Psychosocial Model Research Articles

A Psychosocial Care Model for Families Affected by Congenital Heart Disease.

To develop a model of family-based psychosocial care for congenital heart disease (CHD). Qualitative study using crowdsourced data collected from parents of young children with CHD who received care across 42 hospitals. Yammer, a social networking platform used to facilitate online crowdsourcing and qualitative data collection. Geographically diverse sample of 100 parents (72 mothers and 28 fathers) of young children with CHD. None. Parents joined a private group on Yammer and responded to 37 open-ended study questions over a 6-month period. Qualitative data were coded and analyzed using an iterative process. Three broad themes corresponding to pillars of family-based psychosocial care were identified: pillar 1) parent partnership in family-integrated medical care, pillar 2) supportive interactions focused on parent and family wellbeing, and pillar 3) integrated psychosocial care and peer support for parents and families. Each pillar was supported by subthemes corresponding to specific intervention strategies. Most parents described the need for intervention strategies across multiple pillars, with almost half reporting needs across all three pillars of psychosocial care. Parents' preferences for psychosocial support changed over time with changes to their child's medical status and across care settings (e.g., hospital, outpatient clinic). Results support a model of family-based psychosocial care that is multidimensional and flexible to meet the needs of families affected by CHD. All members of the healthcare team play an important role in providing psychosocial support. Future research incorporating components of implementation science is needed to promote uptake of these findings, with the goal of optimizing family-based psychosocial support in the hospital setting and beyond.

Caring for the careers: A psychosocial support model for healthcare workers during a pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has further placed additional stress on the already fragile and overstretched healthcare system in Zimbabwe. Most healthcare institutions reported staff shortages, inability to cope with the extra workload, burnout and the resultant psychological implications. This study aimed to develop a psychosocial support model that sustains a support structure that will contribute to an enabling work environment promoting efficiency and effectiveness in response to public health emergencies. Empirical findings from interpretive phenomenological analysis studies on healthcare workers' experiences during the COVID-19 in Zimbabwe formed the basis for model development. The model development in this study was informed by the work of Donabedian, Dickoff, James and Wiedenbach, Walker and Avant, Chinn, Kramer and Wilkes. The developed model is described using the elements of Donabedian's framework (structure, process and outcome) and of Dickoff, James and Wiedenbach's (1968) practice theory elements (agents, recipients, context, process, dynamics and outcome) and within the national and international context of the COVID-19 pandemic. The fragile and under-resourced healthcare system has psychosocial implications to the well-being of healthcare workers. The utilisation of this model is critical and facilitates the provision of an enabling and supportive environment that facilitates efficiency in response activities during pandemics.Contribution:This study provides a reference guide in the provision of psychosocial support for healthcare workers particularly during public health emergencies. There is paucity of evidence focusing on the well-being of healthcare workers during a crisis, hence the significance of this study.

P379 Impact of a mental health navigator for cystic fibrosis care in British Columbia

Cystic Fibrosis (CF) Care British Columbia (CFCBC) serves the CF population by providing provincial leadership to support evidence-based, high-quality, accessible, and equitable care across the continuum. To address the priority of mental health, CFCBC developed a new CF psychosocial model of care, along with the addition of a mental health navigator to assist CF clinics. The purpose of the navigator is to strengthen connections between patients and existing community mental health services by providing tools and support for improving health outcomes.

Implementing psychosocial support models in contexts of extreme adversity: lessons from a process evaluation in Colombia.

