Related Distress Research Articles

Psychosocial distress in patients with driver-mutant lung cancer.

e24125 Background: Project PRIORITY, a collaborative research study between The EGFR Resisters and the LUNGevity Foundation, found that 29% of United States respondents had clinical depression. While tyrosine kinase inhibitors (TKI) prolong lives, the impact of an oncogene driven lung cancer diagnosis on emotional well-being is not well studied nor are resource utilization and potential contributing factors to psychosocial distress. Methods: Our primary objective was to study cancer related distress in patients (pts) with newly diagnosed oncogene driver lung cancer. The secondary objective was to correlate distress with neutrophil to lymphocyte ratio (NLR) and body mass index loss (BMI) as a surrogate for cancer cachexia/precachexia to gauge the relationship to psychosocial distress. We retrospectively reviewed pts treated with TKI between 1/1/2008 and 2/1/2021. Sample size was based on estimates of depression in this population. A diagnosis of depression or anxiety was defined by documentation in the visit problem list, and active symptoms were based on progress note documentation. Depression and anxiety were recorded at 6 time points from diagnosis to progression on TKI, and their associations with treatment toxicities, progression free survival (PFS) and overall survival (OS) were assessed. Association with serial BMI and NLR were assessed using longitudinal statistical models. Results: We studied 78 pts: 71.8% female, 62.8% Caucasian, 15.4% African American, 15.6% Hispanic/LatinX, and 11.5% Asian. 94.9% had an EGFR mutation, and 5.1% had an ALK mutation. Prevalence of depression at diagnosis and progression was 11.5% and 25%, with anxiety prevalence 28.2% and 40.6%, respectively. Of these pts, 22.2% had active depression symptoms and 54.5% had active anxiety symptoms at diagnosis, although symptoms were not addressed in 33.3% and 22.7%, respectively. At progression, 68.8% had active depression symptoms and 46.2% had active anxiety symptoms, but symptoms were not addressed in 6.3% and 26.9%, respectively. At diagnosis and progression, 24.4% and 35.9%, respectively, were on treatment for anxiety and/or depression. Social work and psychology evaluated 12.8% and 10.3% of all pts at diagnosis and 10.9% and 17.2% at progression. NLR > 3.5 and > 5 were not associated with depression or anxiety. A more rapid longitudinal decrease in BMI was associated with depression. Grade ≥3 toxicities were not associated with depression or anxiety. Shorter PFS and OS were associated with higher rates of depression, but not anxiety. Conclusions: In this retrospective study of an ethnically diverse patient group at an academic medical center, we found a prevalence of depression and anxiety consistent with the Project PRIORITY findings. We saw an association between depression and more rapid weight loss but did not see correlation with NLR. Prospective evaluation with accurate documentation is needed to better address these questions in future studies.

The Relationship of Psychological Distress and Framingham Score in Coronary Heart Disease Patients

Introduction: Coronary artery disease is the leading cause of mortality and morbidity of both men and women accounting for over one third of total deaths. Objectives: The main objective of the study is to evaluate the relationship of psychological distress and framingham score in coronary heart disease patients. Material and methods: This descriptive study was conducted in Jinnah Hospital Lahore during 2019 to 2020. The data was collected from 100 CHD patients to find the relationship between psychological distress and framingham score. Results: The data was collected from 100 CHD patients. The mean age of the study patients was 54.4 ± 10.6 years. Cigarette smoking was much more common in men than in women (32.6% vs. 0, P<0.001). The serum levels of creatinine, uric acid, and cTAS were significantly higher in men than in women (0.9 ± 0.2 vs. 0.7 ± 0.1, 7.6 ± 2.1 vs. 6.8 ± 2.3, and.0.4 ± 0.0 vs. 0.3 ± 0.1, respectively; P<0.001). Conclusion: It is concluded that positive relationship between psychological distresses with the Framingham score is found, but it is not significant

Relationships of coping styles and psychological distress among patients with insomnia disorder

