistent with norms in the UK data, highlighting the effectiveness of online therapy for university students. Further large‐scale evaluations of student outcomes from remotely delivered therapy are recommended.

Abstract B158: Sources of support and strain in Latino patients with advanced cancer and their family caregivers

Abstract Background: Latino patients with advanced cancer and their caregivers are an understudied and underserved population that experiences high levels of psychological distress and impaired quality of life. As part of a larger effort to culturally adapt a mindfulness intervention for this population, this study qualitatively explored sources of support and strain, with a particular focus on the social context, among Latino patient-caregiver dyads undergoing cancer treatment. Methods: Twenty Latino patients undergoing treatment for a metastatic solid malignancy and their family caregivers were recruited from a county hospital and participated in semi-structured interviews. Interviews were conducted by a trained, bilingual and bicultural staff member and explored participants’ cancer-related experiences, psychosocial needs, and sources of support. Interviews were digitally recorded, transcribed verbatim by a professional external vendor, and translated into English, where applicable. Atlas.ti was used to conduct a thematic descriptive analysis. Results: Patients (55% male) and caregivers (60% female) were predominantly born outside the U.S. (93%) and reported low levels of education (59% < high school graduate) and income (63% household income < $30,000). Preliminary analyses revealed how family can be both an important source of support and strain. Many participants described how the cancer diagnosis brought the family closer while others shared negative experiences including discrimination and distancing by family members. Participants’ religious faith, their church community, friends, work colleagues, and other cancer patients were highlighted as additional sources of support. Reported strains included financial stress (e.g., loss of income, healthcare costs, transportation costs), changes in household dynamics and family roles, and challenges navigating healthcare. In particular, caregivers reported strains managing work, family responsibilities, and caregiving tasks with limited resources. Ongoing analyses are examining differences between caregivers and patients and men and women. Male patients in particular expressed despair over the inability to work and the impact this had on their self-identity and perceived burden to others. Conclusion: Participants emphasized the important role of family and religion as a way of coping with the cancer diagnosis and related challenges. Stress associated with economic challenges and changes in family roles was prevalent and appeared to contribute to depression and anxiety. In conclusion, study findings highlight key sources of support and strain among Latino patient-caregiver dyads that can inform culturally relevant and equity-based cancer-related interventions. Citation Format: Larkin L. Strong, Josheili Llavona-Ortiz, Hilary Ma, Maria E. Fernandez, Elizabeth Dominguez, Rosangela Silva, Jaquelin Hernandez, Kathrin Milbury. Sources of support and strain in Latino patients with advanced cancer and their family caregivers [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B158.

Testing the Effectiveness of a Mobile Smartphone App Designed to Improve the Mental Health of Junior Physicians: Protocol for a Randomized Controlled Trial.

Shift (Black Dog Institute) is the first mobile health smartphone appcreated to support the mental health of junior physicians. Junior physicians experience demanding work conditions, leading to high levels of psychological distress and burnout. However, they are often concerned about the potential career impacts of seeking mental health support. The confidentiality and ease of access of digital interventions may be particularly suited to address these concerns. The Shift app provides therapeutic and psychoeducational content and strategies contextualized for the specific needs of physicians in training. App content includes information on mental health, help seeking, mindfulness, and common workplace-related concerns of junior physicians. This study aims to test, at scale, the effectiveness of Shift among junior physicians working in Australia using a randomized controlled trial design. The primary aim is to examine whether junior physicians using Shift experience a reduction in depressive symptoms compared with a waitlist control group. The secondary aim is to examine whether the app intervention group experiences improvements in anxiety, work and social functioning, help seeking, quality of life, and burnout compared with the control group. A total of 778 junior physicians were recruited over the internet through government and nongovernment medical organizations across Australia, as well as through paid social media advertisements. They were randomly allocated to one of 2 groups: (1) the intervention group, who were asked to use the Shift app for a period of 30 days, or(2) the waitlist control group, who were placed on a waitlist and were asked to use the app after 3 months.Participants completed psychometric measures for self-assessing mental health and wellbeing outcomes, with assessments occurring at baseline, 1 month after completing the baseline period, and 3 months after completing the baseline period. Participants in the waitlist control group were asked to complete an additional web-based questionnaire 1 month after receiving access to the app or 4 months after completing the baseline survey. Participants took part in the study on the internet; the study was completely automated. The study was funded from November 2022 to December 2024 by the New South Wales Ministry of Health. Data collection for the study occurred between January and August 2024, with 780 participants enrolling in the study during this time. Data analysis is underway; the effectiveness of the intervention will be estimated on an intention-to-treat basis using a mixed-model, repeated measures analysis. Results are expected to be submitted for publication in 2025. To the best of our knowledge, this is the first randomized controlled trial to examine the effectiveness of a mobile health smartphone app specifically designed to support the mental health of junior physicians. Australia and New Zealand Clinical Trials Registry ACTRN12623000664640; https://tinyurl.com/7xt24dhk. DERR1-10.2196/58288.

