Psychosocial Distress Research Articles

Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study

BackgroundDuring the 2014–15 Ebola Virus Disease (EVD) epidemic, thousands of people in Sierra Leone were infected with the devastating virus and survived. Years after the epidemic was declared over, stigma toward EVD survivors and others affected by the virus is still a major concern, but little is known about the factors that influence stigma toward survivors. This study examines how key personal and ecological factors predicted EVD-related stigma at the height of the 2014–2015 epidemic in Sierra Leone, and the personal and ecological factors that shaped changes in stigma over time.MethodsUsing three waves of survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines factors associated with self-reported personal stigma toward Ebola survivors (11 items, α = 0.77) among 1008 adults (74.6% retention rate) from 63 census enumeration areas of the Western Rural and Western Urban districts of Sierra Leone. Participants were randomly sampled at the height of the EVD epidemic and followed up as the epidemic was waning and once the epidemic had been declared over by the WHO. Three-level mixed effects models were fit using Stata 16 SE to examine cross-sectional associations as well as predictors of longitudinal changes in stigma toward EVD survivors.ResultsAt the height of the EVD epidemic, female sex, household wealth, post-traumatic stress, EVD-related fear and perceived infection risk are a few of the factors which predicted higher levels of stigma toward survivors. On average, stigma toward EVD survivors decreased significantly as the epidemic declined in Sierra Leone, but female sex, EVD fear, and risk perceptions predicted a slower rate of change.ConclusionThis study identified key individual and psychosocial characteristics which may predict higher levels of stigma toward infectious disease survivors. Future studies should pursue a better understanding of how personal characteristics and perceptions, including psychosocial distress, fear, and perceived infection risk serve as pathways for stigma in communities affected by infectious disease.

Anal preservation on the psychology and quality of life of low rectal cancer.

The aims of this study are to evaluate depression and quality of life (QOL) after laparoscopic abdominoperineal resection (LAPR) or transanal total mesorectal excision (TaTME) surgery in low rectal cancer (RC) patients. This is a prospective observational cohort study. Patients were divided into two groups: either TaTME surgery or LAPR. Psychosocial distress and QOL were assessed using a questionnaire before surgery, at 6 months postsurgery, and 12 months postsurgery. The Hospital Anxiety and Depression Scale was used to assess symptoms of anxiety and depression. The European Organization for Research and Treatment of Cancer-QOL questionnaire core was used to estimate the QOL. In the TaTME group, the scores of psychosocial distress and QOL showed an obvious tendency to decrease and then recover. Meanwhile, in the LAPR group, these scores deteriorated significantly at 6and 12 months, and the recovery was less pronounced. Multivariable analysis suggested that surgical options and tumor stage were significantly associated with psychosocial distress and QOL. For low RC, TaTME could significantly improve patients' QOL and reduce psychological distress as compared to patients with LAPR at 12 months after surgery.

The Experiences of Family Members of COVID-19 Patients in Iran: A Qualitative Study.

Being diagnosed with coronavirus disease-19 (COVID-19) usually causes emotional stress for patients and their families. Understanding the challenges faced by family members of COVID-19 patients is necessary to provide holistic family centered care to support patients and families on their journey to recovery from COVID-19. The aim of this study was to explore the experiences of Iranian family members of COVID-19 patients. This qualitative study was performed using the conventional content analysis approach in 2020 in Gorgan, northeastern Iran. Using a purposive sampling 15 family members of inpatient and outpatient COVID-19 patients who were involved in caring of their patients were selected. Data were collected using in-depth and semi-structured interviews and were analyzed by Graneheim and Lundman's content analysis method with the support of MAXQDA software. Family members' experiences of COVID-19 patients were categorized into two main themes, four category and 10 subcategories. One of the main themes was "psychosocial distress", with two categories of "uncertainty of the disease" and "perceived psychosocial burdens". Another main theme was "adaptation strategies", with the two sub-categories including "adaptative care" and "trusting God". The results of this study provide a broad range of context-specific challenges faced by family members of Covid-19 patients. It is essential for healthcare providers to be aware of the complex psychological and social conditions of families of Covid-19 patients. Hence, healthcare managers and policymakers should implement preventive and supportive programs at all levels in hospitals and community and provide supportive strategies to reduce or eliminate their challenges.

