Stress Subscale Research Articles

Secondary traumatic stress in nurses working with patients with suspected/confirmed COVID-19 in Turkey.

This study aimed to determine the level of secondary traumatic stress in nurses (n = 205) working with patients with suspected or confirmed COVID-19 in Turkey. Data were collected using the personal information form and Secondary Traumatic Stress Scale. Of the total sample, 62% were femaleand 52% of nurses were in the 20- to 30-years age range. 67.8% of the nurses experienced high and severe secondary traumatic stress symptoms, the mean score was 49.66 ± 0.86. At the level of secondary traumatic stress subscales, the highest average score was avoidance symptom (20.09 ± 5.06). More than half of the nurses experienced high and severe secondary traumatic stress where the highest symptom "avoidance."The nurses may need psychosocial support during and after the pandemic.

Depression, anxiety and stress among Australian nursing and midwifery undergraduate students during the COVID-19 pandemic: a cross-sectional study.

To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. Cross-sectional study during August-September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. The response rate was 22% (n=638). Mean scores on all DASS-21 subscales were significantly higher (p<0.001) than means from all comparative sample data. The proportions of students reporting moderate to severe symptoms of depression, anxiety and stress were 48.5%, 37.2% and 40.2% respectively. Being a woman, being younger, having completed more years of study and having poorer self-rated general health were all significantly associated (p<0.05) with higher scores on at least one DASS-21 subscale. Almost half of participants reported at least moderate symptoms of depression; more than a third reported at least moderate symptoms of anxiety or stress. Poor psychological wellbeing can impact students' successful completion of their studies and therefore, has implications for nursing and midwifery workforce recruitment and retention. During and after pandemics, universities should consider screening undergraduate students not only for anxiety and stress, but also for depression. Clear, low-cost referral pathways should be available, should screening indicate that further diagnosis or treatment is required.

Associations between inflammatory markers and well-being during 12weeks of basic military training.

Stress, anxiety and physical exertion are all closely linked to well-being, and each can alter immune function. Diminished well-being has been observed during military training, however there is mixed evidence regarding whether concomitant changes in inflammatory markers occur, with these phenomena indicating potential maladaptive responses to imposed training loads. The aims of this project were (1) assess changes in inflammation and subjective well-being across a 12-week basic military training (BMT) program, and (2) evaluate relationships between circulating inflammatory markers and well-being. A total of 37 men and women undergoing 12weeks of BMT in Australia were recruited. Well-being was assessed via questionnaire (DASS-21), and plasma samples were collected for the analysis of inflammatory cytokines [interleukin (IL)-4, IL-6, IL-1β, IL-8, IL-10, and tumor necrosis factor (TNF)-α] at weeks 1, 4, 8 and 12. Data were analysed using general linear mixed models. Depression, anxiety and stress subscale scores all significantly improved (all P ≤ 0.001), and TNF-α decreased (P = 0.031) across time. Compared to baseline (week 1), significant decreases in associations between depression and IL-10, anxiety and IL-10, and stress and IL-10, IL-4 IL-6 and TNF-α (all P < 0.05), were detected across BMT. The BMT program appears to support improved well-being over the 12weeks, with minimal perturbation to inflammatory markers. Biomarkers and well-being displayed consistent associations and may have utility as psychophysiological indicators of health status in military research, however for now, subjective measures may represent more cost-effective proxies for ongoing monitoring of military personnel.

Survey of Immediate Psychological Distress Levels Among Healthcare Workers in the COVID-19 Epidemic: A Cross-Sectional Study.

