Short Warwick-Edinburgh Mental Well-being Scale Research Articles

A cross-sectional study of Malaysian low-income drug addict wives: Relationship between family impact, coping and mental wellbeing

Background: The involvement of the husbands in the issue of drug addiction has impacted the wives’ livelihoods. Due to drug addiction amongst husbands, the wives experience stress and strain. The Stress Strain Coping Support Model (SSCS) was established to better comprehend how coping influences stress and strain. Thus, the purpose of this study was to determine the relationship between the stress which refers to family impact experienced by the wives of drug addicts, in terms of economic difficulties and marital conflict, and mental wellbeing. Furthermore, this study examines the role of coping as a mediating factor between family impact and mental wellbeing. Methods: This study involved 132 wives of low-income drug addicts in Malaysia, who were selected using a purposive sampling method. Economic Strain Scale (ESS) and Braiker-Kelly Marital Conflict Scale (BKMCS) were used to measure family impact. Coping and Adaptation Processing Scale Short Form (CAPS-SF) and Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) were used to measure coping and mental wellbeing of the respective respondents. Results: Path analysis using SmartPLS software version 3.3.7 showed that there is a direct association between family impact and coping, and between coping and mental wellbeing. The results also showed that family impact was associated indirectly with mental wellbeing through coping. Conclusions: The findings benefited drug addict wives and practitioners related to this field in terms of enhancing the use of coping mechanisms in managing family impact and improving mental wellbeing, specifically amongst low-income drug addict wives.

Sleep Quality, Wellbeing and Happiness in Medical Undergraduates in Western India

Background: Medical students appear to be one group that is especially vulnerable to sleep problems. The study's objective was to evaluate the sleep quality, wellbeing, and happiness of Indian medical students at various stages of their education, as well as students from all three major streams (allopathic, ayurveda, and homoeopathic medicine). Methodology: A convenience sample of 873 medical students was used in this cross-sectional and questionnaire-based study, which included homoeopathic (n=205), allopathic (n=389), and ayurvedic (n=279) medical students. The tools used were the Medical Outcomes Study Sleep Scale, the Short Depression – Happiness Scale, and the Short Warwick-Edinburgh Mental Well-Being Scale. Results: Students in the Allopathic stream showed statistically significantly worse sleep quality ratings than students in the Homoeopathic and Ayurvedic streams. Further, when compared to students in the second and fourth years, third-year students had significantly lower sleep quality ratings. The happiness measure had a statistically significant positive relationship with wellbeing (rho = 0.56, p.001), sleep quality (rho = 0.13, p.001), and sleep adequacy (rho = 0.25, p.001). Conclusion: Sleep is essential for maintaining human bio-psychosocial homeostasis. A concerted effort should be made to educate medical students about sleep hygiene and practical techniques to improve their sleep quality.

The effect of a therapeutic smartphone application on suicidal ideation in young adults: Findings from a randomized controlled trial in Australia.

