High Levels Of Emotional Stress Research Articles

ЭТИКА ПРОФЕССИОНАЛЬНОГО ОБЩЕНИЯ ВРАЧА-СТОМАТОЛОГА И ФОРМИРОВАНИЕ КОММУНИКАТИВНЫХ КОМПЕТЕНЦИЙ

The article discusses the formation of professional communication skills among dentists. Providing medical, especially dental, care is associated with a high level of emotional stress for patients. Fears and anxiety about medical interventions often hinder patients from seeking care, thereby reducing the overall dental health of the population. Psychological and emotional comfort during patient visits often plays a crucial role in choosing a healthcare provider and facility. Furthermore, strong communication skills significantly increase patient compliance and improve the quality of medical care provided. Based on literary data, the article examines the problematic aspects of communication between healthcare providers and patients and analyzes the structure of effective professional communication aimed at ensuring comfortable dental treatment.

"You knew you had to be there, it had to be done": Experiences of health professionals who faced the COVID-19 pandemic in one public hospital in Spain.

The COVID-19 pandemic highlighted the lack of a government contingency plan for an effective response to an unexpected health crisis. This study uses a phenomenological approach to explore the experience of healthcare professionals during the first three waves of the COVID-19 pandemic in a public health hospital in the Valencia region, Spain. It assesses the impact on their health, coping strategies, institutional support, organizational changes, quality of care, and lessons learned. We carried out a qualitative study with semi-structured interviews with doctors and nurses from the Preventive Medicine, Emergency, and Internal Medicine Services and the Intensive Care Unit, using the Colaizzi's 7-step data analysis method. During the first wave, lack of information and leadership led to feelings of uncertainty, fear of infection, and transmission to family members. Continuous organizational changes and lack of material and human resources brought limited results. The lack of space to accommodate patients, along with insufficient training in treating critical patients, and the frequent moving around of healthcare workers, reduced the quality of care. Despite the high levels of emotional stress reported, no sick leave was taken; the high levels of commitment and professional vocation helped in adapting to the intense work rhythms. Healthcare professionals in the medical services and support units reported higher levels of stress, and a greater sense of neglect by their institution than their colleagues in managerial roles. Family, social support, and camaraderie at work were effective coping strategies. Health professionals showed a strong collective spirit and sense of solidarity. This helped them cope with the additional stress and workload that accompanied the pandemic. In the wake of this experience, they highlight the need for a contingency plan adapted to each organizational context. Such a plan should include psychological counseling and continuous training in critical patient care. Above all, it needs to take advantage of the hard-won knowledge born of the COVID-19 pandemic.

Insomnia Symptoms and Associated Factors in Caregivers of Adult Hospitalized Patients.

Caregivers experience high levels of emotional stress and must cope with several clinical and hospital-related environmental factors that seriously impact their night's rest. The purpose of this study was to establish the prevalence of insomnia symptoms in a sample of caregivers of adult hospitalized patients and to examine the relationships between insomnia symptoms and patient and caregiver-associated factors. A total of 152 caregivers were enrolled from the two main hospitals in Granada, Spain. Sociodemographic, economic, and care-related data were collected. Insomnia symptoms, burden, anxiety and depression, social support, and resilience were assessed. Information on patients' hospital admission, dependence, and neuropsychiatric symptoms was also obtained. Most caregivers were middle-aged women caring for their spouses. Self-reported insomnia prevalence was set at 45.4%. Comparison analyses between caregivers suffering from insomnia symptoms and non-insomniacs showed significantly higher burden, anxiety and depression and patients' neuropsychiatric symptoms (p < 0.05) and lower resilience and social support in the former (p < 0.01). A regression analysis showed that anxiety (ORa = 1.15; p < 0.05) and higher caregiver education level (ORa = 5.50; p < 0.05) were factors significantly associated with insomnia symptoms. Patients' neuropsychiatric symptoms showed a trend toward statistical significance as well (ORa = 1.09; p = 0.06). There is an acute need to address, prevent and treat insomnia problems in caregivers.

