WHO-5 Well-being Index Research Articles

The relationship between social support, coping strategies and psychological distress and positive mental well-being in carers of people with borderline personality disorder

BackgroundInformal carers of people with BPD experience high levels of burden and psychological distress relative to other populations. There is a scarcity of research evidencing the influence of modifiable factors on carer outcomes to inform interventions. This study aimed to investigate the relationship between social support, coping strategies and psychological distress and positive mental well-being in this carer population.MethodsIn this cross-sectional study, 1207 carers completed the McLean Screening Instrument for BPD-Carer Version, the Brief COPE, the Multidimensional Scale of Perceived Social Support, the Kessler Psychological Distress scale, the WHO-5 Well-being Index, and the Coronavirus Anxiety Scale. Data for 863 participants who met the inclusion criteria were analysed.ResultsCarers reported low positive mental well-being and high psychological distress. Perceived social support and several coping strategies were significant unique predictors of psychological distress and positive mental well-being. Perceived social support and positive reframing were the strongest predictors of higher positive mental well-being and lower psychological distress. Self-blame, behavioural disengagement and substance use were the strongest predictors of adverse outcomes.ConclusionsThe findings evidence modifiable factors that may be used to improve informal carer outcomes and indicate that carer interventions may be improved by focusing on reducing the use of self-blame, behavioural disengagement and substance use, and development of quality social support and skills to positively reframe caregiving situations.

Green physical activity for leisure connects perceived residential greenspace and mental well-being.

Physical activity serves as a pivotal mediator in previous theoretical frameworks that link greenspace and human health. However, it remains unclear whether the domain of physical activity within and around greenspaces can alter the pathway. The present study recruited 668 participants online and examined a conceptual framework that explores the associations between residential greenspace and mental well-being, with a particular focus on the mediation effect of green physical activity (physical activity undertaken in and around greenspaces). Moreover, socio-demographic characteristics, including gender, age, household income, education status, marital status, and student status, were controlled for during the examination. The investigated green physical activities included leisure activities, transportation walking, and transportation cycling, and they were measured by a pre-established questionnaire. Meanwhile, mental well-being was measured by the WHO-5 well-being index, and residential greenspace was indicated by self-reported perceived greenspace and mean Normalized Difference Vegetation Index (NDVI) values within 500 meters (m) of residential radius. We found that both perceived greenspace (B = 1.852, p < 0.001) and NDVI 500 m (B = 3.230, p = 0.038) were positively associated with mental well-being. However, only perceived greenspace, not NDVI 500 m, exhibited positive associations with the three green physical activity items. Furthermore, only green physical activity for leisure (B = 0.223, p < 0.001), not for transportation (p > 0.05), mediated the relationship between perceived greenspace and mental well-being. Our findings reinforce previous studies on "greenspace-health" frameworks and underline the importance of leisure physical activity in promoting mental well-being.

Psychometrics Validation of the WHO-5 Wellbeing Index in Botswana, Zimbabwe, and Malaysia: Coping With COVID-19 Pandemic in the Global South Study

COVID-19 and the actions to curtail its spread have elevated the value of mental health as well as public health crises and pandemics. This calls for increased research in this area and the use of consistent and valid instruments to measure diverse aspects of mental health in different populations. This study presents preliminary psychometric properties (i.e., factor structure, internal consistency, convergent and discriminant validity) of the WHO-5 index as compared to other mental health instruments used in three countries (Botswana, Zimbabwe, and Malaysia). Data was collected from three countries during the first 5 months after the onset of COVID-19 in the Southern African and Southeast Asia regions: Botswana ( N = 422; Mean Wellbeing = 9.8; SD = 5.4), Zimbabwe ( N = 325; Mean = 9.4; SD = 5.3), and Malaysia ( N = 425; Mean = 13; SD = 5.3). After data quality and scaling properties were evaluated, factor structures were assessed using principal component analysis and internal consistency of the extracted components were examined using Cronbach’s alpha (α). Construct validity was examined using Pearson’s correlations to establish both convergent validity and discriminant validity among the three mental health constructs (i.e., well-being, generalized anxiety, and loneliness). With Cronbach’s alpha of the total WHO-5 Wellbeing index of .86 (Botswana sample), α = .85 (Zimbabwean data) and α = .88 (Malaysian data), as well as (α &gt; .7) for the selected demographic subgroups, the findings broadly suggest that WHO-5 is a unique, reliable, and valid instrument for measuring subjective well-being, and by extension mental health among diverse subgroups—in Botswana, Zimbabwe, Malaysia, and possibly, other similar settings.

