Well-being Scores Research Articles

Wellbeing after finalisation of a workers’ compensation claim: a cross-sectional survey

ABSTRACT Objective Injured workers can be disadvantaged after a workers’ compensation claims ends. This study investigated the association of a range of variables with wellbeing in injured workers who had finalised a workers’ compensation claim >3 months prior. Methods On-line, cross-sectional survey (n = 129, 55.81% female). Wellbeing was measured using the Psychological Wellbeing 18-item (PWB) and the Personal Wellbeing Score (PWS). Results Multivariable quantile regression analysis controlling for education level demonstrated associations between the PWB and levels of psychological distress -1.53 (95% CI -2.11 to -0.94), p < 0.001 and resilience 6.51 (95% CI 2.65 to 10.37), p = 0.001, and between the PWS and levels of psychological distress -0.04 (95% CI -0.51 to -0.29), p < 0.001 and resilience 1.2 (95% CI 0.47 to 1.93), p = 0.001. Conclusions Contemporaneous variables of resilience and psychological distress were stronger correlates with wellbeing than historic claim-related variables.

Predictors of Engagement in Multiple Modalities of Digital Mental Health Treatments: Longitudinal Study.

Technology-enhanced mental health platforms may serve as a pathway to accessible and scalable mental health care; specifically, those that leverage stepped care models have the potential to address many barriers to patient care, including low mental health literacy, mental health provider shortages, perceived acceptability of care, and equitable access to evidence-based treatment. Driving meaningful engagement in care through these platforms remains a challenge. This study aimed to examine predictors of engagement in self-directed digital mental health services offered as part of an employer-based mental health benefit that uses a technology-enabled care platform. Using a prospective, longitudinal design, we examined usage data from employees who had access to an employer-sponsored mental health care benefit. Participants had access to a digital library of mental health resources, which they could use at any time, including daily exercises, interactive programs, podcasts, and mindfulness exercises. Coaching and teletherapy were also available to. The outcome was engagement with the self-directed digital mental health resources, measured by the number of interactions. Poisson regression models included sociodemographic characteristics, patient activation, mental health literacy, well-being, PHQ-9 and GAD-7 scores at baseline, primary concern for engaging in treatment, and the use of coaching or teletherapy sessions. In total 950 individuals enrolled in the study, with 38% using any self-directed digital mental health resources. Approximately 44% of the sample did not use the app during the study period. Those using both self-directed digital and 1:1 modalities made up about one-quarter of the sample (235/950, 24.7%). Those using only coaching or therapy (170/950, 17.9%) and those using only self-directed digital mental health resources (126/950, 13.3%) make up the rest. At baseline, these groups statistically significantly differed on age, PHQ-9, GAD-7, MHLS, and primary concern. Receipt of coaching and teletherapy was associated with the number of self-directed digital mental health resources interactions in adjusted Poisson regression modeling. Use of any coach visit was associated with 82% (rate ratio [RR] 1.82, 95% CI 1.63-2.03) more self-directed digital mental health resource interactions while use of any teletherapy session was associated with 80% (RR 1.80, 95% CI 1.55-2.07) more digital mental health resources interactions (both P<.001). Each additional year of age was associated with increased digital mental health resources interactions (RR 1.04, 95% CI (1.03-1.05), and women had 23% more self-directed digital resources interactions than men (RR 1.23, 95% CI 1.09-1.39). Our key finding was that the use of coaching or teletherapy was associated with increased self-directed digital mental health resource use. Higher self-directed digital resource engagement among those receiving coaching or therapy may be a result of provider encouragement. On the other hand, when a participant engages with 1 modality in the platform, they may be more likely to begin engaging with others, becoming "super users" of all resources.

Can positive emotional writing improve the emotional health level of international medical students? Evidence from a randomized controlled trial

BackgroundDepression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population.MethodThis study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed.ResultsAfter the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group.ConclusionThe findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students.Trial registration numberChiCTR2400087815. Registered at Chinese Clinical Trial Registry.

