Severe Hopelessness Research Articles

Investigating psychiatric morbidity, hopelessness and suicide risk in patients with 22q11.2 deletion syndrome: a case-control study

Background The psychiatric phenotype of the 22q11.2 deletion syndrome (22q11DS) has been largely described. Objectives With a case-control study design, we now compared a sample of 22q11DS patients with a psychiatric diagnosis with a sample of psychiatric patients without 22q11DS to investigate possible differences between groups for depression severity, hopelessness, and suicide. Patients with 22q11DS were divided into two groups according to the levels of hopelessness to evaluate the relationship between hopelessness and the severity of the 22q11DS, the level of disability, functional impairment, physical frailty, and autonomy level. Results Results showed that suicide risk evaluated with the C-SSRS was similar in the two groups of patients and that a diagnosis of 22q11DS does not appear to be a risk factor for suicide; however, 22q11DS patients had more severe hopelessness. Patients with a more severe clinical presentation and worse overall functioning have higher levels of depressive symptoms and hopelessness. Conclusions The results suggest the need to assess and monitor psychiatric symptoms in patients with 22q11DS.

Abstract 4126463: The Relationship Between Hope and Hopelessness in Adults with an Acute Cardiac Event

Introduction: Hope has been positively associated with behavior change in individuals screened for cardiovascular risk, and negatively associated with fatal ischemic heart disease (IHD). Hopelessness is associated with increased risk of mortality or nonfatal myocardial infarction in patients with IHD, and negatively associated with physical activity outcomes. Hope and hopelessness are sometimes considered to be ends of a continuum, yet the relationship between hope and hopelessness is not commonly examined in IHD patients. Aim: To determine the relationship between the State-Trait Hopelessness Scale (STHS) and Snyder Adult State and Adult Trait Hope Scales in a sample of patients with IHD. Hypotheses: 1) There would be an inverse relationship between hopelessness and hope as measured by the scales and 2) discriminant validity of the instruments would be confirmed. Methods: A total of 156 participants were enrolled as part of a 3-group randomized controlled trial testing an intervention to promote physical activity and reduce hopelessness. Data were collected two weeks after hospital discharge. Correlations and partial correlations were computed for all combinations of scales. Principal component analysis (PCA) was conducted on hope and hopelessness scales. Results: A total of 106 participants (68%) had moderate or high trait hope, and 92 (59%) had moderate or high state. Moderate or severe hopelessness was reported by 93 participants (59.6%) for state hopelessness and 108 participants (69.2%) for trait. There were moderately strong negative correlations (r=-0.54 to -0.66, p=<0.001) between the total STHS and the Snyder Hope scales for both full and short versions of the STHS. Correlations were virtually unchanged when adjusted for age, sex, cardiac diagnosis, and marital status (r=-0.5 to -0.63, p<0.001) indicating that as hopelessness increases, hope decreases. PCA revealed 4 factors that explained 64.7% of the variance in scores while demonstrating conceptual distinctions between the STHS and Snyder Hope scales. Conclusions: As hypothesized, as hopelessness increased, hope decreased; however, we found a proportion of patients with hopelessness who still expressed hope for the future. Discriminant validity was supported by inverse correlations and factor analyses indicating conceptual distinctions between the two instruments. Interventions to reduce hopelessness for patients with IHD may be successful since hope and hopelessness are not mutually exclusive.

Co-occurrence of anxiety and depressive symptoms, suicidal thoughts, and hopelessness in patients with narcolepsy type 1

ObjectiveTo assesses the prevalence and co-occurrence of anxiety, depressive symptoms, suicidal thoughts, and hopelessness in patients with narcolepsy type 1 (NT1).Patients/Methods. In this cross-sectional study, 127 patients with NT1 (mean age 38.2 ± 15.5 years, 53.5 % female) and 131 controls (mean age 37.4 ± 14.3 years, 59.5 % female) matched for age, sex, and education, filled in the following validated questionnaires: Beck Depression Inventory-II (BDI), State-Trait Anxiety Inventory (STAI), and Beck Hopelessness Scale (BHS). Comparisons between groups and multivariable logistic regression analyses were performed. ResultsPatients with NT1 presented significantly higher scores in BDI, suicidal thoughts (BDI-item-9), STAI-trait, STAI-state, and BHS than controls. Adjusted for age, sex, and educational level, NT1 was significantly associated with depressive symptoms (BDI≥13; OR 3.23, 95%CI 1.71–6.10), trait anxiety symptoms (STAI-trait≥38; OR 1.91, 95%CI 1.14–3.21), co-occurrence of BDI≥13 with STAI-trait≥38 (OR 2.72, 95%CI 1.47–5.05), and with STAI-state≥38 (OR 2.24, 95%CI 1.17–4.30), and moderate to severe hopelessness (BHS≥9; OR 2.95, 95%CI 1.55–5.63). ConclusionsPatients with NT1 present a multidimensional psychiatric burden and comorbidity between symptoms of depression and anxiety and suicidal thoughts, a concern that deserves tailored interventions.