High quality investments during early childhood allow children to achieve their full potential by setting developmental foundations. However, challenges in the scale-up of evidence-based interventions make across-the-board implementation a non-trivial matter. Moreover, extreme contextual conditions -such as community violence, forced displacement, and poverty- impose a double threat. First, by directly affecting early childhood development (ECD), forced displacement and exposure to violence during early childhood, coupled with deficits in nurturing relationships, can trigger toxic stress, affecting children's mental health and social and emotional learning. Second, contexts of extreme adversity exacerbate common implementation pitfalls in the scale-up of interventions. Recognizing and documenting "what it takes" to successfully implement "what works" can contribute to the expansion and effectiveness of evidence-based programs that promote ECD in these settings. Semillas de Apego (SA, onward), a community-based psychosocial support model for caregivers, materialized as a strategy to promote ECD in communities affected by violence and forced displacement. This article presents the results of the process evaluation of SA during the 2018-2019 implementation in Tumaco, a violence ridden municipality in the south-west border of Colombia, South America. In this phase, the program reached 714 families, 82% direct victims of violence and 57% were internally displaced. The process evaluation combined qualitative and quantitative methodological approaches to produce evidence of factors that promoted implementation quality. Findings identified salient components of the program that promoted the program's acceptability, adoption, appropriateness, fidelity and sustainability: a rigorous cultural adaptation; well-structured team selection and training methodologies; and a team support and supervision protocol to provide continuous capacity building and prevent burn-out and other occupational hazards common among professionals in mental health and psychosocial support interventions. The statistical analysis using monitoring data identified key predictors of the dosage delivered (a measure of fidelity). Evidence suggests that initial attendance to the program and observable characteristics -such as educational attainment, violence victimization and employment status-predict a successful compliance (in terms of dosage to benefit from the program). This study provides evidence for the development of structural, organizational, and procedural processes for the adoption, appropriate adaptation, and high-fidelity delivery of psychosocial support models delivered in territories affected by extreme adversity.

Psychosocial and Spiritual Model as the Analgesic for Patients with Terminal Illness

Terminal illnesses are quite painful and thus require proper attention both from the healthcare personnel and the family. The modern developments in therapeutic and care options in trying to reduce the effects of terminal illness have contributed a lot in the rise of the quality of health care among diagnosed patients. Through the procedure, a person may feel frightened and also anxious. This worry has been documented in patients with life-threatening diseases such as cancer, bubonic plague, or dynamic coronary infarction. Stress in between scientific research and belief are much more frequently revealed in western culture. Terminal illnesses are quite painful and thus require proper attention both from the healthcare personnel and the family. This work tries to figure out how people cope with terminal illnesses, emphasizing the importance of the psychosocial and spiritual model in helping patients who have been diagnosed with these kinds of diseases. It was found that only a small number of patients with terminal illness were receiving support from healthcare personnel. This of course suggests that there is limited availability of psychosocial personnel to handle the emotional and spiritual suffering of patients with terminal illness. In the absence of professional health services, patients may sought the support of family and friends. This work tries to figure out how people cope with terminal illnesses, emphasizing the importance of the psychosocial and spiritual model in helping patients who have been diagnosed with these kinds of diseases.

Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort.

The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and PNDS at 2 months postpartum (PP) in a large sample of women from the general population. We used data from the French ELFE cohort, a nationally representative cohort of children followed-up from birth. The available information about vulnerabilities or risk/protective factors for PNDS was collected during the maternity ward stay (mother or medical records) and at 2 months PP (mother by phone). PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. A measurement model was built based on the psychosocial model for PNDS of Milgrom and colleagues using exploratory factor analysis. The Structural Equation Model was used to investigate the pathways between vulnerability, risk/protective factors and PNDS at 2 months PP. In the study sample (n = 11,583), a lack of a partner's perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, family financial difficulties, prenatal psychological distress and a difficult pregnancy experience were directly associated with the severity of maternal PNDS at 2 months PP, as well as lack of perceived postnatal support. Family financial difficulties and consultation with a mental health specialist before pregnancy were also indirectly associated with the intensity of PNDS through a lack of perceived antenatal emotional support, a difficult pregnancy experience, prenatal psychological distress and a lack of perceived postnatal support. Regarding infant and parenthood characteristics, infant self-regulation difficulties, maternal difficulty in understanding infant crying and infant hospitalisation were directly associated with PNDS severity at 2 months PP, while maternal difficulty in understanding an infant's cries was also indirectly associated with infant self-regulation difficulties. Perinatal professional support should begin antenatally and target the couple's prenatal functioning, with particular attention to women presenting a history of psychiatric disorders, especially those of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is also recommended.

