Warwick-Edinburgh Mental Well-being Scale Scores Research Articles

An out-of-court community-based programme to improve the health and well-being of young adult offenders: the Gateway RCT.

Young adults represent a third of the United Kingdom prison population and are at risk of poor health outcomes, including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of criminal sanctions and address the root causes of offending. However, evidence of their effectiveness has not yet been established. The Gateway programme, issued as a conditional caution, aimed to improve the life chances of young adults committing low-level offences. Participants agreed not to reoffend during the 16-week caution and, following a needs assessment, received individual support from a Gateway navigator and attended two workshops encouraging analysis of own behaviour and its consequences. To evaluate the effectiveness and cost-effectiveness of Gateway in relation to health and well-being of participants compared to usual process (court summons or a different conditional caution). Pragmatic, multisite, parallel-group, superiority randomised controlled trial with two 6-month internal pilots and a target sample size of 334. Randomisation between Gateway and usual process was on a 1 : 1 basis. Four Hampshire Constabulary sites recruited 18- to 24-year-old residents of Hampshire and Isle of Wight who were questioned for an eligible low-level offence. Semistructured interviews were also held with a sample of Gateway programme participants, staff and police study recruiters. Primary outcome was the Warwick-Edinburgh Mental Wellbeing Scale score at 12 months. Secondary outcomes included health status, alcohol and drug use, recidivism and resource use. Recruitment commenced in October 2019 and the trial stopped in April 2021. A total of 191 participants were recruited, with 109 randomised to Gateway and 82 to usual process. Due to an initial overestimation of potentially eligible young people and low retention rates, recruitment targets were adjusted, and a range of mitigating measures introduced. Although recruitment broadly met study progression criteria [35/50 (70%) Pilot 1: 64/74 (86%) Pilot 2], retention was low throughout (overall: data collected at week 4 was 50%: at week 16 it was 50%: 1-year 37%). Low retention was multifactorial, with one of the main barriers being difficulties contacting participants. It was therefore not possible to complete the randomised controlled trial or the health economics analyses. Qualitative interviews held with 58 individuals yielded rare insights into the benefits and limitations of this type of intervention, as well as barriers and facilitators in relation to recruitment in this setting. Despite close collaboration with the police to address recruitment and consent issues, expansion of the inclusion criteria and recruitment area and introducing other measures, the researchers were unable to collect sufficient data within an acceptable timeframe. The Gateway study was a unique endeavour to gather evidence for a potentially life-changing intervention for an underserved population. The experience gained indicates that randomised controlled trials of interventions, with a health-related outcome, are possible in this setting but point towards the need for conservative recruitment and retention estimates in this target population. Other study designs should be considered. The qualitative evaluation provided a range of valuable lessons for those seeking to design similar interventions or conduct research in similar settings. This study is registered as ISRCTN11888938. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 16/122/20) and is published in full in Public Health Research; Vol. 12, No. 7. See the NIHR Funding and Awards website for further award information.

Understanding the burden of poor mental health and wellbeing among persons affected by leprosy or Buruli ulcer in Nigeria: A community based cross-sectional study.

