Stress Subscale Research Articles

Relationships between insomnia, long working hours, and long commuting time among public school teachers in Japan: a nationwide cross-sectional diary study

ObjectivesThe present study aimed to clarify the prevalence and risk factors of insomnia among public school teachers in Japan by examining the relationships between working hours, commuting time, and insomnia. Time spent on work activities among teachers with insomnia was also investigated. MethodsThis study was a secondary analysis of data obtained in a 2016 survey of working conditions among public elementary/junior high school teachers in Japan. A total of 11,390 teachers (women: 47.4%, average age: 42.2 ± 11.3 years) were selected for analysis. The relationships between working hours, commuting time, and insomnia were evaluated using a binomial logistic regression model. The primary outcome was insomnia, defined by a score of ≥6 on the Athens Insomnia Scale. Explanatory factors were working hours/week, commuting time/day, six subscales of occupational stress, age group, presence of children, type of job, type of the school, and the urbanicity of the school. ResultsIn total, 41.7% of men and 44.0% of women were classified into the insomnia group. The insomnia group spent more time preparing for lectures, and a significant association was observed between insomnia and long working hours and commuting time. Results of multivariate logistic regression analysis showed that long working hours, long commuting time, and urbanicity of the school were statistically significantly associated with insomnia. ConclusionsInsomnia is common among public school teachers in Japan. Our findings suggest the importance of reducing the time spent on working to prevent insomnia.

Effective evaluation on informational support of the parenting sense of competence and parenting stress in primiparas

Objective To evaluate the effectiveness on informational support of the parenting sense of competence and parenting stress in primiparas. Methods Ninety-five primiparas in the First Affiliated Hospital of Zhengzhou University were recruited from November 2017 to April 2018, mothers of premature infants discharged from hospital from November 2017 to January 2018 were divided into the control group,and which discharged from February 2018 to April 2018 were divided into the experimental group conveniently.Seven cases in the control group and 5 cases in the experimental group dropped out. The control group received routine nursing care, 4 times of informational support were implemented to the mothers of premature infants at the first 4 months after discharged in the experimental group,included team teaching, live demonstration, set up a wechat group, et al. All primiparas were investigated using the Chinese version of Parenting Sense of Competence Scale(C-PSOC) and the Parenting Stress Index-Short Form(PSI-SF) at the 1th,3th,6th month postpartum. Results At the 6th month postpartum, total scores of the Chinese version of Parenting Sense of Competence Scale and subscale scores of self-efficacy, satisfaction of the mothers of premature infants were 82.60±4.45, 39.19±3.25, 43.40±3.47, respectively in the experimental group,and the scores were 76.83±7.88, 36.90±4.82, 39.93±5.16, respectively in the control group, the difference between the two groups was statistically significant(t=4.117, 2.541, 3.613, P<0.05). At the 6th month postpartum,total scores of the Parenting Stress Index-Short Form and subscale scores of parenting distress,parent-child dysfunctional interaction,difficult child of the mothers of premature infants were 80.31±9.50, 28.62±4.54, 23.98±4.91, 26.14±5.15, respectively in the experimental group,and the scores were 87.36±8.58, 32.55±4.88, 25.95±4.15, 28.84±4.88, respectively in the control group,the difference between the two groups was statistically significant(t=-3.568-3.823, P<0.05). Conclusions Informational support can effectively improve the parenting sense of competence and relieve the parenting stress in primiparas. Key words: Informational support; Primipara; Parenting sense of competence; Parenting stress

Acute stress impairs children's sustained attention with increased vulnerability for children of mothers reporting higher parenting stress.

Despite evidence that acute stress impairs attention in adults, there has been minimal research in children. Here, the effects of acute stress on Go/No-go performance were examined in young children (M age=5.41years). Given the critical role of the parent-child relationship to children's self-regulatory development, the extent to which parenting stress predicts children's cognitive vulnerability to acute stress and autonomic reactivity was also investigated. A between-groups design (n=58 stress, n=26 control) was used with oversampling of the stressor-exposed children to examine individual differences. The Parenting Stress Index and subscales were employed as a measure of parenting stress. Acute stress impaired children's sustained attention, but not inhibitory control. Higher parenting stress was associated with vulnerability to attentional impairment. Parenting distress was also positively associated with sympathetic reactivity to acute stress, but neither sympathetic nor parasympathetic reactivity was associated with attentional impairment. A conceptual model of pathways through which repetitive acute stress may contribute to self-regulatory difficulties is presented, including the potential buffering role of caregivers.

