Health Support Services Research Articles

Lifestyle behaviors and mental health of health professional students during COVID-19, as measured by the CDC’s BRFSS, for the HOLISTIC cohort study

The World Health Organization estimates a 25% increase in anxiety and depression prevalence during the COVID-19 pandemic. 50% of surveyed US healthcare workers reported increased anxiety, and 27% of Chinese health professional students reported psychological distress. The mental health of US health professional students and their coping mechanisms, especially during an adverse time such as the pandemic, is less well understood. This study examined the US health professional students’ lifestyle behaviors and their association with the prevalence of poor mental health days. 890 students across seven health sciences colleges in 2020 and/or 2021 were recruited using convenience sampling. Participants completed socio-demographic questions and items from the U.S. Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor and Surveillance System (BRFSS) 2019 survey. The participants reported a median of 7 days with poor mental health (IQR: 3-15 days) in the past 30 days. Female sex (OR 1.70, 95% CI [1.21, 2.38]), Asian race (OR 1.47, 95% CI [1.06, 2.06]), adverse childhood events (OR 2.01, 95% CI [1.45-2.78]), and frequent cannabis use (OR = 2.03, 95% CI [1.14-3.61]) were each associated with an increased risk of poor mental health during the COVID-19 pandemic. Exercise (OR 0.64, 95% CI [0.42-0.97]) was found to be a protective factor during COVID-19. These results indicate the need to design, implement, and evaluate mental health support services for health professional students, particularly among certain demographic groups. Students who are frequent cannabis users or have significant childhood trauma are more likely to have poor mental health and, as such, may benefit from additional support. A lifestyle psychiatry approach to overall wellness may offer students valuable and holistic coping mechanisms that incorporate lifestyle behaviors known to positively impact mental health.

Promoting Youth Mental Wellbeing: A Photovoice Project with Adolescents and Young Adults in the Hospital Context

Given the importance of youth mental health for public policy, it is crucial to involve young people directly in participatory research to investigate their views and translate their demands into concrete actions. The aim of the study was to define the concept of mental wellbeing as perceived by a group of adolescent and young adult patients in two large hospitals in northwestern Italy and to find out, together with them, what institutions can do to promote youth wellbeing. Thirty-nine participants (13–25 years old, 90% female), divided into four groups, took part in a Photovoice workshop. Individual interviews were conducted with 21 participants and the transcripts were thematically analyzed. The photos were categorized into five themes: nature, traveling, passions and leisure, relationships, and animals. The definition of mental wellbeing can be traced back to eight themes: sharing experiences and emotions with others, calm and tranquility, personal fulfilment, sense of belonging, pleasant physical sensations, freedom and discovery, involvement and commitment, and happiness. The key recommendations for promoting mental wellbeing were providing information about mental health, tackling the stigma of mental illness, and providing psychological support in school and health services. The implications of these findings for policy makers involved in planning health services for young people are discussed.

Huntington's disease caregivers: A qualitative exploration of caregivers experience.

Caring for a family member with Huntington's disease can be complex and challenging. This study set out to investigate the research question: what are the experiences of Huntington's disease caregivers. In this qualitative study, 11 adult caregivers (6 female and 5 male, aged 49-77 years), of a family member with Huntington's disease participated in semi-structured interviews, using either video-link or telephone. Data analysis was informed by interpretative phenomenological analysis. The analysis identified three themes related to the caregiver experience: The impact on the caregiver; The impact of the genetic risk; Accessing health care & support services. Complexities of caregiving are compounded by the lack of services available to Huntington's disease patients, as well as the lack of knowledge and expertise related to the disease. This study highlights the need for enhanced knowledge of the disease in community services, along with access to psychological and multidisciplinary support.

