Poor Coping Strategies Research Articles

Drug-Related Violence, Substance Abuse, and Mental Health Challenges in a Southeastern American Indian Tribe: A Qualitative Study

ABSTRACT Background Drug-related violence [DRV] and substance abuse impact the mental health of economically challenged minority community members. DRV challenges to mental health promotion are exacerbated in American Indian [AI] communities. Purpose To investigate psycho-social and environmental factors influencing DRV, substance abuse, and mental health challenges within the Lumbee, a southeastern American Indian Tribe. Methods In-depth, one-on-one interviews with 37 Lumbee Tribal Members and Key Leaders were conducted. Results Findings align with existing research, revealing the influence of poor socioeconomic conditions, poor coping strategies, broken family structures, and failed federal policy. The substantial influence of local Christian churches on beliefs, attitudes, and practices of the Lumbee community vis-à-vis DRV and mental health was recognized. Discussion Findings indicated that social-environmental factors, seemingly independent of drug use/violence prevention and treatment, play important roles in the Lumbee community’s ability to recover from mental health consequences of DRV. Identifying barriers to, and facilitators of, prevention and treatment are critical to improving the welfare of tribal communities. Translation to Health Education Practice Major competencies associated with this research apply to Areas I & II, Assessment of Needs/Capacity and Planning. Identification of DRV and mental health education, prevention and treatment barriers are critical to quality-of-life improvement in tribal communities.

How to build resiliency in autistic individuals: an implication to advance mental health

IntroductionIndividuals on the autism spectrum (ASD) often experience poor mental health and coping strategies compared to their peers due to social exclusion and co-occurring conditions. Resiliency has been identified as a key factor in preventing adverse outcomes and promoting mental health. Therefore, it is important to determine what strategies can be used to build resiliency among autistic individuals. The current paper is one of the first studies that aims to collect information from autistic individuals and their caregivers on potential strategies to enhance resiliency.MethodsWe interviewed 18 participants from various provinces in Canada, comprising of 13 autistic individuals and 5 parents. We used thematic analysis to identify patterns in the data.ResultsThematic analysis revealed three themes to indicate strategies that could be used to enhance resiliency, including: (a) self-reliant strategies, (b) using community-based facilities, and (c) contextual and individual characteristics.ConclusionAlthough the body of literature on resiliency is evolving, this paper provides a unique perspective as it is one of the few studies that considers the experiences of individuals on the spectrum. In addition, this study focuses on identifying and describing specific strategies that can be used to enhance resiliency and mental health, which consequently can help address the existing gaps in knowledge and practice.

The Role of Psychological Factors in Noncardiac Chest Pain of Esophageal Origin.

Noncardiac chest pain (NCCP) of esophageal origin is a challenging clinical problem of diverse etiology that affects more than 80 million Americans yearly. We assess the prevalence and impact of psychological disorders on NCCP of esophageal origin, describe possible mechanisms associated with this condition, and review psychological therapy options. Online search using PubMed and Medline from January 1, 1966, to April 30, 2023. Psychological disorders have been reported in up to 79% of patients with NCCP of esophageal origin. Several psychological disturbances have been identified with this condition, including depression, anxiety, panic disorder, phobias, and obsessive-compulsive and somatoform disorders. It is unclear whether the psychological disorders trigger the chest pain or vice versa. Multiple psychological mechanisms have been linked to chest pain and may contribute to its pathogenesis and severity. These mechanisms include cardiophobia, poor coping strategies, negative social problem solving, stress and perceived control, hypervigilance to cardiopulmonary sensations, altered pain perception, and alexithymia. Psychological therapies for NCCP of esophageal origin include cognitive behavioral therapy, hypnotherapy, physical and relaxation training, breathing retraining, and alternative medicine. Among the therapeutic options, cognitive behavioral therapy has been shown to be an effective treatment for NCCP of esophageal origin. This review raises awareness about the high prevalence of psychological disorders in NCCP of esophageal origin and highlights the need for clinical trials and trained therapists to address the management of this taxing clinical problem.