The outbreak of COVID-19 has laid unprecedented psychological stress on healthcare workers (HCWs). We aimed to assess the immediate psychological impact of COVID-19 epidemic on the HCWs at Baqiyatallah Hospital in Tehran, Iran. We conducted a cross-sectional survey of HCWs using questionnaires in February and March 2020 in Baqiyatallah Hospital, Tehran. We evaluated depression, stress, and anxiety levels using the DASS-21 questionnaire. Participants were selected by using census sampling. All statistical analyses were performed using R version 3.5.1. The study population included 217 HCWs (111 male, 116 female) and the mean age of the study group was 39.6years old. Approximately two-thirds of the HCWs stayed in the hospital for 2-3weeks. The mean scores of depression and stress were at a "severe" level, while anxiety scores were at an "extremely severe" level. The prevalence of severe scores was 38.71%, 2.30%, and 48.97% for depression, anxiety, and stress, and the prevalence of extremely severe scores was 46.54%, 97.24%, and 4.98% depression, anxiety, and stress, respectively. In stress subscale, moderate stress was 47.46%. Female HCWs reported higher levels of depression compared with males. In this study, HCWs reported experiencing severe and extremely severe psychological burdens. Timely interventions to promote mental health in HCWs exposed to patients with COVID-19 need to be immediately implemented, with female nurses requiring particular attention. This process could be facilitated via tests for molecular biomarkers in accessible body fluids, such as saliva, plasma, and serum.

Psychological outcomes amongst family medicine healthcare professionals during COVID-19 outbreak: A cross-sectional study in Croatia

Background Healthcare professionals (HCPs) in family medicine (FM) in Croatia work in a demanding environment caused by the SARS-CoV-2 pandemic. Besides particular circumstances in healthcare, an unknown virus, social distancing, and homeschooling, the capital was hit with the earthquake during the lockdown. Objectives To assess the prevalence of stress, anxiety, depression, posttraumatic stress disorder (PTSD) and the influence of demographic characteristics, professional differences, medical history, and specific stressors on the psychological outcomes. Methods A cross-sectional study with the online questionnaire containing the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale-Revised (IES-R) was conducted from 1st to 15 May 2020 in FM. Results HCPs (534, 35% response rate), predominantly female (84.5%), participated in the research. High prevalence of stress (30.9%), anxiety (33.1%), depression (30.7%), and PTSD (33.0%) were found. Female participants had higher results in the anxiety subscale of DASS-21 and IES-R scores. Pre-existing conditions were associated with higher levels of stress, anxiety, depression, and PTSD. The IES-R score for PTSD showed borderline correlation (p = 0.053) with working in regions with the highest incidence of COVID-19. Having schoolchildren made a difference on a stress subscale in DASS-21 (p < 0.043), but the earthquake did not have an impact. Conclusion Family physicians and nurses in FM in Croatia are under a great mental load during the COVID-19 outbreak. Results suggest that HCPs of the female sex, with pre-existing chronic conditions, work in regions with a high incidence of SARS-CoV-2 or have schoolchildren at greater risk of the poor psychological outcome.

Psychological effects of the COVID-19 pandemic on parents in an urban setting in Andhra Pradesh

Background: Existing literature around pandemics suggests that preventive measures during lockdown have an adverse impact on psychological well-being across different demographic groups. In particular, parents' stress is somewhat complex and influenced by the demands of looking after children, homeschooling, and an increase in domestic chores and needs exploration and timely attention.Aims: The aim is to study the psychological impact of the COVID-19 pandemic and various associated factors on parents.Settings and Design: This was a cross-sectional study done online using Google Forms sent to WhatsApp groups in an urban setting in Andhra Pradesh, on a purposive sampling basis.Materials and Methods: A purposive sampling approach using a survey questionnaire through WhatsApp produced data from 159 parents who completed the Depression, Anxiety and Stress Scale (DASS-21) short version and the Parental Stress Scale (PSS).Results and Conclusions: Criteria for severe stress on the DASS-21 were met in 47% of parents. Severe anxiety and depression were noted in 39% and 40% of the sampled parents, respectively. Mean parental stress scale score significantly correlated with the depression, anxiety, and stress subscales of the DASS-21. These findings indicate that pandemics and subsequent disease-containment responses such as lockdown may create a condition that parents may find overwhelming and one that could have a negative impact on parents and children. Pandemic planning must address these needs within the disease-containment measures.

Nurse's identity role during Covid-19.