Comparing Pain Outcomes and Treatment Adherence Between In-Person and Virtual Interdisciplinary Pain Rehabilitation Programs at the San Francisco VA Health Care System.

This study compares clinical pain outcomes between patients in a pain treatment program that was conducted in-person, compared to a virtual program. In-Person (N=127) and Virtual (N=101) pain treatment programs were compared based on patient-reported, practitioner-collected, and medical record data. The patients were measured at baseline and post treatment (week 12 for In-Person and week 8 for Virtual patients). We employed last observation carried forward (LOCF) to handle missing data. Both the In-Person and Virtual groups were similar in regard to all baseline outcomes, except the In-Person group having significantly more co-morbidities at baseline, with particularly more cases of mental, behavioral, or neurodevelopmental diseases. Both groups demonstrated significant improvements in the pain-related measurements of pain interference and pain catastrophizing thoughts, but neither group displayed a change in average pain across treatment. Further, both groups improved significantly on emotional well-being scores, but not on physical functioning scores. No significant differences existed between groups on outcomes, except for pain catastrophizing, which was higher in the Virtual group at both time points. The Virtual group had lower rates of dropouts compared to In-Person, while the In-Person group had a larger proportion reach a clinically meaningful change in pain-related outcomes, defined as a >30% improvement. While some changes were unique to the In-Person program, overall, patients in the Virtual program achieved similar treatment outcomes, suggesting that it can successfully treat Veterans seeking pain management, with less need for in-person facilities for both patients and clinicians.

Displaced by nature, driven by choice: Exploring the factors influencing environmental migrants' habitat preferences in coastal Bangladesh

This study examines the factors influencing environmental migrants’ habitat preferences in southwestern Bangladesh. Using a multi-stage sampling technique, we selected 408 households in rural and urban areas, who had moved to their current locations due to climatic extremes. We applied relevant regression models to analyze the complex interplay of socioeconomic, environmental, and institutional factors shaping migration decisions. Our empirical results suggest that, despite having greater access to services in cities, migrants reported lower levels of well-being than their rural counterparts, which could be attributed to reduced social cohesion and limited opportunities for participation in decision-making. Disaster preparedness, early warning access, and prolonged exposure to environmental hazards significantly influence migration decisions and well-being. Protracted post-disaster suffering increases the likelihood of migration to urban slums, emphasizing the vulnerability of rural populations. Men are more likely than women to migrate to urban areas, possibly due to perceived employment opportunities. Surprisingly, while slum dwellers have better service access, their well-being scores are lower than rural residents. Access to education, healthcare, safe drinking water, and early warning systems are all crucial determinants of well-being. Policy recommendations include improving disaster preparedness and early warning systems in rural areas, developing targeted interventions for urban slum migrants focused on social cohesion and income diversification, and implementing gender-specific support programs. This research contributes to understanding environmental migration dynamics in Bangladesh and informs policymakers about sustainable resettlement strategies. Future studies should explore non-linear relationships and expand to diverse geographical contexts.

Predictors of dropping out from a home tele-exercise programme: A cohort study derived from a randomised controlled trial