A cross-sectional study on psychiatric comorbidity, coping strategies, and quality of life in women diagnosed with breast and cervical cancers attending a tertiary care center in South India

Background: Breast and cervical cancers pose significant health challenges for Indian women, impacting their psychological well-being and quality of life. Aim: To compare psychiatric morbidity, explore coping strategies, and evaluate quality of life among women with these cancers. Materials and Methods: A cross-sectional observational study among women aged 18 years and above attending a tertiary care hospital Oncology unit diagnosed first time with breast or cervical cancer, providing informed consent, were recruited by purposive sampling between September 2019 and August 2020. Using a semi-structured questionnaire, sociodemographic and clinical details were collected. Participants were interviewed using Mini International Neuropsychiatric Interview (MINI) version 6, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Coping Checklist, and WHOQOL-BREF. Descriptive and inferential statistics were used. A P value of < 0.05 was considered significant. Results: Sixty-eight participants (34 in each group) were recruited from a tertiary care hospital’s Oncology unit between September 2019 and August 2020. Comorbid psychiatric illnesses were found in 41.2% of cervical and 32.4% of breast cancer participants. Major depressive disorder (20.6% cervical; 8.8% breast) and generalized anxiety disorder (8.8% each) were common. Emotion-focused coping was prevalent, while negative distraction was least used. Quality of life was lowest in social relationships, physical health, and psychological health domains, with no significant intergroup differences. Conclusion: The high prevalence of psychiatric morbidities, poor coping strategies, and impaired quality of life imply that healthcare providers need to be culturally sensitive and integrate mental health screening and support services into routine cancer care.

A Comparative Study to Assess the Occupational Stress, Coping Strategies and Quality of Life among Governoment and Private Intermediate College Lecturers working in selected colleges at Guntur, Andhra Pradesh

The research is on comparative study of occupational stress, coping strategies and quality of life among teaching staff of Intermediate college lecturers working in Guntur. Concept of occupational stress has been of great debate among employers in different organizations and higher institutions since the last decades. Causal-comparative research design was adopted in the study and population comprised of lecturers in four Intermediate colleges in Guntur. the research hypotheses and questionnaires used as research instrument showed that there is significant difference between level of occupational stress to the coping strategies and quality of life among Private Intermediate colleges in Guntur. Percentage count table and Chi- square statistics was used to analyzed the questionnaire and hypotheses. Method: A Comparative study with Descriptive test design was used the simple random technique in which lottery method was used to select the samples for this study. Objectives: The design was adapted To assess, compare and to find the correlation of the level of occupational stress, coping strategies and quality of life among intermediate college lecturers working in the Government College and private college. Also to associate the occupational stress, coping strategies and quality of life with their selected demographic variable among them. Results: Mean, Standard deviation and Independent “t” test value of level of occupational stress, level of coping strategies and quality of life of intermediate college lecturers of government and private college lecturers In Government College the mean score in occupational stress was 33.02 with standard deviation of 14.39 where as in private college the mean score was 41 with standard deviation of 22.77. The calculated “t” test value was 2.094 which is statistically significant at the level of 0.05. In the level of coping strategies the mean score in Government College was 73.84 with standard deviation 11.2 and in private college the mean score was 80.1 with standard deviation of 12.9. The obtained independent “t” test value was 2.59 which is statistically significant the level of 0.05. The obtained mean score of quality of life in Government College was 15.3 with standard deviation 9.48 and in private college the mean score was 15.4 with standard deviation 12.8. The estimated independent “t” test value was 0.044 which is statistically not significant at 0.05 level. Conclusion: From the data of statistical findings, the occupational stress, poor coping strategies and low quality of life is effecting more in Private intermediate college lecturers than Government Intermediate college lecturers who were working in Guntur, Andhra Pradesh.

Stress and exhaustion among medical students: a prospective longitudinal study on the impact of the assessment period on medical education