Effect of Dyspnea, Quality of Life, and Well-being in Postacute COVID-19 Patients: A Prospective Cohort Study

ABSTRACT Context: The persistence of respiratory symptoms beyond 4 weeks otherwise known as postacute COVID-19 symptoms has been reported to significantly affect the clinical outcome, quality of life (QOL), and well-being of patients’ postinfection. Aims: The study aims to determine the pattern of postacute COVID-19 dyspnea symptoms, QOL, and well-being and its association at month 1 and 6 following COVID-19 infection. Settings and Design: A prospective cohort study of two COVID-19 hospitals in Malaysia was conducted. Subjects and Methods: Patients were followed up from admission, discharge, and 6 months after. A standard questionnaire assessed demographics, Modified Medical Research Council (mMRC) dyspnea score, QOL EQ-5D-5L scale (mobility, ability to self-care, ability to perform usual activity, pain, and anxiety), and the World Health Organization (WHO)-5 well-being index. Statistical Analysis Used: Wilcoxon signed-rank, Kruskal–Wallis, and Pearson correlation tests were used. Results: The mMRC, ED-5D-5L, and WHO-5 scores worsened during admission and slowly resolved over the 6 months (n = 388). mMRC scores positively correlated with EQ-5D-5L scores for mobility, self-care, ability to perform usual activity, pain, and anxiety (visit 1 and 6, P = 0.00) during the 1st and 6th months. Higher mMRC and EQ-5D-5L scores indicate worsening dyspnea and QOL. mMRC demonstrated a negative correlation with WHO-5 scores (visit 1: r = −0.30 and visit 6: r = −0.39, P = 0.00), which indicated worsening dyspnea and lower mental well-being. A higher WHO-5 well-being index was associated with lower EQ-5D-5L scores (visit 1 and 6, P = 0.00), demonstrating lowered patient’s well-being with worsening QOL. Conclusions: As such, appropriate health-care support and monitoring of patients, postdischarge is essential to optimize patient outcome.

Efficacy and Safety of Prolonged-Release Melatonin for Primary Insomnia in Elderly Patients

Objective: Insomnia, a prevalent sleep disorder affecting the elderly, necessitates effective and safe treatment options. This study explores the potential of the prolonged-release melatonin (Circadin&lt;sup&gt;®&lt;/sup&gt;) addressing insomnia in elderly patients.Methods: The 8-week prospective observational study involved 115 participants, assessing sleep parameters using the Pittsburgh Sleep Quality Index (PSQI) and WHO-5 Well-being Index. The prolonged-release melatonin (2 mg) was administered nightly, and assessments were conducted at baseline, 4 weeks, and 8 weeks.Results: Both per protocol and last observation carried forward (LOCF) analyses consistently revealed significant improvements in sleep latency, total sleep time, sleep efficiency, and overall well-being. Notably, sleep latency decreased after 4 and 8 weeks, while total sleep time and sleep efficiency increased, reflecting longer and more restful sleep. The WHO-5 Well-being Index exhibited noticeable enhancement. Adverse events, including dizziness and heartburn, were manageable. Despite a high dropout rate, this drug’s potential as an efficacious and safe treatment option for elderly insomnia patients was evident, aligned with prior research.Conclusion: The prolonged-release formulation’s resemblance to the natural circadian rhythm of melatonin release offers advantages over conventional medications. This study contributes to understanding the prolonged-release melatonin’s promise as a valuable therapeutic alternative, encouraging further investigation into its longterm effects and optimal implementation.

Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial

Aims/hypothesisThere is a lack of e-health systems that integrate the complex variety of aspects relevant for diabetes self-management. We developed and field-tested an e-health system (POWER2DM) that integrates medical, psychological and behavioural aspects and connected wearables to support patients and healthcare professionals in shared decision making and diabetes self-management.MethodsParticipants with type 1 or type 2 diabetes (aged >18 years) from hospital outpatient diabetes clinics in the Netherlands and Spain were randomised using randomisation software to POWER2DM or usual care for 37 weeks. This RCT assessed the change in HbA1c between the POWER2DM and usual care groups at the end of the study (37 weeks) as a primary outcome measure. Participants and clinicians were not blinded to the intervention. Changes in quality of life (QoL) (WHO-5 Well-Being Index [WHO-5]), diabetes self-management (Diabetes Self-Management Questionnaire – Revised [DSMQ-R]), glycaemic profiles from continuous glucose monitoring devices, awareness of hypoglycaemia (Clarke hypoglycaemia unawareness instrument), incidence of hypoglycaemic episodes and technology acceptance were secondary outcome measures. Additionally, sub-analyses were performed for participants with type 1 and type 2 diabetes separately.ResultsA total of 226 participants participated in the trial (108 with type 1 diabetes; 118 with type 2 diabetes). In the POWER2DM group (n=111), HbA1c decreased from 60.6±14.7 mmol/mol (7.7±1.3%) to 56.7±12.1 mmol/mol (7.3±1.1%) (means ± SD, p<0.001), compared with no change in the usual care group (n=115) (baseline: 61.7±13.7 mmol/mol, 7.8±1.3%; end of study: 61.0±12.4 mmol/mol, 7.7±1.1%; p=0.19) (between-group difference 0.24%, p=0.008). In the sub-analyses in the POWER2DM group, HbA1c in participants with type 2 diabetes decreased from 62.3±17.3 mmol/mol (7.9±1.6%) to 54.3±11.1 mmol/mol (7.1±1.0%) (p<0.001) compared with no change in HbA1c in participants with type 1 diabetes (baseline: 58.8±11.2 mmol/mol [7.5±1.0%]; end of study: 59.2±12.7 mmol/mol [7.6±1.2%]; p=0.84). There was an increase in the time during which interstitial glucose levels were between 3.0 and 3.9 mmol/l in the POWER2DM group, but no increase in clinically relevant hypoglycaemia (interstitial glucose level below 3.0 mmol/l). QoL improved in participants with type 1 diabetes in the POWER2DM group compared with the usual care group (baseline: 15.7±3.8; end of study: 16.3±3.5; p=0.047 for between-group difference). Diabetes self-management improved in both participants with type 1 diabetes (from 7.3±1.2 to 7.7±1.2; p=0.002) and those with type 2 diabetes (from 6.5±1.3 to 6.7±1.3; p=0.003) within the POWER2DM group. The POWER2DM integrated e-health support was well accepted in daily life and no important adverse (or unexpected) effects or side effects were observed.Conclusions/interpretationPOWER2DM improves HbA1c levels compared with usual care in those with type 2 diabetes, improves QoL in those with type 1 diabetes, improves diabetes self-management in those with type 1 and type 2 diabetes, and is well accepted in daily life.Trial registrationClinicalTrials.gov NCT03588104.FundingThis study was funded by the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement number 689444).Graphical

Functional Variation in the FAAH Gene Is Directly Associated with Subjective Well-Being and Indirectly Associated with Problematic Alcohol Use.