Screening for psychological distress in childhood and mental health-related hospital attendance among young adults

ObjectivesThe prevalence of mental disorders is high and increasing among children and young people. Investigating the relationship between self-reported poor mental health and mental health service utilisation can provide evidence on the benefits of universal screening, but longitudinal data is rare. ApproachData from a nationally representative English cohort (Next Steps) were linked to NHS Hospital Episode Statistics. GHQ-12 assessed psychological distress in Next Steps at age 15; participants were followed until their first mental health-related hospital presentations or were censored at the end of the study (age 27). Cox proportionate hazard models with survey weights estimated associations. ResultsOut of 4058 young people included in the analyses, 19% reported high levels of distress at age 15. During the 12-year follow-up, 5.3%, 2.9% and 2.7% of the participants had at least one mental disorder, drug/alcohol misuse and self-harm presentation, respectively, and 4.2% had a mental health treatment. Higher GHQ-12 scores were associated with mental disorder presentations (HR=1.10, 95% CI:1.04-1.16), and mental health treatments (HR=1.14, 95% CI:1.08-1.20). Associations were weaker for young people living in deprived areas, or if their main parent had lower education. ConclusionsAdolescent psychological distress predicts subsequent hospital attendance in young adulthood, but there are treatment gaps in service utilisation among more disadvantaged individuals. Detecting youth with mental health difficulties through universal screening, may facilitate early intervention, improve life-course outcomes, and reduce secondary healthcare use. ImplicationsLinked cohort and administrative data can improve our understanding on long-term healthcare utilisation and treatment needs.

Predicting cannabis use moderation among a sample of digital self-help subscribers: A machine learning study

BackgroundFor individuals who wish to reduce their cannabis use without formal help, there are a variety of self-help tools available. Although some are proven to be effective in reducing cannabis use, effect sizes are typically small. More insight into predictors of successful reduction of use among individuals who frequently use cannabis and desire to reduce/quit could help identify factors that contribute to successful cannabis use moderation. MethodsWe analyzed data taken from a randomized controlled trial comparing the effectiveness of the digital cannabis intervention ICan to four online modules of educational information on cannabis. For the current study, we included 253 participants. Success was defined as reducing the grams of cannabis used in the past 7 days at baseline by at least 50 % at 6-month follow-up. To train and evaluate the machine learning models we used a nested k-fold cross-validation procedure. ResultsThe results show that the two models applied had comparable low AUROC values of .61 (Random Forest) and .57 (Logistic Regression). Not identifying oneself as a cannabis user, not using tobacco products, high levels of depressive symptoms, high levels of psychological distress and high initial cannabis use values were the relatively most important predictors for success, although overall the associations were not strong. ConclusionsOur study found only modest prediction accuracy when using machine learning models to predict success among individuals who use cannabis and desire to reduce/quit and show interest in digital self-help tools.