The Psychosocial Model of Absenteeism: Transition from 4.0 to 5.0

The research provides insight into the factors that determine absenteeism in different types of organizations, in order to facilitate the adjustment of employees and organizations in the transition process from Industry 4.0 to Industry 5.0. The aim of the study is to predict the absenteeism of employees in the context of job characteristics and mental health. Additionally, the research investigated the effect of size, ownership, and sector of the companies on absenteeism, job characteristics, and mental health. The sample included responses from 502 employees of different sociodemographic characteristics that work in various types of organizations, performing white-collar and blue-collar jobs. A short mental health questionnaire-Mental Health Inventory, MHI-5-was used in order to measure mental health. The Job Characteristics Questionnaire was used to measure the employees' perceptions of their job characteristics-job variety, autonomy, feedback, dealing with others, task identity, and friendship. The absenteeism is operationalized with the question: "During the past 12 months, how many days were you absent from work for any reason?". The findings suggest that mental health and job characteristics significantly reduce absenteeism among different sectors. The result showed that the size, ownership, and sector of the organization significantly affect the absenteeism, job characteristics, and the mental health of the employees. The results support the premises of Industry 5.0 and offer a new human-centric approach to absenteeism through the promotion of mental health through long-term organizational strategies and a more inclusive approach to employees' preferences in relation to job characteristics. The study offers a new, double-sided model of absenteeism, determining causal factors from the perspective of personal and organizational factors.

Epidemiology of disorders of gut-brain interaction in Belgium and differences between two language groups: Results from the Rome foundation global epidemiology study.

The Rome Foundation carried out a worldwide epidemiology study on DGBI according to the Rome IV criteria in 33 countries, including Belgium. DGBI prevalence varied between continents and countries, but prevalence differences within language groups in a single country have not yet been described. We analyzed the prevalence rates of 18 DGBI and their psychosocial impact in Belgium in the French and Dutch language groups. DGBI prevalence was similar in the French-speaking and Dutch-speaking population. Having one or more DGBI was negatively associated with psychosocial well-being. The scores for depression were lower in the Dutch-speaking participants with one or more DGBI compared to the French-speaking participants. Interestingly, we also found significantly lower scores in the general Dutch-speaking versus the French-speaking population for depression and non-gastrointesinal somatic symptoms, and higher global physical health and mental health quality-of-life component scores. In the Dutch-speaking group, medication use for gastric acid was lower, but use of prescribed analgesics was more common. Nevertheless, the use of non-prescribed pain medication was higher in the French-speaking group. Anxiety and sleep medication use was also higher in the latter group. The results of this first in-depth analysis of Rome IV DGBI in Belgium show a higher prevalence for some DGBI in the French-speaking cohort, and a larger associated disease burden. These differences between language/culture groups in the same country support the psychosocial pathophysiological model of DGBI.

Psychosocial model of burnout among humanitarian aid workers in Bangladesh: role of workplace stressors and emotion coping

BackgroundWhile trauma exposure is an established predictor of poor mental health among humanitarian aid workers (HAWs), less is known about the role of psychosocial work-related factors. This study aims to establish a psychosocial model for burnout and psychological distress in HAWs that tests and compares the effects of adversity exposure and workplace stressors in combination, and explores the potential mediating role of individual coping styles.MethodsPath analysis and model comparison using cross-sectional online survey data were collected from full-time international and local HAWs in Bangladesh between December 2020 and February 2021. HAWs self-reported on exposure to adversities, workplace psychosocial stressors (Third Copenhagen Psychosocial Questionnaire), coping styles (Coping Inventory for Stressful Situations), burnout (Maslach Burnout Inventory—Human Services Survey), and psychological distress (Kessler-6).ResultsAmong N = 111 HAWs, 30.6%, 16.4%, 12.7%, and 8.2% screened positive for moderate psychological distress (8 ≤ Kessler-6 ≤ 12), emotional exhaustion (EE ≥ 27), depersonalization (DP ≥ 13), and severe psychological distress (K-6 ≥ 13), respectively. 28.8% reported a history of mental disorder. The preferred model showed distinct pathways from adversity exposure and workplace stressors to burnout, with negative emotion-focused coping and psychological distress as significant intervening variables. While greater exposure to both types of stressors were associated with higher levels of burnout and distress, workplace stressors had a stronger association with psychological outcomes than adversity exposure did (β = .52, p ≤ .001 vs. β = .20, p = .032). Workplace stressors, but not adversities, directly influenced psychological distress (β = .45, p ≤ .001 vs. β = −.01, p = .927). Demographic variables, task-focused and avoidance-focused coping were not significantly associated with psychological outcomes.ConclusionsCompared to exposure to adversities, workplace stressors primarily influenced occupational stress syndromes. Reducing workplace stressors and enhancing adaptive coping may improve psychological outcomes in humanitarian staff.

