Measures Of Anxiety Research Articles

The Effects of Resilience Training on Mental Health Among Students

Background: Research indicates that certain demographic groups, including girls, often experience lower-than-average levels of mental well-being. Therefore, it appears that one approach to enhancing mental health is by teaching resilience skills. Objectives: This study aimed to investigate the effects of resilience training on the mental health dimensions of sixth-grade female students in Qaynat city during the academic year 2021 - 2022. Methods: The study employed an experimental design with a control group, conducting pre- and post-tests. The statistical population comprised female sixth-grade students from an elementary school in Qaynat City. Thirty female students exhibiting high scores on measures of depression, anxiety, and stress were selected and randomly divided into two experimental groups, with 15 participants in each group. The experimental group underwent resilience training consisting of 8 sessions. The desired variables were measured using Lovibond and Lovibond's Depression, Anxiety, and Stress Scale (DASS). The data were analyzed using SPSS 25 software through independent samples t-tests and paired t-tests. Results: The findings revealed that the resilience training intervention significantly reduced symptoms of depression (F = 11.542), anxiety (F = 13.67), and stress (F = 6.01) in the experimental group (P = 0.001). Conclusions: The results suggest that participation in a resilience training program can improve students' mental health. Therefore, implementing such intervention programs in the form of workshops and establishing counseling and support groups may be beneficial for enhancing students' mental well-being.

Climate change anxiety, fear, and intention to act.

Climate change anxiety (CCA) is an emerging yet not clearly defined construct. Here, we examine the relationship between CCA and climate change-related fear in response to messages differently framing uncertainty and anticipation concerning climate change, exploring how the former differs from general anxiety measures. To this purpose, young and healthy volunteers were assigned to three different framing conditions. Their emotional responses as well as eco-emotions and beliefs about climate change were collected. By employing a Bayesian approach, we found that framing the consequences of climate change effectively induces heightened fear and that CCA strongly predicted fear levels, while general anxiety measures did not. Overall, these results reflect CCA's unique and specific nature in influencing climate change-related fear. Interestingly, we found fear to predict intention scores only following the framings that did not effectively induce action intentions, consistent with prior findings on fear without efficacy framing. Instead, reading about the negative consequences motivated action the most. Following this framing, we found that eco-anger, instead of fear, consistently predicted intentions to engage in climate action. These results emphasize the complex interplay between CCA, eco-emotions, efficacy, and behavioral engagement.

Anxiety, depression, and infertility-specific distress among women with female factor infertility.

This study aimed to evaluate whether anxiety, depression, and infertility-specific distress differ among women with female infertility who are trying to conceive and/or seeking infertility treatment. Women with diagnosed female factor infertility in the past 2 years (N = 188) completed demographic questions, and measures of infertility-specific distress, anxiety, and depression. The majority of the sample were actively trying to conceive (78.7%, n = 148) and approximately one third (33.5%, n = 63) were undergoing fertility treatment. Anxiety and depression scores did not differ based on trying to conceive or treatment-seeking, although these subgroups reported higher levels of need for parenthood and rejection of a childfree lifestyle. High levels of mood and anxiety are experienced by women with female infertility. Although infertility-specific distress is experienced more so by women with anxiety and depression, a substantial proportion of those without mental health conditions had high levels of distress, underscoring the need for screening and treatment.

The effectiveness of Chinese instrumental music embedded with binaural beats in relieving anxiety related to academic stress among undergraduates: A randomized controlled trial