Parental Stress and Psychological Distress and Their Association With Spousal Support Among Parents of School-Age Children During the COVID-19 Pandemic in South India: A Cross-Sectional Observational Study.

The COVID-19 pandemic presented unprecedented challenges to families in the form of social isolation, economic difficulties and inaccessibility of educational and supportive services. To assess the levels of parental stress and psychological distress among parents of school-age children during the COVID-19 pandemic and to analyse its correlation with spousal support. A cross-sectional, web-based study was conducted among the parents of school-age children in south India. One hundred thirty-two completed responses were obtained. Study tools included Parental Stress Scale, Spouse Support Scale and Kessler's psychological distress scale-6 item version. The mean parental stress score was 42.39 ± 9.679. Sixty percent of the participants reported moderate to high levels of psychological distress. Parental stress and psychological distress scores were noted to have a significant negative correlation with spousal support scores (r=-.486, p=.000 and r=-.401, p=.000 respectively). Our study findings show that the COVID-19 pandemic has taken a toll on the psychological well-being of parents of school-age children. Supportive interventions to address parenting difficulties need to be undertaken to prevent long-term adverse mental health outcomes. Lessons learnt from the pandemic are important for clinicians and policymakers to take measures to alleviate parental stress as well as to promote the psychological well-being of parents and children.

Psychometric properties of the German versions of the Problem Areas in Diabetes Scale for Children (PAID-C) with Type 1 Diabetes and Their Parents (P-PAID-C).

Children with Type 1 diabetes (T1D) and their parent-caregivers often experience diabetes distress due to the daily demands of diabetes management. Regular screening for diabetes distress is needed to prevent the deterioration of metabolic control and the development of mental health disorders. The aim of this analysis was to examine the psychometric properties of the German versions of the Problem Areas in Diabetes Scale for Children (PAID-C) and for caregiver burden in Parents (P-PAID-C). Data were collected from 136 children aged 7-12 years (46.7% females) and 304 parents (Mage = 42.9 (SD 6.1) years; 78% mothers) by using linguistically translated questionnaires in a multicenter study. Confirmatory factor analysis and correlational analyses were conducted. Results confirmed the two-factor model for the PAID-C and the four-factor model for the P-PAID-C with a slight modification. Cronbach's αs for children and parents were 0.88 and 0.92, respectively. The PAID-C and P-PAID-C scores had small positive associations with HbA1c (rs = .220 and .139, respectively, all p < .05) and strong inverse association with the KIDSCREEN-10 index (r = -.643 and -.520, respectively, all p < .001). P-PAID-C scores increased with increasing depressive symptoms measured in nine-item Patient Health Questionnaire among parents (rs = .534, p < .001). The scores produced by the German PAID-C and P-PAID-C were reliable and valid in measuring diabetes burdens. These German versions of PAID can be utilized to assess diabetes-specific distress and to design interventions for children and their parents experiencing high levels of diabetes distress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Wellbeing in stroke and aphasia (WISA): protocol for a feasibility study setting up an accessible service offering psychological therapy to people with post-stroke aphasia

Background and aimFollowing a stroke, around a quarter of people will have aphasia, a language disability. Aphasia can have a devastating long-term impact on a person’s psychological wellbeing, yet their language difficulties make it challenging to access mental health care. The Wellbeing In Stroke and Aphasia (WISA) study aims to evaluate the feasibility of setting up an accessible psychological service for people with aphasia.MethodsThe service will be open to people with post-stroke aphasia (n = 30) who live in the UK, are able to access the service either in the university clinic or via telehealth and are not currently receiving therapy from a mental health professional. Participants will be offered up to 8 therapy sessions over 6 months, either one-to-one, with family, or in a group. The intervention is Solution Focused Brief Therapy (SFBT), a brief psychological therapy, delivered by speech and language therapists with training in SFBT under the supervision of a stroke-specialist clinical psychologist. As part of this service, a protocol for addressing mental health care has been developed. Feasibility will be assessed by monitoring referral rates, therapy received, discharge processes, resource capability, costs, challenges, and adverse events. Patient-reported outcome measures collected pre and post intervention will assess mental wellbeing, mood, participation, and satisfaction with therapy and the service. A purposive sample will take part in in-depth interviews following therapy.DiscussionGiven the high levels of psychological distress in this client group, there is a need to investigate innovative ways to provide accessible and acceptable psychological support.