BackgroundStress significantly affects both the physical and emotional health of individuals, particularly students in health-related fields. Medical students in Brazil face unique challenges due to the demanding nature of their studies, especially during assessment periods, which heighten academic pressure. These pressures often lead to poor coping strategies and mental health concerns. It is crucial to understand the complex dynamics of stress within medical education to develop strategies that improve student well-being and promote a healthier academic environment. This study aims to investigate the intricate relationship between assessment periods and stress levels among medical students. It seeks to understand how academic demands and sociodemographic factors contribute to stress dynamics during these periods.MethodsAn online observational, longitudinal, and prospective study was conducted from February to October 2022. Medical students were recruited through snowball sampling and participated in surveys administered via Google Forms at two timepoints: before (T1) and during (T2) assessment periods. The surveys collected sociodemographic data and stress symptoms using Lipp’s Inventory of Stress Symptoms for Adults (LSSI).ResultsThe transition from T1 to T2 was defined by a rise in the prevalence of stress from 59.6 to 84.2% (p = 0.001) and a decline in symptom-free students from 40.4 to 15.8% (p = 0.001). There was a significant increase in exhaustion, from 12.3 to 31.6% (p = 0.0001). Higher stress levels were notably more prevalent among younger students (≤ 24 years), females, those from wealthier families, students without scholarships, those without prior degrees, and those in the clinical phase of their studies. However, non significant correlations were found between these sociodemographic and academic factors and the increase in stress.ConclusionThe findings highlight significant concerns regarding the mental health of medical students during assessment periods, marked by increased stress and exhaustion levels. These results emphasize the need for proactive interventions to manage stress effectively in medical education, considering its profound impact on students’ well-being.

Relationship of Alexithymia with Emotion Regulation Strategies and Mental Health in Schizophrenic Patients

The main aim of the study is to analyze the emotional aspects of mental health in schizophrenia. We examined the relationship between levels of alexithymia, different strategies for emotion regulation, levels of stress and subjective well-being. Different studies show that in general people with high levels of alexithymia tend to exhibit a less adaptive profile of emotion regulation. Research on schizophrenia and emotions has revealed that schizophrenic patients lack the ability to recognize and express emotion, as well as understanding emotions in social context. We focus on difficulties processing emotional experiences in schizophrenic disorder and how it is related to the functional difficulties patients experience. In addition we proposed that patients with high levels of alexithymia and poorer coping strategies will be less willing to seek help from professionals. Questions about attitudes toward health specialists were constructed. 30 patients with schizophrenia and 39 healthy controls completed the survey. Patients with higher levels of alexithymia had tendency to use strategies as expressive suppression, which was linked with higher levels of stress. High levels of alexithymia were linked with poorer quality of life and lower life satisfaction. The results will be used for improving therapeutic psychological approaches when working with patients, recommendations for psychological work were given.

Intimate partner violence during pregnancy against adolescents in sub-Saharan Africa: a systematic review

BackgroundAdolescent pregnancy and intimate partner violence (IPV) are major public health issues that are linked to poor health outcomes particularly during pregnancy. In sub-Saharan Africa (SSA), previous studies on IPV...

Empowered management for pelvic pain: The experiences of women with persistent pelvic pain participating in an online self-directed self-management program while they wait for interprofessional care.

Persistent pelvic pain is pain sensed in or around the pelvis and is often associated with negative cognitive, behavioral, sexual, and emotional consequences. The lack of interprofessional persistent pelvic pain management programs that address the complex interplay of biopsychosocial factors result in lengthy wait times and negative health outcomes. Limited access to evidence informed self-management educational resources contributes to poor coping strategies. Evidence shows that self-management education and strategies support patients while they wait for care. However, very few studies explore the patient's lived experience of participating in an online educational program designed for persistent pelvic pain. This study aims to understand the experience of women with persistent pelvic pain participating in an online, self-management education program ("Pelvic Pain Empowered Management" program) while awaiting care at an interprofessional pelvic pain clinic. A descriptive qualitative approach was used to explore the experiences of women participating in an online educational program designed for cis women with persistent pelvic pain. We conducted semi-structured interviews with 11 women, transcribed the data verbatim using NVivo software (NVivo 12, QSR International Pty Ltd.), and analyzed inductively using previously established methods. We identified four main themes relevant to women's experiences of the program: (1) the program shaped expectations around upcoming pelvic pain appointments, (2) the program content is relevant and resonates with people with lived experience of persistent pelvic pain, (3) the program enhanced understanding of persistent pelvic pain, and (4) the program empowered people with skills and strategies to better manage their persistent pelvic pain. Our findings highlight how self-directed online patient education can be leveraged while persistent pelvic pain patients wait for care to support them in setting expectations around care and in engaging in pain self-management.