Evaluating the effect of Family Integrated Care on maternal stress and anxiety in neonatal intensive care units

ABSTRACT Objective: To identify how Family Integrated Care (FICare) affected maternal stress and anxiety. Study Design: This secondary analysis of the FICare cluster randomised controlled trial included infants born between 1 April 2013 and 31 August 2015 at ≤33 weeks’ gestation. Mothers completed the PSS:NICU and STAI questionnaires at enrolment and study day 21. Results: 1383 mothers completed the surveys at one or both time-points. The mean PSS:NICU and STAI scores at day 21 were significantly lower in the FICare mothers than controls (PSS:NICU mean [standard deviation] FICare 2.32 [0.75], control 2.48 [0.78], p = 0.0005; STAI FICare 70.8 [20.0], control 74.2 [19.6], p = 0.0004). The sights and sounds, looks and behaviour, and parental role PSS:NICU subscales and the state and trait STAI subscales were all significantly different between FIC are and controls at day 21. The magnitude of change in all stress and anxiety subscales was greater in the FICare group than controls. These differences remained significant after adjustment for confounders with the greatest change in the parental role (least-squares mean [95% confidence interval] FICare −0.65 [−0.72, 0.57], control −0.31 [−0.38, −0.24], p < 0.0001) and state anxiety subscales. Conclusion: FICare is effective at reducing NICU-related maternal stress and anxiety.

Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review.

The objective of this review was to evaluate the effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults 18 years and over. Stress has reached epidemic proportions globally. Unidentified sequela of physiological and psychological stress can result in anxiety, depression, heart disease, cancer, immunologic conditions and death. There is a high cost associated with the treatment of stress related health conditions in the United States and worldwide. Many treatments are pharmacologic and cannot be self-initiated. Therefore, it is critical to identify evidence-based, low-cost, non-pharmacologic, self-administered interventions that can mitigate physiological and psychological stress. This review considered adults 18 years and over engaged in diaphragmatic breathing as an isolated intervention to reduce physiological and psychological stress. There were no exclusions based on physical or psychological conditions. The comparator was no treatment or usual treatment, which may constitute ordinary breathing. The comprehensive literature search included published and unpublished studies in English from the beginning of the databases through January 2018. The databases searched included: PubMed, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, ProQuest Nursing and Allied Health and Health Source: Nursing/Academic Edition. The recommended JBI approach to critical appraisal, study selection, data extraction and data synthesis was used. Three studies met the criteria for review: one randomized controlled trial and two quasi-experimental studies. Statistical pooling was not possible due to clinical and methodological heterogeneity of interventions and outcome measures of the included studies. All three studies demonstrated the effectiveness of diaphragmatic breathing on reducing stress. One study showed improvement in the biomarkers of respiratory rate and salivary cortisol levels, one showed improvement in systolic and diastolic blood pressure, and one study showed an improvement in the stress subscale of the Depression Anxiety Stress Scales-21 (DASS-21) after implementation of a diaphragmatic breathing intervention. Although there were limitations across the studies, such as sample size, and length and duration of the intervention over time, ranging from one 20-minute intervention to nine months, the studies demonstrated that diaphragmatic breathing had a positive effect on lowering physiological and psychological stress. The evidence suggests that diaphragmatic breathing may decrease stress as measured by physiologic biomarkers, as well psychological self-report tools. Given the benefits of diaphragmatic breathing on stress reduction, ongoing research is needed to continue to establish the evidence-base for this self-administered, low-cost, non-pharmacologic intervention.