BackgroundInsomnia appears to be one of the most frequent sleep complaints in the general population. It has significant negative impact on daily functioning. However, there has been little research that described the effect of coping style in insomnia disorder.MethodsThe Simplified Coping Style Questionnaire (SCSQ) was used to evaluate 79 adult patients with insomnia disorder alongside 80 healthy controls. Additionally, sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and Symptom Checklist-90-Revised (SCL-90R) was utilized to determine the status of depression, anxiety and other psychological symptoms.ResultsPositive coping style score was significantly lower, whereas negative coping style score and nine symptomatic dimensions of SCL-90R were significantly higher in insomnia patients than in controls. Positive coping style score was adversely related to PSQI score, obsessive-compulsive, depression, anxiety and phobic anxiety, whereas negative coping style score was positively related to PSQI score, somatization and interpersonal sensitivity. Further multiple stepwise regression analysis showed that PSQI total score was independently and positively correlated with negative coping style score.ConclusionsInsomniacs use more negative coping styles and less positive ones. Positive coping is adversely associated with insomnia symptoms and psychological distress, whereas negative coping is positively related to those symptoms. And negative coping has a negative effect on sleep quality. we should attach importance to coping styles of insomniacs in clinical practice, which may help to develop more targeted prevention and intervention strategies.

Contending with Spiritual Reductionism: Demons, Shame, and Dividualising Experiences Among Evangelical Christians with Mental Distress

The belief that mental distress is caused by demons, sin, or generational curses is commonplace among many evangelical Christian communities. These beliefs may have positive or negative effects for individuals and groups. Phenomenological descriptions of these experiences and the subjective meanings associated with them, however, remain somewhat neglected in the literature. The current study employed semi-structured interviews with eight evangelical Christians in order to idiographically explore their experiences of mental distress in relation to their faith and wider communities. Through an interpretative phenomenological analysis, two superordinate themes were constructed: negative spiritualisation and negotiating the dialectic between faith and the lived experience of mental distress. Participants variously experienced a climate of negative spiritualisation, whereby their mental distress was demonised and dismissed, and they were further discouraged from seeking help in secular institutions and environments. Participants often considered such dismissals of their mental distress as unhelpful and stigmatising and experienced heightened feelings of shame and suffering as a result. Such discouragement also contributed to the process of othering and relational disconnection. Alongside a rejection of church teachings, which exclusively spiritualised psychological distress, participants negotiated a nuanced personal synthesis of faith, theology, and distress, which assumed a localised and idiographic significance. This synthesis included advocating for the uptake of aetiological accounts, which contextualised mental distress in terms of the whole person and resisted de-politicised, dichotomised, and individualistic narratives. Results are discussed in relation to a broad range of literature in the field, while further research suggestions are provided.

The chain mediating role of social support and stigma in the relationship between mindfulness and psychological distress among Chinese lung cancer patients.

Psychological distress greatly impaired the psychological and physical well-being of lung cancer patients. Identification of protective and risk factors is a prerequisite of developing effective psychological treatment protocol. The study aims to determine the relationship of mindfulness and psychological distress and further clarify the mechanism of mindfulness against psychological distress through perceived stigma and social support among Chinese lung cancer patients. A cross-sectional survey study involving 441 valid Chinese lung cancer patients was conducted from September 2018 to August 2019. After all validated questionnaires that measured psychological distress, level of mindfulness, social support, and perceived stigma were returned by patients, we firstly performed correlation analysis to assess the associations between mindfulness, social support, perceived stigma, and psychological distress. Then structural equation modelling analysis was conducted to further clarify the mediating effects of perceived stigma and social support on the relationship between mindfulness and psychological distress. According to our hypothesis and further modification, our revised model adequately fits to data. Mindfulness (β = - 0.107, p = 0.008) and social support (β = - 0.513, p < 0.001) had a direct effect on psychological distress. Meanwhile, mindfulness had a direct effect on perceived stigma (β = - 0.185, p < 0.001), and perceived stigma had a direct effect on social support (β = - 0.373, p < 0.001). Furthermore, mindfulness had also the indirect effect on psychological distress through the chain mediating role of stigma and social support among lung cancer patients. Mindfulness has direct negative effect on psychological distress and has also indirectly negative psychological distress through impacting social support and perceived stigma.