Abstract 12755: Increased Physical Activity and Higher Perceived Social Support Are Associated With Improved Quality of Life in Patients With Heart Disease Reporting Hopelessness

Introduction: Hopelessness has been identified in up to 52% of patients with ischemic heart disease (IHD). Hopelessness is associated with both decreased self-reported physical activity (PA) and lower perceived social support. Quality of life (QOL) is positively associated with PA and perceived social support in patients with IHD. However, the relationships among PA, perceived social support, and QOL in patients with IHD reporting hopelessness has not been explored. Purpose: To examine the associations among PA, perceived social support, and QOL in patients with IHD reporting hopelessness. Hypotheses: 1) Higher PA and increased perceived social support are each separately associated with higher QOL. 2) PA mediates the relationship between perceived social support and QOL. Methods: Data were collected two weeks after hospital discharge from patients with moderate to severe hopelessness using the State-Trait Hopelessness Scale. Perceived social support, PA, and QOL were measured using the ENRICHED Social Support Inventory, Cardiac Rehabilitation Exercise Participation Tool, and EQ-5D-5L, respectively. Linear regression was performed to assess the associations among study variables, controlling for age, gender, marital status, and employment. Results: The majority of participants (n = 154) were male (68.2%) and non-Hispanic white (90.9%) with a mean age of 62 years (SD = 9.68). Approximately half of participants were married (53.9%) and not working (55.2%). Higher perceived social support and higher PA were each separately associated with higher QOL after adjusting for demographic variables (perceived social support: r partial = 0.23, p = 0.011; PA: r partial = 0.23, p = 0.007). PA partially (21.30%) (r partial = 0.181, p = 0.040) mediated the relationship between perceived social support and QOL (r partial = 0.172, p = 0.066), suggesting that increasing perceived social support may improve PA, thus improving patients’ QOL. Conclusions: Our hypotheses of positive association among PA, perceived social support, and QOL were confirmed. Further research in larger, more heterogeneous samples is needed to examine potential causal relationships among PA, perceived social support and QOL in patients with IHD who report hopelessness.

Risk factors and alarm signs associated with suicide

Introduction: suicide is the second cause of death in Ecuador, according to the INEC the statistics of death by suicide in adolescents from 10 to 19 years old is 13,1 % because this stage brings with it physical and psychological changes causing drastic behavior changes, which are influenced by factors and signs associated with suicide.Objective: to determine the risk factors and warning signs associated with suicide in adolescents at the Héroes del Cenepa Educational Unit located in the Pastaza province, Mera canton.Methods: quantitative approach, descriptive study design, cross-sectional, study population of 160 adolescents in the middle stage between the ages of 14 and 18, high school students of the Héroes del Cenepa Educational Unit.Results: the findings for most relevant risk factors and warning signs of suicide were neglected personal appearance (24,38 %) (Personal Domain), intrafamily violence - verbal and psychological (23,13 %) (Family Domain); mistreatment at school (bullying) - sometimes (53,13 %), the suicidal risk according to the Plutchik scale is 33,75 % (Mild/moderate) and according to the Beck A. scale it is 67,50 %. (Suicide Risk Predictor – moderate and severe hopelessness).Conclusions: the investigated population presents predominant risk factors. Suicidal risk (Plutchik and Beck A. Scales) is high, it is recommended to implement health care programs to reduce the incidence of suicide

Body image and hopelessness in older adults: The intervening roles of aging self-stereotypes and marital status.