Fatty acid amide hydrolase (FAAH) is an enzyme that degrades anandamide, an endocannabinoid that modulates mesolimbic dopamine release and, consequently, influences states of well-being. Despite these known interactions, the specific role of FAAH in subjective well-being remains underexplored. Since well-being is a dynamic trait that can fluctuate over time, we hypothesized that we could provide deeper insights into the link between FAAH and well-being using longitudinal data. To this end, we analyzed well-being data collected three years apart using the WHO (Ten) Well-Being Index and genotyped a functional polymorphism in the FAAH gene (rs324420, Pro129Thr) in a sample of 2822 individuals. We found that the A-allele of rs324420, which results in reduced FAAH activity and elevated anandamide levels, was associated with lower well-being scores at both time points (Wave I, B: -0.52, p = 0.007; Wave II, B: -0.41, p = 0.03, adjusted for age and sex). A subsequent phenome-wide association study (PheWAS) affirmed our well-being findings in the UK Biobank (N = 126,132, alternative C-allele associated with elevated happiness, p = 0.008) and revealed an additional association with alcohol dependence. In our cohort, using lagged longitudinal mediation analyses, we uncovered evidence of an indirect association between rs324420 and problematic alcohol use (AUDIT-P) through the pathway of lower well-being (indirect effect Boot: 0.015, 95% CI [0.003, 0.030], adjusted for AUDIT in Wave I). We propose that chronically elevated anandamide levels might influence disruptions in the endocannabinoid system-a biological contributor to well-being-which could, in turn, contribute to increased alcohol intake, though multiple factors may be at play. Further genetic studies and mediation analyses are needed to validate and extend these findings.

Validation of the suicidal ideation scale for Hijra (third gender) people in Bangladesh

Background: Hijra people, recognized as a third gender in Bangladesh, experience a variety of mental health problems, including suicidal ideation. However, there is no psychometric instrument to measure the suicidal ideation of hijra people. The aim of the study was to validate the suicidal ideation scale (SIS) for hijra people in Bangladesh. Methods: Standard validation processes were followed to develop the initial Bangla version of the scale. After the pretest, the final version of the scale was prepared. A cross-sectional survey with a combination of purposive and snowball sampling was conducted. A total of 314 participants were recruited from Dhaka. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted besides the analysis of reliability and validity. Results: The SIS was found to have a two-factor structure, collectively explaining 46.69% of the total variance during EFA. The measurement model was supported by a number of fit indices while conducting CFA. The higher Cronbach’s alpha (0.80) suggested internal consistency reliability. The scale demonstrated acceptable test-retest reliability (0.89). Convergent and divergent validity was tested with the World Health Organisation WHO-5 Well-being Index, and Perceived Stress Scale, respectively. Conclusions: The results suggested that the SIS is a psychometrically valid instrument to measure the suicidal ideation of hijra people in Bangladesh.

OS12.6.A PRELIMINARY RESULTS FROM COPENHAGEN STUDY ON QUALITY OF LIFE IN YOUNG ADULTS WITH GLIOMAS

Abstract BACKGROUND Young patients diagnosed with gliomas face a life-changing disease, with a limited life length. They face challenges participating in daily social life and educational/work life. While the therapy for this patient group has the goal of prolonging life-length, little is known of their quality of life (QoL). A potential lower QoL due to diagnosis and the side effects of the treatment needs to be continuously assessed by health professionals. This study aimed to assess the QoL over time in young patients diagnosed with gliomas and to elucidate if these patients may need additional help and support. A second aim was to test the feasibility of repeated use of two validated online questionnaires to guide the clinicians working with this patient group. A third aim was to calculate a clinical cut-off score for the Functional Assessment of Cancer Treatment-Brain (FACT-Br). MATERIAL AND METHODS The design was a longitudinal, prospective study with a continuous inclusion during a 3-year period (2020-2023). Patients included were 18-35 years old suspected with a low-grade glioma at their first consultation in the clinic. The QoL was evaluated using FACT-Br and WHO-5 (WHO-5 Well-Being Index). The patients received the online questionnaires at pre-selected time points (pre-operation, 3-month, 6-month, 12-month) followed by a 3-month break and then repeated. The feasibility was evaluated in terms of compliance over time, defined as a completion of the first consecutive four questionnaires. A linear Generalized Estimating Equation (GEE) analysis was used to identify changes in FACT-Br total score. RESULTS A total of 33 patients were included in the study (Mdn=26y; 60% men; drop-out/exclusion n=3). At 3-month follow-up (n=30) four patients (13,3%) had a WHO-5 score below cut-off value (50/100 points) and five patients (16,7%) had a FACT-Br score below calculated cut-off (144/200 points) (M=160). The cut off-score for FACT-Br was calculated using a ROC-curve based on the WHO-5 cut-off value (n=30). The quality was deemed good (AUC=0,895). The Fact-Br total score showed no significant change over time (n=30). One subscale regarding functional wellbeing did show a significant change (p=0.021) (180 days change = 0,74; 95%-CI: 0,39-1,09). In March 2023 11 of 13 (84,6%) patients had a complete set of the first four consecutive questionnaires. CONCLUSION There was no significant change in the overall QoL (FACT-Br), but one subscale improved significantly. Five patients had a FACT-Br score below the calculated cut-off at 3 month-follow-up which might indicate a need for further support. Our study suggests that online QoL questionnaires are feasible in a clinical setup with this patient group. These results may give health professionals better insight in the need of support thus securing the best quality of life possible in young patients waiting for disease progression.