BackgroundSuicidal ideation is a major risk for a suicide attempt in younger people, such that reducing severity of ideation is an important target for suicide prevention. Smartphone applications present a new opportunity for managing ideation in young adults; however, confirmatory evidence for efficacy from randomized trials is lacking. The objective of this study was to assess whether a therapeutic smartphone application (“LifeBuoy”) was superior to an attention-matched control application at reducing the severity of suicidal ideation.Methods and findingsIn this 2-arm parallel, double-blind, randomized controlled trial, 455 young adults from Australia experiencing recent suicidal ideation and aged 18 to 25 years were randomly assigned in a 2:2 ratio to use a smartphone application for 6 weeks in May 2020, with the final follow-up in October 2020. The primary outcome was change in suicidal ideation symptom severity scores from baseline (T0) to postintervention (T1) and 3-month postintervention follow-up (T2), measured using the Suicidal Ideation Attributes Scale (SIDAS). Secondary outcomes were symptom changes in depression (Patient Health Questionnaire-9, PHQ-9), generalized anxiety (Generalized Anxiety Disorder-7, GAD-7), distress (Distress Questionnaire-5, DQ5), and well-being (Short Warwick–Edinburgh Mental Well-Being Scale, SWEMWBS). This trial was conducted online, using a targeted social media recruitment strategy. The intervention groups were provided with a self-guided smartphone application based on dialectical behavior therapy (DBT; “LifeBuoy”) to improve emotion regulation and distress tolerance. The control group were provided a smartphone application that looked like LifeBuoy (“LifeBuoy-C”), but delivered general (nontherapeutic) information on a range of health and lifestyle topics. Among 228 participants randomized to LifeBuoy, 110 did not complete the final survey; among 227 participants randomized to the control condition, 91 did not complete the final survey. All randomized participants were included in the intent-to-treat analysis for the primary and secondary outcomes. There was a significant time × condition effect for suicidal ideation scores in favor of LifeBuoy at T1 (p < 0.001, d = 0.45) and T2 (p = 0.007, d = 0.34). There were no superior intervention effects for LifeBuoy on any secondary mental health outcomes from baseline to T1 or T2 [p-values: 0.069 to 0.896]. No serious adverse events (suicide attempts requiring medical care) were reported.The main limitations of the study are the lack of sample size calculations supporting the study to be powered to detect changes in secondary outcomes and a high attrition rate at T2, which may lead efficacy to be overestimated.ConclusionsLifeBuoy was associated with superior improvements in suicidal ideation severity, but not secondary mental health outcomes, compared to the control application, LifeBuoy-C. Digital therapeutics may need to be purposefully designed to target a specific health outcome to have efficacy.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12619001671156

Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19.

Academic stress may be the single most dominant stress factor that affects the mental well-being of college students. Some groups of students may experience more stress than others, and the coronavirus disease 19 (COVID-19) pandemic could further complicate the stress response. We surveyed 843 college students and evaluated whether academic stress levels affected their mental health, and if so, whether there were specific vulnerable groups by gender, race/ethnicity, year of study, and reaction to the pandemic. Using a combination of scores from the Perception of Academic Stress Scale (PAS) and the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), we found a significant correlation between worse academic stress and poor mental well-being in all the students, who also reported an exacerbation of stress in response to the pandemic. In addition, SWEMWBS scores revealed the lowest mental health and highest academic stress in non-binary individuals, and the opposite trend was observed for both the measures in men. Furthermore, women and non-binary students reported higher academic stress than men, as indicated by PAS scores. The same pattern held as a reaction to COVID-19-related stress. PAS scores and responses to the pandemic varied by the year of study, but no obvious patterns emerged. These results indicate that academic stress in college is significantly correlated to psychological well-being in the students who responded to this survey. In addition, some groups of college students are more affected by stress than others, and additional resources and support should be provided to them.

Wellbeing and Social Network Characteristics in Rural Communities: Findings from a Cohort in Social Housing in Cornwall, United Kingdom

The mental wellbeing of those living in resource poor and rural localities is a public health priority. Despite evidence of a link between social networks and mental wellbeing, little is known about this relationship in the context of rural and resource poor environments. The current study uses novel social network methodology to investigate the extent to which social network size and composition is related to mental wellbeing in a social housing community in rural England. Data come from 88 individuals living in social housing in Cornwall. These participants are part of a larger study of 329 social housing households surveyed in 2017 and 2018. Mental wellbeing was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). A series of multivariable linear regression models were used to test associations between social network characteristics and mental wellbeing. Social network size was significantly associated with the SWEMWBS (b = 0.39, p < 0.01), such that individuals with larger networks reported better mental wellbeing, but after controlling for community social cohesion, this effect dissipated. Neither gender composition or talking with network members about health and wellbeing were significantly associated with the SWEMWBS. Findings suggest that both the quantity of social connections and perceptions of community cohesion are moderately associated with mental wellbeing in rural and resource poor localities. As such, efforts to improve mental wellbeing would benefit from targeting multiple aspects of social relationships, rather than focusing solely on increasing the size of individuals’ social networks.

