Psychosocial Counseling Research Articles

Exploring a brief medical improvisational performing arts intervention for genetic counseling graduate students.

Psychosocial counseling is the foundation of genetic counseling. Genetic counseling students are required to receive in-depth training on psychosocial counseling techniques. In other medical disciplines, "medical improv," an educational method derived from improvisational theatre, has been used to allow trainees to practice clinical skills without also having to focus on medical knowledge they've not yet mastered. The present study aims to investigate the acceptability of medical improv as an educational tool for genetic counseling students. Fourteen genetic counseling students and new genetic counselors completed a 2-hr medical improv workshop and participated in follow-up interviews to discuss the workshop. Participants' responses to the intervention were positive, with 92.9% of participants responding that they would recommend medical improv training to other genetic counseling students. Participants described the medical improv workshop as helping build psychosocial skills in a safe environment, which may facilitate the use of more advanced counseling skills in clinical situations. By training students to practice psychosocial skills and building students' confidence, medical improv may help genetic counseling students and genetic counselors be more effective in challenging clinical situations, and to feel more comfortable in experimenting with new ideas and psychosocial techniques in their clinical practice.

'A sorrow shared …': a qualitative content analysis of what couples with recurrent miscarriages expect from one another and their families and friends.

STUDY QUESTIONWhen couples have to face recurrent pregnancy loss (RPL), what are the partners’ wishes and needs and what is their perception of helpful and unhelpful factors with regard to their own, their partners’ and their families’ and friends’ ways of dealing with the problem?SUMMARY ANSWERWomen and men with repeated miscarriages want open communication about their losses, but expect a sensitive and empathetic attitude from others, not pity or trivialization.WHAT IS KNOWN ALREADYRPL not only causes the women affected and their partners considerable emotional distress; it also has an impact on the couples’ relationships and the way they relate to their families and friends. Studies suggest that women have a greater need than their male partners to talk about their losses and that these differences may lead to dissatisfaction and cause relational tension. In addition, men often assume a ‘mainstay’ role, supporting their partners and displaying fortitude in the face of distress. As yet, however, little research has been conducted so far on the question of what the members of couples with RPL expect from one another and from their families and friends.STUDY DESIGN, SIZE, DURATIONThe study sample consisted of 147 couples and 17 women with at least 2 miscarriages attending the special unit for RPL at the University Women’s Hospital in Heidelberg (Germany) for the first time between September 2018 and October 2020 (response rate: 82.7%). The patients were asked to participate in this combined qualitative and questionnaire study.PARTICIPANTS/MATERIALS, SETTING, METHODSIn order to explore the wishes and needs of those affected in more detail, the free text responses obtained were examined in this study by using qualitative content analysis. Categories and subcategories were created inductively to summarize and systematize content.MAIN RESULTS AND THE ROLE OF CHANCEPatients affected by RPL want their partners and their families and friends to deal with the topic openly and empathically. In the partnership itself, acceptance of individual grieving modes and sharing a common goal are important factors. Men, in particular, want their partners to be optimistic in facing up to the situation. Regarding communication with family and friends, it transpired that ‘good advice’, playing the matter down, inquiries about family planning, pity and special treatment are explicitly not appreciated.LIMITATIONS, REASONS FOR CAUTIONThe sample was a convenience sample, so self-selection effects cannot be excluded. In addition, the level of education in the sample was above average. Accordingly, the sample cannot be regarded as representative. The results of the content analysis are based on the respondents’ written answers to open-ended questions in the questionnaire. Unlike qualitative interview studies, further questioning was not possible in the case of ambiguities or to request more details.WIDER IMPLICATIONS OF THE FINDINGSFrank and sincere communication about miscarriages and about one’s own emotions and needs should be promoted both in the partnership and among family members and friends in order to strengthen the potential of social support as a resource. Open communication about the different needs of both partners is necessary to create mutual understanding. The results show the importance not only of empathy and consideration for the couples concerned but also their desire not to be pitied. Striking a fine balance between fellow-feeling and pity may also lead to tension, and this potential dilemma should be addressed in psychosocial counselling. Overall, the study contributes to a better understanding of what couples want from their families and friends when they are attempting to come to terms with RPL and highlights potential challenges in the interaction between affected couples and their families and friends.STUDY FUNDING/COMPETING INTEREST(S)No funding was received for this study. None of the authors declared any conflicts of interest.TRIAL REGISTRATION NUMBERDRKS00014965.

