Psychosocial Problems Research Articles

Disaster Management Experiences and Psychosocial Problems of Individuals Who Survived the Earthquake in Turkey in the Earthquake of the Century: A Phenomenological Study

ABSTRACTAimThe aim of this study is to examine the disaster management experiences and psychosocial problems of individuals who survived the earthquake in Turkey during the earthquake of the century.Materials and MethodsA qualitative research design, phenomenological research, was applied in this study. This qualitative study included 33 volunteer earthquake survivors. The interviews were conducted using WhatsApp. Colaizzi's phenomenological analysis method was used to analyze the data.ResultsIn the analysis of the data, five themes (perception of the earthquake concept, things to do during an earthquake, actions taken to survive under the rubble, meeting everyday chores and dealing with post‐earthquake challenges, perceptions of disaster management), and fifteensubthemes (features of the earthquake, emotions, thoughts, correct actions, incorrect actions, actions for the body, situation‐oriented actions, housing, nutrition, hygiene, sleep, security, preparation, coping, and intervention) were identified.ConclusionThe study showed that the earthquake negatively affected individuals psychosocially, but the effective spiritual coping mechanisms utilized to cope with the catastrophic event under the rubble supported the survival process. In addition, it was determined that the participants believed that religion and spirituality were important in coping with the earthquake.

An educational approach using interprofessional (IP) role plays and patient narratives to inculcate empathy and communication among undergraduates in breast cancer management.

Interactive teaching methods such as patient narratives and role plays are effective tools in medical education. Incorporating the patient's perspective of the disease and standardized treatment in the teaching process helps the students become more empathetic and have better doctor-patient communication. An interactive module was conducted using role plays and patient narratives to teach communication skills and doctor-patient relationships to randomly chosen Seventy-seven final-year(4thyear) medical students to address the various psychosocial problems faced by the patients with breast cancer. Participants' perspectives regarding the intervention were collected using pre and post-tests, session feedback, and interviews. The data were analyzed quantitatively and qualitatively, as appropriate. Observed Structured Clinical Examination (OSCE)stations with case scenarios to break bad news to simulated patients were used for the assessment. Most participants felt that such interactive sessions were needed where they played the role of a doctor before facing an actual patient. While reading the narratives, they felt that the narrators' emotions were genuine and that they felt involved. Most of them could relate to the social and emotional aspects of the patient and understood the Interprofessional (IP) teamwork in the treatment of a breast cancer patient. 93.4% of the participants felt they gained competence in managing difficult communication situations with patients. Interactive teaching methods like narratives and role play may help enhance students' communication and empathy, which is vital for future doctors. They seamlessly integrate into existing curricula, offering practical experiences that deepen understanding and empathy without disrupting learning.

Adrenal Crisis and Adrenal Insufficiency Admissions in Patients 30-59 Years: Contribution of Psychosocial Factors.

Adrenal crises (AC) occur in middle aged adults with adrenal insufficiency (AI). Psychosocial difficulties may impede effective self-management in some cases. This study aimed to investigate associations between psychosocial problems and hospital admissions for AI/AC in middle aged adults. Data on all hospitalisations among patients aged 30-59 years with a diagnosis of AI were extracted from a regional database for the years 2005-2020. Trends in hospitalisations and associations between admissions and comorbid psychosocial problems were assessed. Of the 3948 admissions for AI between 2005 and 2020, 63.4% were in women. Admissions increased by 91.4%, from 61.89 to 118.44/million (p < 0.0001), while AC admission rates increased by 176.5% (from 7.71 to 21.33/million, p=NS). Secondary AI (SAI) admissions rose by 133.0%, from 27.98/million to 65.20/million (p < 0.001). Admissions increased in women in each decade but only in males aged 50-59 years. Comorbid infection was identified in 28.1% of admissions and at least one comorbid contributory psychological problem was found in 25.6%. Males, patients with SAI and those not living in a domestic partnership had a higher combined psychosocial problem burden. Females admitted with at least one sign of an AC had significantly higher psychosocial problem scores than those with less severe presentations. These results suggest that psychosocial factors may play a role in some admissions for AI/AC in adults aged between 30 and 59 years, possibly contributing to the otherwise unexplained rise in hospitalisations for AI.

Experiences and needs of persons who have undergone limb amputation in Saki West, Oyo State, Nigeria.