The Effect of Inhaling the Aroma of Rosemary Essential Oil on the Pre-Hospital Emergency Personnel Stress and Anxiety: A Quasi-Experimental Study

Background: The prevalence of stress and anxiety in pre-hospital emergency personnel is high. Objectives: The present study was conducted to investigate the effect of inhaling the Aroma of Rosemary essential oil on stress and anxiety of emergency medical personnel. Methods: In this quasi-experimental study, 8 pre-hospital emergency stations affiliated to Birjand University of Medical Sciences in Birjand city were randomly selected. Then, 4 stations were randomly allocated to the intervention group and 4 stations were assigned to the control group. In the next step, among personnel of each station about 8-10 participants were selected according to the inclusion criteria (39 participants in each group). Afterwards, these participants completed demographic and DASS-42 questionnaires (stress and anxiety subscales). Badges with 25% rosemary essential oil in the intervention group and badges impregnated with refined sweet almond oil were used in the control group for two hours in 3 shifts per week for one month. The anxiety and stress subscales of the DASS-42 questionnaire were completed by the participants one hour as well as 30 days after the last intervention in each group. In this study, chi-square, Mann-Whitney and Friedman tests were used. Results: The statistical analysis showed that the mean stress and anxiety scores in the two groups did not have significant differences before intervention (P > 0.05). One hour after the last intervention, statistical analysis showed that the mean of stress scores in the intervention group was significantly reduced compared to the control group (P 0.05). In the case of anxiety, one hour after the intervention the mean scores in the intervention group were significantly decreased compared to the control group (P 0.05). Conclusions: Aromatherapy with rosemary essential oil can have positive effects in reducing stress and anxiety in pre-hospital emergency personnel.

Burden in caregivers of adults with epilepsy in Asian families

PurposeThe literature on caregiver burden tends to focus on children and teenagers with epilepsy and less on adults. As caregiving is a dynamic, complex process across the trajectories, this study aims to examine the factors associated with caregiving burden in those caring for adults with epilepsy. MethodThis is a cross-sectional, survey-based study in which participants responded to questionnairesregarding perceived burden (ZBI), quality of life (IEQoL), psychological distress (DASS-21), family functioning (FAD) and perceived social support (MSPSS). Additional measures include socio-demographics and clinical characteristics of the care-recipient. ResultsA total of 111 caregivers participated, of whom 72.1% were females, 55% parents, 59.5% Chinese, 51.4% unemployed and 46.0% with tertiary education.Approximately half (42.3%) reported mild-to-moderate levels of burden (mean ZBI score 29.93, SD 16.09).Furthermore, multiple regression analysisidentified10 predictors of caregiver burden, namely family functioning, weekly caregiving hours, number of caregivers per family, attitude towards epilepsy, family support, caregivers’ gender, personal income and as well as care-recipients’ age of onset, seizure frequency and ADL dependency (F(10, 85) = 11.37, p < 0.001). Stepwise regression highlighted family functioning as the main predictor (β = 0.299, p < 0.001). The total ZBI score was positively correlated with caregivers’ reported levels of depression (r = 0.549, p < 0.001), anxiety (r = 0.599, p < 0.001) and stress (r = 0.576, p < 0.001) subscales in DASS-21, and negatively correlated with IEQoL (r=-0.637, p < 0.001). ConclusionThis study shows that caregivers’ burden is highly associated with the family system (family functioning, support and number of caregivers), besides demographics, psychosocial and clinical characteristics. Future research is required to learn how to support this sub-group of caregivers within the family system.

Leading the charge: Identifying stressors in nursing leadership

Objective: This study aimed to examine and identify specific stressors for charge nurses at a rural Midwestern hospital.Methods: The Charge Nurses Stress Questionnaire (CNSQ) was administered to charge nurses of all units at a small Midwestern hospital. A total of 30 charge nurses completed the survey. The charge nurses completed 25 questions on four stress subscales, in addition to 11 demographic questions.Results: Study results revealed the highest stressors were primarily related to being unable to meet patient needs. This situation includes when a nurse cannot reach the provider when an urgent patient need arises; when the unit is at capacity with high acuity patients and receives notification another patient has been assigned to the unit; and when the patient is in pain or otherwise suffering, and care is delayed because orders are needed.Conclusions: Stress was noted by all charge nurses. The levels of different stressors from subscales correlate with each other, and thus an increase in one subscale of stress directly affects the level of stress of another subscale. The level of stress among charge nurses was not statistically significant among the nurses of different age, different units, different shifts, and different years of experience.