COVID-19-Related Psychological and Psychosocial Distress Among Parents and Youth With Physical Illness: A Longitudinal Study.

Despite the initial thrust of research aimed at understanding the impact of the COVID-19 pandemic on youth with physical illness and their parents, knowledge gaps in the literature remain, providing the impetus for additional investigation. This study described changes in psychological distress from prior to during the COVID-19 pandemic for parents and youth with physical illness, compared parent-proxy and youth self-reported perceptions of COVID-19-related psychosocial health, and modeled factors associated with psychological and psychosocial distress. There were 147 parent–youth dyads (2–16 years) from MY LIFE—a longitudinal study of youth with physical illness. The Kessler-6 (K6) measured psychological distress for the time before the COVID-19 lockdown (December 19 to March 20) and during the pandemic (December 20 to March 21) among parents and youth. COVID-19-related psychosocial health was measured using the CRISIS. Parents and youth reported increases in K6 scores (d = 0.62 and 0.38). Parent-proxy reports on the K6 were lower vs. youth self-reports prior to and during the pandemic (d = 0.63 for both). In contrast, parents reported lower proxy CRISIS scores for worries (d = 0.38) and effects of social restrictions (d = 0.52). Pandemic parent K6 scores were associated with age, combined in-person and online schooling for youth, COVID-19-related worries, and effects of social restrictions. For youth, only COVID-19-related worries and effects of social restrictions were associated with K6 scores. Parent worries were associated with youth sex, parental stress, family functioning, online and combination learning, and social restrictions. Parental depression and worries were associated with effects of social restrictions. Youth worries were associated with online and combination learning, and social restrictions. Youth disability, online learning, and worries were associated with effects of social restrictions. Few clinical factors are associated with COVID-19-related psychological and psychosocial distress. Instead, parent/family factors and youth learning environment have prominent roles in predicting outcomes and have implications for the health, education, and social services systems.

Do patient characteristics affect the predictive validity of Functional Capacity Evaluations?

PurposeThe aim of this study was to identify patient-related characteristics that affect the predictive validity of the FCE assessment ELA.MethodsA prospective multicenter study was conducted on 303 patients with musculoskeletal disorders (MSD) recruited from eleven rehabilitation centers. The ELA-based estimation of the participants' ability to cope with physical work demands was considered valid if RTW was paired with a positive ELA outcome (≥ moderate) as well as if non-RTW was accompanied by a negative ELA outcome (rather or very poor). In the remaining cases, the ELA result was judged as non-valid. To reduce the risk of false conclusions, the rating was performed inversely in participants that (1) reported severe limitations regarding their productivity at work, (2) attributed RTW to a change in job resp. a reduction of their physical work demands and in those that (3) attributed non-RTW to non-physical reintegration barriers only. Using questionnaires, 28 patient-related characteristics were collected. Logistic regression models were calculated to identify characteristics that affected the predictive validity of ELA.ResultsELA was considered valid in 208 of 303 (69%) participants. A moderate and strong pain-related disability at work were associated with a 0.15-fold (95% confidence interval (95% CI) 0.05–0.46), respectively, 0.19-fold (95% CI 0.05–0.72) chance for a valid outcome. In addition, a negative influence was found in participants that reported psychosocial distress (odds ratio (OR) 0.35; 95% CI 0.15–0.82), a native language different from the national language (OR 0.16; 95% CI 0.05–0.56) as well as in those that expected to return to work, but not within one month (OR 0.17; 95% CI 0.06–0.46). Further variables—including age, employment status, fear-avoidance beliefs and the level of physical work demands—did not affect the predictive validity of ELA.ConclusionsThe results suggest that the predictive validity of ELA is primarily limited by patients that report a moderate or strong pain-related disability at work, psychosocial distress as well as the expectation to return to work, but not within one month. Furthermore, a negative influence can be assumed for language barriers.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00420-021-01807-7.