The geographic identification of elevated suicide risk model: evaluating a method for examining suicide-related behaviors at the neighborhood level in Harris County, Texas

BackgroundThe 2024 National Strategy for Suicide Prevention has called for the development of community-based suicide prevention resources, and improved existing prevention efforts. In line with such efforts, Hill and colleagues developed the Geospatial Identification of Elevated Suicide Risk model that estimates the relative prevalence of adolescent suicide risk within specific geographical areas. The current study seeks to further evaluate and refine the model for use as a tool to evaluate risk and protective factors at the neighborhood level.MethodDrawing from multiple sources, data was collected detailing adolescent suicidal ideation, suicide attempts, suicide fatalities, and census tract characteristics. Utilizing data resulting from an initial pool of 74,883 suicidal ideation and attempt screens found in electronic health records, suicidal ideation and attempt rates were calculated, described, and mapped onto relevant census tracts via the Census Geocoder. Once mapped, a total of 1,098 census tracts were examined for criterion validity and minimum data evaluations.ResultsData indicate that rates of positive suicide risk screens are relatively normally distributed when using a minimum cell size of at least n = 5, with additional improvements at n = 10 screens per census tract. Of 48,928 records with completed screens and patient address data listed in the electronic health record, 44,776 addresses (91.5%) were matched to U.S. census tracts via the Census Geocoder database. When evaluating criterion validity, the simultaneous multivariate logistic regression revealed that the model did not fit well to the data, and suicide attempts and suicidal ideation only predicted 0.02% of the variance in the probability of suicide fatality. Finally, a classification tree revealed that a minimum of 10 data points were required to delineate between high and low-risk census tracts.ConclusionThe refined model may act as a helpful tool to evaluate neighborhood level risk and protective factors. Findings suggest a prevention-oriented, as opposed to risk prediction, approach to suicide risk management at the community level may be needed; such an approach would prioritize community connectedness, adequate mental health support services, and reduction of community-level risk factors (e.g., substance misuse), among others.

Predictors of unsuppressed viral load among men who have sex with men living with HIV in South Africa.

South Africa has the largest HIV epidemic of the world, but predictors of unsuppressed viral load among MSM are scarce. We did a cross-sectional study to assess socio-demographic characteristics, year of antiretroviral therapy (ART) initiation, and viral load data from 1385 MSM registered in five key population clinics in five districts in South Africa in 2023 and 2024. We used logistic regression to assess predictors of unsuppressed viral load (≥200 copies/ml). We then conducted a case--control study involving 57 cases (viral load≥200 copies/ml) and 57 matched controls (viral load<200 copies/ml; matched on age, ART start date, clinic, and outreach vs. facility attendance) drawn from the cross-sectional study to explore additional differences between groups. In the cross-sectional study, predictors for unsuppressed viral load included on ART for 1-2 years [odds ratio (OR) 3.53; 1.77-7.69] or 3-5 years (OR 2.33; 1.18-5.04) vs. more than 5 years, being an outreach vs. facility-based client (OR: 2.64; 1.79-3.94), and enrolled at Johannesburg (OR: 3.53; 2.25-5.64), or Durban (OR: 0.36; 0.84-0.70), vs. Pretoria. The case-control study identified predictors for unsuppressed viral load, which included missing more than four ART dosages per month (OR: 5.55; 1.19-41,03), having moderate to severe anxiety (OR: 3.90; 1.34-12,52), hazardous alcohol use (OR: 2.70; 1.14-6.81), and Christian vs. no religion (OR: 3.89; 1.34-12.29). We identified regional differences and key predictors of unsuppressed viral load among MSM living with HIV in South Africa. Screening for risk factors for unsuppressed viral load at ART continuation may inform where adherence support and other health services are needed.

