Psychological Challenges Research Articles

Quantitative Study of Physical, Social, Psychological, and Environmental Challenges Faced by Patients With Drug-Resistant Tuberculosis.

Background This study chronicles the socioeconomic and emotional challenges experienced by patients suffering from drug-resistant tuberculosis (DR-TB) in India, the country with the highest tuberculosis (TB) burden globally. Current government measures under the National TB Elimination Programme (NTEP) that include widely available molecular diagnostic methods, well-defined DR-TB regimens, free drug distribution, treatment adherence strategies, etc. need to expand to cover socioeconomic and emotional aspects of the disease. Objective The objective of this study was to assess the effects of DR-TB and its treatment on the quality of life of patients in the psychological, social, environmental, and physical domains using validated scales. Method Conducted at a tertiary care center in Pune, this quantitative study utilized the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to objectively assess the quality of life of 64 DR-TB patients. The questionnaire was self-administered but assisted by the investigator to understand the meaning of the questions, and it covered four domains: psychological, social, environmental, and physical. Results The results indicated significant psychological distress, with the psychological domain scoring the lowest mean (33.41), followed by social (35.52), environmental (41.27), and physical domains (41.88). These findings underscore the profound impact of DR-TB on the mental health, social interactions, and overall well-being of these patients. Furthermore, substantial employment challenges, financial constraints, and fears of disease transmission were prevalent among patients, highlighting socioeconomic disparities. Conclusion The study emphasizes the necessity of holistic interventions that include psychological support, socioeconomic empowerment, and public health campaigns to improve the quality of life and treatment adherence for DR-TB patients. Future research should explore integrated care models that address both the clinical and psychosocial needs of patients. The insights from this study suggest a need for policy enhancements and resource allocation to better support this vulnerable population, ultimately aiming for more comprehensive and sustainable DR-TB management, thus focusing not only on the outcome but also on morbidity.

Developing Music Therapy in Maternity Care in Ireland: A Qualitative Study.

Music therapy can be a form of preventive or early intervention. It strengthens and utilizes women's own resources to build resilience, aids relaxation, reduces symptoms of anxiety and depression, promotes parent-infant attachment, and adapts to physical and psychological challenges during the perinatal period. The inclusion of music therapy in Irish maternity services has the potential to improve the quality of healthcare delivery provided to parents and infants. Recent studies demonstrate that the prospect of music therapy is welcomed by parents and perinatal healthcare professionals in Ireland, but such services are yet to be formally embedded in maternity care. Building on a cross-sectional survey, this qualitative study employed 6 semi-structured interviews with women and perinatal healthcare professionals in Ireland to understand their perspectives on developing music therapy in Irish maternity care services. Four themes were identified from the thematic analysis of these interviews: (1) music has multiple functions during the perinatal period; (2) music programs contribute to holistic perspectives and approachability in perinatal care; (3) music therapy provides specialist support; and (4) further development of music therapy services is challenging. The findings offer important insights and practical considerations on the key components of the music therapy programs and strategies in developing music therapy in Irish maternity settings. This information can directly inform music therapy researchers and practitioners in designing music therapy programs and developing relevant services in collaboration with maternity care professionals and policymakers.

Changes in Psychological Challenges, Positive Experiences, and Coping Strategies among International Students in the United States before and during the COVID-19 Pandemic: A Qualitative Study.

The purpose of this study was to understand how the challenges and coping strategies among international students in the United States changed before and during the COVID-19 pandemic. We conducted a qualitative study through one-on-one in-depth interviews during April-June 2021. A total of 34 international students in the San Francisco Bay Area participated in this study. NVivo was used to analyze the qualitative data. Before COVID-19, the challenges were primarily related to a sense of belonging, such as culture shock, language barriers, and loss of identity. However, some positive experiences from school life and new culture were also found before COVID-19. During the pandemic, students faced difficulties with online learning and lockdown protocols that they had never experienced before. The ongoing challenges before and during COVID-19 were identity crisis, racism and discrimination, and financial struggles. Common coping strategies for overcoming these difficulties included engaging in physical activity, social exposure, self-improvement, and mental self-care. The frequency of online engagement and motivation for self-improvement were particularly highlighted during COVID-19. However, international students expressed a preference for improved support systems, including financial aid, paid research opportunities, and more accessible campus resources. Future research could focus on the strategies to support the psychological well-being of international students in coping with unexpected situations, such as disease outbreaks.

