Psychosocial Challenges Research Articles

Assessment of the impact of social media addiction on psychosocial behaviour like depression, stress, and anxiety in working professionals

ObjectiveSocial media (SM), with its addictive nature and the accompanying psychosocial challenges such as stress, anxiety, and depression, is the primary factor exacerbating mental health problems and adversely impacting individuals’ wellbeing. Our study’s goal was to determine how SM affects employees’ psychosocial behaviours and assess the various factors that contributed to the employee’s excessive use of SM.MethodsA cross-sectional correlational analysis was conducted. Using a relevant questionnaire on employees, the study was assessed to establish the relationship or association between SM addiction and psychosocial disorders like depression, anxiety, and stress. 200 people with a minimum age of 24 were enrolled in the study. The questionnaire contained the social networking addiction scale (SNAS) and the depression, anxiety, and stress-21 (DASS-21) scales; the data were statistically assessed.ResultsThe association between SM addiction and psychosocial behaviours has been examined using statistical tools including descriptive statistics and the Chi-square analysis. SM addiction has a strong, statistically significant correlation with depression (p = 0.001), stress (p = 0.001), and anxiety (p = 0.001).ConclusionThis study discovered a connection between SM use and depression, stress, and anxiety among working employees, raising questions regarding worries about overuse and addiction to SM. Various factors influencing excessive usage included revealed that employees also majorly over used SM for entertainment, boredom avoidance, constant knowledge sharing, and relationship-building.

What Self-Management Skills Do Turkish Caregivers Have in Caring for People with Dementia? Results of a Qualitative Survey.

Family caregivers can be overwhelmed by the care they provide within the family without external support. The development of self-management skills and the associated ability to actively and responsibly manage one's own health or illness situation therefore plays a vital role in the home care of people living with dementia. As part of an individualized intervention for family caregivers of people of Turkish origin with dementia, existing self-management skills were examined through qualitative interviews to gain insight into health literacy and empowerment in caregiving and in interviewees' own practices to maintain their health. Ten caregivers of Turkish origin who were responsible for family members living with dementia were interviewed using problem-centered interviews. We found that the target group has very heterogeneous self-management competencies, which are based, on the one hand, on existing supportive resources and, on the other hand, on diverse care-specific, psychosocial and life-world challenges in intrafamily care that have not been overcome. Self-management skills in family caregivers are influenced by a complex interplay of both available resources that support these skills and challenging caregiving situations. This dynamic combination of resources and challenges results in varying levels of self-management ability among family caregivers. Strengthening resources can help caregivers to meet the challenges resulting from caregiving and to expand their self-management competencies. There is great need for action in promoting self-management skills among Turkish caregivers of people living with dementia in home care. Interventions to promote self-management skills must take into account the individual resources of those affected as well as their social and cultural diversity.

Feasibility and potential effectiveness of nurse-led video-coaching interventions for childhood, adolescent, and young adult cancer survivors: the REVIVER study

BackgroundChildhood, adolescent, and young adult (CAYA) cancer survivors, at risk for late effects, including cancer-related fatigue, cardiovascular issues, and psychosocial challenges, may benefit from interventions stimulating behaviour adjustments. Three nurse-led eHealth interventions (REVIVER) delivered via video calls and elaborating on person-centred care, cognitive behaviour therapy and/or motivational interviewing were developed. These interventions target: 1) fatigue management, 2) healthier lifestyle behaviours, and 3) self-efficacy and self-management. This study aimed to assess the feasibility and potential effectiveness of the REVIVER interventions for CAYA cancer survivors and healthcare professionals.MethodsIn a single-group mixed methods design, CAYA cancer survivors aged 16–54, more than five years post-treatment, were enrolled. Feasibility, assessed via Bowen's outcomes for feasibility studies, included acceptability, practicality, integration and implementation, demand and adherence. Qualitative data from semi-structured interviews and a focus group interview with survivors and healthcare professionals supplemented the evaluation. Paired sample t-tests assessed changes in self-reported quality of life, fatigue, lifestyle, self-management, and self-efficacy at baseline (T0), post-intervention (T1), and 6-month follow-up (T2).ResultsThe interventions and video consults were generally acceptable, practical, and successfully integrated and implemented. Success factors included the nurse consultant (i.e., communication, approach, and attitude) and the personalised approach. Barriers included sustainability concerns, technical issues, and short intervention duration. Regarding demand, 71.4%, 65.4%, and 100% of eligible CAYA cancer survivors engaged in the fatigue (N = 15), lifestyle (N = 17) and empowerment (N = 3) intervention, respectively, with 5, 5 and 2 participants interviewed, correspondingly. Low interest (demand) in the empowerment intervention (N = 3) and dropout rates of one-third for both fatigue and empowerment interventions were noted (adherence). Improvements in quality of life, fatigue (fatigue intervention), lifestyle (lifestyle intervention), self-efficacy, and self-management were evident among survivors who completed the fatigue and lifestyle interventions, with medium and large effect sizes observed immediately after the intervention and six months post-intervention.ConclusionsOur study demonstrates the feasibility of nurse-led video coaching (REVIVER interventions) despite lower demand for the empowerment intervention and lower adherence to the fatigue and empowerment interventions. The medium and high effect sizes found for those who completed the interventions hold potential clinical significance for future studies investigating the effectiveness of the REVIVER interventions.