Skin Cancer-Related Health Behavior Interventions in the Context of the Health Belief Model

The incidence of skin cancer is increasing around the world every year. Although there are many reasons for the occurrence of skin cancer, UV radiation caused by sunlight is seen as the most important factor. Therefore, reducing exposure to UV radiation should be a top priority for skin cancer prevention. In addition, different demographic features also affect the amount of UV exposure. These include age, gender and professional groups. On the other hand, people can be exposed to UV radiation voluntarily. Sunbathing or using tanning devices can be shown as examples for this. For these reasons, interventions to reduce exposure to UV radiation should focus on demographic features and the desire to tan. At the same time, it is emphasized in the literature that theory-based and systematic interventions are more effective than others. In this context, we think that the Health Belief Model, which is an effective psychosocial model for health behaviors, will be useful in developing sun protection behaviors. In this review, interventions based on the Health Belief Model in the context of tanning behavior, age, gender, and outdoor activities for the prevention of skin cancer and the improvement of sun protection behaviors have been discussed.

Social support enhances the mediating effect of psychological resilience on the relationship between life satisfaction and depressive symptom severity

Psychosocial factors, including life satisfaction, resilience, and social support, have been proposed to influence depressive symptom severity in adults because the age of onset of depressive disorders, i.e. adolescence to early adulthood, is associated with various impairments in psychosocial functioning. In this study, a psychosocial model was constructed to verify these relationships to prevent depression. For this study, 370 participants were recruited from the community via poster or online advertisements. They completed several questionnaires to assess depressive symptom severity: the Connor-Davidson Resilience Scale (CD-RISC), Satisfaction with Life Scale (SwLS), Peace of Mind (PoM) scale, Social Support Questionnaire (SSQ), and Beck Depression Inventory (BDI-II). A negative association was found between depressive symptom severity and all other variables, including PoM and CD-RISC scores, life satisfaction, and social support. Such factors can be considered protective against increased depressive symptom severity. In addition, indirect effects of PoM and resilience on the negative association between SwLS scores and depressive symptom severity were observed. Moreover, social support was found to mediate the correlation between PoM and resilience, implying that social support mediates the relationship between state of mind and resilience. The psychosocial model suggested that depressive symptom severity is influenced by internal factors (an individual’s state of mind, subjective view of events and their life) and external factors (including social support).

The prevalence of internet gaming disorders and the associated psychosocial risk factors among adolescents in Malaysian secondary schools.

Internet Gaming Disorder (IGD) has been placed under the conditions for further study segment in DSM-5. The purpose of the current study was to develop a preliminary psychosocial model as a reference for providing appropriate intervention, particularly for adolescents with IGD. A total of 5290 adolescents from secondary schools in seven states in Malaysia were recruited by using proportionate random sampling. A standardized set of validated questionnaires such as DASS-21, BIS-11, and IGDS9-SF were distributed to participants that fulfilled the inclusion criteria. The prevalence of IGD among Malaysian adolescents was 3.5%. The bivariate analysis summarized that factors such as stress, impulsivity, gender, time spent using the internet, and relationship with parents and friends; have statistically significant associations with IGD. The logistic regression model revealed that adolescents with IGD were 9 times more likely to experience extremely severe stress (p < 0.001). Several psychosocial factors were associated strongly with IGD in the current study, however, mental health shows the most significant issues among adolescents with IGD. Immediate intervention through a psychological approach to internet gaming is needed from parents, schools, and also respective stakeholders. IGD may become one of the addictions diseases that cause deterioration in many aspects of an adolescent's future life without serious intervention.

Emotional dissonance and burnout among child welfare workers: The moderating role of social support from colleagues, supervisors, and organization

Summary Occupational burnout has significant costs for individuals, employers, and the society. Knowledge about risk and protective factors is therefore highly important. This study examined emotional dissonance as a risk factor and colleague, supervisor, and organizational support as protective factors regarding burnout among child welfare workers. It was expected that emotional dissonance would be positively related to burnout, and that social support would attenuate the magnitude of the association. Based on the Psychosocial safety climate model, it was also suggested that organizational support would be negatively associated with levels of emotional dissonance and thereby also burnout. Findings The study was based on a cross-sectional probability sample of employees working in the child welfare service in Oslo municipality, Norway ( N = 678). Emotional dissonance was positively related to burnout. In contrast to expectations, the interaction analyses showed a reverse buffering effect where the examined sources of social support intensified the association between emotional dissonance and burnout. Organizational support had an indirect association with burnout through emotional dissonance. Applications While the cross-sectional nature of the study does not allow for any conclusions about causal effects, the findings indicate that other stress-buffering job resources than social support are more beneficial in efforts focusing on reducing the detrimental impact of emotional demands in child welfare work. However, more knowledge concerning the actual effectiveness of receiving support is necessary to draw more definite conclusions.