Mismatch between actual and preferred extent of telework: cross-sectional and prospective associations with well-being and burnout

BackgroundThis study aimed to determine whether telework mismatch, i.e., lack of fit between actual and preferred extent of telework, is cross-sectionally and prospectively associated with well-being and burnout.MethodsA questionnaire was sent to employees in a Swedish manufacturing company in November 2020 (baseline) and September 2021 (follow-up). It contained questions about well-being (WHO-5 Well-Being Index) and burnout (Copenhagen Psychosocial Questionnaire III), as well as the preferred extent of telework and extent of telework performed. Telework mismatch was calculated as the difference between the actual and preferred extent of telework. Change in mismatch over time was categorized as 1) less mismatch at follow-up than at baseline, 2) more mismatch at follow-up, and 3) identical levels of mismatch at baseline and follow-up. Multivariate and univariate analyses of variance were used to determine the effects of mismatch and change in mismatch over time on baseline ratings and changes in ratings of well-being and burnout. All analyses were performed with and without adjustment for age, sex, marital status, children, type of employment, commuting time and extent of telework performed.ResultsThe response rate was 39% at baseline (n = 928, 67% men, mean(SD) age: 45(11) years) and 60% at follow-up (n = 556, 64% men, mean(SD) age: 46(11) years). A cross-sectional association was found between telework mismatch and well-being, showing that employees who teleworked more than they would like reported worse well-being than those who teleworked less than they would like. No statistically significant association was found between telework mismatch and burnout. The ability of telework mismatch at baseline to predict changes in well-being or burnout over 10 months was small and non-significant. No association was found between change in telework mismatch over the 10-month period and corresponding changes in well-being or burnout.ConclusionOur results suggest that telework should be thoughtfully practiced in companies/organizations to avoid negative consequences for employees who already telework more than they prefer. Studies are needed to determine how long-term changes in match between preferred and actual extent of telework is associated with employee well-being, including how the association is modified by the nature of the job and the work environment.

Basic Psychological Need Satisfaction and Students’ Well-being: The Mediating Role of Subjective Vitality

Objectives: The self-determination theory (SDT) posits that basic psychological needs (BPNs) are indispensable and vital nutrients for well-being. The present research was done to apply SDT to understand students’ well-being, which proposes that the realization and fulfillment of BPNs and subjective vitality significantly influence the overall well-being of an individual. Therefore, the current study analyzed the mediational effect of subjective vitality in the BPN satisfaction and well-being relationship. Methods: This study included a sample of 219 (165 females and 54 males) university students with a mean age of 25 years. The basic psychological needs satisfaction and frustration scale (BPNSFS) was used to assess BPNs. Subjective vitality was assessed using a 6-item individual difference version subjective vitality scale by Ryan and Frederick, and well-being was evaluated by the WHO well-being index. Correlational and multiple regression analysis was done and mediational analysis was done using Hayes PROCESS macro. Results: The results indicated that fulfillment of BPNs (β=0.413, P&lt;0.01) and subjective vitality (β=0.208, P&lt;0.01) are significant predictors of students› well-being. Mediation analysis showed that subjective vitality completely mediated the relationship between BPN satisfaction and well-being. Furthermore, the measures of BPNS (t=2.242) and well-being (t=2.154) differed significantly, while no significant differences were found in subjective vitality (t=0.108) with respect to gender. Discussion: The findings of this study highlighted the role of BPN satisfaction and subjective vitality in the promotion of students’ well-being. Moreover, the present study highlighted the underlying mechanism, through which BPNs influences students’ well-being. This study contributes to the theoretical literature by emphasizing the vital role played by BPNs and subjective vitality in students’ well-being.

