Improvements In Psychological Well-being Research Articles

Understanding the impact of the pandemic on university students: Changes in sleep, eating patterns, and psychological well-being

BACKGROUND: Covid-19 is one of the world’s major pandemics. It has affected millions of people in various ways. OBJECTIVE: This study investigates the influence of pandemic-induced shifts in eating and sleeping behaviors on the psychological well-being of university students. METHODS: The study adopted a cross-sectional research design. A total of 604 students participated in the study. The Personal Form, the Psychological Well-Being Index, and the Pittsburgh Sleep Quality Index were used to collect data. The research was conducted between October 2021 and December 2022. RESULTS: The participants reported a mean psychological well-being score of 40.76±9.38, alongside a Pittsburgh Sleep Quality Index score of 7.46±3.30. Analysis revealed a significant negative correlation between the mean psychological well-being scores and the Pittsburgh Sleep Quality Index scores (p < 0.01). Throughout the pandemic, the participants experienced a decline in physical activity, an increase in their body weight, and a change in their eating habits. While psychological well-being remained relatively high, sleep quality was notably poor. Notably, improvements in psychological well-being corresponded with enhancements in sleep quality, suggesting a reciprocal relationship between the two variables. CONCLUSIONS: The pandemic negatively impacted the physical activity and body weight of young adults. This study highlights the importance of promoting physical activity among university students during pandemics and similar crises to reduce adverse effects on body weight. It also highlights the importance of educating students about the importance of healthy sleep and how to maintain good sleep hygiene.

Investigating the therapeutic efficacy of psilocybin in advanced cancer patients: A comprehensive review and meta-analysis.

Psilocybin, a naturally occurring psychedelic compound found in certain species of mushrooms, is known for its effects on anxiety and depression. It has recently gained increasing interest for its potential therapeutic effects, particularly in patients with advanced cancer. This systematic review and meta-analysis aim to evaluate the effects of psilocybin on adult patients with advanced cancer. To investigate the therapeutic effect of psilocybin in patients with advanced cancer. A comprehensive search of electronic databases was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Google Scholar for articles published up to February 2023. The reference lists of the included studies were also searched to retrieve possible additional studies. A total of 7 studies met the inclusion criteria for the systematic review, comprising 132 participants. The results revealed significant improvements in quality of life, pain control, and anxiety relief following psilocybin-assisted therapy, specifically results on anxiety relief. Pooled effect sizes indicated statistically significant reductions in symptoms of anxiety at both 4 to 4.5 months [35.15 (95%CI: 32.28-38.01)] and 6 to 6.5 months [33.06 (95%CI: 28.73-37.40)]. Post-administration compared to baseline assessments (P < 0.05). Additionally, patients reported sustained improvements in psychological well-being and existential distress following psilocybin therapy. The findings provided compelling evidence for the potential benefits of psilocybin-assisted therapy in improving quality of life, pain control, and anxiety relief in patients with advanced cancer.

The Impact of the COVID-19 Pandemic on Elite Swimmers and Water Polo Players: Lessons for the Future.

The COVID-19 pandemic has disrupted global daily life, including the world of elite athletes. This paper examines the multifaceted impact the COVID-19 pandemic had on elite swimmers and water polo athletes, specifically their mental health, their concerns over the virus, their intentions of getting vaccinated, and sleep disturbances that they may have faced. We conducted a cross-sectional study on elite swimmers and water polo players, using an anonymous questionnaire. A total of 200 elite athletes participated. The majority of the participants reported a negative impact on their mental health, screened positive for insomnia (n = 107 (53.5%), with females (n = 101; 57.7%), swimmers (n = 100, 66.7%), and university students (n = 71, 71.7%) being more vulnerable (p < 0.001). Concerns about contracting the disease especially during important training or tournament periods and potential career disruption also affected their psychological well-being. While the majority (75%) had the intention of getting vaccinated, an alarming percentage was yet uncertain over its decision. This study highlights the significant psychological distress faced by elite aquatic athletes during the pandemic. It emphasizes the difficulties faced by elite swimmers and water polo athletes and determines not only the importance of addressing the vaccination intentions of athletes, but also how critical it is to confront the challenges they face both for their personal health and for the restoration of world sports to their pre-pandemic state. More large-scale studies are required to inform policies targeted at minimizing disruption to the athletes' career, provision of information on preventive measures and vaccination, and improvement in psychological well-being in case of similar major public health issues in the future. Additionally, this study calls for further research to explore the unique challenges faced by aquatic athletes, such as those related to their training environments and fear of contagion, to better support them in future public health crises.

Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care

BackgroundCardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme.MethodsA random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein).ResultsSelf-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables.ConclusionsParticipation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group.Trial registrationClinicalTrials.gov (NCT01741428), 04/12/2012.

Impact of a resilience-building energy management intervention for people with systemic sclerosis: a mixed methods study.

People with SSc often experience fatigue, which significantly affects daily life functioning and quality of life. We aimed to explore participants' experiences of a peer health-coached resilience-building energy management to enhance well-being (RENEW) intervention on symptoms and well-being and to use mixed methods to compare how SSc duration influenced the experiences of participants who had clinically significant fatigue improvement vs those who did not. Semi-structured interviews were conducted with 21 participants from the parent clinical trial randomized to the RENEW intervention. Data were analysed using the rigorous and accelerated data reduction technique combined with thematic content analysis. A mixed methods approach used a joint display to identify themes related to the impact of SSc duration on fatigue improvement status. Participants were categorized into short/improvement, short/limited improvement, long/improvement, and long/limited improvement. Our team generated four themes: participant and peer health-coach relationship, physical and psychological well-being improvement, need for a tailored approach and easy program access through technology. Mixed methods analysis revealed that, regardless of SSc duration, participants with improved fatigue reported increasing self-awareness of SSc-related symptoms and learning coping strategies to manage fatigue. Participants in the short/improvement group reported preferences for slower pacing of the program and pairing with a coach with similar symptom severity. Participants in the long/limited improvement group sought SSc-specific symptom management information. Incorporating peer health coaches and technology is beneficial for self-management interventions for people with SSc. Future tailoring of RENEW based on SSc duration and symptom severity is needed. clinicatrials.gov, NCT04908943.

A WHO digital intervention to address depression among young Chinese adults: a type 1 effectiveness-implementation randomized controlled trial

Common mental disorders among young people are rising globally. Current university-based interventions are inadequate to address the need for evidence-based interventions. We investigated the effectiveness and implementation of Step-by-Step (SbS), a WHO digital intervention to address depression, among Chinese university students with depressive symptoms. In this paper, we report a type 1 hybrid effectiveness-implementation randomized controlled trial conducted between September 2021 and September 2022. The control condition was enhanced treatment as usual (ETAU, psychoeducation). The primary outcome was improvement in depression symptoms. Secondary outcomes were improvements in psychological well-being, anxiety symptoms, and self-identified psychosocial problems. Effectiveness of the intervention was evaluated using generalized linear mixed models. Implementation outcomes were evaluated by thematic analysis of participant interviews. A total of 371 participants were enrolled to two treatment conditions in a 1:1 ratio. SbS resulted in a greater reduction in depressive symptoms at posttreatment (p = 0.004, Hedges’ g = 0.35), but no significant difference between SbS and ETAU was observed at three-month follow-up (p = 0.179, Hedges’ g = 0.16). The treatment effect was larger among those who adhered to the treatment (Hedges’ gs = 0.59 and 0.30). Subjective well-being also improved for SbS at both time points (Hedges’ gs = 0.31 and 0.30). In addition, SbS resulted in more improvement in anxiety symptoms at posttreatment (p = 0.029, Hedges’ g = 0.26), but not at three-month follow-up (p = 0.265, Hedges’ g = 0.13). The qualitative results demonstrated that the intervention was well-implemented as a self-help mental health service, with minimal support from peer supporters. In conclusion, Step-by-Step, a digital intervention developed by WHO, was effective in reducing depressive symptoms in the short term and improving psychological well-being in a longer term. The sustained effect on depression needs further investigation. Improving uptake and engagement in the program is needed for its scale-up implementation as a university-based mental health service for Chinese young adults. Trial registration: ChiCTR2100050214.