Patients’ Experiences With Complementary and Alternative Treatments to Manage Chemotherapy Symptoms

This phenomenological study aims to explore the experiences of individuals undergoing chemotherapy, focusing on their symptoms and the use of complementary and alternative treatments to cope with these challenges. Thirteen individuals diagnosed with cancer in a city in the central region of Turkey were interviewed using a semi-structured, in-depth approach in this phenomenological study. The criterion sampling method was employed to select participants, and interviews continued until data saturation was achieved. Thematic analysis was applied to the audio-recorded and transcribed interviews. The study adhered to the COREQ checklist for reporting qualitative research. The data analysis revealed 2 main categories (effects of cancer and chemotherapy on individuals, the use of complementary and alternative treatments to cope with the symptoms of patients receiving chemotherapy) and 6 themes (psychological effects, social impacts, physical effects, social practices, psychological practices, and physical practices). The study demonstrated that individuals faced significant psychological, physical, and social challenges due to cancer, posing difficulties in coping. The symptoms had a substantial negative impact on individuals. The research identified the use of various alternative methods, such as yoga, the Mediterranean diet, and music therapy, as coping strategies. It is recommended that individuals undergoing chemotherapy explore complementary and alternative treatment methods to effectively manage symptoms.

Exploring Moderation Dynamics: Callous-Unemotional Traits, Parental Practices and Conduct Problems in JuvenileDelinquency.

Callous-unemotional (CU) traits, parental practices and conduct problems (CP) have been consistently identified across numerous studies as significant predictors of the severity and persistence of juvenile delinquency. This study seeks to investigate the moderation dynamics underlying the relationships between these variables among Arab incarcerated youth. Specifically, the study aims to (1) explore whether parental practices moderate the relationship between CU traits and CP among incarcerated youth in Jordan and (2) examine the bidirectional moderating influence of CU traits in shaping the dynamic relationship between parental practices and CP within the context of Arab juvenile delinquency. An observational survey design was employed, gathering data from 184 incarcerated youth across 11 rehabilitation centres in Jordan. Latent profile analysis identified three parental practice classes: more positive, balanced and more negative. Moderation analyses indicated significant associations between CU traits, parental practices and CP. Parental practices, especially positive ones, moderated the relationship between CU traits and CP, highlighting the protective influence of balanced parenting. Furthermore, bidirectional moderation effects were observed: CU traits moderated the link between parental practices and CP, while CP influenced parenting practices, particularly in the presence of elevated CU traits. The findings of this study underscore the vital role mental health nurses can play in addressing the behavioural and psychological challenges faced by youth involved in the justice system and their families. Specifically, mental health nurses can aid in ameliorating mental distress by supporting parents in understanding and managing CU traits and CP. Nurses can provide targeted educational programmes that empower parents with strategies to reinforce positive parenting practices and reduce negative interactions. Furthermore, nurses can facilitate access to community resources and therapy options, helping families build a supportive environment conducive to the mental well-being of the youth. These interventions are crucial not only for the direct treatment of juveniles but also in providing holistic support to their families, thereby enhancing the overall efficacy of mental health care in juvenile delinquency. This study highlights the essential role that mental health nurses play in managing behavioural issues among youth, emphasising the significance of implementing culturally sensitive interventions. Mental health nurses possess a pivotal position in early detection and intervention, which enables them to guide families in fostering positive parenting practices, essential for preventing delinquent behaviours. Their efforts to promote understanding and responsiveness within family dynamics make a significant contribution to the mental well-being of individuals, highlighting the necessity of their role in global mental health.

Alcohol consumption in cancer patients receiving psycho-oncologic care analysis of socio-demographic, health-related and cancer-related factors.