Well-being app to support young people during the COVID-19 pandemic: randomised controlled trial

ObjectivesTo evaluate the efficacy and acceptability of ‘Whitu: seven ways in seven days’, a well-being application (app) for young people.DesignProspective randomised controlled trial of Whitu against waitlist control, with 45...

Immersive Reality Experience Technology for Reducing Social Isolation and Improving Social Connectedness and Well-being of Children and Young People Who Are Hospitalized: Open Trial.

BackgroundChildren and young people who are hospitalized can feel disconnected from their peers and families, which can, in turn, predispose them to psychological problems, including anxiety and depression. Immersive reality experience technology, recently developed by the New Zealand Patience Project Charitable Trust, may help to overcome these issues. Immersive reality experience technology uses immersive 360° live streaming and a virtual reality headset to enable children and young people who are hospitalized to connect through cameras located in either their school or home environment and via SMS text messaging with a designated buddy.ObjectiveThis trial aims to expand qualitative findings from a previous smaller proof of concept trial to ascertain the views of New Zealand children and young people who are hospitalized, their caregivers, and teachers regarding immersive reality experience technology and quantitatively evaluate the effectiveness of immersive reality experience technology in reducing social isolation and improving social connectedness and well-being using validated outcome measures.MethodsAn open trial of immersive reality experience technology was conducted between December 2019 and December 2020 for which 19 New Zealand children and young people aged 13 to 18 years who had been hospitalized at Starship Hospital—a specialist pediatric hospital in Auckland—for at least 2 weeks were recruited. All young people completed the Short Warwick–Edinburgh Mental Well-Being Scale, an abbreviated version of the Social Connectedness Scale, and the Social Inclusion Scale at baseline. Of the 19 participants, 10 (53%) used immersive reality experience technology as often as they wished over a 6-week period and completed postintervention measures. Semistructured interviews with a subset of the 10 young people, 4 caregivers, and 6 teachers were conducted immediately after the intervention.ResultsParticipants reported improvements in social inclusion (mean change 3.9, SD 2.8; P=.06), social connectedness (mean change 14.2, SD 10.0; P=.002), and well-being (mean change 5.7, SD 4.0; P=.001). Key themes from interviews with participants, caregivers, and teachers were the importance of support for using immersive reality experience technology, connecting versus connectedness, choice and connection, and the value of setting it up and getting it right. Recommendations for improving connectedness via immersive reality experience and related technologies were also provided.ConclusionsImmersive reality experience technology can improve the social inclusion, social connectedness, and well-being of New Zealand children and young people who are hospitalized. With some technological modifications and simplified implementation, immersive reality experience and related technology could become part of standard care and support children and young people who are hospitalized in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems, and more easily return to normal life following the completion of treatment.Trial RegistrationAustralian New Zealand Clinical Trials Network Registry ACTRN12619000252112; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376837&isReview=true

The use of composite time trade-off and discrete choice experiment methods for the valuation of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): a think-aloud study

PurposeTo identify patterns and problems in completing composite time trade-off (C-TTO) and discrete choice experiment (DCE) exercises for the valuation of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) to inform the optimisation of a valuation protocol.MethodsFourteen cognitive interviews were conducted in the UK using concurrent and retrospective think-aloud and probing techniques. Each participant completed 8 C-TTO tasks and 8 DCE tasks within a computer-assisted personal interview setting. Verbal information was transcribed verbatim. Axial coding and thematic analysis were used to organise the qualitative data and identify patterns and problems with the completion of tasks.ResultsWhile participants found the tasks generally manageable, five broad themes emerged to explain and optimise the response to the tasks. (1) Format and structure: attention to the design of practice examples, instructions, and layout were needed. (2) Items and levels: underlying relationships were discovered across different combinations of levels of SWEMWBS items. (3) Decision heuristics: participants engaged in diverse strategies to assist trade-off decisions. (4) Valuation feasibility: certain states were difficult to imagine, compare and quantify. (5) Valuation outcome: the data quality was affected by participants’ discriminatory ability across states and their time trade-off decisions.ConclusionThe interviews contributed insights regarding the robustness of the proposed methods. The application of C-TTO and DCE valuation techniques was practical and suitable for capturing individual attitudes towards different mental well-being scenarios. A modified protocol informed by the results is being tested in a larger sample across the UK.