Pills and prayers: a comparative qualitative study of community conceptualisations of pre-eclampsia and pluralistic care in Ethiopia, Haiti and Zimbabwe

BackgroundPre-eclampsia is a leading cause of preventable maternal and perinatal deaths globally. While health inequities remain stark, removing financial or structural barriers to care does not necessarily improve uptake of life-saving treatment. Building on existing literature elaborating the sociocultural contexts that shape behaviours around pregnancy and childbirth can identify nuanced influences relating to pre-eclampsia care.MethodsWe conducted a cross-cultural comparative study exploring lived experiences and understanding of pre-eclampsia in Ethiopia, Haiti and Zimbabwe. Our primary objective was to examine what local understandings of pre-eclampsia might be shared between these three under-resourced settings despite their considerable sociocultural differences. Between August 2018 and January 2020, we conducted 89 in-depth interviews with individuals and 17 focus group discussions (n = 106). We purposively sampled perinatal women, survivors of pre-eclampsia, families of deceased women, partners, older male and female decision-makers, traditional birth attendants, religious and traditional healers, community health workers and facility-based health professionals. Template analysis was conducted to facilitate cross-country comparison drawing on Social Learning Theory and the Health Belief Model.ResultsSurvivors of pre-eclampsia spoke of their uncertainty regarding symptoms and diagnosis. A lack of shared language challenged coherence in interpretations of illness related to pre-eclampsia. Across settings, raised blood pressure in pregnancy was often attributed to psychosocial distress and dietary factors, and eclampsia linked to spiritual manifestations. Pluralistic care was driven by attribution of causes, social norms and expectations relating to alternative care and trust in biomedicine across all three settings. Divergence across the contexts centred around nuances in religious or traditional practices relating to maternal health and pregnancy.ConclusionsEngaging faith and traditional caregivers and the wider community offers opportunities to move towards coherent conceptualisations of pre-eclampsia, and hence greater access to potentially life-saving care.

Emerging Adults and Social Distancing During COVID-19: Who Was More Likely to Follow Guidelines and What Were the Correlates With Well-Being and Weight-Related Behaviors?

The aim of this study is to identify the prevalence, predictors, and psychosocial well-being (depressive symptoms, stress) and weight-related behavior (eating behaviors, physical activity, and sedentary behavior) correlates of social distancing during COVID-19 among emerging adults. A rapid-response survey was sent to participants ( n=720; mean age=24.7 ± 2.0 years, 62% female) in a population-based cohort study in Minnesota during April–October 2020. Half of emerging adults reported fully social distancing. Emerging adults from White backgrounds were least likely to social distance while those from Asian backgrounds were most likely to social distance, in addition to those living with a parent. Females who partially/did not social distance reported less healthy eating behaviors, while males and “essential workers” reported higher levels of psychosocial distress. Public health messaging and practical supports for social distancing may need to be made more relevant to emerging adults during public health crises. Resources may need to differ depending on sex of emerging adult.

The association of general practitioners' awareness of depression and anxiety with change in quality of life in heart failure patients: results of the prospective observational RECODE-HF cohort study.

Depression and anxiety are more prevalent in patients with heart failure (HF) than in the general population and reduce quality of life (QoL); therefore, clinical guidelines recommend screening HF patients for depression/anxiety. We investigated, whether the general practitioners' (GPs) awareness of patients' symptoms of depression and/or anxiety (psychosocial distress) was associated with a change in QoL. In this prospective observational study, we recruited 3,129 primary care HF patients in Germany. Patients completed baseline and 12-month follow-up questionnaires. Their GPs were interviewed. We identified 666 patients with psychosocial distress and compared 2 groups by analysis of covariance: 235 patients with psychosocial distress whose GP was aware of the psychosocial distress and 431 patients with psychosocial distress whose GP was unaware of such distress. Primary outcome was the change in QoL, assessed by the EQ-5D visual analogue scale. Patients with psychosocial distress showed lower baseline QoL than those without (45.9 vs 64.1; P < 0.001). Within the patients with psychosocial distress, the GPs' awareness of psychosocial distress was not associated with improvement of QoL (F = 1.285; P = 0.258) or remission of psychosocial distress (odds ratio = 0.887; P = 0.608). We found no association between the GPs' awareness of psychosocial distress and change in QoL. Although data for effective treatments of depression in HF are currently insufficient, psychosocial distress strongly impairs the QoL in HF patients. These findings might influence the development of clinical practice guidelines in HF.