The carcinogenic effects of alcoholic beverages and the negative impact of alcohol consumption on cancer progression and treatment outcomes are well established in oncology research. Many cancer patients experience significant psychological distress, often manifesting as elevated levels of depression and anxiety. In the general population, alcohol consumption is commonly used as a coping mechanism for such distress. For cancer patients facing substantial psychological challenges, psycho-oncology care is available to help manage their symptoms and the overall impact of their condition. However, there is limited understanding of the alcohol consumption patterns in this particularly vulnerable group of patients, as well as the disease-related factors that may influence their drinking behavior. This study aims to examine the prevalence of potentially risky alcohol consumption in cancer patients receiving psycho-oncology care and to identify sociodemographic, health-related, and psychosocial factors associated with alcohol consumption after cancer diagnosis. By understanding drinking patterns and the factors associated with them, we aim to promote healthier behaviors and enhance treatment outcomes for cancer patients receiving psycho-oncology care. A consecutive sample of 1.225 patients from the psycho-oncology outpatient clinic of the University Medical Center Hamburg Eppendorf (UKE) was analyzed with regard to their alcohol consumption behavior using the Alcohol Use Disorders Identification Test-Consumption Items (AUDIT-C). Self-report questionnaires were employed to assess sociodemographic, health-related, and cancer-specific information. For statistical analysis, multiple linear regression was utilized. In the sample of cancer patients receiving psycho-oncology support one in six of both female and male patients showed risky alcohol drinking behavior (e.g. AUDIT-C above three for women and four for men). In the analysis (R-Square: 0.056) male gender (regression coefficient B 0.686, 95% CI: 0.453-0.919) and patientsreporting a higher physical health-related quality of life (SF8-PCS) (B 0.021, 95% CI: 0.011-0.032) were associated with higher levels of alcohol consumption, whereas having children (B -0.481, 95%CI: -0.700- -0.262) was associated with lower alcohol consumption. With regard to cancer type, a single-factor analysis of variance with gender as the centered covariate showed that patients with gastrointestinal cancer had had lower average consumption levels compared to the groups of patients with breast cancer, melanoma, genitourinary cancer, and lymphoma. Also, patients with sarcoma had lower average consumption levels than patients with lymphoma. The results allow to identify patient characteristics and cancer types associated with higher or lower alcohol consumption levels and higher likelihood of risky consumption behavior in this sample of cancer patients receiving psycho-oncological support. Cancer patients are particularly susceptible to the hazardous effects of alcohol consumption. The results of this study help to identify cancer patients at risk of worsening prognosis due to alcohol consumption and to develop intervention programs to minimize alcohol consumption in this group.

"How can you think about losing your mind?": A reflexive thematic analysis of adapting the LivDem group intervention for couples and families living with dementia.

Introduction: Despite the psychological challenges that dementia creates, comparatively little attention has been paid to how individuals or families can be helped to adjust to dementia. One of the few interventions to do this is the Living well with Dementia (LivDem) post-diagnostic course. LivDem focuses on supporting individuals to talk more openly about their dementia. However, while family supporters attend preliminary and follow up sessions, their role is limited and finding a way for them to be more actively involved might enhance the impact of the intervention and make it more flexible. We therefore set out to explore how the current LivDem intervention could be adapted for couples and families. Method: We completed eleven semi-structured interviews and focus groups with four groups of stakeholders: people living with dementia and their families: LivDem facilitators; researchers in this area; and psychotherapists with experience of working with couples or families living with dementia. Interviews were transcribed and analysed using reflexive thematic analysis. Results: Four main themes were generated: "Hear the impact on everybody"; People who are "ready to do that"; "It's such a fine line"; and "You deal with it in your family". Participants emphasised that the intervention needs to be delivered by willing and skilled facilitators to people who are ready to talk in their family context; and this intervention needs to be embedded within connected services. Conclusions: Stakeholders felt that it would be possible to adapt the LivDem model for couples and families so long as a number of conditions were met. An adapted family or couple version of LivDem has the potential to facilitate improved adaptation to dementia and to be incorporated into dementia pathways and delivered with the NHS and the voluntary sector. Further research is needed to establish the feasibility of such an intervention.

Psychological and social difficulties in young non-help-seeking adolescents at risk for psychosis: insights from a large cohort study.

This study used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), and explored the psychological and social challenges of 14-year-olds who report psychotic symptoms. Research on help-seeking youths indicates comorbid symptoms of depression, anxiety, and social deterioration, but less is known about non-help-seeking individuals who may not use healthcare services, possibly skewing comorbidity profiles. Also, findings suggest that adolescents manifesting psychotic symptoms refrain from pursuing help. This gap underscores the necessity of studying non-help-seeking adolescents to better understand their needs and the risks they face without intervention. We analyzed responses from adolescents who completed the 14-year questionnaire in MoBa (N = 127), identifying those as at risk by their high scores on psychosis-risk items, within the top 0.4% (N = 58). Comparative analyses were conducted against matched controls to assess differences in psychological and social functioning (N = 69). Results indicated that the at-risk adolescents experience significantly more depression and anxiety and have lower self-esteem and poorer social functioning than controls. Social functioning parameters, including leisure activities, social competence, quality of parental relationship, and sense of school belonging, were significantly worse than those observed in controls. The results indicate a pronounced vulnerability among non-help-seeking adolescents at-risk, similar to issues seen in help-seeking youths. These findings highlight the importance of early identification and intervention strategies that reach beyond traditional clinical settings, suggesting the efficacy of population or community-based screenings to prevent long-term adverse outcomes. The study proposes a broader understanding of psychosis risk, stressing the importance of inclusive approaches to support at-risk adolescents effectively.