Maternal breastfeeding is associated with offspring microbiome diversity; a secondary analysis of the MicrobeMom randomized control trial.

Microbial dysbiosis in infancy can influence long-term health outcomes such as childhood obesity. The aim of this study is to explore relationships among maternal well-being during pregnancy, breastfeeding, and the infant gut microbiome. This is a secondary analysis of healthy pregnant women from the MicrobeMom study, a double-blind randomized control trial of maternal probiotic supplementation (Bifidobacterium breve 702258) versus placebo antenatally and up to 3 months postpartum. Maternal well-being was assessed using the WHO-5 well-being index at 16 weeks' and 34 weeks' gestation. Breastfeeding practices were recorded at discharge from hospital and at 1 month postpartum. Infant stool samples were obtained at 1 month of age. Next generation shotgun sequencing determined infant microbial diversity. Independent sample t-tests and Mann-Whitney U tests informed adjusted regression analysis, which was adjusted for delivery mode, antibiotics during delivery, maternal age and body mass index (BMI), and probiotic vs. control study group. Women (n = 118) with at least one measure of well-being were on average 33 years (SD 3.93) of age and 25.09 kg/m2 (SD 3.28) BMI. Exclusive breastfeeding was initiated by 65% (n = 74). Any breastfeeding was continued by 69% (n = 81) after 1 month. In early and late pregnancy, 87% (n = 97/111) and 94% (n = 107/114) had high well-being scores. Well-being was not associated with infant microbial diversity at 1 month. In adjusted analysis, exclusive breastfeeding at discharge from hospital was associated with infant microbial beta diversity (PC2; 0.254, 95% CI 0.006, 0.038). At 1 month postpartum, any breastfeeding was associated with infant microbial alpha diversity (Shannon index; -0.241, 95% CI -0.498, -0.060) and observed species; (-0.325, 95% CI -0.307, -0.060), and infant microbial beta diversity (PC2; 0.319, 95% CI 0.013, 0.045). Exclusive breastfeeding at 1 month postpartum was associated with infant alpha diversity (Shannon index -0.364, 95% CI -0.573, -0.194; Simpson index 0.339, 95% CI 0.027, 0.091), and infant's number of observed microbial species (-0.271, 95% CI -0.172, -0.037). Breastfeeding practices at 1 month postpartum were associated with lower microbial diversity and observed species in infants at 1 month postpartum, which is potentially beneficial to allow greater abundance of Bifidobacterium. ISRCTN53023014.

Association between negatively perceived parenting attitudes and dissociation: a cross-sectional study on the general population in Japan.

Many studies have reported that early traumatic experiences, mainly abuse, are associated with forming dangerous attachments and a contributing factor to dissociation. On the other hand, other studies have investigated the association of non-abusive nurturing and attachment styles with dissociation. The aim of this study is to determine the frequency of dissociative experiences in the general Japanese population and investigate the effects of "overprotection" and "lack of care" as nurturing styles and "abandonment anxiety" and "avoidance of intimacy" as attachment styles on dissociation. A total of 1,042 residents aged 18 to 69 years were administered with the Dissociative Experiences Scale (DES), the Japanese version of the WHO-5 Well-Being Index (WHO-5-J), the Parental Bonding Instrument (PBI), and the Experiences in Close Relationships Inventory-the-generalized-other-version (ECR-GO). Hierarchical multiple regression analyses on the effects of "overprotection" and "care" as nurturing attitudes "abandonment anxiety" and "avoidance of intimacy" as attachment styles on dissociation (DES-NDI and DES-T) were conducted. Based on the findings of this study, "care" and "overprotection" as nurturing attitudes were shown to be a contributing factor to dissociation (DES-NDI and DES-T). "Avoidance of intimacy" as an attachment style was shown to contribute to pathological dissociation. On the other hand, the influence of attachment style on the relationship between nurturing style and dissociation was not determined. This study provided essential data on the distribution of dissociative experiences in the general Japanese population. It was indicated that nurturing style, particularly overprotection, may be linked to nonfunctional stress coping and interpersonal anxiety and could be a contributing factor to mental disorders, including dissociation. Furthermore, considering that the effect of nurturing styles on dissociation does not vary with attachment styles, the effect of nurturing styles on dissociation may be more profound.