Effect of delayed awareness and fatigue on the efficacy of self-isolation in epidemic control.

The isolation of infectious individuals is a key measure of public health for the control of communicable diseases. However, involving a strong perturbation of daily life, it often causes psychosocial distress, and severe financial and social costs. These may act as mechanisms limiting the adoption of the measure in the first place or the adherence throughout its full duration. In addition, difficulty of recognizing mild symptoms or lack of symptoms may impact awareness of the infection and further limit adoption. Here we study an epidemic model on a network of contacts accounting for limited adherence and delayed awareness to self-isolation, along with fatigue causing overhasty termination. The model allows us to estimate the role of each ingredient and analyze the tradeoff between adherence and duration of self-isolation. We find that the epidemic threshold is very sensitive to an effective compliance that combines the effects of imperfect adherence, delayed awareness and fatigue. If adherence improves for shorter quarantine periods, there exists an optimal duration of isolation, shorter than the infectious period. However, heterogeneities in the connectivity pattern, coupled to a reduced compliance for highly active individuals, may almost completely offset the effectiveness of self-isolation measures on the control of the epidemic.

A Sexual and Gender Minority Inclusive Tool to Identify and Reduce Psychological Distress Related to Vaginal Brachytherapy Treatment

Evidence has shown treatments for gynecologic cancers can pose a significant impact to quality of life (QoL) and psychosocial functioning for cancer patients and cancer survivors, with very limited understanding of the impact of such treatments on the lesbian, gay, bisexual, transgender and queer/questioning community, also referred to as sexual and gender minorities (SGM), a diverse and medically underserved population. Specifically, intracavitary vaginal brachytherapy (ICVBT) for endometrial cancers can cause a negative impact on QoL and can even result in PTSD after treatment. Thus, better understanding a patient's unique identity and chosen sexual preferences, as well as assessing underlying anxiety, psychosocial issues, and/or prior non-consensual sexual encounter(s) can potentially alleviate distress during and after this sensitive treatment. Here, we present an innovative, SGM-inclusive assessment tool to identify potential risk factors for physical and/or psychosocial distress that may occur in patients undergoing ICVBT.We combined two previously published, validated tools to assess for urinary, bowel, and sexual symptoms in patients undergoing ICVBT. Next, as part of the ongoing LGBTQ initiative at our academic comprehensive cancer center, our department's LGBTQ Task Force, which is composed of volunteer patients, physicians, nurses, physicists, dosimetrists, and support staff reviewed the questionnaire and provided critical feedback for inclusivity. We subsequently had the questionnaire reviewed for health literacy by our Patient Education Liaisons.The task force recommended inclusion of sexual orientation and gender identity (SOGI) demographic questions to the survey, and adjustment of previous questions for improved inclusivity of SGM-identifying patients, especially those who identify as transgender, gender non-binary, and/or who choose to not engage in penetrative vaginal intercourse. Additionally, it was recommended to include a question that screens for a history of non-consensual sexual encounters to reduce triggering past trauma. The task force felt these items were important for the practitioner to discuss with their patient prior to the procedure, with the goal to reduce acute anxiety and possibly prevent acute and long-term negative physical and/or emotional outcomes.Our ICVBT survey tool is designed to screen for "at-risk" patients, and provide a pathway for open dialogue between patients and physicians to potentially reduce undue harm during this important, yet sensitive treatment. To the best of our knowledge, this is the first such ICVBT survey tool to assess for a history of sexual trauma, and include SOGI and gender-inclusive questions. This adaptation has allowed our team to approach patients in a sensitive manner inclusive of their identity and prior experiences. Preliminary data is being collected and will be presented at the conference.

