Patient Health Research Articles

Mental health surveillance in elite Para athletes: early identification and follow-up of athletes at risk of mental health problems

ObjectiveThere is a lack of prospective data on mental health of elite Para athletes. The objective was to identify and follow elite Para athletes at risk of mental health problems.MethodsIn...

Suicidal ideation in male UK military personnel who sustained a physical combat injury in Afghanistan and the mediating role of leaving service: The ADVANCE cohort study.

Suicidal Ideation (SI) is a risk factor for suicide, a leading cause of death amongst young men globally. In this study we assess whether sustaining a serious physical combat injury is associated with SI and whether leaving service mediates this association. We analysed data from male UK Armed Forces personnel who sustained a combat injury in Afghanistan and a frequency-matched comparison group who did not sustain such an injury (the ADVANCE cohort). SI was measured from the Patient Health Questionnaire-9 item 'thoughts that you would be better off dead or of hurting yourself in some way'. Approximately, 11.9% (n = 61) of the uninjured group, 15.3% (n = 83) of the overall injured group, 8.5% (n = 13) of an Amputation injury (AI) subgroup and 17.6% (n = 70) of a Non-Amputation Injury (NAI) subgroup reported SI in the past 2 weeks. The NAI subgroup reported greater likelihood of SI (Relative Risk Ratio (RR) = 1.44, 95% confidence interval (CI) [1.04, 2.00]) compared to the comparison group, whereas the overall injured group (RR = 1.23, 95% CI [0.90, 1.68]) and AI subgroup (RR = 0.65, 95% CI [0.36, 1.18]) did not. Leaving service fully mediated the association between sustaining a NAI and SI (natural direct effect RR = 1.08, 95% CI [0.69, 1.69]). UK military personnel with NAI reported significantly higher rates of SI compared to demographically similar uninjured personnel, while those who sustained AIs reported no significant difference. Leaving service was associated with greater rates of SI for both injured and uninjured personnel and fully mediated the association between sustaining a NAI and SI.

Prevalence and impact of signs and symptoms of temporomandibular disorders in dental students and faculty.

Temporomandibular disorders (TMD) affect individuals undergoing increased stress, for example, dental professionals. No study to date has compared dental students and faculty in TMD manifestation. This cross-sectional study compared prevalence, risk factors, and impact on daily activities of self-reported TMD signs/symptoms between dental students and faculty at a predoctoral dental school, and between preclinical (first- to second-year) and clinical (third- to fourth-year) students. A REDCap survey was sent to dental students and faculty, assessing TMD signs/symptoms (TMD Symptom Questionnaire), pain intensity (Chronic Graded Pain Scale), jaw function (Jaw Function Limitation Scale), parafunctions (Oral Behavioral Checklist), previous TMD treatments, anxiety/depression symptoms (Patient Health Questionnaire), perceived stress (Perceived Stress Scale), and sleep quality (RU-SATED Scale). Outcomes were compared between groups using chi-square and t-tests, adjusting for covariates with analyses of covariance (ANCOVA). Data derived from N=145 participants (N=108 students, N=37 faculty). Dental students reported significantly higher prevalence (90.1% vs. 75.7%, p=0.020) and greater number of TMD signs/symptoms (5.3±3.5 vs. 3.0±2.7, p<0.001) compared to faculty. Students reported significantly more parafunctional activities (p=0.000), jaw-strain episodes (prolonged mouth opening, p=0.007), higher stress level (p=0.008), and lower sleep quality (p=0.002) than faculty. Difference in number of TMD signs/symptoms was maintained after adjusting for stress, sleep quality, and parafunctional/jaw-strain activities. Clinical students utilized significantly more often evidence-based TMD treatment compared to preclinical students. High prevalence of self-reported TMD was observed among dental students and faculty, with students reporting higher prevalence and impairment despite working in the same environment. Findings underscore the importance of education on preventive measures early in dental training to address contributing factors and TMD management.