The uptake and outcomes of an online self-help mindfulness programme during COVID-19

ABSTRACT Objectives The COVID-19 pandemic has had negative mental health impacts. Online psychological interventions can facilitate rapid access to mental health resources. This study examined the outcomes of a 4-lesson, self-help online mindfulness course during the early months of the pandemic in Australia. Methods 5058 adults commenced the Introduction to Mindfulness course and completed measures of psychological distress (Kessler-10) and wellbeing (Short Warwick-Edinburgh Mental Well-being Scale). 3696 individuals commenced their course between 2016 and 2019 (“pre-COVID” group), while 1362 started their course between 12 March 2020 and 31 July 2020 (“during-COVID” group). Results Participants in the during-COVID-pandemic group reported slightly lower levels of psychological distress and higher levels of wellbeing compared to the pre-COVID group. In both groups, the mindfulness course was associated with medium effect size reductions in psychological distress (g = .49-.55) and small effect size improvements in wellbeing (g = .27-.41). Conclusions The mindfulness course was associated with reduced psychological distress before and during the pandemic. Results underscore the generalisability of online mindfulness interventions to pandemic situations. KEY POINTS What is already known about this topic: The mental health impacts associated with the COVID-19 pandemic have been substantial. Mental health service provision has adapted to meet community health needs in the wake of the pandemic. It is unclear if the effectiveness of online mental health interventions will generalise topandemic conditions. What this paper adds: The outcomes of an online mindfulness course were explored. The course was associated with improved psychological distress and wellbeing both before and during the COVID-19 pandemic in Australia. Results highlight the utility of digital mental health services during COVID-19.

Do the Determinants of Mental Wellbeing Vary by Housing Tenure Status? Secondary Analysis of a 2017 Cross-Sectional Residents Survey in Cornwall, South West England.

Housing is a social determinant of health, comprising multiple interrelated attributes; the current study was developed to examine whether differences in mental wellbeing across housing tenure types might relate to individual, living, or neighbourhood circumstances. To achieve this aim, an exploratory cross-sectional analysis was conducted using secondary data from a county-wide resident survey undertaken by Cornwall Council in 2017. The survey included questions about individual, living, or neighbourhood circumstances, as well as mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). A random sample of 30,152 households in Cornwall were sent the survey, from whom 11,247 valid responses were received (38% response), but only 4085 (13.5%) provided complete data for this study. Stratified stepwise models were estimated to generate hypotheses about inequalities in mental wellbeing related to housing tenure. Health, life satisfaction, and social connectedness were found to be universal determinants of mental wellbeing, whereas issues related to living circumstances (quality of housing, fuel poverty) were only found to be related to wellbeing among residents of privately owned and rented properties. Sense of safety and belonging (neighbourhood circumstances) were also found to be related to wellbeing, which together suggests that whole system place-based home and people/community-centred approaches are needed to reduce inequalities.

Subjective mental well-being among higher education students in Finland during the first wave of COVID-19.

Aims:Increased mental health problems during the COVID-19 pandemic have become a major concern among young adults. Our aim was to understand which COVID-19-related questions predicted mental well-being during the outbreak.Methods:Two cross-sectional datasets were used. The primary dataset was collected in May 2020 (n = 1001), during the initial COVID-19 outbreak, and the secondary in April 2019 (n = 10866), before the pandemic. Mental well-being was assessed with the Short Warwick–Edinburgh Mental Well-Being Scale. Relationships between mental well-being and COVID-19-related questions were investigated with lasso regression. As an exploratory analysis, two-way ANOVAs were used to compare mental well-being before and during the outbreak.Results:Higher levels of mental well-being were associated with lower levels of academic stress and COVID-19-related worry, along with a higher satisfaction with the procedures and information provided by the higher education institutions and the government. COVID-19-related symptoms and infections did not have an impact on students’ mental well-being during the outbreak. Small to moderate effect sizes across the time points were detected, indicating an overall decrease in mental well-being across age and gender during the outbreak.Conclusions: COVID-19 had an impact on higher education students’ mental well-being. Higher education institutes may play a crucial role in protecting their students’ well-being during uncertain times.