Background and aim of the work:The main purpose of this study is to investigate on the experience of nurses working in the Covid-19 area focusing on their role’s perception. In particular, we explored the nurses’ perception of job satisfaction in relation to the images sent back by public opinion through the mass media and social communication channels. During the first wave of Covid-19 nurses have acquired media visibility, but their feeling is represented more by the discomfort of finding themselves suddenly glorified in the face of a lack of professional, social, and economic recognition.Materials and methods:A Mix-Method methodology and convenience sampling was adopted, on the population of professionals and students in post-graduate specializations, belonging to the Department of Medicine and Surgery of the University of Parma, and by nurses from the ASST-Bergamo Est, Lombardia Italy, who worked in the Covid emergency during the firstwaveof the pandemic, from February 2020 to May 2020. In the quantitative phase Stamm’s Professional Quality of Life Scale - ProQOL was administered to 89 respondents through a Google Form, In the qualitative phase, 3 Focus Groups were conducted on a total of 17 students.Results:At the ProQOL questionnaire, a moderate score was found in the Compassion Satisfaction scale (CF = 38.28) and in the Secondary Traumatic Stress subscale (STS-24.33), while low values emerged in the Burnout subscale (BO = 16.02). Five specific topics emerged from the focus groups: Professional collaboration, Job satisfaction, Nurse’s personal skills, Failure to protect the public image and the nursing profession.Conclusions:The professional collaboration, union with the work team, sense of solidarity, job satisfaction, professional growth, and awareness of one’s role seem to have worked favorably on Compassion Satisfaction, while keeping Compassion Fatigue levels under control.

Stress and Gaming: Biopsychological Understanding among Medical Graduates

Background: Video games are seen as a modality to manage stress. The study examined the role of playing violent gaming on stress. Materials and Methods: The observational design was used for the assessment of stress among 04 medical undergraduates in the age group of 18 years to 20 years. Salivary cortisol and stress subscale of Depression, Anxiety, and Stress scale were used to assess stress. Results: Salivary cortisol and psychological scale findings revealed the presence of higher stress among violent game players. Conclusions: The findings imply the need to evolve emotional regulation approaches for management of stress among gamers.

Association between quality of work life and stress among nurses in a tertiary care hospital in Saudi Arabia

Background: Quality of work life (QWL) influences the performance and commitment of employees in health-care organizations. Objectives: This study aimed at assessing the QWL and its associated factors among nurses in a tertiary care hospital in Al-Madinah, Saudi Arabia. Methods: This cross-sectional study was conducted among 212 nurses at Madinah Cardiac Center in Al-Madinah in Saudi Arabia using the Brooks and Anderson's quality of nursing work life survey and the stress subscale of the Depression, Anxiety and Stress Scale. The t-test, analysis of variance, Pearson correlation coefficient, and multiple linear regression were conducted to analyze the data. Results: Most participants (65.1%) had high QWL and one-third (33%) had severe stress. Factors that independently predicted QWL were monthly income (P = 0.007), number of working hours per week (P = 0.041), and stress level (P = 0.001). Conclusion: Most participants had high QWL. Minimizing stress and improving the work environment are necessary to improve the QWL of nurses.

A Correlational Study Between Attachment Behaviors and Spiritual Health with Stress in Pregnant Women Referred to Healthcare Centers in Qazvin, Iran, in 2015

Background: Prenatal stress causes negative health outcomes for the mother and fetus. Hence, investigating coping strategies is essential to reduce such negative effects. Objectives:: The current study aimed to investigate the correlation between attachment behaviors and spiritual health with stress during pregnancy. Methods: In this cross-sectional study, 200 pregnant women referred to the health centers affiliated to Qazvin University of Medical Sciences in 2015 are studied. Participants were selected using the multi-stage sampling technique. Data were collected using Paloutzian &amp; Ellison's Spiritual Well-Being Scale, Cranley's Maternal-Fetal Attachment Scale, the Pregnancy Stress Scale, and a researcher-made questionnaire consisting of demographic and midwifery information. Data were analyzed by SPSS version 20 using Pearson’s correlation coefficient and the multivariate linear regression analysis. Results: The mean scores for spirituality, attachment behaviors, and prenatal stress were 104.15 ± 10.59, 95.91 ± 8.9, and 88.92 ± 36.93, respectively. A positive weak correlation was spotted between attachment and stress (P = 0.02, r = 0.15), and spiritual health was found to have a negative, weak but significant association with the financial status (P &lt; 0.001, r = -0. 22) and personal-family (P = 0. 03, r = -0.14) subscales of stress. No significant correlation was observed between spiritual health and the total score of stress (P &gt; 0.05). Conclusion: This study demonstrated that maternal-fetal attachment was correlated with prenatal stress while spiritual health was not correlated with prenatal stress; however, spiritual health could predict some subscales of stress.