Turkish Version of the Psychological Responses to Grief Before Loss of Health Scale

This study aimed to assess the Turkish validity and reliability of the original Spanish version of the Psychological Responses to Grief before Loss of Health Scale (RPD-PDS-38). The research sample consisted of 538 women who were diagnosed with breast or gynecological cancers, volunteered, and had no communication problems. The scale was determined to consist of 30 items with 6 factors, explaining 63.9% of the total variance. Exploratory and confirmatory factor analyses established that the 30-item Turkish version yielded six interpretable factors (Faith and Hope, Acceptance, Anger, Negotiation, Depression, and Denial). While this is the same as the original version of the scale in the number of factors (six factors), it differs from the original version in that the original scale has 38 items and explains 46.46% of the total variance. Assessment is carried out based on the scores received from the sub-dimensions. The higher the scores received from the sub-dimensions, the more often individuals experienced a stage of grief. The scale was determined to be a reliable measuring instrument. The study suggests that the Turkish version of the RPD-PDS-30 scale is a valid and reliable instrument for assessing psychological responses to grief before the loss of health in patients diagnosed with breast and gynecological cancers in Turkey.

Effect of inhalation therapy on oral health in patients with chronic airway disease

The primary treatment for both chronic obstructive pulmonary disease (COPD) and asthma is inhalation therapy. When utilized over an extended period of time, inhalation treatment serves as both a controller and a relief therapy. Oral adverse effects can result from inhaled medications, particularly bronchodilators and corticosteroids that are deposited in the oropharyngeal region. Reduced saliva flow rate, periodontal disease, oral thrush, dental caries, and dental erosion are just a few of the side effects and difficulties associated with using inhaler therapy that are frequently discovered in the oral region. This problem may arise from improper inhaler use, concomitant diseases and conditions of the patient, inadequate education, and inadequate assessment of oral health during inhalation medication. In order to prevent side effects and complications from inhaler therapy, it is essential to comprehend the different types of inhaler drugs and the pathophysiology associated with oral health complications. This will enable clinicians to modify the components of the drug type, the type of inhaler therapy device, and the appropriate method of use based on the unique characteristics of each patient.

Knowledge and Practices of Nurses on Preoperative Fasting Guidelines Care for Adult Patients: A Review

Preoperative fasting is the term used to describe the time before a surgical procedure during which patients are not permitted to consume any liquids or solids by mouth. Pre-operative fasting guidelines for adult patients are critical for ensuring the well-being and safety of surgical patients. Pre-operative fasting is a standard practice designed to reduce the risk of complications during surgery, such as gastric aspiration. Fasting helps to prevent complications like pulmonary aspiration pneumonia, which can occur if patients do not empty their stomachs before surgery. Fasting durations for solids, liquids, and clear fluids are typically recommended in guidelines. Fasting before surgery or medical procedures that require anesthesia is a common practice. Fasting is done to reduce the risk of aspiration, which occurs when stomach contents enter the lungs during anesthesia and can lead to serious complications. The general guidelines for preoperative fasting typically include avoiding solid food for a specific period before the procedure, as well as limiting liquid intake. Fasting durations and recommendations, on the other hand, can vary. There has been some evolution in preoperative fasting guidelines in recent years. The traditional method involved fasting for extended periods, sometimes up to 12 hours or more for solid food and 2-6 hours for clear liquids. Recent research and updated guidelines in various countries suggest that shorter fasting periods may be just as effective in preventing aspiration while also improving hydration and reducing the stress associated with prolonged fasting. Many healthcare facilities are now more relaxed about preoperative fasting, allowing clear liquids up to 2 hours before surgery and light meals up to 6 hours before the procedure. It is important to note, however, that these guidelines are subject to change, specific fasting instructions are dependent on factors such as the type of surgery, the patient's health status, and .....