Reframing interventions for optimal child nutrition and childhood obesity: the importance of considering psychological factors.

This review aims to emphasise the impact of poor nutrition on children's health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.

Breathe In, Breathe Out: Yoga’s Healing Touch on Sinusitis-induced Psychological Comorbidities

Sinusitis, characterized by inflammation of the nose and paranasal sinuses, commonly presents with symptoms such as nasal congestion, discharge, facial pain, and headache. The aim of this report is to highlight the potential benefits of Bhastrika (bellows breath) and Jala Neti (nasal cleansing with saline solution) as interventions to alleviate sinusitis-induced psychological comorbidities. This case report focuses on a 26-year-old female patient diagnosed with sinusitis who presented with severe headache, blurred vision, ear pain, and facial discomfort. A comprehensive evaluation confirmed the diagnosis of sinusitis, and the patient expressed a desire for nonpharmacological interventions due to personal preferences and concerns about medication side effects. The patient was prescribed a 6-month intervention comprising Bhastrika and Jala Neti, which involved the practice of bellows breath and nasal cleansing with saline solution. Regular practice of these techniques was observed, and the patient reported significant improvement in self-rated psychological symptoms, including reduced headache frequency, improved vision clarity, decreased ear pain, and alleviation of facial discomfort. These interventions may contribute to the overall improvement in psychological well-being experienced by the patient in this case. Further research is warranted to explore the effectiveness of these interventions in a larger population and to elucidate the underlying mechanisms through which they exert their therapeutic effects.

Effects of remote dignity therapy on mental health among patients with hematologic neoplasms and their significant others: A randomized controlled trial

BackgroundFamilies of patients with hematologic neoplasms involved in dignity therapy have exhibited a remarkable improvement in psychological well-being and family functioning. However, the applicability and generalizability of family participatory dignity therapy are limited as it is influenced by factors such as intervention time, place, and participants. Whether remote support from significant others is feasible and effective remains unknown. ObjectivesThis study aimed to confirm the efficacy of significant others participating in remote dignity therapy (r-DT) on hope, dignity loss, meaning of life, and sense of stigma among patients with hematologic neoplasms as well as their significant others' depression and anxiety. DesignA randomized, single-blinded, two-arm, parallel-group controlled trial. Setting(s) and participantsParticipants included patients with hematologic neoplasms and their significant others, who were recruited from Fujian Medical University Union Hospital from May 2021 to January 2022. MethodsA total of 72 eligible participants (patients and significant others) agreed to participate, and were randomly assigned to an intervention group (n = 35) or a control group (n = 37). Each pair of participants in the intervention group participated in two or three conversations based on the online video function of the WeChat platform, performed by one therapist in accordance with a specific communication outline. To evaluate the effects of the intervention, we assessed the patients' degree of dignity loss, hope level, meaning of life, and sense of stigma, as well as their significant others' depression, anxiety, and intimacy at baseline (T0), 15 days (T1), 30 days (T2), and 60 days (T3), and compared the scores between the two groups after the completion of the intervention. The Generalized Estimation Equation Model (GEE) was used to examine the effects of time, group, and their interaction. ResultsThe intervention group statistically significantly differed in lower dignity loss (t = 2.190, p = 0.032), higher hope level (t = −2.010, p = 0.049), and higher meaning of life (t = −2.066, p = 0.043) than the control group at T1. Regarding their significant others, the results of the comparison between the two groups showed that significant others in the intervention group had reduced levels of anxiety and depression at T1 and T2 (p < 0.05). The majority of patients (84.38 %) and significant others (75.00 %) provided positive evaluations of the program. ConclusionsThe r-DT showed a short-term positive effect on decreasing patients' dignity loss and promoting patients' hope and meaning of life; among their significant others, it decreased anxiety and depression. Trial registrationRegistered in the China Clinical Trial Registry on 17 March 2021(ChiCTR2100044374). Tweetable abstractRemote dignity therapy decreased patients' dignity loss and promoted their hope and meaning of life; among their significant others, it decreased anxiety and depression.