The effect of training on stress and coping with stress in patients receiving infertility treatment

Amaç: Bu çalışma, infertilite tedavisi gören hastalara verilen eğitimin stres ve stresle başa çıkmalarına etkisi incelemek amacıyla yarı deneysel olarak planlanmış ve uygulanmıştır.&#x0D; Gereç ve Yöntem: Çalışma yarı deneysel niteliktedir. İstanbul ilinde bir vakıf hastanesine IVF tedavisi için başvuran bireylerle, Mayıs 2017- Ocak 2018 tarihleri arasında gerçekleştirildi. Örneklemi 40 infertil birey oluşturdu. Veriler araştırmacı tarafından yüz yüze görüşme yöntemiyle toplandı. Ön test uygulandıktan sonra eğitim verildi. Eğitimden bir ay sonra son test uygulandı. &#x0D; Bulgular: İnfertil kadınların ortaokul mezunlarının verilen eğitim öncesi stresi ölçeği puanın daha yüksek olduğu, eğitim sonrası bu farkın ortadan kalktığı, infertilite nedenine göre infertilite stresi ile başa çıkma ölçeği alt boyutu puan ortalamaları arasında istatistiksel olarak anlamlı fark olduğu, kadınların İnfertilite Stresi ile Başa Çıkma Ölçeği alt boyutlarından aktif yok sayma, aktif mücadele etme ve pasif yok sayma başa çıkma yöntemlerinin kullanımı arttıkça İnfertilite Stresi Ölçeği alt boyut stresi arttığı tesbit edildi. &#x0D; Sonuç: Bu çalışmada infertilite ve stres araşındaki ilişki araştırmış olup, tedavi süreci ve sonuçların hastalarda önemli bir stres kaynağı olduğu sonucuna varılmıştır. Elde edilen sonuçlara göre infertilite tedavisi için hastaneye başvuran hastaların stres düzeyi ve stresle başa çıkma yöntemlerinin belirlenmesi, bu konuda eğitim ve danışmanlık verilmesi önerilmektedir.

A cross-sectional survey on occupational stress and associated dyslipidemia among medical staff in tertiary public hospitals in Wenzhou, China.

IntroductionOccupational stress is considered to be a harmful physical and emotional response to an individual's psychological and/or physiological state in the work environment and is highly prevalent among medical staff. However, few epidemiological studies have investigated occupational stress in medical staff. Our study aims to explore the characteristics of occupational stress and its relationship with dyslipidemia in Chinese medical staff at tertiary hospitals and establish the basis for future preventive strategies.MethodsA cross‐sectional study was conducted in three tertiary public hospitals in Wenzhou City, Zhejiang Province, China. Data were collected using random sampling procedures to examine demographic characteristics and job‐related data. The participants completed the Occupational Stress Inventory—Revised (OSI‐R) questionnaires and serum lipids tests. Partial correlation analysis was conducted to explore the relationship between occupational stress and dyslipidemia.ResultsA total of 1,176 medical staff responses to questionnaires were obtained. The occupational stress levels of medical staff were higher than those of normative populations, while their coping resources were lower. Most of the subscales of occupational stress demonstrated higher results for doctors and males than for nurses and females with crude analyses. Each subscale of OSI‐R was found to be associated with a different type of blood lipid level.ConclusionsThe occupational stress level of medical staff in tertiary public hospitals in Wenzhou was high, and occupational stress may contribute to dyslipidemia. An investigation into occupational stress levels and their association with dyslipidemia in this population could draw more attention to medical staff in tertiary public hospitals.

