Anxiety Questionnaire Research Articles

Assessment of functional outcome and quality of life after-treatment of oral squamous cell carcinoma

Objective To assess the functional outcome and impact on the quality of life after treatment for squamous cell carcinoma using Qol questionnaire. To assess the level of anxiety and depression among patients treated for SCC. To emphasize the implementation of the QoL questionnaire as a regular assessment tool to identify post-treated patients' special needs and improve care protocol. Methodology A cross-sectional survey was done with post-operative patients of oral squamous cell carcinoma, where a structured, closeended questionnaire was used comprised of 30 items that are intended to inquire about patient's post-operative status of quality of life based on standardized scales as EORTC Quality of life (QLQ-C30), Quality of life Questionnaire Head & Neck (QLQ-H&N35) and HADS Questionnaire of hospital Anxiety and depression scale. However, the sample was subdivided into three groups according to the treatment received Patients treated with surgery & reconstruction, Patients treated with Radiotherapy, and Patients treated with Surgery + Reconstruction and Radiotherapy respectively. The data was collected from three tertiary care hospitals and the total sample size was 120. Results and conclusion Treatment that included both surgery and radiotherapy resulted in the highest level of symptom burden and psychological morbidity including depression and anxiety. These changes were most devastating to younger patients as they mostly lamented over loss of bodily function, reduced ability to work and changes in body appearance became key determinants of social and psychological well-being. The study also highlights the need to establish a more long-term follow-up beyond treatment and perform a QoL questionnaire to discover per-patient needs.

Protocol for a randomised controlled trial of Overcome Death Anxiety: an online cognitive behavioural therapy intervention in a clinical sample.

Evidence suggests that death anxiety is a transdiagnostic construct underlying numerous anxiety-related conditions. A previous phase I trial of Overcome Death Anxiety (ODA), a novel online stand-alone psychological intervention to reduce death anxiety, demonstrated preliminary evidence of efficacy and acceptability in a clinical population. However, this trial was limited by a small sample size (n=20). To further evaluate the efficacy of this intervention in reducing death anxiety in a clinical population, compared with a waitlist control. This paper describes the protocol of a phase II randomized controlled, unblinded trial of ODA. A total sample of 256 adults living in Australia, diagnosed with an anxiety-related condition, will be recruited. These participants will be randomised to ODA or a waitlist control. Primary outcomes will be measured as changes in scores on death anxiety questionnaires, reflecting treatment efficacy. The secondary outcomes to be measured are depression, anxiety, stress, suicidality, insomnia, and meaning of life, as well as feedback about treatment program acceptability. This trial will assess the efficacy of ODA for reducing death anxiety in a population diagnosed with various anxiety-related conditions, as well as the overall acceptability and tolerability of the intervention. This study will provide evidence to evaluate the efficacy of ODA in people diagnosed with an anxiety-related condition.

Prevalence of Depression, Anxiety, and Stress among Students during the Covid-19 Pandemic

The worldwide CoVid-19 pandemic poses great impact to human lives remarkably to psychological well-being. Thus, this study aimed to investigate and determine the prevalence of depression, anxiety, and stress (DAS) among students during the pandemic. A descriptive quantitative research design was utilized in the study. In gathering the data, the study utilized the standardized survey questionnaire of Depression, Anxiety, and Stress Scales 42 (DASS-42) to evaluate the students DAS level. The data compilation used online questionnaires through the platform Google Forms. The study reported a significantly high level of depression, anxiety and stress from the sample population. The result of the study found that levels of depression, anxiety and stress vary from age, gender, educational level and grade/strand/course program. Younger age groups (adolescents and young adults) suffer higher DAS level among other age groups while gender reveals that females compared to males are far more vulnerable to anxiety and stress. Moreover, students regardless of educational level and strand/course program experience significantly severe level of anxiety. In conclusion, COVID-19 is an epidemiological crisis that is casting a shadow to students’ DAS level.