Imperative of Psycho-Social Counselling among Basic Education Teachers for Effective Job Performance in Nigeria

Imperative of Psycho-Social Counselling among Basic Education Teachers for Effective Job Performance in Nigeria

A Holistic Approach to Addressing Post-Fitting Needs in the Short and Long Term for New Hearing Aid Users.

Helping your client adjust to being a hearing aid (HA) user and learn to manage their hearing challenges requires a combination of technical skill and psychosocial counseling in the short- and long-term periods. A key aspect of providing support in this time period is to keep the door open for psycho-social-emotional counseling that is often necessary even when the HA user was motivated to make this change, and even when, objectively, they seem to be fit successfully. Another key aspect is not to assume that once they have checked off all the HA fitting boxes, you are done. Over the long term, the user will experience changes in their own hearing abilities and in their life circumstances that will require on-going support to adapt to new communication needs. Approaching the post-fitting period from a person-/family-centered perspective and using a holistic approach to consider how this treatment fits into the HA user's broader life will result in the most success for that person.

Pattern and Etiology of Injuries on Physical Assault cases at Emergency Department of Bir Hospital, Kathmandu

Introduction: Violence is one of the leading causes of preventable injuries. It is also one of the major public health problems worldwide. Nepal also witnessed 16,831 deaths due to injuries in 2017 which increased from 6.31% in 1990. Methods: A descriptive cross sectional study was conducted on victim of physical assault to study the pattern and etiology of their injury who had visited Emergency department of Bir Hospital and National Trauma Centre, Kathmandu. The data was mainly collected through physical examination of the victims and a proforma was used to collect the necessary information regarding the history, victim, incident and alleged weapon, which were presented in frequency and percentage. Results: A total of 206 presented within a year. Male to female ratio was 1.26:1. The commonest age group involved was 15-24 years i.e. 36.4%. Alcohol intoxication was found as aggravating factor in majority. Blunt object was the most common alleged weapon of injury in assault followed by body parts of the alleged assailant ie.fist and feet. Soft tissue, head and neck were the most common site of injuries. Conclusions: Physical assault is the one of the predominant cause of morbidity and mortality in young adult leading to loss of productive lives. Educational programs, psycho-social counselling to family members and intimate partner violence, interventions that focuses on detection and treatment of psychological illness, reduction of alcohol use and associated aggression are suggested to decrease the fre-quency of violence .

Partnering with support persons and clinicians to improve the health care experiences of patients with cirrhosis.

To explore the care experiences of Aboriginal and Torres Strait Islander Australians diagnosed with cirrhosis with a focus on support needed. Cirrhosis disproportionately affects Indigenous Australians, and liver diseases contribute to the mortality gap between Indigenous and other Australian adults. A qualitative study. Using yarning methods, Indigenous patients (n=13) and support persons (n=3) were interviewed by an Aboriginal researcher during April-July, 2020. Thematic analysis was used to identify common themes using an inductive approach. Six themes emerged. (1) Experience of diagnosis. This theme included stories of delays in the system, self-awareness of signs and symptoms and relief of being diagnosed. (2) 'Shame, shame, shame'. Experiences of prejudices and discrimination from health professionals, the lack of understanding of cirrhosis among health professionals, and stories about alcohol cessation and counselling around alcohol cessation. (3) Health literacy. Participants' understanding of cirrhosis was variable. While the importance of knowledge was recognised, 'what works for someone might not work for others'. Several patients partnered with their support persons and clinicians to bridge the health literacy gap. (4) Sources of support included family and friends, transport facilities, health professionals and peers. (5) Positive and negative aspects of communication and patient consultation were discussed. (6) Psychosocialcounselling to 'look after the caring side'. The need for more mental health care services was raised. Barriers related to poor health literacy, stigma and lack of practical and emotional support, and issues with communication and patient consultation, may lead to inequitable access to cirrhosis care and treatment for Indigenous Australians. Gaining knowledge of the experiences of Indigenous Australians with cirrhosis is important for providing patient-centred and culturally appropriate care. Liver specialist nurses have an important role in bridging the health literacy gap and in supporting Indigenous patients and families.