Virtual reality vs. Tablet video for venipuncture education in children: A randomized clinical trial.

Pediatric patients usually experience high levels of pain and distress due to venipuncture. This randomised study aimed to evaluate the effects of virtual reality-based preprocedural education in comparison with video-based education in terms of pain and distress experienced by children scheduled to undergo venipuncture. Ninety children aged 4-8 years who were scheduled to undergo venipuncture surgery were randomly assigned to either a video or virtual reality group. Children in the video group received preprocedural education on venipuncture via a video displayed on a tablet and those in the virtual reality group received the same education via a head-mounted virtual reality display unit. The educational content for the two groups was identical. An independent assessor blinded to the group assignment observed the children's behavior and determined their Children's Hospital of Eastern Ontario Pain Scale scores, parental satisfaction score, procedure-related outcomes, venipuncture time, number of repeated procedures and difficulty score for the procedure. The virtual reality group experienced less pain and distress, as indicated by their Children's Hospital of Eastern Ontario Pain Scale scores compared with the video group (5.0 [5.0-8.0] vs. 7.0 [5.0-9.0], P = 0.027). There were no significant intergroup differences in parental satisfaction scores or procedure-related outcomes. For pediatric patients scheduled to undergo venipuncture, preprocedural education via a head-mounted display for immersive virtual reality was more effective compared with video-based education via a tablet in terms of reducing pain and distress.

Distress reactions and susceptibility to misinformation for an analogue trauma event

Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film’s reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted.

Emotional well-being among community mental health professionals during COVID-19: an exploratory study

ABSTRACT This paper presents a study related to burnout and well-being deriving from professional practice in community mental health services. The sample consisted in 133 workers from the public mental health system of Barcelona (Spain). An ad-hoc questionnaire was used, and data was analyzed from a descriptive approach. The results reveal a high level of emotional distress and exhaustion related to professional practice that prevents from job satisfaction and affects work quality. Furthermore, the pandemic led to an increase in distress related to work in that field. Finally, the limitations of the study and directions for future research are raised.

Symptoms, distress, finances, social support, resource utilization, and unmet care needs of patients with gynecological cancer

PurposeThis study explored the unmet care needs of gynecological cancer patients, including overall and subdomain needs (i.e., physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and information needs), and related factors. MethodsIn this cross-sectional study, gynecological cancer patients treated at a medical center in northern Taiwan were recruited. Data on demographics, symptoms, distress, finances, social support, resource utilization, and care needs were collected. Spearman's correlation and the Mann–Whitney U test were used for analysis. ResultsThis study of 118 cancer patients found that 73% had unmet psychological and emotional needs, followed by 54% with unmet health system and information needs. The most common physical symptoms were insomnia, fatigue, and pain, with 51.7% experiencing moderate or high levels of distress. Overall, the patients received considerable social support, both instrumental and emotional, primarily through medical information booklets (39.0%), cancer information websites (28.8%), and rehabilitative resources (20.3%). Factors associated with unmet care needs included younger age, non-ovarian cancer, symptoms (pain, fatigue, appetite loss, insomnia, dyspnea, nausea, and vomiting), distress, finances, social support, and the use of cancer information websites. ConclusionPsychological and emotional unmet needs is prevalent among patients with gynecological cancer; psychological support is crucial. Younger patients and those with non-ovarian cancer had more unmet care needs. These needs are linked to severe symptoms, distress, financial difficulties, limited social support, and low use of cancer information websites. Enhancing support for this population through targeted interventions is necessary.