The aim of the current study was to examine the association between body image and hopelessness as well as the roles of aging self-stereotypes and marital status in this association in older adults. There were 821 older adults who participated in the present study and completed questionaries about body image, aging self-stereotypes, hopelessness, demographic information (age and sex), marital status, and health status. The results showed that body image was associated with hopelessness in older adults, and aging self-stereotypes mediated the link between body image and hopelessness. Moderated analyses further indicated that the path from body image to aging self-stereotypes was stronger for single older adults than for those who were married. The results emphasize that older adults' dissatisfaction with their body image can enhance negative aging self-stereotypes, which then result in more severe hopelessness. Marital relationships can alleviate the negative effect of body image on aging self-stereotypes in older adults.

Correlation of Spiritual Well-Being and Hopelessness In Leukemia Patients at District Peshawar Cancer Hospitals.

Background: Cancer is considered the most fatal diseases which is accountable for Cancer second leading cause of death in the developed country like United States and contributes to a high mortality rate in all age groups. Patient with cancer face life-threating situation through the period of diseases process. Aim: To explore the spiritual well-being and hopelessness among the leukemia patient and it correlation with each other. Methodology: A descriptive correlation design was used while patient with leukemia were the study participants and HMC and IRNUM were study setting. Sample size of the study was 320 while using consecutive sampling technique. Data was collected through two valid and reliable questionnaires of spiritual well-being and hopelessness, after the approval of study by IRB. Results: In the study majority of the participants were male 213(67%) and female 107(33%) In spiritual well-being the higher number of participants was moderate spiritual well-being (66%), followed by higher spiritual well-being (22%) and poor spiritual well-being (12%). The higher number of participant hopelessness were moderate (49%), then severe hopelessness (28%), and mild hopelessness (23%). Conclusion: The study concluded that there is a positive correlation between spiritual well-being and hopelessness. Spiritual and religious well-being is important to cope with these issues and improves quality of life. Keywords: Hopelessness, Cancer, spiritual well-being, leukemia

Sexual abuse, psychological symptoms and hopelessness among runaway female adolescents in Turkey

ABSTRACT This seminal study from Turkey investigates sexual abuse (SA) victimization, psychological symptoms, and hopelessness in female adolescents with runaway behavior. A total of 76 female adolescent participants aged 15–18 completed the Brief Symptom Inventory (BSI) and Beck Hopelessness Scale (BHS). Among these adolescents, 63.1% (n = 48) were victims of SA, 61.8% (n = 47) had a Global Severity Index (GSI) T-score of 63 or above, and 68.4% (n = 52) had moderate–severe hopelessness. Although there was no significant difference, the SA rate was higher in those who had experienced SA before running away. ‘Intrafamilial relationship problems’ and ‘SA-related factors’ were the most frequently reported reasons for runaway behavior. Victims of SA had significantly higher scores in all BSI subdimensions and global symptom severity than those previously not SA victims. The results suggest that high levels of psychological symptoms, hopelessness, history of SA, and poor parent–child relationships are possible factors that can describe female adolescents who have run away from home. Psychosocial prevention programs involving adolescents and parents are needed to prevent at-risk female adolescents from running away from home.

A Mixed-Methods and Prospective Approach to Understanding Coping Behaviors, Depression, Hopelessness, and Acute Stress in a U.S. Convenience Sample During the COVID-19 Pandemic.

The COVID-19 pandemic has led to increases in U.S. residents' stressors while limiting many of the resources previously available to cope with stress. Coping behaviors may contribute to the prevention or proliferation of psychological distress during and after the pandemic. Understanding these coping behaviors and associated psychological outcomes can help health educators develop programs that encourage effective coping and promote mental health. This study used a sequential mixed-methods approach informed by Roth and Cohen's conceptualization of coping to understand the use of approach coping behaviors- which are active and directed toward the perceived threat-and avoidance coping behaviors-which include activity directed away from perceived threat during the COVID-19 pandemic. U.S. residents (N = 2,987) were surveyed online in April 2020 and again in September 2021. Open-ended responses at baseline were thematically analyzed to illustrate coping behaviors in participants' own words. At baseline, more than half (56%) of the sample met criteria for probable depression, 51% for acute stress symptoms, and 42% for moderate to severe hopelessness. At follow-up, 45% meet criteria for probable depression and 23% for acute stress. However, the proportion of the sample who reported moderate to severe hopelessness increased to 48%. We used mixed-effects general linear models to examine changes over time and found that increases in approach coping behaviors were associated with decreases in depressive symptoms and hopelessness; increases in avoidance coping were associated with higher levels of depressive symptoms and higher levels of hopelessness. Increases in both types of coping were associated with increases in acute stress symptoms related to COVID-19. Although there was some attenuation in distress in our sample between April 2020 and September 2021, our findings suggest a need for interventions that encourage the use of approach coping behaviors and that both increase access to and decrease stigma for mental health support.