Skin neglected tropical diseases including leprosy and Buruli ulcer (BU)are a group of stigmatizing and disability-inducing conditions and these aspects of the diseases could lead to poor mental health. The study was designed to assess the burden of poor mental health and wellbeing among persons affected by leprosy or BU in Nigeria. A community based cross-sectional study design was employed. The study involved persons affected by leprosy or BU. Ten local government areas with the highest number of notified leprosy or BU cases between 2014 and 2018 in southern Nigeria were purposively selected. Information were obtained using Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorders-7 (GAD-7), Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and OSLO Social Support Scale. Outcome measure was poor mental health/wellbeing and was determined by proportion of respondents who had depressive symptoms, anxiety disorder and poor mental wellbeing. A total of 635 persons affected by leprosy or BU participated in the study. The mean age of respondents was 43.8±17.0 years and highest proportion, 22.2% were in age group, 40-49 years. Majority of respondents, 50.7% were males. A higher proportion of respondents, 89.9% had depressive symptoms, 79.4% had anxiety disorders and 66.1% had poor mental wellbeing. Majority, 57.2% had poor mental health/wellbeing. Among the respondents, there was a strong positive correlation between depression and anxiety scores, (r = 0.772, p<0.001). There was a weak negative correlation between depression score and WEMWBS score, (r = -0.457, p<0.001); anxiety score and WEMWBS score, (r = -0.483, p<0.001). Predictors of poor mental health/wellbeing included having no formal education, (AOR = 1.9, 95%CI: 1.1-3.3), being unemployed, (AOR = 3.4, 95%CI: 2.2-5.3), being affected by leprosy, (AOR = 0.2, 95%CI: 0.1-0.4) and having poor social support, (AOR = 6.6, 95%CI: 3.7-11.8). The burden of poor mental health/wellbeing among persons affected by leprosy or BU is very high. There is need to include mental health interventions in the management of persons affected with leprosy or BU. Equally important is finding a feasible, cost-effective and sustainable approach to delivering mental health care for persons affected with leprosy or BU at the community level. Improving educational status and social support of persons affected by leprosy or BU are essential. Engaging them in productive activities will be of essence.

Caregiver Employees' Mental Well-Being in Hong Kong.

The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick -Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. The mean score of the Short Warwick-Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (-0.050, p < 0.001) and Short Warwick-Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick-Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population.

A cross-sectional analysis of biodiversity, publicly accessible green space and mental well-being in Wales using routinely collected data

There is a lack of studies investigating the effects of green space and biodiversity on mental well-being, across a large study area. Generally, exposure to natural environments promotes better physical health, mental health and well-being. This study investigated associations between publicly accessible green space, biodiversity and mental well-being for individuals living in Wales using routinely collected survey and biodiversity data. This study used the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) to measure mental well-being. The 2018–19 National Survey for Wales responses containing the WEMWBS scores and socio-demographic factors were linked to green space and biodiversity data in census areas. By utilising Generalised Additive Models this study found that all environmental metrics were associated with mental well-being. However, after adjustment for socio-demographic factors, only bird species richness remained associated with mental well-being, with a highly non-linear relationship. There was little to no evidence of associations between green space or biodiversity when stratifying by income group. When stratified by rural and urban areas, we found bird, plant and total species richness to be associated with mental well-being.Environmental interventions should consider promoting bird species richness in urban areas which may benefit mental well-being. Future areas of research could include longitudinal studies to explore causal links between green spaces, biodiversity and mental well-being, utilising individual-level exposure.

What Works to Improve Wellbeing? A Rapid Systematic Review of 223 Interventions Evaluated with the Warwick-Edinburgh Mental Well-Being Scales.

The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) is a commonly used scale of mental wellbeing focusing entirely on the positive aspect of mental health. It has been widely used in a broad range of clinical and research settings, including to evaluate if interventions, programmes or pilots improve wellbeing. We aimed to systematically review all interventions that used WEMWBS and evaluate which interventions are the most effective at improving wellbeing. Eligible populations included children and adults, with no health or age restrictions. Any intervention study was eligible if the wellbeing outcome was measured using the 7 or 14-item WEMWBS scale assessed both pre- and post-intervention. We identified eligible intervention studies using three approaches: a database search (Medline, EMBASE, CINAHL, PyschInfo and Web of Science from January 2007 to present), grey literature search, and by issuing a call for evidence. Narrative synthesis and random-effects meta-analysis of standardised mean differences in the intervention group were used to summarise intervention effects on WEMWBS score. We identified 223 interventions across 209 studies, with a total of 53,834 participants across all studies. Five main themes of interventions were synthesised: psychological (n = 80); social (n = 54); arts, culture and environment (n = 29); physical health promotion (n = 18); and other (n = 28). Psychological interventions based on resilience, wellbeing or self-management techniques had the strongest effect on wellbeing. A broad range of other interventions were effective at improving mental wellbeing, including other psychological interventions such as cognitive behavioural therapy, psychoeducation and mindfulness. Medium to strong effects were also seen for person-centred support/advice (social), arts-based, parenting (social) and social prescribing interventions. However, a major limitation of the evidence was that only 75 (36%) of studies included a control group. WEMWBS has been widely used to assess wellbeing across a diverse range of interventions, settings and samples. Despite substantial heterogeneity in individual intervention design, delivery and groups targeted, results indicate that a broad range of intervention types can successfully improve wellbeing. Methodological changes, such as greater use of control groups in intervention evaluation, can help future researchers and policy makers further understand what works for mental wellbeing.