Self-rated health and health-related quality of life among cancer patients: the serial multiple mediation of anxiety and depression

BackgroundHealth-related quality of life (HRQOL) in cancer patients has attracted increasing attention, which may be associated with self-rated health (SRH), anxiety, and depression. However, limited studies have focused on the mediating role of anxiety and depression in the relationship between SRH and HRQOL among cancer patients. Therefore, this study aims to explore the serial multiple mediating effects of anxiety and depression between SRH and HRQOL in cancer patients.MethodsThis cross-sectional study investigated a total of 565 hospitalized cancer patients in Anhui province in China from November 2020 to October 2021. SRH was assessed using a single-item measure, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Socio-demographic and clinical characteristics were analyzed using descriptive statistics. The relationships between SRH, anxiety, depression, and HRQOL were evaluated by Pearson correlation analysis. The serial multiple mediation of anxiety and depression was assessed by SPSS PROCESS macro.ResultsSRH, anxiety, depression and HRQOL were significantly correlated(P < 0.001). In comparison to the fair SRH, the good SRH exhibited a significantly positive direct effect (Effect = 0.2366, Bootstrap 95%CI: 0.0642 ~ 0.4090) and total effect on HRQOL (Effect = 0.4761, Bootstrap 95%CI: 0.2975 ~ 0.6546). Conversely, the poor SRH demonstrated a significantly negative total effect on HRQOL (Effect= -0.4321, Bootstrap 95%CI: -0.7544~ -0.1099). When considering the fair SRH as the reference group, the poor SRH displayed a negative indirect effect on HRQOL through the single mediation of anxiety (Effect= -0.1058, Bootstrap 95%CI: -0.2217~ -0.0107) and the serial mediation of anxiety and depression (Effect= -0.0528, Bootstrap 95%CI: -0.1233~ -0.0035). Conversely, the good SRH had a positive indirect impact on HRQOL through the single mediation of anxiety (Effect = 0.1153, Bootstrap 95%CI: 0.0583 ~ 0.1900) and depression (Effect = 0.0667, Bootstrap 95%CI: 0.0206 ~ 0.1234), as well as the serial mediation of anxiety and depression (Effect = 0.0575, Bootstrap 95%CI: 0.0192 ~ 0.1030).ConclusionSRH can improve HRQOL through the decrease of anxiety and depression in cancer patients. Focusing on SRH would be beneficial for their mental health and HRQOL in cancer patients.

Changes in modifiable risk factors in women at increased risk for breast and ovarian cancer during the COVID-19 pandemic

BackgroundModifiable lifestyle factors exert a substantial influence on the development of various diseases. The COVID-19 pandemic necessitated the implementation of containment measures to mitigate the viral spread, which affected the maintenance of healthy habits. MethodsChanges in lifestyle factors (e.g. physical activity, nutrition, smoking, drinking alcohol) within a cohort of German women at increased risk of breast cancer (BC) or ovarian cancer (OC) were evaluated through an anonymous web-based survey. The self-reported assessment of mental health was conducted using the PHQ-4 questionnaire. This tool combines two items from the Patient Health Questionnaire for Depression (PHQ-2) and two queries from the Generalized Anxiety Disorder Scale (GAD-2). Potential predictors of lifestyle changes were determined via multiple logistic regression analysis. A heuristic model was employed to project potential long-term consequences on BC incidence. ResultsDuring the pandemic, 41.6 % of respondents reported reduced engagement in physical activity (PA), whereas 14.3 % reported increased engagement in PA. A score ≥5 on the PHQ-2 scale emerged as an independent risk factor for reduced PA (OR 12.719; 95 % CI 1.089–148.549; p = 0.043). By the heuristic approach, we projected an increase of BC by 3384 cases in Germany by 2030, which is attributable to the alterations in PA patterns during the pandemic. DiscussionImpaired mental health during the pandemic constituted a risk factor for unfavorable changes in PA. Consequently, a surge in BC may arise due to decreased engagement in PA. Healthcare professionals must remain aware of the potential risk factors that facilitate adverse alterations in modifiable risk factors caused by pandemic-related contingency measures or similar future events.