The Effectiveness of Positive Group Psychotherapy for Improving Psychological Well-Being in Peer Support for People with HIV/AIDS on Medan Plus In Medan City

Peer supporters who are living with HIV/AIDS play a crucial role in assisting and exchanging information with other individuals living with HIV/AIDS (PLWHA). The desire to contribute more effectively motivates PLHIV to become peer supporters. However, they often encounter challenges that affect their psychological well-being while fulfilling their responsibilities. This research aims to evaluate the effectiveness of group positive psychotherapy in enhancing the psychological well-being of peer supporters among PLWHA. The study employed a quasi-experimental pretest-posttest control group design, utilizing a non-probability sampling method for data collection. The participants included an experimental group (n = 10) and a control group (n = 10). The positive psychotherapy group module comprised five sessions, covering topics such as positive introduction and gratitude journaling, character strengths and signature strengths, hope and optimism, altruism, and meaning and purpose. The Psychological Well-Being Scale-27 (PWBS-27) was used for measurements. Data analysis involved the application of the Mann-Whitney nonparametric statistical test. The results indicated a significant improvement in psychological well-being among the experimental group compared to the control group after undergoing the positive psychotherapy intervention (U = 6, Z = -3.327, p &lt; .001, r = .74). Therefore, the group positive psychotherapy demonstrated effectiveness in enhancing the psychological well-being of individuals supporting people with HIV, yielding a relatively high effect size.

Whole-Body Cryostimulation in Post-COVID Rehabilitation for Patients with Obesity: A Multidisciplinary Feasibility Study.

A post-COVID condition can reduce activity and quality of life, resulting in a significant socioeconomic and health burden. Understanding its impact on patients' health is important for the development of personalized rehabilitation interventions. An independent association between obesity and post-COVID condition was found because of complications and comorbidities. Sixteen patients with obesity and post-COVID symptoms (i.e., dyspnea, pain, poor sleep quality, muscle fatigue), admitted to the Istituto Auxologico Italiano, Piancavallo (VB), Italy, were recruited for a four-week rehabilitation program including conventional exercise therapy, nutritional intervention, psychological support and whole-body cryostimulation (WBC). All participants attended all sessions of the program. Anthropometric data showed statistically significant changes in weight, waist circumference and body mass index. Biochemical analyses showed significant reductions in lipid and inflammatory profiles. There was a significant improvement in physical performance, reduction in pain and improvement in psychological well-being. A multidisciplinary rehabilitation protocol including WBC, designed for patients with obesity and a post-COVID condition, is safe and feasible. The overall improvements demonstrate that multidisciplinary rehabilitation was effective on post COVID patients and suggest that the use of WBC is safe and could play a role as a booster in rehabilitation programs.

Examining the link between distressing life events, social media distress disclosure, and perceived stress: A moderated mediation model

People share not only positive but also distressing personal information on social media. Although much work has been done to understand distress disclosure practices on social media, little is known about the association between social media distress disclosure and different components of disclosure risk, as well as the link between distressing life events, social media distress disclosure, and psychological well-being. This study examines the theoretical antecedents (i.e., situational and non-situational factors) of social media distress disclosure and tests a moderated mediation model that assesses the mediator role of social media distress disclosure on the relationship between distressors (i.e., frequency and intensity of distressing life events) and perceived stress. Results from an online survey (n = 967) revealed that social media users’ distress disclosure frequency is associated with both situational (i.e., distressing life events and exposure to others’ distress disclosure) and non-situational (i.e., perceived risks and benefits of distress disclosure) factors. Specifically, the findings indicated that social media users’ distress disclosure frequency was not only affected by self-oriented risk but also other-oriented risk—imposition risk. Furthermore, the moderated mediation model revealed that the association between distressors and perceived stress was mediated by social media distress disclosure frequency, and this mediated relationship was moderated by risk-benefit calculus and satisfaction with social media distress disclosure. Overall, this study advances our understanding of social media distress disclosure and extends existing self-disclosure theories by specifying the conditions by which individuals can expect an improvement in psychological well-being following disclosure of distressing information on social media.

