Related Distress Research Articles

Detangling Associations Between Maternal Depressive Symptoms and Diabetes Relationship Distress With Adolescents' HbA1c.

Previous research in families of children with type 1 diabetes demonstrates that maternal depressive symptoms are a known risk factor for poor diabetes outcomes. We sought to examine whether maternal diabetes relationship distress or maternal depressive symptoms were more strongly associated with adolescent glycemic outcomes. Analyses were conducted using data from mothers who consented to screen for a behavioral intervention. The screener included the Patient Health Questionnaire and the Parent Diabetes Distress Scale, Parent/Teen Relationship Distress subscale. Hemoglobin A1c (HbA1c) was extracted from adolescents' medical records. Our sample consisted of 390 maternal caregivers of adolescents with type 1 diabetes aged 11-17. Screening data revealed that 35% of mothers reported clinically significant diabetes distress related to their relationship with their adolescents, and 14% of mothers reported clinically significant depressive symptoms. The adolescents of mothers who reported diabetes relationship distress had significantly higher mean HbA1c levels (9.7 ± 2.2%) compared to those whose mothers were not distressed (8.2 ± 1.8%, d = .72). Similarly, adolescents whose mothers reported clinically significant depressive symptoms had higher mean HbA1c levels (9.6 ± 2.4%) than those whose mothers were not depressed (8.6 ± 2.0%, d = .48). After adjusting for clinical and demographic factors, mothers' reports of diabetes relationship distress were more strongly associated with adolescents' HbA1c than maternal depressive symptoms. Our findings suggest that screening for maternal distress-particularly distress related to the caregiver-adolescent relationship-could match families with psychosocial support or other resources to improve both psychosocial and glycemic outcomes.

Therapist self-disclosure in teletherapy early in the COVID-19 pandemic: Associations with real relationship and traumatic distress.

The usefulness of therapists' self-disclosure (TSD) in psychotherapy remains controversial, and little is known regarding the potential risks and benefits of TSD in times of global crisis such as the COVID-19 pandemic and in teletherapy. We examined two independent samples of therapists (N = 1705; Study 1) and patients (N = 772; Study 2) on their perceptions of increases in TSD during the transition to teletherapy early in the COVID-19 pandemic (spring 2020). Approximately 20% of therapists and 14% of patients reported perceptions of definite increases in TSD. Therapists' top reasons for increased TSD were therapists' heightened distress and an effort to connect with patients in teletherapy. Importantly, therapist perceptions of their increased TSD were positively related to subjective vicarious trauma, real relationship, psychodynamic theoretical orientation and negatively with humanistic orientation, but not with age, race/ethnicity, length of clinical experience, working alliance, or professional self-doubt. Patients' perceptions of increased TSD were positively related with patient pandemic-related traumatic distress and their own self-disclosure, but not with patient-reported therapeutic relationship variables. Longitudinally, patients' perceptions of TSD increases predicted higher pandemic-related traumatic distress at 3-month follow-up, after controlling for their baseline traumatic distress and other variables. These results highlighted that increased TSD in teletherapy may be a potential marker for heightened distress in both patients and therapists during a global crisis and a transition to teletherapy. The findings also contrasted the literature and emphasized that therapists, but perhaps not patients, may have considered increased TSD as a reflection of genuine therapeutic connection.

Exploring chronic pain related attentional experiences, distress and coping strategies among Arabic-speaking individuals in Jordan and the United Kingdom.

The lived experiences of chronic pain (CP) among Arabic-speaking populations remain underexplored. A better understanding of these experiences and their associations with attention difficulties, coping mechanisms, and treatment options could lead to improved support for this group. This qualitative study utilised a descriptive design and involved one-to-one interviews with 51 participants with CP who had just completed two attention tasks. Interviews were conducted using a semi-structured topic guide, transcribed verbatim and translated from Arabic to English before agreeing on the coding framework. Themes and subthemes were extracted using a framework analysis approach. The study identified six main themes: Factors contributing towards developing or exacerbating CP, the impact of CP on psychosocial functions, including attention, the perceived role of social support, coping strategies for managing CP, perceptions about available treatments and recommendations for interventions. CP significantly impacts individuals' physical and psychosocial functions, and it is reciprocally associated with attentional difficulties. Despite using various approaches to manage their CP, none of the participants used psychological interventions or counselling. Understanding the diverse impacts of CP and the coping strategies employed to develop culturally sensitive interventions, review current related policies, and improve healthcare services is crucial to managing CP among this population.