Associations of self‐reported psychological stress with memory and cerebrospinal fluid biomarkers of Alzheimer’s disease in middle‐aged adults

AbstractBackgroundSelf‐reported psychological stress is associated with an increased risk of cognitive decline and dementia. However, it remains unclear whether stress is related to key biomarkers of Alzheimer’s disease (AD). This cross‐sectional study examined the relationship of psychological stress with memory and cerebrospinal fluid (CSF) biomarkers of AD in middle‐aged adults without dementia.MethodThe Healthy Brain Project (HBP) is a prospective web‐based study of adults aged between 40 and 70 years. A total of 2208 participants (76% female) completed the Depression, Anxiety, and Stress Scale (DASS) and Paired Associates Learning subtest of the CANTAB unsupervised on the HBP web platform. Additionally, a sub‐group of participants (n = 67; 41% APOE e4 carriers) attended an in‐person assessment where CSF samples were obtained to measure levels of amyloid‐beta (Aβ42), total tau (t‐tau), phosphorylated tau 181 (p‐tau), and neurofilament light chain (NFL). Separate linear regression analyses investigated associations of the DASS‐Stress score with memory performance and AD biomarkers. All analyses were adjusted for age, sex, education, and race.ResultIn the web‐based cohort, higher levels of self‐reported psychological stress were significantly associated with poorer memory (unstandardised β = ‐0.014, standard error [SE] = 0.004, p <.001). However, there were no significant associations between psychological stress and CSF levels of Aβ42, t‐tau, p‐tau, and NFL (all p > .05), with small effect sizes (Cohen’s f2 ≤ 0.05).ConclusionHigher levels of self‐reported psychological stress were associated with poorer memory in a large middle‐aged cohort but were not associated with AD biomarkers in a subset of participants with available CSF. One potential explanation is that non‐AD pathologies may underlie the relationship between stress and poorer memory; for example, poor coping strategies (e.g., smoking, overeating, and physical activity) might increase the risk of vascular cognitive impairment. However, it is also likely that the small sample size of the in‐clinic cohort was insufficient to detect any subtle relationships between stress and AD pathologies. Further research is needed to determine the associations between stress and the development of the clinical and biological manifestations of AD.

Coping and mood in carers of people with Parkinson’s disease – an anonymized online survey

AbstractBackgroundFamily and informal carers play a substantial role in the care of patients with Parkinson’s disease (PD) especially those who develop neuropsychiatric symptoms and dementia. As PD progresses, carers are at increased risk for poor health outcomes and greater levels of stress. Furthermore, negative emotional states, such as depression and anxiety with stress, are major risk factors for the development and maintenance of poor adaptive coping strategies. However, the literature examining these in PD carers is sparse. We aimed to identify and examine relationships between mood symptomatology and coping strategies in carers of people with PD.MethodsAn anonymised self‐administered online survey was conducted for data collection within the UK (Ethics Approval Ref‐LRU‐21/22‐28386). The survey consisted of questions regarding demographics, coping strategies and mood symptoms. A snowballing sampling was used to recruit via advertising in various Parkinson’s support groups within UK. Participants who were unpaid carers (family, partner or friend) of people with PD above the age of 18 years, fluent in English and had a device to do the online survey were eligible.Results105 carers for people with PD participated online between 23rd May 2022 to 15th July 2022. 96.2% of the carers were women and most in the age range of 45‐64 years (57.1%). 93.3% of the carers were spouse or partners, lived (89.5%) and taken care of the person with PD for over 5 years (54.3%), providing care ‘most of the time’ (59%). 61.9% PD persons had dementia and 29.5% had psychosis symptoms. We found that PD carers used more of non‐adaptive than adaptive coping strategies. 91.4% of carers had anxiety and 92.4% had depressive symptoms in varying frequency. Non adaptive coping strategies were associated with increased mood symptoms.ConclusionsCarers with adaptive coping strategies had lower frequency of mood symptoms. Further research in larger samples is needed not only to understand the relationships of coping strategies and mood symptoms in carers of people with PD but also important to devise interventions to support these carers to improve their well‐being.