Psychological well-being as a motive for and result of post-bariatric body contouring procedures.

This study investigates whether psychological well-being in post-bariatric patients seeking body contouring procedures differs from those who do not seek body contouring procedures, those who have already undergone body contouring procedures, and those who are unsure about body contouring procedures. An anonymous, nonrandomized, cross-sectional survey study was designed. Psychological well-being of four groups of post-bariatric-patients (undergone body contouring procedures, seeking body contouring procedures, not seeking body contouring procedures, unsure about body contouring procedures) were compared. A total of 345 patients were included in this study. No significant difference between patients seeking body contouring procedures and those not seeking body contouring procedures was found with regard to depressive symptoms, self-esteem, and body image. Patients who had already undergone body contouring procedures scored lower on depressive symptoms (p=0.035) and reported feeling more attractive (p<0.001) and less insecure (p=0.030) than patients who had not yet undergone body contouring procedures but sought it. Satisfaction with the result of the body contouring procedures was associated with lower depression levels (p<0.001), higher self-esteem (p<0.001) and a more positive body-image (p<0.001). Depressive symptoms or low self-esteem are not motivational factors for post-bariatric patients to seek body contouring procedures. Body contouring procedures are associated with improvement in psychological well-being in post-bariatric patients. Patients' satisfaction with the result of the body contouring procedures is significantly associated with positive psychological well-being.

Exploring the potential impact of group identity on post-traumatic growth in the aftermath of Corona outbreak: function of social-emotional competence as a mediator.

This research endeavors to examine the potential effects of human and societal interactions on individuals' post-traumatic growth in the aftermath of the Corona outbreak. To achieve the aforementioned objective, the current research investigates the correlations between post-traumatic growth and group identity, while also examining the potential mediating function of social-emotional competence. A cross-sectional design included a representative sample of 2,637 high school students located in the capital territory of Pakistan using convenience sampling method. To explore the associations, correlation and mediation analyzes utilizing the group identification scale, the social-emotional competence scale, and the post-traumatic growth scale was performed with SPSS PROCESS 4 macro and AMOS. The findings demonstrated that group identification emerged as a substantial predictor substantially associated with post-traumatic growth. Moreover, the relationship linking group identification and post-traumatic growth was found to be partially moderated by social-emotional competence. The phenomenon of group identification can exert influence on post-traumatic growth through both direct and mediating pathways, with the latter being essentially mediated by social-emotional competence. The aforementioned outcomes possess significant academic and practical implications concerning the promotion of post-traumatic growth and the improvement of psychological well-being after the Corona outbreak.

Effects of Mindfulness-based Stress Reduction Program on Perceived Stress, Internalized Stigma, and Psychological Well-being in Psychiatric Inpatients

Purpose: The aim of the study was to investigate the effects of a mindfulness-based stress reduction program on the perceived stress, internalized stigma, and psychological well-being of psychiatric inpatients. Methods: A non-equivalent control group study with a pretest-posttest design was used. Participants were obtained from the closed wards of a psychiatric hospital in K-city. A total of 45 people were included in this study, 22 in the experimental group and 23 in the control group. The pre, post, and follow-up scores of both the experimental and control groups were obtained using the Korea Perceived Stress Scale, the Korea Internalized Stigma of Mental Illness Scale, and the Korea Psychological Well-Being Scale to validate the effectiveness of the program. A 45 minute program was performed twice weekly for three weeks. Results: There was a statistically significant reduction in perceived stress (F=6.92, p=.002) and internalized stigma (F=22.76, p&lt;.001), and a significant improvement in psychological well-being (F=38.34, p&lt;.001) in the experimental group. Conclusion: A mindfulness-based stress reduction program could be implemented as an intervention to reduce perceived stress and internalized stigma and enhance psychological well-being in psychiatric inpatients.