English

Admission of a new born to the Neonatal Intensive Care Unit (NICU) is a stressful and unexpected event to most parents. This quantitative study aimed at identifying factors that contribute to stress in mothers nursing babies in the NICU at the Women and New Born Hospital in Zambia. A cross sectional study was conducted among 280 mothers who were randomly selected over a three-month period. Stress levels were assessed using Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) questionnaire. Informed consent was obtained from the mothers for the study. Inclusion criteria for the study were mothers of admitted neonates and their neonates who had to remain in the NICU for at least 24 h. Stata software version 13 was used to analyse data Chi square test to determine association between stress and maternal and infant characteristics. Kruskal wallis test was used to determine association between subscales of the PSS: NICU tool and interquartile and median were calculated since the data was not normally distributed. Results revealed that participants were more stressed by alteration of the parental role and the appearance and behaviour of their neonate. All participants rated admission of the neonate as being stressful. Maternal characteristics that were associated with stress included education level and duration of stay in Kruskal-Wallis test showed a statistical difference between the stress subscales with alteration of parental role being the most stressful subscale. Mothers have different stress levels with most of them experiencing moderate and extreme stress; appropriate counselling targeted towards specific stressors identified is required. The limitation of this study is that it did not monitor levels of stress at different times of admission Future research should monitor how maternal stress changes throughout the neonate&rsquo;s NICU stay. This information can be used to design effective support programme to help mothers adopt coping strategies during their infant&rsquo;s hospitalization. Key words: Maternal stressors, neonatal intensive care, Stressor Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU). &nbsp

Compassion Fatigue in Surgical Trainees

Compassion fatigue (CF) is the profound sense of emotional exhaustion that care providers can experience as the result of helping others in distress. CF can contribute to burnout (BO), depression, and stress-related illness. While surgeons and surgical trainees may be at high risk for developing CF, it has not been adequately characterized or explored in this population. The objective of this study was to examine the prevalence and impact of CF in surgical trainees with a view to inform a management strategy. A mixed method study was conducted using survey and interview methods. An email survey including the Professional Quality of Life Scale Version 5, an instrument to assess CF, was sent to all trainees in the Department of Surgery at the University of Toronto. Survey data were analyzed descriptively and using one-sample t tests. Semistructured interviews were conducted with volunteered trainees. Data collection and analysis occurred iteratively and inductively using the constant comparison method. One hundred fifteen trainees completed the survey representing a 47% response rate. Ninety-nine respondents (40.7%) completed the Professional Quality of Life Scale tool. The mean score on the compassion satisfaction subscale was 36.9 (SD 6.7), on the BO subscale was 26.2 (SD 5.6), and on the secondary traumatic stress (STS) subscale was 21.2 (SD 6.3). The mean on the compassion satisfaction subscale was not statistically different from the population mean (p = 0.22). The means for the BO and STS scales were statistically higher in our study sample compared to the normative data (p < 0.0001 for each). Thematic qualitative findings indicated trainees experienced CF symptoms. Participants described systemic barriers to mitigating CF including workload and a cultural expectation to be unemotional at work. Surgical trainees report high levels of BO and STS and currently use informal coping strategies outside of their academic and hospital environments. Trainees are likely to welcome and benefit from an organized response to support their emotional health when facing difficult patient encounters.

Systematic review of the measurement properties of the Depression Anxiety Stress Scales-21 by applying updated COSMIN methodology.