Background: Online home exercises represent opportunities to increase physical activity levels. However, high dropout rates are commonly reported in such programmes. This study aimed to investigate the predictors of dropping out from an online home exercise programme. Methods: A total of 760 individuals from nine countries participated in this 8-week prospective cohort study derived from a randomised controlled trial. The participants were randomised into "4-week live-streamed exercise –&gt;4-week recorded exercise" or "4-week no intervention –&gt;4-week recorded exercise" group. Repeated measurements using weekly questionnaires were performed. Pain intensity, disability, mental well-being score, exercise motivation, sleep quality, impulsiveness/anxiety, and physical activity level were analysed. Results: A total of 53.8% (95% confidence interval [CI] 50.3%–57.3%) participants dropped out from the programme. The identified predictors of dropping out from the programme were: well-being (odds ratio [OR] 0.94, 95% CI 0.91–0.97) and disability (OR 1.02, 95% CI 1.002–1.04) at baseline considering the first 4 weeks; age (0.98; 95% CI 0.96–1.00) and baseline well-being (0.93; 95% CI 0.89–0.97) considering the entire follow-up (8 weeks); exercise motivation (0.92; 95% CI 0.87 to 0.97) and general impulsiveness/anxiety (1.04; 95% CI 1.01–1.07) repeated measured over time. Conclusion: About half of the participants dropped out from the online home exercise programme. Higher baseline scores in mental well-being and age predicted a reduction in dropping out. Higher baseline disability predicted an increase in dropping out. During the follow-up, higher exercise motivation was associated with a reduction in dropping out, and higher impulsiveness and anxiety were associated with an increase in dropping out.

Quality of Life among Men and Women Diagnosed with Infertility in Khyber, Pakhtunkhwa

Background: Infertility is a sensitive global issue, characterized by a couple's inability to conceive or maintain a pregnancy. Infertility is classified into two types: primary infertility, where a couple has never achieved pregnancy, and secondary infertility, where a couple cannot conceive or maintain a pregnancy after engaging in unprotected intercourse. Objective: This study aimed to evaluate the quality of life among men and women diagnosed with infertility in Khyber Pakhtunkhwa. Methodology: The study used a cross-sectional design and was conducted in outpatient clinics in Khyber Pakhtunkhwa with a sample of infertile individuals (n=377). Quality of life among infertile couples was assessed using the standardized FERTIQOL instrument, with additional variables relevant to the study context. Results: The results showed that the average quality of life score for infertile couples was 63.84 out of a possible 120. According to the FERTIQOL assessment, the emotional wellbeing score was low at 14.29, and the mind-body score was also poor at 15.49. The relational score, at 18, was considered average, while the social domain score of 16.05 indicated a poor quality of life. The study also examined associations between quality of life and various sociodemographic factors, including age, gender, education, income, and type of infertility. Although most of these variables were not statistically significant, gender and education were found to be significantly associated with quality of life, with p-values of 0.00 and 0.16, respectively. Conclusion: Based on these findings, it can be concluded that infertile couples experience a low quality of life.

The Thoughtful program: a randomized controlled study of a mentalization-based mental health education intervention in a psychiatric outpatient population

Background P-factor and mentalizing theory and research set perspectives for transdiagnostic psychiatric treatments. Aims To test the effects of a low-cost mentalization-based health education program (the Thoughtful program) in an unselected waiting list population, from a psychiatric outpatient clinic in North Norway. Methods Waiting list patients were randomized (1:1 allocation): 79 patients in the control group were offered standard individual assessment and treatment. Seventy-nine patients in the intervention group were offered a one-day (six-hour) group-based Thoughtful course, plus individual assessment, and treatment. Results During a 6-month follow-up period, the number of patients in active assessment and treatment was 66% higher in the control group than in the intervention group. Self-reported patient questionnaire scores on mentalizing, well-being and suicidal ideation scores showed no significant changes in the control group. In the intervention group, significant changes were reported: Mentalizing scores improved by 72% and well-being scores improved by 55%. Suicidal ideation scores were not significantly changed. No adverse effects were registered. Limitations The results from this study should be interpreted with caution because of a small population size and low questionnaire response rate. The follow up period was limited to 6 months. Transfer of program information from intervention group patients to control group patients could not be guaranteed. It may be considered a limitation that diagnostic pattern analysis was not included in the study. Conclusions A low-cost transdiagnostic mentalization-based educational program in an outpatient psychiatry clinic may improve patient mentalizing and wellbeing without adverse effects and reduce the use of hospital services.