Effect of Oral and Local Unani Formulations in Chronic Leg Eczema: A Case Report

Nār Fārsī muzmin (Chronic eczema) is common dermatological condition with diverse etiology and morphology. It is clinically characterised by itching, redness, edema, papulovesicles in the acute stage and dry lichenified skin in the chronic stage. Its prevalence is incessantly increasing, affecting the Quality of Life (QoL) of patients. The medical study shows that those with eczema suffer from high levels of emotional stress, and the more severe the condition is the more psychological stress there may be. A 58 years old female patient was diagnosed with chronic leg eczema and treated with Majoon Shahtara orally and Marham Kafoor topically for 2 weeks. Outcome of the study was assessed with EASI, POEM, VAS and DLQI scores before and after treatment and the difference was significant clinically and statistically. Keywords: Eczema; Majoon Shahtara; Marham Kafoor; Nār Fārsī; EASI; POEM; VAS; DLQI.

Factors associated with long-term smoking relapse in those who succeeded in smoking cessation using regional smoking cessation programs.

It is known that approximately 10% of successful quitters relapse annually. This study aimed to investigate the factors related to long-term smoking relapse in individuals who succeeded in maintaining smoking cessation for 6 months after attending a regional smoking cessation program.This study enrolled 943 individuals registered for the regional smoking cessation program at the Busan Smoking Cessation Center in 2018–2019 who maintained smoking cessation for 6 months. A survey was conducted using a smartphone link or through phone calls, and the data for 305 participants who finally completed the survey were analyzed. The questionnaire addressed individual, inter-individual, organizational, and community-level factors related to smoking relapse. Multivariate logistic regression analysis was performed to evaluate the factors associated with smoking relapse by period. The Cox proportional hazard regression model was used for the factors associated with smoking relapse for the entire period.The smoking relapse rate at the time of the survey was 25.4%. In the analysis of smoking relapse by period, relapse was associated with the belief that smoking relieves stress, the number of single-person households, and poor subjective health status. In the analysis of smoking relapse during the entire period, we observed a significant association with the belief that smoking relieves stress (hazard ratio [HR]: 2.65, 95% confidence interval [CI]: 1.52–4.61), single-person households (HR: 1.95, 95% CI: 1.16–3.26), and high levels of emotional stress (HR: 1.72, 95% CI: 1.04–2.85).Long-term follow-up is necessary to prevent smoking relapse in single-person households, individuals who believe that smoking relieves stress, and those experiencing high levels of subjective emotional stress. Interventional therapies for stress relief and awareness improvement in smokers need to be developed.

Piloting the Use of Concept Mapping to Engage Geographic Communities for Stress and Resilience Planning in Toronto, Ontario, Canada.

The physical and social characteristics of urban neighborhoods engender unique stressors and assets, contributing to community-level variation in health over the lifecourse. Actors such as city planners and community organizations can help strengthen resilience in places where chronic stress is endemic, by learning about perceived stressors and assets from neighborhood users themselves (residents, workers, business owners). This study piloted a methodology to identify Toronto neighborhoods experiencing chronic stress and to engage them to identify neighborhood stressors, assets, and solutions. Crescent Town was identified as one neighborhood of interest based on relatively high levels of emotional stress in Twitter Tweets produced over two one-year periods (2013–2014 and 2017–2018) and triangulation using other neighborhood-level data. Using concept mapping, community members (n = 23) created a ten-cluster concept map describing neighborhood stressors and assets, and identified two potential strategies, a Crescent Town Residents’ Association and a community fair to promote neighborhood resources and build social networks. We discuss how this knowledge has circulated through the City of Toronto and community-level organizations to date, and lessons for improving this methodology.