Linking belief in a just world and psychological capital to psychological basic needs satisfaction and mental health of young adults living with HIV: A comparative analysis

People living with HIV (PWH) have higher risks for negative experiences and emotions such as discrimination, self-blame, and denial, which make them vulnerable to mental health problems. Those living with HIV and are in the developmental stage of young adulthood (18–39 years) have added psychological challenges arising from the pressure to perform the developmental tasks of this stage, which may gratify or thwart basic psychological needs (BPNs) and impact their mental health. The study examined whether positive psychological attributes, including a belief in a just world (BJW) and psychological capital, could be resources for satisfying basic psychological needs, hence boosting the mental health of Young Adults Living with HIV (YALWH). A comparison sample of university students was also included in the study. The results show that BJW was positively directly associated with BPN satisfaction, BPN frustration, and mental health (flourishing aspect) in the student sample but not in the YALWH sample. Psychological capital was appositively associated with BPN satisfaction and flourishing in the student sample. On the other hand, psychological capital is only positively associated with BPN satisfaction and negatively with BPN frustration and distress in the YALWH sample. The serial medial analysis revealed that the effects of BJW on mental health (flourishing) are mediated by psychological capital and BPN satisfaction in both samples. On the other hand, the effects of BJW on distress are mediated by psychological capital and BPN frustration, again in both samples. Incorporating interventions for strengthening positive psychological attributes could be helpful for YALWH and other young adults to attain desirable developmental outcomes for this stage and their mental health.

Preservice English teachers’ views on online language assessment in Turkey

Technology has rapidly accelerated the adoption of online language assessments (OLA), presenting unique opportunities and challenges. This study explores preservice English teachers’ views on OLA in Turkish Turkey. Using a qualitative phenomenological approach, interviews were conducted with 11 English preservice teachers from a state university in Turkey. The findings reveal both the advantages and disadvantages of OLA. On the positive side, preservice teachers highlighted the environmental and financial benefits of reducing paper use and operational efficiencies like automated grading and the flexibility of remote assessments. They also appreciated the enhanced learning experiences provided by multimedia and interactive elements and the innovative assessment opportunities offered by online platforms. However, significant challenges were identified, including technical and infrastructure barriers, varying levels of digital literacy, and concerns about assessment integrity and security. Psychological challenges were also prominent, with many preservice teachers experiencing increased stress and anxiety due to unfamiliarity with online formats and the pressures of adapting to new technologies. These insights underscore the need for comprehensive training and support to help preservice teachers navigate the complexities of OLA, ensuring both effective implementation and the well-being of future educators.

Navigating psychological barriers in agricultural innovation adoption: A multi-stakeholder perspective

Agricultural innovation is pivotal for enabling cleaner production within the sector. Nonetheless, smallholder farmers in the Global South encounter functional and psychological challenges impeding innovation adoption efforts. Existing literature tends to narrowly focus on common barriers associated with individual innovations, often limiting the broader significance of psychological hindrances. This study takes a unique approach by delving primarily into the realm of psychological barriers, encompassing internal challenges that impede adoption, and explores external support strategies to overcome such hindrances. A multi-stakeholder approach was employed to gather validated insights based on data from eighteen semi-structured interviews involving rice farmers and agricultural technology companies. Research findings revealed that trust, effort, attitudinal, and normative barriers are prominent psychological hindrances to innovation adoption. To this effect, pertinent enabling factors and overcoming strategies should demonstrate clear benefits, infuse trust, reduce effort requirements, and develop human capital. This research is among the first to demystify and categorise psychological barriers and corresponding overcoming strategies into an integrated framework. The resulting framework allows for a novel and comprehensive analysis of the potential strategies to overcome the psychological barriers collectively, a complex issue involving interrelations and hidden dynamics that are challenging to explore otherwise. This study contributes to the Innovation Resistance Theory through its application within the context of smallholder farmers and leads to implications to expedite the transformation towards a more sustainable and innovative agriculture sector.

