Risk Factors For Psychological Distress Research Articles

Analysis of the Degree of Psychological Distress of Elderly Patients with Recurrent Trigeminal Neuralgia and Its Influencing Factors

Objective: To analyze the degree of psychological distress among elderly patients with recurrent trigeminal neuralgia and its influencing factors. Methods: A single-center cross-sectional study was conducted on 126 elderly patients with recurrent trigeminal neuralgia who visited the Pain Department of our hospital from March 2022 to April 2024. Logistic regression analysis was employed to evaluate the factors influencing psychological distress, based on general patient data, the Distress Thermometer (DT), the Perceived Social Support from Family Scale (PSS-Fa), and the Pittsburgh Sleep Quality Index (PSQI). Results: Among the 126 elderly patients with recurrent trigeminal neuralgia, those with a DT score ≥ 4 (72 patients, 57.14%) were more prevalent than those with a DT score < 4 (54 patients, 42.86%). The average DT score for all patients was 4.35 ± 1.72. Patients in the DT score ≥ 4 group were older than those in the DT score < 4 group (t = 4.207, P = 0.000), had lower PSS-Fa scores (t = 5.925, P = 0.000), and had higher PSQI scores (t = 17.858, P = 0.000). There were no statistically significant differences in gender, marital status, residence area, education level, disease type, or pain location (all P > 0.05). Older age and poor sleep quality were identified as independent risk factors for psychological distress in elderly patients with recurrent trigeminal neuralgia (OR = 1.258, OR = 1.713, both P < 0.05), while higher levels of family support were identified as a protective factor (OR = 0.581, P = 0.025). Conclusion: Elderly patients with recurrent trigeminal neuralgia experience psychological distress, and the degree of severity depends on age, quality of sleep, and level of family support.

Internalized Homonegativity is Indirectly Associated with Smoking Status through Somatic Anxiety

Objective: In this study, we examined how internalized homonegativity (IH), a non-adaptive cognitive response to lesbian, gay, and bisexual (LGB) minority stressors, related to the manifestation of somatic anxiety symptoms and reduced the likelihood of being a former smoker. Methods: Participants (N = 77) smoked ≥ 100 cigarettes in their lifetime, some of whom successfully quit their use (N = 23 former smokers). The Lesbian, Gay, and Bisexual Identity Scale and the State-Trait Inventory for Cognitive and Somatic Anxiety were used to assess IH and somatic anxiety. Results: Current smokers experienced higher IH rates than former smokers (former = 0, current = 1; b = .65, p < .05). IH was positively associated with somatic anxiety (b = .17, p < .001), and the association between IH and smoking status was mediated through somatic anxiety (b = .17; CI = [.0002, .6539]). Conclusion: One’s experience with IH may be a risk factor for psychological distress and continued smoking. Current findings can aid in the development of future longitudinal or experimental studies

Suicidal ideation in people with multiple sclerosis and its association with coping self-efficacy

BackgroundChronic neurological disease such as multiple sclerosis (MS), is a significant risk factor for psychological distress, which can result in suicidal behaviour. Suicidal ideation (SI) is considered a harbinger of suicide-related mortality. However, so far, little is known about the role of protective factors against SI in MS. ObjectiveThis study aims to assess the association between coping self-efficacy and SI when controlled for sociodemographic variables, clinical variables, sleep-related problems, and depression. MethodsThe study sample consisted of 162 people with MS, was predominantly female (75.9 %), the mean age was 40.9 ± 11.4 years, the mean disease duration was 11.7 ± 7.1 years, and the mean functional disability score was 3.55 ± 1.1. We used the Coping Self-Efficacy scale (CSE), the General Health Questionnaire-28 (GHQ-28), the Expanded Disability Status Scale (EDSS), the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Multidimensional Fatigue Inventory (MFI). Multiple linear regressions were utilized to statistically analyse the data. ResultsAll assessed coping self-efficacy dimensions were significantly associated with SI in MS when controlled for sociodemographic variables, clinical variables, sleep-related problems, and depression. Furthermore, all assessed coping self-efficacy dimensions were able to alleviate the negative association between income, depression and SI. ConclusionPeople with MS may significantly benefit from psychological support aimed at promoting coping self-efficacy and utilization of various coping strategies. Problem-focused coping, coping focused on getting support, and coping focused on stopping unpleasant thoughts and feelings seem to have comparable associations with SI, and thus interventions aimed at empowering any of these dimensions may be beneficial in diminishing the severity of SI.