Nature of climate change-induced risks in semi-arid northwestern Ghana: Gauged observations, perceptions of smallholder farmers, and perspectives for livelihood adaptation

Climate variability and impact have been an endemic challenge to smallholder farmers who largely depend on rainy weather for livelihoods in semi-arid north-western Ghana. Many households in semi-arid regions exhibit low levels of adaptive capacity due to ineffective adaptation strategies and poor coping strategies. This study examined (1) trends in gauged rainfall and temperature data spanning the period from 1984 to 2014 and (2) smallholder farmers’ perceptions about yearly cyclical weather, and difficulties associated with climate change adaptations. The study adopted the participatory rural appraisal design using questionnaire, interviews and focus group discussions for collection of data for analysis. Estimated parameters partially supported that yearly temperatures are increasing, whereas annual rainfall is declining, although the latter is not significantly related to the former. Smallholder farmers’ perceptions about changing weather conditions did not corroborate the observed declining annual rainfall trend. These farmers are faced with livelihood-affecting risks during either ‘prolonged dry periods from October to May’ or ‘short annual rainy season from mid-May to September. Therefore, access to climate information and available climate adaptation strategies could improve farming activities and livelihoods of farmers in response to climate change.

Individualized and ecological analyses of the needs of family caregivers of older adults with dementia: The phenomenological approach

AbstractBackgroundDementia is a worldwide public health challenge. Caring for a person with dementia affects their caregivers in different ways.ObjectivesUsing an integration of the Model of Human Occupation (MOHO) and Bronfenbrenner’s ecological systems theory (EST), this study aimed at exploring the needs of and stress arising in family members who are caregivers of people with dementia and identifying the coping strategies these family members use in caring.MethodsUsing the purposeful sampling strategy and a blend of closed‐and‐open‐ended questions, four focus groups were conducted in four different districts. A phenomenological explanation approach was used to examine participants’ caring experience and their needs.ResultsEighty family caregivers (FCGs) of people with dementia, who are their family members, were recruited. Seeking understanding, stabilization, preparation, implementation, and adaptation are the themes that were identified for analysis. The results indicated caregiving is a demanding task, both mentally and physically.ConclusionBeing older, having a lower socioeconomic status and having lower levels of informal support were related to higher levels of care stress and poorer coping strategies in FCGs. Moreover, active service provision can be started in the early stages of caring and this should accompany with the active involvement of service in the volitional aspects of the FCGs.

Suicidal Ideation and Behavior Among Mexican University Students Before and During the COVID-19 Pandemic

Objective The COVID-19 pandemic has affected the mental health of populations around the world, but few longitudinal studies of its impact on suicidal thoughts and behaviors have been published especially from low- and middle-income countries. Methods This is a prospective cohort study of 1,385 first-year students from 5 Universities in Mexico followed-up for 1 year. We report 1-year cumulative incidence of suicidal thoughts and behaviors before (September 19, 2019–March 29, 2020) and during the COVID-19 period (March 30, 2020–June 30, 2020), focusing on those in the COVID-19 period with risk conditions and positive coping strategies during the pandemic. Results There was an increase in the incidence of suicidal ideation during the COVID-19 period compared to the pre-COVID-19 period (RR 1.65, 95%CI 1.08–2.50). This increase was mostly found among students with heightened sense of vulnerability (RR 1.95), any poor coping behavior (RR 2.40) and a prior mental disorder (RR 2.41). While we found no evidence of an increased risk of suicidal planning or attempts, there was evidence that those without lifetime mental health disorders were at greater risk of suicidal plans than those with these disorders especially if they had poor coping strategies (RR 3.14). Conclusion In the short term, how students deal with the pandemic, being at high risk and having poor coping behavior, increased the new occurrence of suicidal thoughts and behaviors. Studies with longer follow-up and interventions to reduce or enhance these behaviors are needed. HIGHLIGHTS Suicidal ideation increased during the COVID-19 period Those with heightened sense of vulnerability and poor coping were more affected Studies with longer follow-up are needed