Investigating the Role of Second Chance Schools and COVID-19 Pandemic on the Mental Health and Self-Image of Greek Adult Students.

COVID-19 has globally impacted both physical and mental health. This study aimed to explore the impact of Second Chance Schools (SCS) and the COVID-19 pandemic on the mental health and self-image of Greek SCS students. A total of 251 SCS students from two consecutive study cycles participated, completing the research instruments at the beginning and end of their studies. Participants' anxiety, depressive symptomatology, well-being, self-esteem and self-efficacy were evaluated by means of the GAD-7, PHQ-8, WHO-5 Well-being Index, Rosenberg Self-Esteem Scale and Generalized Self-Efficacy Scale, respectively. The research spanned three years, including a year of universal lockdown, a year with protective measures and a year without anti-COVID-19 measures. Factor analysis, regression analyses and two two-way repeated measures ANOVAs were applied to the collected data. All five psychological dimensions measured by the study's instruments were grouped into two factors, namely mental health and self-image. Well-being positively influenced mental health, while anxiety and depression had a negative impact. On the other hand, self-efficacy and self-esteem positively contributed to self-image. Mental health and self-image were moderately correlated. Pre-SCS values of mental health and self-image predicted a higher percentage of variance in post-SCS values compared to anxiety, depression, well-being, self-efficacy and self-esteem. Moreover, mental health improved after the completion of SCS, but only for participants after the lifting of anti-COVID-19 measures. Conversely, self-image improved for all participants regardless of the presence of anti-COVID-19 measures. Overall, the SCS had a considerable impact on the participants' mental health and self-image, although the effect was influenced by COVID-19.

Depressive symptoms are associated with fatigue, poorer functional status and less engagement in sports in axSpA and PsA: an analysis from the RABBIT-SpA cohort

BackgroundIn patients with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA), concomitant depression might have a negative impact on the course of disease and treatment outcomes. The aims of this analysis are to determine the prevalence of depressive symptoms in axSpA and PsA patients in a real-world cohort study and to identify sociodemographic and clinical associated factors for moderate or severe depressive symptoms in both diseases.MethodsPatients from the RABBIT-SpA cohort with an axSpA or PsA diagnosis and a valid WHO-5 Well-Being Index score at baseline were included. A descriptive analysis of baseline and outcome parameters by category of depressive symptoms was performed and factors associated with the presence of depressive symptoms (moderate or severe) were examined in a logistic regression.ResultsTwo thousand four hundred seventy patients (1,245 axSpA; 1,225 PsA) were included in the analysis. In both diagnoses, the proportion of patients with moderate depressive symptoms was 8% and 21% with severe symptoms.Patients with moderate or severe depressive symptoms were less likely to engage in sports than those with no or mild depressive symptoms, had more comorbidities and higher scores for disease activity, functional limitations, fatigue, and pain and took more analgesics.In axSpA, patients with a higher disease activity, a greater functional impairment and more severe fatigue were more likely to experience depressive symptoms, while patients with more years in education and engaging in sports for at least 1 h/week were less likely to experience depressive symptoms. PsA patients with a greater functional impairment and more severe fatigue were more likely to experience depressive symptoms while those engaging in sports for at least 1 h/week were less likely to experience depressive symptoms.ConclusionWe confirmed a high prevalence of depressive symptoms in both PsA and axSpA. Factors negatively associated with the presence of depressive symptoms were fatigue, not engaging in sports, and greater functional limitations. Depressive symptoms may affect the perception of disease activity / severity by patients. Thus, depressive symptoms are an important condition in axSpA and PsA that should be considered when evaluating disease activity and treatment outcomes.