Perceptions and Correlates of Distress Due to the COVID-19 Pandemic and Stress Management Strategies Among Adults With Diabetes: A Mixed-Methods Study

BackgroundGreater risk of adverse health outcomes and public health measures have increased distress among people with diabetes during the coronavirus-2019 (COVID-19) pandemic. The objectives of this study were to explore how the experiences of people with diabetes during the COVID-19 pandemic differ according to sociodemographic characteristics and identify diabetes-related psychosocial correlates of COVID distress. MethodsPatients with type 1 or 2 diabetes were recruited from clinics and community health centres in Toronto, Ontario, as well as patient networks. Participants were interviewed to explore the experiences of people with diabetes with varied sociodemographic and clinical identities, with respect to wellness (physical, emotional, social, financial, occupational), level of stress and management strategies. Multiple linear regression was used to assess the relationships between diabetes distress, diabetes self-efficacy and resilient coping with COVID distress. ResultsInterviews revealed that specific aspects of psychosocial wellness affected by the pandemic, and stress and illness management strategies utilized by people with diabetes differed based on socioeconomic status, gender, type of diabetes and race. Resilient coping (β=−0.0517; 95% confidence interval [CI], −0.0918 to −0.0116; p=0.012), diabetes distress (β=0.0260; 95% CI, 0.0149 to 0.0371; p<0.0001) and diabetes self-efficacy (β=−0.0184; 95% CI, −0.0316 to −0.0052; p=0.007) were significantly associated with COVID distress. ConclusionsCertain subgroups of people with diabetes have experienced a disproportionate amount of COVID distress. Assessing correlates of COVID distress among people with diabetes will help inform interventions such as diabetes self-management education to address the psychosocial distress caused by the pandemic.

Disparity of perception of quality of life between head and neck cancer patients and caregivers

BackgroundCaregivers are invaluable sources of support for individuals recovering from head and neck cancer (HNC). Accordingly, minimizing caregiver distress is essential to promote the well-being of both caregivers and their patients. This study assessed if psychosocial distress (i.e., anxiety and depression) among HNC caregivers is associated with a difference in how caregivers and their patients perceive patients’ quality of life (QOL) after treatment completion.MethodsCaregivers’ and patients’ perceptions of patient QOL were assessed using the University of Washington QOL Questionaire (UWQOL), a validated HNC-specific health-related QOL questionnaire. The survey is interpreted in terms of its two composite scores: a physical QOL score and a social-emotional QOL score with higher scores indicating better QOL. Caregiver anxiety was assessed using the Generalized Anxiety Questionaire-7 (GAD-7) and caregiver depression was assessed using the Patient Health Questionaire 8 (PHQ-8). Patients completed the UWQOL as part of clinic intake while caregivers were asked to complete the UWQOL for their patients in addition to the PHQ-8 and GAD-7 in private. Linear regression was used to analyze the association between differences in caregivers’ and patients’ QOL scores (both social-emotional and physical QOL subscale scores) and GAD-7 and PHQ-8 scores.ResultsOf 47 caregivers recruited, 42.6% (n = 20) viewed patients’ social-emotional QOL more negatively than patients themselves, while 31.9% viewed patients’ physical QOL more negatively. After controlling for covariates, differences in perception of social-emotional QOL (p = .01) and differences in perception of physical QOL (p = .007) were significantly associated with caregiver depression, but not anxiety. Caregivers who disagreed with patients regarding patients’ social-emotional QOL scored 6.80 points higher on the PHQ8 than agreeing caregivers. Caregivers who disagreed regarding patients’ physical QOL scored 6.09 points higher.ConclusionCaregivers commonly view patients’ QOL more negatively than patients themselves. These caregivers tend to have greater psychosocial distress than caregivers who agree with their patients. Interventions designed to identify and aid at-risk caregivers are critically needed. We propose screening for differences in perception of patient QOL as a way of identifying distressed caregivers as well as provider-facilitated communication between patients and caregivers as possible interventions that should be examined in future research.