EXPLORING THE CAUSES OF SELECTED CONDUCT DISORDERS AMONG SCHOOL-GOING ADOLESCENTS IN UGANDA AND SOUTH AFRICA

The study’s main issue was the causes of selected conduct disorders among adolescents in school. Adolescent conduct disorders emanate from a variety of factors that include social, economic, school, genetic status and parental factors. The purpose of the study was to explore the causes of selected conduct disorders among adolescents in school. The study was qualitative, explorative and phenomenological in nature. The study participants were parents and teachers. Data were collected using online (WhatsApp) focus group discussions due to restrictions brought about by COVID-19 that made physical interaction risky. Data were analysed in an integrative manner using findings from the two countries from parents and teachers, and thematically using themes generated from the outcomes of the online discussions. Findings indicate that conduct disorders among secondary school adolescents are a result of developmental, parental, school, social and academic factors. The study concludes that conduct disorders are recognised among the secondary school adolescents in Uganda and South Africa and pose a challenge to education and affect the proper functioning of schools. From the findings and conclusions, the researchers recommend hands-on parenting, adolescent psycho-social services, guidance and counseling services in schools, career guidance based on students’ needs, academic strengths and aspirations, positive peer groups and moderation of punishment at home and at school. This has implications on the need for dynamics in parenting, teacher-student relationships and psychosocial services that are detrimental in building healthy developmental milestones that have a direct impact on behavior and conduct among adolescents.

Socio-demographic characteristics as predictors of psychosocial resources of call centre agents

This study investigated the socio-demographic predictors of psychosocial resources in call centre agents. A non-probability sample of 409 call centre agents from Nigeria (n = 145, female = 63%, male = 37%) and South Africa (n = 264, female = 72%, male = 28%) were participants (mean age = 45 years, SD = 0.49; single = 62% [Nigeria]; 73% [South Africa]). The call agents completed the Maslach Burnout Inventory (MBI), the Orientation to Life Questionnaire (OLQ), the Assessing Emotions Scale (AES), and the Personal Views Survey (PVS II) in person. Regression analysis results indicated that younger age and married status predicted higher professional efficacy. Longer tenured employees had a higher sense of coherence and challenge, while those with shorter tenure had higher overall hardiness. Human resources departments should provide psychosocial counselling resources differentiated by pertinent socio-demographic characteristics.

Psychosocial problems and cognitive functions in children with spina bifida.

Objectives This study aims to assess psychosocial functioning in relation to lesion level and ambulatory status in children with spina bifida (SB) and compare them to their peers. Patients and methods Between March 2013 and May 2013, a total of 31 patients with SB (11 males, 20 females; mean age: 9.4 years; range, 6 to 14.7 years) and 36 typically developing peers (16 males, 20 females; mean age: 9.8 years; range, 6.5 to 14.8 years) were included in the study. All participants were assessed using a semi-structured psychiatric diagnostic interview via the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL), Wechsler Intelligence Scale for Children-Revised (WISC-R), Behavioral Rating Inventory of Executive Functions (BRIEF) parent form, Social Responsiveness Scale (SRS), and Aberrant Behavior Checklist (ABC). Results In the SB group, the rate of psychiatric disorders was significantly higher (p=0.001) and the SRS scores and the planning and organizational components of the executive function were higher than their peers (p=0.02 and p=0.007, respectively). The psychiatric diagnosis rate, BRIEF, and SRS total scores did not significantly differ according to lesion level and ambulatory status. The BRIEF initiate and organization of materials subtest scores and ABC scores were significantly lower at high lesion levels (p=0.02, p=0.02, and p=0.02, respectively) and non-community walkers (p=0.002, p=0.03, and p=0.003, respectively). Conclusion Psychiatric disorders, impairment in social responsiveness, and planning and organization components of the executive function are prevalent in children with SB with no intellectual disabilities, compared to their peers. Therefore, psychosocial counseling and multidisciplinary follow-up for SB patients seem to be beneficial.