Amputation is a life-changing experience involving the surgical removal of a body part. However, little is known about the experiences of persons who have undergone limb amputation in the Saki West Local Government Area (LGA), which prompted this study. An exploratory qualitative study design was used. Thirty participants were interviewed using face-to-face focus group discussions. Five sessions were conducted, with six participants in each session. Data were analysed using the thematic analysis framework of Braun and Clarke. A total of 76.3% of the participants were males and 73.3% were married. Their ages ranged from 22 and 69y, with a mean age of 48.0y and a monthly income of 20000 naira (US$12). Three major themes emerged from the study: the needs and challenges of those who have undergone amputation, coping strategies of those who have undergone amputation and recommendations by persons who have undergone amputation. The study revealed that people who have undergone amputation experienced psychological pain, such as a loss of self-worth and stigmatization from friends and loved ones. Coping strategies identified were accepting the situation and emotional support from family. Participants recommended providing financial support, empowerment programs, employment opportunities and fostering a community of amputees in the Saki West LGA. Amputees undergo psychological and psychosocial problems that can affect their health and recovery. They need emotional and financial support, rehabilitation services and provision of prostheses from family, society and the government. These services should be adequately provided in the Saki West LGA, the largest among the 10 suburban local governments in Oyo State, with numerous commercial activities and a high risk for road traffic accidents.

Psychosocial, emotional and behavioral problems, quality of life, and mental health care seeking behaviors among children and adolescents in Jordan: a national school-based survey

ObjectivesThis study aimed to estimate the prevalence of psychosocial, emotional, and behavioral problems and their symptoms among children and adolescents in Jordan, assess their quality of life, and examine mental health help-seeking behavior.MethodsA large-scale school-based national survey was conducted in Jordan among children and adolescents aged 8 to 18 years (grades 3 to 12) from the host and refugee populations, utilizing a multi-stage stratified cluster sampling technique to select a nationally representative sample. Two versions of structured questionnaires were used: proxy parent version for students in grades 3 to 6 (8–11 years) and self-report version for students in grades 7 to 12 (12–18 years). The study questionnaires employed internationally recognized and validated tools in English, which were translated into Arabic.ResultsA total of 8,000 (3,433 (42.9%) boys, 4,567 (57.1%) girls) and (3,593 (44.9%) children, 4,407 (55.1%) adolescents) were included. About 24.5% of children had anxiety symptoms (18.0% of Jordanians, 34.5% of Syrian camp refugees, 33.7% of Syrian urban refugees, and 24.7% of Palestinian camp refugees) and 16.6% of children had major depressive disorder symptoms (11.0% of Jordanians, 25.4% of Syrian camp refugees, 25.0% of Syrian urban refugees, and 14.0% of Palestinian camp refugees). Almost 13.9% of children and 19.7% of adolescents had abnormal levels of total emotional and behavioral difficulties. Nearly 16.5% of children and 35.0% of adolescents had poor overall health-related quality of life. When experiencing a personal or emotional problem, only 28.1% of children’s parents would seek help for their children and 19.7% of adolescents would seek help for themselves.ConclusionThe study revealed a high prevalence of various mental health issues’ symptoms, particularly among refugees and female adolescents. Intention to seek help is relatively low, suggesting that children and adolescents’ mental health needs are not being widely met. It is crucial to implement integrated and coordinated plans and programs that effectively target multiple factors that impact children and adolescents’ mental health, while also respecting the prevailing cultural context. A key aspect of promoting the mental well-being of children and adolescents in Jordan is the inclusive involvement of refugees and individuals from other nationalities.

RESUMO Introdução: Os transtornos mentais são definidos como sendo síndromes caracterizadas por uma perturbação clinicamente expressiva na cognição, na regulação emocional ou no comportamento de um indivíduo, que refletem uma disfunção nos processos psicológicos, biológicos ou de desenvolvimento subjacentes ao funcionamento mental. Estes estão frequentemente associados ao sofrimento ou às incapacidades. Sabe-se que uma das características marcantes de determinados transtornos