In the name of war: Hypermasculinity in Elma Shaw’s redemption road

The paper examines hyper-masculinity in West African war literature. Masculinity, hegemonic masculinity, and hyper-masculinity are all recurrent themes in Social Sciences and other fields of study but not so much in Literature. The disparity between the war history of West Africa, the few literary works on conflicts in West Africa, and the dearth of literary studies on Africa’s war literature underscore this study. Elma Shaw’s Redemption Road is one of the very few war novels on Liberia’s civil war that spanned from 1989 to 2003 and cost the lives of over 250,000 people. Through the frameworks of postcolonialism and hypermasculinity, this paper analyses hypermasculinity and gender relations in Shaw’s post-colonial war novel. The geopolitical struggles of the post-colony, the emblematic dichotomies of feminine and masculine, and their implications on gender relations in war discourse are centralized. The study demonstrates that faulty childhood context, faulty governance, poor coping strategies, and the fear-loaded cultural oppression of males to show manliness culminate in the trials of men in this fictional post-colonial Liberia. These tensions exacerbate the chaos of war as they render the conflict setting a ripe fodder for violent gender relations. They also engender the inexplicability of femininity in masculinity discourses for the only reason that females are the litmus for the test and measurement of masculinity in many patriarchal cultures as demonstrated in the novel. Thus, the paper reveals insights into why male characters become hyper-masculine in the novel. This revelation facilitates a better understanding of gender issues in war contexts. The conclusion to the discourse is that in fictional war-torn Liberia, excessive masculinity is not a masculine nomenclature but a colonially influenced gender coping parading that has lasting negative implications on gender relations.

A cross-sectional study of coping strategies and resilience and its association with psychological symptoms of doctors working in a dedicated COVID-19 care center.

Health-care professionals who are involved in treating COVID patients use multiple coping strategies to overcome stress. Studies have shown that individuals having poor coping strategies and resilience are more prone toward psychological symptoms. The study was conducted to assess the coping strategies and resilience and its association with psychological symptoms of frontline doctors working in a COVID care center. It was a cross-sectional study using convenient sampling conducted among 150 frontline doctors working in a COVID care center. The study tools included were sociodemographic questionnaire, Depression, Anxiety, and Stress Scale 21, Brief-COPE Scale, and Connor-Davidson Resilience Scale which was sent using Google Forms to participants after obtaining informed consent. Statistical analysis was conducted using Chi-square test for categorical variables, t-test for continuous variables, and Mann-Whitney U test for ordinal data, Spearman correlation for correlations, and backward multiple linear regression to predict psychological symptoms. Doctors with severe stress had higher dysfunctional coping and lower resilience scores (P = 0.001). There was a positive correlation of stress, anxiety, and depression with problem-focused, emotional-focused, and dysfunctional coping, and there was a negative correlation between total resilience scores with stress and depression. Stress and anxiety were predicted by dysfunctional coping and resilience. Depression was predicted by dysfunctional coping (β = 1.25, P < 0.001), resilience (β = -0.08, P = 0.005), and duration of working hours per month (β = -0.008, P = 0.05). There is an urgent need to look at therapeutic strategies and factors which enhance resilience and promote better coping in this population.

Psychosocial distress, perceived social support, and coping in women survivors of domestic violence seeking help from a women's helpline in urban India.

Domestic violence against women is a worldwide phenomenon and a major public health concern. The adverse effects on the physical and mental health of the women survivors of domestic violence are influenced by various psychosocial factors. This study aimed to understand psychological distress, perceived social support, and coping strategies among women survivors of domestic violence and its implications. It is a cross-sectional study conducted with 30 women survivors of domestic violence from urban Bengaluru who were registered with a women's helpline. Data were collected using a socio-demographic schedule, a self-reporting questionnaire assessing psychological distress, perceived social support scale, and ways of coping scale. Descriptive and inferential statistics were used to analyze the data. Psychological distress was the highest among participants facing violence due to perpetrator using alcohol (M = 11.6, SD = 3.9) and (M = 11.73, SD = 3.5) dowry harassment. Perceived social support from family (M = 14.76, SD = 4.54) and friends (M = 11.85, SD = 4.7) was the highest among participants who reported that alcohol use was not a reason for violence. It can be noticed that alcohol use, dowry harassment, and poor coping strategies were the main reasons for domestic violence, which has led to severe psychosocial distress among the women survivors.

Update on Mayer-Rokitansky-Küster-Hauser syndrome.