Hopelessness and HIV infection: an exploratory study with a gender-specific perspective

BackgroundAn understudied psychological response to HIV-related stressors among people living with HIV is hopelessness. Hopelessness is the expectation that things will not improve and feeling helpless to change one’s current situation. The aim of this study was to assess prevalence and levels of hopelessness and its direct and indirect contributors in people living with HIV in Sweden.MethodsParticipants included 967 women and men from the “Living with HIV in Sweden” cross-sectional study with available data regarding hopelessness measured by the Beck Hopelessness Scale. Binary and multiple logistic regression analyses were used to determine direct and indirect factors that may contribute to feelings of hopelessness. Path analyses were used to assess the underlying structure of hopelessness. All analyses were conducted by gender.ResultsAlmost half the participants reported moderate to severe hopelessness. There were no differences in frequency of feeling hopeless or level of hopelessness by gender or sexual orientation. Dissatisfaction with finances, dissatisfaction with physical health, and low HIV-related emotional support were found to be directly associated with hopelessness for both women and men. Although having some indirect factors in common, unemployment and HIV stigmatization, women and men had different underlying structures of hopelessness.ConclusionsOur findings are important to HIV clinicians in identifying those at risk of hopelessness from a gender perspective in order to reduce preventable psychological distress among people living with HIV.

Depression and Psycho-Social Well Being in emerging adulthood

Introduction Depression is defined as a state of feeling sad, severe hopelessness and dejection: a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way. Depression imposes itself not only on adults but it takes its toll on children and adolescents as well. Normally, parents want their children to be happy. Despite their best to provide and protect them, children still encounter disappointments, frustrations, or real heartbreak. The current study is an attempt to investigate depression and possible risk factors in adolescents in relation to psycho-social well-being in adolescents. Methodology A cross sectional survey research design was adopted in order to address the problem of depressive symptoms, risk factors and psychosocial well-being of adolescents in secondary schools. A total of 400 male and female emerging adults served as subjects in the study. Questionnaire was used to collect quantitative data. While qualitative data was collected with the use of focus group discussion and interview to buttress quantitative data collected with questionnaire. Chi- square was used to analyze the quantitative data and a thematic content assessment was used to analyze qualitative data. Results The results revealed that depression is negatively correlated with various dimensions of psycho-social well being and there exist a significant difference among male and female adolescents in context of depression. Again, findings reveal that the psychosocial well-being of adolescents is significantly affected by anxiety symptom. Equally it was retained that loneliness, low self-esteem and aggression has a significant negative effect on adolescents psychosocial well-being. It is thus, recommended that it will necessary to utilize the results of this study to implement programs or courses in psychology that will inform people about the early signs of adolescent risk factors and symptoms of depression. Implication This implies that a good proportion of adolescents in secondary schools are seen to portray some symptoms and risk factors for depression which has negatively affected their well-being both socially and psychologically. It is hope that this study will be helpful in highlighting the undesirable nature of depression among adolescents.

Abstract 11534: Persistent Hopelessness is Reduced in Home Exercisers in a Primarily Rural Population of Adults with Ischemic Heart Disease