The study aimed to determine the effectiveness of binaural beat (BB) Chinese music, with dynamic theta- to delta-frequency progression, in relieving anxiety among Singapore undergraduates. It also examined whether the binaural effects differ between students with high and normal trait anxiety. This was a randomized controlled trial with 151 undergraduates assigned to listen to a single 30 min episode of BB Chinese music, Chinese music, or audiobook. The Perceived Stress Scale (PSS) measured stress, while the state subscale of the State-Trait Anxiety Inventory (STAI-S) and root mean square of successive R–R interval differences (RMSSD) were outcome measures for anxiety. Results indicated that mean STAI-S and PSS reductions were not statistically significant between groups. No significant difference in mean change of RMSSD was detected when the BB Chinese music group was compared with the Chinese music or audiobook groups. However, students with high baseline trait anxiety experienced a greater, marginally significant reduction in STAI-S scores and an increase in RMSSD than those with normal trait anxiety after BB exposure. BB Chinese instrumental music may not have anxiolytic effects on healthy undergraduate populations, as evidence for an anxiolytic effect was observed only among students with high baseline trait anxiety, warranting further research on this population.

Concurrent factors associated with adherence to adjuvant endocrine therapy among women with non-metastatic breast cancer.

Adjuvant endocrine therapy (AET) reduces breast cancer morbidity and mortality, yet women often report suboptimal adherence. Though correlates of AET adherence are well-documented, few studies examine the relative importance of multi-level factors associated with adherence. The aim of this study was to identify factors most strongly associated with AET adherence in women with breast cancer. Between 10/2019 and 6/2021, women (N = 100) with non-metastatic, hormone receptor-positive breast cancer, taking AET who reported AET-related distress enrolled into a clinical trial. Participants completed baseline measures, including the Medication Adherence Rating Scale-5, sociodemographics, and validated measures of anxiety, depression, medication-taking self-efficacy, social support, and treatment satisfaction. We created a latent factor and tested associations between sociodemographic, medical, and psychosocial characteristics and adherence. Associated predictors (p < .10) were entered into a structural model, which was corroborated via multivariate regression modeling. A four-indicator latent adherence factor demonstrated good model fit. Participants (Mage = 56.1years, 91% White) who were unemployed (B = 0.27, SE = 0.13, p = .046) and reported greater treatment convenience (B = 0.01, SE = 0.01, p = .046) reported greater adherence. Scores of participants who reported greater medication-taking self-efficacy (p = .097) and social support (p = .062) approached better adherence. Greater medication-taking self-efficacy (B = 0.08, SE = 0.02, p < .001) and being unemployed (B = 0.28, SE = .14, p = .042) were most strongly associated with greater adherence, independent of other predictors. Multivariate modeling confirmed similar findings. Medication-taking self-efficacy and employment status were associated with AET adherence above other related factors. Enhancing patients' confidence in their ability to take AET for breast cancer may represent an important intervention target to boost adherence.

The Short Version of the Italian Maastricht Vital Exhaustion Questionnaire (MVEQ): Psychometric Properties and Relationships with Anxiety, Depression, and Stress in a Community Sample of Older Adults

Vital Exhaustion (VE) refers to a physical and mental state of excessive fatigue, feelings of demoralization, hopelessness, and increased irritability. The short form of the Maastricht Vital Exhaustion Questionnaire (MVEQ) is a widely used measure to assess VE. Despite its utility is broadly recognized, the validity and reliability of the scale have yet to be examined in the Italian context. The present study aimed to evaluate the psychometric properties of the shortened MVEQ in a community sample of Italian older adults. A total of 722 older adults (Mage = 72.97, SD = 7.71; 60.4% females) completed the MVEQ, as well as other self-report questionnaires assessing anxiety, depression and stress in order to evaluate the criterion-related validity of the scale. A confirmatory factor analysis (CFA) was conducted to examine the original MVEQ latent structure. Internal consistency was assessed through model-based omega coefficient. Test-retest reliability was examined by re-administering the MVEQ after three months to a subsample of 568 participants. Factorial invariance tests across gender were conducted by means of multi-group CFAs. The one-factor model showed an acceptable fit to the data. The MVEQ yielded a reliable total score (ω = 0.822) and showed moderate-to-large correlations with measures of anxiety, depression, and stress (r range 0.30 to 0.75, ps < 0.001). Test-retest reliability was supported by an Intraclass Correlation Coefficient (ICC) of 0.661. Lastly, the scale was factorially invariant across gender. Overall, the MVEQ provided evidence of reliability and criterion-related validity in a sample of Italian older adults and may be useful for both clinical and research practices.