Enhancing Interprofessional Skills with SKY Campus: A Pilot Study on Mental Well-being at UCD

Abstract Background Public health professionals and students face increasing mental health challenges. Sudarshan Kriya Yoga (SKY), known for its mental health benefits such as stress reduction and improved emotional regulation, offers a promising strategy for enhancing well-being in public health education. Objectives To evaluate the immediate effects of a three-day participatory SKY workshop on mental well-being of Master of Public Health students at University College Dublin, Ireland. Methods A non-randomized, controlled pilot study will involve MPH students at UCD. Participants, aged 18 and above, enrolled in the MPH programme, will provide informed consent to attend a three-day SKY workshop in September 2024. The workshop, delivered by certified trainers, includes three sessions of three hours each. Standardised and validated Patient-Reported Outcome Measures (PROMs) such as the Perceived Stress Scale (PSS-10) and WHO-Five Well-being Index (WHO-5) will be used to assess perceived stress and mental wellbeing at baseline and immediately after the workshop. Results Based on previous literature, it is hypothesized that participants will show a significant reduction in perceived stress and improvement in mental wellbeing scores. Data will be analysed using descriptive statistics and Wilcoxon signed-rank tests to evaluate changes in PROM scores. Conclusions This pilot study aims to provide preliminary evidence on the effectiveness of SKY in improving mental wellbeing among public health students. Successful outcomes could support integrating SKY into the public health curriculum, promoting its adoption across other institutions, and enhancing the professional skills development of future public health professionals. This component is proposed in the ASPHER core curriculum programme for public health as an important cross curricular subject area Key messages • Integrating SKY Campus workshops into public health education enhances interprofessional skills and mental well-being, offering a holistic approach to professional development in global health. • This study uses standard PROMs to assess the SKY workshop’s impact, aiming for significant improvements in stress and mental well-being to shape global public health curricula.

Can grit predict well-being?

BackgroundBurnout affects over 50% of surgical residents, and efforts focused on well-being during training are needed. Grit, defined as perseverance toward achieving long-term goals, is a measure of mental fortitude and may be protective against burnout and predictive of well-being.MethodsAn anonymous electronic survey was distributed to surgical and non-surgical resident trainees as well as general surgery faculty. Grit was measured using a 12-question validated Grit Scale and well-being was measured using a 5-question validated WHO-5 Well-Being Index. Linear regression was used to identify associations between post-graduate year (PGY), grit, and well-being. Student’s t-test was used to compare grit and well-being scores among male and female trainees.Results23/38 (60.5%) surgical residents completed the survey. Grit scores ranged from 3 to 4.67 (scale of 1–5) and well-being scores from 24 to 84 (scale of 0–100). There was no correlation between grit and well-being (R2 = 0.01, p < 0.63) or between PGY class and grit (R2 = 0.06, p < 0.27). However, there was a positive correlation between PGY class and well-being (R2 = 0.18, p < 0.05). Female residents trended towards higher grit (4.12 female vs 3.76 male, p < 0.07) and lower well-being (53 vs 60, p < 0.18). Compared with non-surgical residents, there were no significant differences in mean grit or well-being. The pooled trainee group demonstrated a positive correlation between PGY class and well-being (R2 = 0.09). Faculty reported higher grit (4, p < 0.03) and well-being (68.8, p < 0.002) than residents.ConclusionDespite high overall grit, trainees experience relatively low well-being; this effect is exaggerated in females. Grit and well-being trend to increase with PGY years and as faculty. The lack of association between grit and well-being in trainees suggests that intrinsic grit is not enough; well-being is impacted by external factors and encourages future work to identify and modify these factors for a positive impact on trainees.