Introduction: Mental disorders are defined as syndromes characterized by a clinically significant disturbance in an individual's cognition, emotional regulation or behavior, which reflect a dysfunction in the psychological, biological or developmental processes underlying mental functioning. These are often associated with suffering or disabilities. It is known that one of the striking characteristics of certain disorders is related to their chronicity, which reduces the possibility of a cure and raises the discussion about controlling their symptoms to maintain the quality of life of individuals who suffer from them. A little associated but relevant intervention, if the state of chronic users in mental health is analyzed, is palliative care and its palliative actions that do not seek a cure, but to offer the maximum possible comfort to the user from diagnosis until their last day of life. Objective: Gather and analyze information regarding palliative psychiatry and its benefits for patients with mental disorders. Methodology: Articles published in indexed journals in the Scientific Electronic Library Online (SCIELO), National Library of Medicine/NLM (MEDLINE), and National Library of Medicine/NLM (PUBMED) databases were evaluated, in addition to official sites such as the Ministry of Health of Brazil and the World Health Organization, covering the period from 2014 to 2024. Results and Discussion: After completing the data collection phase, 33 relevant articles were identified for analysis of the proposed theme. It has been noted that palliative psychiatry encompasses a wide range of issues, including widely known mental health conditions such as anxiety or depression, severe mental illnesses refractory to treatment, neuropalliative care, and symptom burden at various levels. Furthermore, it addresses ethical and psychosocial problems, psychological suffering, personality, desire and desire to die, dignity, loneliness, social isolation, as well as psychopharmacology. And that this care would be advantageous and of fundamental importance to patients with serious mental illnesses. Conclusion: Given the new perspectives for mental health care in an increasingly humanized way, the articles highlighted the benefits of palliative psychiatry and its importance in improving the quality of life of patients with serious mental disorders. However, it was also observed that many barriers need to be overcome to guarantee quality care for the group in question.

RESUMO Introdução: Os transtornos mentais são definidos como sendo síndromes caracterizadas por uma perturbação clinicamente expressiva na cognição, na regulação emocional ou no comportamento de um indivíduo, que refletem uma disfunção nos processos psicológicos, biológicos ou de desenvolvimento subjacentes ao funcionamento mental. Estes estão frequentemente associados ao sofrimento ou às incapacidades. Sabe-se que uma das características marcantes de determinados transtornos

Introduction: Mental disorders are defined as syndromes characterized by a clinically significant disturbance in an individual's cognition, emotional regulation or behavior, which reflect a dysfunction in the psychological, biological or developmental processes underlying mental functioning. These are often associated with suffering or disabilities. It is known that one of the striking characteristics of certain disorders is related to their chronicity, which reduces the possibility of a cure and raises the discussion about controlling their symptoms to maintain the quality of life of individuals who suffer from them. A little associated but relevant intervention, if the state of chronic users in mental health is analyzed, is palliative care and its palliative actions that do not seek a cure, but to offer the maximum possible comfort to the user from diagnosis until their last day of life. Objective: Gather and analyze information regarding palliative psychiatry and its benefits for patients with mental disorders. Methodology: Articles published in indexed journals in the Scientific Electronic Library Online (SCIELO), National Library of Medicine/NLM (MEDLINE), and National Library of Medicine/NLM (PUBMED) databases were evaluated, in addition to official sites such as the Ministry of Health of Brazil and the World Health Organization, covering the period from 2014 to 2024. Results and Discussion: After completing the data collection phase, 33 relevant articles were identified for analysis of the proposed theme. It has been noted that palliative psychiatry encompasses a wide range of issues, including widely known mental health conditions such as anxiety or depression, severe mental illnesses refractory to treatment, neuropalliative care, and symptom burden at various levels. Furthermore, it addresses ethical and psychosocial problems, psychological suffering, personality, desire and desire to die, dignity, loneliness, social isolation, as well as psychopharmacology. And that this care would be advantageous and of fundamental importance to patients with serious mental illnesses. Conclusion: Given the new perspectives for mental health care in an increasingly humanized way, the articles highlighted the benefits of palliative psychiatry and its importance in improving the quality of life of patients with serious mental disorders. However, it was also observed that many barriers need to be overcome to guarantee quality care for the group in question.

