Psychological Difficulty Research Articles

Treatment adherence and nasogastric tube use in hospitalized youth with anorexia nervosa and premorbid overweight/obesity

ABSTRACT Youth with restrictive-eating disorders (EDs) often experience significant distress and difficulty with treatment adherence during nutritional rehabilitation. This study assessed whether youth with restrictive EDs and premorbid overweight/obesity admitted for inpatient nutritional rehabilitation experience greater psychological distress and difficulty with treatment adherence than youth with premorbid BMI <85th percentile. A retrospective chart review examined 150 youth hospitalized for medical complications of restrictive EDs. Rates of nasogastric tube (NGT; used when youth could not complete meals), agitation medication use, and disposition recommendation were compared across premorbid BMI groups. Patients with premorbid overweight/obesity were three times more likely to require NGT feeds. These findings suggest greater challenges with nutritional rehabilitation, specifically consuming nutrition orally, in patients with premorbid overweight/obesity, highlighting the need for early and individualized psychological support for this vulnerable patient population.

The effects of inpatient suicide on nurses at Weskoppies Hospital: A qualitative study.

Inpatient suicide is a serious adverse event in psychiatric wards. Suicide can cause severe trauma to both patients and health professionals, who may develop maladaptation with poor coping skills. Healthcare practitioners are the second victims and historically, this concept has been overlooked. The psychological effects and lack of support have not been sufficiently explored. The emotional well-being and clinical practice of nurses who experienced inpatient suicide at Weskoppies Psychiatric Hospital was explored. Weskoppies Psychiatric Hospital, South Africa. In this qualitative case study, 12 nurses who had lost a patient to inpatient suicide some time during their employment were purposefully selected. Data were collected through individual in-depth interviews, which were audio recorded and transcribed. The data were thematically analysed. Nurses were negatively affected by inpatient suicide resulting in a range of emotional and psychological effects, including fear, anger, sadness, flashbacks, guilt, and difficulty in coping. Clinical practice factors included being doubtful and extra vigilant. Although nurses received psychological support from the institution, they recommended in-service training with periodic reviews to prevent and manage inpatient suicide. Inpatient suicide is a serious adverse event, and mental health practitioners become second victims. These events do not only impact the psychological well-being of nurses but also influence the clinical practice. Mental health practitioners should receive adequate training and support in preventing and handling inpatient suicide. This study provided insights into nurse's perspectives on the effects of inpatient suicide and how they can be supported.

The impact of the disaster on the residents of the city of Derna, Libya, psychologically, behaviorally, and intellectually

"The current research aims to determine whether disasters have an impact on the residents of the city of Derna in Libya psychologically, behaviorally, and intellectually. It also aims to investigate whether there are differences in the psychological, behavioral, and intellectual impact of disasters based on variables such as gender, age, extent of material damage, loss of a family member, and place of residence. The researcher followed a descriptive-analytical approach, and to achieve the research objectives, the researcher used two tools for collecting information and data: interviews and observations. The research community consisted of all residents of the city of Derna in eastern Libya, totaling 175,297. The sample consisted of 411 individuals, including 231 males and 180 females, selected using non-random sampling methods (purposive, quota, and accidental). The researcher arrived at a number of results, the most important being that disasters have psychological, behavioral, and intellectual effects that are evident among the research sample, such as acute psychological depression, aggressive behaviors, and difficulty in thinking. Additionally, there were differences between males and females in their response to disasters in favor of females due to the nature of females being emotionally sensitive and physically weaker. Furthermore, differences were also found among the research sample in the impact of disasters based on age, with children being more affected and more prone to behavioral disorders and psychological diseases, followed by the elderly over 60 years old. The rest of the age groups were less affected compared to children and the elderly. The research results also indicated that those who lost one or more family members and had their homes and properties damaged were more affected and sadder compared to other sample individuals whose properties were not damaged and who did not lose anyone. Finally, the results showed differences in the impact of disasters on the residents of the city of Derna in Libya psychologically, behaviorally, and intellectually based on their place of residence. The impact was greater on those living in the city center and on Sea Street because they suffered greater damage compared to those living in the east and west of the city.