Exploration of wellbeing in entering first year doctor of pharmacy students

IntroductionThe purpose of this study was to assess wellbeing in entering first-year student pharmacists beginning their doctor of pharmacy degree program. MethodsThis was a mixed-methods study conducted in entering first-year student pharmacists during their pharmacy school orientation. After their wellbeing orientation session, students were asked to complete a voluntary survey that asked students to rate their current level of wellbeing according to the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Students also wrote a reflection related to their wellbeing and perceptions. Qualitative analysis was completed for student responses to reflection questions to identify recurring themes. ResultsOne hundred thirty-one students attended the wellbeing orientation session and completed the reflection assignment. Of those, 87 (66.4%) completed the voluntary quantitative survey. On average, first-year student pharmacists indicated having a moderate level of wellbeing based on WEMWBS scores. Major themes that emerged as most influential on student pharmacist wellbeing included sense of optimism/self-care, social isolation and emotional connectedness, and uncertainty/worry/anxiety. ConclusionsEntering student pharmacists had slightly lower than average levels of wellbeing based on WEMWBS scores. Pharmacy programs should continue to consider the importance of variables that impact student wellbeing (e.g., promotion of self-care, mental health, social and emotional connectedness).

EP-641 ‘Feel Good Factor’: Positive recognition impacted staff morale, encouraged juniors and led to the overall departmental development during the COVID-19 pandemic

AimsLow doctor morale and mental well-being is associated with poor patient care, especially during the COVID-19 pandemic. We report on a local initiative, Feel Good Factor (FGF), and its impact on doctors and the department.MethodsFGF is a monthly presentation at the departmental meeting implemented at WHH, started in December 2019; where kind acts are applauded. A 10-item questionnaire was distributed to doctors working in two Surgery Departments (WHH and QEQM) in May 2021. Questionnaires collected demographic data, awareness of both positive/negative events and mental well-being using Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Data was collected on audits, QIP's, sickness due to mental health, junior progression and publications.Results48 doctors responded (58.3% QEQM). There was no significant difference in overall WEMWBS score. Doctors in the WHH department were more decisive (70% vs 25%, p = 0.043); positive incident reporting was higher at WHH (25.0% vs 0.0%, p = 0.025). A trust-wide record number of 45 audits, 22 publications, 6 national studies and 11 juniors progressed in 2020. Patient clinical marker of NELA mortality was one of the least. There was no sickness leave due to mental health. FGF was also shortlisted for the annual BMJ awards.ConclusionFGF is associated with increased awareness of positive events. Improved doctor morale led to widespread participation in projects and departmental output leading to national recognition. Initiatives such as FGF should be encouraged and advertised to other departments, to improve the hospital rating.

Online Multicomponent Program for Mental Health Promotion of Medical Students: An Intervention Study

Background: Youth mental health is a significant public health concern. Mental health issues are increasing in severity and number in college campuses. Improving adolescent mental well-being remains a challenge for most societies.&#x0D; Aim: Promote the well-being and mental health outcomes of Kasr Al-Ainy medical school students.&#x0D; Methods: An intervention study conducted at Kasr Al-Ainy Faculty of medicine. Study Participants (n=664) from 4th and 5th graders were assigned to either of two conditions: Fourth graders (n=325) to intervention (Horizon Egypt) website which provided information across positive psychology domains and Fifth graders (n=312) to control neutral entertainment-based website. Participants were assessed pre- and post-intervention on Depression Anxiety Stress Scale-Short form (DASS-21) and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS).&#x0D; Results: There was no pre-intervention statistically significant differences between Horizon Egypt and control group on demographic variables, DASS-21, or WEMWBS scores. Qualitative data indicated that all participants reported that Horizon Egypt website was easy to use, 85% agreed the program was fun, 91% agreed the activities were interesting and 77% agreed they would continue to use it after study completion. Compared to the control condition, participants in the Horizon Egypt condition with high levels of adherence reported significant decrease in depression, anxiety, stress and improvements in well-being score.&#x0D; Conclusion &amp; Recommendations: Acceptability of Horizon Egypt website was high. The online delivery of positive psychology programs may be an alternative way to address mental health issues and improve youth well-being.&#x0D;