Perinatal Depression, Labor Anxiety and Mental Well-Being of Polish Women During the Perinatal Period in a War and Economic Crisis

Objective: The armed conflict in Ukraine and its impact on Europe’s economy have led to an war and economic crisis, potentially affecting the mental health of women during the perinatal period. This study aimed to assess the severity of depressive symptoms and labor anxiety among Polish women in perinatal period during this crisis. Methods: From June 2, 2022, to April 11, 2023, 152 women completed three sets of online surveys—two during pregnancy (before 33 weeks and/or between 33 and 37 weeks) and one postpartum (4 weeks after childbirth). The questionnaires used to evaluate the anxiety and depressive symptoms included Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI-2), Labor Anxiety Questionnaire (LAQ), and team-developed questionnaires evaluating war-related anxiety (WAQ) and global situation anxiety (GSAQ) Statistical analyses included U-Mann Whitney, Kruskal-Wallis, Wilcoxon signed-rank, Friedman tests and Spearman’s correlations, with a significance level set at p < .05. Results: Among Polish pregnant women aged 23–43, 31.6% of participants experienced depressive symptoms, while 70.4% reported increased labor-related anxiety. Additionally, 24.3% experienced significant anxiety due to the war, and 25% suffered from severe anxiety related to the global situation. Positive correlations were noted between EPDS and GSAQ scores (R = 0.34, p < .001) and LAQ and WAQ scores (R = 0.21, p = .008). Conclusions: The prevalence of perinatal depression is high during war and economic crisis, underscoring the urgent need to improve screening for perinatal depression in Poland. Further, the manuscript did not discuss symptom patterns across the three time points.

The Effectiveness of Mindfulness Integrated Cognitive Behavioral Therapy on Negative Emotions and Cognitive Regulation of Emotions in Patients with Multiple Sclerosis: A Clinical Trial Study

Introduction: Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system. Patients with MS suffer from problems such as negative emotions and poor emotion regulation. The present study investigated the effectiveness of mindfulness integrated cognitive behavioral therapy (MICBT) on negative emotions and emotion regulation in patients with MS. Methods: This research was a semi-experimental study using a pre-test-post-test with a control group. A total of 52 patients with MS referring to Shafa Hospital in Kerman city, were selected by the convenience sampling method in 2023 and were randomly divided into two experimental (26 people) and control (26 people) groups. Patients completed the questionnaire of depression, anxiety and stress scale-21 items (DASS-21) and cognitive emotion regulation questionnaire of Garnefski in the pre-test and post-test. The data were analyzed in the descriptive section using independent t-test and chi-square tests, and in the inferential section using multivariate analysis of covariance, using SPSS-24 software. Results: The results of covariance analysis showed that there was a significant difference between the groups in depression, stress, anxiety, positive and negative emotional strategies in the post-test (P&lt; 0/001). Comparison of mean values showed that in the MICBT group, depression (14/46), stress (16/85) and anxiety (11/38) and negative emotion regulation strategies (M=35/38) decreased, while positive emotion regulation strategies (M=75/35) increased significantly. Conclusion: MICBT is suggested as an effective method in reducing depression, stress, anxiety and improving cognitive regulation of emotions in patients with MS.

Prevalence and associated factors of anxiety and depression among patients with hypothyroidism in Southern Iran

PurposeDepression and anxiety are the main disorders in patients suffering from hypothyroidism. These disorders can lead to increased patient suffering. Since hypothyroidism is one of the most prevalent endocrine diseases, controlling the metabolic variables that increase the severity of anxiety and depression is important. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors, including metabolic variables, among people with hypothyroidism.Patients and methodsWe performed a cross-sectional study of 1,600 patients with hypothyroidism in Kerman, the southern part of Iran. The prevalence of depression and anxiety was estimated using the Beck Depression Inventory and the Hamilton Anxiety questionnaires, respectively. First, univariate logistic regression was performed. Factors whose P-values were smaller than 0.2 in univariate logistic regression were included in multiple logistic regression for confounder adjustments. The analysis was performed using SPSS version 20.ResultsThe rates of depression and anxiety were 59% (95% CI: 53.18–62.11) and 63% (95% CI: 58.42–67.22), respectively. Factors found to be independently associated with anxiety were high TSH, high LDL, high TG, high FBS, high TGAb, high TPoAb, high TC, and hypertension. For depression, high TSH, high LDL, high TG, high FBS, high TC, and hypertension were identified. High TGAb and high TPoAb were independently associated with anxiety but not with depression.ConclusionsStudy findings revealed that a large proportion of patients with hypothyroidism suffer from depression and anxiety. This study also identified factors associated with these disorders. Controlling some metabolic variables may decrease the prevalence and severity of these disorders, help patients with better treatment, and improve their quality of life.