This review presents an update of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome on its etiologic, clinical, diagnostic, psychological, therapeutic, and reproductive aspects. The etiology of MRKH syndrome remains unclear due to its intrinsic heterogeneity. Nongenetic and genetic causes that may interact during the embryonic development have been proposed with no definitive etiopathogenesis identified. The proportion of concomitant extragenital malformations varies in different studies, and the discrepancies may be explained by ethnic differences. In addition to physical examination and pelvic ultrasound, the performance of pelvic magnetic resonance imaging is crucial in detecting the presence of rudimentary uterine endometrium. MRKH syndrome has long-lasting psychological effects on patients, resulting in low esteem, poor coping strategies, depression, and anxiety symptoms. Providing psychological counseling and peer support to diagnosed patients is recommended. Proper and timely psychological intervention could significantly improve a patient's outcome. Various nonsurgical and surgical methods have been suggested for treatment of MRKH syndrome. Due to the high success rate and minimal risk of complications, vaginal dilation has been proven to be the first-line therapy. Vaginoplasty is the second-line option for patients experiencing dilation failure. Uterine transplantation and gestational surrogacy are options for women with MRKH syndrome to achieve biological motherhood.

The Use of a Personalized 3D Printed Model for Pre-Operative Education in Patients with Severe Periarticular Foot and Ankle Fractures

Category: Trauma; Other Introduction/Purpose: Complex periarticular foot and ankle fractures have shown to have significant psychosocial effects on patients such as developing catastrophizing behaviours and poor pain coping strategies. These factors have shown to influence patient satisfaction. Interestingly, a positive association exists between patient satisfaction and preoperative expectations being met. For patient expectations to be met, clear comprehensive preoperative education is required. 3D printing has gained popularity due to its benefits in preoperative planning as well as patient education. Our aims were to 1) investigate the impact of a personalized 3D printed model for patient education on pre- and post-operative expectations and overall satisfaction and 2) investigate the impact of this teaching modality on PROMS and their correlation to patient expectation and satisfaction. Methods: Twenty-eight patients presenting complex periarticular foot and ankle fractures (pilon, talus and calcaneus) were randomized to either control or intervention (3D). All patients underwent a preoperative standardized education session with or without a personalized 3D printed model. Patient expectation and satisfaction were quantified pre- and postoperatively using the MODEMS questionnaires while the following PROMs (VAS and SF-12) were assessed at 2 weeks, 3 months, 6 months and 12 months post-operatively. Results: No significant differences were found between groups for MODEMS pre- (p=0.329) and postoperative expectation (p=0.654), and satisfaction (p=0.411). While not statistically significant, there was a trend towards expectations being better met in the intervention group when compared to the control group (31.2% vs 43.5% respectively). Also, there were no significant differences between groups for VAS and SF-12 at different time points, expect for SF-12 at 3 months for physical component only. A strong positive correlation (0.905, p=0.013) was found between MODEMS preoperative expectation and VAS scores at 12 months in the intervention group. Conclusion: Although there were no significant differences found between groups for pre- and postoperative patient expectation and overall satisfaction at 12 months, there is a trend towards expectations being better met in the intervention group. This could indicate that lower and more realistic expectations are set preoperatively when educating patients using a 3D model. Expectations preoperatively are strongly correlated with pain scores at 12 months in the intervention group demonstrating an association with realistic expectations and improved pain scores when a 3D model was used. Thus, personalized 3D printed education is a non- invasive tool that may impact pain coping strategies post-operatively.

Uncertainty in illness among individuals with schizophrenia: a phenomenology study in Indonesia

PurposeIndividuals with schizophrenia experience uncertainty due to the unpredictable symptoms, the course of the illness and poor knowledge about the disease, treatment and prognosis. Uncertainty in illness is linked with poor treatment outcomes, coping strategies, check-up decisions and psychological distress. This study aims to explore the uncertainty in illness among individuals with schizophrenia.Design/methodology/approachEight individuals with schizophrenia living in the community were interviewed regarding their illness. The phenomenology approach was used to collect and analyze the data.FindingsThree themes emerged from the findings of the study; the unpredictable course of the illness, compliance amid uncertainty and uncertainty of information about their illness. This study provides an essential overview of how patients with schizophrenia live in uncertain conditions.Originality/valueIt should be considered by various parties, particularly the community mental health nurses working with individuals with schizophrenia. Considering the uncertainty of illness while looking after or interacting with patients and their family is significant in improving adequate mental health-care delivery.