Warwick Edinburgh Mental Well-Being Scale (WEMWBS): measurement invariance across genders and item response theory examination

BackgroundThe Warwick Edinburgh Mental Well-Being Scale (WEMWBS) is a measure of subjective well-being and assesses eudemonic and hedonic aspects of well-being. However, differential scoring of the WEMWBS across gender and its precision of measurement has not been examined. The present study assesses the psychometric properties of the WEMWBS using measurement invariance (MI) between males and females and item response theory (IRT) analyses.MethodA community sample of 386 adults from the United States of America (USA), United Kingdom, Ireland, Australia, New Zealand, and Canada were assessed online (N = 394, 54.8% men, 43.1% women, Mage = 27.48, SD = 5.57).ResultsMI analyses observed invariance across males and females at the configural level and metric level but non-invariance at the scalar level. The graded response model (GRM) conducted to observe item properties indicated that all items demonstrated, although variable, sufficient discrimination capacity.ConclusionsGender comparisons based on WEMWBS scores should be cautiously interpreted for specific items that demonstrate different scalar scales and similar scores indicate different severity. The items showed increased reliability for latent levels of ∓ 2 SD from the mean level of SWB. The WEMWBS may also not perform well for clinically low and high levels of SWB. Including assessments for clinical cases may optimise the use of the WEMWBS.

Adolescent Carers' Psychological Symptoms and Mental Well-being During the COVID-19 Pandemic: Longitudinal Study Using Data From the UK Millennium Cohort Study

PurposeDuring the COVID-19 pandemic, adolescent carers in the UK may have experienced psychological distress owing to increased caring burden and loss of a break from their caring role. This study investigated longitudinal association between adolescents' caring status and mental health outcomes from 2018/2019 to February–March 2021. MethodsThe participants (n = 3,927) answered mental health questions in both the Millennium Cohort Study sweep 7 survey (age 17 years in 2018/2019) and at least one of three waves of the COVID-19 survey from May 2020 to February–March 2021. Caring status at the age of 17 years was assessed using a single question regarding whether the participant regularly looked after anyone who needed care, without being paid. Outcome measures were psychological symptoms, measured using the Kessler Distress Scale, and mental well-being, measured using the Warwick-Edinburgh Mental Well-being Scale. ResultsCompared with 3,616 noncarers, 311 (7.9%) adolescent carers reported significantly higher Kessler Distress Scale and lower Warwick-Edinburgh Mental Well-being Scale scores during the pandemic. These associations were largely explained by psychosocial risk factors. Worse outcomes were associated with poor sleep quality, attempted suicide at baseline, low social support, and a strong feeling of loneliness during the pandemic. These factors were significantly more likely to be observed among adolescent carers than noncarers. DiscussionUK adolescent carers exhibited worsened mental health outcomes one year after the first national lockdown. This increased distress may be attributable to psychosocial risk factors during the pre–COVID-19 and current COVID-19 periods, and they require psychosocial support.

Examining the effectiveness of Gateway\u2014an out-of-court community-based intervention to reduce recidivism and improve the health and well-being of young adults committing low-level offences: study protocol for a randomised controlled trial