Development and validation of the Food Noise Questionnaire.

Food noise has received attention in the media, although no validated questionnaires exist to measure it. This study developed and tested the reliability and validity of the Food Noise Questionnaire (FNQ). Participants (N = 400) successfully completed, the FNQ and a demographic questionnaire and self-reported weight and height. A subsample (n = 150) completed the FNQ 7 days later for test-retest reliability, and this subsample's first FNQ data were subjected to exploratory factor analysis. The remaining subsample (n = 250) completed two preoccupation with food questionnaires to test convergent validity, along with mood, anxiety, and stress questionnaires to test for discriminant validity. Confirmatory factor analysis was conducted using this subsample's FNQ data. Data from 396 participants were analyzed (4 participants did not complete all FNQ items). The FNQ had excellent internal consistency reliability (Cronbach α = 0.93) and high test-retest reliability (r = 0.79; p < 0.001; mean [SD] = 7.4 [1.0] days between administration). Factor analyses found that the five FNQ items loaded onto a single factor, with good fit indices (χ2[5] = 52.87, p < 0.001; root mean square error of approximation [RMSEA] = 0.20; comparative fit index [CFI] = 0.95; standardized root mean squared residual [SRMR] = 0.03). The FNQ showed good convergent (all r > 0.78; p < 0.001) and discriminant (all r < 0.39; p < 0.001) validity. The FNQ provides a psychometrically reliable and valid measure of food noise, although further research is needed to evaluate its clinical utility.

Investigating the effectiveness of ailurophobia treatment using virtual reality technique compared to metacognitive therapy: a randomized clinical trial

BackgroundFear of cats as a specific phobia disorder can cause disruption in some aspects of the affected people’s lives. On the other hand, due to the fact that the two approaches of metacognitive treatment and behavioral therapy methods such as virtual reality are considered common treatment methods in anxiety disorders; It seems that it is necessary to examine the two approaches based on the effectiveness, durability and cost-benefit issue to present and introduce to therapists.MethodsThe present study was a Randomized Clinical Trial study that was conducted on 28 patients with Ailurophobia. Based on simple random sampling, the participants were allocated in two groups: metacognitive intervention and virtual reality intervention. In order to collect data, demographic information questionnaire, cat anxiety questionnaire and researcher-made cat fear questionnaire were used. Data analysis was done with SPSS version 22 software and statistical tests of chi-square, t, analysis of variance. An alpha level of less than 0.05 was considered as a significant level.ResultsThe results of the study showed that there was a statistically significant difference between the average anxiety score in the two groups of virtual reality and metacognitive therapy (P˂0.001). So that in the virtual reality group, the anxiety score was significantly reduced. Also, other results of the study indicated that the mean score of the fear of cats scale was significantly lower in the virtual reality group than in the metacognitive therapy group (P˂0.001).ConclusionsAlthough both treatment approaches based on virtual reality and metacognition are effective in reducing the level of anxiety and fear of cats in patients with Ailurophobia; However, the effectiveness and continuity of treatment in people receiving virtual reality treatment are more significant.IRCT registration numberIRCT20230105057057N1. Registration date: 2023-03-04.RegistryIranian Registry of Clinical Trials.

Characteristics of patients diagnosed with psychogenic non-epileptic seizures (PNES) who request reinstatement of their driving privileges.