Long-term Follow-up of Sexual Quality of Life after Laparoscopic Surgery in Patients with Deep Infiltrating Endometriosis

We performed a long-term follow-up to quantify the impairment of sexual quality of life (SQL) and health-related QL (HRQL) in sexually active women after laparoscopic excision of deep infiltrating endometriosis (DIE). Prospective case-control study. Hospital Clinic of Barcelona. A total of 193 patients (after dropout and exclusions) were divided into 2 groups: one hundred twenty-nine premenopausal women with DIE (DIE group) and 64 healthy women who underwent tubal ligation (C group). All patients underwent laparoscopic surgery: laparoscopic endometriosis surgery in the DIE group and laparoscopic tubal ligation in the C group. All women were followed for at least 36 months, and they completed the Medical Outcomes Study 36-item short form questionnaire to assess their HRQL and 3 self-administered questionnaires that evaluate different aspects of SQL: the generic Sexual Quality of Life-Female questionnaire, the Female Sexual Distress Scale to evaluate "sexually related distress," and the Brief Profile of Female Sexual Function to screen hypoactive sexual desire disorder. The patients with DIE as well as the controls completed the 4 questionnaires before surgery, and the patients with DIE also completed the questionnaires at 6 and 36 months after surgery. A comparison of the patients and controls before surgery showed a statistically significant impairment in SQL and HRQL among the patients with DIE. A statistically significant improvement in SQL and HRQL was observed in the DIE group 6 months after surgery, with scores being similar to those of the C group. An evaluation 36 months after surgery showed that SQL and HRQL were better than presurgical SQL and HRQL in the DIE group, with a slight reduction compared with the 6-month evaluation. SQL and HRQL improved in patients with DIE undergoing complete laparoscopic endometriosis resection and were comparable to those of healthy women at 6 months after surgery, showing a slight reduction at 36 months of follow-up.

Nurses as 'second victims' to their patients' suicidal attempts: A mixed-method study.

To understand the effects of patients' suicidal attempts and events on nurses' second victim symptoms and to explore the association between these experiences and nurse absenteeism and turnover. The term 'second victim' is when a healthcare professional expresses psychological symptom following adverse patient event. This has been previously shown to be associated with absenteeism and higher staff turnover. A mixed-methods study with a sequential exploratory approach. A qualitative approach was used for nurses to relate their experiences of their patients' suicidal attempts. A cross-sectional quantitative study was conducted in 150 nurses who worked in internal departments. The Second Victim Experience and Support Tool was used to substantiate and measure second victim related distress of nurses who treated suicidal patients. The qualitative data were analysed by a constant comparative analysis method. The analytic analysis of the quantitative study included Pearson's correlations and hierarchical linear regression model to assess the explanatory variables to absenteeism and staff turnover. The study adhered to the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies. The qualitative part identified three themes and nine sub-themes, including the new variable 'sense of being alone'. The quantitative part of the study found that nurses expressed a medium level of second victim related distress. After controlling for demographic variables, second victim distress and the sense of being alone following patients' suicidal events may explain nurse absenteeism and turnover. Nurses who experience suicidal attempts of their patients react as second victims. These symptoms lead to nurse absenteeism and turnover. Nurses who experience suicidal attempts of their patients need treatment and support as second victims, the same as in any other medical adverse event. The nursing leadership should emotionally support these nurses and prevent consequential staff organisational problems.

Patient Reported Outcomes of Scalp and Forehead Reconstruction for Defects Following Oncological Resections (North-East Indian Tertiary Cancer Centre Study).

Background Approximately 1-2% of all scalp tumours are malignant, but they comprise up to 13% of all malignant cutaneous neoplasms. The current study presents our experience of reconstruction of scalp and forehead for malignant tumours treated at our centre. Methods This is a single institutional observational study conducted at a tertiary cancer centre in North East India. Post-operative outcomes related to quality of life of patients were measured with help of FACE-Q scales. Face-Q -Satisfaction with outcome and FACE-Q- appearance related psychosocial distress scores were analysed. Histograms were used for descriptive statistics. Data were checked for normality using Kolmogorov-Smirnova and Shapiro-Wilk test. For non-normal data Wilcoxon test was used. A p value less than 0.05 was considered as statistically significant at 5% level of significance. Results Mean age of patients was 57.6 ± 14.2years. The mean defect size was 89.036 ± 81.77 cm2. The mean satisfaction with outcome scores and distress scores at 3-months was 54.9 ± 8.6 and 34.8 ± 8.5 respectively with a statistically significant p value of 0.001.Mean satisfaction scores and psychological distress scores were better at the end of three months when compared to at the time of discharge with a statistical significant p value of < 0.0001. Conclusion Scalp and forehead reconstructions for defects following oncological resections are technically challenging and if chosen carefully with meticulous planning, both local and free tissue transfers give satisfactory outcome in long term follow up. There are lots of reconstruction options for scalp and forehead defects and knowledge of the basic bio-geometry of the each flap is must.