Navigating Identity Uncertainty: Identity Distress During the COVID-19 Pandemic

The long-term effects of the COVID-19 pandemic have only recently begun to be explored. Among college students, who were faced with sudden and unprecedented changes and challenges, it is likely that COVID-19 detrimentally impacted the establishment of a sense of self, a key developmental task of the college years. However, no research has examined the relationships among COVID-19 related worries, identity distress, and psychological and academic adjustment. To address these gaps in the current study, we examined the prevalence of identity distress, the relationship between COVID-19 related worries and identity distress, and the direct and indirect associations between COVID-19 related worries and psychological and academic adjustment among a sample of 1627 college students ( M age = 20.51, SD = 2.21). Findings indicated that over a third of the sample reported high levels of identity distress and that COVID-19 related worries were negatively associated, both directly and indirectly through identity distress, with psychological and academic adjustment.

Modifying Candidacy and Management to Improve Extracorporeal Support During Supply-Demand Mismatch

BackgroundCandidacy for venovenous extracorporeal membrane oxygenation is dictated by ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) criteria. We evaluated the effect of modifying candidacy on the basis of escalating demand and limited resources. MethodsWe retrospectively reviewed adult patients diagnosed with COVID-19–related severe acute respiratory distress syndrome who failed to respond to conventional ventilation and required extracorporeal support at our institution. Candidacy was restricted with a published probability model because of supply-demand mismatch and high mortality observed after the first surge. Age <55 years, mechanical ventilation days <3, and minimal comorbidities were prioritized. Primary outcomes included time to decannulation, extubation, tracheostomy, discharge, and death. Hospital and intensive care unit length of stay and hospitalization costs were evaluated. Predictors included cannulation strategy, before and after criteria implementation, use of cytoreductive techniques, timing of tracheostomy, and body mass index. Propensity score matching, multistate Cox proportional hazards models, and generalized linear models were used. ResultsOur sample comprised 105 patients, 26 from before criteria implementation (“before” phase) and 79 after (“after” phase). Propensity score results indicated no significant differences in death (P = .152) and costs (P = .063) between the groups. Patients who received cytoreductive therapy had lower total costs (P = .033). Those who underwent single-site cannulation had higher probability of decannulation (P = .009), discharge (P < .001), tracheostomy (P < .001), and extubation alive (P < .001) and lower risk of death (P = .017). ConclusionsModifying candidacy by objective criteria with the use of adjunctive therapies may improve outcomes and lower costs during periods of supply-demand mismatch.

Diabetes-Related-Distress and its Relationship with Glycaemic Control Among Type 2 Diabetes Mellitus Patients Attending a Specialty Clinic in Lagos, Nigeria

Background: Diabetes Mellitus (DM) is a chronic metabolic disease with various complications throughout its course. The presence of emotional burden in diabetes disease, which is referred to as diabetes-related distress (DRD) is common among such patients and may affect their response to treatment. Objectives: To assess the relationship of diabetes-related distress and glycaemic control among patients with Type 2 Diabetes mellitus. Methods: This hospital-based cross-sectional study was conducted at the Family Medicine Department of LASUTH, Ikeja, Lagos. A total of 317 patients with Type 2 Diabetes mellitus were systematically recruited. The data were collected over a four-month period. Important clinical information including clinical characteristics and diabetes-related distress using the diabetes distress scale (DDS-17) was collected. Glycosylated haemoglobin (HbA1c) was also assessed. Results: The degrees of DRD were as follows: 54.9% (No/little), 40.1% (moderate) and 5.0% (severe). The mean HbA1c estimate for all participants was 7.83±1.8%. Among the 317 study participants, 67.2% had poor glycaemic control while 32.8% had good glycaemic control. There was a statistically significant association between DRD and glycaemic control (p &lt; 0.001). Likewise, the various domains of DRD had statistically significant associations with glycaemic control with the exception of physician-related domain. Participants with better glycaemic control reported lower levels of DRD than participants with poorer glycaemic control. Conclusion: There is a high level of diabetes-related distress patients with diabetes mellitus. Good glycaemic control is important in improving or preventing DRD. Therefore, T2DM patients should be screened for DRD during their treatment.