집단미술치료가 중년여성의 우울과 분노에 미치는 영향

The purpose of this study is to find out the effect of group art therapy on depression and anger in middle-aged women. Six middle-aged women with high psychological depression and difficulty in controlling their anger in social and family life were selected as the subjects of the study. Group art therapy was conducted once a week for 60 minutes 20 times, and the effectiveness verification was pre- and post-analysis with a depression diagnosis scale (BDI) and a state-characteristic anger scale (STAXK-K). Looking at the results of the study, first, as a result of conducting a depression diagnosis scale (BDI) to find out changes in depression in middle-aged women, it was effective in reducing depression scores and psychological changes. Second, as a result of confirming the results of middle-aged women's anger with a state-characteristic anger scale (STAXK-K), it was found that middle-aged women's anger decreased and was stable. Therefore, this study proposes to develop self-esteem and anger control programs, including family counseling, to continuously control pathological depression and anger caused by situational and environmental factors in middle-aged women.

Association Between Workplace Social Support and Use of Health-Promoting Wearable Devices: A Prospective Cohort Study of Japanese Employees.

We examined the relationship between workplace environmental factors, including support from supervisors and colleagues, and the continued use of a wearable device meant to promote occupational health. One hundred employees at a Japanese manufacturing company participated in a 3-month study, and information related to their physical health status was recorded by a wearable device. We analyzed the results using the χ2 test and logistic regression analysis. We found that men aged 40-49 years and employees reporting low support from supervisors and colleagues were significantly more likely to be continuing device users. Participants with low workplace support had adjusted odds ratios approximately two to three times higher than those with high levels of support, which was significant. Employees with low workplace support were able to communicate at work, access appropriate support, and enthusiastically participate in occupational health promotion with little psychological difficulty in using the device. Occupational health promotion using wearable devices can complement traditional face-to-face occupational health promotion.

Long-Covid19 Symptoms After Infection in Covid Long-Haulers.

The negative molecular swab does not mean that the body and mind are healed: even months after Sars-Cov-2 infection, patients may continue to have symptoms. The symptoms mainly present at 6-12 months in patients recovered from Covid-19 are: asthenia, breathlessness, difficulty in breathing deeply, myalgia but also psychological disorders and difficulty in concentrating such as “brain fog”. The study was conducted from June 2021 to July 2021 at Health Prevention Department in Benevento (Campania Region, South Italy). 133 patients accepted the questionnaire in the form of telephone interview. The purpose of this study is precisely to highlight how, although a year after infection, a number of patients still show post-COVID symptoms. In particular 77 of 133 positive patients are resulted Long-Haulers (58%).

Investigating the elements influencing the psychological issues of reform school students

Reformatory students are those whose deviant behaviors and habits prevent them from receiving education under normal educational conditions. These students frequently lead a careless, undisciplined lifestyle, being unwilling to work and learn eager to play and demanding. Therefore, when they are admitted to reformatories with severe study and lifestyle requirements, they have great psychological difficulty adjusting to their new environment. Students’ psychological issues in adapting to reformatory learning and living regimes are difficult and psychological deficits make it challenging for students to adapt to reformatory learning and living conditions. In Vietnam, 665 students from reformatory schools were polled to determine the causes of psychological issues. According to the findings, a variety of elements contribute to students’ psychological difficulties. Individual student conditions such as health, awareness, attitudes and actions as well as inappropriate habits, living without goals or aspirations, etc. are on the subjective side of the equation. On the objective side are the students’ conditions, family, education and psychological obstacles brought on by less-than-ideal circumstances which will make it more difficult for community students to adapt. Both the new school and society must pay more attention to reformatory students in order to establish the conditions necessary for successful integration into the new school and ultimate readmission into society for these students.