BackgroundYoung adult offenders represent a third of the UK prison population and are at risk of poor health outcomes including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of formal criminal justice sanctions and focus resources on addressing the root causes of offending. Although diversions are widely used, evidence of their effectiveness has not yet been established.Hampshire Constabulary, working together with local charities, have developed the Gateway programme, an out-of-court intervention aimed at improving the life chances of young adults. Issued as a conditional caution, participants undertake a health and social care needs assessment, attend workshops encouraging analysis of own behaviour and its consequences and agree not to re-offend during the 16-week caution.MethodsThis is a pragmatic, multi-site, parallel-group, superiority randomised controlled trial with a target sample size of 334. Participants are aged 18–24, reside in Hampshire and Isle of Wight and are being questioned for an eligible low-level offence. Police investigators offer potential participants a chance to receive the Gateway caution, and those interested are also invited to take part in the study. Police officers obtain Stage 1 consent and carry out an eligibility check, after which participants are randomised on a 1:1 basis either to receive Gateway or follow the usual process, such as court appearance or a different conditional caution. Researchers subsequently obtain Stage 2 consent and collect data at weeks 4 and 16, and 1 year post-randomisation. The primary outcome is the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes include health status, alcohol and drug use, recidivism and resource use. The primary analysis will compare the WEMWBS score between the two groups at 12 months.DiscussionThis pioneering trial aims to address the evidence gap surrounding diversion in 18–24-year-olds. The findings will inform law enforcement agencies, third sector organisations, policymakers and commissioners, as well as researchers working in related fields and with vulnerable target populations.Trial registrationInternational Standard Randomised Controlled Trial Register (ISRCTN 11888938).

High Five: creating compassion and mental wellbeing in young people in Scotland and Brazil

High Five is an innovative programme developed by CI health and education partners, based on “Five ways to wellbeing’’ published by the New Economics Foundation. It presents simple messages about self esteem, self compassion, kindness and wellbeing and prepares children and young people to talk about challenging topics such as death and dying, bereavement or loss. For high school and college students it also explores issues of sexuality, bullying, self harm and suicide prevention. Aims are to nurture empathy, create compassionate communities in schools and develop a cohort of young compassionate citizens as future community leaders.Inverclyde population is 80,000 with high levels of poverty, unemployment, alcohol misuse, drug addiction and poor mental health. Programme partners are health, education, social care and Third sector.Developed during 2016, it has been adapted for different educational stages. It is now in all Inverclyde primary schools and has been delivered to around 200 high school or college students. In the pilot, college students demonstrated significant improvement in Warwick-Edinburgh Mental Well-being Scale scores (WEMWBS). They found photo sharing an excellent reflective tool and set up a wellbeing Facebook page. During 2017, High Five was adapted for children age 6 using creativity and fun to learn about wellbeing. Now adapted for age 14 – 17, the programme has seen an increase in young people volunteering and participating in intergenerational befriending. Other successes include some young people with emotional support needs who re-engaged in school.The lesson plan and packs developed frame High Five in the mental, emotional, social and physical wellbeing experience and outcomes of the school curriculum. This has enabled the programme to be embedded in all Inverclyde primary schools. The High Five programme was introduced to 3 high schools in Sao Sebastiao, Litoral Norte, Sao Paulo state, Brazil through the Transforming Together project. For ‘Yellow September’ all 10 high schools are taking part in a joint health and education campaign to raise awareness about suicide prevention. From 2020, pupils from schools in Scotland and Litoral Norte will link by zoom to exchange insights about mental health and wellbeing, make new friendships, and discover new possibilities for their future.High Five is evidence based, effective and can be readily adapted across age ranges and life stages. This integrated approach across health, social care and education is improving wellbeing and building social capital and kindness. The programme is being embedded in schools in Inverclyde and embraced by schools in Sao Paulo. Short term impacts on wellbeing and increasing volunteering are matched by longer term gains from inspiring a new generation of compassionate citizens.High Five is an effective integrated approach to create wellbeing and resilience in communities with challenging socio-economic profiles across the globe. Embraced equally by young people in Scotland and in Brazil, it is a powerful and transferable tool to enhance mental wellbeing and improve population health.

Virtual Reality (VR)-Based Environmental Enrichment in Older Adults with Mild Cognitive Impairment (MCI) and Mild Dementia.