Psychosocial, physical problems and coping strategies of patients having long term / permanent tracheostomy

BackgroundTracheostomy is a common surgical procedure in which a stoma is created in trachea by direct incision over the anterior aspect of the neck, which can cause disfigurement of the anterior neck and many other associated physical and psychosocial issues. Patients with long-term/permanent tracheostomy have to live with tracheostomy even after getting discharged from the hospital, which can further complicate the condition of the patients as they are unable to cope up with the problems associated with long-term tracheostomy. There is dearth of literature related to intensity of problems among patients having long term/ permanent tracheostomy in India. Therefore, the aim of the study is to assess psychosocial, physical problems and coping mechanism in patients with long-term/permanent tracheostomy.MethodsA cross-sectional descriptive study was conducted at ENT outpatient department and ENT Minor operation theatre, tertiary care hospital India. Total of 100 patients having long term/permanent tracheostomy were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, Physical and Psychosocial problems, and Coping strategies were collected by structured questionnaires.ResultThe majority of individuals who had long-term or permanent tracheostomies had only minor health issues. Patients experienced more psychosocial issues than people in the general healthy population. The majority of patients employed active coping, acceptance, and religion as coping mechanisms, whereas the coping mechanisms which were minimally used includes: humor and substance abuse. Patients' coping strategies vary significantly according on their age, employment status, marital status, and the duration of their tracheostomy.ConclusionLong-term/Permanent tracheostomy can cause multiple physical and psychosocial issues in patients, but eventually, patients get adapted to it. Support from family members and significant others plays a vital role in better coping with tracheostomy in situ, also it is critical for health care providers to be aware of their problems and coping mechanisms so that they can provide required care and assistance.

Challenges in the Management of Tuberous Sclerosis-associated Neuropsychiatric Disorders

Abstract Tuberous sclerosis is a rare autosomal dominant multisystem disorder of genetic origin affecting TSC1 and TSC2 genes. Individuals with tuberous sclerosis are affected by a broad range of behavioral, academic, intellectual, psychiatric, and psychosocial problems, typically underidentified and undertreated. We are presenting the case of a young male with tuberous sclerosis presented with seizures followed by the development of behavioral and dermatological manifestations. We faced difficulties in the management due to the lack of appropriate guidelines. Initially, no response was seen with atypical antipsychotics and antidepressants, and when some improvement was noticed with typical antipsychotics, extrapyramidal symptoms intervened in the progress and caused more distress to the patient. Hence, one should focus on early recognition and prompt treatment of the individual suffering from TSC. The lack of proper guidelines for managing neuropsychiatric manifestation poses a significant challenge. More research is needed in this area.

The quality of psychosocial health and psychosocial illness among women with and without shelter homes: a cross-sectional study

BackgroundExisting research on the psychosocial wellbeing of sheltered women is primarily from Western contexts, with limited studies from collectivistic cultures like Pakistan. This study aims to compare the psychosocial health and illness of sheltered women in Pakistan with those of women living with their families.MethodsA total of 184 sheltered women and 207 women from the general population from four Pakistani cities participated in this study. Data were collected using two validated instruments: the Psychosocial Health Evaluator and the Sukoon Psychosocial Illness Scale. The study employed independent sample t-tests, simple linear regression and Pearson correlation.ResultsThe study revealed significant differences between women residing in shelters and those in the general population. Sheltered women exhibited lower levels of psychosocial health and higher levels of psychosocial illness. Emotional, sexual, spiritual, and social health were notably lower among sheltered women. Sheltered women also reported elevated levels of psychosocial problems, including emotional, social, and professional difficulties. Additionally, the length of stay in shelters was negatively correlated with psychosocial health and positively correlated with psychosocial illness, while education showed a positive correlation with psychosocial health.ConclusionThe current research highlights the psychosocial vulnerability of women residing in shelter homes. Government, non-governmental organizations, and mental health professionals are advised to work together to uplift the psychosocial health of women residing in Pakistani shelter homes. Appointments of psychological counselors in shelter homes are highly recommended in this regard.

New masculinities in uro-oncology: A social theory that contributes to the mental health of patients with penile cancer.