Psychological mechanism of acceptance and commitment therapy and rational emotive behavior therapy for treating hoarding: Evidence from randomized controlled trials.

Hoarding is a common problem behavior worldwide and is detrimental to the physical and mental health of individuals and groups. Currently, effective interventions for hoarding are cognitive-behavioral therapies, but their post-intervention efficacy is questionable, and the available research does not examine the mediating variables of the effects of interventions on clinical outcomes. Moreover, current research on hoarding has focused on Western countries. Therefore, there is a need to investigate the efficacy of other forms of cognitive behavioral therapy on hoarding as well as other psychological outcomes related to hoarding and mediating variables that contribute to its effectiveness in different cultural contexts. One hundred thirty-nine college students with higher hoarding behaviors were randomly divided into three groups: 45 in the Acceptance and Commitment Therapy (ACT) group, 47 in the Rational Emotive Behavior Therapy (REBT) group, and 47 in the control group. They completed the Saving Inventory-Revised (SI-R), Obsessive-Compulsive Symptom Scale (OCSS), Difficulties in Emotion Regulation Scale (DERS), Experiences in Close Relationships Inventory-Attachment Anxiety Subscale (ECR), Depression Anxiety Stress Scales (DASS-21), Acceptance and Action Questionnaire II (AAQ-II), and Cognitive Fusion Questionnaire (CFQ) before and immediately after the intervention. The results showed that ACT and REBT improved individuals' psychological flexibility, cognitive fusion, acquisition-difficulty discarding, clutter, negative affect (anxiety, depression, stress), attachment anxiety, obsessive-compulsive disorder, and difficulty in emotion regulation compared to the control group. In addition, ACT was more effective than REBT in improving psychological flexibility and reducing hoarding, cognitive fusion, depression, stress, and obsessive-compulsive disorder; there were no significant differences between the two in anxiety and emotion regulation difficulties. Furthermore, psychological flexibility is a mediator of the effect of ACT and REBT on some behavioral and psychological outcomes (hoarding, negative affect, attachment anxiety). Limitations were discussed.

Impact of high‐intensity interval training including Indigenous narratives on adolescents’ mental health: a cluster‐randomised controlled trial

ObjectivesWe investigated the efficacy of teacher‐delivered high‐intensity interval training (HIIT) with Indigenous narrative options on the mental health of school students in low–mid socioeconomic areas, compared to standard curriculum physical education practice. MethodsA cluster‐randomised controlled trial was conducted in eight schools (N=368, age range 11–13 years) over 16 weeks. The primary outcome was the Strengths and Difficulties Questionnaire (SDQ) score. Generalised linear mixed models, controlling for the SDQ at baseline were applied, expressed as β, 95% confidence intervals, standardised effect, and p‐value. Focus groups elicited experiences with participating in and delivering the intervention. ResultsThere were no clear effects for SDQ total score (β ‐0.15, CI ‐0.98 ‐ 0.67, SE 0.42, p=0.714). Teachers did not deliver the Indigenous narrative options consistently owing to the perceived preparation needed and lack of confidence. ConclusionsHIIT delivered in this manner had no effect on self‐perceived psychological difficulty or mental wellbeing in a cohort of young adolescents. Implications for public healthFuture research should continue to explore opportunities to improve mental wellbeing via physical activity, but HIIT should not be implemented as a universal intervention for mental health gains alone. Teachers need more support to utilise Indigenous narratives as part of HIIT delivery.