Association between workplace interpersonal relationships and psychological distress among care workers at elder care facilities.

As the number of older people requiring care continues to increase across the globe, maintaining care workers' mental health is an important task for all countries. This study examines the association between interpersonal relationships at work and psychological distress among care workers at elder care facilities in Japan. This study was a secondary data analysis of cross-sectional data. There were 406 participants who were analyzed. Questions consisted of demographic variables, psychological distress, interpersonal problems in the workplace, and intention to improve interpersonal relationships. Psychological distress was evaluated using the Japanese version of the K6 scale. Factors related to psychological distress were identified by logistic regression analysis. Prevalence of psychological distress was 53.2%. Care workers experiencing interpersonal problems in the workplace were 5.95 (95% CI: 3.82-9.43) times more likely to experience psychological distress than care workers without such problems. Moreover, those who displayed an intention to improve their interpersonal relationships were 0.33 times (95% CI: 0.15-0.71) less likely to experience psychological distress than those who did not. This study found there is a strong association between workplace interpersonal relationships and psychological distress among care workers at elder care facilities. Therefore, experiencing interpersonal problems in the workplace may be a risk factor for psychological distress, and displaying an intention to improve one's interpersonal relationships may attenuate psychological distress.

Cultural concepts of distress among Albanian young adults living in Switzerland - a qualitative study.

Existing research recognizes the critical role that social, sociodemographic, and acculturative processes play in increasing vulnerability for experiencing psychological distress among second-generation migrants. However, to date, far too little attention has been given to the study of psychological distress in this social group. The main objective of this study is to examine cultural identities, as well as expressions and causes of psychological distress among second-generation Albanian-speaking migrants in Switzerland. Semi-structured qualitative interviews were conducted with 13 Albanian-speaking participants between 19 and 35 years of age using the interview of the Barts Explanatory Model Inventory. Data were analyzed by qualitative content analysis using MAXQDA-2018 software. Study participants showed bicultural identities, which caused value conflicts and a feeling of being "caught" between Swiss and Albanian culture. Some participants experienced the fear of disappointing their parents. Others find it difficult to deal with conflicting norms and values. Parentification was another important cause within their cultural concept of distress. At the same time, (implicit) social support, i.e., spending time with the family and the community, was an important coping mechanism. Second-generation immigrants are exposed to specific risk factors for psychological distress. A better understanding of these risk factors and their coping mechanisms is essential for providing them with meaningful support services, both in prevention and psychotherapy.

Sexual Orientation, Health, and Well-Being in Spanish People.

Although several studies have found disparities in health outcomes between heterosexual and lesbian, gay, and bisexual (LGB)-identifying individuals, few studies have focused on subjective well-being and protective factors for health and well-being. The purpose of this work is twofold: (1) to examine the relevance of sexual orientation to health and well-being in women and men; (2) to identify protective and risk factors for psychological distress, self-rated health, and well-being for gay men, lesbian women, bisexual women and men, and heterosexual women and men. The sample consisted of 908 women and 586 men from the general Spanish population aged 16-64, half of whom identified themselves as LGB and half as heterosexual. All were assessed using eight questionnaires and inventories. The results showed that differences varied depending on the health indicator considered. In general, bisexuals had the poorest health, with lower self-rated health and lower self-esteem. In all groups, self-esteem was a protective factor against psychological distress and was associated with better health and well-being. To a lesser extent, social support served as a protective factor against psychological distress and was associated with greater well-being in all groups. It is concluded that although sexual orientation is relevant to the health and well-being of individuals, there are differences among sexual minorities, with bisexuals having lower self-esteem than homosexuals.