Relationship between hearing loss and depression: A cross-sectional analysis from the National Health and Nutrition Examination Survey 2015–2018

BackgroundHearing loss is a prevalent issue resulting from loud noise exposure, aging, diseases, and genetic differences. As individuals age, the likelihood of experiencing hearing loss and depression escalates; yet, the link between hearing loss and the risk of depression remains ambiguous. This study explores the relationship between hearing and depression risk, taking into account sociodemographic and health-related factors. MethodsUsing data from the National Health and Nutrition Examination Survey (NHANES) 2015–2018, a cross-sectional analysis was conducted, focusing on adult participants. It evaluated their hearing status and depression levels using the Patient Health Questionnaire-9 (PHQ-9). The study examined a range of variables, such as age, gender, socioeconomic status, lifestyle choices, and comorbidities, to understand their influence on the link between hearing loss and depression. ResultsAnalysis indicated a significant association between moderate to severe hearing loss and an increased risk of depression, notably in older adults. This relationship remained significant even after adjusting for a variety of sociodemographic and health factors. LimitationsThis is a study using the NHANES database using self-reported surveys. ConclusionThe findings of this study emphasize the need to integrate hearing health in the holistic assessment and treatment of depression, particularly advocating for combined care strategies for the elderly.

The Brief Symptom Inventory-9 (BSI-9): Development and validation in a German general population sample

BackgroundThe Brief Symptom Inventory-18 (BSI-18) is a self-report questionnaire with three subscales, somatisation, anxiety, and depression, based on longer measures of distress. The present study proposes a shorter, nine-item version (BSI-9) of the BSI-18 as a brief screening tool for distress.MethodsConfirmatory factor analyses and reliability and validity analyses were carried out using a representative sample of the German general population. Confirmatory factor analysis demonstrates a good model fit for the three-dimensional BSI-9.ResultsThe total scale was found to have strong internal consistency (αCronbach = 0.87 for the global severity index). The internal consistency coefficients of the three-item subscales reflect the brevity of these scales (somatisation αCronbach = 0.72, depression α Cronbach = 0.79, anxiety αCronbach = 0.68). The subscales were found to be significantly related with subscales of the Patient Health Questionnaire-4 and Hopkins Symptom Checklist-25.LimitationsThe present study used a limited number of distress measures, and a more recent dataset would be useful to provide a more current picture of the general population’s distress levels.ConclusionsThe BSI-9 provides a short, valid, and reliable screener for distress in the general population. Future work should examine its utility in clinical settings and different cultural contexts.

Interval life events are an important determinant of heterogeneity in outcomes in a randomised trial: a novel, simple method of assessment

ObjectiveAlthough life events are clearly important to health, most of the scientific focus has been on baseline life events that occur prior to a study. Life events that occur after...

Understanding the relationship between smartphone distraction, social withdrawal, digital stress, and depression among college students: A cross-sectional study in Wuhan, China

BackgroundSmartphone distraction considerably affects the depression level of college students. These two variables are highly associated with social withdrawal and digital distress. However, the underlying mechanisms of how social withdrawal and digital stress were involved in the relationship between smartphone distraction and depression remain unclear. MethodsA cross-sectional survey was conducted in seven colleges of Wuhan, Hubei Province, from September to November 2021. Participants were selected using convenience sampling. Smartphone distraction, social withdrawal, digital stress, and depression level were assessed using the Smartphone Distraction Scale (SDS), 25-item Hikikomori Questionnaire (HQ-25), Multidimensional Digital Stress Scale (DSS), and the Patient Health Questionnaire-9 (PHQ-9), respectively. All scales demonstrated good reliability in this study, the reliability of each scale was 0.920, 0.884, 0.959, and 0.942. ResultsThe final analysis included 1184 students (692 males and 492 females), aged between 17 and 37 years. Participants were from various academic disciplines, including medical and non-medical. The findings revealed that smartphone distraction had a significant direct effect on depression (c = 0.073, 95 % CI: 0.037 to 0.108, p < 0.001) and three significant indirect mediation effects: (1) social withdrawal (B = 0.083, 95 % CI: 0.066 to 0.101, p < 0.001), accounting for 27.76 % of the total effect; (2) digital stress (B = 0.109, 95 % CI: 0.088 to 0.132, p < 0.001), accounting for 36.45 % of the total effect; and (3) the chain mediating roles of social withdrawal and digital stress (B = 0.034, 95 % CI: 0.026 to 0.043, p < 0.001), accounting for 11.37 % of the total effect. The total mediating effect was 75.59 %. LimitationsThis study is based on cross-sectional data, which limits the causality inference. ConclusionsThese findings suggest that educational institutions should identify college students with excessive smartphone use early and provide timely interventions to minimize negative outcomes. It is also significant to reduce the risk of social withdrawal and digital stress to maintain the physical and mental health development of college students.