Pandemic-related stress and suicide risk among healthcare professionals during the pandemic

Background Depression and suicide are common in the hospital workplace. Extreme stress is more likely in periods of major crisis. Methods To determine the stress levels and sources of stress for healthcare providers, a survey was administered to approximately 3000 clinicians in a single healthcare system in April 2022, gathering both quantitative and free-text responses. Results A total of 485 clinicians completed the questionnaire. Their responses revealed a high level of pandemic-related, personal, and professional stress, as well as burnout. Top stressors included staffing issues, increased workload, isolation and lack of professional connection, administrative and policy struggles, dealing with patient expectations, mental health and emotional toll, lack of resources and support, training and career disruptions, and public misinformation. In addition, 3.9% confided in someone about thoughts of taking their life, and 2% indicated they currently had thoughts of suicide. Overall, 1.8% of respondents experienced no stress; 19.7%, a little stress; 37.9%, a moderate amount of stress; 24.3%, a lot of stress; and 16.4%, a great deal of stress. Conclusions Healthcare institutions must address these issues by providing more support, resources, and mental health services to healthcare workers.

Analyzing Public Support for School-Based Mental Health Services.

Public schools play a central role in addressing the mental health crisis among American youth, but most schools are limited in the services they provide. As of 2019, 44% of administrators cited concerns about the public's reaction as an obstacle to expanding these services. We draw on observational data from three national surveys to study the individual-level characteristics that are associated with support for these programs. Then, we use a conjoint experiment, which randomly varies the details of a proposal at a hypothetical school board meeting to identify the programs, policies, and contexts that are most likely to gain the public's support. We find support for school mental health programs to be higher for women, racial minorities, younger people, and Democrats. The conjoint experiment results suggest that school mental health services receive more support when they are funded via state as opposed to local taxes, and when parental permission is required to participate. The results offer guidance for policymakers, emphasizing high overall public support for school mental health services, while highlighting key factors that may facilitate their implementation and acceptance.

Depression and Complicated Grief Among Parents of Pediatric Cancer Patients in Cameroon: Implications for Global Health in Low-income Countries.

Bereaved parents of pediatric cancer patients frequently experience severe grief and psychological distress, but studies on the prevalence of major depressive disorder (MDD) and complicated grief (CG) among this population in Cameroon are lacking. This study aimed to determine the prevalence of MDD and CG among bereaved parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital Cameroon, and to identify predictors of these mental health outcomes. This cross-sectional study included parents of deceased pediatric cancer patients treated at Mbingo Baptist Hospital between January 2015 and January 2022. Multivariate logistic regression identified predictors of MDD and CG as adjusted odds ratios (AOR) with 95% confidence intervals (CIs). The prevalence of CG in this population was 86%, while 66.7% of the study subjects screened positive for MDD. Significant predictors of MDD included age [OR 1.091, p=0.018], financial hardship [OR 9.47, p=0.014], accurate knowledge of the child's prognosis [OR 0.268, p=0.046], perceived social support [(poor social support OR 6.402, P=0.039), (moderate social support OR 8.556, p=0.045)], and coping capacity [medium resilient copers OR 7.874, p=0.027]. Predictors of CG included age [OR 1.157, p=0.032], financial hardship [OR 11.501, p=0.04], years passed since child loss [1-2 years OR 4.634, p=0.049], and coping capacity [(low resilient copers OR 14.011, p<0.01), (medium resilient copers OR 19.023, p<0.01)]. The study revealed high prevalence of MDD and CG among bereaved parents of pediatric cancer patients in Cameroon. Financial difficulty, social support, and coping capacity had substantial impact on parental mental health outcomes in this population. Personalized mental health support services into pediatric oncology care is critical for assisting bereaved families and encouraging resilience in the face of loss may improve health and wellbeing of the families. The study may have implications for global mental health in similar low-income countries.