Cognitive and emotional disturbances of patients with type II diabetes mellitus

At all stages of development of somatic disease, one of the most significant factors influencing the clinical picture and the nature of the disease is the mental state of the patient. It is known that the basis of psychosomatic disorders, which include type II diabetes, are emotional disorders that adversely affect psychosomatic pathology and can not only provoke its occurrence, but also lead to recurrence of psychosomatic disease. A comprehensive clinical, psychopathological and psychodiagnostic examination of 82 patients with moderate type 2 diabetes mellitus (46 women and 36 men) aged (35.9±10.1) years was perfomed, in compliance with the principles of bioethics and deontology. The study of cognitive functions by Mini-mental State Examination (MMSE) revealed mild (51.2%) or moderate (49.8%) cognitive impairment in examined patients, on average in the group examined the overall score by the MMSE Scale was (25.2±0.2) points. The conducted psychodiagnostic study showed an increase in the level of situational [(55.7±6.1) points] and personal anxiety [(54.5±6.4) points] by the Spielberger-Khanin Scale. 65.8% of the examined patients had a mild episode, 11.5% had a moderate depressive episode, and 56.1% of the examined patients had a mild, 40.3% moderate anxiety episode by the Hamilton Anxiety Rating Scale. The examined patients are characterized by a high level of emotional stress, anxiety, asthenic symptom complex and hypochondriac manifestations. Keywords: type II diabetes mellitus, cognitive disorders, emotional disorders, anxiety.

First aid and rescue of a critically injured person at 5,700 m

Accidents during mountaineering are special because mountain rescue operations are time-consuming and material-intensive. Since even in Europe it takes a long time for professional help to reach the injured person, first aid rugulary has to be provided by the accompanying mountaineers. This case report of a seriously injured person at an altitude of 5,700 m describes the special challenges of such a rescue operation. After the accident, the patient has to be moved out of the immediate danger zone to enable examination, treatment must be startet and further transport organized. This requires profound training in makeshift mountain rescue techniques, the use of diagnostic algorithms and safe application of medications. Generally, material and manpower are very limited in such situations and exhaustion due to the challenging tour is an aggravating factor. Therefore, the group has to look for external help and support at an early stage. For this purpose, efficient communication equipment is required and contacts must already be established. There is a high level of emotional stress when treating friends. In order to cope successfully with such a stressful situation, profound education and intensive training, as well as a strategy for external support developed in advance, are necessary. Key Words: Mountain Rescue, Traumatic Brain Injury, S-Ketamine, Remote Area, Wilderness Medicine

The psychological impact of the coronavirus disease pandemic on hospital workers in Daegu, South Korea

ObjectiveThis study aimed to assess the immediate stress and psychological impact experienced by healthcare workers and other personnel during the Coronavirus disease (COVID-19) pandemic. MethodThe sample consisted of 2554 hospital workers (i.e., physicians, nurses, allied health professionals, and auxiliary staff members) who were working in Yeungnam University Hospital in Daegu, South Korea. The Impact of Event Scale-Revised (IES-R) was administered to the hospital workers twice over a 2 week interval. A high-risk group, identified on the basic of first total IES-R, was assessed further with the Mini International Neuropsychiatric Interview (MINI) and the Clinical Global Impressions-Severity (CGIS) scale and was offered periodic psychiatric consultations on a telephone. ResultsThe participating nurses and auxiliary staff members had significantly higher IES-R scores (p < 0.01) than the physicians. During the second evaluation, the IES-R scores of the high-risk participants had decreased by 13.67 ± 16.15 points (p < 0.01), and their CGI-S scores had decreased by 1.00 ± 0.74 points (p < 0.01). The psychological symptoms of the high-risk group who received telephone-based psychiatric consultation showed improvement after 2 weeks. ConclusionsThe present findings suggest that hospital workers experience high levels of emotional stress during a pandemic. In particular, the present findings underscore the need to provide more information and support to nurses and other administrative workers. There is a need for greater awareness about the importance of mental health care among hospital workers, and rapid and ongoing psychiatric interventions should be provided to workers during the pandemic period.