Patients who experience seizures, including PNES, are usually advised to discontinue driving, or have their driving privileges revoked until a determined period of seizure-freedom is achieved. In this retrospective study, patients with PNES who requested driving privileges or reported having resumed driving were compared to those who did not on measures of depression, anxiety, PTSD, and cognitive flexibility/motor speed. DiagnosisofPNESwasconfirmedwithvideo-EEG.Demographicand clinical dataand requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Tests of motor speed and hand eye coordination and self-report questionnaires of depression, anxiety and PTSD administered as part of neuropsychological assessment were analyzed. A total of 403 patients with PNES evaluated in 2010-2020 were identified. Of those, 365 patients were eligible for inclusion, and of those, 60 applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was significantly less depressed (p=0.001) when tested than the group that did not. Furthermore, a significant difference was seen in measures of motor performance between those who requested to resume driving and those who did not (DKEFS T1, p=0.006, DKEFS T2, p=0.001, DKEFS T3, p=0.002, DKEFS T4, p=0.001; GPT dominant, p=0.05, GPT non-dominant, p=0.003). Driving a motor vehicle is a useful measure of improvement for PNES because patients with seizures are required to discontinue driving until seizure-freedom is achieved. This study revealed that lower levels of depression and better fine motor functioning were associated with reported seizure-freedom and driving resumption. Depression is commonly associated with diminished performance (slower motor response times and impaired fine motor movements) on tests of motor functioning, both of which may result in less interest in pursuing permission to resume driving. These findings suggest that mood symptoms (and associated performance on measures of motor speed and coordination) may have prognostic significance in patients diagnosed with PNES. This also suggests that timely treatment of depression in newly diagnosed patients with PNES may be indicated.

A Study of Self- Concept and Examination Anxiety of Class -XII Students in Relation to Various Variables

The current research is focused on examining the self-concept and examination anxiety of Class 12 students from Gujarati-medium schools in Petlad taluka. The study involved a sample of 150 boys and 145 girls, all secondary school students. The purpose was to investigate differences between the self-concept and test anxiety of these students, as influenced by variables such as gender and academic stream. Data collection was achieved using a self-concept questionnaire and a structured test anxiety questionnaire developed by Dr. D. A. Uchat. The t-value of 2.797 for average scores on the self-concept and anxiety tests indicated significance at the 0.01 level. This suggests a notable difference between the self-concept and test anxiety of boys and girls.

Photopsias are associated with greater levels of depression and anxiety

ABSTRACT Clinical relevance Vitreous floaters have been associated with depressive and anxiety symptoms. However, there is a scarcity in the literature regarding the possible impact of vitreous flashes on the psychological status of the patients. Background Photopsias and vitreous floaters frequently co-exist. Floaters have been accompanied by exacerbated levels of depression and anxiety. The aim of this study was to examine whether the presence of photopsias in patients suffering from vitreous floaters is accompanied by exacerbated levels of anxiety and depression. Methods One hundred and four patients complaining of floaters were included in the study; 51 experienced also photopsias and 53 did not. A comprehensive ocular examination, including funduscopy and optical coherence tomography scans was performed to every patient, while their clinical and demographic data were also assessed. Every participant completed the PHQ-9, the Zung SDS, and the HADS anxiety and depression questionnaires. Results The clinical and demographic data did not differ significantly between the study groups (p > 0.05).The scores of every questionnaire were significantly higher among the patients with vitreous flashes (p < 0.05 for all). After adjustment for several confounders, the values remained significantly impaired. Conclusion Photopsias negatively affect the psychological and mental well-being of the patients, by the terms of amplified levels of depression and anxiety. These findings underscore the necessity for a more holistic approach to managing patients presenting with vitreous flashes.

Food Allergy and Mental Health in Children and Adolescents-The Role of Shared Familial Environment.

Evidence suggests a link between food allergy and poor mental health, however, this may be explained by shared genetic and environmental factors. We aimed to investigate the association between food allergy of different severity and mental health in children, and the role of familial factors. This population-based, longitudinal cohort study is based on the Child and Adolescent Twin Study in Sweden with questionnaire data reported by parents and/or children. Food allergy 'ever' and doctor's diagnosis were reported at age 9-12 years, and ≥ 1 recent dispensation of adrenaline was used as a marker for current severe food allergy. Outcomes were identified using validated questionnaires for anxiety; Screen for Child Anxiety Related Disorders (SCARED); Strength and Difficulties Questionnaire (SDQ) and depression; Short Mood and Feelings Questionnaire (SMFQ), Center for Epidemiological Studies Depression Scale (CES-D) and Diagnostic and Statistical manual of Mental Disorders (DSM-IV-MDE) and reported at 9-12, 15 and 18 years of age. Multivariate linear and logistic modelling was applied to the whole cohort and a co-twin control approach to remove confounding by familial factors. In total, 3039 (8.9%) children had a parent-reported food allergy. Among these, 1292 (43.5%) had non-severe food allergy without diagnosis, 1490 (49%) had non-severe food allergy with diagnosis and 257 (8.5%) had severe food allergy. Compared to children with no food allergy, non-severe food allergy with diagnosis by 9-12 years was associated with parent-reported anxiety/depression; SCARED (adjOR 2.10, 95% CI 1.48-2.98), SMFQ (adjOR 1.92, 95% CI 1.19-3.10) at 9-12 years and SDQ (adjβ 0.2, 95% CI 0.0-0.4) at 15 years. All other associations were null including for those with severe food allergy. All positive estimates in the full cohort were attenuated using co-twin controls. Evidence associating paediatric food allergy severity and poor mental health was weak, and positive associations observed were likely due to familial confounding.