Relationship Between Accelerometer-Based Physical Activity, Sedentary Behavior, and Mental Health in Young Finnish Men.

Healthy lifestyle behaviors including physical activity (PA) have been recognized to contribute positively to mental health. Most of the evidence on relationship between PA and mental health relies on self-reported PA results. Device-based measures on PA or sedentary behavior (SB) are less frequently used in mental health research. The present study aimed at examining the relationship between mental health and PA/SB measured by accelerometers in young Finnish men. The sample consisted of 409 men (mean age 28 ± 7 years), who participated in the military refresher training in Finland. Self-rated mental health was measured with Mental Health Inventory (MHI-5) and short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) measuring mental health both from the perspective of mental health problems and mental well-being. PA was measured with accelerometer from the perspective of light, moderate, vigorous, and total activity, as well as SB. Linear regression models and compositional analysis were applied. Age, education, marital status, employment status, BMI, alcohol use and smoking were used as covariates. Evidence on relationship between total PA (standardized regression coefficient 0.340; 95% CI 0.022–0.657, p = 0.036) and SB (standardized regression coefficient −0.340; 95% CI −0.657 to −0.022, p = 0.036) with symptoms of mental health problems was found after adjusting for age, education, marital and employment status. The relationship was marginally significant (p = 0.056) after adjusting also for BMI, alcohol use and smoking. No evidence on relationship between PA or SB and mental well-being was found, neither in standard linear regression analysis nor in compositional approach. In our sample of young adult men, PA seemed to have a stronger relationship with symptoms of mental health problems rather than with mental well-being. The findings lead to a conclusion that all PA per se may not be independently associated with mental well-being in young adult males and raise the question whether the domain of PA and its context play a critical role in these relationships.

'Dear Doctor': a randomised controlled trial of a text message intervention to reduce burnout in trainee anaesthetists.

One in four doctors in training in the UK reports feeling 'burnt out' due to their work and similar figures are reported in other countries. This two-group non-blinded randomised controlled trial aimed to determine if a novel text message intervention could reduce burnout and increase well-being in UK trainee anaesthetists. A total of 279 trainee anaesthetists (Core Training Year 2, Specialty Training Years 3 or 4) were included. All participants received one initial message sharing support resources. The intervention group (139 trainees) received 22 fortnightly text messages over approximately 10 months. Messages drew on 11 evidence-based themes including: gratitude; social support; self-efficacy; and self-compassion. Primary outcomes were burnout (Copenhagen Burnout Inventory) and well-being (Short Warwick-Edinburgh Mental Well-being Scale). Secondary outcomes were as follows: meaning in work; professional value; sickness absence; and consideration of career break. Outcomes were measured via online surveys. Measures of factors that may have affected well-being were included post-hoc, including the impact of COVID-19 (the first UK wave of which coincided with the second half of the trial). The final survey was completed by 153 trainees (74 in the intervention and 79 in the control groups). There were no significant group differences in: burnout (β = -1.82, 95%CI -6.54-2.91, p = 0.45); well-being (-0.52, -1.73-0.69, p = 0.40); meaning (-0.09, -0.67-0.50, p = 0.77); value (-0.01, -0.67-0.66, p = 0.99); sick days (0.88, -2.08-3.83, p = 0.56); or consideration of career break (OR = 0.44, -0.30-1.18, p = 0.24). Exploratory post-hoc analysis found the intervention was associated with reduced burnout in participants reporting personal or work-related difficulties during the trial period (-9.56, -17.35 to -1.77, p = 0.02) and in participants reporting that the COVID-19 pandemic had a big negative impact on their well-being (-10.38, -20.57 to -0.19, p = 0.05). Overall, this trial found the intervention had no impact. However, given this intervention is low cost and requires minimal time commitment from recipients, it may warrant adaptation and further evaluation.