Attitudes toward a COVID-19 vaccine and vaccination status in cancer patients: a cross-sectional survey

PurposeWe aim to assess attitudes toward a COVID-19 vaccine and vaccination status in cancer patients and to explore additional factors such as the level of information and comprehensibility and accessibility of this information, anxiety symptoms in general and toward COVID-19, and general health literacy.MethodsWe included 425 outpatients (mean age 61.4, age range 30–88 years, 60.5% women) of the Psychosocial Counseling Center for Cancer patients of the Department of Medical Psychology and Medical Sociology, Leipzig. We recorded attitudes toward a COVID-19 vaccine and vaccination status via self-report. The impact of psychosocial factors, including anxiety (GAD-7), COVID-19-specific anxiety (OCS; FCV-19S) and health literacy (HLS-EU-Q16) were analyzed with point-biserial correlations using Pearson’s r.ResultsWe found that the vast majority (95.5%) reported being vaccinated against COVID-19 and that overall trust in safety and protective effects of a COVID-19 vaccine was high (90.9%). The vaccination readiness among nonvaccinated cancer survivors was low to very low with “fear of side effects” the most mentioned (72.2%) reason against a COVID-19 vaccine. There was no significant correlation between vaccination status and fear or anxiety symptomatology, and health literacy. Obsessive thoughts about COVID-19 was significantly higher in nonvaccinated cancer patients.ConclusionsMajority of respondents are positive about COVID-19 vaccine, accompanied by a very high rate of COVID-19 immunization in our sample. Further studies with a larger sample of nonvaccinated cancer patients should further investigate the relationship on fear and vaccination hesitancy and align communication strategies accordingly.

Women Tell All: A Comparative Thematic Analysis of Women's Perspectives on Two Brief Counseling Interventions for Intimate Partner Violence.

Background: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1–6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals). Methods: 58 participants (Mage = 39.21) completed post-intervention semi-structured qualitative interviews, including helpfulness ratings, at two follow-up assessments (10- and 14-weeks post-enrollment) to assess the acceptability, usefulness, and perceived fit of the interventions for women’s needs. Interviews were transcribed and analyzed using a hybrid deductive-inductive analytic approach. Results: While both the RISE and ECAU interventions were deemed helpful (interventions were rated as ‘highly helpful’ by 77% of RISE and 52% of ECAU participants), differences were identified in perceived impacts of the intervention, application of content, approach to patient-centeredness, and implementation recommendations. Conclusions: Findings shed light on women Veterans’ experiences and preferences for IPV psychosocial counseling interventions. Such knowledge can inform evidence-based, trauma-informed, and individualized care for women Veterans who experience IPV and may have relevance to other populations of women who experience IPV.

Psychosocial burden and associated factors among nurses in care homes during the COVID-19 pandemic: findings from a retrospective survey in Germany

BackgroundCare homes were hit hard by the COVID-19 pandemic. Although high levels of psychosocial burden (i.e., anxiety, depression and stress) during the pandemic have been described for healthcare workers in hospitals, evidence on the psychosocial burden for nurses in care homes during the pandemic is scarce.MethodsA total of 811 nurses participated in a retrospective online survey between November 2020 and February 2021. Information about the COVID-19 situation (i.e., working demands, COVID-19 cases in their facility, and COVID-19-related burden) of nurses in German care homes during the first wave of the pandemic (March 2020 to June 2020) was gathered. The Stress Scale of the Depression Anxiety and Stress Scales (SDASS-21), the Generalized Anxiety Disorder Scale-2 (GAD-2), the Patients-Health-Questionnaire-2 (PHQ-2), and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used to screen for psychosocial burden.ResultsAmong nurses, 94.2% stated that working demands since the COVID-19 pandemic increased. Further, 59.1% showed clinically relevant levels of either stress, anxiety, and/or depression. Multiple regression analysis showed significant associations between COVID-19-related burden and qualification (p < .01), dissatisfaction with COVID-19 management of care home manager (p < .05), COVID-19-related anxiety (p < .001), and dementia as a focus of care (p < .05). Stress, depression, and anxiety showed associations with COVID-19 related burden at work (p < .01), COVID-19-related anxiety (p < .001), social support (p < .01), and sense of community (p < .05). Stress was also associated with COVID-19 cases among residents (p < .05), and size of care home (p < .05).ConclusionShort- and long-term strategies (i.e., psychosocial counseling, mandatory team meetings, more highly qualified nurses, additional training) in the work environment of nursing, in crises, but beyond, should be encouraged to reduce the burden on nursing staff in care homes.