Impact of SARS-CoV-2 infection on acute intracerebral haemorrhage in northern Italy

IntroductionGrowing evidence has been published as to the impact of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) on cerebrovascular events over the last few months, with considerable attention paid to ischemic strokes. Conversely, little is known about the clinical course of intracerebral haemorrhage (ICH) and simultaneous SARS-CoV-2 infection. MethodThe Italian Society of Hospital Neurosciences (SNO) promoted a multicentre, retrospective, observational study (SNO-COVID-19), involving 20 Neurological Departments in Northern Italy. Clinical data on patients with acute cerebrovascular diseases, admitted from March 1st to April 30th, 2020, were collected. A comparison was made of the demographical and clinical features of both SARS-CoV-2 positive and negative patients with ICH. Results949 patients were enrolled (average age 73.4 years; 52.7% males); 135 patients had haemorrhagic stroke and 127 (13.4%) had a primary ICH. Only 16 patients with ICH (12.6%) had laboratory confirmed SARS-CoV-2 infection, both symptomatic and asymptomatic. SARS-CoV-2 related pneumonia or respiratory distress (OR 5.4), lobar location (OR 5.0) and previous antiplatelet or anticoagulant treatment (OR 2.9) were the only factors significantly associated with increased mortality in ICH. SARS-CoV-2 infection, regardless of respiratory involvement, led to a non-significantly increased risk of in-hospital death (37.5% vs 23.4%, p = 0.2). DiscussionICH patients with COVID-19 did not experience an increase in mortality as striking as ischemic stroke. The inflammatory response and respiratory complications could justify the slight increase of death in ICH. Bleeding sites and previous antiplatelet or anticoagulant treatment were the only other predictors of a worse outcome.

"The Financial Impact Is Depressing and Anxiety Inducing": A Qualitative Exploration of the Personal Financial Toll of Arthritis.

The financial experience faced by working-age people with arthritis includes living below the poverty line for many. Financial distress among people with arthritis is known to contribute to poorer health outcomes, including high psychological distress and more severe pain. Despite the demonstrated societal cost of arthritis care and management, the personal costs borne by the individual are not well understood. The aim of this study was to explore the perceived financial impacts of living with arthritis among younger adults (defined as those ages 18-50 years). A qualitative descriptive study design was used. Participants with inflammatory arthritis or osteoarthritis were recruited from the community, including urban and rural settings. An interview schedule was developed, informed by existing literature, which was piloted prior to data collection. Deductive and inductive coding techniques were used to identify financial-related themes arising from the data. Semistructured interviews were conducted with 21 adults (90% female) with a mix of arthritis conditions, including rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Four themes were identified: direct arthritis-attributable medical costs, indirect arthritis-attributable costs, insurance and pension costs, and broader financial impacts on the family. Nonsubsidized costs were frequently referenced by participants as burdensome and existed even within the publicly funded Australian health care system. Adults with arthritis experience significant arthritis-attributable financial burden and related distress. Financial concerns should be actively identified and considered within shared clinical decision-making to provide more patient-centered care for these individuals.

Americans' distress early in the COVID-19 pandemic: Protective resources and coping strategies.

The rapid emergence of the coronavirus disease 2019 (COVID-19) pandemic in the United States has dramatically altered daily life and taken a toll on Americans' physical, mental, social, and financial well-being. Based on previous widespread disasters, future high prevalence of short- and long-term adverse mental health consequences are anticipated. Studies of COVID-19 outside the United States indicated moderately high levels of distress, but we have little information regarding Americans' distress nor the factors associated with relative distress or adjustment during this unprecedented time. This study represents the first national view of Americans' distress during the massive disruption of COVID-19 and identifies levels of stress exposure, protective psychosocial resources, and coping strategies. Data were collected April 7-9, 2020 from an online platform, using best practices for ensuring high-quality data; 1,015 completed respondents are included ([53.9%] women; average age = 38.9 years; mostly White [82.4%] and non-Hispanic [91.5%]). Respondents' locations ranged across the United States, from 18.5% in the Northeast to 37.8% in the South. Fairly high levels of stress exposure and peritraumatic and general distress (depression, anxiety, and stress) were reported. Emotion regulation skills along with active and distraction coping emerged as the strongest predictors of lower distress levels. These results identify potential targets for online mental health interventions-focusing on engaging in adaptive emotion regulation and coping (e.g., through telehealth mental health first aid)-during the pandemic to offset the likely rise in distress over the months ahead. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Results of the cellular immuno-therapy for covid-19 related acute respiratory distress syndrome (circa-phase i trial