Effects of a Home-Based Physical Activity Program on Blood Biomarkers and Health-Related Quality of Life Indices in Saudi Arabian Type 2 Diabetes Mellitus Patients: A Randomized Controlled Trial.

The purpose of this study was to undertake a randomized control trial examining the effects of a 12-week home-based physical activity program on Saudi Arabian adults with type 2 diabetes. Sixty-four patients with type 2 diabetes mellitus were recruited from the Jazan Diabetes and Endocrinology Center, located in the Jazan region of southwestern Saudi Arabia. Patients were randomly assigned to either control, i.e., usual care (males = 46.9% and females = 53.1%, age = 45.88 ± 8.51 years, mass = 76.30 ± 15.16 kg, stature = 160.59 ± 8.94 cm, body mass index (BMI) = 29.73 ± 6.24 kg/m2, years since diagnosis = 8.12 ± 6.22 years) or a home-based physical activity (males = 50% and females = 50%, age = 42.07 ± 9.72 years, mass = 74.58 ± 13.67 kg, stature = 158.94 ± 9.38 cm, BMI = 29.44 ± 4.38 kg/m2, years since diagnosis = 12.17 ± 8.38 years) trial arms. The home-based physical activity group was required to undertake aerobic training by increasing their habitual step count by 2000 steps per day and performing resistance training 3 times per week for 12 weeks. The primary outcome was hemoglobin A1c (HbA1c), and secondary measures of anthropometrics, blood biomarkers, physical fitness, and patient-reported quality of life outcomes pertinent to type 2 diabetes were measured at timepoints, i.e., baseline, 12 weeks, and 24 weeks (follow-up). Intention-to-treat analyses revealed no significant alterations in the primary outcome (control: baseline = 8.71%, 12-weeks = 8.35%, and follow-up = 8.72%; home-based physical activity: baseline = 8.32%, 12-weeks = 8.06%, and follow-up = 8.39%) between trial arms. However, improvements in psychological wellbeing at follow-up measured using the Patient Health Questionnaire-9 were significantly greater in the home-based physical activity group (baseline = 6.84, 12-weeks = 5.96, and follow-up = 5.00) compared to the control (baseline = 6.81, 12-weeks = 5.73, and follow-up = 8.53). No other statistically significant observations were observed. Home-based physical activity is not effective in mediating improvements in HbA1c levels or secondary hematological, blood pressure, anthropometric, or fitness indices. However, given the link between psychological wellbeing and the etiology/progression of disease activity in type 2 diabetes, home-based physical activity may be effective for tertiary disease management. Future trials should examine the efficacy of relative exercise intensities greater than those in the current study.

The role of therapist support on the efficacy of an internet-delivered stress recovery intervention for healthcare workers: a randomized control trial

ABSTRACT Internet-delivered CBT interventions effectively improve different aspects of mental health, although the therapist’s role remains unclear. The aim of this trial was to evaluate the efficacy of a therapist-supported 6-week internet-delivered intervention in improving stress recovery among healthcare workers compared to a group with optional therapist support. A total of 196 participants were recruited and randomly allocated to regular therapists’ support or optional therapists’ support groups. The primary outcome measure was the Recovery Experiences Questionnaire (REQ), developed to assess four components of stress recovery: psychological detachment, relaxation, mastery, and control. Secondary outcomes measured perceived stress (PSS-10), anxiety (GAD-7), depression (PHQ-9), and psychological well-being (WHO-5). All four stress recovery skills improved significantly after participating in the intervention at a 3-month follow-up, with small to medium effects (0.27–0.65) in both groups. At follow-up, we also found a significant reduction in perceived stress, depression, and anxiety in both groups, as well as an improvement in psychological well-being. The results indicate that ICBT can be effective in improving stress recovery skills among healthcare workers with optional support from the therapist, provided at the participants’ request. This RCT suggests that optional therapist support could meet participants’ needs and reduce resources needed in routine care.