Perceptions of church members regarding congregants on antiretroviral therapy in Limpopo Province, South Africa

The purpose of the study was to explore the perceptions of church members regarding congregants who are on antiretroviral therapy in Limpopo Province, South Africa. The study was conducted in churches of Vhembe District, Limpopo Province, South Africa. The study utilised an exploratory, descriptive, qualitative research design. The study focused on church members in Vhembe District of Limpopo Province. A non-probability purposive sampling method was used to select church members for participation. The sample size was 30 church members, determined by saturation of data. Semi-structured interviews were utilised to collect data, and data was analysed using Tech's eight steps of the coding process, through the content analysis method. The study yielded four themes, namely, church members’ understanding of antiretroviral therapy, attitudes of church leaders towards congregants on antiretroviral therapy, the roles, and responsibilities of church leaders towards congregants on antiretroviral therapy and, psychosocial challenges faced by congregants on antiretroviral therapy. Church members understood what antiretroviral therapy is used for, and some were specific about its impact in suppressing the viral load and improving the CD4 count. However, some church leaders were reported to be negative towards congregants on ART. As much as church members knew about ART and its use, people living with HIV/AIDS were subjected to rejection, discrimination, and stigmatization and lacked general support in churches. HIV/AIDS awareness campaigns are necessary to impart to church members information that is readily available, appropriate, and effective. These campaigns could be delivered through workshops targeting church members, including both church leaders and congregants.

Exploring the Role of Self-Efficacy in Maintaining Healthy Lifestyle Habits among Patients with Cardiometabolic Diseases; Findings from the Multi-Center IACT Cross-Sectional Study.

(1) Background: Cardiometabolic disease progression can be delayed if patients engage in healthy lifestyle behaviors, adherence to which is highly influenced by psychosocial factors. The present study aimed at investigating the association of self-efficacy with the adherence level to healthy lifestyle behaviors among patients with cardiometabolic diseases in Greece. (2) Methods: 1988 patients (1180 females) with cardiometabolic diseases participated. Anthropometric, demographic, socioeconomic, clinical, and lifestyle characteristics were recorded. Patients were also asked to evaluate their efficacy to comply with healthy lifestyle behaviors. (3) Results: The majority exhibited unhealthy lifestyle behaviors. A subgroup demonstrated elevated self-efficacy in maintaining healthy habits despite facing diverse psychosocial challenges. Individuals with higher educational attainment, socioeconomic status, and rural/semi-urban residency had significantly elevated self-efficacy. Those with heightened self-efficacy exhibited significantly lower BMI and reduced prevalence of certain health conditions. Self-efficacy significantly influenced adherence to the Mediterranean diet, physical activity engagement, and smoking cessation, even in challenging circumstances. (4) Conclusions: This study represented an innovative approach in examining the role of self-efficacy in shaping health behaviors and outcomes within a Greek population. By integrating specific psychosocial circumstances into the analysis, valuable insights were provided into the contextual factors influencing self-efficacy and adherence to healthy lifestyle behaviors.

Columbia-Suicide Severity Rating Scale (C-SSRS) Reveals High Rates of Suicidality in 602 Patients With Cleft and Craniofacial Conditions.