Results of the cellular immuno-therapy for covid-19 related acute respiratory distress syndrome (circa-phase i trial

Psychological and sleep-related factors among quarantined Omani students returning from abroad

ABSTRACT Background One of the many repercussions from the COVID-19 pandemic has been stress. The death toll from the pandemic, as well as sleep loss, have been noted to be the root causes of COVID-19 related stress and distress among students in the Arabian Gulf countries. Aims This study aimed to examine the relationship between self-reported sleeping problems and the socio-demographic, clinical and lifestyle factors among quarantined Omani students arriving from abroad Methods This was a cross-sectional analytical study conducted during the COVID-19 pandemic, from April 1-10 2020. The participants were all Omani students who had arrived from abroad during the pandemic. The outcome measures consisted of the Athens Insomnia Scale (AIS) and the Generalized Anxiety Disorder -7 (GAD-7), as well as relevant socio-demographic, clinical, and lifestyle factors. Result A total of 376 participants were included in this study with 49.5% (n = 186) noted to be suffering from insomnia. Multivariate logistic analysis suggested that female students were 2.4 times (odds ratio [OR] = 2.43; confidence interval [CI]: 1.50-3.93; P < .001) more likely to suffer from insomnia when compared to male students. Conclusion Almost half of the participants self-reported sleeping problems, with a higher prevalence among female students. Further studies are needed to confirm these findings

Structural distress: experiences of moral distress related to structural stigma during the COVID-19 pandemic.

IntroductionThe COVID-19 pandemic has taken a significant toll on the health of structurally vulnerable patient populations as well as healthcare workers. The concepts of structural stigma and moral distress are important and interrelated, yet rarely explored or researched in medical education. Structural stigma refers to how discrimination towards certain groups is enacted through policy and practice. Moral distress describes the tension and conflict that health workers experience when they are unable to fulfil their duties due to circumstances outside of their control. In this study, the authors explored how resident physicians perceive moral distress in relation to structural stigma. An improved understanding of such experiences may provide insights into how to prepare future physicians to improve health equity.MethodsUtilizing constructivist grounded theory methodology, 22 participants from across Canada including 17 resident physicians from diverse specialties and 5 faculty members were recruited for semi-structured interviews from April–June 2020. Data were analyzed using constant comparative analysis.ResultsResults describe a distinctive form of moral distress called structural distress, which centers upon the experience of powerlessness leading resident physicians to go above and beyond the call of duty, potentially worsening their psychological well-being. Faculty play a buffering role in mitigating the impact of structural distress by role modeling vulnerability and involving residents in policy decisions.ConclusionThese findings provide unique insights into teaching and learning about the care of structurally vulnerable populations and faculty’s role related to resident advocacy and decision-making. The concept of structural distress may provide the foundation for future research into the intersection between resident well-being and training related to health equity.

A special kind of stress: Assessing feelings of decisional distress for breast cancer treatment decisions

ObjectiveWomen with breast cancer need to make difficult treatment decisions and may experience decisional distress (worry, anxiety, and thought intrusion) associated with these decisions. This study investigated ways that decisional distress was both associated with and distinct from other variables regarding decisional process and life functioning, and it investigated the validity of a decisional distress scale. MethodsA total of 263 women previously or currently diagnosed with breast cancer reported on initial treatment decisions regarding surgery, chemotherapy, or radiation, or decisions involving oral endocrine therapy (either currently or retrospectively). Participants completed online measures of decisional distress, alliance and confusion in patient-practitioner relationships, positive and negative interactions in close relationships, financial and general distress, and decision satisfaction. ResultsDecisional distress demonstrated a unidimensional factor structure invariant across treatment context groups, a wide range of meaningful variation, significant correlations with all hypothesized variables (especially patient confusion), but also key distinctions from other variables. ConclusionDecisional distress is a meaningful construct that can be assessed with precision, and important for understanding medical decision-making processes and patient quality of life. Practice implicationsAssessing decisional distress is crucial for evaluating treatment decision outcomes. One key to reducing decisional distress may involve reducing patient confusion.