The characteristics of children referred to a child protection team in Japan and factors associated with decision-making: A retrospective study using a medical database

BackgroundDespite the potential efficacy of hospital-based multidisciplinary child protection team (CPTs), research analyzing Japanese CPT databases is scarce. ObjectiveWe aimed to describe the characteristics of children and families reported to a CPT in Japan and investigate factors associated with the substantiation of maltreatment. Participants and settingThis retrospective, cross-sectional study took place in a national children's hospital in Japan and included 350 children who were reported to CPTs between April 2014 and March 2018. MethodsUnivariable and multivariable logistic regression analyses were conducted using the CPT database and medical records. ResultsAmong 350 cases, 33.4 % were substantiated. Children of <6 years of age comprised 73.4 % of the cases. The majority (67.7 %) received an injury-related diagnosis and physical maltreatment was suspected in 68.3 % of cases. In the univariable analysis, older age, a primary diagnosis other than injury, reporting department, psychological maltreatment, witnessing intimate partner violence, maltreatment by relatives other than biological father or mother, developmental disability, emotional/behavioral difficulty or psychological disorder, maternal/paternal psychological difficulty, and maternal history of maltreatment were significantly associated with substantiation. When adjusted for demographic, child and familial factors, a diagnosis other than injury (AOR 2.02, 95 % CI = 1. 11–3.65) and parental psychological difficulties (AOR 2.49, 95 % CI = 1.37–4.55) were independently associated with substantiation. ConclusionMost cases reported to our CPT were young children with an injury-related diagnosis. Substantiation was associated with a diagnosis other than injury and parental psychological difficulties. Further prospective and comprehensive studies are needed to establish universal guidelines for databases of hospital-based CPTs.

Impact of Radiation-induced Trismus on Patients’ Life Quality

Head and neck cancers (HNC) account for 10–15% of all cancers globally. Curative radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) with or without surgery are widely accepted standard treatment modalities for these patients. Radiation-induced fibrosis is one of the side effects of these treatments, and it causes degeneration, inflammation, pain, and atrophy of the masticatory muscle fibers and the temporomandibular joint, resulting in trismus. Trismus, also known as hypomobility of the mouth, is defined as a restricted opening of the mouth. Radiation-induced trismus (RIT) can occur within the first three months of treatment or up to 12–48 months later during the follow-up period. It has a significant negative influence on daily activities and vital oral functions, including speech problems, difficulty eating or drinking, psychological problems, malnutrition, dehydration, and difficulty with oral hygiene, reducing the quality of life (QoL). Given the underappreciated nature of trismus and its negative consequences in HNC patients receiving RT or C-CRT, the purpose of this review was to provide a concise review of the physical, social, and emotional implications of RIT and their impact on QoL measures, as well as the available evaluation methods for physicians in the related medical fields.

Seeing the End from the Beginning: The Plights of Children’s Education in the Conflict-Affected Areas in Katsina State, Nigeria

A qualitative study examined children's educational and health well-being in areas affected by armed violence. Coordinated attacks on some villages and communities in Katsina State had rendered thousands of people homeless while some infants became orphans. The study was carried out in some designated Internally Displaced Camps in the seven most affected Local Government Areas in Katsina State. The researchers explored three qualitative data collection techniques in the study and elicited data from the field. Key Informant Interviews were conducted with camp officials, In-Depth Interviews were conducted with parents of the children aged 0-8 years taking refuge in the camps, and a non-participant observation method was used to observe the behaviour of the targeted children. The study revealed that children uprooted from their various villages were in dire need of assistance, particularly food, shelter, and medical attention. Also, there was no provision for temporary early childhood education services for the children who were supposed to be in school. Children traumatized by the gravity of the armed violence exhibit some elements of psychological disorder and difficulty in integrating with other displaced persons in the Camps and outsiders. The study concluded that children left without education at the most critical stage of life might become threats to society because they will grow without the requisite formal education that would enable them to become valuable members of their society.

The dark side of creativity: its connection to work-family conflict

ABSTRACT Creativity has its ‘dark side.’ This study investigated the relationship between employee creativity and work-family conflict drawing on boundary theory. Data were collected from 1074 participants who were full-time employees. By employing PROCESS macro, we found the relationship between employee creativity and work-family conflict is fully mediated by psychological detachment difficulty. We also found that family-work conflict moderates the effect of creativity on psychological detachment difficulty such that for those who experience lower family-work conflict, the effect of creativity on the mediator (i.e. psychological detachment difficulty) is stronger than for those who experience higher family-work conflict.