Validation of a Cancer-Focused Information Seeking Experience (ISEE) Scale

Background Searching for health information is critical for maintaining one’s health and reducing risk of disease, including cancer. However, some people are more likely to experience challenges in finding and comprehending health information; therefore, it is important to measure health information-seeking behavior. In order to add to prior research conducted with the scale, this study provides the first formal evaluation of the validity and reliability of the four-item, cancer-focused Information Seeking Experience (ISEE) scale in a cross-sectional, nationally representative health survey of U.S. adults. Results Results indicated that the four ISEE scale items were within limits of normality (skew range = -.44–.11; kurtosis range = -1.07 – −.71), exhibited medium to strong pairwise correlations (r’s = .54–.72), and indicated a strong internal consistency (Cronbach’s α = .85). The scale was unidimensional (CFI = .997, TLI = .992, SRMR = .012), and the scale demonstrated construct validity with known sociodemographic characteristics. As predicted, the ISEE scale had relatively weak relationships with the Patient Health Questionnaire for Depression and Anxiety, Patient-Centered Communication Scale, and the Patient-Reported Outcomes Measurement Information System (PROMIS) Instrumental Support 4a, demonstrating discriminant validity. Conclusions Tracking information-seeking experience in the population is critical, especially to inform efforts that ensure individuals have accessible, understandable, and reliable information about cancer. The ISEE scale was found to assess various aspects of cancer information-seeking in a reliable and valid manner and may be used in future surveys to track information support needs of those who seek health and cancer information.

Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support.

Depression and anxiety are commonly experienced by people with chronic kidney disease (CKD). This study aimed to evaluate person- and service-level factors associated with depression and anxiety symptoms. We sought to also understand utilisation of mental health treatments and preferences for future psychological support. An online survey recruited participants from six UK kidney services with varying levels of psychosocial provision. The survey was also advertised on social media. Participants completed screening questionnaires for depression and anxiety, alongside questions about mental health history, self-efficacy, treatment and support.The study included adults (18years or older) living with CKD (stages 3b and above) or those receiving any form of Kidney Replacement Therapy (KRT), including individuals with a functioning kidney transplant. Eligible participants had to complete study measures and be proficient in reading and writing in either English or Welsh, as the survey was administered in these languages.This survey was developed with our Patient and Public Involvement group and was administered from January 2023 until 31st January, 2024 using Qualtrics and RedCap. Four hundred fifty-eight people completed the survey. Moderate-severe symptoms of depression and anxiety were 37.7% and 26.5%, respectively. Over 50% reported a history of diagnosed depression. In addition to depression, sleep problems and fatigue were identified as future support needs, with over a third indicating a preference for in-centre provision. In case-mix adjusted analysis, there was no variability in depression and anxiety symptoms across centres. Centre location and size were unrelated to symptoms. Age, female gender, current mental health treatments, self-efficacy and perceptions regarding opportunity for support, were associated with symptoms of depression and anxiety. In sub-analysis, there was a negative association between psychosocial staffing levels and depression symptoms. Patient-related factors and behavioural characteristics were related to variation of these symptoms. There was little evidence of symptom variability across centres, although in a small sub-analysis, psychosocial provision showed a weak negative correlation with depression symptoms. Our findings highlight preferences of future needs which could be helpful for designing future research and service provision.

The Effect of Biofeedback on Constipation, Sleep, Depression, Anxiety and Quality of Life in Patients with Dyssynergic Defecation: a QUASI Experimental Study (Before and After Study).