Evaluating the effectiveness and utility of a novel culturally-adapted telemonitoring system in improving the glycaemic control of Asians with type-2 diabetes mellitus: a mixed method study protocol

BackgroundRegular supervision of patients with type-2 diabetes mellitus (T2DM) by healthcare providers is essential to optimise their glycaemic control but is challenging to achieve in current care models. Telemonitoring is postulated to bridge this gap by leveraging on internet-of-things and mobile-health technology. This study aims to determine the effectiveness of a novel telemonitoring system (OPTIMUM) in improving the glycaemic control of patients with T2DM compared with standard of care alone.MethodsThis mixed-method study comprises an initial randomised controlled trial involving 330 Asian adults with T2DM, aged 26–65 years old with an HbA1c of 7.5–10%, with 115 in the intervention and control arms each. Those in the intervention arm will use standardised Bluetooth-enabled devices to transmit their capillary glucose, blood pressure and weight measurements to the OPTIMUM system. Primary care physicians and nurses will remotely supervise them according to an embedded management algorithm for 6 months, including tele-education via weekly videos over 8 weeks and asynchronous tele-consultation if abnormal or absent parameters are detected. Patients in both arms will be assessed at baseline, 6, 12 and 24 months post-recruitment. The primary outcome will be their HbA1c difference between both arms at baseline and 6 months. Blood pressure and weight control; quality of life, medication adherence, confidence in self-management, diabetic literacy and related distress and healthcare utilisation using validated questionnaires; and incident retinal, renal, cardiac and cerebrovascular complications will be compared between the two arms as secondary outcomes at stipulated time-points. Intervention arm patients will be interviewed using qualitative research methods to understand their experience, acceptance and perceived usefulness of the OPTIMUM system.DiscussionOverall, this study seeks to evaluate the effectiveness of cultural-adapted telemonitoring system in improving glycaemic control of Asians with type-2 diabetes mellitus compared to standard of care. The results of this trial will better inform policy makers in adopting telemedicine for population health management.Trial registrationClinicalTrials.gov NCT04306770. Registered on March 13, 2020.

Prior On-Off Relationship Instability and Distress in the Separation and Divorce Transition.

Divorce is considered distressing for many individuals (Sbarra etal., Current Directions in Psychological Science, 2015, 24, 109); however, individuals in poor-quality relationships may experience certain benefits of leaving an unstable union (Amato & Hohmann-Marriott, Journal of Marriage and Family, 2007, 69, 621). On-off relationship cycling, or the breakup and reconciliation of a relationship, is a salient indicator of poor relationship quality and a common form of relationship instability (Dailey etal., Personal Relationships, 2009, 16, 23) that is associated with distress (Monk etal., Family Relations, 2018, 67, 523). In line with divorce-stress-adjustment and relational turbulence theory perspectives, we hypothesized that those whose relationships were characterized by on-off instability would experience less distress during the separation and divorce process. Given gender inequality in marriage (e.g., Dempsey, Journal of Sociology, 2002, 38, 91; Monin & Clark, Sex Roles, 2011, 65, 320), we also hypothesized that this association would be more pronounced for women. Using data from 98 divorced or separating couples, we found that relationship cycling prior to the separation and divorce process was associated with fewer distress symptoms for women. Conversely, a history of relationship cycling was associated with more distress symptoms for men. Our study provides support and extends prior investigations illustrating that, for some, those in unions characterized by more turmoil, may experience relief following a termination.