Little is known about rates of suicidal ideation and behavior among youth with cleft lip and/or palate (CLP) and other craniofacial conditions. Records of patients ages 6 and older who were administered the Columbia-Suicide Severity Rating Scale (C-SSRS) Lifetime Version during routine multidisciplinary cleft or craniofacial team visits between 2019 and 2023 were examined. Demographics information, C-SSRS data, and diagnoses were assessed with statistics including t tests, the Fisher exact test, and odds ratios. A total of 1140 C-SSRS questionnaires across 602 (433 CLP and 169 craniofacial) patients with an average age of 11.2±3.7 years were included. Eighty-four (13.6%) patients endorsed lifetime suicidal ideation, 9 (1.5%) had at least one instance of suicidal behavior, 30 (5.0%) endorsed nonsuicidal self-injury, and 2 (0.3%) engaged in self-injurious behavior. Compared with CLP, those with other craniofacial conditions had similar odds of endorsing suicidal ideation and behavior ( P ≥0.05). Compared with those with isolated cleft palates, CLP had greater odds of endorsing suicidal ideation and behavior, though those differences were not significant ( P ≥0.05). Incidence of suicidality was unchanged before, during, and after the COVID-19 pandemic ( P ≥0.05). Dividing patients by sex or insurance type revealed no difference in suicidality ( P ≥0.05). Patients with CLP and craniofacial conditions have a high incidence of suicidal ideation and behavior, though levels are similar between these groups. Suicidality in these patients was not negatively impacted by the COVID-19 pandemic. Early identification of safety risks and psychosocial challenges through regular screening can facilitate connection with appropriate clinical interventions.

The impact, perceptions and needs of parents of children with epidermolysis bullosa.

Epidermolysis bullosa (EB) is a rare, incurable genodermatosis that presents with blistering and skin fragility. Complications can be localised or generalised, limited to the skin or have systemic effects resulting in death. Caring for a child with this painful condition can have a profound effect on the quality of life of parents and the family. There is currently no published research on the lived experience of parents caring for a child with EB in a resource-limited environment in Africa. This qualitative research used interpretative phenomenological analysis with the aim of understanding the lived experiences of parents caring for children with EB. Semi-structured interviews were conducted with 13 participants between May 2022 and October 2023. Guba's framework of trustworthiness was used to ensure rigour. Seven experiential themes with associated sub-themes were identified. The themes were (1) grappling with understanding EB, (2) the psychological experience, (3) living with the responsibility, (4) barriers to feeling supported, (5) changing relational dynamics, (6) experience of healthcare professionals and (7) parental needs. Parents caring for children with EB face emotional, physical, psychosocial and financial challenges. Addressing parents' needs and concerns will go a long way in decreasing this burden. A biopsychosocial approach with an awareness of cultural context is essential for family-centred holistic EB care.Contribution:This is the first study in Africa that focussed on the lived experiences of parents caring for a child with EB.

Mobile Health System for Meeting Health Information Needs in Patients With Head and Neck Cancer Undergoing Radiotherapy: Development and Feasibility Study.

Patients with head and neck cancer undergoing radiotherapy encounter physical and psychosocial challenges, indicating unmet needs. Mobile health technology can potentially support patients. This single-armed feasibility study included 30 patients with head and neck cancer undergoing radiotherapy. Patients were asked to use the Health Enjoy System, a mobile health support system that provides a disease-related resource for 1 week. We assessed the usability of the system and its limited efficacy in meeting patients' health information needs. The result showed that the system was well received by patients and effectively met their health information needs. They also reported free comments on the system's content, backend maintenance, and user engagement. This study supplies a foundation for further research to explore the potential benefits of the Health Enjoy System in supporting patients with head and neck cancer.

Building Resilience in New Graduate RNs: Lessons Learned.

Transitioning into oncology practice can be challenging for new graduate RNs. High patient acuity, a steep learning curve, psychosocial challenges, and frequent patient deaths can be overwhelming. The purpose of this program was to provide resilience training for new graduate oncology nurses as part of an existing nurse residency program. Building resilience among oncology nurses was a primary goal during the COVID-19 pandemic and continues to be an important goal. Resilience training in this program consisted of didactic lectures, personalized goal setting, one-on-one mentoring, and a follow-up support group. Various measurement scales were used at baseline, 6 months, and 12 months to assess resilience, professional quality of life, and new graduate experience measures, including communication and organizational skills. Resilience significantly declined from baseline to six months; professional quality of life and new graduate experience measures also worsened. Some improvements in organizational skills and communication emerged at 12 months. Results indicate an ongoing need to consider extending nurse residency programs, resilience training, and support beyond the traditional one-year period.