Introduction: Hopelessness and rurality are each associated with increased mortality in adults with ischemic heart disease (IHD), yet there is no known research examining hopelessness in rural adults with IHD. Purpose: This pilot study examined state hopelessness in a primarily rural population of adults with IHD living in West-Northcentral United States. Methods: A longitudinal design was used to collect data from 42 participants during their hospitalization with IHD and at a long-term recovery time point. Rural-Urban Commuting Area (RUCA) codes were used to stratify participants by rurality level, with 64% (n=28) categorized as rural. The relationships between changes in hopelessness and other variables were evaluated with both single- and multi-variable linear models. Results: A moderate to severe level of state hopelessness (>1.8 on the State-Trait Hopelessness Scale) was present in 47.6% (n=20) of participants during their hospitalization and persisted over time, with 57.1% (n=24) of participants reporting hopelessness between 200 to 540 days post-hospital discharge (p=0.42). Changes in state hopelessness levels from baseline to follow-up were not significantly associated with demographics, rurality, prior or current exercise, prior depression, depression score (measured by the Patient Health Questionnaire-8), or time to follow-up (p>0.05). However, participation in home-based exercise (measured by the Cardiac Rehabilitation Exercise Participation Tool) was associated with a significant decrease in state hopelessness among those reporting moderate to severe state hopelessness (n=20) at baseline, with an estimated decrease of 0.72 points in hopelessness levels (SE=0.32; p=0.04). There was no association for hospital-based exercise (p=0.91). Conclusions: Hopelessness symptoms were frequent and persistent in a primarily rural sample of adults with IHD, with a decrease in symptoms observed in the moderately to severely hopeless who participated in home-based exercise. Knowledge of hopelessness in rural IHD patients is important for health care professionals in acute care and outpatient settings so at-risk patients can be identified and interventions employed. Future work should replicate these findings in larger samples.

Association Between Hopelessness And Suicidal Ideation In Iranian Medical Students: A Cross-Sectional Study.

There are limited studies regarding suicidal ideation among Iranian medical students. We aimed to evaluate the prevalence of suicidal ideation and its association with hopelessness among Tehran University of Medical Sciences (TUMS) medical students. We designed a cross-sectional study conducted in TUMS in 2018. We developed a questionnaire consisting of three parts; the Beck Hopelessness Scale (BHS), four questions regarding suicidal ideation, and questions regarding demographic characteristics. We used the available sampling technique and sent the questionnaire to 517 medical students of TUMS. In total, 224 medical students completed and sent back the questionnaire (response rate=43.32%). Participants' mean age was 22.68 (SD=3.38) years, and 140 participants (62.5%) were female. One hundred seven students (47.76%) had mild, 58 (25.89%) had moderate, and 13 (5.8%) had severe hopelessness. Males, senior students, and dissatisfied students with their academic performance experienced more severe hopelessness (P<0.05). Thirty-six participants (16.07%) had suicidal ideation. After adjusting for age, gender, marital status, and student's satisfaction with their academic performance, BHS total score was independently associated with suicidal ideation (OR=1.29, 95% CI=1.14-1.46, P<0.0001). The prevalence of suicidal ideation and hopelessness is relatively high among Iranian medical students. Students with more severe hopelessness are at higher risk of suicidal ideation, and evaluating hopelessness among medical students can be used to screen medical students at risk of suicidal ideation.

The primary care physicians' despair levels: Original research article.

The profession of medicine is very depressing both mentally and physically. There were studies conducted to investigate the reasons of depression and burnout. Hopelessness leads to depression and may be it is the first sign. The aim of our study is to determine the despair levels of primary care physicians. This research is a descriptive study. The study conducted with family physicians and Beck Hopelessness Scale was applied. Statistical analysis of the data was performed using IBM SPSS 23. 40.9% of those without children, 48.9% of those with chronic diseases, 47% of those who had been subjected to violence and 53.5% of those who are not satisfied with working in the primary care received severe hopelessness scores, and these score were significant (P<.05). The dissatisfied aspects of Family Medicine System should be examined in detail, and necessary measures should be taken against violence, which is a common problem in the whole healthcare sector. In this way, employee satisfaction and therefore patient satisfaction can be achieved.

Which Nutritional and Demographic Characteristics Effect Hopelessness in Young Adults: A Cross-Sectional Study of University Students from Turkey

Objectives: Aim of the study to investigate the effects of nutritional status and demographic characteristic on hopelessness of university students. Study Design: A cross-sectional study with random sampling of students who age between 17-25 years, at XXXXXXXX University. A questionnaire form investigating demographic characteristics and nutritional habits was applied to students. Food frequency questionnaire form and also Beck Hopelessness Scale was used. Total scores range from 0–20 point and it categorized according to symptom severity as follows: 0–3: normal; 4–8: mild; 9–14: moderate; 15–20: severe hopelessness. Statistical analysis of the data was evaluated with SPSS 21.0 statistical package program. p <0.05 was considered statistically significant. Results: The mean hopelessness score of student was 4.63±3.75 and mean of most of their hopelessness scores (50.1%) was normal. Sleeping 5-6 hours and ≥10 hours, using smoke and alcohol, using alcohol at least one time or more in a week was associated with higher hopelessness score and skipping meal was associated with low hopelessness score (p<0.05). Unhealty foods such as processed meat product, fried vegetable, fried potato, soup (ready), peanut butter, candies, hamburger, ketchup, margarine, mayonnaise, cips was associated with higher hopelessness score when consumed frequently (daily or 5-6 times in a week) (p<0.05). Conclusion: Mean hopelessness score of university students which we examined was determined as normal. Sleeping time, using smoke and alcohol, consuming usually unhealty foods were relationship with hopelessnes scale.