Психологическая помощь студентам в адаптации к вузовской жизни

The paper deals with the problems of socio-psychological adaptation of junior students of higher education institutions to higher education. Students who did not cope with the difficulties of the adaptation period are distinguished by indifference to study and social life, deviant behavior, doubts about the correctness of the chosen professional path, difficulties in relations with classmates and mentors. As a result, these students have a high level of emotional stress, increased anxiety, low self-esteem, apathy, pessimism, and depressive disorders that hinder their professional and personal development. In this regard, the study of socio-psychological problems of first-year students in order to provide them with quality assistance is relevant, since it helps to increase their self-esteem, spiritual and professional growth of the individual, and therefore the effectiveness of the higher education system as a whole. The paper summarizes the theoretical research in the field of psychological science and presents the results of applying a comprehensive program of psychological assistance to first-year students in the framework of the psychological support service existing on the basis of Lobachevsky State University.

VARIETIES OF INTERPERSONAL BEHAVIOR OF RUSSIAN SEAFARERS DURING WORK IN INTERNATIONAL CREWS

Introduction. The psycho-emotional sphere is one of the most prone to the hard conditions of maritime labor. When working in the sea on ships of foreign companies, there are often violations of working conditions. It can cause the emergence of socio-psychological conflicts that turn into psycho-emotional stress. In this regard, the study of the emotional sphere of Russian seafarers working on ships under the flags of foreign states is very relevant.Objective: to determine the characteristics of the state of the emotional sphere of Russian sailors when working in international crews and justify the need for its correction in the voyage and inter-voyage periods.Materials and methods. The psycho-emotional state of Russian seafarers who worked on ships of foreign companies was studied in real-time mode during a sea voyage using the method of «Diagnostics of interpersonal relationships» by T. Leary, adapted by L. N. Dog.Results and its discussion. A rather high level of emotional stress was found during the voyage, probably due to the difficulty of communicating with foreign sailors, the severity of work and, as a result, the occurrence of conflict situations.Conclusion. Emotional stress can result in the emergence of neurotic reactions in seafarers. For work on ships flying a foreign flag, it is recommended to conduct a careful selection of crews and not allow the conclusion of contracts with psychologically unstable persons.

Factors Associated with Antihypertensive Medication Non-Adherence: A Cross-Sectional Study Among Lebanese Hypertensive Adults.

BackgroundPoor adherence to antihypertensives is associated with negative outcome of the disease as well as loss of health-care resources. Addressing the epidemic of poor adherence requires identifying factors associated with this behaviour. The aim of this study is to describe adherence to antihypertensive medication among Lebanese hypertensive patients and to evaluate the association between socio-economic, patient- and conditions-related factors and non-adherence.MethodsA cross-sectional study was carried out on adherence to antihypertensive medications covering all governorates of Lebanon. This study was conducted between February 2018 and January 2019 on a random sample of 1497 hypertensive patients. A face-to-face questionnaire was used to assess adherence to antihypertensive medication and its determinants according to the five World Health Organization (WHO) main categories. Logistic regression analysis was performed to test the adjusted association between the multiple exposure factors, and drug adherence data were collected by trained interviewers.ResultsAdherence to antihypertensive medications was reported by 1253 (83.7%) of the patients. After multivariate analysis, patients who tried to control their stress level (OR = 0.77, 95% CI [0.38–0.95]), those who had normal BP readings (OR =0.49, 95% CI [0.18–0.97]), and those who believed in the effectiveness of their treatment (OR = 0.31, 95% CI [0.14–0.76]) had a significantly lower chance to exhibit non-adherence to their treatment. However, older patients (OR= 1.87, 95% CI [1.23–2.21]), divorced/separated patients (OR= 2.14, 95% CI [1.31–5.48]), married (OR=1.96, 95% CI [1.27–3.90]), widowed (OR=2.11, 95% CI [1.62–6.50]), obese patients (OR = 1.76, 95% CI [1.21–1.94]), and patients who smoked hookah and cigarettes (OR = 2.62, 95% CI [1.17–6.76]) were more likely to exhibit non-adherence.ConclusionOur study highlights the influence of factors such as old age, marital status, BMI and high level of emotional stress on non-adherence to medication in hypertensive patients. These determinants should be incorporated into adherence improving strategies.