Leaving the stigma to the patients? Frequency of crisis experiences among mental health professionals in Berlin and Brandenburg and how they cope with it

Background Although mental health professionals’ mental health problems are gaining increased attention, there is little systematic research on this topic. Aims This study investigated the frequency of crisis experiences among mental health professionals and examined how they approach these experiences in terms of their personal and social identities. Methods An online survey was conducted among mental health professionals in 18 psychiatric hospital departments in the German federal states of Berlin and Brandenburg (N = 215), containing questions about personal crisis experiences, help sought, service use, meaningfulness of lived experiences, causal beliefs of mental illness and psychotherapeutic orientation. Social identification was assessed via semantic differential scales derived from preliminary interview studies. To investigate relationships between the variables, explorative correlation analyses were calculated. Results Results showed a high frequency rate of crisis experiences, substantial rates of suicidal ideation and incapacity to work and high service use. Most participants regarded their experiences as meaningful for their personal identity. Meaningfulness was positively related to a psychosocial causation model of mental illness, to psychodynamic psychotherapeutic orientation and to a high degree of disidentification with users and crisis experienced colleagues. Conclusion The (paradoxical) disintegration of personal and social identity of may be understood as a strategy to avoid stigmatization. A more challenging coping style among professionals is discussed.

The Relationship Between Acceptance, Biopsychosocial Factors, and Quality of Life: A Structural Equation Model

Disability acceptance is one of the most significant constructs in the psychosocial adaptation process. Although prior research has examined the relationship among different biopsychosocial factors, disability acceptance, and quality of life (QoL), limited study focused on entering a series of biopsychosocial factors simultaneously into analysis to reflect live experience of individuals with disabilities. This study aimed to examine the role of acceptance regarding the relationship between a series of biopsychosocial factors (i.e., general health, physical functioning, pain, anxiety, depression, stress, loneliness, stigma, sense of community, and neighborhood problems) and QoL based on Livneh’s psychosocial adaptation model to inform psychosocial interventions. A total of 430 participants with disabilities completed an online survey consisting of instruments measuring target variables. Exploratory and confirmatory factor analyses indicated a three-factor structure for selected biopsychosocial factors (i.e., psychological difficulties, physical status, and community issues). Structural equation modeling results showed that the proposed model indicated a fair model fit after respecification. Effect analyses showed that disability acceptance directly affected QoL and partially mediated the relationship between physical status and QoL and psychological difficulties and QoL. In addition, loneliness has been found to significantly and directly predict QoL in the respecified model. The model demonstrated that disability acceptance and loneliness have a significant impact on QoL.

Efficacy of mindfulness and goal setting interventions for increasing resilience and reducing smoking in lower socio-economic groups: randomised controlled trial protocol