"That was a tip from my physician"-Gender-specific pathways of patients and relatives to outpatient psychosocial cancer counselling centres-A qualitative study.

This study aims to identify pathways patients and their relatives take to outpatient psychosocial cancer counselling centres. We had a special interest in how access for men can be eased. Cancer patients and relatives were purposively sampled in two regions in Germany. Participants were either outpatient cancer counselling centres (OCCCs) users or non-users and participated in qualitative face-to-face interviews. We used different guidelines for users and non-users. The interviews were analysed using content analysis. One hundred and three people participated in the study. Important pathways to outpatient psychosocial cancer counselling centres for both men and women were: information about the service and its content, easy access (obtaining appointments quickly and without bureaucracy, close to home), and recommendations from another person, in particular from their treating physician. Pathways especially important for men are positive and repeated recommendations from their treating physician and other people they trust, organisation by others on the men's behalf, the Internet, the possibility to talk to a male counsellor, making it a routine in the hospital to refer distressed patients to the counselling services, and the emphasis on information sharing. Women reported more often than men that they discovered and accessed OCCCs via information material. Men in particular need recommendations from others, especially from their treating physician, in order to make use of psychosocial cancer counselling. In addition, stressing the provision of information instead of exploring and expressing emotions can ease access for men to cancer counselling.

The Possibility of Translation: Turning Ghosts into Psychosomatic Disorders in Nepal

Following in the wake of the People’s War (1996–2006) and the 2015 earthquakes, donor-funded projects supporting community mental health programmes and psychosocial counselling have proliferated in Nepal. This article explores one outcome of the expansion of ‘psy’: the transformation of ghosts and spirits, bhut-pret, into a psychosomatic affliction of repressed emotion and unconscious desire. By engaging theories of translation, I approach interventions for cases of ‘mass conversion disorder’ and the therapeutic encounters, contestations and uncertainties that coalesced around them as a lens into the politics of psychic life currently under way in Nepal.

Experiences of nurses diagnosed with COVID-19 in Turkey: A qualitative study.

This study examined the experiences of nurses diagnosed with COVID-19 under the guidance of Meleis' Transitions Theory. Nurses, who make up the majority of healthcare professionals, are struggling with COVID-19, a silent war, on the front lines at the cost of their lives. The pandemic has deeply affected nurses' lives, and hundreds of nurses around the world have been diagnosed with COVID-19 and died. A descriptive qualitative approach was used in this study. Data were collected from 18 nurses who experienced COVID-19 symptoms, with a semistructured interview form prepared based on Meleis' Transitions Theory concepts. Interview transcripts were analyzed using a thematic analysis technique. The Consolidated Criteria for Reporting Qualitative Research checklist was used in the study. The six themes that emerged in the data analysis were emotions experienced when nurses tested positive for COVID-19, emotions experienced during the quarantine process, posttraumatic growth, methods of coping with COVID-19, nursing care after COVID-19 treatment, and metaphors about COVID-19. This study showed that being diagnosed with COVID-19 caused nurses to have both positive (posttraumatic growth, empathic and psychosocial nursing care) and negative experiences (fear of death, stigma, etc.). They tried to cope with adverse situations due to COVID-19 by obtaining social support, thinking positively, and engaging in domestic activities. To reduce COVID-19-related physical and psychological symptoms, appropriate policies should be developed for effective and rapid nursing workforce planning, extending the time allocated for postdiagnosis treatment, updating infection control and prevention guides, training nurses, and providing ongoing psychosocial counseling services that nurses can access.