Barriers and Facilitators to Pediatric Oncology Social Work Practice: A Qualitative Study

Background: Childhood cancer is significant due to its high prevalence and its impact on the entire family, resulting in various psychological, social, economic, and communication challenges for the families. Objectives: The aim of this study was to explore the barriers and facilitators to pediatric oncology social work practices in Iran. Methods: This qualitative study used a content analysis method and involved 19 pediatric oncology social workers. We used a purposeful sampling method until data saturation was reached. Data were collected through semi-structured interviews and field observations and then analyzed. Results: This study demonstrated that the factors influencing social workers' practice include personal characteristics and interpersonal communication at the micro level, while barriers mainly consist of cultural, social, economic, organizational, and structural dimensions at the macro level. Conclusions: In order to better support children with cancer and their families, policymakers and health system managers need to give special attention to the status of social workers. Strengthening support systems and addressing the challenges they face can be effective in protecting the professional practices of these caregivers.

Digital learning in nursing education: lessons from the COVID-19 lockdown

BackgroundThe COVID-19 pandemic necessitated a swift transition to e-learning, significantly impacting nursing education due to its reliance on practical, hands-on experiences and the critical role nurses play in healthcare. Nursing students need to achieve high levels of clinical competence through experiences traditionally obtained in clinical settings, which e-learning had to replicate or supplement. Understanding the unique challenges faced by nursing students in e-learning environments is crucial for developing educational strategies that enhance learning outcomes and contribute to improved patient care. This study aimed to explore the experiences of nursing students and newly qualified nurses (as students) with e-learning during the COVID-19 lockdown, focusing on how it influenced their learning and professional development.MethodThis exploratory and descriptive study employed qualitative interviews with 31 participants, including full-time nursing students, part-time nursing students, and newly qualified nurses (as nursing students). Conducted online via Zoom during February and March 2022.ResultsThe findings suggest that integrating small group interactions and employing strategic pedagogical support can enhance e-learning effectiveness. However, barriers such as technological difficulties, psychological challenges, and social isolation were also identified. Understanding these unique opportunities and challenges can help educational institutions optimize e-learning strategies, ensuring nursing students are well-prepared for their crucial roles in healthcare.ConclusionThe rapid shift to e-learning due to the COVID-19 pandemic presented challenges such as technological, psychological and social aspects, but also opportunities to rethink and enhance nursing education delivery. Implementing appropriate pedagogical e-learning strategies, such as scaffolding and small group learning, can better prepare nursing students for their essential roles in healthcare. This study contributes to the body of knowledge on digital education and provides a foundation for future research aimed at optimizing e-learning in nursing education.

Effects of Digital Picture Books on Young Children Undergoing Cardiac Catheterisation and Their Family Caregivers: A Randomised Controlled Trial.

To assess the impact of digital picture books on preoperative anxiety, pain and sleep quality in young children undergoing cardiac catheterisation and the anxiety of their family caregivers. A randomised, single-blinded, two-arm, parallel-group controlled trial. Participants are young children aged 2-7 years with congenital heart disease scheduled for cardiac catheterisation and their family caregivers. They were enrolled at Fujian Medical University Union Hospital between September 2022 and July 2023. They were randomised to either a control group receiving usual care or an intervention group receiving digital picture book sessions. Anxiety and pain levels were assessed using standardised scales, and sleep quality was measured using actigraphy. The study included 64 pairs of young children and family caregivers. Digital picture books significantly reduced preoperative anxiety and bandage removal pain in children and anxiety in family caregivers. However, there was no statistical difference in sleep quality between the intervention group and the control group. Digital picture books prove to be an effective intervention for reducing anxiety and pain in paediatric cardiac catheterisation patients and anxiety of their family caregivers. The intervention did not affect sleep quality, suggesting the need for additional strategies to address this aspect of the hospital experience. This study demonstrated the effectiveness of digitally illustrated books in reducing preoperative anxiety and pain in young children and anxiety in family caregivers. Digital picture books offer a creative and engaging way to help children and their families cope with the stress and anxiety associated with medical procedures. Further research in this area may lead to the development of more innovative and effective interventions for paediatric patients and their family caregivers. The study's impact lies in its innovative approach to addressing the psychological and emotional challenges faced by young children and their family caregivers during the stressful experience of cardiac catheterisation. By demonstrating the efficacy of digital picture books in significantly reducing preoperative anxiety and postoperative pain, the research presents a non-pharmacological, accessible and engaging intervention that can be seamlessly integrated into existing healthcare practices. The findings have the potential to transform paediatric care by offering a safe, developmentally appropriate and cost-effective method to support the emotional well-being of children and their families, thereby enhancing the overall patient experience and clinical outcomes. Moreover, the study's emphasis on family caregiver involvement underscores the importance of a holistic approach to care that considers the needs of both the patient and their support system. Children and their family caregivers were invited to provide valuable input which has been critical to the development of the intervention. The participant information sheet and consent form, as well as the consent/recruitment process, were reviewed by a consumer advisor advocate from the pilot study. CONSORT. Chinese clinical trial registry: ChiCTR2200063973. Registered on 22 September 2022, https://www.chictr.org.cn/showproj.html?proj=132833.