Restore and Rebuild (R&R) – a feasibility pilot study of a co-designed intervention for moral injury-related mental health difficulties

ABSTRACT Background: Moral injury can significantly negatively impact mental health, but currently no validated treatment for moral injury-related mental health difficulties exists in a UK context. This study aimed to examine whether the Restore and Rebuild (R&R) treatment was feasible to deliver, acceptable and well tolerated by UK military veterans with moral injury related mental health difficulties. Method: The R&R treatment was delivered to 20 patients who reported distress related to exposure to a morally injurious event(s) during military service. R&R is a 20-session psychotherapy with key themes of processing the event, self compassion, connecting with others and core values. Treatment was delivered online, weekly, one-to-one by a single therapist. Qualitative interviews with patients and the therapist who delivered R&R were conducted to explore acceptability and analysed using thematic analysis. Results: Following treatment, patients experienced a significant reduction in symptoms of post-traumatic stress disorder, depression, alcohol misuse and moral injury related distress. R&R was found to be well tolerated by patients and improved their perceived wellbeing. Conclusions: These results provide preliminary evidence that veterans struggling with moral injury related mental ill health can benefit from R&R treatment.

Spiritual Pathology Theory of the Sound Heart Model: Socio-Cultural Factors of Spiritual Distress

Introduction: Spiritual Pathology is the study of disturbing factors in the relationship between man and God, the process of disruption in secure attachment to God, which causes spiritual distress in relation to self, people, and the world of creation.Areas covered: Balbi defines attachment as deep emotional bond with special people in life, whose interaction brings security, joy and happiness, and their presence brings peace in times of stress. Kirkpatrick generalized the style of attachment to parents to attachment to God. Expert opinion: In the Sound Heart Model, worship is natural need. The basis of religion is secure attachment to God. Secure attachment to God is belief in the presence and sufficiency of God, as a responsive safe haven. The basis of attachment to God is positive image of God and “recognizing the truth of religion” by the Prophet. The Prophet, as interpreter of Qur’an and spiritual role-model, has healthy spiritual personality. Acceptance of religion, at the time of intellectual maturity, should be done without imitation and coercion, based on knowing the truth of religion, with a free and informed choice. Spiritual pathology is the study of socio-cultural factors that cause misunderstanding of religion, negative image of God and insecure attachment to God.

Does corporate social responsibility mediate the relationship between board diversity and financial distress: evidence from an emerging economy?

PurposeThe study hypothesized that the impact of board diversity on financial distress (FD) is not direct but rather mediated by the firm’s corporate social responsibility (CSR) activities. Consequently, the purpose of this study is to examine the impact of CSR as a mediator in the board diversity–FD relationship.Design/methodology/approachThe study examined six board diversity dimensions – age, gender, nationality, education and tenure in 81 nonfinancial Pakistan Stock Exchange (PSX)-listed firms from 2010 to 2021. The CSR engagement of the sample firms is evaluated using a multidimensional financial approach and the likelihood of FD is computed using Altman’s Z-score. The system-generalized method of moments estimator is used to meet the study objectives. In addition, several tests are run to determine the robustness of the study’s findings.FindingsBased on the procedure for mediation analysis outlined by Baron and Kenny (1986), the authors found that CSR is significantly inversely associated with the likelihood of FD. Second, board diversity variables age, gender and national diversity were positively associated with CSR. Third, board age, gender and national diversity are significantly inversely related to FD. Finally, it was found that there is partial mediation between board age diversity and FD, whereas full mediation is shown between board age diversity and FD and between board nationality diversity and FD.Practical implicationsThis study provides practical insights into PSX’s board diversity for companies, regulators and policymakers.Originality/valueThis research studies the connection between board diversity and FD. In addition, the current study extended the analysis by testing for the first time the mediating role of CSR in the diversity–distress relationship, particularly in the context of an emerging economy.