Association of Life's Essential 8 with depression among adults: A cross-sectional study of NHANES.

The prevalence of depression continues to rise, and it has a high death and disability rate. Life's Essential 8 (LE8) is an updated measurement of cardiovascular health (CVH), and a higher score of LE8 represents healthier CVH. Our study aimed to investigate the association between the LE8 and depression among adults. This cross-sectional study used data from the National Health and Nutrition Examination Survey. CVH was measured by using LE8 according to American Heart Association definitions. Depression was assessed by the 9-item Patient Health Questionnaire (PHQ-9). Weighted univariable and multivariable logistic analyses were performed to investigate the association of LE8 with depression. Subgroup analyses were also conducted in different groups based on age, gender, race, body mass index (BMI), smoking, arthritis, cardiovascular disease, and chronic kidney disease. A total of 22,149 participants were included in the database, with a mean LE8 score of 71.27. The prevalence of depression was 7.32%. The mean scores of LE8 in health behaviors and health factors were 73.28 and 69.26, respectively. After adjustment of potential confounders, a higher LE8 score was associated with lower odds of depression (odds ratio = 0.27, 95% confidence interval: 0.20-0.37). A similar association was observed in the subgroup analyses. Higher overall LE8 scores and higher scores for each component (diet, physical activity, nicotine exposure, sleep duration, BMI, blood lipids, blood glucose, and blood pressure) were associated with lower odds of depression. LE8 score might be a useful tool for both cardiologists and psychiatrists in screening for and monitoring physical and mental health. Primary care physicians also could better tailor care and interventions to address both physical and mental health needs.

Psychometric properties of the ultra-brief self-report Patient Health Questionnaire-4 (PHQ-4) to assess anxiety and depression in Arabic-speaking adults

BackgroundAnxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire – 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress.Methods587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4.ResultsConfirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ2/df = .13/1 = .13, RMSEA = .001, SRMR = .002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald’s omega = .86; Cronbach’s alpha = .86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores.ConclusionThe PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.

Spiritual needs and influencing factors among people with stroke in China: a cross-sectional study

BackgroundStroke is one of the primary causes of disability in China and around the world, having an impact on the health and well-being of stroke patients. The importance of spiritual needs for stroke patients has always been a controversial topic internationally, partly because related research was mostly qualitative and may not directly reflect the degree of spiritual needs. In addition, most studies focus on the same cultural background, there is a lack of research that delves into the nuances of Chinese culture and background. The goal of this study is to evaluate the level of spiritual needs and influencing factors in Chinese stroke patients and to explore the mediating role and pathways of these variables on spiritual needs.MethodsFrom August 2022 to January 2023, we conducted a cross-sectional questionnaire survey of 422 stroke patients in the affiliated hospitals of Hunan University of Chinese Medicine in Changsha Province by cluster sampling. We measured the patient’s spiritual needs, quality of life, anxiety and depression levels, and family support using the Spiritual Needs Questionnaire (SPNQ), the MOS36 item Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), and the Family Support Self Rating Scale (PSS-Fa). We used the General Information Questionnaire to gain insight into the sociodemographic characteristics of the patients. Nonparametric tests and multiple linear regression models were used to analyze the independent relationship between spiritual needs and quality of life, anxiety, depression, and family support. The mediation model in AMOS 24.0 software was used to analyze the mediating role among the five variables.ResultsThe score of spiritual needs of people with stroke included in this study was 37 points [IQR 33 to 40)]. The influencing factors of spiritual needs included primary economic sources for disease-related expenditures (p = 0.044), number of stroke occurrences (p = 0.001), duration of illness (p = 0.023), activities of daily living (p = 0.006), depression scores(p = 0.034), and family support scores(p = 0.008). Anxiety (β = 0.347, p = 0.004), depression (β = 0.368, p = 0.005), and family support (β = 0.167, p = 0.023) had directly or indirectly affected the spiritual needs of people with stroke. Quality of life (β=-0.202, p = 0.017) had a direct effect on spiritual needs.ConclusionsThe spiritual needs of people with stroke were at an intermediate level. Our findings highlight that the SPNQ score is associated with anxiety, depression, quality of life, and family support. Therefore, nurses should identify the spiritual needs of patients and provide them with effective and comprehensive spiritual care by reducing negative emotions and enhancing social support, promoting the development and progress of spiritual care in China. This study offers a theoretical basis for the spiritual care of clinical people with stroke and constructing a stroke spiritual care model.