Exploring lived experiences in oral cavity cancer: An Asia-Pacific perspective on psychosocial challenges and opportunities for enhanced patient-centric care.

12097 Background: Locally advanced oral cavity squamous cell carcinoma (LA OC SCC) is profoundly emotionally taxing, characterized by a dual burden of undergoing treatment and adapting to post-treatment changes. The research explores lived experiences including psychosocial aspects, to identify approaches to establish a resilient supportive system for patients to improve coping and reduce anxiety and distress. Methods: A total of115in-depth interviews were conducted across Australia, Hong Kong, South Korea, Taiwan and Vietnam. Informants were LA OC SCC patients who underwent surgery and adjuvant chemoradiotherapy, their caregivers, multidisciplinary team (surgeons and clinical, radiation and medical oncologists) and supportive care HCPs (nursing, case managers/care coordinators, psychologists, speech therapists, dietitians, and dentists). Interview guide design and thematic analysis were guided by the Psycho-Onco Emotional Anxiety (POEM) framework and the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results: The POEM framework illuminated patients’ lived cancer experiences, emotions and psychological thoughts and processes influenced by beliefs of the world, others and self which impact coping responses that maintain or drive anxiety. Key themes emerged: physical and functional impairments result in negative psychosocial impact; constraints hinder person-centered care communications with HCPs and interpersonal dynamics with significant others; and personal and interpersonal experiences result in negative coping, exacerbated by inadequate health services and social support. Multimodal therapeutic interventions for LA OC SCC lead to physical and functional impairments implicating psychosocial and psychosexual quality of life. LA OC SCC stigma, societal norms and highly socially constrained patients grapple with distress from inadequate psychosocial support. Furthermore, HCPs may have preconceptions of LA OC SCC patients hindering patient-centered approaches to care and management. In certain regions, insufficient hospital support systems exacerbate the toll of strained interpersonal relationships and caregiver burden on physical, psychological and emotional well-being. Consequently, treatment adherence, self-care and survivorship experiences of patients and caregivers are affected. Conclusions: Utilizing the POEM framework, the study delved into nuanced patient and caregiver-narrated experiences in 5 Asia-Pacific countries/territories with distinctive supportive care systems. Findings underscore the imperative of improving patient-centric care through enhanced psychosocial support for patients and caregivers, identifying specific areas where health services can be better equipped to support holistic patient health delivery, especially psychosocial health.

Trends in location of death for individuals with pediatric cancer in the United States.

1591 Background: Children and adolescents with cancer face unique symptomatic, psychosocial, and existential challenges at the end of life (EOL). Premature death alongside severe pain and complex symptoms is distressing for the patients and families. Location of death is an important clinical and psychosocial decision for many patients. Therefore, we explored differences in location of death amongst pediatric patients with cancer using a large, national US database. Methods: We performed multinomial logistic regressions and analyzed trends in place of death for children and adolescents (ages 0 to 19) diagnosed with cancer from 2003-2019 using the Centers for Disease Control and Prevention Wide-Range Online Data for Epidemiologic Research database (CDC WONDER). We studied associations in place of death with essential decedent characteristics (age, sex, and race) for ICD10 codes C00-C96 and D00-D49, which encompass the most common causes of cancer death in children and adolescents. Results: Of 1,910 pediatric oncology decedents, 910 died in a hospital, 794 died at home, 12 died in nursing facilities, 59 in hospice, and 135 in outpatient facilities. Over time, death at home decreased by 50%. Death in the hospital increased by 64% and death in hospice increased by 200%. Children 10-19 years-of-age were more likely to die in hospice than children younger than 4 and children between 5-9 years-of-age. Additionally, they were less likely to die in outpatient medical facilities and ED. 1,388 decedents were White, 411 were Black, 18 were American Indian, and 93 were Asian. Children of racial and ethnic minorities were significantly more likely to die in hospitals than White children with cancer (Black: 1.81 [1.44-2.28], Asian: 1.57 [1.03-2.41], and Hispanic: 1.60 [1.26-2.04]). Black children with cancer were also more likely (1.67 [1.11-2.53]) to die in outpatient facilities compared to White children. Asian children & Black children were less likely to die at home (0.48[0.38-0.61] and 0.55 [0.35-0.86] respectively). Conclusions: In contrast to the adult population that has demonstrated steady increases in deaths at home, for children with cancer, relative rates of death at home decreased while death in the hospital increased, with distinct differences among race/ethnic groups. Adequate education and support are needed to facilitate both autonomy and symptom palliation at EOL. Future work must explore underlying reasons for differences in place of death across time and demographic groups, so as to identify and alleviate any potential barriers, and to promote equitable access to a good death for each individual.