Evaluation of anxiety and hopelessness levels in emergency service workers during the COVID-19 pandemic in Turkey

Background/Aim: The COVID-19 pandemic led to a significant threat to the lives of individuals, particularly frontline healthcare workers. This brought about negative emotions, such as anxiety and hopelessness. Despite the existence of research evaluating psychiatric symptoms among healthcare personnel during the COVID-19 pandemic, this study is also significant in terms of evaluating and emphasizing the common negative emotions experienced by frontline healthcare workers during the pandemic. This study aimed to evaluate anxiety and hopelessness levels in emergency service workers during the COVID-19 pandemic and to examine these levels in terms of specific variables. Methods: This cross-sectional study was conducted among emergency service healthcare workers, including doctors, nurses, and healthcare officers working in a training and research hospital from July 10 to August 10, 2020 during the pandemic. Participants completed a survey that included a sociodemographic information form, the State and Trait Anxiety Inventory (STAI), and the Beck Hopelessness Scale (BHS). A total of 135 personnel without a history of psychiatric illness or use of psychiatric medication were included in the study. Results: Of the 135 participants in the study, 67 were female, and 68 were male. The mean state anxiety score for all participants was 44.5 (12.6), trait anxiety score was 44.2 (7.3) and hopelessness score was 7.1 (5.2). It was found that the anxiety of emergency service workers during the pandemic was at a moderate level and their hopelessness was at a mild level. In the study, higher scores were found in hopelessness and state-trait anxiety measurements in married individuals compared to single participants (P=0.040, P=0.003, P=0.001, respectively). Trait anxiety scores were significantly higher among those with chronic diseases compared to those without chronic diseases, and in those living with families compared to those living alone (P=0.039 and P=0.017, respectively). A positive and moderate relationship was observed between hopelessness levels and state-trait anxiety levels (P&lt;0.001 for all, r=0.457, r=0.425, respectively). Conclusion: During the COVID-19 pandemic, increased levels of anxiety and hopelessness were detected among healthcare workers in emergency services. It was observed that as the working time in the emergency department increased, hopelessness and state anxiety levels of the employees also increased.

Atypical social cognition processing in bulimia nervosa: an fMRI study of patients thinking of others' mental states.

Feeding and eating disorders are severe mental disorders that gravely affect patients' lives. In particular, patients with anorexia nervosa (AN) or bulimia nervosa (BN) appear to have poor social cognition. Many studies have shown the relationship between poor social cognition and brain responses in AN. However, few studies have examined the relationship between social cognition and BN. Therefore, we examined which brain regions impact the ability for social cognition in patients with BN. We used task-based functional magnetic resonance imaging (fMRI) to examine brain responses during a social cognition task and the Reading Mind in the Eyes Test (RMET). During the fMRI, 22 women with BN and 22 healthy women (HW) took the RMET. Participants also completed the eating disorder clinical measures Bulimic Investigatory Test, Edinburgh (BITE) and Eating Disorders Examination Questionnaire (EDE-Q), the Patient Health Questionnaire (PHQ-9) measure of depression; and the Generalized Anxiety Disorder (GAD-7) measure of anxiety. No difference was observed in the RMET scores between women with BN and HW. Both groups showed activation in brain regions specific to social cognition. During the task, no differences were shown between the groups in the BOLD signal (p < 0.05, familywise error correctedfor multiple comparisons). However, there was a tendency of more robust activation in the right angular gyrus, ventral diencephalon, thalamus proper, temporal pole, and middle temporal gyrus in BN (p < 0.001, uncorrectedfor multiple comparisons). Moreover, HW showed a positive correlation between RMET scores and the activation of two regions: medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC); however, no significant correlation was observed in women with BN. While activation in the mPFC and ACC positively correlated to the RMET scores in HW, no correlation was observed in BN patients. Therefore, women with BN might display modulated neural processing when thinking of others' mental states. Further examination is needed to investigate neural processing in BN patients to better understand their social cognition abilities. UMIN, UMIN000010220. Registered 13 March 2013, https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000010220.