EMDR Therapy's Efficacy in the Treatment of Pain

Chronic pain is the most common global cause of functional and quality of life limitations. Although there are many effective therapies for the treatment of acute pain, chronic pain is often unsatisfactory. Against this background, there is currently an urgent need to develop innovative therapies that enable more efficient pain relief. Psychosocial factors play an important role in the development and persistence of chronic pain. Especially in patients with high levels of emotional stress, significant anxiety, or relevant psychological comorbidity, classical pain therapy approaches often fail. This is in line with the results of recent pain research, which has shown that dysfunctions in emotion processing have a significant influence on the persistence of pain symptoms. The recognition that pain can become chronic through maladaptive emotional processing forms the pathophysiological basis for the application of eye movement desensitization and reprocessing (EMDR) in the treatment of chronic pain. In this sense, EMDR can be used as an established method for desensitizing and processing of emotional distress from trauma therapy specifically for processing emotional stress in patients with chronic pain. Against this background, it is not surprising that the implementation of EMDR for patients with chronic pain is expanding. However, the increasing clinical use of EMDR in the treatment of chronic pain has also led to a reputation to test the efficacy of EMDR in pain management through randomized clinical trials. In addition to numerous case control studies, there are now also six randomized controlled clinical trials available that demonstrate the efficacy and safety of EMDR in the treatment of different pain conditions. However, in order to overcome several methodological limitations, large multicenter studies are needed to confirm the results.

La autoeficacia en el post-infarto

Introducción. Después de un infarto agudo de miocardio, los pacientes experimentan altos niveles de estrés emocional y ansiedad. Estas percepciones limitan sus comportamientos saludables.Objetivo. Determinar el nivel de autoeficacia general en pacientes post-infarto agudo de miocardio según la edad, género, estado de rehabilitación y atención en una unidad de cardiología en Girardot.Materiales y métodos. Investigación descriptiva, evaluada a través de la Escala general de autoeficacia versión ll, en una población de 149 personas entre los 35 y 65 años. Para el análisis estadístico de los resultados se utilizaron medidas estadísticas descriptivas y pruebas de correlación.Resultados. La edad de los participantes tuvo una media de 52 años. El análisis de la autoeficacia por grupo de edad evidenció incidencia mínima de la autoeficacia en el grupo de edad. Según el género, los hombres se percibieron más autoeficaces que las mujeres. Además, los pacientes que no asistieron a la rehabilitación cardíaca tuvieron un nivel de autoeficacia general ligeramente mayor en comparación con los rehabilitados.Conclusiones. No hubo relación entre la edad, el género y la rehabilitación frente al nivel de autoeficacia. Estas variables dependieron de otras diferentes a las del estudio.

THE IMPACT OF VIRTUAL REALITY ON SELF-ACTUALIZATION OF TEENAGERS: ANTHROPOLOGICAL DIMENSION

Purpose. Mechanization and computerization of modern society causes dramatic changes in the forms and methods of teaching. Their uniqueness lies in bringing computer technology and the Internet for education, causing formation of extreme polar social assessments of their impact on the harmonious development of children and adolescents, on possibility of self-actualization of natural potentials of teenagers whose minds are often on the brink of real and virtual worlds. Methodology is caused by interdisciplinary approach, involving not only the use of scientific methods such as analysis, synthesis and generalization, but also the methods of comparative analysis and analogies which were used to solve specific research problems related to the study of influence of computer technology and created through it virtual reality on self-actualization of teenagers. Originality lays in the explication of conceptual philosophical core to study the impact of virtual reality on self-actualization of teenagers and to prove possibility of differentiation of such concepts as "actualization" and "self-actualization" for the study of specific features of teenagers’ development. Such the approach provides a theoretical justification of major conflicts of personality development in adolescence and clearly demonstrates the threats that virtual reality brings to the process of person formation and development of mankind. Conclusions. Due to high levels of emotional stress in teenagers’ worldview, there is no evidence to suggest that they are at the level of self-actualization. The latter is possible only in the case of organic inclusion of adolescents in real socio-cultural processes, while their simulation in the virtual world can lead to inhibition of personality development.