The Depression Anxiety Stress Scales (DASS)-21 measures emotional symptoms of depression, anxiety, and stress, is relatively short, and is freely available in the public domain, which has resulted in it being applied to various clinical and non-clinical populations in many countries. The aim of this study was to systematically review the measurement properties of the DASS-21. The MEDLINE, Embase, and CINAHL databases were searched. The methodological quality of each identified study was assessed using the updated COSMIN Risk of Bias checklist. The quality of the measurement properties of the studies was rated using the updated criteria for good measurement properties. The quality of evidence was rated using a modified version of the GRADE approach. This study included 48 studies in its review. The content validity of the DASS-21 demonstrated sufficient moderate-quality evidence. The instrument exhibited sufficient high-quality evidence for bifactor structural validity and internal consistency. The instrument also showed sufficient high-quality evidence for hypothesis testing of construct validity. Regarding criterion validity, only the DASS-21 Depression subscale demonstrated sufficient high-quality evidence. The measurement invariance across gender demonstrated inconsistent moderate-quality evidence. There was insufficient low-quality evidence for the reliability of each subscale. For responsiveness there was sufficient low-quality evidence for depression and stress subscales, and insufficient very-low-quality evidence for anxiety subscale. The DASS-21 demonstrated sufficient high-quality evidence for bifactor structural validity, internal consistency (bifactor), criterion validity (Depression subscale), and hypothesis testing for construct validity. Further studies are required to assess the other measurement properties of the DASS-21.

Evaluation of the acceptability and clinical utility of an Arabic-language mindfulness CD in an Australian community setting.

The cultural, linguistic, and religious diversity of Australia's population presents challenges for mental health service delivery. Arabic-speaking communities in Australia underutilise mental health services despite high levels of trauma and psychological distress. Clinicians who work with this population lack linguistically and culturally appropriate clinical resources. The aim of this study was to explore the acceptability and clinical utility of a Mindfulness Skills CD translated into formal Arabic. The 70 participants were Arabic-speaking adults, mostly Lebanese-born Muslim women, who enrolled in a 5-week mindfulness program using the CD and agreed to follow-up at 12 weeks. Both recruitment and data collection were undertaken by a female project officer who is a widely respected member of the Arabic community in south-east Sydney. Compliance with the program protocol was high and all but 4 participants continued to use the CD beyond the 5 weeks. Overall, participants reported that mindfulness techniques fitted well with their way of life and were compatible with their cultural and religious practices. Most found mindfulness complementary to their regular reflective prayer. Using the Mindfulness Skills CD was associated with statistically significant reductions in psychological distress as measured by the Kessler Scale (K10) and the Depression, Anxiety, and Stress Scale (DASS21) postprogram (K10; DASS21 Depression and Stress subscales) and at follow-up (all measures). The evaluation showed that the Arabic Mindfulness Skills CD is an effective and culturally appropriate mental health resource for this population group. This low-cost, easily distributed resource is suitable for use in individual self-management and as an adjunct to primary and specialist mental health care.

Workplace incivility and its influence on professional quality of life among nurses from multicultural background: A cross-sectional study.

To investigate the workplace incivility of nurses working in two Saudi hospitals and analyse its influence on the nurses' professional quality of life (ProQOL). The prevalence and economic impact of workplace incivility cannot be overstated and disregarded. To the current authors' knowledge, no extensive study on this topic has been conducted in Saudi Arabia. The influence of workplace incivility to ProQOL of nurses from different cultural backgrounds has never been thoroughly investigated. Descriptive, cross-sectional design. A sample of 378 nurses working in two government hospitals in Saudi Arabia were surveyed using the Nursing Incivility Scale and the ProQOL Scale version 5 from February to May 2018. A multivariate multiple regression analysis was conducted to analyse the multivariate effect of workplace incivility on the nurses' ProQOL. The study adhered to the STROBE guideline (See Supporting Information File 1). The nurses perceived a moderate level of workplace incivility from the different sources of uncivil acts measured in this study. Among the five sources of incivility explored in this study, the nurses reported the majority of workplace incivility experienced from patients/visitors (M=2.44, SD=0.80), while the lowest was from supervisors (M=1.90, SD=0.66). The mean scores of the respondents in the compassion satisfaction, burnout and secondary traumatic stress subscales were 36.50 (SD=6.30), 26.43 (SD=4.81) and 26.47 (SD=6.06), respectively. General incivility, supervisor incivility, physician incivility and patient/visitor incivility showed a significant multivariate effect on the three ProQOL subscales. Nurses' experience of workplace civility and its sources were associated with ProQOL. The findings of this study can be used as guide in establishing human resource policies towards achieving nurses' needs, reducing workplace incivility and improving ProQOL.