Brain network functional connectivity changes following psychosocial stress in subjective cognitive decline

AbstractBackgroundNeurodegenerative processes in early AD may disrupt the coordinated activity of brain networks important for the regulation of endocrine and emotional stress response. Stress reactivity and the effect of psychosocial stress on brain network function may thus be useful markers of neural changes related to early AD processes. The goal of this study was to examine the effect of psychosocial stress on brain network function in older adults with Subjective Cognitive Decline (SCD), a population at increased risk for Alzheimer’s disease.MethodParticipants (n=25) were evaluated to exclude cognitive impairment and significant psychiatric disorders. SCD was operationalized using the Cognitive Complaints Index (CCI) with a required minimum score of 20%.The Montreal Imaging Stress Task (MIST) was used to induce moderate psychosocial stress. Subjective measures included the stress subscale of the Stress‐Arousal Checklist (SACL) and the Profile of Mood States (POMS).Resting‐state fMRI scans were completed before and after the MIST. Seed‐based analyses were used to examine changes in functional connectivity (FC) in the default mode (DMN‐posterior cingulate), cognitive control (CCN‐dorsolateral prefrontal cortex), and salience (SN‐anterior insula) networks (p uncorrected &lt;0.005, FDR corrected p &lt;0.05).ResultParticipants had an average CCI of 45% (SD = 10.5%). There was an increase in subjective stress (stress‐SACL; t=6.12, p &lt; 0.0001) and worsening mood symptoms (POMS total score; t=3.23, p=0.004) during the MIST. In the DMN, stress exposure with the MIST resulted in decreased FC between the posterior cingulate cortex and regions of the CCN, (middle and superior frontal gyri). In the SN, stress exposure increased FC between the right anterior insula and the right middle/inferior temporal gyri and DMN regions including the precuneus and posterior cingulate cortex. We did not observe changes in FC in the CCN.ConclusionThese findings suggest that in SCD stress reduces coordinated activity of the CCN and DMN and increases connectivity between SN and DMN which may reflect impaired regulation of DMN activity and enhanced vigilance for emotional information. Further work is needed to determine how these changes may differ from normal aging and whether network changes may indicate early AD‐related cognitive and emotional disruption.

Effectiveness of a Smartphone App (BioBase) for Reducing Anxiety and Increasing Mental Well-Being: Pilot Feasibility and Acceptability Study.

BackgroundThe prevalence of workplace-related stress and anxiety is high, resulting in stress-related physical and mental illness. Digital self-guided interventions aimed at key areas of workplace design may be able to provide remote anxiolytic effects.ObjectiveThe aim of this feasibility study is to assess changes in anxiety and mental well-being after use of the BioBase programme, a mobile phone platform for psycho-educational modules, tools, and real-time feedback of physiological data.MethodsA 4-week observational study was carried out in 55 healthy adults who were screened for stress with the Depression Anxiety Stress Scale (DASS) Stress subscale. Participants completed anxiety (6-item State-Trait Anxiety Inventory [STAI]) and mental well-being (Warwick-Edinburgh Mental Well-being Scale [WEMWBS]) questionnaires at baseline and at 4 weeks. Feedback questionnaires were administered after 4 weeks.ResultsAfter 4 weeks of using the programme and controlling for any effect of being paid to take part in the study, STAI significantly decreased (baseline mean 45.52 [SD 13.2]; 4-week mean 39.82 [SD 11.2]; t54=–3.51; P<.001; CI –8.88 to –2.52; Cohen d=0.96) and WEMWBS significantly increased (baseline mean 48.12 [SD 6.4]; 4-week mean 50.4 [SD 6.9]; t53=2.41; P=.019; CI 0.44-4.23; Cohen d=0.66). Further, higher baseline stress was significantly associated with a greater decrease in STAI (t53=–3.41; P=.001; CI –8.10 to –2.10; R2=0.180) and a greater increase in WEMWBS (t52=2.41; P=.019; CI 0.38-4.11, R2=0.101). On feedback, participants found the programme easy to use/navigate, with the content being acceptable and relevant to workplace-related stressors; 70% (21/30) of participants would recommend the programme to a friend.ConclusionsThe BioBase programme is a potentially effective intervention in decreasing anxiety and increasing mental well-being, with larger changes in those with higher baseline levels of stress.