Mental Health Outcomes of Immigrant- and US-Born Caregivers: California Health Interview Survey, 2019-2020.

Objectives. To compare the mental health outcomes of US-born with immigrant caregivers of adult care recipients. Methods. We conducted a cross-sectional secondary analysis of the 2019 California Health Interview Survey (CHIS), administered via web or telephone to 22 152 participants between September and December 2019. We characterized (1) caregivers and noncaregivers, and (2) US-born versus immigrant caregivers. Then, we estimated and compared (3) the relationship between caregiving status and severe psychological distress among US-born and immigrant respondents, and (4) correlates of severe psychological distress among US-born and immigrant respondents. Results. Caregivers were more likely than noncaregivers to report severe psychological distress (P < .05). Immigrant caregivers residing separately from their care recipient were significantly more likely to experience severe psychological distress (odds ratio = 3.76; P < .01). Conclusions. US-born and immigrant caregivers may experience different risk factors for psychological distress associated with caregiving. Clinical and community resources should be tailored to caregivers' distinct needs with consideration of how access to resources (e.g., language), circumstances (e.g., acculturation), and cultural norms (e.g., filial piety) may be associated with exacerbation of psychological distress among immigrants. (Am J Public Health. 2024;114(S2):S189-S199. https://doi.org/10.2105/AJPH.2023.307396).

Self-compassion and parenting efficacy among mothers who are breast cancer survivors: Implications for psychological distress.

Mothers who are breast cancer survivors may experience psychological distress in relation to diminished parenting efficacy. Self-compassion may protect mothers from psychological distress, yet little is known about self-compassion in this population. The extent to which self-warmth (self-kindness, mindfulness and sense of common humanity) and self-coldness (self-judgement, isolation and over-identification) dimensions of self-compassion moderate parenting efficacy in predicting depression, anxiety and stress was examined in a sample of 95 mothers who were breast cancer survivors. Independently, poorer parenting efficacy was associated with more depression and stress symptoms. Within regression models, self-coldness was a direct predictor of depression, anxiety and stress, while self-warmth moderated the relationship between parenting efficacy and stress. Self-warmth presents as a potential protective factor for stress associated with poor parenting efficacy, while self-coldness is a potential direct risk factor for psychological distress. Mothers who are breast cancer survivors may benefit from self-compassion focused psychosocial interventions.

Frequency and risk factors of psychological distress among individuals with epilepsy before and during the outbreak of the SARS-CoV-2 Omicron variant in China: an online questionnaire survey

BackgroundThe COVID-19 pandemic substantially increases the risk of severe psychological distress among people with epilepsy (PWE), especially those with monthly household income < 5000 RMB or with uncontrolled seizures. Patients with Kessler scores > 12 should consult a psychiatrist, especially during major disasters. This study was aimed to compare the frequency of psychological distress among Chinese PWE before and during the outbreak of the SARS-CoV-2 Omicron variant, and to identify risk factors for such distress.MethodsIn this prospective study, we collected sociodemographic data of PWE aged > 14 years, who were treated at our center during December 1 to 15, 2022. All participants completed the 6-item Kessler Psychological Distress Scale before the outbreak and again during the outbreak. Health visitors who were unrelated to those patients during the outbreak were included as a control. Multivariate logistic regression analysis was performed to identify risk factors of severe psychological distress and its exacerbation.ResultsOf the 223 PWE, 127 were tested positive for SARS-CoV-2, while 174 of 218 controls were positive for SARS-CoV-2. The neurological symptoms were similar between PWE and controls with SARS-CoV-2. The average Kessler score of PWE was significantly higher during the outbreak than before it (9.93 ± 3.98 vs. 8.52 ± 0.23, P < 0.001). The average score of controls during the outbreak (5.146 ± 0.35, P < 0.001) was significantly lower than that of the PWE. We identified three independent predictors for severe psychological distress in PWE during the outbreak, i.e., monthly household income < 5000 RMB (OR = 0.252, 95%CI 0.064–0.998, P = 0.048), severe psychological distress before the outbreak (OR = 0.067, 95%CI 0.026–0.174, P < 0.001), and seizure onset within 30 days before the assessment during the outbreak (OR = 0.356, 95%CI 0.157–0.805, P = 0.013). Of the three predictors, the last one was also an independent predictor for exacerbation of psychological distress during the outbreak (OR = 0.302, 95%CI 0.123–0.741, P = 0.009).ConclusionsOur analysis suggests that the COVID-19 pandemic has substantially increased psychological distress of individuals with epilepsy, regardless of the viral infection or not. Various neurological symptoms similar to those of “long COVID” appeared for the first time among these individuals during the Omicron outbreak, highlighting the need for clinicians to screen carefully for this condition. Management of epilepsy during the pandemic or a similar major disaster should focus on the control of seizures and maintenance of mental health, especially among those with monthly household incomes below 5000 RMB, suffering uncontrolled seizures and having a history of severe psychological distress.