Identifying phenotypes in persons with temporomandibular disorders, using latent class analyses: Temporomandibular disorders and phenotypes.

The heterogeneity of persons with temporomandibular disorders (TMD) and the lack of effective treatments have called for a biopsychosocial model and the development of a more personalised treatment approach. Emphasis on phenotypes might be a beneficial approach. Identifying phenotypes among persons with TMD using potential prognostic factors, including personal characteristics and responses to clinical tests. Additionally, examining the distribution of TMD diagnoses within the identified phenotypes. A cross-sectional study including 208 persons (85% females) seeking physiotherapy for problems in the temporomandibular area. All participants were examined clinically and answered questionnaires electronically. The phenotypes were identified using latent class analysis based on seven potential prognostic factors selected within pain, function and psychological domains. Table analysis was used to explore the distribution of TMD diagnoses within the identified phenotypes. Most participants fit into one of three identified phenotypes. Phenotype 1 (32%) was characterised by functional disability, low psychosocial scores and low risk for developing chronicity and future work disability; Phenotype 2 (29%) by parafunctional habits, low psychosocial score and seeking treatment to reduce pain; and Phenotype 3 (39%) by high levels of mental distress, fear avoidance and a large risk of future work disability. Intra-articular disorders dominated Phenotype 1, myalgia and TMD-related headache Phenotype 2, while Phenotype 3 included all the different TMD diagnoses. The knowledge about the three identified phenotypes might be useful for clinicians treating persons with TMD and for the development of preventive strategies and more personalised treatment.

Level of patient contact and Impact of Event scores among Canadian healthcare providers during the COVID-19 pandemic

BackgroundHealthcare providers (HCP) continue to provide patient care during the COVID-19 pandemic despite the known risks for transmission. Studies conducted early in the pandemic showed that factors associated with higher levels of distress among HCP included being of younger age, female, in close contact with people with COVID-19, and lower levels of education. The goal of this study was to determine if level of patient contact was associated with concern for post-traumatic stress disorder (PTSD) as measured by the Impact of Event Scale-Revised (IES-R).MethodsThis cross-sectional study, embedded within a prospective cohort study, recruited HCP working in hospitals in four Canadian provinces from June 2020 to June 2023. Data were collected at enrolment and annually from baseline surveys with the IES-R scale completed at withdrawal/study completion. Modified Poisson regression was used to determine the association between level of patient contact and concern for PTSD (i.e., IES-R scores ≥24).ResultsThe adjusted rate ratio (RR) associated with concern for PTSD among HCP with physical contact/direct patient care was 1.19 (95% confidence interval (CI) 1.03, 1.38) times higher than for HCP with no direct contact. In fully adjusted linear regression models, physical care/contact was associated with higher avoidance and hyperarousal scores, but not intrusion scores.ConclusionsAdministrators and planners need to consider the impact of heightened and ongoing stress among HCP by providing early screening for adverse emotional outcomes and delivery of tailored preventive strategies to ensure immediate and long-term HCP health.

Financial distress and medical financial hardship among young adult survivors of blood cancer.