Improving Access to Specialist Eye Care for Indigenous Australians via Telehealth: An Observational Cohort Study.

Background: Indigenous people are often neglected in eye health research and service delivery programs, despite having a greater burden of vision loss, most of which is avoidable. The objective of this work was to improve access to specialist eye care for Indigenous Australians living in rural and remote areas, by providing direct access to expert diagnostic services based in metropolitan areas through a tele-ophthalmology system. Methods: Over a four-year study period, 13 remote communities in Queensland and the Northern Territory were identified that had limited or no access to eye screening services. Relationships with health service providers in the communities were established to codesign a sustainable model of service delivery and referral pathways to ensure that patients identified with eye issues received appropriate treatment. Results: Over the course of the study, screening records from 378 patients were uploaded to a web-based telehealth system and diagnosed by ophthalmologists. From these examinations, 64 new cases of diabetic retinopathy (DR) were identified (including 2 cases of proliferative DR and 4 cases of severe nonproliferative DR), and diabetic macular edema was noted in 18 patients. The majority of participants screened had no eye problems, which enables the removal of these patients from the queues of overwhelmed specialist lists, improving service efficiency. The study also demonstrates capacity building of healthcare workers to perform eye screening and improved patient health awareness where the retinal cameras were used as an educational tool. Conclusions: A valuable screening service has been established in the target areas, where access to ophthalmic services has been improved for residents of the study screening locations. Routine eye examination (instead of opportunistic eye examination) is feasible for early detection of some eye diseases for remote and rural patients.

The report of AAPM task group 288: Recommendations for guiding radiotherapy event narratives.

Incident reporting and learning systems provide an opportunity to identify systemic vulnerabilities that contribute to incidents and potentially degrade quality. The narrative of an incident is intended to provide a clear, easy to understand description of an incident. Unclear, incomplete or poorly organized narratives compromise the ability to learn from them. This report provides guidance for drafting effective narratives, with particular attention to the use of narratives in incident reporting and learning systems (IRLS). Examples are given that compare effective and less than effective narratives. This report is mostly directed to organizations that maintain IRLS, but also may be helpful for individuals who desire to write a useful narrative for entry into such a system. Recommendations include the following: (1) Systems should allow a one- or two-sentence, free-text synopsis of an incident without guessing at causes; (2) Information included should form a sequence of events with chronology; and (3) Reporting and learning systems should consider using the headings suggested to guide the reporter through the narrative: (a) incident occurrences and actions by role; (b) prior circumstances and actions; (c) method by which the incident was identified; (d) equipment related details if relevant; (e) recovery actions by role; (f) relevant time span between responses; (g) and how individuals affected during or immediately after incident. When possible and appropriate, supplementary information including relevant data elements should be included using numerical scales or drop-down choices outside of the narrative. Information that should not be included in the narrative includes: (a) patient health information (PHI); (b) conjecture or blame; (c) jargon abbreviations or details without specifying their significance; (d) causal analysis.