Incidence and risk factors for psychological distress in adult female patients with breast cancer: a systematic review and meta-analysis.

Cancer-related distress can be described as a complex and unpleasant combination of psychological (such as cognitive, behavioral, and emotional), social, and spiritual challenges that may impact an individual's ability to effectively cope with the physical symptoms of cancer and its treatment. Existing literature has confirmed psychological distress (PD) as an important sequela of breast cancer diagnosis and treatment. However, the incidence and risk factors for PD in adult female patients with breast cancer remain unclear; therefore, focusing on the PD of female breast cancer patients is meaningful, as they are at highest risk of contracting breast cancer, and might differ in their coping styles from men. This review aimed to identify the incidence and risk factors for PD in adult woman patients with breast cancer, and to help guide targeted intervention to prevent distress. PubMed, Embase, Cochrane Library, CINAL, PsycINFO, China Knowledge Resource Integrated Database, Wanfang Database, the Chinese Biomedical Database, and Weipu Database were searched for data regarding the incidence and risk factors of PD in adult women with breast cancer. The prevalence of PD, assessed using the distress thermometer, ranged between 11.2%-86.7%, and a meta-analysis of 47 studies with 15,157 adult female breast cancer patients showed that the pooled prevalence was 52.0%. Further, this study identified 40 risk factors. However, owing to the inclusion of at least two studies for a certain risk factor, 10 risk factors were merged for the meta-analysis. Independent risk factors included higher education level, late-stage tumor, emotional concerns, no medical insurance, modified radical mastectomy, and history of depression; age and neuroticism were not associated with PD; and higher monthly income was revealed as a protective factor against it. The incidence of PD in female patients with breast cancer is high and it involves 10 risk factors, though some are controversial owing to insufficient evidence. Further research is needed to explore the underlying mechanisms of PD and develop risk factor-based holistic intervention programs to reduce its incidence. The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023433578).

Prevalence and risk factors of psychological distress among Indonesian incarcerated male juveniles

Background/Aim: Adolescence is a developmental period that is rife with emotional problems as adolescents lack psychological maturity. Ju-venile offenders who are incarcerated may be more vulnerable to psy-chological distress. Aim of this study was to analyse the prevalence and risks of psychological distress among male juveniles (MJs) incarcerated in Indonesia. Method: The participants of this study were 206 male juvenile offenders (MJOs) aged 12-17 from 28 Special Child Development Institutions (Lem-baga Pemasyarakatan Khusus Anak; LPKA) in Indonesia. The participants' socio-demographic data was gathered while the strength and difficulties questionnaire (SDQ) was used to assess the extent of their psychological distress. Results: Of the 47.6 % of participants that reported psychological dis-tress, peer relationship problems (64.6 %) was the most severe, followed by conduct problems (51.5 %). The binary logistic regression results re-vealed that education level (p = 0.005) and psychological trauma (p &lt; 0.001) correlated with psychological distress and that they were respon-sible for 37.5 % of psychological distress. Therefore, education level and psycho-trauma significantly affect the extent of the psychological distress that MJOs in Indonesia experience. Conclusion: Juveniles require support to further their formal or informal education. Furthermore, healthcare providers could develop appropriate interventions to manage specific traumatic events as well as prevent or improve the mental health of MJOs.