Exploring the Value and Affordances of Psychoanalysis in the Teaching of English Literary Texts in South African Secondary Education

Teachers and learners at South African secondary schools face a variety of challenges, of which some are psychological, emotional, and hidden from the untrained eye. It is, therefore, crucial to search for methods or theories to help learners with emotional and psychological challenges. The study explored and interrogated one overlooked theory that could help in this regard: the psychoanalytic theory. This Freudian theory is believed to offer a different kind of literary criticism which focuses on the subconscious mental activities and unusual behaviours in literary texts to resolve psychological challenges in education and society. The study investigated the nature, affordances, teaching methods, and challenges and solutions associated with the theory. The study also revealed some practical benefits of the theory for English literary education and life in general. Additionally, the study found that the theory is valuable in equipping teachers and learners with psychoanalytic knowledge and skills to critically analyse English literary content. The study also established that psychoanalytic abilities can help identify and resolve psychological challenges in an educational environment and society in general.

Swinging Between Hope and Despair: Experiences of Patients with Behçet's Disease: A Phenomenological Research Study

Background: Behçet's disease (BD) can severely impact the psychosocial and emotional aspects of patients, significantly disrupting their quality of life. Objectives: The purpose of this study was to describe the psychosocial and emotional experiences of patients with BD and their coping strategies. Methods: This study was conducted using a qualitative method with a hermeneutic phenomenological approach. Data were collected through unstructured and in-depth interviews (9 conducted face-to-face and 6 via WhatsApp video calls) until data saturation was reached. Face-to-face interviews took place at the rheumatology clinic and the rheumatologist’s office from April to July 2023. Data analysis was performed using Diekelmann's seven-step method. The trustworthiness of the study was ensured based on the criteria of Lincoln and Guba, as well as Sim and Sharp. Results: By analyzing the data, 580 codes were extracted, leading to the identification of 12 sub-themes and 2 main themes. The first theme, "emotional, mental, and communicative instability," included the sub-themes of indecisiveness and uncertainty, moving away from desires and wishes, feelings of despair and demise, fears caused by the disease outcomes, sadness and mental anguish, isolationism, and reluctance to seek support. The second theme, "psychological and communicative strengthening strategies," comprised the sub-themes of having an occupation, seeking support, hoping for miracles and healing, doing mental exercises, and engaging in hobbies. Conclusions: This study revealed numerous emotional, psychological, and communicative challenges faced by patients with BD, as well as the strategies they use to cope with these problems. It is recommended that the findings of this study be used to enhance the care team's understanding of the mental and communicative issues experienced by these patients and to improve their skills in teaching psychological strengthening strategies.

Supporting Women after Obstetric Fistula Surgery to Enhance Their Social Participation and Inclusion.

Obstetric fistula is a childbirth complication causing abnormal openings between the urinary, bowel, and genital tracts, leading to involuntary leakage and potential long-term disability. Even after surgical repair, women continue to face psychological and social challenges that affect their social inclusion and participation. This study explored family and service provider perspectives on current support systems and identified gaps affecting women's inclusion and participation post-fistula surgery. Building on a prior study of women who underwent obstetric fistula surgical repair, we qualitatively examined available formal and informal post-surgical supports in Ethiopia. We conducted 20 interviews with family members and service providers and analyzed them using Charmaz's grounded theory inductive analysis approach. We identified four themes that indicated the available formal support in fistula care, the impact of formal support on women's social participation and inclusion, the gaps in formal support systems, and post-surgery informal supports and their challenges. Both groups believed support needs for women after surgery remain unmet, highlighting the need to strengthen holistic support services to improve women's social inclusion and participation. This study contributes to limited research on formal and informal support for women, emphasizing the need for enhanced economic, psychological, and sexual health-related support post-obstetric fistula surgery.