Background: Despite an alarming rise in the global prevalence of dementia, the available modalities for improving cognition and mental wellbeing of dementia patients remain limited. Environmental enrichment is an experimental paradigm that has shown promising anti-depressive and memory-enhancing effects in pre-clinical studies. However, its clinical utility has remained limited due to the lack of effective implementation strategies. Objective: The primary objective of this study was to evaluate the usability (tolerability and interactivity) of a long-term virtual reality (VR)- based environmental enrichment training program in older adults with mild cognitive impairment (MCI) and mild dementia. A secondary objective was to assess the effect of VR-based environmental enrichment on stabilization of cognitive functioning and improvement of mental wellbeing in older adults with MCI and mild dementia. Methods: A total of seven participants (four patients with MCI and three with mild dementia) received biweekly VR-based environmental enrichment over a course of 6 months. The tolerability and interactivity of the participants in the VR training was serially assessed via virtual reality sickness questionnaire (VRSQ) and recording of input-error ratio. Cognitive functioning was assessed through Montreal cognitive assessment (MoCA) before and after the study. Mental wellbeing was assessed through Warwick-Edinburgh Mental Well Being Scale (WEMWBS). Results: VR-based environmental enrichment was well-tolerated by the patients with significant decrease in VRSQ scores (p < 0.01) and input-error ratio (p < 0.001) overtime. VR training was also effective in stabilization of MoCA scores over the course of therapy (non-significant difference in the MoCA scores before and after the therapy) and was associated with a trend (p < 0.1) towards improvement in WEMWBS scores between the first and the last assessments. Qualitative observations by the care-givers further corroborated a noticeable improvement in mental wellbeing of patients. Conclusions: This pilot study shows that VR can be a feasible, tolerable, and potentially effective tool in long-term support of older adults with MCI and mild dementia.

Mental wellbeing of healthcare workers working in quarantine centers during the COVID-19 pandemic in Qatar.

Background: Healthcare workers managing Coronavirus 19 (COVID-19) patients are at increased risk of poor mental wellbeing. The available literature on the psychological impact in the Arabian Gulf region is limited, and a more in-depth analysis of factors affecting frontline healthcare workers’ mental wellbeing is warranted. The aim of this study was to evaluate and explore healthcare workers’ wellbeing working in quarantine centers in Qatar.Methods: This study was a cross-sectional, web-based survey conducted on healthcare workers managing patients in designated quarantine centers. Healthcare workers associated with 51 COVID-19 quarantine centers were eligible to participate in this survey from April 19 to May 3, 2020. The primary outcome of interest was mental wellbeing as measured by the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS).Results: A total of 127 of 169 contacted staff members completed the survey, with a participation rate of 75%. Approximately 17.4% of participants had well-being scores of less than 45, indicating suboptimal wellbeing and a high risk of psychological distress and depression. The multivariable logistic regression analysis showed that nurses are associated with increased risk (more than the fivefold higher risk of having WEMWBS score < 45) of adverse mental wellbeing (adjusted OR 5.65; 95% CI 0.57, 56.4; p = 0.140).Conclusion: The psychological impact of working in quarantine centers on healthcare workers was less than what has been reported globally. Nurses are the most vulnerable group. It is essential that health services monitor the psychological impact on its workforce and puts appropriate mitigation strategies in place.

Burden in primary family caregivers caring for uremic patients on maintenance peritoneal dialysis.

Managing the burden of care for patients with chronic debilitating diseases is an important issue. Herein, we assessed the burden in primary family members caring for uremic patients on maintenance peritoneal dialysis. One hundred seventy caregivers and 170 patients were recruited. Self-perceived scoring along the Zarit Caregiver Burden Scale (ZCBS), World Health Organization Five-item Well-Being Index (WHO-5), and Warwick-Edinburgh Mental Well-being Scale (WEMWBS) were determined for caregivers. There was an inverse relationship between ZCBS and WHO-5 or WEMWBS scores in caregivers, suggesting that the higher the burden, the lesser the self-perceived well-being. One hundred two of 170 caregivers (60%) reported mild to moderate burden, indicating a common presence of mild to moderate caring-related mental and physical stress. Moreover, 31 caregivers (18.2%) reported moderate to severe burden. Several patient disease factors, including diabetes and frailty, increased caregiver burden, while insurance coverage and out-of-pocket medical costs were also positively correlated. Caregivers who lived with patients and spent longer hours in caring-related activities had higher burden scores, while regular exercise seemed to partially alleviate the burden. Our study clearly showed that caring for patients with maintenance peritoneal dialysis caused physical, mental, and social burden in family caregivers, with the extent of the stress being influenced by patients' disease severity and other demographic factors in both patients and caregivers.