Effect of the COVID-19 pandemic on anxiety, depression, hopelessness, and sleepiness levels of obstetricians and gynecologists in Turkey

Introduction: The coronavirus disease 2019 (Covid-19), emerged as a severe respiratory system disease in Wuhan city of China in December 2019 and suddenly spread through the world, so called a pandemic by World Health Organisation. The rapid transmission of Covid-19 pandemic increased the workload of healthcare staff. Additionally to workload, unknowns of the disease like treatment strategies, tips of protection methods have increased the distress of healthcare workers and have the risk to detoriate the mental status. All that psychological and physical stress factors may quickly destroy the anxiety level, sleep quality and mood of the healthcare workers. Materials and methods: In the study, a survey composed of socio-demographic features, Beck Anxiety Scale, Beck Depression Scale, Beck Hopelessness Scale and Epworth Sleepiness Scale of participants were used as data collection tool. . The internet survey is hold on from 18th April to 2nd May 2020 and completed survey count arrived to number 122. Results:According to results, 20.5% moderate and 8.2% of the physicians have shown severe depression signs. When anxiety levels were examined 83.7% of the physicians have displayed mild signs, 9.8% moderate and 6.5% have displayed severe anxiety signs. When hopelessness of the physicians were investigated, 29.5% of them have moderate and 8.2% have severe hopelessness signs. According to sleepiness situations, 20.5% of them have shown severe sleepiness signs. Conclusion: As anxiety levels of obstetricians and gynecologists have increased at pandemic period, depression levels have increased strongly; hopes of physicians have decreased and slept off.

Assessment of Parental Hopelessness For A Child With Cancer

Background: The feeling of hopelessness begins immediately after the diagnosis &amp; continues through the treatment. Caring and treatment of a child with cancer brings an enormous physical, psychological, social &amp; economical burden upon the family.&#x0D; Objective: The objective of the study was to assess the level of hopelessness of the parents with a child suffering from cancer.&#x0D; Materials and Methods: The study was conducted among 217 parents with childhood cancer among which 129 were mothers and 88 were fathers, recruited from the Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital, Dhaka from January 2018 to November 2018. The research participants were selected following the convenient method of sampling on the basis of defined selection criteria. The data were collected by face to face interview of the respondents respectively maintaining privacy and confidentiality using a questionnaire called Beck Hopelessness Scale. The research instruments were interviewer's questionnaire and hopeless measuring standard scales.&#x0D; Results: A total 19.4 %( n=42) had severe hopelessness and 4.6%(n=10) had minimal hopelessness status. That, mothers were more severely affected by hopelessness than fathers. Among the 19.4% of the parents with severe hopelessness 2 28.7%,(n =37) were mothers and only 5.7%,(n=5) were fathers. That parents who were less educated were more severely affected by hopelessness than higher educated parents.&#x0D; Conclusion: Efficiently designed investigations are important to assess and treat psychological distress of the parents with childhood cancer patient.&#x0D; KYAMC Journal Vol. 11, No.-4, January 2021, Page 184-188

Anjiotensin Dönüştürücü Enzim İnhibitörü ya da Anjiotensin Reseptör Blokörü Kullanan Kardiyovasküler Hastalarda COVID-19 Pandemisinin Sosyal, Psikolojik ve Klinik Etkileri