Trauma-informed Financial Empowerment Programming Associated with Improved Financial Well-being

AbstractFinancial well-being and overall health are significantly linked, especially among those in poverty who have been exposed to violence and suffer from unaddressed trauma. Yet existing public assistance programs fail to address the presence or impact of trauma and adversity. Built specifically for families living in poverty who experience adversity, the Building Wealth and Health Network (the Network) provides a space for families to heal from the effects of trauma while also building social networks and economic security. The sample for this study was primarily Black (91%) women (92%) in Philadelphia with at least one child. A repeated measures linear regression model was performed via a Difference-in-Differences approach to test differences in financial well-being scores between two groups (full participation vs. low/no participation) at two time points (baseline vs 3 months, and baseline vs 6 months). We use this program as a field study to better understand the financial well-being of program participants who took part in fewer or more program sessions. Those who participated in more sessions reported greater increases in two measures of financial well-being at three months and six months post baseline, when compared to those with low or no participation.

International Nurse Migration Experience of the First Two Years: A Mixed Methods Study.

The aim of this study was to explore experiences of internationally educated nurses' first 2 years working and living in England in an age of contemporary migration. Exploratory mixed method design. An online survey collected responses from August 2022 to October 2022. A mixed-methods approach was applied to gain a breadth of understanding through quantitative outcomes integrated with depth of qualitative analysis. Data findings from 773 international nurses identified the recognition of prior professional skills and experiences, induction processes, career development systems and the role of line managers are integral to professional integration and could be improved. Communication barriers were frequently transient and time limited, and participants often had incomplete insight of human resource policies. Personal factors affecting life outside of work revealed compromise and sacrifice with accommodation choices, and participants were often not satisfied with their economic status, housing, cost of living in England, and social support. Mental well-being scores varied by country of origin and participants happier with decision to migrate to England had significantly higher mental well-being scores. International nurses have divergent professional and personal motivations for migration unique to individual circumstances. Recognition for transferable skills and experience, receipt of a comprehensive and warm welcome from organisations, safe and well-maintained suitable accommodation and living conveniently located to shops, work and transportation, improve experience. International nurses must have sufficient financial gains from salaries and opportunity to unite with children and families. Progressing migration experience of international nurses can improve retention and augment improving patient care and outcomes. No patient or members of public contributed to this research.

Implant outcomes following breast conservation therapy in patients with history of augmentation mammoplasty

BackgroundIn women who are eligible, breast conservation therapy (BCT) is often the preferred local treatment for early-stage BC. Concern for implant contracture in patients undergoing BCT including radiation therapy (RT) with prior augmentation mammoplasty has been expressed in several prior studies. The exact incidence of patient dissatisfaction remains unknown. MethodsA single institution retrospective review was performed for patients with prior augmentation mammoplasty who received BCT for BC between 2010 and 2020. 77 patients met inclusion criteria. Of these, 34 were consented and completed study survey which included validated BREAST-Q modules. Data was reviewed with primarily descriptive analyses. P-values were calculated from Fisher’s exact test and Kruskal-Wallis rank sum test. Results34 patients completed study survey, with 55.9 % of patients (n=19) having silicone implants and 44.1 % (n=15) having saline. Most implants (91.1 %, n=31) were retropectoral. Median total dose of RT was 4005 cGy and median age of implants at BC diagnosis was 16 years (range 2, 40). 41 % (n=14) of patients reported dissatisfaction with breast appearance, with median BREAST-Q RASCH score for satisfaction with breasts 48 (range 20–82). No differences in breast satisfaction were seen in patients with silicone implants compared to saline (p= 0.171) although there were improved reported physical well-being chest scores in patients with saline implants (median 100 vs 89; p = 0.039). ConclusionsA large proportion of women are dissatisfied with implant appearance following BCT with RT. Future larger studies are needed to explore contributing factors for dissatisfaction including implant type, location, RT dosing and fractionation.

A real-world study on the clinicopathological profile, treatment outcomes and health-related quality of life, anxiety and depression among patients with desmoid tumor at two tertiary care centers in India.