Sociocultural, the penis has represented an essential element in the identity and masculinity of Western men. Therefore, its injury, damage, or loss leads to psychosocial problems affecting these people's health and well-being. Penile cancer is a rare malignancy (it represents 1.44% of the cases of genitourinary cancers) that has direct effects on the genitals, and its treatment consists of penectomy (removal of the penis). The loss of the penis due to this disease has a profound impact on the survivors. It is associated with higher rates of depression, anxiety, and loss of male identity, some even feeling like "castrated animals" or fewer men, having not only biological but also social and psychological problems, leading to the loss or decrease of sexual activity, self-esteem, and ability to relate to others. The new masculinities (a social theory much discussed these days) is offered as an alternative to understanding the behavior of men concerning what represents the penis, and the construction of their identity, focusing on the need to reconstruct the idea of masculinity and unlink the identity of men outside their genitals, the discussion of such social elements can be offered alternatives to help improve the psychological condition of patients who have survived the penectomy and contribute significantly to their health and quality of life, especially in improving your mental health.

BIDIRECTIONAL ASSOCIATIONS BETWEEN WELL-BEING AT SCHOOL, PSYCHOSOCIAL PROBLEMS AND PTSS IN CHILDREN EXPOSED TO FAMILY VIOLENCE

BackgroundChildren exposed to family violence are more likely to have lower well-being at school, more psychosocial problems and more post-traumatic stress symptoms (PTSS) than children not exposed. ObjectiveWe examined whether well-being at school, psychosocial problems, and PTSS affect each other over time in children exposed to family violence. Participantsand Setting: 332 Dutch children aged 8-17 years exposed to family violence (and their parents) who were reached through child protection services (CPS). MethodsParticipants completed questionnaires on well-being at school, psychosocial problems, PTSS, and family violence shortly after being reported to CPS and again one year later. A cross-lagged panel model was conducted to examine the relationships between well-being at school, psychosocial problems, and PTSS over time. FindingsPTSS at Time 1 predicted psychosocial problems at Time 2 (β = .14, p < .05), no other cross-lagged effects were significant. Lower well-being at school was concurrently associated with more psychosocial problems and more PTSS at both time points, and more psychosocial problems was also concurrently associated with more PTSS at both occasions. ConclusionMore PTSS in children exposed to violence appears to be related to more psychosocial problems one year later. The concurrent associations between lower well-being at school, more psychosocial problems and more PTSS at both time points, suggest that these aspects do not appear to be independent, but rather interrelated and co-developing over time. The results highlight the importance of paying attention to children’s well-being at school among children exposed to family violence.

Developing an explanatory model of alcohol misuse among South Sudanese refugees in northern Uganda: A qualitative study

BackgroundAlcohol misuse is a significant health problem among forcibly displaced populations including male South Sudanese refugees in northern Uganda, yet interventions are sorely lacking. Developing an explanatory model of alcohol misuse in this population is the first step to designing appropriate and effective interventions. The aim of the current study was to examine alcohol misuse in this setting and to conceptualize an explanatory model of alcohol misuse. MethodA total of 57 interviews were conducted with male refugees (18+ years) with alcohol misuse (n=17), their family members (n=15), community and religious leaders (n=15), and mental health and psychosocial support providers (n=10) in Rhino Camp settlement in northern Uganda. A thematic analysis approach was used to inductively analyze the data. ResultsAlcohol misuse was identified as a significant psychosocial problem among men in this setting. The adversity (e.g. trauma, loss, poverty), psychological distress (e.g. demoralization), perpetuators (e.g. ease of availability of alcohol, family conflict), and consequences of alcohol use (e.g. interpartner violence, exacerbated poverty) were identified. An explanatory model emerged from the data showing a reinforcing relationship in which adversity causes psychological distress, which leads to increased alcohol use via a number of personal, interpersonal, community and societal perpetuators, and over time increased alcohol use amplifies psychological distress which further increases alcohol misuse. ConclusionsGiven the need to address alcohol misuse in this population, this explanatory model of alcohol misuse can be used to inform prevention and treatment interventions for alcohol misuse. These interventions should endeavor to address the identified determinants of alcohol misuse while being cognizant of the social and cultural considerations specific to males in this population.

Care models for psychosocial problems in primary care

Care models for psychosocial problems in primary care

Screening for Psychosocial Distress: A Brief Review with Implications for Oncology Nursing.