BackgroundSmoking and resulting health problems disproportionately impact low socioeconomic status (SES) individuals. Building resilience presents an approach to ‘closing the gap’. Mindfulness-based interventions and setting realistic goals are preferred in low socioeconomic communities. We aim to test if these interventions, delivered online and consolidated with peer support offered via ex-smokers, are successful in promoting smoking cessation and resilience. Our conceptualisation of resilience encompasses the inner capacity/skills and external resources (e.g., social support) which smokers utilise to bounce back from adversity. We include a process evaluation of barriers/facilitators to interventions and cost-effectiveness analysis (from health system perspective).MethodsWe plan a four-arm parallel 12-month RCT with a 6-month follow-up to test the efficacy of three group-based interventions each followed by peer support. Arm 1: mindfulness-integrated cognitive behavioural therapy; Arm 2: mindfulness training; Arm 3: setting realistic goals; Arm 4: active control group directed to quit services. All interventions will be administered online. Participants are adult smokers in Australia (N = 812) who have an average weekly household income less than $457AUD or receive welfare benefits. Group-based interventions will occur over 6 months, followed by 6 months of forum-based peer support. Primary outcome: self-reported 14-day period prevalence of smoking abstinence at 6 months, with remote biochemical verification of saliva cotinine (< 30 ng/mL). Secondary outcomes include: internal resilience (Connor-Davidson Resilience Scale-25); external resilience (ENRICHD social support tool); quality adjusted life years (EQ-5D-5L); self-efficacy for smoking abstinence (Smoking-Abstinence Self-Efficacy Questionnaire); motivation to quit smoking (Biener and Abrams Contemplation Ladder); nicotine dependence (Fagerstrom Test for Nicotine Dependency); equanimity (Equanimity Scale-16); stress (Perceived Stress Scale-10); goal assessment/attainment (Problems and Goals Assessment Scale).DiscussionThis study is the first to compare resilience interventions for low SES smokers which have been identified by them as acceptable. Our various repeated measures and process evaluation will facilitate exploration of mechanisms of impact. We intervene within the novel framework of the Psychosocial Model of Resilience, applying a promising paradigm to address a critical and inequitable public health problem.Trial registration Australian New Zealand Clinical Trials Registry ID: ACTRN12621000445875, registered 19 April 2021 (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381007&isReview=true). The Universal Trial Number is U1111-1261–8951

Community-based psychosocial rehabilitation model for people with schizophrenia

Schizophrenia is a mental disorder that triggers the occurrence of impaired function in the human brain, behavior, cognitive, and emotional functions. This disorder has become a problem in the study of mental health, which must be treated comprehensively by using empirical treatment combined with rehabilitation. Hopefully, increasing the maximum level of healing and reducing recurrence rates can improve social function and quality of life. Thus, this review aims to narrate the model and effective community-based psychosocial rehabilitation center. The articles of the studies published from 2017-2021 were collected and analyzed in this literature review. The keywords used were community-based rehabilitation for schizophrenia. The results show that in addition to pharmacological therapy, six community-based psychosocial non-pharmacological therapy methods are considered effective for intervention in patients with schizophrenia. The methods are club methods in elderly schizophrenic patients, community-based methods, direct patient decision-making methods, case and club management methods, psychoeducational and social skills methods, and community care unit methods. All of the above methods analyzed showed significant effectiveness in community-based psychosocial rehabilitation treatment in developing countries.

Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers.

Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model. The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention. The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful. Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

Impacts of Subchronic and Mild Social Defeat Stress on Plasma Putrefactive Metabolites and Cardiovascular Structure in Male Mice.

Psychosocial stress precipitates mental illnesses, such as depression, and increases the risk of other health problems, including cardiovascular diseases. In this study, we observed the effects of psychosocial stress on the histopathological features of systemic organs and tissues in a mouse psychosocial stress model, namely the subchronic and mild social defeat stress (sCSDS) model. There were several pathological findings in the tissues of both sCSDS and control mice. Mild fibrosis of the heart was observed in sCSDS mice but not in control mice. Extramedullary hematopoiesis in the spleen and hemorrhage in the lungs were observed in both the control and sCSDS mice. Focal necrosis of the liver was seen only in control mice. Furthermore, putrefactive substances in the blood plasma were analyzed because these metabolites originating from intestinal fermentation might be linked to heart fibrosis. Among them, plasma p-cresyl glucuronide and p-cresyl sulfate concentrations significantly increased owing to subchronic social defeat stress, which might influence cardiac fibrosis in sCSDS mice. In conclusion, several pathological features such as increased cardiac fibrosis and elevated plasma putrefactive substances were found in sCSDS mice. Thus, sCSDS mice are a potential model for elucidating the pathophysiology of psychosocial stress and heart failure.

Global Aspects of Psychosocial Rehabilitation

Rehabilitation is required when limitations in health prevent full functioning. On a global level, WHO estimates that more than 2.4 billion could benefit from a rehabilitative intervention of some kind. The health limitations may have several causes frequently with a mental health dimension and the benefits of psychosocial rehabilitation are increasingly recognized globally. An example is given of a psychosocial model focusing on traumatized individuals and the development of a rehabilitative field manual to be used in Low and middle income countries (LOMIC) or settings of limited resources.