Psycho-emotional status of fertile aged women with disorders of autonomic homeostasis, who had an artificial abortion

Changes in living conditions of the modern woman enhance its role in society life except the positive general public importance has a certain negative impact on her health. This is primarily due to the significant physical, psycho-emotional and stress impact on the female body. To these changes belong socio-economic conditions, population migration, and information overload in psychologically important areas of life, which is caused by political, social, economic, moral and ethical destabilization of society. All this leads to emotional stress, resulting in a risk of adverse changes in reproductive health, because women psycho-emotional state is her constituents. On the other hand, the vegetative regulation is one of the most important mechanisms of adaptation to stressful conditions in which the last two years are Ukrainian women. Worst of the recent history of our country events are rise to a high level of social tension affecting the health of women through stress action on the body.We have examined 120 women of childbearing age with impaired autonomic homeostasis in the form of autonomic dysfunction syndrome and somatoform dysfunction of the autonomic nervous system hypertonic, hypotonic and cardiac type who underwent artificial abortion. Study results have shown that the most of women, who detected high levels of emotional stress, has disorders of the vegetative homeostasis in the form of somatoform dysfunction of the autonomic nervous system on hypotonic type.Analysis of situational and personal anxiety in women showed almost the same number of patients with low, medium and high levels of psychological adaptation. The moderate level of personal anxiety was observed in the vast majority of women with hypotonic type of somatoform dysfunction of the autonomic nervous system.The main changes in the state of psychological adjustment in fertile age women that had an artificial abortion were disadaptation and stress.

Stress and Quality of Life of Senior Brazilian Police Officers

This study examines levels of occupational stress, quality of life, work-related stressors, and coping strategies among senior police officers in Brazil. A quantitative questionnaire survey conducted among 418 senior members of the Sao Paulo Police Force reveals that high-ranking Brazilian police officers perceive their profession as being very stressful. A large proportion (43%) of police officers are found to have significant stress symptoms. A greater proportion of females (54%) than males (40%) are found to have stress. The most frequently reported stressor is interaction with other departments within the police force. Quality of life is found to be deficient in the 'professional' and 'health' areas. This study is the first to show a clear association between high levels of emotional stress and poor quality of life in Brazilian police officers. The large number of stress symptoms and poor quality of life identified in the present study indicates that there is a need for preventive actions inside the Brazilian police force to motivate lifestyle changes, improve stress-management skills, and promote a better quality of life among high-ranking police officers.

Some Individual Psychological Predictors of Professional Disadaptation Forming in Surgeons and Physicians

Professional work of surgeons and physicians is characterized by high level of emotional stress, lack of time and information, high responsibility for the health and life of patients. Professional disadaptation (PD) is defined as any violation of dynamic balance between the individual and the professional environment. Symptoms of PD include fatigue, exhaustion, psychosomatic disorders, insomnia, negative attitude to work, chemical abuse, overeating, negative professional “self-concept”, aggressive feelings (irritability), depressed mood and related emotions: cynicism, pessimism, hopelessness, apathy, guilt. Some personal characteristics of surgeons and physicians were investigated to evaluate their role in PD forming with the use of Professional disadaptation questionnaire by O.N. Rodina, Subjective level of control questionnaire (SLC), Characterological questionnaire by H. Shmieshek. At first stage 280 physicians, working in public hospitals in Vinnytsya, Ukraine, were surveyed, after that respondents were divided into groups as follows: surgeons with PD symptoms, physicians with PD signs and control group (CG) – doctors without PD signs. Study results indicated that in the professional relations field professionals with PD were more external compared to the CG doctors (p ≤ 0,05). Displacement of the locus of control in professional relationships to the externality area reflects the increased sensitivity and subjective vulnerability in social interaction. Also characterological features of the surveyed doctors were investigated. A positive correlation was found between certain characterological types (cyclothymic, pedantic, epyleptoid) and PD. The study suggests that individual psychological factors, such as locus of control and character, significantly interact with severity of PD in surveyed medical workers.