Compassion Fatigue, Professional Quality of Life, and Psychological Endurance Among Organ Transplant Coordinators

PurposeOrgan transplant coordinators are affected by the experienced traumas of patients and relatives, which increases their risk of compassion fatigue. This study was conducted to determine the effect of compassion fatigue on organ transplant coordinators and to reveal its relationship with professional quality of life and endurance. Materials and MethodsThis descriptive study was carried out between November 2017 and March 2018 among organ transplant coordinators working in Turkey. Out of the total 187 coordinators, 91 (48.6%) agreed to participate. Data collection was performed via a demographic information questionnaire, the 24-item Compassion Scale developed by Pommier, the 30-item Professional Quality of Life (ProQOL) Scale developed by Stamm, and the 33-item Psychological Endurance Scale developed by Friborg et al. FindingsAmong the compassion subscales, the highest mean scores were in the kindness subscale, while the lowest mean scores were received from the indifference subscale. In the ProQOL, the compassion satisfaction subscale received the highest scores. The scores of the Psychological Endurance Scale were also high. There were statistically significant, weak to moderate correlations between all compassion subdimensions with absolute values of correlation coefficients (r) ranging from 0.260 to 0.690 (P < .05). There was a significant positive correlation between the burnout and compassion fatigue/traumatic stress subscales of the ProQOL (r = 0.660; P < .001). ConclusionsThese results demonstrate that ProQOL and psychological endurance are essential determinants of compassion fatigue among organ transplant coordinators. We suggest that correcting the working quality of organ transplant coordinators will reduce compassion fatigue and increase their psychological stability.

Evaluating a Web-Based Social Anxiety Intervention Among Community Users: Analysis of Real-World Data.

BackgroundSocial anxiety is both harmful and prevalent. It also currently remains among the most undertreated major mental disorders, due, in part, to socially anxious individuals’ concerns about the stigma and expense of seeking help. The privacy and affordability of computer-aided psychotherapy interventions may render them particularly helpful in addressing these concerns, and they are also highly scalable, but most tend to be only somewhat effective without therapist support. However, a recent evaluation of a new self-guided, 7-module internet-delivered cognitive behavioral therapy intervention called Overcome Social Anxiety found that it was highly effective.ObjectiveThe initial evaluation of Overcome Social Anxiety revealed that it led to significant reductions in symptom severity among university undergraduates. The aim of this study was to extend the results of the initial study and investigate their generalizability by directly evaluating the intervention’s effectiveness among a general community sample.MethodsWhile signing up for Overcome Social Anxiety, users consented to the usage of their anonymized outcome data for research purposes. Before and after completing the intervention, users completed the Fear of Negative Evaluation Scale (FNE), which we employed as the primary outcome measure. Secondary outcome measures included the Depression Anxiety Stress Scales (DASS) and 2 bespoke questionnaires measuring socially anxious thoughts (Thoughts Questionnaire) and avoidance behaviors (Avoidance Questionnaire).ResultsParticipants who completed the intervention (102/369, 27.7%) experienced significant reductions in the severity of their symptoms on all measures employed, including FNE (P<.001; Cohen d=1.76), the depression subscale of DASS (P<.001; Cohen d=0.70), the anxiety subscale of DASS (P<.001; Cohen d=0.74), the stress subscale of DASS (P<.001; Cohen d=0.80), the Thoughts Questionnaire (P<.001; Cohen d=1.46), and the Avoidance Questionnaire (P<.001; Cohen d=1.42).ConclusionsOur results provide further evidence that Overcome Social Anxiety reduces the severity of social anxiety symptoms among those who complete it and suggest that its effectiveness extends to the general community. The completion rate is the highest documented for a fully automated intervention for anxiety, depression, or low mood in a real community sample. In addition, our results indicate that Overcome Social Anxiety reduces the severity of symptoms of depression, physiological symptoms of anxiety, and stress in addition to symptoms of social anxiety.