282 Psychosocial challenges and opportunities of farmers and farmworkers: a systematic literature review

282 Psychosocial challenges and opportunities of farmers and farmworkers: a systematic literature review

Exploring the perceptions and experiences of female’s with ß-thalassemia major in a Tertiary Care Private Hospital in Pakistan

Introductionß-Thalassemia, a genetic condition which influences both the physical and emotional facets of individuals specially females while also exerting substantial financial strain on families and healthcare systems. Recognizing the pivotal influence of social support, particularly on mental well-being, this study endeavors to delve into the shared psychosocial challenges experienced by females grappling with ß-thalassemia major. MethodsEmploying a qualitative-descriptive methodology and purposive sampling, this study conducted in-depth interviews with forty-two young girls, 18.64 ± 4.27, diagnosed with ß-thalassemia major and representing diverse academic backgrounds, using a semi-structured in-depth interview guide. NVIVO-12 software facilitated extended data analysis, encompassing coding, categorization, theme development, and mind-mapping techniques to unravel nuanced insights from the collected data. FindingsThis groundbreaking study delves into the psychosocial factors that impact the well-being of female ß-thalassemia patients. The research highlights the key factors that positively contribute to their quality of life by conducting thorough inductive content analysis. These include receiving an education, having robust family support, experiencing overall life satisfaction, and making meaningful societal contributions. The findings of this study can be used to improve the lives of female ß-thalassemia patients and enhance their overall well-being. Contrariwise, notable impediments encompassed depression, social isolation, limited access to insurance services, challenges in educational and employment spheres, as well as difficulties in nurturing social relationships. These findings underscore the multifaceted influences shaping the quality of life for girls navigating ß-thalassemia, shedding light on empowering and challenging elements within their experiences. ConclusionIn conclusion, psychosocial factors supporting or hindering the well-being of young girls with ß-thalassemia major in Pakistan include an inductive environment at homes, organizations, education, institutions with adequate knowledge of thalassemia disease among patients, and society. More research is needed to understand their needs and advocate for societal support and acceptance. Family and friends support are crucial for improving their quality of life, necessitating focused efforts to provide understanding and aid within the community.

Mental health prevalence in Brazil: Understanding anxiety and depression in southern Capixaba region.

e23295 Background: The rising significance of mental health issues and psychological distress among cancer patients has prompted an in-depth investigation. In the brazilian context, this crucial aspect remains largely unexplored, with limited available data and insufficient investment in understanding the psychosocial dimensions of cancer care. This study aims to generate brazilian-specific data to facilitate the development and implementation of targeted psychosocial interventions within cancer care. Methods: From August 1, 2023, to December 31, 2023, a random selection of 263 patients at a brazilian cancer center underwent assessment for signs and symptoms of anxiety and depression using the Anxiety and Depression Assessment Scale – HAD. This validated screening scale, comprising 14 Likert-type questions, features two subscales with seven items each to track anxiety and depression symptoms. Severity scores for each subscale range from zero to 21, with higher scores indicating increased anxiety and depression levels. In this study, interviewers assessed the severity of symptoms, employing scales ranging from 0 to 21. Three score levels were identified: mild (0-7), moderate (8-11), and high (12-21). Inclusion criteria encompassed age over 18, residency in the southern region of the State of Espírito Santo, a cancer diagnosis, and active treatment. Exclusion criteria included non-residency in th southern region of th state, lack of cancer diagnosis, and oncohematological treatments. Of the 263 eligible participants, 21 were excluded for not meeting inclusion criteria, and 16 declined to participate, resulting in a final sample of 226 patients. Results: The sample comprised 160 women, with 64.90% diagnosed with breast cancer and 35.10% with other neoplasms. Among the 66 men, 41% had prostate cancer and 59% had other neoplasms. Anxiety levels in women were mild (28%), moderate (24%), and high (48%), while in men, levels were mild (39%), moderate (21%), and high (53%). Depression levels in women were mild (42%), moderate (19%), and high (39%). Notably, six suicide attempts occurred among women before cancer diagnosis, and one occurred after diagnosis. Among men, depression levels were mild (47%), moderate (22%), and high (31%). With no history of attempts of suicide in the men population. Conclusions: The study's robust dataset provides compelling and valid information, unveiling a substantial prevalence of mental disorders within the analyzed populations. It emphatically underscores the critical need for tailored supportive care in addressing the unique psychosocial challenges faced by this demographic. Furthermore, the findings advocate for the urgent implementation of targeted psychosocial support interventions to enhance the overall well-being of individuals navigating the complex terrain of cancer and its associated mental health implications.