Lung morphology changes in patients with COVID-induced acute respiratory distress syndrome depending on the respiratory therapy options

Background. Morphologic examination of lung tissue in COVID-related acute respiratory distress syndrome is shown in publications predominantly regarding the course of disease but not the type of respiratory support. The aim of the single center study was to determine the influence of different types of respiratory therapy on morphologic findings in lung tissue of patients, who had died from COVID-19. Material and methods. The examined patients with COVID-related related acute respiratory distress syndrome (n = 30) were divided into three groups. Group 1 included those who received non-invasive lung ventilation in continuous positive airway pressure (CPAP) mode through a face mask (n = 10), group 2 consisted of patients who received oxygen therapy with a flow of 15 l/min through a rebreather mask (n = 10), and group 3 included people who underwent invasive lung ventilation through an endotracheal tube (n = 10). Results. In lung tissue of patients of group 1, we revealed prevalence of edema and hemorrhagic changes as well as discrepancy of diffuse alveolar damage (DAD) manifestations and duration of the disease. So, morphological manifestations of exudative phase of DAD were found even after 14 days of disease, and interstitial pneumonia with fibrosing alveolitis was observed only in 12.5 % of patients. The presence of dystelectasis, compensatory emphysema and thinning of the alveolar wall were typical morphological findings in the patients of group 2. Numerous hyaline membranes covered alveolar walls and led to a decrease in gas exchange area, alveolar-capillary block and were the cause of impaired lung ventilation function. Morphological signs of proliferative phase of DAD in patients of group 3 were accompanied by the development of alveolar fibrosis and secondary bacterial bronchopneumonia, especially in prolonged invasive lung ventilation. Conclusions. Low-flow oxygen therapy may lead to the progression of respiratory failure due to self-damaging of intact lung tissue. We have also revealed negative impact of invasive pulmonary ventilation on the number of bacterial complications and fibrosis stimulation. The most favorable morphologic changes were found in patients with non-invasive CPAP ventilation.

The Relationship of the Prenatal Distress with Health Literacy and Health Perception of Pregnant Women.

The effects of health-literacy and health-perception on prenatal distress levels of pregnant women were not investigated. We aimed to examine the relationship between pregnant women's prenatal distress levels with their health-literacy and health-perception and affecting factors. This descriptive and correlational study was conducted with 223 pregnant women in Ankara, Turkey in 2021. Data were collected with a personal information form, Health Literacy Scale (HLS), Health Perception Scale (HPS), and Prenatal Distress Scale (PDS). Participants' mean score on the PDS was 11.39±6.17. Participants who had a high level of education (P=0.040), working (P=0.026), no history of miscarriage/abortion (P=0.040), and a bad relationship with their spouses (P<0.001) had significantly higher mean scores on the PDS. There was a significant negative correlation between total PDS and HLS scores (P<0.001) and a positive correlation between total PDS and HPS scores (P<0.001). Total HLS and HPS scores, spousal relationship status, education level, and employment had an effect on the mean PDS score and that the explanatory power of the model was found 21.5% (R2=0.215). Pregnant women had a moderate level of prenatal distress. While the prenatal distress levels of pregnant women with high health-literacy levels decreased, the levels of those who were employed, had a higher level of education, and had a bad relationship with their spouses increased. Awareness of the factors affecting pregnant women's prenatal distress can guide the provision of adequate care and support interventions during pregnancy.

The use of emotionally focused therapy with polyamorous relationships.

Approximately 5% of people in the United States engage in some form of consensual non-monogamy (CNM; Archives of Sexual Behavior, 2018, 47, 1439). Therapists are becoming increasingly aware of the need to treat members of CNM relationships, including polyamorous relationships. To date, no research has been conducted and little has been written about applying existing couple therapy models normed on heterosexual, cisgender, monogamous relationships to CNM or polyamorous relationships. Emotionally focused therapy (EFT) is an empirically supported treatment for relationship distress that offers promise for working with polyamorous relationships due to the model's systemic and attachment theoretical foundations. We propose EFT is an ideal model for working with polyamorous relationships because of the focus on externalizing, interpersonal and intrapersonal emotional and experiential coherence, and the attachment bond. Building and sustaining multiple attachment relationships allows for the fulfilment of a diverse range of relational needs and wants as well as provides a secure base for individual and relational exploration. In this article, we first provide general information about polyamory and discuss the research on attachment theory and polyamory. We then provide a step-by-step conceptualization of how EFT therapists can expand the model to include extra-dyadic attachment relationships. In addition, we include specific ways in which the model would need to be adapted when working with polyamorous clients. We conclude with recommendations for EFT therapists working with polyamorous relationships.