Navigating the battlefield within: Exploring the interplay of political armed conflict, mental health, and emotion regulation

The study explored the intricate relationship between political armed conflict, mental health outcomes, and emotion regulation strategies, focusing on cognitive reappraisal and emotion suppression. Drawing on extensive literature, we examined the impact of the Israel-Hamas war on mental health, particularly post-traumatic stress symptoms (PTSS) and anxiety. Using data from a nationally representative sample of 517 Israeli adults surveyed four weeks after the October 7 war began, we conducted path analysis to examine the direct and indirect effects of conflict exposure on mental health outcomes mediated by emotion regulation. Cognitive reappraisal was positively associated with well-being, while emotion suppression was linked to higher levels of PTSS and anxiety and lower levels of well-being. Subjective exposure to war events was associated with higher levels of anxiety and PTSS, and cognitive reappraisal served as a protective factor for overall well-being. We also observed ethnicity, age, and gender differences in exposure levels and mental health outcomes. Emotion regulation emerges as a crucial factor in navigating the psychological challenges posed by war exposure, with cognitive reappraisal associated with positive mental health outcomes and emotion suppression linked to adverse effects.

Persistent Psychological Distress and Its Associated Determinants Among Iranian COVID Survivors: A Cross-Sectional Study

Background: The COVID-19 pandemic has resulted in widespread physical and psychological challenges, including persistent psychological distress (PD). Research suggests that while some COVID survivors maintain satisfactory psychological functioning, others may experience long-term, severe PD. Addressing these challenges, along with associated sociodemographic determinants, requires a comprehensive, community-based approach. Objectives: This study aims to determine the prevalence of PD, including depression, anxiety, and stress, among Iranian COVID survivors by analyzing various regional, temporal, and sociodemographic determinants. Methods: The study, conducted between July 2021 and February 2022, aimed to determine persistent PD among Iranian COVID survivors. Ethical approval and other necessary permits were obtained. The final sample size consisted of 300 participants selected from an initial pool of 11,337 medical records. Participants received questionnaires electronically, including the “Socio-Demographic Clinical Questionnaire (SDCQ)” and the “Depression, Anxiety, and Stress Scale 21 (DASS21).” The study used SPSS 26 for statistical analysis, calculating means, standard deviations, and frequencies. Relationships between determinants were examined using ANOVA and chi-square tests. Bayesian regression analysis was employed to explore correlations and predictive power between COVID-19, PD, and the various determinants. Results: The prevalence of depression, anxiety, and stress, considered collectively as PD among participants, was 49%, 53%, and 61%, respectively, with mean severity scores of 10.68 ± 2.16 for depression, 9.18 ± 1.84 for anxiety, and 15.93 ± 2.79 for stress. More severe manifestations of PD were observed in participants from Hospital III (P > 0.05, r ≈ 0.17) and during the temporal period of 12 - 24 weeks post-infection (P < 0.05, r ≈ -0.12). Additionally, significant correlations between PD and determinants such as sex, Intensive Care Unit (ICU) admissions, and intubation were noted (P < 0.05). Bayesian analysis further highlighted cross-correlations between PD and other determinants among Iranian COVID survivors (P < 0.05, BF < 0.1). Conclusions: In conclusion, the study found that Iranian COVID survivors experienced mild levels of depression, anxiety, and stress, with prevalence rates ranging from 49% to 61%. The highest severity of PD was observed in participants from Hospital III and during the period of 12 - 24 weeks post-infection. Additionally, a network of cross-correlations was identified between PD and various other determinants among Iranian COVID survivors.

Calling All Leaders

ABSTRACT The U.S. Surgeon General recently published two reports highlighting the current public health crisis of unhealthy work environments that are contributing to mental health and physical, emotional, and psychological challenges for 161 million American workers. He identifies leaders as crucial partners in addressing this crisis. This editorial presents an approach to leadership assessment not often discussed in the human services sector, namely, using evidence-supported tools to assess a leader candidate’s qualifications prior to hire. Details of this approach, specific tools, as well as implications for social work practice, are reviewed.