COVID-19 pandemic and the psyche, bruxism, temporomandibular disorders triangle

ABSTRACT Objective To investigate the effect of the Coronavirus pandemic on the report of psychological status, bruxism, and TMD symptoms. Methods An online survey was drafted to report the presence of psychological status, bruxism activities, and reported symptoms of TMDs perceived during the COVID-19 pandemic in a population of 506 individuals. Results Mental health is not positive during the Coronavirus pandemic: almost half the subjects reported an increase in bruxism behaviors, while up to one-third reported an increase in their symptoms involving the TMJ and jaw muscles. Specifically, 36% and 32.2% of participants reported increased pain in the TMJ and facial muscles, respectively, and almost 50% of the subjects also reported more frequent migraines and/or headaches. Conclusion Increased psychosocial distress during the COVID-19 pandemic can increase the frequency of TMD symptoms and bruxism behaviors, which, in turn, constitute a triangle of mutually interacting factors with the psychological and emotional status.

Proposed domains for assessing postpartum recovery: a concept elicitation study

To propose postpartum recovery domains. Concept elicitation study. Semi-structured interviews. Ten writing committee members and 50 stakeholder interviews (23 postpartum women, nine general obstetricians, five maternal and fetal medicine specialists, eight nurses and five obstetric anaesthetists). Alternating interviews and focus group meetings until concept saturation was achieved (no new themes discussed in three consecutive interviews). Interviews were digitally recorded and transcribed, and an iterative coding process was used to identify domains. The primary outcome was to identify recovery domains. We also report key symptoms and concerns. Discussion frequency and importance scores (0-100; 0 = not important; 100 = vitally important to recovery) were used to rank domains. Discussion frequency was used to rank factors helping and hindering recovery, and to determine the greatest challenges experienced postpartum. Thirty-four interviews and two focus group meetings were performed. The 13 postpartum recovery domains identified, (ranked highest to lowest) were: psychosocial distress, surgical/medical factors, infant feeding and breast health, psychosocial support, pain, physical function, sleep, motherhood experience, infant health, fatigue, appearance, sexual function and cognition. The most frequently discussed factors facilitating postpartum recovery were: family support, lactation/breastfeeding support and partner support. The most frequently discussed factor hindering recovery was inadequate social support. The most frequent challenges reported were: breastfeeding (week 1), breastfeeding (week 3) and sleep (week 6). We propose 13 domains that comprehensively describe recovery in women delivering in a single centre within the USA. This provides a novel framework to study the postpartum recovery process. We propose 13 postpartum recovery domains that provide a framework to study the recovery process following childbirth.

Building a telepalliative care strategy in nursing homes: a qualitative study with mobile palliative care teams

BackgroundDespite increasing use of telemedicine in the field of palliative care, studies about the best circumstances and processes where it could replace face-to-face interaction are lacking. This study aimed to: (1) identify situations that are most amenable to the use of telemedicine for the provision of palliative care to patients in nursing homes; and (2) understand how telemedicine could best be integrated into the routine practice of mobile palliative care teams.MethodsA qualitative study based on semi-structured focus groups (n = 7) with professionals (n = 33) working in mobile palliative care teams in France.ResultsBetween June and July 2019, 7 mobile palliative care teams participated in one focus group each. Using thematic analysis, we found that telemedicine use in palliative care is about navigating between usual and new practices. Several influencing factors also emerged, which influence the use of telemedicine for palliative care, depending on the situation. Finally, we built a use-case model of palliative care to help mobile palliative care teams identify circumstances where telemedicine could be useful, or not.ConclusionsThe potential utility of telemedicine for delivering palliative care in nursing homes largely depends on the motive for calling on the mobile palliative care team. Requests regarding symptoms may be particularly amenable to telemedicine, whereas psycho-social distress may not. Further studies are warranted to assess the impact of influencing factors on real-life palliative care practices. Telemedicine could nonetheless be a useful addition to the mobile palliative care teams’ armamentarium.