Psychosocial care is an integral component of caring for individuals living with cancer. The identification of psychosocial distress has been acknowledged as a hallmark of quality cancer care, and screening for distress standards has been established in several countries. The purpose of this brief review is to highlight recent developments in screening for distress in oncology populations; to provide insight into significant trends in research and implementation; and to explore implications for oncology nursing practice. This paper reports a brief review of the literature from March 2021 to July 2024 on the topic of screening for distress in oncology. The literature was accessed through PubMed and reviewed by two authors. Trends in the topics presented were identified independently and then discussed to achieve consensus. The search within the designated period produced 47 publications by authors in North America, Australasia, and Europe. Topic trends included the design and adaptation of tools for special populations, the use of technology, descriptions of programs, identification of benefits, challenges, and overcoming barriers to screening for distress. Screening for distress is endorsed as part of the provision of quality oncology care. Nurses have an important role in screening individuals at risk for developing psychosocial problems and acting to reduce the associated morbidity. By continuing to be informed and educated about the emerging developments in screening for distress, nurses can understand and overcome barriers to implementation.

Long-term effects of unintended pregnancies carried to term on mothers and children

Abstract Background Research on psychological effects of unintended pregnancies that are carried to term presents mixed results, and evidence on long-term associations is scarce. The aim of the current study was to examine effects of unintended pregnancies carried to term on both mothers and children, up to 16 years postpartum. Methods This study is based on the Dutch population-based birth cohort study ‘Amsterdam Born Children and their Development’ (ABCD-study), which included pregnant people in 2003 (n = 7784) and is still following these mothers and their children. Structural Equation Models were analyzed per time-point, examining associations between unintended pregnancy and maternal psychosocial distress, and children’s internalizing- and externalizing problems, while controlling for co-occurring risks. Further, mediating effects via maternal mental health and bonding on children were assessed. Results Around 5 years postpartum, pregnancy mistiming was positively associated to maternal psychological distress. Antenatal psychological distress was a much stronger predictor of maternal psychological distress than unintended pregnancy. Pregnancy mistiming was a significant predictor of internalizing and externalizing problems and unwanted pregnancy of internalizing problems in the children from these pregnancies, around 5 years postpartum. These associations were mostly mediated by maternal mental health and poorer maternal bonding. All associations were no longer present at 12 and 16 years postpartum. Conclusions Unintended pregnancies often coincide with maternal mental health problems, and results showed that associations between unintended pregnancy and both mother’s and children’s psychosocial problems are strongly influenced by maternal mental health. Therefore it is important to improve maternal mental health for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy. Key messages • Carrying an unintended pregnancy to term impacts psychological health in both mothers and their children up to 5 years but no longer at 12 or 16 years postpartum. • The effects of unintended pregnancy on psychological health in mothers and children are mostly explained by maternal mental health and bonding, so the focus should be on improving these.

Understanding smoking cessation process in Tunisia from 2020 to 2023: description of quit attempts

Abstract Background Many smokers attempt multiple cessation methods before seeking specialist intervention. This study aims to describe these prior cessation attempts and identify relapse factors to enhance support for these individuals. Methods Data from 440 patients consulting the Department of Epidemiology Statistics at Abderrahman Mami Hospital from 2020 to 2023 were analyzed. It included information on previous quit attempts, methods used, longest duration of abstinence, number of attempts, reaction to cessation, and reasons for relapse. Statistical description was conducted using IBM SPSS 25. Results Among participants, More than half of the smokers had previously attempted to quit smoking 63,4%, with an average of 2 attempts ± 1,7 (0-10 attempts) per patient. The majority of patients (86.8%) quit smoking without using substitution methods. Among those who resorted to substitution, nicotine replacement therapy was the most frequently used method (n = 30; 6.8%). The longest duration of abstinence averaged 8 years. The main reaction to smoking cessation among patients was an improvement in their health (9,1%). The most common reasons for relapse were psychosocial problems (5.5%), followed by relapses during social events (4.3%), and withdrawal symptoms (3%). Conclusions This study emphasizes the importance of considering each patient’s journey during their smoking cessation process. Analyzing these factors will enable better management of the cessation program with the patient, as well as a deeper understanding of their feedback regarding our program, ensuring long-term cessation success. Key messages • Failed spontaneous quit attempts prior to NRT initiation are prevalent among smoking patients. • Understanding failed spontaneous cessation attempts can guide the development of more effective strategies.