The medical management of DT comprises tyrosine kinase inhibitors (TKIs), hormonal agents, anti-inflammatory drugs with the recently approved gamma secretase inhibitor nirogacestat being the current standard of care. Real-world data on evolving treatment landscapes of DT remains scarce. This is a retrospective study of patients with DT registered between 1995 and 2020 at All India Institute of Medical Sciences, New Delhi and Tata Medical Center, Kolkata. Baseline characteristics were analyzed in form of median values and interquartile range. Categorical and continuous variables were compared by chi square and independent samples T- tests respectively. Anxiety, depression and QoL were prospectively measured among 30 patients using Hospital Anxiety and Depression (HADS) and Functional Assessment of Cancer Therapy-General (FACT-G) scales respectively between 2022 to 2023. 200 patients were included with a male-predominant (n=111, 55.5%) population and median age 26.5 (2.5-75) years. Extremity (n=100, 50%) and abdomen (n=65, 32.5%) were commonest primary sites and median of 2 (1-4) lines of treatment were received. First-line included surgery (n=116, 58%), systemic therapy (n=67, 33.5%), radiotherapy (10, n=5%) and active surveillance (n=7, 3.5%). First-line systemic agents included tamoxifen (n=55, 27.5%), imatinib (n=7, 3.5%), sorafenib (n=1, 0.5%) and chemotherapy (n=4, 2%). 2019 onward, 3% and 63% underwent active surveillance and surgery respectively. Best radiological response obtained with tamoxifen was stable disease (SD) (n=76, 59%) and partial response (PR) (n=31, 24.2%). Best radiological response obtained with sorafenib was PR (n=17, 60.7%) and SD (n=9, 32.1%). Thirty patients underwent HADS and FACT-G scale assessment. Mean HADS-Anxiety subscale score was 3.6 (+/-3.9 SD) and HADS-Depression sub-scale score was 2.6 (+/-3.5 SD) with clinically significant anxiety and depression in 2 (6.7%) patients each. The overall mean FACT-G score was 87.5 (+/-12.6 SD) and lower mean physical well-being (p=0.006) and emotional well-being (0.017) scores were significantly associated with higher HADS-anxiety (>/=8) scores. Assessment of anxiety, depression and QoL are paramount to gauge the psychological impact of DT. This study gives an overview of clinical and management profile of patients with DT in India, with limitations of selection bias, heterogeneous population and small sample size for QoL assessment.

Application of WeChat-based cognitive behavioural stress management for early-stage cervical cancer patients: a randomised controlled study

Background This randomised controlled study was aimed at investigating the effects of WeChat-based cognitive behavioural stress management (WB-CBSM) on the mental health of patients with early-stage cervical cancer treated with surgical resection. Methods A total of 184 patients with early-stage cervical cancer were randomised to receive either WB-CBSM (n = 92) or normal care (NC) (n = 92) for 8 weeks. Results Compared with the NC group, the WB-CBSM group exhibited reduced Hospital Anxiety and Depression Scale (HADS)–anxiety scores at months (M)1 (t = 2.022, P = 0.045), M3 (t = 2.575, P = 0.011), and M6 (t = 2.709, P = 0.007); anxiety rates at M3 (χ2 = 4.834, P = 0.028) and M6 (χ2 = 5.182, P = 0.023); HADS–depression scores at M3 (t = 2.069, P = 0.040) and M6 (t = 2.449, P = 0.015); and depression rates at M6 (χ2 = 4.268, P = 0.039). Moreover, the WB-CBSM group showed increased Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being scale scores at M1 (t = −2.001, P = 0.047), M3 (t = −2.281, P = 0.024), and M6 (t = −3.501, P = 0.001); the Quality of Life Questionnaire-Core 30 (QLQ-C30) global health score at M3 (t = −2.034, P = 0.043) and M6 (t = −2.426, P = 0.016); and QLQ-C30 function score at M3 (t = −2.009, P = 0.046). However, the groups exhibited decreased EuroQol-5 dimension scores at M3 (t = 2.056, P = 0.041) and M6 ((t = 2.242, P = 0.026) and QLQ-C30 symptom scores at M1 (t = 2.026, P = 0.044) and M3 (t = 2.210, P = 0.028). Conclusion WB-CBSM reduced anxiety and depression and improved the spiritual well-being and quality of life of patients with early-stage cervical cancer treated with surgical resection.