Refugees in Brazil: An investigation of Syrian refugees' psychological experiences.

Although there is a strong body of literature on the psychosocial distress of refugees from Global South to Global North, there is limited literature on refugees who migrate from Global South (i.e., Syria) to Global South (i.e., Brazil). The present study aims to investigate Syrian refugees in Brazil. Participants were 202 Syrians. Most respondents were men (62.9%), with an average age of 35.9 years old (SD= 11.13). Results suggest an effect of positive ethnic identity in psychological and physical distress, who also perceive more discrimination than individuals who negatively identify with their ethnicity. Structural equation model suggests the fit of the proposed mediation model. Our findings add to the much-needed line of investigations examining Syrian refugees settling in Brazil.

Prognostic factors associated with quality of life in heart failure patients considering the use of the generic EQ-5D-5L\u2122 in primary care: new follow-up results of the observational RECODE-HF study

BackgroundThe implementation of care concepts fitting the needs of patients with chronic heart failure (HF) remains challenging. In this context, psycho-emotional well-being is not routinely assessed, and under-researched despite indications that it is of great relevance for, e.g., acceptance, adherence, and prognosis. The aim of this study was to observe clinical characteristics for their prognostic utility in HF patients, and to compare the patients’ health-related quality of life (QoL) with German population norm values.MethodsThe current post-hoc analysis was performed on data collected amongst participants of the RECODE-HF study who had fully answered the EQ-5D-5L™ items at both baseline and 12 months (n = 2354). The status in the patients’ self-assessment items, EQ-5D visual analog scale (VAS) and EQ-5D index was categorized into worse/unchanged/improved. General linear mixed models (GLMM) with logit link were applied. Subgroups included 630 patients (26.8%) screened positive and 1724 patients (73.2%) screened negative for psychosocial distress (PSD).ResultsThe 12-months change in EQ-5D index, generally resulting from change in individual EQ-5D items, additionally associated not only with high NYHA class but sociodemographics (employment/living alone/GP practice years) (96.2% correctly classified in GLMM). The 12- months change in individual QoL aspects showed associations with age*NYHA, gender, body-mass index, and comorbidities dyslipidemia, myocardial infarction, asthma/chronic pulmonary disease. Important social roles were reflected in particular when HF patients lived alone or the doctor mentioned to the patient that the patient had HF. Patients with/without PSD differed in some sociodemographic and clinical parameters. However, no influence of PSD could be demonstrated in the 12-month follow-up of the EQ-5D-5L™. Nonetheless, comparison of the 12-months QoL with general German population norm values by age groups < 75 years and 75+ showed markedly health restrictions in HF patients in all EQ-5D-5L™ aspects.ConclusionOur analysis revealed different prognostic factors primarily associated with change of burden in different QoL aspects in HF patients. In GP practice it is important to consider in addition to the overall day-related VAS all the individual health-related QoL aspects to take a holistic view of the patient, as well as to pay particular attention to the interrelation of individual characteristics.

Lifestyle behaviors trend and their relationship with fear level of COVID-19: Cross-sectional study in Saudi Arabia.