Dyssynergic defecation(DD) is the inability to coordinate abdominal and anorectal muscle contraction during defecation. Patients with constipation often report poor quality of life, sleep issues, and increased risk of mood disorders. Biofeedback is a recommended treatment for DD. we evaluated the effect of EMG-biofeedback on constipation symptoms as the primary outcome and also on insomnia, mood disorders (depression and anxiety), and quality of life as secondary outcomes in patients with dyssynergic defecation. Thirty-one patients with DD (74.2% women, mean age 46.23 ± 13.42years), diagnosed using Rome IV criteria, Bristol Stool Form Scale, and anorectal manometry, were included. Patients underwent six to ten sessions of EMG-based biofeedback. We evaluated symptoms using the Wexner constipation questionnaire, Visual Analog Scale (VAS), SF-36 for quality of life, Insomnia Severity Index (ISI), and Hamilton questionnaires for anxiety and depression (HAM-A and HAM-D) before and after treatment. As consistent with study hypotheses, the Wexner scores significantly improved after biofeedback (p < 0.0001, t = 6.98). ISI scores improved (p = 0.01, t = 2.74), as did VAS scores (p < 0.0001, t = 5.14). HAM-A and HAM-D scores showed significant reductions (HAM-A: p = 0.0001, t = 5.01; HAM-D: p = 0.003, t = 2.17). However, SF-36 did not show significant improvement in quality of life (p > 0.05, t = -0.93). Biofeedback effectively improved constipation symptoms, insomnia, and mood disorders but did not impact quality of life.

The effect of probiotic administration on the severity of menopausal symptoms and mental health of postmenopausal women: a triple-blind randomized controlled trial in the West of Iran.

Menopausal symptoms are a reproductive health issue for women. Some studies have suggested that the use of probiotics may alleviate the severity of menopausal symptoms and mental health status. This study aimed to evaluate the effect of probiotic administration on the severity of menopausal symptoms and improve mental health in postmenopausal women in Hamadan, Western Iran. A triple-blind randomized controlled trial was conducted from February 20, 2023, to August 23, 2023, at the Comprehensive Health Service Centers in Hamadan City, Western Iran. Participants were randomized to intervention and control groups. The participants in the intervention group were administered probiotic supplements in 200 mg daily capsules for 6 weeks, and those in the control group received 200 mg daily capsules containing starch powder for 6 weeks. The primary outcomes were measured using the Menopausal Rating Scale and Depression Anxiety and Stress Scale questionnaires at baseline, week 3, and week 6. A total of 84 women took part in the study, with 42 individuals assigned to each of the intervention and control groups, respectively. The findings indicated no significant differences in baseline characteristics between the study groups (P > 0.05). The results indicated that the study outcomes changed differently over time between the two groups. The participants in the intervention group exhibited greater improvements in depressive symptoms, anxiety, and stress symptoms, as well as in physical, psychological, and urogenital symptoms at both week 3 and week 6, compared with the control group (P < 0.05). This study provides evidence regarding potential treatment effects of probiotics consumption in alleviating physical and mental symptoms related to menopause. Further multicenter and large-scale clinical trials with longer follow-up are recommended.

Birthing parent adverse childhood experiences and risk of atopic diseases in 5-year-old children.

Following up on previous findings from the All Our Families (AOF) cohort, the current study investigated the relationship between birthing parent history of adverse childhood experiences (ACEs) and child atopy, including asthma, allergy, and eczema, at five years of age. Potential indirect effects were explored. Participants completed the ACEs scale, validated questionnaires of anxiety and depression symptoms, and reported on their and their children's atopic disease history. Archival analyses of AOF data (N = 3,387) was conducted using logistic regression and path analysis with counterfactually based indirect effects. Birthing parent history of ACEs was associated with an 18% increased risk of child allergy at five years (OR = 1.18, 95% CI: 1.09, 1.20). Exploratory path analyses indicated a significant indirect effect of ACEs through birthing parent history of atopy on child asthma, allergy, and eczema at five years. There were no significant indirect effects through birthing parent symptoms of anxiety or depression during pregnancy, at two or five years postpartum. Birthing parent history of ACEs, combined with birthing parent history of atopy, may elevate the risk of child atopy. This presents an opportunity for early intervention for children at risk of atopic disease.