Dimensionality and psychometric properties of the Parent Diabetes Distress Scale-Greek (PDDS-Gr).

Type 1 diabetes (T1D) is a chronic disease characterised by insulin deficiency due to autoimmune destruction of beta-pancreatic cells. T1D, formerly known as juvenile diabetes, is the most common form of diabetes in children and adolescents. On diagnosis, parents of children with TID experience considerable stress, because they need to care for a child in a challenging and life-threatening situation that requires adherence to an intensive medical regimen, constant monitoring of, and coping with their child's condition. T1D is a complex condition that affects both children and their parents in many aspects of their daily lives. This study presents the psychometric properties of the Greek translation of the Parent Diabetes Distress Scale (PDDS), which assesses diabetes distress in parents of children with T1D. A sample of 95 parents, mainly mothers (88.4%), with a mean age of their children 12.2 years (± 3.6) and a diabetes duration of 4.7 years (± 3.4), completed the Greek translation of the PDDS. Exploratory factor analysis (EFA) revealed a five-factor model: 'Parent/child relationship distress', 'Personal distress', 'Child diabetes management distress', 'Future distress', and 'Healthcare team distress'. Confirmation Factor Analysis (CFA) confirmed the construct validity of the scale. The internal consistency indices (Cronbach alpha) for the subscales ranged from 0.69 to 0.89, while the unidimensional structure had an alpha of 0.90. Furthermore, convergent validity was shown with moderate positive correlations between the PDDS-Gr and the subscales of the DASS-21 (depression, anxiety, and stress), the child's age (in years), and the HbA1c value. Finally, parents of children with inadequate glycemic control (HbA1c ≥ 7%) presented higher scores on both the unidimensional structure and the subscales 'Parent/child relationship distress' and 'Healthcare team distress' of the PDDS-Gr. The PDDS-Gr is a valid and reliable tool for assessing diabetes distress in parents of children with T1D and can be used in both clinical and research settings.

Poster (Knowledge Generation) ID 1969461

Background Individuals with SCI often receive care from their family members. Caregiving responsibilities lead to caregiver burden. Receiving social support may mitigate the negative impacts of caregiving. Caregivers can obtain support from people they meet in-person, such as family members and people with whom they interact through social platforms. Objectives Our objective was to investigate the moderating effect of in-person and online social supports on the association between relationship quality, caregiver competence, caregiver distress and caregiver burden. Methods/Overview 115 caregivers who resided in Canada or the United States, understood and spoke English, and self-identified as primary family caregivers of an individual with SCI were sampled. Participants completed measures assessing relationship quality, competence, distress, burden, and in-person and online social support. Three separate moderation analyses for each outcome variable (i.e. relationship quality, competence, and distress), were conducted. In analyses, burden was the predictor, and online and in-person support were moderators. Results Moderation analyses showed that online support moderates the link between caregiver burden and distress. Slope analyses revealed that the positive relationship between burden and distress was weaker when caregivers reported lower levels of online support (p=0.005); this relationship was more robust when caregivers reported higher levels of online support (p &amp;lt;.001). Other moderation analyses were not statistically significant. Conclusions Online support increases distress in family caregivers. It is likely that comparing their life with other caregivers or being exposed to other caregivers’ grief negatively affects caregivers. More research is needed to understand how online support impacts caregivers negatively.