Linguistic Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual-Well-being-Expanded Version 4 Tool into Malayalam Language and its Feasibility in Advanced Cancer Patients Receiving Palliative Care

Objective: The objective of this study was to validate the ‘Functional Assessment of Chronic Illness Therapy-Spiritual-Well-being-Expanded(FACIT-SpEx) Version 4’ tool in Malayalam and assess its feasibility among advanced cancer patients receiving palliative care. Materials and Methods: The study was carried out at the outpatient Department of Cancer Palliative Medicine of Malabar Cancer Centre between November 2022 and June 2023. Initially, the FACIT-Sp-Ex version 4 tool with 23 items was translated into the Malayalam language with a forward-backward translation procedure. This was followed by pilot testing in 10 advanced adult cancer patients receiving palliative care who could read and comprehend the Malayalam language. After answering the draft version of the validated tool, patients responded to questions from a Malayalam-translated cognitive debriefing script. Results: The process of translation and cross-cultural adaptation went on smoothly with very few hurdles. The Malayalam terms used in three items Sp7, Sp9 and Sp23 when back translated were found to be different from the source. These issues were resolved with the use of the most suitable translations and closest equivalents available in Malayalam. In the pilot testing, the majority (70%) of the patients were female. The mean age of patients was 45.90 (standard deviation [SD] = 7.62) years. Carcinoma breast (50%) was the most common type of cancer. All the patients knew their diagnosis, while only 80% knew the prognosis. Almost 90% of the patients were receiving some form of palliative anticancer treatment. All patients completed the draft version of the validated tool. The mean spiritual well-being score measured using this validated tool was 71.20 (SD = 15.10). Analysis of the debriefing interviews revealed that the Malayalam version was easy to complete, relevant, and appropriate. Conclusion: Linguistic validation and cognitive debriefing produced the Malayalam translated FACIT-Sp-Ex version 4 tool conceptually equivalent to the original FACIT-Sp-Ex version 4 tool, and it is feasible for its use.

Predicting Children’s Mental Well-Being During COVID-19 Pandemic Based on Maternal Cognitive Emotion Regulation

Background: During the COVID-19 pandemic, the lack of warm, supportive, and positive relationships caused behavioral and psychological problems in children. This study aimed to predict the psychological well-being of primary school students during the COVID-19 pandemic based on parental self-efficacy and cognitive emotion regulation in mothers based on the mediating role of the parent-child relationship. Methods: The present applied research used a descriptive correlation in terms of data collection and analysis. This research was conducted on 385 cases, including students and their parents, who were selected using a random sampling method. The research instruments included the Reef&amp;apos;s psychological well-being questionnaire (18 questions), Johnston and Mash parenting sense of competence scale, Garnefski&amp;apos;s cognitive emotion regulation questionnaire, and Fine&amp;apos;s parent-child relationship scale. Two psychology experts assessed the face validity of the questionnaires. Reliability of the questionnaires was measured using Cronbach’s alpha coefficients. SPSS software was used to analyze the data. Results: The average total scores of psychological well-being, parenting sense of competence, parent-child relationship, and cognitive emotion regulation were 68, 58.3, 72.1, and 61.4, respectively. Maternal cognitive emotion regulation was a significant predictor of the parent-child relationship (p&amp;lt; 0.01). We found that parenting sense of competence and maternal cognitive emotion regulation were able to predict students&amp;apos; psychological well-being through parent-child relationship during the COVID-19 pandemic. Conclusion: Increasing the level of parenting sense of competence and regulating parental emotions can improve the relationship between parents and their children.

Functional outcome and histologic analysis of late onset total type brachial plexus injury treated with intercostal nerve transfer to median nerve with local umbilical cord-derived mesenchymal stem cells or secretome injection: a double-blinded, randomized control study.