Anxiety, pain catastrophizing, and pain outcomes among older adults with chronic orofacial pain.

Although chronic orofacial pain (COFP) is common among older adults, the role of psychological factors in pain outcomes among this population has received limited attention. This study examined the role of anxiety and pain catastrophizing, two corelates of pain in other populations, in pain intensity and interference among 166 older adults with COFP (79% female, Mage = 68.84, SD = 5.56). Participants completed an online survey including measures of anxiety, pain catastrophizing, and pain intensity/interference. We applied mediation analyses to test indirect associations between anxiety and pain outcomes via pain catastrophizing. Results indicated that anxiety was positively associated with pain intensity and pain interference (bs = .70-1.12, ps < .05). There was also an indirect association between anxiety and pain interference through pain catastrophizing (b = .35, 95% CI [.0383, .7954]), indicating pain catastrophizing partially accounts for this relationship. Assessing and addressing anxiety and pain catastrophizing has the potential to improve treatment outcomes in this population.

Statistics anxiety or statistics fear? A reinforcement sensitivity theory perspective on psychology students’ statistics anxiety, attitudes, and self-efficacy

This research investigates the role of reinforcement sensitivity theory (RST) in statistics education among two distinct samples of undergraduate psychology students. In Study 1, 318 students in a third-year statistics course completed self-report measures of RST, anxiety, attitudes, and self-efficacy concerning the study of statistics. In Study 2, 577 students from first-, second-, and third-year statistics courses participated. Controlling for age and gender, both studies found students who were high in goal-drive persistence reported lower statistics anxiety, higher statistics self-efficacy and more favourable attitudes toward learning statistics, while students who were high in the tendency to avoid threat reported higher statistics anxiety. Those with a more sensitive behavioural inhibition system reported greater statistics anxiety and less favourable attitudes, in Study 2 but not Study 1. Results indicate that RST dimensions account for as much as 23% of additional variance in statistics anxiety, 18% in statistics self-efficacy, and 11% in attitudes, after controlling for age and gender. These studies highlight the utility of RST dimensions, notably goal-drive persistence, threat sensitivity, and behavioural inhibition, in providing critical information as to personality differences among students that need to be considered when developing programs targeting statistics anxiety, attitudes, and self-efficacy.

Validation of the difficulties in emotion regulation scale (ders-28) in spanish young adult substance users

The 28-item Difficulties in Emotion Regulation Scale (DERS) is widely used to measure Emotional Dysregulation (ED). However, its psychometric performance has not been examined in Spanish-speaking substance users. This study aimed to validate the DERS-28 in 1,676 [M = 19.56 (SD = 1.70), % women = 64.6] young adults with past-month substance use. Exploratory and confirmatory factor analyses, as well as reliability assessments using Classical Test and Item Response Theories, were conducted. The analyses supported a bifactor solution (invariant to sex) comprising five specific dimensions and a general factor (ED), each demonstrating adequate score reliability. Bifactor indices indicated an essentially unidimensional latent structure (ωHG = .808; ECVG = .554; H = .951; FD = .966). Convergent validity (values of |r| ranged between .036-.645) was supported by associations with clinical variables, including measures of substance use related problems, anxiety, stress, and depression. Among the DERS-28 dimensions, lack of control exhibited the largest effects. Despite its reliability and validity, limitations such as self-reported substance use and recruitment in college settings should be considered. In conclusion, the DERS-28 proves to be a reliable and valid tool, demonstrating utility for prevention purposes among young adults.