A Cross-Sectional Survey on Psychological Health and Influencing Factors Among 2628 Asymptomatic and Mild COVID-19 Patients in Fangcang Shelter Hospital.

The Coronavirus disease 2019 (COVID-19) remains a global public health concern. Many people have been forced to change their lifestyles, which has led to psychological and sleep problem. This study aims to investigate the psychological health problems and factors among patients in the Fangcang Shelter Hospital (FSH) during the COVID-19 pandemic. A Cross-Sectional survey was conducted to investigate the sleep, anxiety, depression and stress disorders of 2628 asymptomatic and mild patients treated in FSH of Zhengzhou, Henan Province, from 30 October to 6 December 2022, by scanning a WeChat two-dimensional code. Sociodemographic data and influencing factors in FSH were collected, Insomnia Severity Index (ISI), 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Impact of Event Scale-Revised (IES-R) were administered. Descriptive statistics, t-tests or analysis of variance, Spearman or Pearson correlation analysis, and multivariate regression analysis were used to explore the relationships between different variables and their impact on psychological health indicators. The proportions of patients with insomnia, depressive disorder, anxiety, and stress disorders were 33.49%, 35.80%, 31.74%, and 43.57%, respectively. Spearman correlation analysis demonstrated that factors such as gender, higher education level, positive nucleic acid test results, longer illness duration, underlying diseases, and extended electronic device use were associated with elevated psychological distress scores. Notably, within FSH, extended exposure to light, a noisy environment, and sleep schedule management significantly impacted the prevalence of insomnia, depression, anxiety, and stress disorders (p<0.01). Multivariable binary logistic regression analysis identified higher education level, light exposure, noisy environment, sleep management, and electronic device usage as the primary risk factors for psychological distress. Patients in FSH face psychological distress influenced by sociodemographic factors, environment, and lifestyle, highlighting the need for integrated psychological support in healthcare, particularly in temporary medical facilities during crises.

Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry

BackgroundPsychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum.MethodsA cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions.ResultsThe prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020).ConclusionThe high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

Relationship between partner support and psychological distress among young women during pregnancy: A mixed-method study from a low- and middle-income country

BackgroundYoung pregnant women are at a higher risk of mental disorders globally. Lack of male partner support is a risk factor for psychological distress among adult women during pregnancy. However, little research has been done in India; in particular, none of the studies have concentrated on young pregnant women. MethodsA community-based cross-sectional study was conducted among young women (n = 194) during their second and third trimester of pregnancy from rural Pune, India, in 2017. Logistic regression assessed the association between male partner support and psychological distress. In-depth interviews with pregnant women (n = 10) and health workers (n = 6) were conducted, and thematic analysis was used. ResultsThe prevalence of distress was 17.01 % (95 % CI 11.7–22.3). Lack of partner support for ensuring care and rest (aOR = 4.09, 95 % CI 1.67–10.00, p= 0.002) and decision- making regarding place of delivery (aOR = 4.20, 95 % CI 1.65–10.66, p = 0.003) was associated with distress, after adjusting for in-law's support, partner's alcohol use and poverty. Findings from a qualitative study showed that lack of partner support in multiple domains, including housework, preference for a male child, and financial support, led to distress. LimitationsThe study relied on self-reported data that is subjected to recall bias. Data on established risk factors of distress, including a history of mental disorders among women during pregnancy, was not collected. ConclusionsAntenatal interventions that integrate and promote male partner support in pregnancy care and delivery care decisions and address gender bias can potentially reduce psychological distress among young women in rural Pune, India.