Responsible leadership practices amid COVID-19 to foster nurses’ occupational calling and curtail emotional exhaustion: a pre-and post-intervention effects analysis

BackgroundThe COVID-19 pandemic has placed an unprecedented strain on healthcare systems and their workers worldwide, including nurses. Frontline nurses experienced increased levels of stress and fatigue due to extensive and prolonged work hours, inadequate protective equipment, and fear of contracting the virus. This has resulted in a rise in emotional exhaustion among nurses. Therefore, it is crucial for organizations to address these challenges to sustain workers’ psychological wellbeing for better patient outcomes.Purpose/ObjectivePast studies have shown no link between responsible leadership (RL) and nurses’ occupational calling (OC) and emotional exhaustion (EE) amid COVID-9 or any situational setting. Therefore, this study evaluated the effectiveness of RL practices in improving the OC and alleviating the EE of nurses working in the COVID-19 ward of 94 government healthcare settings, including rural health centers (RHCs) and special COVID-19 response centers (CRCs), in Pakistan.MethodologyThe study employed a quasi-experimental pre-and post-design with responsible leadership-based interventions and a descriptive approach. Leadership practices included effective communication on COVID-19 guidelines, infection control measures, mental health support services, and others. An online questionnaire survey measured pre- and post-intervention effects using RL, OC, and EE scales. The sample comprised 289 frontline nurses, recruited via convenient sampling, who participated in a three-months program in the COVID-19 ward. Data analysis was conducted using AMOS and SPSS software, involving basic analysis and paired T-tests.FindingsThe paired t-test results revealed a significant improvement in nurses’ OC after the implementation of the RL intervention. The mean score for OC increased from 5.162 (SD = 1.151; t-value = 76.253) to 5.403 (SD = 1.054; t-value = 87.138; p < 0.001). Similarly, the intervention significantly reduced EE among nurses. The mean score for EE decreased from 4.386 (SD = 1.037; t-value = 71.879) to 3.614 (SD = 1.336; t-value = 45.987; p < 0.001). Both were statistically significant.Implications for nursing managementPolicymakers may need to consider the role of leadership practices in mitigating the negative effects of the pandemic on healthcare professionals’ well-being (i.e., EE and OC).ConclusionsLeadership intervention can provide healthcare workers with the necessary skills and resources to cope with the challenges of their jobs, ultimately improving the quality of care provided to patients.

Prevalence of maternal substance use problems during pregnancy and the first 2 years of life: a whole-population birth cohort of 970 470 Australian children born 2008–2017

ObjectivesTo estimate the prevalence of maternal substance use problems during the first 1000 days of children’s lives, to inform planning and resourcing of antenatal screening and substance use in pregnancy...

INVESTIGATING FACTORS AFFECTING ABSENTEEISM DUE TO HEALTH PROBLEMS USING COUNT DATA MODELS

This study aims to determine the factors affecting the number of days individuals are absent from work due to health problems in the last 12 months by using the Poisson Regression Model, Negative Binomial Regression Model, Zero-Inflated Poisson Regression Model, and Zero-Inflated Negative Binomial Regression Model using the micro data sets of the Turkey Health Survey conducted by the Turkish Statistical Institute in 2022. The model results indicate that the variables of age, marital status, education level, general health status, occupation, receiving psycho-social support health services from primary health care institutions, illness lasting/expected to last 6 months, and hypertension in the last 12 months are significant. It was found that women were absent from work more days than men, that the number of days individuals were absent from work decreased as their age increased, and that individuals were absent from work more as their general health worsened.

‘We do not like talking about our problems’: socialization and idealized masculinity as drivers of help-seeking avoidance among college men in South Africa