IntroductionCOVID-19 pandemic cautionary measures have affected the daily life of people around the globe. Further, understanding the complete lifestyle behaviors profile can help healthcare providers in designing effective interventions and assessing overall health impact on risk of disease development. Thus, this study aims to assess the complete spectrum of lifestyle behaviors (physical activity, sedentary behavior, sleep, distress, social support, dietary habits, and smoking) prevalence and its association with fear of COVID-19 in people living in Saudi Arabia.MethodsSelf-administered survey consisted of seven sections was used to collect data on fear of COVID-19 using Fear of COVID-19 Scale (FCV-19S), physical activity and sedentary behavior using the Global Physical Activity Questionnaire (GPAQ), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), psychosocial distress using Kessler Psychological Distress Scale (K-10), social support using the MOS social support survey, and dietary habits using a short version of food frequency questionnaire (FFQ). The online survey was distributed via social media platforms during lockdown period of COVID-19 pandemic (May–June 2020). Each section consisted of validated questionnaire examining one of aforementioned lifestyle behaviors. Associations were analyzed using multiple linear regression.ResultsA total of 669 individuals attempted to complete the online survey, 554 participants completed at least 2 sections of the survey (82.8%), and 41.3% (n = 276) completed the whole online survey. The majority of the sample were female (83%), not smokers (86.5%), had sufficient sleep duration (7.5 hrs ± 2.1), and only indicated mild level of distress (21.4 ± 8.9); they also reported high level of sedentary behavior (7.7 hrs ± 4.5), poor sleep quality (5.4 ± 2.4), were not engaged in healthy eating habits, and moderate level of perceived social support (62.0% ± 27). Only physical activity results indicated that about half of the sample were engaged in moderate to vigorous level of physical activity (54.3%). Further, being female (β = 0.12; 95% CI: 0.45, 2.94) and married (β = 0.13; 95% CI: 0.3, 2.63) were associated with fear of COVID-19 level (β = 0.21; 95% IC: 0.05, 0.19) with a confidence interval level of 95%. In addition, distress was associated with fear.ConclusionThe trend of lifestyle behaviors measured during lockdown period changed from previously published rates. Future research needs to establish the short-term and long-term effect of lifestyle behaviors complete profile on physical and mental health.

Psychosocial Distress in Chronic Disease Patients in Salatiga

Patients of hypertension (HT), diabetes mellitus (DM), and mixed (DM-HT) have a vulnerability to stress due to illness and psychosocial responses. Research aimed to identify psychosocial distress, the components, and their relationship to levels of GDP, systole/diastole, and cholesterol in three groups. The quantitative survey research was designed for 42 people, with purposive sampling at the Manunggal Clinic. The collection of psychosocial distress data was by a standard questionnaire. While systole/diastole, GDP, and cholesterol levels with an examination in the laboratory, in April-May 2018. Analysis with ANOVA and Pearson test, α0.05. Shows sufferers have low distress, moderate distress, and high distress. The average score of emotional component (3.2), chronic disease management difficulties (3.2), difficulties with doctors (3.0), and difficulties with friends/people around (2.6). ANOVA test showed no significant difference in psychosocial distress scores (p=0,079). The Pearson test showed a weak correlation between psychosocial distress and systole; diastole; GDP and cholesterol. Conclusion: Psychosocial distress of chronic disease sufferers in Salatiga is included in the category of moderate and high. The highest score on the emotional burden component and the difficulty of chronic disease management. There were no significant differences in psychosocial distress scores, blood pressure, blood sugar levels, and cholesterol in the three groups.

Examining women's health through a psychosocial lens.

During the COPASAH Global Symposium 2019, a group of therapists and mental health practitioners tried to highlight the issue of women's mental health with two specific focuses, one being the lived experiences of persons living with mental illness and the secondary burn-out and shame faced by their caretakers. The second session explored the contours of somatisation that is often seen in the human body as a result of the impact of trauma. The participants reflected on the value of lived experiences and also discussed the challenges faced in getting representation for people living with mental illness. The challenges listed by participants were concentrated around the participation and representation of persons living with intellectual disability and psychosocial disability. Somatisation of traumatic experiences needs recognition in a country like India where women's life-stressors exist right from childhood that keeps them on the threshold of mental illness and/or psychosomatic illnesses. Psychosocial health issues are relegated to a subordinate category of discussion while public health, reproductive health, and health rights feature in mainstream discussions in various seminars, researches and conferences in India. This paper is based on two sessions of the COPASAH Global Symposium 2019 and focuses on the gender and psychosocial dimensions of health from the framework of women being subjected to unpaid care work, through social and reproductive labour and stressors resulting in psycho-social distress. To this end, it is important to build a community of practitioners that looks beyond the reproductive health of women.