The long-term financial impact of cancer care has not been adequately addressed in young adults. As part of a remote intervention study, we describe medical financial distress and hardship among young adult survivors of blood cancer at study entry. Young adults were recruited from 6 US hospitals. Using a Research Electronic Data Capture link, young adults confirmed their eligibility-namely, currently 18 to 39 years of age, blood cancer diagnosis 3 or more years ago, off active treatment, and not on parent's insurance. Following consent, the baseline assessment was sent. The primary outcome measure, the Personal Financial Wellness Scale, measured financial distress (scored as severe, 1-2; high, 3-4; average, 5-6; and low to no, 7-10). Medical financial hardship encompassed material hardship, psychological impact, and coping behaviors. Descriptive summary statistics and linear regression were used. Among the 126 participants, 54.5% came from minority racial or ethnic groups. Median time since diagnosis was 10 years (interquartile range = 6-16 years), with 56% having received a diagnosis when they were between 18 and 39 years of age. The overall mean (standard deviation) Personal Financial Wellness Scale score was 5.1 (2.4), but 49% reported severe or high distress. In multivariable analysis, female sex, Hispanic ethnicity, and lower income were strongly associated with worse Personal Financial Wellness Scale scores. Among participants with severe financial distress (n = 26), 72% reported 2 or more household material hardships, had worse scores across all psychological domains, and altered survivorship care because of cost (68%). Nearly half of long-term young adult cancer survivors reported severe or high levels of financial distress. Individuals with severe or high distress also reported more medical financial hardship than other participants. This finding highlights the need for ongoing financial intervention in this vulnerable population. NCT05620979.

The effects of progressive muscle relaxation exercise on dementia caregivers

While progressive muscle relaxation has demonstrated effectiveness in reducing anxiety, stress, and depression in general populations, its impact on caregivers of dementia patients remains understudied. This study investigated the effectiveness of Progressive Muscle Relaxation (PMR) in improving the well-being of dementia caregivers. Caregivers of individuals with dementia (n = 57) participated in a 3-month intervention, engaging in PMR thrice weekly. Participants completed assessments of depression, anxiety, stress, and caregiver burden at pre-test and post-intervention period. The intervention led to significant reductions in anxiety, stress, depression, and caregiver burden among participants. Female caregivers reported to have higher levels of anxiety and stress compared to males. Caregivers under financial stress showed high levels of distress and increased caregiver burden. These promising findings suggest the need for further research with larger, multicenter samples. Notably, PMR is a readily implementable intervention by nurses, requiring minimal equipment and offering a cost-effective approach to supporting caregiver well-being.

Mental distress of intensive care staff in Germany during the COVID-19 pandemic. Results from the VOICE study

The coronavirus disease 2019 (COVID-19) pandemic posed major challenges to the healthcare system worldwide and led to particular stress among healthcare workers. The aim of this analysis was to investigate the level of global mental stress of direct healthcare workers in Germany during the COVID-19 pandemic. In this prospective cross-sectional study with four measurement points (T1: 4-5/2020, T2:11/2020-1/2021, 5-7/2021, 2-5/2022), psychological distress symptoms were recorded in an online survey with the Patient Health Questionnaire (PHQ-4) among hospital staff working in direct patient care (N = 5408 datasets). The total dataset was exploratively analyzed according to field of activity, gender, and professional group affiliation. Clinically relevant psychological distress (PHQ-4 ≥ 5) was present in 29.3% (n = 419/1429) of intensive care staff. Acomparison of the four cross-sectional surveys showed asignificant increase in the rate of clinically relevant mental distress in the first pandemic year (23.2% at T1 vs. 30.6% at T2; p < 0.01), which stabilized at ahigh level in the second pandemic year (33.6% at T3 and 32.0% at T4). Women did not differ from men in this respect (n = 280/919, 30.4% vs. n = 139/508, 27.4%; p = 0.74). Nursing staff were significantly more often psychologically stressed than physicians (n = 339/1105, 30.7% vs. n = 80/324, 24.7%; p = 0.03). Intensive care staff did not show significantly higher stress than staff working in nonintensive care areas (n = 419/1429, 29.3% vs. n = 1149/3979, 28.7%, p = 0.21). German healthcare workers reported high levels of mental distress during the pandemic, which increased during the course of the pandemic, but no significant difference was found between intensive care and nonintensive care staff in our sample. This may be due to the fact that the pandemic in Germany was comparatively moderate internationally and neither acollapse of the healthcare system in general nor acollapse of intensive care structures in particular took place.