Exploring Risk Factors of Psychological Distress among Chinese Medical Workforce

As the pioneer in responding COVID-19 pandemic in 2019, many problems were exposed in the health system, which was concealed and neglected before the pandemic, especially mental health wellness among health workers. This paper focused on the risk factor in the health work environment, to find the external reasons for health workers as this is the most obvious and examinable way to target the association. Different risk factors in the Chinese health workplace indicated one risk factor which influences health workers in one circumstance, could also exist in other contexts. In conclusion, there is not only one risk factor associated with mental health problems, but various factors work together to trigger the bad influence. The suggestion is to pay more attention to health workers mental health wellness by monitoring their mental health status constantly, therefore, implement the intervention timely. Research and policy reviews are required for providing health workers with better circumstances, to support and sustain their mental health and well-being. Further studies are required in the Chinese rural context, as there are more challenging treatments that still require the intervention of medical professionals, and the risk factors present in remote areas may be different from those in urban medicine, so the reasons for affecting the mental health of medical staff may be different.

PIM-COVID study: protocol for a multicentre, longitudinal study measuring the psychological impact of surviving an intensive care admission due to COVID-19 on patients in the UK

IntroductionPsychological distress is common in intensive care unit (ICU) survivors and is anticipated in those who were treated for severe COVID-19 infection. This trainee-led, multicentre, observational, longitudinal study aims to...

Of fear, burnout, and stress: Comparison of psychological distress levels among frontline medicine residents during different COVID-19 pandemic waves in Pakistan

Background: While studies have evaluated the impact of coronavirus disease 2019 (COVID-19) on the mental health of healthcare workers (HCW), to our knowledge, there are no studies in Pakistan, which have compared psychological distress levels during the first and second waves of the pandemic. This study was done to assess anxiety levels of Internal Medicine residents and identify risk factors for psychological distress.&#x0D; Methodology: Cross-sectional study was conducted in the Aga Khan University Hospital, Karachi. A questionnaire comprising of demographic data and risk assessment tools, a seven-item Generalized Anxiety Disorder scale (GAD-7), and a nine-item Patient Health Questionnaire (PHQ) was used for data collection from Internal Medicine residents using nonprobability convenience sampling technique in May–June 2020 and April 2021.&#x0D; Results: A total of 88 responses were recorded. Response rate was 75.7 percent (56/74) and 43.2 percent (32/74) during the first and second waves, respectively. Mean age was 27.9 ± 3.2 years and mean clinical career in years was 3.2 ± 2.1. Majority, 51.8 percent (29/56) and 68.8 percent (22/32), were not satisfied with community prevention measures and 75 percent (42/56) and 65.6 percent (21/32) considered interventions necessary in case of psychological distress during pandemic, during the first and second waves, respectively. A higher number of HCW reported their family not supporting their frontline work during the first wave (16.1 percent vs 3.1 percent; p value 0.023). There was a statistically significant difference in psychological distress levels as median GAD-7 scores were 5(IQR 2–8) vs 9.5(IQR 3.25–13) (p value 0.009) and median PHQ-9 scores were 4(IQR 2–11) vs. 7(IQR 4–s17) (p value 0.056) during the first and second waves, respectively.&#x0D; Conclusion: There was a significant difference in anxiety levels during the first and second waves of COVID-19, and family support for frontline work was higher during the second wave. Further studies are required to assess these differences.

Day to Day and Environmental Risk Factors for Psychological Distress Among Healthcare Workers: A Mixed Methods Analysis.