Maternal experiences of caring for an infant with neurological impairment after neonatal encephalopathy in Uganda: a qualitative study

Purpose: The study investigated maternal experiences of caring for a child affected by neurological impairment after neonatal encephalopathy (NE) (“birth asphyxia”) in Uganda. Methods: Between September 2011 and October 2012 small group and one-on-one in-depths interviews were conducted with mothers recruited to the ABAaNA study examining outcomes from NE in Mulago hospital, Kampala. Data were analysed thematically with the aid of Nvivo 8 software. Findings: Mothers reported caring for an infant with impairment was often complicated by substantial social, emotional and financial difficulties and stigma. High levels of emotional distress, feelings of social isolation and fearfulness about the future were described. Maternal health-seeking ability was exacerbated by high transport costs, lack of paternal support and poor availability of rehabilitation and counselling services. Meeting and sharing experiences with similarly affected mothers was associated with more positive maternal caring experiences. Conclusion: Mothering a child with neurological impairment after NE is emotionally, physically and financially challenging but this may be partly mitigated by good social support and opportunities to share caring experiences with similarly affected mothers. A facilitated, participatory, community-based approach to rehabilitation training may have important impacts on maximising participation and improving the quality of life of affected mothers and infants.Implications for RehabilitationCaring for an infant with neurological impairment after NE in Uganda has substantial emotional, social and financial impacts on families and is associated with high levels of emotional stress, feelings of isolation and stigma amongst mothers.Improved social support and the opportunity to share experiences with other similarly affected mothers are associated with a more positive maternal caring experience. High transport costs, lack of paternal support and poor availability of counselling and support services were barriers to maternal healthcare seeking.Studies examining the feasibility, acceptability and impact of early intervention programmes are warranted to maximise participation and improve the quality of life for affected mothers and their infants.

Influence of psychosocial factors on adherence to antihypertensive drug therapy: results from a Cardiovascular Health Program cohort followed in the Metropolitan Region of Santiago, Chile

Inadequate blood pressure control in hypertensive patients remains a persistent health problem in Chile and worldwide. Poor adherence to antihypertensive drug therapy is one of the frequently cited factors. To determine the influence of psychosocial factors in the adherence to drug therapy in hypertensive patients followed through a Cardiovascular Health Program (CHP) that provides free access to primary care centers located in the Metropolitan Region of Santiago, Chile. Cross sectional study. A randomized sample of 513 hypertensive patients (30 to 68 years) was obtained from a universe of 1.484 patients. Adherence to treatment was determined by the Morisky-Green-Levine test. Demographic, socioeconomic and average values of blood pressure were recorded. Validated questionnaires were utilized to assess the patient-physician relationship, awareness of being hypertensive, patient perception of social support, family cohesion, patient self-health assessment and symptoms of emotional stress and depression. The drug therapy adherence was 36.6%, higher in women (38.4% vs 28.9%; p < 0.001). After multivariate analysis, absence of adherence was associated with male gender (OR: 1.76 [95% CI 1.21-2.56]), low education (OR: 1.72 [95% CI 1.18 to 2.53]), inadequate patient-physician relationship (OR: 1.56 [95% CI 1.13 to 2.27]), and high level of emotional stress and depression (OR: 1.93 [95% CI 1.27 to 2.94]). Our study highlights the influence of inadequate patient-physician relation, high level of emotional stress and depression, low education level and income and male gender in the lack of adherence to antihypertensive drug therapy in hypertensive patients followed throughout the CHP.