Intercostal nerve transfer is a surgical technique used to restore function in patients with total brachial plexus injury. Stem cell and secretome therapy has been explored as a potential treatment for brachial plexus injuries. This study aimed to compare the functional and histologic outcome of intercostal nerve transfer to median nerve with local stem cells or secretome injection in total type brachial plexus injuries. This was a double-blinded, randomized controlled study (RCT). We included patients with neglected total type brachial plexus injury (BPI) who underwent nerve transfer and local injection of either umbilical cord-derivedmesenchymal stem cells (UC-MSC) or secretome into median nerve-flexor digitorum superficialis (FDS) neuromuscular junction (NMJ). We measured preoperative and 8-month postoperative FDS muscle strength, SF-36, DASH score, and histologic assessment. We then analyzed the difference outcome between those two groups. A total of 15 patients were included in this study. Our study found that after nerve transfer and implantation with either UC-MSC or secretome, significant postoperative improvements were observed in physical functioning, role limitations, energy/fatigue, emotional well-being, social functioning, pain, general health, and DASH scores, particularly in the overall cohort and the secretome group. When we compared the mean difference of clinical outcome from preoperative to postoperative between UC-MSC and secretome groups, the UC-MSC group showed better improvement of health change in SF-36 subgroup compared to secretome group. From the analysis, there was no significant difference in the histologic outcomes (inflammation, regeneration, and fibrosis) in overall cohort between preoperative and postoperative cohort. There was also no significant difference in mean change of the histologic outcomes (inflammation, regeneration, and fibrosis) preoperative and postoperatively between UC-MSC and secretome groups. Implantation of either UC-MSC or secretome along with nerve transfer may provide clinical improvement, while to achieve histologic improvement, further conditioning should be performed.

THE RELATIONSHIP BETWEEN SEXUALITY AND PERSONAL PSYCHOLOGICAL WELL-BEING

The article presents the results of a study on the relationship between manifestations of psychological well-being and sexuality. Scientific interest in the problem of sexuality, its relationship with all spheres of personal life continues to expand the understanding of this phenomenon. Sexuality as a phenomenon is included in various aspects of human life. This is a direct way out of the need to study sexuality in relation to the psychological well-being of an individual. Based on the correlation analysis, no significant links were found between the overall total score of psychological well-being and self-esteem of sexuality. At the same time, such components of psychological well-being as self-acceptance, environmental management, and purpose in life are interrelated with self-esteem of sexuality. It was established that this triad acts as a kind of prerequisite for one’s own ideas about sexuality.

Smartphone Addiction among Adolescents in Southern Italy and Correlation with Other Risky Behaviors.

Addiction to smartphone is defined as the disability to cease using the device despite the physical, psychological, or social consequences. The diagnosis of this disorder is increasing exponentially among teenagers, even more so after Corona Virus Disease 2019 (COVID-19) pandemic. This study aims to analyze the risk of mobile phone addiction among teenagers in Italy and its relationship with other risk behaviors, such as drug consumption and emotional well-being, following the COVID-19 pandemic. A cross-sectional observational study was conducted in Catania, Sicily, during 2022. The study sample comprised 342 students from a secondary education center that answered to a validated Italian version of the Smartphone Addiction Scale Short Version (SAS-SV) accessing through computers and mobile devices. Subjective Wellbeing was measured with the Personal Wellbeing Index-School Children (PWI-SC). Also, they completed the NIAAA Brief Alcohol Use Screener. Our results showed that 30.1% of students who participated in the survey were classified with a smartphone addiction. Besides, most of the participants used the Smartphone for social networks (86.0%). Regarding the other aspects measured, the mean self-perceived well-being score measured with the PWI-SC was 55.5, and 36.2% of participants were categorized as "high risk" for depression. Finally, four out of ten participants were at "moderate or high risk" of an alcohol use disorder. Our results suggest that the use of mobile phones is increasing in adolescents, an age group also exposed to social and health problems.