Individual health trainers to support health and well-being for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT

Background Little is known about the effectiveness or cost-effectiveness of interventions, such as health trainer support, to improve the health and well-being of people recently released from prison or serving a community sentence, because of the challenges in recruiting participants and following them up. Objectives This pilot trial aimed to assess the acceptability and feasibility of the trial methods and intervention (and associated costs) for a randomised trial to assess the effectiveness and cost-effectiveness of health trainer support versus usual care. Design This trial involved a pilot multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1 : 1 individual allocation to receive support from a health trainer and usual care or usual care alone, with a mixed-methods process evaluation, in 2017–18. Setting Participants were identified, screened and recruited in Community Rehabilitation Companies in Plymouth and Manchester or the National Probation Service in Plymouth. The intervention was delivered in the community. Participants Those who had been out of prison for at least 2 months (to allow community stabilisation), with at least 7 months of a community sentence remaining, were invited to participate; those who may have posed an unacceptable risk to the researchers and health trainers and those who were not interested in the trial or intervention support were excluded. Interventions The intervention group received, in addition to usual care, our person-centred health trainer support in one-to-one sessions for up to 14 weeks, either in person or via telephone. Health trainers aimed to empower participants to make healthy lifestyle changes (particularly in alcohol use, smoking, diet and physical activity) and take on the Five Ways to Well-being [Foresight Projects. Mental Capital and Wellbeing: Final Project Report. 2008. URL: www.gov.uk/government/publications/mental-capital-and-wellbeing-making-the-most-of-ourselves-in-the-21st-century (accessed 24 January 2019).], and also signposted to other options for support. The control group received treatment as usual, defined by available community and public service options for improving health and well-being. Main outcome measures The main outcomes included the Warwick–Edinburgh Mental Well-being Scale scores, alcohol use, smoking behaviour, dietary behaviour, physical activity, substance use, resource use, quality of life, intervention costs, intervention engagement and feasibility and acceptability of trial methods and the intervention. Results A great deal about recruitment was learned and the target of 120 participants was achieved. The minimum trial retention target at 6 months (60%) was met. Among those offered health trainer support, 62% had at least two sessions. The mixed-methods process evaluation generally supported the trial methods and intervention acceptability and feasibility. The proposed primary outcome, the Warwick–Edinburgh Mental Well-being Scale scores, provided us with valuable data to estimate the sample size for a full trial in which to test the effectiveness and cost-effectiveness of the intervention. Conclusions Based on the findings from this pilot trial, a full trial (with some modifications) seems justified, with a sample size of around 900 participants to detect between-group differences in the Warwick-Edinburgh Mental Well-being Scale scores at a 6-month follow-up. Future work A number of recruitment, trial retention, intervention engagement and blinding issues were identified in this pilot and recommendations are made in preparation of and within a full trial. Trial registration Current Controlled Trials ISRCTN80475744. Funding This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 20. See the National Institute for Health Research Journals Library website for further project information.

Pilot study of an integrated model of sleep support for children: a before and after evaluation

ObjectiveDespite the success of behavioural sleep support interventions in the third sector, sleep support is not universally available for families in the UK. The aim of the study was to...

Mental wellbeing among people in prison in Scotland: an analysis of repeat cross-sectional surveys.

ABSTRACTBackgroundMental wellbeing among people in prison is poorly studied, despite featuring in many health and justice policies. We aimed to describe for the first time mental wellbeing among an unselected national prison sample.MethodsSince 2013, the Scottish Prisoner Survey—a biennial survey of people in custody in Scotland—has included the Warwick-Edinburgh mental wellbeing scale (WEMWBS), a 14-item scale with higher scores indicating greater wellbeing. We analysed data from sweeps in 2013 (n = 3158), 2015 (n = 2892) and 2017 (n = 2405) using Student’s t-test, ANOVA and multiple linear regression. We also used WEMWBS data from the Scottish Health Survey stratified by age, gender and deprivation to compare with the population at liberty.ResultsMean WEMWBS scores overall were 43.4 in 2013 (SD = 12.2), 41.8 (SD = 11.9) in 2015 and 41.2 (SD = 12.3) in 2017. Mean scores were lower among people on remand and with multiple prison episodes. Age-standardized mean scores were lower among people in prison than their peers at liberty.ConclusionsPoor mental wellbeing is an important, under-studied facet of the extreme health inequalities associated with imprisonment. These results identify that people on remand or with multiple episodes are particularly disadvantaged and provide a baseline for monitoring impacts of service or policy interventions.