EXPLORING THE RELATIONSHIPS BETWEEN PSYCHOLOGICAL CHANGES, SLEEP QUALITY, AND HYPERTENSION AMONG COMMUNITY-DWELLING ELDERLY

Objective: to examine the relationship between psychological changes and sleep quality with the incidence of hypertension in the elderly.Method: This cross-sectional study, conducted with a purposive sample of 126 elderly participants, assessed psychological changes using the Depression, Anxiety, and Stress Scale (DASS-42) questionnaire and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Blood pressure was measured using a sphygmomanometer to assess hypertension. Data analysis included independent t-tests and chi-square tests, with logistic regression used to identify predictors of hypertension. Results: The independent t-test revealed significant differences in stress levels between participants with and without hypertension (t = -6.614, p = 0.020). Similarly, significant differences in depression levels were observed between these two groups (t = -0.044, p = 0.014). Elderly individuals with poor sleep quality had a 5 times higher risk of experiencing hypertension (OR = 4.625, p = 0.008). Multivariate analysis indicated that age was a predictor of hypertension incidence (β = 0.208, p = 0.004), and sleep quality was also a predictor (β = -1.501, p = 0.023). Discussion: The findings suggest that psychological factors and sleep quality influence hypertension development in the elderly, likely through physiological mechanisms such as heightened sympathetic activity and vascular stress. These results highlight the importance of addressing both psychological health and sleep quality in managing hypertension risk. Conclusion: Sleep quality is a predictor of hypertension incidence in the elderly. Those with poor sleep quality have a 5 times greater risk of developing hypertension compared to those with good sleep quality. Keywords: elderly, hypertension, psychological changes, sleep quality

Development of Questionnaires for Assessing Anxiety, Sleep Quality, and Quality of Life in the Elderly for Nursing Practice

The elderly face complex and interrelated health challenges, including anxiety, sleep disturbances, and decreased quality of life, which can affect their physical and psychological well-being. In nursing, screening using valid and reliable questionnaires can help nurses identify mental health problems early, prevent complications, and provide appropriate interventions. Therefore, assessment scales such as the Elderly Anxiety Questionnaire (EAQ), Elderly Sleep Quality Questionnaire (ESQQ), and Elderly Quality of Life Questionnaire (EQLQ) were developed to assess anxiety, sleep quality, and quality of life in the elderly according to current conditions and needs. This study aims to develop and validate the EAQ, ESQQ, and EQLQ as initial screening tools for clinical and community practice nurses. The method used a qualitative approach; questionnaires were distributed to 60 elderly participants selected based on inclusion and exclusion criteria, followed by statistical validity and reliability tests. The results showed that the r-count value for the three questionnaires was more significant than the r-table (0.254), indicating good item validity. The reliability test using Cronbach's alpha also showed that the three questionnaires had high reliability. In conclusion, EAQ, ESQQ, and EQLQ are practical tools for detecting the mental condition of the elderly and supporting the role of nurses in providing comprehensive care. This study contributes significantly to nursing practice by providing tools for initial screening, data collection, and analysis to improve the quality of care for the elderly. Further research with a larger sample size is recommended to strengthen these findings.

Analisis Kemampuan Pemahaman Konsep Siswa SMK Ditinjau Dari Kecemasan Matematis

This research is motivated by the importance of concept understanding skills that must be possessed by every student. Concept understanding ability is a basic ability that must be possessed by every student because in learning mathematics to be able to proceed to new material students must understand the concept first. One of the factors that affect concept understanding ability is mathematical anxiety. The purpose of this study is to analyze and describe the concept understanding ability of vocational students in terms of mathematical anxiety. This type of research is descriptive research with a qualitative approach. This research was conducted at SMK Muhammadiyah 4 Sangkapura, with the research population being class X students with a total of 13 students in the 2023/2024 even semester. The data collection methods used were mathematical anxiety questionnaire, concept understanding ability test and interview. The questionnaire results were used to group students into categories of low, medium and high levels of mathematical anxiety, then select 3 students as research subjects. The results of the concept understanding ability test and interviews were then analyzed based on the level of mathematical anxiety. The results showed that students with low levels of mathematical anxiety were able to fulfill all indicators 1 to 6, then students with moderate levels of mathematical anxiety were able to fulfill 5 indicators, namely indicators 1, 2, 3, 5 and 6. While students with high levels of mathematical anxiety were only able to fulfill 2 indicators, namely indicators 1 and 2.