The Relationship Between Self-Stigma and Subjective Well-Being in Tuberculosis Patients

Pulmonary tuberculosis (TB) sufferers often face psychosocial problems in the form of stigma. Stigma contributes to psychological morbidity. Morbidity impacts psychological well-being. This research aims to determine the relationship between stigma and subjective well-being in tuberculosis at the Klakah Community Health Center, Lumajang Regency. This study is correlative research with a cross-sectional approach. The population in this study was Tuberculosis Patients at the Klakah Lumajang Community Health Center in 2024. The sample was adjusted based on the Slovin formula to 37 respondents. The side technique used is purposive sampling. Data was collected using the validated The Van Rie tuberculosis stigma scale and The BBC subjective well-being scale questionnaires. Data analysis in this study used Spearman Rho. The results showed that almost half of tuberculosis patients had a high level of Self-Stigma (45.9%), almost half of them had a low level of subjective well-being (43.2%). Data analysis shows that there is a significant relationship between Self-Stigma and subjective well-being in tuberculosis patients (p-value = 0.000; α = 0.05; r = -0.874) which shows a relationship with a strong negative correlation level which means that self- Low stigma will have implications for increasing subjective well-being. The psychosocial health issue of stigma appears to be one of the most important issues that must be addressed to avoid its enormous and negative impact on health promotion.

The Mediating Role of Health Empowerment in the Relationship Between Social Support and Loneliness Among Nursing Home Residents: A Correlational Study.

Loneliness is a significant public health problem due to the physical, cognitive and psychosocial changes that occur with ageing. Social support and empowerment can be particularly important for older people, alleviating loneliness and improving mental well-being. The present study aimed to investigate the mediating role of health empowerment in the relationship between perceived social support and loneliness among nursing home residents. The study was conducted with a correlational design and reported based on STROBE checklist. The study was completed with 277 older adults aged 65 years and over residing in nursing homes. Process Macro Model 4 was conducted to verify the mediating role. The response rate was 95.6%. Most older adults experienced a feeling of loneliness, and the level of social support and empowerment perceived by most of them was high. The study found a mediating role of health empowerment in the relationship between social support and loneliness. Social support was significantly positively correlated with health empowerment and negatively correlated with loneliness. The significant standardised indirect effect of health empowerment on loneliness evidenced a partial mediating role. This study concluded that health empowerment has a partial mediating role in the effect of perceived social support and loneliness. Nurses could develop effective strategies for preventing psychosocial problems in nursing home residents. Nurses could contribute significantly as educators, counsellors and leaders in planning interventions to empower older adults. By empowering older adults regarding healthcare, nurses could increase their perception of social support, improving mental health by increasing effective coping with loneliness. Nurses could design intervention programmes to increase perceived social support, as well as health empowerment levels, and reduce older adults' loneliness in nursing homes. Older adults completed the instruments.

Suicide in young and middle-aged individuals: lessons from a psychosocial autopsy study

Abstract Background Sociodemographic characteristics of suicides are available from Statistics Netherlands. To improve suicide prevention, it is not only necessary to know who dies but also why people die. A psychosocial autopsy was conducted in the Netherlands to investigate differences in psychosocial characteristics and precipitating factors of suicides of young (&amp;lt;30) and middle-aged (40-70) suicide decedents. Methods Data were collected from bereaved individuals. A questionnaire detailed sociodemographic and psychosocial characteristics of the decedents. We reconstructed the suicidal process in the months preceding the suicide in an interview. Findings from the questionnaire and interview were integrated. An independent expert committee formulated recommendations for suicide prevention. Results 162 suicides were investigated. Young decedents showed high levels of substance use and academic pressure. Young adults with developmental disorders were vulnerable in the transition to adulthood. Young males reached out less to support and care. By contrast, suicides of young females were distinguished by comorbidity of psychiatric disorders, frequent suicidal behaviours, high levels of care use, wait lists and a loss of (treatment) perspective, harmful social media use and bullying. Work and financial problems were common in middle-aged decedents. Physical disability and pain were frequently mentioned for middle-aged females. Suicide in middle-aged males was characterized by financial distress, interpersonal conflicts such as divorce, high levels of binge drinking and addiction. Conclusions Our data provide a topology of the needs of individuals at risk for suicide. Suicide prevention strategies can be improved by better transition support and explicit suicide monitoring in young adults with a developmental disorder, active waitlist policies in mental healthcare, and improved collaboration between debt counsellors and mental care professionals based on shared accountability. Key messages • Bereaved individuals elucidated a wide range of psychosocial problems in suicide decedents. • Suicide prevention should adhere to a needs-based approach.