A Multimethod Exploration of Moral Distress and Moral Injury Among Health Care Assistants Working in Psychiatric Settings

Moral distress and moral injury among health workers yield adverse physical, psychological, and labor force outcomes. Research is limited on how psychiatric healthcare assistants experience these issues. In this multi-method study, we conducted a quantitative survey and qualitative interviews to examine moral distress and injury among psychiatric healthcare assistants. Almost half screened positive for moral injury. Three qualitative themes emerged: 1) hierarchies prevent contributions to care; 2) trust as a factor in de-escalating patient violence; and 3) navigating psychosocial challenges. Further research is recommended to investigate how to best support and inform practice and policy changes for psychiatric healthcare assistants.

Insights into disability and psycho-social care of patients with inflammatory bowel disease.

In recent years, the concept of disability has increasingly garnered attention as a crucial long-term target of inflammatory bowel disease (IBD) management. The treatment paradigm has changed dramatically from full control of the disease (clinical and endoscopic remission) toward physical and emotional well-being with the goal of preventing disability and normalizing quality of life. However, in certain cases, despite achieving good disease control, patients may still experience symptoms associated with disability, and reduced emotional wellness. These symptoms can significantly impact various biopsychosocial factors, including interpersonal relationships, educational or work-related activities, body image, and sexual functioning. Nevertheless, they often remain overlooked in the context of IBD care. In this narrative review, we aim to shed light on the burden of certain disability-related symptoms such as bowel urgency, sexual dysfunction, impaired fertility and fatigue, emphasizing the importance of acknowledging and validating them in a clinical setting. There is a demanding need for comprehensive care for IBD patients, with IBD clinicians being mindful of the psychosocial challenges faced by their patients. Providing timely and appropriate management of these challenges alongside IBD treatment is key to achieving holistic remission and enhancing the overall quality of life while reducing disability.

Parents' Mental and Emotional Disorders and Psychosocial Problems in Children at Public Elementary School 1 Kucur

The psychosocial challenges faced by children may not always correspond with the emotional disorders exhibited by their parents. A robust support system from their social network can significantly contribute to the enhancement of their mental well-being. This study aims to investigate the relationship between parental emotional disorders and psychosocial issues in school-aged children. The research utilizes a descriptive correlational approach with a cross-sectional design, involving 165 students aged 6 to 12 from Public Elementary School 1 Kucur who are currently enrolled in school, along with one consenting parent, resulting in 330 respondents. The Self-Reporting Questionnaire-29 (SRQ-29) is used to identify parental emotional issues, while the Strengths and Difficulties Questionnaire (SDQ) assesses children's psychosocial problems. An analysis employing Somers' D Gamma was conducted to ascertain the correlation between parental mental-emotional disorders and children's psychological well-being. The findings reveal that the highest average score for parental mental-emotional disorders stands at 82.4%. In comparison, the highest average score for total difficulties in children's psychosocial issues is 58.8%, while the highest average prosocial score is 92.7%. The statistical analysis reveals no significant connection between parental emotional disorders and children's psychosocial problems on the prosocial scale (p=0.897) and total difficulties score (p=0.897). In conclusion, the findings of this research do not establish a direct link due to the numerous factors influencing children's psychosocial challenges.

Understanding patient-related barriers to hydroxyurea use among adolescent and adult patients with sickle cell disease in Mulago and Kiruddu hospitals, Uganda, a qualitative study.