Changes over time in mental well-being, fruit and vegetable consumption and physical activity in a community-based lifestyle intervention: a before and after study

ObjectivesThere is a theoretical basis for believing that healthy lifestyle interventions can improve mental well-being and evidence to show that mental well-being is protective of future health. This study contributes to the evidence base by examining changes in mental well-being associated with the One Body One Life (OBOL) healthy lifestyle programme in a community setting in the West Midlands. Study designQuantitative, before and after the evaluation. MethodsWe conducted a before and after study of the lifestyle intervention ‘OBOL’, a multi component intervention that includes exercise and healthy eating education. Mental well-being was measured with the Warwick–Edinburgh Mental Well-being Scale. Physical activity and fruit and vegetable consumption were self-reported. Measures were collected before and after the 12-week intervention and three months post completion. Non-parametric tests were used to assess differences between groups, and linear mixed models were used to assess change over time. ResultsFour hundred and eighty-one (81% of attendees) adult participants completed a valid Warwick–Edinburgh Mental Well-being Scale before starting OBOL; of whom, 63.8% completed the Warwick–Edinburgh Mental Well-being Scale immediately post intervention and 25.2% at three months. Mental well-being levels increased significantly (P < 0.001) over the course of the intervention and were sustained at the three-month follow-up (baseline median Warwick–Edinburgh Mental Well-being Scale score = 48 [interquartile range 41–55], completion = 53 [interquartile range 46–57], 3-month follow-up = 52 [interquartile range 46–56]). Change in mental well-being was clinically significant after accounting for age and gender. Changes in both fruit and vegetable consumption and physical activity appeared to explain some but not all of the variation in mental well-being. ConclusionWe found significant improvements in mental well-being among participants directly after the intervention which were sustained at the three-month follow-up. These findings contribute to a growing body of knowledge on the contribution of lifestyle interventions to promoting and sustaining mental well-being.

The impact of urinary incontinence on health-related quality of life (HRQoL) in a real-world population of women aged 45-60 years: results from a survey in France, Germany, the UK and the USA.

To develop a clear understanding of the relationship between severity of urinary incontinence (UI) and health-related quality of life (HRQoL) and mental well-being in a population of women of working age with the requisite demands of a busy, active life. A survey of women with UI, aged between 45 and 60 years, was conducted via the internet in the UK, France, Germany and USA between 1 and 30 September 2013. Validated outcome measures were used to assess symptoms and the impact of UI on activities of daily life, HRQoL, and mental well-being: The International Consultation on Incontinence Modular Questionnaire Short Form; (ICIQ-UI Short Form); the ICIQ-Lower Urinary Tract Symptoms Quality of Life; (ICIQ-LUTSqol); the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). The relationships between UI, HRQoL and mental well-being were analysed using analyses of variance and regression. The survey was completed by 1203 women with UI with an average age of 52.7 years. Based upon responses to the ICIQ-UI Short Form about the amount of urine that leaks, respondents were categorised as having light (n = 1023, 87%), medium (n = 134, 11%), or severe UI (n = 20, 2%). The scores on the ICIQ-UI Short Form increased with severity [mean (sd) scores: light UI 7.9 (3.4), medium UI 13.8 (2.9), and severe UI 18.3 (3.9)], as did the impact on HRQoL, assessed using the ICIQ-LUTSqol [mean (sd) scores: light UI 30.6 (7.3), medium UI 41.0 (11.2), and severe UI 56.9 (17.6)]. Mental well-being decreased with severity of UI, the mean (se) WEMWBS scores were: light UI 48.3 (10.1), medium UI 44.5 (9.5), and severe UI 39.9 (16.2). In women with UI, aged 45-60 years, UI symptoms directly affect HRQoL, which subsequently impacts negatively on mental well-being.