Positive psychotherapy for psychosis in Hong Kong: A randomized controlled trial

Recovery-oriented practice has been advocated in mental health services in Hong Kong since 2009. Well-being has become an important area of focus for mental health services. Positive Psychotherapy for Psychosis (PPP) is a well-being-focused intervention for use in psychosis, with preliminary evidence from a randomized controlled trial in the United Kingdom of impact on well-being and symptomatology. The aim of this study was to test the effectiveness of PPP on the well-being of people with psychosis in Hong Kong.The study was a randomized controlled trial with two-arm parallel groups. Both groups received treatments as usual, and in addition the intervention group received a 13-session intervention based on a Cantonese Chinese translation of the PPP manual. Intention-to-treat analysis was used. The trial was registered (ANZCTR: ACTRN12620000464965).A total of 154 participants (78 intervention, 76 control) were recruited. As compared to control group, intervention group participants showed significant changes over time on the primary outcome of well-being assessed using the Chinese Short Warwick-Edinburgh Mental Well-being Scale (p = 0.001) and on secondary outcomes of hope (Agency subscale: p = 0.029) and self-efficacy (p = 0.001).Positive Psychotherapy for Psychosis was found to be an effective treatment in improving the well-being and other mental health outcomes for people with psychosis. It can be recommended for use in mental health services to promote recovery.

COVID-19 Pandemic and Maternal Psychological Wellbeing During the Malaysian Movement Control Order: A Cross-Sectional Study.

Background: COVID-19 pandemic had resulted in nationwide lockdown as a disease control measure. Potential harm to self and baby due to COVID-19 infection as well as uncertainties about delivery are among contributors to maternal anxiety. We aimed to assess the prevalence of psychological distress among pregnant women during the Malaysian Movement Control Order (MCO).Methods: A cross-sectional study was conducted between May and June 2020 in a teaching hospital in Kuala Lumpur, Malaysia. A self-administered electronic questionnaire was distributed which included the following; (1) Depression, Anxiety and Stress Scale-21 (DASS 21), (2) Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), (3) MCO effect questionnaire, and (4) newly designed COVID-19 pregnancy-related anxiety. Chi-square test and logistic regression were performed to determine significant associations whilst mean scores comparison were conducted through Mann-Whitney-U-test.Results: Four hundred and fifteen women were included in the final analysis. The prevalence of psychological distress among our cohort was 14.7%; with a two-fold increase of risk among the non-Malays (AOR 1.98, 95% CI 1.00–3.89) whilst a greater number of social support showed a protective effect (AOR 0.51, 95%CI 0.28–0.92). Malay ethnicity (p < 0.001) alongside greater household income (p = 0.014) were positive predictors of a higher sense of maternal wellbeing. Multiparous women and those of higher economic status experienced the more negative effect of the MCO. Around 88% of our women reported a higher level of COVID-19 pregnancy-related anxiety. Younger (p = 0.017) and first-time mothers (p = 0.039) were more likely to be anxious. Although adequate maternal knowledge on COVID-19 was associated with a greater sense of maternal wellbeing (p = 0.028), it was also linked to a higher level of COVID-19 related anxiety (AOR 3.54, 95% 1.29–9.70).Conclusion: There was a relatively low prevalence of psychological distress among expectant mothers in Malaysia during the first wave of the COVID-19 pandemic. Expectant mothers should receive accurate and reliable information on the effect of COVID-19 on pregnancy to relieve some maternal anxiety. Maternal health screening is important to identify individuals who would benefit from extra support and mental health intervention, especially in prolonged lockdown.