Objective: The heart expresses angiotensin converting enzyme (ACE)-2 that makes it vulnerable to severe acute respiratory syndrome-coronavirus-2. Besides ACE inhibitors/angiotensin receptor blockers (ARBs) are used for cardiovascular diseases. Although no significant increase in the risk of coronavirus disease-2019 (COVID-19) infection and no increase in the severity of disease in patients receving ACE inhibitor/ARB therapy were shown, it has been noticed that some patients have tendency to stop the use of these agents. The aim of this study is to determine the behavior attitude of the cardiovascular outpatients during pandemic who use ACE inhibitor/ARB and to asses the impact of COVID19 on them. Material and Methods: One hundred outpatients were included. A survey questioning the social, psychological and the clinical implications of COVID-19 was applied to volunteers. To measure the anxiety and despair levels, Beck scorings were used. Results: A small number of patients stopped using ACE inhibitors/ARBs. Severe hopelessness and severe anxiety levels were seen in a few patient. Gender, fear of getting sick, thinking to have enough information about COVID-19 and accessibilty to cardiovascular drugs were the factors affecting the Beck scores. Social distancing and cleaning hands are stated as the best measures for protection. Most of the patients preferred primary health clinics for routine controls and a few patient had knowledge about tele-medicine. Conclusion: Although a confusion has occured in the public about the use of ACE inhibitors/ARBs, drug release rates were found to be low. The anxiety and disparity levels are subsantially not severe. But it is still important to continue informing patients about the precautions and the use of tele-medicine.

Suicide Risk Management Protocol for a Randomized Controlled Trial of Cardiac Patients Reporting Hopelessness.

Investigators conducting studies that include potentially suicidal individuals are obligated to develop a suicide risk management (SRM) protocol. There is little available in the literature to guide researchers in SRM protocol development. The aim of the study was to describe an SRM protocol developed for a randomized controlled trial (RCT) currently enrolling cardiac patients who report moderate to severe levels of hopelessness. The SRM protocol identifies suicidal ideation and measures ideation severity through use of the Columbia-Suicide Severity Rating Scale risk factor questions. Based on responses, study participants are deemed safe or at low, moderate, or high risk for suicide. The SRM protocol guides research staff through a plan of action based on risk level. The protocol further guides staff through a plan over the course of this prospective study-from hospital enrollment to home-based visits. Research staff are well trained to identify suicidal ideation risk factors, initiate specific questioning about suicidal intent, determine level of risk, identify protective factors and a safe environment, and make referrals if needed. Of the 51 patients hospitalized with cardiac disease who reported moderate to severe hopelessness, 43 scored at a safe suicide risk level and 8 scored at low risk. Thirty-five of the 51 patients enrolled in the RCT. Of the 35 participants who received home visits to date, there have been three instances of low and one instance of moderate suicide risk. The SRM protocol has been consistently and accurately used by research personnel in both hospital and home settings. One modification has been made to the protocol since study activation, namely, the addition of an assessment of counseling history and encouragement of continued counseling. Booster training sessions of research staff will continue throughout the course of the RCT. Use of the SRM protocol identifies study participants who are safe or at risk for suicide in both hospital and home settings, and research staff can refer participants accordingly. The SRM protocol developed for this RCT can serve as a model in the development of SRM protocols for future research in acute care, community, or home-based settings.

Determination of Hopelessness Levels of Final Year Students of The Faculty of Medicine

Background: Hopelessness, which includes both the characteristics of depression and anxiety, is thought to be triggered by environmental stress. In case of hopelessness, emotional disorders, despair and inability to solve problems arise. This study was conducted to determine the level of hopelessness of the final year students in medical school and to determine whether there is a difference in the levels of hopelessness according to gender and age variables.Methods: A total of 124 medical faculty last year students, 60 of them (48.4%) male, were included in this study. Using the Beck's Hopelessness Scale Score, the hopelessness levels of the students and the three major aspects of hopelessness, i.e. feelings and expectations about the future, loss of motivation and hopes about the future were evaluated.Results: The mean Beck's Hopelessness Scale Score of the students was 6.29 . 30.6% of the students had no hopelessness, 48.4% had mild hopelessness, 13.7% had moderate hopelessness and 7.3% had severe hopelessness. No statistically significant difference was found between gender and age groups. For the students who preferred medical school to serve humanity, the mean Beck's Hopelessness Scale Score were significantly lower than those who did not prefer for this purpose; Beck's Hopelessness Scale Score means were found to be significantly higher for those who preferred to earn more money. While the majority of the students (89%) did not have any professional future concerns, it was found that the Beck's Hopelessness Scale Score mean was significantly higher in students who were concerned about not being able to earn enough in the future.Conclusion: It was found that the students' feelings and expectations about the future were not negative, the loss of motivation was not significant and the hopes about the future were quite high.