Impact of low iodine diets on ablation success in differentiated thyroid cancer: A mixed-methods systematic review and meta-analysis.

Debate remains regarding whether to recommend a low iodine diet (LID) before radioactive-iodine treatment and its duration and stringency. This mixed-methods review aimed to determine if iodine status affects treatment success, the most effective diet to reduce iodine status, and how LID impacts wellbeing. Five electronic databases were searched until February 2021. An effectiveness synthesis (quantitative studies) and views synthesis (qualitative, survey, and experience-based evidence) were conducted individually and then integrated. Quality assessment was undertaken. Fifty-six quantitative and three qualitative studies were identified. There was greater ablation success for those with an iodine status of &lt;50 mcg/L (or mcg/gCr) compared with ≥250 (odds ratio [OR] = 2.63, 95% confidence interval [CI], 1.18-5.86, n = 283, GRADE certainty of evidence very low). One study compared &lt;50 mcg/L (or mcg/gCr) to 100-199 and showed similar rates of ablation success (OR = 1.59, 95% CI, 0.48-6.15, n = 113; moderate risk of bias). People following a stricter LID before ablation had similar rates of success to a less-strict diet (OR = 0.67, 95% CI, 0.26-1.73, n = 256, GRADE certainty of evidence very low). A stricter LID reduced iodine status more than a less strict (SMD = -0.40, 95% CI, -0.56 to -0.24, n = 816), and reduction was seen after 1 and 2 weeks. The main challenges were a negative impact on psychological health, over restriction, confusion, and difficulty for sub-groups. Although a LID of 1-2 weeks reduces iodine status, it remains unclear whether iodine status affects treatment success as only a few low-quality studies have examined this. LIDs are challenging for patients. Higher-quality studies are needed to confirm whether a LID is necessary.

Compassion fatigue in a health care worker treating COVID-19 patients: a case report

BackgroundDoctors treating COVID-19 are under extreme stress. It was reported that healthcare workers providing palliative care could present elevated levels of compassion fatigue. We herein report a case if the attending doctor of severe COVID-19 cases who felt extreme psychological difficulty and suffered from compassion fatigue.Case presentationA 29-year-old female doctor presented with anxiety and insomnia. Her stress from overwork was exacerbated during the treatment of two related COVID-19 patients, a 47-year-old man with COVID-19 and his 76-year-old mother, who suffered acute stress disorder after the death of her son. The mother first refused treatment, but with psychiatric intervention she was able to recover and be discharged. In the course of these cases of COVID-19, their attending physician felt psychological distress and presented with insomnia and anticipatory anxiety due to the poor prognosis of the mother. After being presented with a systematic approach to improve her work situation by the hospital executive staff and undergoing psychotherapy for compassion fatigue, she recovered and was able to return to work.ConclusionsWe report a physician in charge of severe cases of COVID-19, who suffered an adverse impact on her mental health. Excessively empathic engagement in the care of patients who do not survive and their relatives provides high risk for compassion fatigue. The stress-related distress of HCWs should be more widely recognized in order to improve support systems for them.

Cost and Psychological Difficulty: Two Aspects of Demandingness

ABSTRACT The demandingness of a moral prescription is generally understood exclusively in terms of the welfare costs involved in complying with that prescription. I argue that psychological difficulty is a second aspect of demandingness, whose relevance cannot be reduced to that of welfare costs. Appeal to psychological difficulty explains intuitive verdicts about the permissibility of favouring oneself over others, favouring loved ones over strangers, and favouring one’s short-term good over one’s long-term good. There are also significant implications for the morality of addressing severe global poverty.