An off-target scale limits the utility of Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) as a measure of well-being in public health surveys

ObjectivesTo assess the utility and measurement properties for the well-being scale Short Warwick–Edinburgh Mental Well-Being Scale (SWEMWBS) in a Swedish general population survey. Study designA cross-sectional survey study. MethodsData were retrieved from the 2018 public health survey in Stockholm County, containing a random sample of 22 856 persons stratified to be representative for the municipalities and districts within the region. The data were analyzed according to Rasch Measurement Theory. ResultsPerson attribute values are positively skewed (mean 2.32, SD 1.85), with wide gaps in the item threshold attribute values. Overall item fit statistics were acceptable, and person measurement separation reliability was 0.83, indicating three statistically distinct ranges in the estimated well-being values. ConclusionWhile the SWEMWBS items indicated acceptable fit to the Rasch measurement model, targeting of items to sample is skewed toward lower levels of well-being, and there is a ceiling effect. Thus, we suggest a careful reconsideration of SWEMWBS as a tool for use in general public health surveys, especially for assessing change over time and group differences, as there are large measurement uncertainties for the majority of cases when the population as a whole is sampled. We encourage revisions applying a coherent and comprehensive ordinal construct theory for well-being to fill the gaps in the upper end of the SWEMWBS scales' item thresholds. The addition of more challenging items would improve targeting for population-based surveys, increase reliability, and provide more actionable information that could be useful in improving individuals' well-being.

After Over a Year of Pandemic: Mental Well-being and Life Satisfaction of Filipino College Students

The COVID-19 pandemic has been there for over a year and may substantially negatively impact student’s mental well-being. This study aimed to assess the subjective mental well-being and satisfaction with life of Filipino college students. This cross-sectional study involved the analysis of 1,141 college students in the Philippines. The data were collected using the Short Warwick-Edinburgh Mental Wellbeing Scale and the Satisfaction with Life Scale. Results indicated that while 52.8% reported high satisfaction with life, 40.2% had poor mental well-being. Self-reported health status (β=1.899, p=.000), age (β=0.179, p=.000), and year level (β=0.306, p=.000) predicted mental well-being. On the other hand, subjective mental well-being (β=0.736, p=.000), self-reported health status (β=0.967, p=.000), and age (β=0.691, p=.025) predicted life satisfaction. The COVID-19 pandemic has likely affected students’ mental health and well-being. Interventions should be initiated to address the mental health needs of the students during this pandemic and even beyond the health crisis.

Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): performance in a clinical sample in relation to PHQ-9 and GAD-7

PurposeThis study assesses the construct validity and sensitivity to change of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) as an outcome measure in the treatment of common mental disorders (CMD) in primary care settings.Methods127 participants attending up to 5 sessions of therapy for CMD in primary care self-rated the SWEMWBS, the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) scales. SWEMWBS’s construct validity and sensitivity to change was evaluated against the PHQ-9 and GAD-7 across multiple time points in two ways: correlation coefficients were calculated between the measures at each time point; and sensitivity to change over time was assessed using repeated measures ANOVA.ResultsScore distributions on SWEMWBS, but not PHQ-9 and GAD-7, met criteria for normality. At baseline, 92.9% (118/127) of participants scored above clinical threshold on either PHQ-9 or GAD-7. Correlations between SWEMWBS and PHQ-9 scores were calculated at each respective time point and ranged from 0.601 to 0.793. Correlations between SWEMWBS and GAD-7 scores were calculated similarly and ranged from 0.630 to 0.743. Significant improvements were seen on all three scales over time. Changes in PHQ-9 and GAD-7 were curvilinear with greatest improvement between sessions 1 and 2. Change in SWEMWBS was linear over the five sessions.ConclusionsThis exploratory study suggests that SWEMWBS is acceptable as a CMD outcome measure in primary care settings, both in terms of construct validity and sensitivity to change. Given patient preference for positively over negatively framed measures and statistical advantages of measures which are normally distributed, SWEMWBS could be used as an alternative to PHQ-9 and GAD-7 in monitoring and evaluating CMD treatment.