An international online survey on extent of phubbing and its correlates

Introduction: Phubbing can be described as an individual looking at his or her mobile phone during a conversation with other individuals, dealing with the mobile phone and escaping from interpersonal communication. Being a new concept, research on its correlates is limited. The aims of the study were to find the extent of phubbing and its correlates. Material &amp; Methods: It was an online survey through Google forms with cross-sectional design and convenience sampling. Those above 18 years who were willing to participate and provided consent were included. The questionnaire included socio-demographic and clinical details, Patient health questionnaire (PHQ-4), and couples ‘satisfaction index (CSI) scale. Descriptive statistics, group comparisons, and Pearson's correlation were done. Results: 904 participants (463 from India, 224 from Nepal, 132 from Indonesia, others 85) were included in the study. 2.3% had a higher likelihood of phubbing. The total phubbing score showed a statistically positive significant correlation with the duration of internet use (p&lt;0.001), social media use (p&lt;0.001), and total PHQ score (p&lt;0.001) and statistically negative significant correlation with duration of the relationship (p=0.004), and total CSI score (p&lt;0.001). Phubbing was significantly higher among males (p=0.044), those educated less than graduate level (p=0.012), in a relationship (p=0.009), using psychoactive substances frequently (p=0.001), dissatisfied with the relationship (p=0.024), and among those with anxiety (p&lt;0.001) and depressive symptoms (p&lt;0.001). There was no difference in phubbing in between the countries (p value= 0.193). Conclusion: Prevention and management of phubbing should target those at risk. Focusing on reducing phubbing will improve mental health, couples’ relationship, and reduce excessive internet and social media use.

The prevalence of, and factors associated with, a risk of depression in residential aged care services residents: Findings from the FIRST study.

Depression is common amongst Australian residential aged care services (RACS) residents. This study aimed to estimate the risk of depression amongst residents and identify factors associated with this risk. In care settings such as RACS, time-efficient screening tools to identify depression risk may be a preferred tool. The two-item Patient Health Questionnaire (PHQ-2), derived from the nine-item PHQ-9 used commonly in the United States (US), was employed in this study. A resident was identified as being at risk of depression where the score was ≥3. Multivariable logistic regression analysis was used to identify independent factors associated with being at risk of depression. Residents' mean age was 87.7 (standard deviation: 7.3) years and 73% were female. One-fifth of residents (n = 108 or 20%) were at risk of depression. Age (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93-0.99); Pain Assessment in Advanced Dementia (PAINAD) score (OR 1.55, 95% CI 1.11-2.16); Epworth Sleepiness Scale (ESS) score (OR 1.08, 95% CI 1.03-1.13); and 38-item Frailty Index (FI) score (OR 1.07, 95% CI 1.03-1.10) were significantly associated with being at risk of depression, whilst sex, urinary incontinence, polypharmacy,Dementia Severity Rating Scale (DSRS) and Nursing Home Life Space Diameter (NHLSD) score were not. One in five residents were at risk of depression. Younger age, higher pain, higher daytime sleepiness and higher frailty status were associated with depressive risk. Future studies focusing on interventions targeting these factors may contribute to improved health outcomes.

Factors influencing parental fatigue in children with retinoblastoma based on the unpleasant symptoms theory

Parents of children with retinoblastoma, the most common primary ocular malignant tumour in childhood, bear a heavy caregiving burden and are very susceptible to fatigue. However, little is known about their current status of fatigue and factors influencing fatigue; therefore,this study, based on the theory of unpleasant symptoms, and included 317 parents of children with retinoblastoma in China, whose general demographic data were collected, and on whom the fatigue severity scale (FSS), the generalized anxiety disorder (GAD-7) and 2-item patient health questionnaire (PHQ-2) were administered, from 9 March to 1 June 2020. The parents’ FSS score and fatigue incidence were 4.41 ± 1.14 and 67.19%, respectively. The fatigue level was positively correlated with anxiety, depression, education, times of hospitalisations, and treatment types (r = 0.125–0.468, P < 0.05) and negatively correlated with health status, sleep quality, economic status, and family economic situation (r = − 0.120 to − 0.322, P < 0.05). Parent’s anxiety level, being an only child and female sex of child influenced parents’ fatigue. Healthcare personnel need to focus their attention on this high-risk fatigue group and implement appropriate interventions to reduce their fatigue level, promote their physical and mental health, and facilitate better care for children.