MENTAL HEALTH AND QUALITY OF LIFE DURING COVID-19 PANDEMIC IN INDIAN POPULATION

Objective: As there is a dearth of researches targeting the Indian population on this issue, we decided to conduct a survey to assess the psychological impact of COVID-19 on mental health and quality of life of Indians.&#x0D; Methods: In this Cross-Sectional study, a total of 2245 participants above 16 y of age were included. Mental health variables were assessed via depression, anxiety and stress subscale (DASS-21), Insomnia Severity Index (ISI-7), Patient health questionnaire (PHQ-15), Quality of life (QoL-5) and social media exposure.&#x0D; Results: The multivariate logistic regression demonstrated female (OR-1.17, 95% CI: 0.99 to 1.38) had significantly higher depression scores whereas, housewife had higher depression (OR-1.68, 95% CI: 1.33 to 2.13), anxiety (OR-1.64, 95% CI: 1.15 to 2.35), insomnia (OR-1.32, 95% CI: 1.14 to 1.53), somatic symptoms (OR-1.76, 95% CI: 1.21 to 2.57). Front line workers had a higher psychological impact with increased scores of anxieties (OR-1.23, 95% CI: 0.79 to 1.53), stress (OR-1.82, 95% CI: 0.76 to 2.55), insomnia (OR-1.65, 95% CI: 1.31 to 2.09). Lower education level had significantly higher score in depression (OR-1.14, 95% CI: 0.73 to 1.32), insomnia (OR-2.42, 95% CI: 2.07 to 2.84), somatic symptoms (OR-2.59, 95% CI: 1.80 to 3.37). Poor physical health, social media exposure was significantly associated with heightened anxiety score.&#x0D; Conclusion: There is a need for psychological intervention as the dynamics and severity of COVID-19 is rapidly changing. These findings could guide the public health authorities to target and implement health measures to combat the pandemic.

The depression anxiety and stress Scales-21: Bifactor statistical indices in support of the total and depression scores

This study explored several, latent factor models of the Depression Anxiety and Stress Scale?21 (DASS?21) using both a sample of clinically depressed patients and a Facebook sample from Serbia. The DASS?21, the Beck Depression Inventory?II, and the State Trait Anxiety Inventory?Trait were administered to a sample of depressed individuals (N = 296; Mage = 52.21, SDage = 11.56). A Facebook sample (N = 376; Mage =29.12, SD = 8.96) completed the DASS?21 only. A bifactor model with one general distress (G) and two specific factors (Depression and Anxiety) were supported. The three factors had high omega coefficients, whereas omega hierarchical for Depression and Anxiety were low. Based on all evidence from our study, external validation, factor determinacy, and replicability, we concluded that the Serbian version of the DASS?21 assesses reliably general distress and anhedonia in both people with the clinical level of severity of distress and in general population. The Anxiety subscale can be safely used in clinical settings when one wishes to assess individuals presenting with a mixture of distress and anxious arousal. However, until further validation support is provided, we do not recommend use of this scale when the task is to estimate precisely anxious arousal only. The Stress subscale assesses general distress only. Low omega hierarchical coefficients of the Depression and Anxiety subscales could be addressed by re-selecting their items from the initial item pool, based on which the DASS?21 was created, using those with substantial loadings on both the G and their respective group factors.

Shifts in alcohol consumption during the COVID-19 pandemic: early indications from Australia.