Functional Capacity in COVID-19 related Acute Respiratory Distress Syndrome Survivors

Background/Purpose:: The aim of this retrospective study is to determine the functional capacity, global muscle weakness and quality of life in COVID-19 survivors. Acute respiratory distress syndrome survivors frequently develop impaired physical function, quality of life, and muscle weakness.&#x0D; Methods: Acute respiratory distress syndrome survivors related to COVID-19 underwent standardized physical clinical evaluation, Medical Research Council-sumscore, hand-grip strength, 6-minute walk test, 5 repetition-chair-stand test, timed up and go test and Short form-36 evaluation following 4-6 weeks after hospital discharge in Physical Medicine and Rehabilitation Outpatient Clinic.&#x0D; Results: Fifteen patients (10 men, 5 women) with median age 69 years and length of intensive care unit stay 10 days were analyzed. There were impairments in 6-minute walk test, 5 repetition-chair-stand test, hand-grip strength and, Role-physical, Role-emotional and Social functioning domains of Short form-36. 6-minute walk distance was negatively correlated with timed up and go. SF-physical functioning was positively correlated with hand-grip strength, Medical Research Council-sumscore and 5 repetition-chair-stand. SF-general health was positively correlated with hand-grip strength.&#x0D; Conclusion: There were varying degrees of functional impairment in survivors. Therefore, it could add advantage to assess these patients after nearly 4-6 weeks following discharge in order to ascertain rehabilitation needs and giving appropriate therapies.

Efficacy of Wharton Jelly Mesenchymal Stromal Cells infusions in moderate to severe SARS-Cov-2 related acute respiratory distress syndrome: a phase 2a double-blind randomized controlled trial.

The COVID-19 pandemic caused a wave of acute respiratory distress syndrome (ARDS) with a high in-hospital mortality, especially in patients requiring invasive mechanical ventilation. Wharton Jelly-derived Mesenchymal Stromal Cells (WJ-MSCs) may counteract the pulmonary damage induced by the SARS-CoV-2 infection through pro-angiogenic effects, lung epithelial cell protection, and immunomodulation. In this randomized, double-blind, placebo-controlled phase 2a trial, adult patients receiving invasive mechanical ventilation for SARS-CoV-2 induced moderate or severe ARDS were assigned to receive 1 intravenous infusion of 1 × 106 WJ-MSCs/kg or placebo within 48 h of invasive ventilation followed by 2 infusions of 0.5 × 106 WJ-MSCs/kg or placebo over 5 days. The primary endpoint was the percentage of patients with a PaO2/FiO2 > 200 on day 10. Thirty patients were included from November 2020 to May 2021, 15 in the WJ-MSC group and 15 in the placebo group. We did not find any significant difference in the PaO2/FiO2 ratio at day 10, with 18 and 15% of WJ-MSCs and placebo-treated patients reaching a ratio >200, respectively. Survival did not differ in the 2 groups with a 20% mortality rate at day 90. While we observed a higher number of ventilation-free days at 28 days in the WJ-MSC arm, this difference was not statistically significant (median of 11 (0-22) vs. 0 (0-18), p = 0.2). The infusions were well tolerated, with a low incidence of anti-HLA alloimmunization after 90 days. While treatment with WJ-MSCs appeared safe and feasible in patients with SARS-CoV2 moderate or severe ARDS in this phase 2a trial, the treatment was not associated with an increased percentage of patients with P/F > 200 at 10d, nor did 90 day mortality improve in the treated group. https://beta.clinicaltrials.gov/study/NCT04625738, identifier NCT04625738.

Effect of sound therapy on whole scalp oscillatory brain activity and distress in chronic tinnitus patients.

Sound therapy is a common tinnitus treatment, where the tinnitus percept is either fully or partially masked by an external sound. Some tinnitus patients experience a decrease in tinnitus related distress after the use of sound therapy. Differences in the neural response to sound therapy may form a basis for classifying tinnitus patients. In this study, the long-term (2 months) effects of sound therapy on the oscillatory brain activity and tinnitus related distress were investigated in chronic tinnitus patients. Baseline oscillatory activity in the group of tinnitus participants was also compared to a matched control group. No differences were found in the oscillatory activity when comparing the tinnitus group to the control group. Differences were found for the frequency range between 27.5 and 41.5 Hz corresponding to high beta and gamma power when comparing the tinnitus group before and after the use of sound therapy. Furthermore, a reduction of the tinnitus-related distress was found after the long-term use of sound therapy. However, there was no correlation between the changes in the oscillatory activity and the reductions of the tinnitus-related distress. Overall, the lack of correlation between the changes in tinnitus-related distress and changes in power activity hampers the interpretability of the findings and undermines the utility of using oscillatory activity as a biomarker for the effect of sound therapy treatment.