BackgroundThis article explores how identities and contexts influence help-seeking avoidance behaviour among college men.MethodsThis exploratory qualitative study purposively selected 88 male students (aged 18–30) from some universities and Technical and Vocational Training colleges (TVETs) in South Africa. Data were collected through focus group discussions (FGDs). Eight FGDs were conducted, one in each selected university (n = 2) and TVETs (n = 6) in 2018–2019. Data were analyzed using a thematic analysis approach.ResultsWe found that college men’s early life experiences and socialisation strongly influenced their ability to express emotion and access services when in need of help. The data also revealed a masculinity that men aspired to and wanted to be seen as embracing or personifying while on campus. Most men ascribed to an ideal of masculinity that made it difficult for them to share their feelings (e.g., emotional pain, sadness; and bottle their emotions) and seek help from campus-based counselors or peers. The few men who reported using campus mental health support services appraised them as unsuitable and unhelpful for them, and indicated a preference for services that were more culturally relevant. Most men indicated a preference for male counselors, of which there were very few.ConclusionsThese findings may be useful for the formulation of evidence-based context-specific and culturally sensitive approaches for increasing men’s access to mental health and psychological support services on South African college campuses.

Vulnerability and psychosocial impacts of extreme weather events among young people in Australia.

Vulnerability and psychosocial impacts of extreme weather events among young people in Australia.

Analisis Kebutuhan Tenaga Admisi IGD dengan Metode Analisis Beban Kerja Kesehatan di Rumah Sakit Khusus Daerah Duren Sawit

Admission services in the emergency department (IGD) are an important part of hospital operations that require effective management to support health services. Optimal medical record management requires human resource planning according to actual workload. This research was conducted to analyze the need for admission registration at the Duren Sawit Regional Special Hospital (RSKD) with a quantitative approach using descriptive methods. The research results show that RSKD Duren Sawit has Standard Operational Procedures (SPO) which refer to Minister of Health Regulation No. 33 of 2015 in planning health human resource needs (HRK). Health workload analysis indicates that the ideal requirement is seven admissions officers, while currently only five officers are available, so there is a shortage of two officers. Factors that influence the workload of admission registration include: Man, namely the limited number of officers in the medical records unit, Machine, namely the BPJS server down and power outages, Material, namely the mixed admissions work room with the cashier so the medical record files are still in one room, Method, namely the HR application process at RSKD Duren Sawit found no obstacles, Money, namely there is no budget planning for additional officers in the medical records unit.

Screening for gambling-related harm: Scholarly commentary addictive behaviors.

Screening for gambling-related harm: Scholarly commentary addictive behaviors.

Screening and Interventions for Intimate Partner Violence in Pregnancy: The Perspective of Survivors.

Screening and Interventions for Intimate Partner Violence in Pregnancy: The Perspective of Survivors.

Stakeholders' Perspectives on the Landscape of Peer Support in Swedish Mental Health Services: A Qualitative Study

Abstract The integration of peer support workers (PSW) into the mental health services workforce has offered additional avenues to strengthen service provision. In Sweden, the availability of peer support workers has grown significantly over the past decade, yet there has been insufficient investigation into their organization and implementation. Consequently, there is a growing need for further research into the current state of peer support within the Swedish context. To examine stakeholders’ perspectives on the current state of peer support within the context of Swedish mental health services. In this qualitative study, a purposeful sampling method was employed in order to recruit 30 stakeholders, including peer support workers (n = 17) within mental health services, county council and municipal officials (n = 8), and representatives from user organizations (n = 5). The informants took part in focus groups or semi-structured individual interviews. The results highlight key factors from stakeholders for advancing peer support, providing PSWs with career paths and skill development, and advocating to top-level authorities. Organizational structures need to support sustainability, with Sweden's user organizations playing a crucial role to mitigate peer drifting. Long-term success relies on secure employment and a clear implementation strategy. The physical work environment shapes peer support implementation and requires clearly defined work roles. Navigating mental health services was viewed as challenging. According to the results, it requires stakeholders to balance perspectives and address feelings of inadequacy among PSWs, underscoring the need to legitimize the PSW profession in mental health care. To ensure genuine progress in the current organization of peer support, this work role must become a foundational aspect of service delivery, rather than merely an add-on, to foster the development of a more recovery-oriented mental health service in Sweden.