Despite a growing literature on mental health among clinical staff during COVID-19, factors shaping distress for nonclinical staff are understudied and may be driven by inequalities at work. We aimed to discuss the role of workplace factors in shaping psychological distress for a diverse group of clinical, nonclinical, and other health and hospital workers (HHWs). This convergent parallel mixed-methods study with HHWs in a US hospital system included an online survey ( n = 1127) and interviews ( n = 73) collected from August 2020 to January 2021. We thematically analyzed interviews; findings informed log binomial regression estimating risk factors for severe psychological distress (Patient Health Questionnaire - 4 item version [PHQ-4] scores of 9 or greater). Qualitatively, day-to-day stressors fostered fear and anxiety, and concerns about work environments manifest as betrayal and frustration with leadership. Distress was associated with burnout, financial concerns, and feeling betrayed or unsupported by the institution and leadership. Staff in service versus clinical roles had higher risk for severe distress (adjusted prevalence ratio = 2.04, 95% confidence interval = 1.13-2.66); HHWs receiving workplace mental health support had lower risk (adjusted prevalence ratio = 0.52, 95% confidence interval = 0.29-0.92. Our mixed-methods study underscores how the pandemic brought inequalities to the surface to increase distress for vulnerable HHWs. Workplace mental health activities can support HHWs now and during future crises.

Nursing students' academic conditions, psychological distress, and intention to leave school: A cross-sectional study

Psychological distress and intention to leave school are highly prevalent among nursing students. Academic conditions, including psychosocial stressors and school-work-life conflicts, could contribute to psychological distress and intention to leave school. To explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school. Cross-sectional correlational design. Data collection was performed in February and October 2021 in two nursing schools in Canada: Cegep (publicly funded college, technical degree) and university (bachelor's degree). 230 nursing students (Cegep 131, university 99). A self-administered online questionnaire assessed academic conditions (psychosocial stressors (Demand-Control-Support, Effort-Reward Imbalance and Overcommitment scales) and school-work-life conflicts (single item)), psychological distress (Kessler-6 scale), intention to leave school, and several covariates. Poisson robust multivariate regression models were built to explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school. A large proportion of participants experienced high efforts, school-work-life conflicts, overcommitment, and psychological distress (49.5-84.7%). One out of five participants had had intention to leave school "many times" (Cegep 20.61%; university 22.22%). In adjusted analysis, overcommitment and school-work-life conflicts were associated with a higher prevalence of psychological distress (Prevalence ratio=2.10; 95% Confidence Intervals=1.15-3.84 and Prevalence ratio=2.32; 95% Confidence Intervals=1.24-4.32, respectively). Adverse associations were observed between effort-reward imbalance (Prevalence ratio=2.32; 95% Confidence Intervals=1.09-4.94) as well as school-work-life conflicts (Prevalence ratio=2.40; 95% Confidence Intervals=1.05-5.45) and intention to leave school. Academic conditions might be risk factors for psychological distress and intention to leave school among nursing students. Interventions targeting modifiable academic conditions might improve nursing students' mental health and retention.

Prevalence and Psychosocial Correlates of Diabetes Mellitus in South Africa: Results from the South African National Health and Nutrition Examination Survey (SANHANES-1).

In South Africa, there are a limited number of population estimates of the prevalence of diabetes and its association with psychosocial factors. This study investigates the prevalence of diabetes and its psychosocial correlates in both the general South African population and the Black South African subpopulation using data from the SANHANES-1. Diabetes was defined as a hemoglobin A1c (HbA1c) ≥6.5% or currently on diabetes treatment. Multivariate ordinary least squares and logistic regression models were used to determine factors associated with HbA1c and diabetes, respectively. The prevalence of diabetes was significantly higher among participants who identified as Indian, followed by White and Coloured people, and lowest among Black South Africans. General population models indicated that being Indian, older aged, having a family history of diabetes, and being overweight and obese were associated with HbA1c and diabetes, and crowding was inversely associated with HbA1c and diabetes. HbA1c was inversely associated with being White, having higher education, and residing in areas with higher levels of neighborhood crime and alcohol use. Diabetes was positively associated with psychological distress. The study highlights the importance of addressing the risk factors of psychological distress, as well as traditional risk factors and social determinants of diabetes, in the prevention and control of diabetes at individual and population levels.