In 2016, Uganda added Hydroxyurea (HU) to the list of essential drugs to treat sickle cell disease SCD. However, Hydroxyurea utilization has been low for several countries in sub-Saharan Africa. This study examined patient-related barriers to hydroxyurea use among adolescent and adult patients with sickle cell disease in Mulago and Kiruddu hospitals, in Uganda. To understand the patient-related barriers to hydroxyurea use among adolescent and adult patients with sickle cell disease, we conducted a parallel convergent mixed methods study at outpatient departments of two national referral hospitals in Uganda from October 2022 to January 2023. The cross-sectional mixed-methods study employed both quantitative and qualitative methods. We collected survey data from a systematic sample of 259 participants and conducted individual interviews with a purposive sample of 40 participants (20 adolescents or their caregivers and 20 adult patients with SCD) and interviewed them individually on their knowledge, perceptions, barriers, and facilitators of HU utilization. Descriptive data were analyzed using Stata 16, whereas qualitative data were analyzed thematically using an inductive approach supported by NVivo 12 software. We triangulated data to determine the concordance of qualitative and quantitative data. The study enrolled 40 participants for qualitative interviews and 259 patients for quantitative, with an average age of 16, over half being female, 46% having secondary education, and 96% unmarried. The prevalence of HU use was 78%. The study identified three themes as follows: Patient barriers at the individual including Inadequate knowledge about HU, Persistent pain, Poor adherence to HU, Poor communication with health care workers, and Psychosocial and emotional challenges. At the facility level, long queues and poor quality of care, drug-related side effects that affect HU, and drug stock-outs were reported. Myths, rumors, and misconceptions about HU, and gender-related barriers were reported to affect HU utilization at a community level. Facilitators for the use of HU and recommendations for improvement. Facilitators included perceived benefits, long duration on HU, information sharing by healthcare workers, availability of complementary drugs, confirmation of diagnosis, and availability of medication at public health facilities or private pharmacies. Patients suggested continuous adherence support, encouragement from healthcare workers, sensitization about benefits and risks, a peer-to-peer approach, and financial support for adolescents and women to start businesses to resolve financial problems. Implementing the use of HU has been challenging in Uganda and needs improvement. Facilitators to hydroxyurea use have been highlighted, though Patient-identified barriers at individual, facility, and community levels that need to be resolved. The experiences and insights shared by our participants provide invaluable guidance for increasing the uptake of HU. Further studies are needed to establish validated instruments to assess patients' pain communication and adherence to the HU regimen.

Addressing Psychosocial Challenges through Action: A Fieldwork Experience in Community Medicine Department, Aligarh Muslim University

This research article explores the psychosocial challenges faced by patients in the community. The study draws on firsthand experiences as a social work intern in the Community Medicine department. It delves into the intricacies of psychosocial issues prevalent among community members, including substance abuse, family problems, depression, and financial instability. The article emphasises the importance of targeted interventions to address the multifaceted needs of individuals in the community. To tackle these psychosocial challenges, the research outlines community workshops, counselling services, mental health awareness campaigns, and support groups. The interventions aimed to empower individuals, foster resilience, and promote overall well-being within the community. After implementing these initiatives, the article analyses the observed changes in individuals, highlighting improvements in coping mechanisms, enhanced social support networks, and increased awareness of mental health issues. Moreover the study also provides insights into the effectiveness of psychosocial interventions in community medicine.The study highlights the importance of holistic healthcare approaches that prioritize the psychosocial dimensions of well-being

“What is Rape, Why Me, So What Now?” Out of the Shadows: Women’s Post-Rape Life Experiences in Turkey

Women who have experienced rape are at risk for short/long term physical and mental health problems, psycho-social and socio-economic challenges, they may have a variety of related social service needs. This study aims to explore the post-rape life experiences of women in Turkey, a country where male violence against women, particularly rape, remains prevalent. Utilizing a qualitative research methodology, semi-structured in-depth interviews were conducted with 28 women, who are resident in Turkey and survivors of rape. The findings derived from thematic analysis illuminate the dual burden faced by the survivors: the trauma from rape itself, and the imposed submissiveness within a patriarchal society. These experiences contribute to the deepening of the emotional and psychological aftermath of the trauma, pushing the survivors into a vulnerable state. The results of this study underscore the urgent need for systemic and cultural changes in Turkey, as well as enhanced support mechanisms and social services for survivors of rape. There is a need for research to examine the needs that arise from the intersecting issues experienced by women who have been subjected to rape.