Identification and validation of severity standards for the academic anxiety scale

The Academic Anxiety Scale (AAS; Cassady, 2022; Cassady et al., 2019) is a measure of the construct academic anxiety, which is a generalized representation of anxieties experienced by learners in educational settings. Academic anxiety has been identified as a preclinical indicator of anxiety that provides important predictive utility to clinical symptomologies such as anxiety and depression but also serves as a more inclusive representation than other commonly studied anxieties in academic contexts (e.g., test anxiety, reading anxiety, math anxiety). Latent Class Analyses were employed to identify severity levels for learners completing the AAS, which revealed four classes of learners characterized by levels of academic anxiety: Non-Anxious, Mild Academic Anxiety, Moderate Academic Anxiety, and High Academic Anxiety. Descriptions of the characteristics of the four classes of learners as well as the potential utility for using the AAS in a universal screening context are discussed.

Hovering Is Not Helping: Relationships among Helicopter Parenting, Attachment, Academic Outcomes, and Mental Health in College Students

Helicopter parenting (or overparenting) refers to developmentally inappropriate or intrusive tactics to control a child’s behavior. Helicopter parents are usually trying to help their children, but their behavior has been associated with adverse academic, adjustment, and mental health outcomes in older children (i.e., adolescents, young adults), who should be developing more autonomy. The current study examined potential associations between helicopter parenting, attachment security, and academic and mental health outcomes in college students, hypothesizing that higher rates of helicopter parenting would be associated with more insecure attachment with parental figures and closest friends, poorer mental health (i.e., higher rates of depression and/or anxiety), and reduced academic motivation, performance, and self-efficacy. Our sample of 135 college students completed measures of anxiety, depression, and somatization, academic self-efficacy and motivation, perceptions of parental involvement, and dimensions of attachment in multiple relationships (i.e., mother, father, and closest friend). As expected, the bivariate and regression analyses revealed that higher levels of parental involvement (i.e., helicopter parenting) predicted significantly more insecure parental and peer attachment, greater internalizing, and lower effort regulation among college students.

Characterizing Measurement-Based Care in the Texas Youth Depression and Suicide Research Network (TX-YDSRN)

AbstractIntegration of measurement-based care (MBC) into clinical practice has shown promise in improving treatment outcomes for depression. Yet, without a gold standard measure of MBC, assessing fidelity to the MBC model across various clinical settings is difficult. A central goal of the Texas Youth Depression and Suicide Research Network (TX-YDSRN) was to characterize MBC across the state of Texas through the development of a standardized tool to assess the use of MBC strategies when assessing depression, anxiety, side effects, and treatment adherence. A chart review of clinical visits indicated standardized depression measures (71.2%) and anxiety measures (64%) were being utilized across sites. The use of standardized measures to assess medication adherence and side effects was limited to less than six percent for both, with the majority utilizing clinical interviews to assess adherence and side effects; yet medication was changed in nearly half. Rates of utilization of standardized measures for participants with multiple MBC forms were similar to those who only provided one form.

Evaluation of an automated matching system of children and families to virtual mental health resources during COVID-19

BackgroundChildren and their families often face obstacles in accessing mental health (MH) services. The purpose of this study was to develop and pilot test an electronic matching process to match children with virtual MH resources and increase access to treatment for children and their families during COVID-19.MethodsWithin a large observational child cohort, a random sample of 292 families with children ages 6–12 years were invited to participate. Latent profile analysis indicated five MH profiles using parent-reported symptom scores from validated depression, anxiety, hyperactivity, and inattention measures: (1) Average Symptoms, (2) Low Symptoms, (3) High Symptoms, (4) Internalizing, and (5) Externalizing. Children were matched with virtual MH resources according to their profile; parents received surveys at Time 1 (matching process explanation), Time 2 (match delivery) and Time 3 (resource uptake). Data on demographics, parent MH history, and process interest were collected.Results128/292 families (44%) completed surveys at Time 1, 80/128 families (63%) at Time 2, and a final 67/80 families (84%) at Time 3, yielding an overall uptake of 67/292 (23%). Families of European-descent and those with children assigned to the Low Symptoms profile were most likely to express interest in the process. No other factors were associated with continued interest or uptake of the electronic matching process. Most participating parents were satisfied with the process.ConclusionsThe electronic matching process delivered virtual MH resources to families in a time-efficient manner. Further research examining the effectiveness of electronically matched resources in improving children’s MH symptoms is needed.