How health care facilities and family support pregnancy through pregnant women’s sports activities: a case study in Pidie district, Aceh, Indonesia

Object: This study aims to evaluate which of the antecedents of distance to health care facilities, social support and quality of health services have a more dominant influence on antenatal care intentions and their impact on pregnant women’s health through sport activities during pregnancy Methods: The study was quantitative with survey method of 300 pregnant women in the third trimester in Pidie district, Indonesia. Data collected using questionnaire. The variables analyzed were distance from home to health care facilities, quality service from health care providers, social support (health providers, family and peers), antenatal care intentions and antenatal care behavior. SEM-PLS was used for data analysis. Results: Factors that influencing antenatal care intentions were the quality of services and family support. Family support had the greatest impact on antenatal care intentions. Social support, distance and quality of services contributed 22.2% to antenatal care intentions. In combination with pregnancy care intentions, the contribution to pregnant women’s physical health through sport activities during pregnancy was 44.3%. Conclusions: This study confirms the importance of family support in improving antenatal care intentions and shows that antenatal care intentions are important in influencing antenatal care behavior for pregnant women’s physical health through sport activities during pregnancy.

MENTAL HEALTH PROBLEMS IN PARENTS OF CHILDREN WITH ADHD: A QUANTITATIVE COMPARATIVE STUDY

Background: Parenting a child with ADHD presents unique psychological challenges, often leading to heightened stress, anxiety, and depression. Although extensive research has explored these mental health concerns, studies comparing the psychological distress between mothers and fathers of children with ADHD remain scarce, particularly in Pakistan. Understanding these differences is crucial for designing targeted interventions that support parental well-being. This study aims to bridge this gap by examining the association between stress, anxiety, and depression among parents of children with ADHD and identifying gender-based differences in these mental health outcomes. Objective: This study investigates the relationship between stress, anxiety, and depression among parents of children with ADHD. Additionally, it examines differences in psychological distress between mothers and fathers and explores the mediating role of anxiety in the relationship between stress and depression. Methods: A cross-sectional correlational research design was employed. Using purposive sampling, data were collected from 216 parents (123 mothers and 93 fathers) of children diagnosed with ADHD under 18 years of age. The Depression Anxiety Stress Scale (DASS-21) was used to assess stress, anxiety, and depression. Statistical analyses, including Pearson correlation, independent t-tests, and mediation analysis via the Hayes Process Macro (Model 4), were conducted using SPSS version 29. Ethical approval was obtained from the institutional review board, and informed consent was secured from all participants. Results: A significant positive correlation was observed between stress and anxiety (r = .54, p &lt; .01), stress and depression (r = .28, p &lt; .01), and anxiety and depression (r = .42, p &lt; .01). Mothers reported significantly higher levels of stress (M = 6.21, SD = 5.18) than fathers (M = 4.07, SD = 3.38, p &lt; .001, d = 0.48). Anxiety scores were also significantly higher among mothers (M = 9.78, SD = 7.10) compared to fathers (M = 5.53, SD = 3.84, p &lt; .001, d = 0.74). Similarly, mothers exhibited greater depression (M = 13.66, SD = 6.80) than fathers (M = 8.90, SD = 6.18, p &lt; .001, d = 0.73). Mediation analysis confirmed that anxiety significantly mediated the relationship between stress and depression (β = .32, 95% CI [.13, .29]). Conclusion: The study highlights the significant psychological burden faced by parents of children with ADHD, with mothers experiencing greater distress than fathers. Anxiety serves as a key mediator in the relationship between stress and depression, emphasizing the need for early intervention strategies. These findings underscore the necessity of mental health support services, structured coping mechanisms, and educational programs to enhance parental well-being and improve outcomes for families managing ADHD.

Drivers of onward HIV transmission risk among adolescent boys growing up with HIV: a longitudinal cohort study

IntroductionHIV transmission to sexual partners is determined jointly by viraemia and condomless sex, both of which are higher among adolescents living with HIV compared with adults. Moreover, decisions around condom...