Predictors of quality of life for parents of children with autism disorders in Iran

Background: The objective of this survey was predictors of quality of life for parents with Autism disorder (AD) children in Hamadan City. Materials and Methods: The sample size was included 82 mothers and 81 fathers of children with AD. The questionnaires of Parenting Stress Index-Short Form (SF) and SF-34 were used. The three stress subscales (Parental Distress; Parent–Child Dysfunctional Interaction [PCDI] and Difficult Child [DC]), age of diagnosis of AD, age of child and number of siblings were considered as predictors. Results: These analyses showed that the model among mothers and fathers was able to predict high a significant of variance in quality of life (F = 7.841, P

Stress, Depression, Sexual Function, and Alexithymia in Infertile Females with and without Polycystic Ovary Syndrome: A Case-Control Study.

BackgroundInfertile females experience some types of distress such as social stress, depression, and sexual dys- function that may be exacerbated by polycystic ovary syndrome (PCOS). The current study aimed at comparing psychological profile of infertile females with PCOS with that of women without PCOS with respect to four domains: infertility stress, depression, sexual dysfunction, and alexithymia.Materials and MethodsThe current case-control study was conducted on 240 infertile females (120 with PCOS and 120 without PCOS) in Fatemeh Azahra Infertility and Reproductive Health Research Center (Babol, Iran) from 2016 to 2017. The following questionnaires were used to collect data: the fertility problem inven- tory (FPI), the female sexual function index (FSFI), the Beck depression inventory-II (BDI-II), and the Toronto alexithymia scale (TAS-20).ResultsFemales with PCOS had higher FPI total scores than the ones without PCOS (120.68 ± 29.42 vs. 112.83 ± 30.94). Of the subscales of infertility stress, the mean scores of social stress and rejection of a future life without a child were higher in females with PCOS than the ones without PCOS (P<0.05). Also, the mean total scores of alexithy- mia symptoms (TAS-20) in females with PCOS were significantly higher than those of the ones without PCOS (59.83 ± 11.36 vs. 55.69 ± 11.52). There was no significant difference between the two groups regarding the mean scores of depression symptoms and sexual function.ConclusionInfertile females with PCOS experienced higher levels of infertility stress and inability to distinguish and describe their feelings compared with the ones without PCOS. It is suggested that infertility care providers should provide more psychosocial support for infertile females with PCOS.

Supported Internet-Delivered Cognitive Behavioral Therapy Programs for Depression, Anxiety, and Stress in University Students: Open, Non-Randomised Trial of Acceptability, Effectiveness, and Satisfaction.

BackgroundMany university campuses have limited mental health services that cannot cope with the high demand. One alternative is to use internet-delivered cognitive behavioral therapy (iCBT) as a way of tackling barriers such as lack of availability and scheduling issues.ObjectiveThis study aimed to assess feasibility, acceptability, effectiveness, and satisfaction of a supported iCBT intervention offering 3 programs on depression, anxiety, and stress to university students. The design was an open or nonrandomized feasibility trial.MethodsParticipants were recruited from 3 counseling centers at a large midwestern University in the United States. Those agreeing to take part chose 1 of 3 iCBT programs—Space from Depression, Space from Anxiety, or Space from Stress —all comprised 8 modules of media-rich interactive content. Participants were supported throughout the trial by a trained professional. The Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) questionnaire, and stress subscale of the Depression Anxiety and Stress Scale (DASS-21) were completed at baseline, 8 weeks, and 3-month follow-up. A Satisfaction With Treatment (SAT) questionnaire was completed at 8 weeks, and qualitative interviews were completed by a subsample of participants at 3 months.ResultsA total of 102 participants were recruited, with 52 choosing Space from Anxiety, 31 choosing Space from Depression, and 19 choosing Space from Stress. Mixed-effects models showed a significant decrease in symptoms of depression (F4=6.36, P<.001), anxiety (F4=7.97, P<.001), and stress (F4=8.50, P<.001) over time across all 3 programs. The largest decreases in PHQ-9 scores at 8 weeks were among participants who chose the Space from Depression program (d=0.84); at 3 months, the largest decreases in PHQ-9 scores were among those who chose the Space from Stress program (d=0.74). The largest decreases in GAD-7 scores were among those who chose the Space from Anxiety program (d=0.74 at 8 weeks and d=0.94 at 3 months). The largest decrease in DASS-21 stress subscale scores was among those who chose the Space from Stress program (d=0.49 at 8 weeks and d=1.16 at 3 months). The mean time spent using the platform per session was 27.4 min (SD 33.8), and participants completed 53% (SD 37.6) of the total program content on average. Most (37/53, 69%) participants found the programs helpful or very helpful and liked the convenience and flexibility of the intervention. Qualitative interviews (n=14) indicated the intervention met students’ expectations, and they saw it as a valuable complement to face-to-face treatment.ConclusionsThe iCBT programs tested in our study appear to be feasible, acceptable, and effective in a university environment. Participants described the benefits of having a flexible, supported Web-based intervention available on campus. Larger trials should be conducted to further test the effectiveness of supported Web-based interventions that give students a choice of program depending on their symptom profile.