Background and aimThe effect of the COVID‐19 pandemic on alcohol consumption is currently unclear. This study aimed to provide early estimates of how stress and demographics will interact with shifts in harmful alcohol consumption from before the COVID‐19 outbreak to 2 months into social distancing.DesignCross‐sectional convenience sample.SettingAustralia.ParticipantsA total of 1684 Australians aged 18–65 years who drink at least monthly.MeasurementsItems from the Alcohol Use Disorders Identification Test (AUDIT) and the stress subscale of the Depression Anxiety and Stress Scale (DASS).FindingsOverall, harmful drinking decreased during social distancing measures in our sample [2019 score = 8.2, 95% confidence interval (CI) = 7.9–8.4; during the pandemic = 7.3, 95% CI = 7.1–7.6]. Younger drinkers, particularly young women, decreased their consumption the most, but there was a small increase in consumption in middle‐aged women. Drinkers experiencing high levels of stress also reported a relatively higher shift in harmful consumption compared with those with low levels of stress (β = 0.65, P = 0.003), despite reporting a small decrease overall.ConclusionsThe closure of licensed premises and social distancing measures in Australia in response to the COVID‐19 outbreak appear to have reduced harmful alcohol consumption in younger drinkers, particularly young women.

The determination of the perceived stress levels and health-protective behaviors of nursing students during the COVID-19 pandemic.

PurposeThe study was carried out to determine the perceived stress levels and health‐protective behaviors of nursing students during the COVID‐19 pandemic.Design and MethodsThis study used a descriptive design. The sample consisted of a total of 372 students.FindingsThe examination of the protective measures adopted by the students against COVID‐19 indicated that the mean perceived stress subscale scores of the students who did not use a mask and disposable wipes when coughing/sneezing were statistically significantly higher (p < .005).Practice ImplicationsThe stress levels of students should be determined at certain intervals, and interventional studies on coping methods that will reduce stress levels should be planned.

Psychometric Properties of the Persian Version of the Overall Anxiety Severity and Impairment Scale (OASIS)

Objectives: This study was conducted to assess the psychometric properties of the Persian version of the overall anxiety severity and impairment scale (OASIS), a measure designed to evaluate the severity and functional impairments associated with clinical and subsyndromal anxiety. Methods: Using a descriptive-analytic framework, first, the OASIS was translated into Persian according to the forward-backward translation guidelines. Then, a total of 463 students of Guilan University of Medical Sciences in the academic year 2017 - 18 were selected using the convenience sampling method. Participants completed seven measures (i.e., OASIS, anxiety and stress subscales of depression anxiety stress scales-21, Beck anxiety inventory, openness subscale of NEO five-factor inventory, positive affect and negative affect scales, Connor-Davidson resilience scale, and state subscale of state-trait anxiety inventory), and the data were analyzed by SPSS V. 20.0 for windows and Lisrel V. 8.80. Results: Internal consistency reliability of the OASIS was acceptable (Cronbach’s α = 0.877). The exploratory factor analysis indicated that all items were loaded on a single factor (loadings = 0.799 - 0.849). The confirmatory factor analysis revealed that the single-factor model has resulted in an adequate model fit. The OASIS was positively correlated with the anxiety- and negative affect-related scales, whereas it was negatively correlated with the resilience- and positive affect-related scales. Correlations with the openness subscale were not significant. Conclusions: In line with previous studies, the findings showed that the psychometric properties of the Persian version of the OASIS are acceptable. Therefore, it seems that the measure can be used in clinical practices and research studies in Iran.

The association of occupational stress and sleep duration with anxiety symptoms among healthy employees: A cohort study.

The aim of this study is to identify occupational stress associated with the development of new-onset anxiety symptoms and the dose-response relationship between sleep duration and the onset of anxiety symptoms. Data from 29,251 healthy employees who had undergone at least two comprehensive health examinations at Kangbuk Samsung Hospital Health Screening Center were analysed. Anxiety symptoms were assessed using the Beck Anxiety Inventory. Occupational stress and sleep duration were measured using a self-reported questionnaire about total sleep time and the Korean Occupational Stress Scale-Short Form (KOSS-SF), respectively. Flexible parametric proportional hazards model used to estimate the hazard ratios. Compared with the groups without case-level anxiety, discomfort in an organizational climate, high job demands, job insecurity, organizational injustice and lack of reward were associated with the onset of case-level anxiety. Compared with less than 6 hr of sleep per day, the beneficial level of sleep duration was 7 ≤ to <9 hr a day. Almost all subscales of job stress were associated with the development of anxiety symptoms. In addition, the efficacious level of sleep duration for reducing the onset of future anxiety symptoms was 7 ≤ to <9 hr a day.