A Cross-sectional Study of Female HIV Patient Perspective of Dyadic Adjustment in HIV Sero-concordant and Sero-discordant couples

Background: Dyadic Adjustment is defined as the process with which couples form a steady relationship. This study assessed dyadic adjustment in HIVcouples in Ogun State, Nigeria.&#x0D; Methods: This cross sectional study was carried out among 458 women accessing HIV care in tertiary hospitals in Ogun State, Nigeria. Participants were evaluated using the Revised Dyadic Adjustment Scale and analyzed using the Stata/SE 15.1 statistical Package. Chi-square and t-tests were used to determine the correlates of dyadic adjustment (Distress/Non-distress) while logistic regression was used to determine the predictors of distress.&#x0D; Results: Only 28.82% had relationship distress while the majority (71.18%) had no distress. There was a statistically significant association between marital status and the level of distress. Those who were currently married were less likely to have distress than those who were single or previously married.&#x0D; Conclusion: Those who were not married were more predisposed to distress. More support for these groups is therefore recommended.&#x0D; Keywords: Couple, Distress, Dyadic adjustment, HIV, Sero-concordant, Sero-discordant

Evaluating the Clinical Impact of National Dementia Behaviour Support Programs on Neuropsychiatric Outcomes in Australia.

Background/Objective: People living with dementia (PLWD) in residential aged care homes (RACHs) are frequently prescribed psychotropic medications due to the high prevalence of neuropsychiatric symptoms, also known as behaviours and psychological symptoms of dementia (BPSD). However, the gold standard to support BPSD is using psychosocial/non-pharmacological therapies. This study aims to describe and evaluate services and neuropsychiatric outcomes associated with the provision of psychosocial person-centred care interventions delivered by national multidisciplinary dementia-specific behaviour support programs.Methods: A 2-year retrospective pre-post study with a single-arm analysis was conducted on BPSD referrals received from Australian RACHs to the two Dementia Support Australia (DSA) programs, the Dementia Behaviour Management Advisory Service (DBMAS) and the Severe Behaviour Response Teams (SBRT). Neuropsychiatric outcomes were measured using the Neuropsychiatric Inventory (NPI) total scores and total distress scores. The questionnaire version “NPI-Q” was administered for DBMAS referrals whereas the nursing home version “NPI-NH” was administered for SBRT referrals. Linear mixed effects models were used for analysis, with time, baseline score, age, sex, and case length as predictors. Clinical significance was measured using Cohen's effect size (d; ≥0.3), the mean change score (MCS; 3 points for the NPI-Q and 4 points for the NPI-NH) and the mean percent change (MPC; ≥30%) in NPI parameters.Results: A total of 5,914 referrals (55.9% female, age 82.3 ± 8.6 y) from 1,996 RACHs were eligible for analysis. The most common types of dementia were Alzheimer's disease (37.4%) and vascular dementia (11.7%). The average case length in DSA programs was 57.2 ± 26.3 days. The NPI scores were significantly reduced as a result of DSA programs, independent of covariates. There were significant reductions in total NPI scores as a result of the DBMAS (61.4%) and SBRT (74.3%) programs. For NPI distress scores, there were 66.5% and 69.1% reductions from baseline for the DBMAS and SBRT programs, respectively. All metrics (d, MCS, MPC) were above the threshold set for determining a clinically significant effect.Conclusions: Multimodal psychosocial interventions delivered by DSA programs are clinically effective as demonstrated by positive referral outcomes, such as improved BPSD and related caregiver distress.

Mental and somatic health in university students with type 1 diabetes: new results from DiaSHoT18, a cross sectional national health and well-being survey.

To explore mental and somatic health, quality of life, alcohol-related problems, sleep problems, and diabetes related distress in university students with type 1 diabetes (T1D), compared to students without T1D. Further, we evaluated associations with gender, treatment modalities, and achieved metabolic control. All fulltime Norwegian students aged 18-35 years pursuing higher education in 2018 (n=162.512) were invited into a comprehensive national survey on health and well-being. Students that stated having diabetes was asked further questions about their diabetes care. Of 49,684 participating students, 324 participants stated having T1D. Students with T1D did not show more mental or somatic health symptoms, or report a higher level of loneliness. However, T1D was significantly associated with lower quality of life (QoL). Students with good metabolic control reached the same QoL as students without T1D. Mental disorders and suicidality were associated with lacking metabolic control. The proportion of unhealthy drinking habits was generally low, and even lower in students with T1D. Sleeping patterns were generally good, but students using continuous glucose measurement were awakening more often during sleep. Females with T1D showed higher levels of diabetes related problems and distress, but good metabolic control was associated with lower diabetes distress level. Students with T1D scored equally on most mental and somatic health scales. Their quality of life was significantly worse compared to their healthy peers. Knowledge on the impact of metabolic control, gender and the use of CSII and CGM can be valuable for the caretakers of young adults with T1D.