Relationship between perceived occupational stress and psychological well-being among secondary school heads in Khyber Pakhtunkhwa, Pakistan.

The purpose of the study was to examine the relationship between perceived occupational stress and psychological well-being among secondary school heads in Khyber Pakhtunkhwa. A sample of 402 secondary school heads (male n = 260, female n = 142) was selected through multistage sampling technique. A descriptive, quantitative and correlative research design was used. For gathering information from the participants, two standardized tools i.e., “Occupational Stress Index (OSI)” and “Ryff’s Psychological Wellbeing Scale (RPWB)” were used for measuring perceived occupational stress and psychological well-being respectively. For statistical analysis, mean, standard deviation, Pearson’s product-moment correlation and multiple regression were employed. The findings revealed that there is a strong negative correlation between perceived occupational stress and psychological well-being. Furthermore, moderate negative correlation was found between all the sub-scales of perceived occupational stress and psychological well-being. All the subscales of occupational stress except low status were found significant predictors and have negative effect on psychological well-being of secondary school heads. So, it was suggested that Elementary & Secondary Education Department Khyber Pakhtunkhwa should have a collaboration with policy makers to formulate a comprehensive strategy for stress reduction management for secondary school heads so that they may develop good psychological well-being and perform their duties effectively.

Depression, Anxiety and Stress among Female College Students in Delhi having Normal and Disordered Eating Behaviours

Background: Disordered eating behaviour is an emerging problem among young Indian females who undergo multiple changes during early adulthood. It may pose serious health consequences for these young women in their reproductive age. Psychological factors such as depression, anxiety and stress are likely to influence the eating practices of young females and predispose them to disordered eating behaviour. Objectives: The study was conducted to determine the prevalence and severity of depression, anxiety and stress among female college students in Delhi having normal and disordered eating behaviours. Materials and Methods: A total of 734 female undergraduate college students from University of Delhi comprised the study sample. An adapted Eating Attitudes Test (EAT)-26 was used to identify subjects having disordered eating behaviour and Depression Anxiety Stress Scale (DASS)-21 was used to assess the occurrence and severity of depression, anxiety and stress among them. Results: Findings revealed that prevalence of depression, anxiety and stress, ranging from mild to extremely severe forms, among the subjects was 46.6%, 63.8% and 43.1% respectively. Scores on stress, anxiety and depression subscales for subjects having disordered eating behaviour were significantly higher than those having normal eating behaviour and with regard to severity of depression, anxiety and stress, significant differences were found between the subjects. Significant positive correlations between EAT-26 scores of subjects and their scores on depression, anxiety and stress subscales were also found. Conclusion: The study indicated that prevalence of depression, anxiety and stress was substantial among the female college students in Delhi and played an important role in the occurrence of disordered eating behaviour among them. Suitable interventions for alleviating depression, anxiety and stress among young females need to be promoted to prevent disordered eating behaviour among them.