Variables determining higher health care effectiveness in patients with cardiovascular disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The projected incidence of cardiovascular disease and the aging population (deaths from cardiovascular disease increase after age 50) are expected to increase in the coming years. It is therefore imperative to improve health care for patients with CVD in primary care. Objective The aim of this study was to analyze the variables that influence the efficiency of health care delivery, which is synonymous with high quality of life, intensification of health behaviors, and high satisfaction of needs in patients with chronic cardiovascular disease. Methods The study was conducted on 157 patients with chronic cardiovascular disease who came to a follow-up appointment with a general practitioner. The WHOQOL-BREF Quality of Life Questionnaire, the Health Behavior Inventory Questionnaire (HBI), the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), and the Hospital Anxiety and Depression Scale-Modified Version (HADS-M) were used for the study. The Wilcoxon test and Fisher's exact test, as well as Spearman's rank correlation coefficient and logistic regression, were used for the analyzes. Results Analysis of patients revealed an association between home care effectiveness and the following variables (OR per unit): age (OR = 0.96, 95% CI: 0.92-0.99), educational level (OR = 1.45, 95% CI: 1.13-1.91), financial status (OR = 0.98, 95% CI: 0.20-0.89), assessment of physical well-being (OR = 2.60, 95% CI: 1.29-5.65), improvement in psychological well-being after a nurse visit (OR = 1.36, 95% CI: 0.00-0.17), and medication irregularity (OR = 0.30, 95% CI: 0.09-0.86). There was no association between effectiveness of care and duration of cardiovascular disease (p = 0.149), number of visits to a cardiology clinic (p = 0.414), number of visits to a PHC (p = 0.223), interventions by a family nurse practitioner (p = 0.075), and health care services provided by a physician such as ae.g., medical interview (p = 0.064), physical examination (p = 0.731), blood pressure measurement (p = 0.558). Conclusions Patients with CVD characterized by lower educational status, poorer financial status, poorer self-perception of physical well-being, expectation that the GP will provide information about disease progression, expectation that a social worker will provide information about the possibility of receiving social services, and the expectation that the family nurse would be more accessible when needed, as well as being characterized by irregular medication adherence and nonadherence to good eating habits, were much more likely to receive worse health care. Patients with cardiovascular disease can be well supported in primary care settings as long as the model of care is tailored to their specific needs. This includes care coordination within the health care team, home care, and support from general practice.

Peer support interventions in patients with kidney failure: A systematic review

BackgroundPeer support has been associated with improved health-related outcomes (e.g., psychological well-being and treatment adherence) among patients with serious, chronic conditions, including kidney disease. Yet, there is little existing research evaluating the effects of peer support programs on health outcomes among patients with kidney failure being treated with kidney replacement therapy. MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a systematic review using five databases to assess the effects of peer support programs on health-related outcomes (e.g., physical symptoms, depression) among patients with kidney failure undergoing kidney replacement therapy. ResultsPeer support in kidney failure was assessed across 12 studies (eight randomized controlled trials, one quasi-experimental controlled trial, and three single-arm trials) with 2893 patients. Three studies highlighted the links between peer support and improved patient engagement with care, while one found peer support did not significantly impact engagement. Three studies showed associations between peer support and improvements in psychological well-being. Four studies underscored the effects of peer support on self-efficacy and one on treatment adherence. ConclusionsDespite preliminary evidence of the positive associations between peer support and health-related outcomes among patients with kidney failure, peer support programs for this patient population remain poorly understood and underutilized. Further rigorous prospective and randomized studies are needed to evaluate how peer support can be optimized and incorporated into clinical care for this vulnerable patient population.

Add-On Aripiprazole May Benefit Older Adults With Refractory Depression

Add-On Aripiprazole May Benefit Older Adults With Refractory Depression