Unmet support needs in donor sperm treatment: consequences for parents and their donor-children

Are unmet needs for psychosocial counselling, peer support and friends/family support in parents directly and/or indirectly related to the mental health of parents and their donor-children? A cross-sectional sample of 214 parents participated in this quantitative study via an online questionnaire. The sample comprised mothers and fathers in a heterosexual relationship (n = 85), mothers in a lesbian relationship (n = 67) and single mothers (n = 62). Parents were recruited via three Dutch fertility clinics and four network organizations. Unmet support needs were measured with an adapted version of the Unmet Needs for Parenting Support questionnaire, changing the original items into items about donor conception. The items were derived from a qualitative study and checked by experts in donor conception. The parents' mental health was measured with the Adult Self Report and the donor-children's mental health with the Child Behaviour Checklist. A multigroup mediation analysis was conducted to explore relationships between parents' unmet support needs and their child's mental health, with the parents' mental health as a possible mediator. There were no direct relations between parents' unmet support needs and the mental health of donor-children. Unmet needs for psychosocial counselling, peer support and friends/family support for parents and children's mental health were indirectly related through the mental health of the parents: 0.074 (CI 95% = 0.013-0.136; P = 0.017), 0.085 (CI 95% = 0.018-0.151; P = 0.036) and 0.063 (CI 95% = 0.019-0.106; P = 0.013), respectively. We recommend that fertility clinics, network organizations and authorities for infertility counsellors make their support available to parents for extended periods after their treatment. Further qualitative studies are necessary to assess how to relieve unmet support needs during donor sperm treatment.

Safety and efficacy of agomelatine in children and adolescents with major depressive disorder receiving psychosocial counselling: a double-blind, randomised, controlled, phase 3 trial in nine countries

Major depressive disorder is a severe illness that frequently manifests before the age of 18 years, often recurring later in life. Paediatric medical treatment options are scarce. The melatonin receptor agonist and 5-hydroxytryptamine2C receptor antagonist agomelatine is used to treat adults, and could offer a new therapeutic option for paediatric patients. Therefore, we aimed to investigate the short-term antidepressant efficacy and safety of agomelatine in children and adolescents with major depressive disorder. We performed a 12 week, randomised, double-blind, parallel-group, multicentre, phase 3 trial in 46 specialist psychiatric units or centres in Bulgaria, Finland, Hungary, Poland, Romania, Russia, Serbia, South Africa, and Ukraine. Participants (aged 7-17 years) were eligible if they were unresponsive to psychosocial therapy during the 3-week run-in period (Children's Depression Rating Scale-revised [CDRS-R] score of ≥45). Ethnicity was not recorded. We investigated short-term antidepressant efficacy of agomelatine (10 mg or 25 mg per day) versus placebo with an active control (fluoxetine 10-20 mg depending on symptom severity) after 12 weeks of treatment in children (aged 7-11 years) and adolescents (12-17 years) with major depressive disorder. Patients were randomly assigned (1:1:1:1) to agomelatine 10 mg, agomelatine 25 mg, placebo, or fluoxetine via an interactive response system with permuted-block randomisation. Standardised manualised psychosocial counselling, developed for this trial, was initiated from selection and continued throughout the study, including the open-label extension. All people involved in the conduct of the clinical trial and patients were masked to treatment allocation. Study outcomes were measured using standardised interviews at each study visit. The primary endpoint was change in CDRS-R raw score from baseline to week 12. This study is registered with EudraCT, 2015-002181-23. Between Feb 23, 2016, and Jan 14, 2020, 466 individuals were assessed for eligibility and of 400 included patients, 396 (247 [62%] girls, 149 [38%] boys; mean age 13·7 years [SD 2·7]) were analysed (full analysis set). The primary objective was met; 25 mg/day agomelatine (n=94, with n=102 receiving 10 mg/day) resulted in an improvement versus placebo (n=101) in CDRS-R raw score of 4·22 (95% CI 0·63-7·82; p=0·040) at 12 weeks, with a similar effect for fluoxetine (n=99), establishing assay sensitivity. The overall effect was confirmed in adolescents (n=317), but not in children (n=79). No unexpected safety signals were observed with agomelatine, with no significant weight gain or effect on suicidal behaviours. This first study in a paediatric population supports the efficacy of 25 mg/day agomelatine, in addition to psychosocial counselling, in treating adolescent patients with major depressive disorder, with no unexpected safety signals. This medication could provide another option in the limited psychopharmaceutical repertoire for management of major depressive disorder. Servier. VIDEO ABSTRACT.