A randomized controlled trial of the online OurRelationship program with varying levels of coach support

Online programs that reduce relationship distress fill a critical need; however, their scalability is limited by their reliance on coach calls. To determine the effectiveness of the online OurRelationship program with varying levels of coach support, we conducted a comparative effectiveness trial with 740 low-income couples in the United States. Couples were randomly assigned to full-coach (ncouples = 226; program as originally designed), automated-coach (ncouples = 145; as a stand-alone program with tailored automated emails only), contingent-coach (ncouples = 145; as an adaptive program where tailored automated emails are followed by more coaching if couples did not meet progress milestones), or a waitlist control condition (ncouples = 224). All analyses were conducted within a Bayesian framework. Completion rates were comparable across conditions (full-coach: 65 %, automated-coach: 59 %, contingent-coach: 54 %). All intervention couples reported reliable pre-post gains in relationship satisfaction compared to waitlist control couples (dfull = 0.46, dcontingent = 0.47, and dautomated = 0.40) with no reliable differences across intervention conditions. Over four-month follow-up, couples in full- and contingent-coach conditions maintained gains in relationship satisfaction and couples in the automated-coach condition continued to improve. Given the comparable completion rates and minimal differences in effect sizes across intervention conditions, all three coaching models appear viable; therefore, the choice of model can vary depending on available resources as well as couple or stakeholder preferences. This study was preregistered (ClinicalTrials.govNCT03568565).

Dysmenorrhea and psychological distress: a meta-analysis.

Dysmenorrhea is characterized by pelvic pain associated with menstruation. Similar to people with other pain conditions, females who experience dysmenorrhea report increased psychological distress. However, the pooled magnitude of this association has not been quantified across studies. Accordingly, this meta-analytic review quantifies the magnitude of the associations between dysmenorrhea severity and psychological distress. We conducted a systematic search of the literature using PsycINFO, PubMed, CINHAL, Embase, and Web of Science. Analyzed studies provided observational data on dysmenorrhea severity and anxiety symptoms, depressive symptoms, and/or global psychological distress. A total of 44 studies were included, and three random-effects meta-analyses were conducted, with average pooled effect sizes calculated using Person's r. We found significant, positive associations between measures of dysmenorrhea severity and measures of depressive symptoms (r = 0.216), anxiety symptoms (r = 0.207), and global psychological distress (r = 0.311). Our review suggests that females with greater dysmenorrhea severity experience greater psychological distress. Future directions include defining a clinically meaningful dysmenorrhea severity threshold, understanding the mechanisms and directionality underlying the dysmenorrhea-psychological distress relationship, and designing and testing interventions to jointly address dysmenorrhea and psychological distress.

Factors associated with family carers’ fall concern: Prospective study protocol

BackgroundFamily carers are important in preventing community-dwelling older people from falling. Family carers’ concerns about older people’s risk of falling could affect their own physical and psychological health, lifestyle, and burden of care. While there are many studies exploring factors associated with fear of falling among older people, there is no research on family carers’ fall concern of older people (care recipients) who are hospitalised. AimThis paper describes a prospective study protocol exploring the relationship of fall concern, psychological distress, and quality of life of family carers when their care recipient is hospitalised and after discharge. MethodsThe study will recruit 180 family carers and older people. Family carers providing support for an older person without cognitive impairment who has been admitted to a private metropolitan hospital in Western Australia and assessed to have a risk of falling will be included. Data will be collected using an interviewer-administered survey. All participants will complete the survey within 48 h before the patient’s discharge, follow-up one week later (only for family carers), and again 30 days after the patient is discharged. Data related to falls, fall concern, psychological distress, and quality of life will be obtained from family carers and care recipients. DiscussionThis study will provide deeper understanding about the factors affecting fall concern among family carers of older people during hospitalisation and after discharge. This will help healthcare professionals better support family carers to implement fall prevention strategies for older people whilst in hospital and in the community.