Interview Anxiety of Job Applicants in Relation to Age, Gender, and Academic Performance

Interview anxiety is a prevalent issue among job applicants. It poses a significant threat to applicants' interview performance. Past studies suggest a substantial gap in the comprehension of the various factors that can influence the anxiety experienced by job applicants during interviews. The goal of this research was to explore the interview anxiety of male and female job applicants in relation to their age and academic performance. A personal information form along with the adapted Bangla version of the Measurement of Anxiety in Selection Interview (MASI) scale was applied to 260 job applicants selected purposively from different public universities in Dhaka city. In the present study, a cross-sectional survey design was employed and data were analyzed by using independent sample t-tests, Pearson product-moment correlation analysis, and stepwise multiple regression analysis. The results of the study indicated that females experience more anxiety in the selection interview than males. For both males and females, there was a positive correlation between age and interview anxiety, and academic performance was negatively correlated with interview anxiety. The results further revealed that, for both males and females, age and academic performance could predict interview anxiety where academic performance was the strongest predictor of interview anxiety. These findings may be useful to employers and human resource professionals concerned with these issues and to raise awareness regarding the interview anxiety of job applicants. Jagannath University Journal of Science, Volume 10, Number II, Dec. 2023, pp. 136-144

Suicidal Ideation in Canadian Family Caregivers for a Person with Dementia: A Portrait of the Situation.

This study aimed to explore the prevalence of suicidal thoughts and potential associations (i.e., strength and direction) with caregiver characteristics or factors. A targeted survey was distributed to dementia caregivers aged 55+ years. Questions concerning psychological distress, suicidal thoughts while caregiving and antecedents of suicidal behaviours were administered. A sample of 71 French-speaking Canadian caregivers completed the survey between May and October 2019. Among them, 52.1 per cent (n = 37) reported suicidal ideation while providing care to a relative or a friend living with dementia. Caregivers who presented suicidal ideation reported more abusive behaviour toward the care recipient. Caregivers who reported suicidal thoughts were significantly more distressed than caregivers without them on measures of burden, depression, and anxiety. Suicidal thoughts in caregivers are important evaluation targets, primarily for the prevention of suicide, but also because caregivers who report suicidal thoughts also present a heightened risk for abusing the care recipient.

Internet Use and Effects on Mental Well-being During the Lockdown Phase of the COVID-19 Pandemic in Younger Versus Older Adults: Observational Cross-Sectional Study.

Majority of individuals, including both younger and older adults, had to adapt to digital means to cope with lockdown measures and pandemic-induced lifestyle changes during the COVID-19 pandemic. While internet accessibility was beneficial during the pandemic, existing literature suggests that excessive use could lead to the rise of problematic internet use in adolescents and younger adults. However, the effects on older adults remain unclear. This study aimed to examine differences in internet use during the lockdown phase of the COVID-19 pandemic and explore how age differences in mental health could be explained by time spent on the internet. A door-to-door survey of a nationally representative sample of 602 adults in Singapore was carried out using computer-assisted personal interviewing during the early phase of the COVID-19 pandemic (October to November 2020). Participants were categorized into younger (21-59 years old) and older (60 years or above) age groups. We assessed self-reported measures of depression, anxiety, and stress; psychosocial adaptability; ability to perform essential activities; social support; health status; digital media use patterns, and time spent on the internet. Procedures complied with existing safe distancing measures. Older adults reported being less able to use digital platforms to meet needs and acquire information updates compared with younger adults during the lockdown period of the pandemic. Older adults spent significantly less time on the internet for both work and personal uses per day (mean 146.00 min, SD 9.18 min) compared with younger adults (mean 433.27 min, SD 14.32 min). Significant age differences in depression, anxiety, and stress were found, with younger adults showing poorer mental health. Mediation analysis showed that age differences in depression, anxiety, and stress were partially explained by time spent on the internet. These variables together explained 43%, 40%, and 40% of the variances in depression, anxiety, and stress scores, respectively. The findings showed that younger adults spent significantly more time on the internet compared with older adults during the lockdown phase of the pandemic. They were also ahead in their ability to use digital resources to meet needs and engage socially compared with older adults. Despite this, the mental health of younger adults was poor, and this was partially accounted for by the amount of time spent on the internet. Since past research suggests that excessive time spent on the internet could lead to disordered use, the benefits brought by digital technologies could have been attenuated during the lockdown phase of the pandemic. Considering this potential negative effect, it is imperative to educate both young and old adults in the appropriate use of information and communication technology.