“Dear Doctor” text message intervention to reduce burnout in trainee anaesthetists: a randomised controlled trial

BackgroundOver one in five UK doctors reports feeling burnt out because of their work. This study aimed to determine if a novel text message intervention could reduce burnout in UK trainee anaesthetists. MethodsIn this two-arm, non-blinded, randomised controlled trial, we recruited 2nd to 4th year trainees registered with the Royal College of Anaesthetists, UK. Eligible trainees were given information about the trial and asked to provide their mobile phone numbers to indicate consent to participate. Participation was optional. Participants who signed up to the trial were randomly assigned (using a random number generator in the statistical programme Stata) to receive either fortnightly text messages over 10 months (treatment group) or no intervention messages (control group). Randomisation was stratified by training year and region. A literature review and qualitative study informed the intervention design and content: our intervention was low cost to deliver and minimally time-intensive for participants (contrasting many previous interventions), and it aimed to address factors identified as contributing to burnout. The message content also drew on 11 themes from the behavioural science and wellbeing literature (eg, gratitude, social support, self-compassion) to improve burnout and wellbeing. The co-primary outcomes were burnout (measured by the work-related subscale of the Copenhagen Burnout Inventory) and wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). Secondary outcomes were meaning in work, professional value, sickness absence, and consideration of career break. Exploratory outcomes were factors potentially affecting wellbeing, including COVID-19. Outcomes were measured via an online survey. Intervention impact for those who completed the endline survey was evaluated using regression adjusting for gender, training year, training region, and baseline measurement. We conducted exploratory analyses of intervention impact in subgroups of participants using the same regression model. The Imperial College Research Ethics Committee approved the study on Aug 14, 2019 (reference number 19IC5205). The Imperial Joint Research Compliance Office approved the additional exploratory outcomes in an amendment on July 21, 2020. This trial is registered with the ISRCTN registry, ISRCTN11418903. FindingsIn September-October 2019, 279 trainees were randomised, of whom 153 (80 female; 73 male) completed the endline survey (74 in the treatment group; 79 in the control group). There were no significant group differences in burnout (β=–1·82, 95% CI –6·54 to 2·91, p=0·45), wellbeing (–0·52, –1·73 to 0·69, p=0·40), or secondary outcomes (all p values ≥0·24). However, 49 (66%) of 74 participants in the treatment group recommended the messages be sent to future trainees. Exploratory analyses found the intervention was associated with reduced burnout in participants who reported personal or work-related difficulties (β=–9·56, –17·35 to –1·77), and those for whom COVID-19 had a large negative wellbeing impact (β=–10·38, –20·57 to –0·19). InterpretationThe intervention had no impact overall, but was recommended by most, and associated with reduced burnout in participants reporting difficult personal or work circumstances. Given this intervention is low cost and requires minimal time commitment, it may warrant adaptation (eg, based on participant feedback) and further evaluation. FundingNational Institute for Health Research.

Psychosocial school conditions and students’ positive mental well-being

Abstract Background School is a key social determinant of adolescent health. However, earlier research on psychosocial school conditions has largely focused on their relationship with aspects of adverse health, and fewer studies have examined the links with positive health. The aim of this study was to investigate boys' and girls' experiences of school demands, teacher support, and classmate support and their associations with positive mental well-being. Methods Data were derived from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, with information collected among 1,418 students in grade 9 (∼15-16 years). School demands, teacher support, and classmate support were captured by indices based on multiple items. Positive mental well-being was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMBWS). Gender-stratified linear regression analyses were performed, clustering for school class. Results Higher demands were associated with lower mental well-being (boys: b=-0.36, p &amp;lt; 0.05; girls: b=-0.65, p &amp;lt; 0.05). Conversely, mental well-being increased with greater teacher support (boys: b = 0.53, p &amp;lt; 0.05; girls: b = 0.56, p &amp;lt; 0.05) and classmate support (boys: b = 0.70, p &amp;lt; 0.05; girls: b = 0.50, p &amp;lt; 0.05). Interactions between demands and the support variables showed that at the lowest levels of teacher and of classmate support, mental well-being was low and not associated with school demands. With increasing levels of teacher and classmate support, the overall level of mental-well-being increased and revealed an inverse association between school demands and mental well-being. Conclusions The findings indicate that psychosocial school conditions are important not only for adverse health among adolescents, but also for their positive health. The study contributes with knowledge about how psychosocial conditions in school may hinder or enhance positive health among students. Key messages School demands, teacher and classmate support were associated with mental well-being among both boys and girls, although the association with demands was seen only at higher levels of support. The findings indicate that psychosocial school conditions are important not only for adverse health among adolescents, but also for their positive health.