PH Professional Network: Genetic Counseling and Pulmonary Arterial Hypertension

PH Professional Network: Genetic Counseling and Pulmonary Arterial Hypertension

Effects of Male International Migration on Mental Health of Wives Left Behind in Nepal

Introduction: International male migration is very common and has been increasing significantly in recent days in Nepal.The increasing pattern of male migration has greatly impacted left-behind women. The aim of the study was to assess the effects of male international migration on the mental health (depression) of wives left behind in Nepal. Methods: A cross-sectional study was conducted with a total of 800 women (400 wives left behind and 400 wives of non-migrants) in the Chitwan district of Nepal.A systematic random sampling approach was employed for the recruitment of study respondents.Data were collected through a structured questionnaire with face-to-face interviews.Depression was measured by using a valid tool of depression screening questionnaire consisting of a 20-items scale. Data were managed in SPSS version 19 and analysed with a descriptive statistic followed bylogistic regression analysis. Ethical approval was obtained from the Nepal Health Research Council and individual written consent was obtained prior to the interview. Findings: The prevalence of depression in left-behind wives was 79 percent whereas only a 26.3 percent prevalence rate was found in the wives of non-migrants. There was a significant difference in depression between left-behind wives and the wives of non-migrants. The left-behind wives (OR = 10.57, p &lt; 0.001) had around 11 times greater odds of having depressive symptoms compared to the wives of non-migrants. Logistic regression shows that theCaste/ethnicity (OR 1.15), level of education (OR 2.4), own named property (OR 1.7), and having children (OR 8.39) were identified as factors influencing depression in left-behind wives. However, the age of the wives (OR 0.46), level of education (OR 1.77), and employment status (OR 1.7) were found as factors that influence the depression in the wives of non-migrants. Findings between the left-behind wives and the wives of non-migrants depict that only women’s education (OR 2.94 vs 1.77) was found to be significantly associated with depression in both groups. Conclusions: The increasing trend of male international migration has negative effects on left-behind wives regarding health and wellbeing. There should have targeted intervention mental health screening and counselling programs forboth non-migrant and left-behind wives for early detection and treatment. Government should plan psychosocial counselling clinics and awareness-raising programmes particularlyto the higher male migration communities for early detection and treatment.

Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer.

Objective: To test the psychometric properties, internal consistency, dimensional structure, and convergent validity of the German version of the Demoralization Scale-II (DS-II), and to examine the association between demoralization, sociodemographic, disease- and treatment-related variables in patients with cancer.Methods: We recruited adult patients with cancer at a Psychosocial Counseling Center and at oncological wards. Participants completed the 16-item DS-II, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-2 (GAD-2), Distress Thermometer (DT), and Body Image Scale (BIS). We analyzed internal consistency of the DS-II using Cronbach‘s Alpha (α). We tested the dimensional structure of the DS-II with Confirmatory Factor Analyses (CFA). Convergent validity was expressed through correlation coefficients with established measures of psychological distress. The associations between demoralization, sociodemographic, disease- and treatment-related variables were examined with ANOVAs.Results: Out of 942 eligible patients, 620 participated. The average DS-II total score was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20, and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency ranged from high to excellent with α = 0.93 for the DS-II total scale, α = 0.90 for the Meaning and Purpose subscale, and α = 0.87 for the Distress and Coping Ability subscale. The one-factor and the two-factor model yielded similar model fits, with CFI and TLI ranging between 0.910 and 0.933, SRMR < 0.05. The DS-II correlated significantly with depression (PHQ-9: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress (DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29, SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60).Conclusion: The DS-II has very good psychometric properties and can be recommended as a reliable tool for assessing demoralization in patients with cancer. The results support the implementation of a screening for demoralization in specific risk groups due to significantly increased demoralization scores.