Young Children’s Experiences with Yoga after School

ABSTRACT Currently, little is known about the lived experiences of children who participate in yoga, particularly using their own words. This study provides insights into how young children aged 6 to 10 years old were able to understand their bodies within a yoga space. The purpose of this study was to investigate young children’s lived experiences of yoga through qualitative interviews. Parents of children engaged in yoga were also interviewed to gain a sense of their point of view about the experiences of yoga for their children. Results indicated yoga had assisted children to find, and express joy, and fun by moving their bodies into different shapes. The physical and psychological difficulty of some of the yoga shapes assisted children to develop a persistent mind-set which enabled them to transfer knowledge to different contexts, such as difficulties at school, and finding ways to relax, and be with themselves. Yoga as an activity after-school develops strategies such as resilience, and assists in other contexts such as school, and family. The parents’ described how they were looking for techniques to help calm their children, and how challenging this was with the constant stimulation of everyday activities. The findings suggest that yoga may have a place in the school curriculum for the purpose of teaching students’ simple coping skills when experiencing feelings of stress, and anxiety, and assist with controlling their behavior.

ОЦЕНКА ПРОЯВЛЕНИЙ ЭЙДЖИЗМА СРЕДИ СТУДЕНТОВ МЕДИЦИНСКОГО УНИВЕРСИТЕТА

Ageism is a type of age discrimination among the elderly population. The article presents the results of a study of the manifestations of ageism among 1st and 4th year students of the medical faculty of the Educational Institution "Belarusian State Medical University". It is shown that students recognize the problem of age discrimination among the elderly in society. The index of the urgency of the problem of ageism for medical students was 42.1. Among the fourth-year students, in comparison with the first-year students, there are fewer respondents who are optimistic about their own old age, but there are more of those who are able to actively avoid old age. The prevalence of gerontological stereotypes among medical students is high. Stereotypes change in the learning process of the respondents, but they do not disappear. The respondents believe that the most important reasons for the emergence of ageism are not only gerontological stereotypes, but also the unwillingness to communicate with the elderly because of their own fear of old age or the psychological difficulty of communicating with the elderly. Medical students treat the elderly well and characterize them with positive epithets. The tendency of students of a medical university to unintentional ageism was revealed.

Elucidating the Cognitive Mechanisms Underpinning Behavioural Activation

.Depression represents a pervasive and devastating psychological difficulty. It affects over 21% of the population at some point in their lives and can have an unimaginable impact on both individuals and society. Behavioural activation represents a popular intervention for depression and is commonly used by psychologists internationally. Despite its popularity, the cognitive mechanisms underpinning the efficacy of behavioural activation remain elusive. This paper will review the literature on this intervention and propose an account of the cognitive mechanisms underlying its therapeutic efficacy. Specifically, it is argued that behavioural activation is effective because it increases both the density of outcomes in ones environment and the density of highly salient action-outcome contingencies, which may otherwise be absent due to reduced motivation. The clinical implications are subsequently discussed, with reference to future research.

Concerns and reactions to COVID-19 in the confined population according to age and sex (Preocupaciones y reacciones ante el COVID-19 en población confinada según edad y género)

ABSTRACT Given the situation of lockdown implemented because of the COVID-19 virus, there is a need to study the sociodemographic variables and risk factors associated with psychological problems and greater difficulty with adapting to the situation, which could in turn help in the development of psychological treatment offered during and after isolation. The objective of this study is to analyse whether age and sex are related to the concerns and reactions experienced by the population. Fifteen days after the official lockdown order, we sent out an online survey comprising 23 questions. A sample of 1,711 was collected, which included participants’ sociodemographic data, previous personal traits, psychological reactions, health habits, concerns and health activities. The results of the analyses showed a statistically significant association between age and feeling overwhelmed or claustrophobic, tiredness, concern that a family member becomes infected with the disease, irritability, fear and sadness, and between sex and concern that a family member becomes infected with the disease, sadness and fear.