Anxiety Predicts Worse Cardiorespiratory Fitness Outcomes in Cardiac Rehabilitation for Lower Socioeconomic Status Patients.

The purpose of this study was to show that patients in cardiac rehabilitation (CR) with lower socioeconomic status (SES) have worse clinical profiles and higher rates of psychiatric difficulties and they have lower cardiorespiratory fitness (CRF) improvements from CR than their counterparts with higher SES. Improvement in CRF during CR predicts better long-term health outcomes. Research suggests that higher anxiety impairs CRF in structured exercise regimes and is overrepresented among patients with lower SES. However, no study has determined whether this relationship holds true in CR. This study is a secondary analysis of a randomized controlled trial to improve CR attendance among patients with lower SES. Anxiety (ASEBA ASR; Achenbach System of Empirically Based Assessment, Adult Self Report) and CRF measures (metabolic equivalent tasks [METs peak ]) were collected prior to CR enrollment and 4 mo later. Regression was used to examine the association of anxiety with CRF at 4 mo while controlling for other demographic and clinical characteristics. Eight-eight participants were included in the analyses, 31% of whom had clinically significant levels of anxiety ( T ≥ 63). Higher anxiety significantly predicted lower exit CRF when controlling for baseline CRF, age, sex, qualifying diagnosis, and number of CR sessions attended ( β =-.05, P = .04). Patients with clinically significant levels of anxiety could be expected to lose >0.65 METs peak in improvement. The results from this study suggest that anxiety, which is overrepresented in populations with lower SES, is associated with less CRF improvement across the duration of CR. The effect size was clinically meaningful and calls for future research on addressing psychological factor in CR.

Impact of Visual and Aural Education on the Anxiety Level of Patients Under Spinal Anesthesia for Preoperative Caesarean Section

Background: The implementation of Sectio Caesarea (SC) requires anesthesia to relieve pain in patients who will undergo surgical procedures. SC action can cause anxiety in pregnant women who will undergo surgery. Purpose: Knowing the effect of audiovisual education on the anxiety level of preoperative ectio caesarea patients with spinal anesthesia at RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Method: This research design uses a pre-experimental design with a Pre and post-test without control approach. Accidental sampling technique. The number of samples obtained was 40 respondents. Measurement of anxiety using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) with audio visual education intervention. Findings: The age of the patients was mostly in the category of 20-35 years, 35 patients (87.5%) and the majority of parity with primiparous 24 patients (60%), Anxiety of preoperative cesarean section patients before giving audio visual education about cesarean section surgery with spinal anesthesia the majority with moderate anxiety 25 patients (62.5%), Anxiety of preoperative cesarean section patients after giving audio visual education about cesarean section surgery with spinal anesthesia the majority with not anxious or normal a total of 21 (52.5%). Conclusion: There is an effect of audio-visual education on the anxiety level of preoperative sectio caesarea patients with spinal anesthesia at RSUD dr. H. Soemarno Sosroatmodjo Tanjung.&#x0D;