Residence in segregated settlements (colonies) rather than Roma identity increases the risk of unfavourable mental health in Hungarian adults.

Roma are the largest and most disadvantaged minority in Europe, but there is few research on how mental health and social support of Roma people living in segregated settlements compares to the majority population. Our aim was to compare the subjective well-being, life satisfaction, mental status, and social support of representative samples of adults living in segregated settlements (colonies) and identifying as Roma with those of the general population in Hungary. A cross-sectional study was conducted with random samples of 417 individuals from the general Hungarian adult population (55.6% female, mean age = 43.89 ± 12.61 years) and 394 adults living in segregated settlements (colonies) (73.9% female, mean age = 42.37 ± 12.39 years). Demographic questions were used as well as the WHO Well-Being Index (WBI-5), the single item Life Satisfaction Scale, the 12-item version of the General Health Questionnaire (GHQ-12), and the Oslo Social Support Scale (OSSS-3). Residents of colonies reported significantly lower levels of subjective well-being and life satisfaction than the general population. The proportion of individuals at high risk for mental morbidity was more than twice as high among colony dwellers (16.4%) as in non-colony dwellers (7.6%). Similar unfavorable differences were seen at the expense of self-identified Roma compared to self-identified Hungarians but no difference was found in terms of social support either by type of residence or ethnicity. 32.2% of colony-dwellers self-identified themselves as Hungarian. Mental health assessed by principal component was directly determined by settlement type of permanent residence, age, educational attainment, employment, financial status, and social support but not ethnic identity. The study based on representative data shows that residents of segregated settlements are in worse mental health than those not living in colonies; that housing segregation is not limited to Roma people, and that housing conditions and financial status are major social determinants of mental health for which data must be collected to avoid using self-reported Roma identity as a proxy measure of socioeconomic deprivation.

Validity and reliability of the hypoglycemia confidence scale for patients with type 1 diabetes

Background: This study aims to assess the validation and reliability of the Turkish adaptation of the Hypoglycemic Confident Scale and to investigate its relationship between the Hypoglycemia Fear survey, WHO Well-Being Index, Hba1c, sociodemographic characteristics and variables.&#x0D; Methods: The survey consists of a total of 81 questions concerning the sociodemographic status, clinic status variables, and the Hypoglycemic Confidence Scale formed by 35 standard questions and 46 scale questions. &#x0D; Result: In this study, assessment of the reliability of the scale was achieved by internal consistency and test-retest methods, and the Cronbach alpha internal consistency reliability coefficients were 0.814 in the first test and 0.885 in the second test. It was observed that the responses given to the items of the Hypoglycemic Confidence Scale at two separate times were consistent with one another. The overall correlation of the scale (r = 0.927, p &lt; 0.0001) was positive and highly significant (p &lt; 0001). A significant, inverse, and moderate correlation was found between HbA1c values and Hypoglycemic Confidence Scale total scores (p &lt; 0,0001, r = -0,479). Similarly, a higher hypoglycemic confidence score was observed to be associated with higher WHO Well-Being Index score and lower hypoglycemic fear. &#x0D; Conclusion: This study shows that the Hypoglycemia Confidence Scale created by Polonsky et al. is a valid and reliable scale that can be put into use in our country.1 The Hypoglycemic Confidence Scale may be beneficial in diabetic patient follow-up and achieving treatment goals in diabetic patients.

The Relationship between Burnout and Wellbeing Using Social Support, Organizational Justice, and Lifelong Learning in Healthcare Specialists from Romania.

Background and objectives: The goal of this study was to evaluate the levels of organizational justice, social support, wellbeing, and lifelong learning associated with the level of burnout experienced by medical and non-medical staff from public and private medical units. Materials and Methods: A cross-sectional study was conducted on a sample of 497 healthcare professionals: 367 medical personnel (Mage = 43.75 ± 0.50), including 216 nurses, 97 physicians, and 54 respondents with other medical specialities such as biologists, psychologists, physical therapists, pharmacists, etc., and 130 non-medical staff respondents (Mage = 45.63 ± 0.80), including administrative personnel. The Maslach Burnout Inventory, the ECO System, the Multidimensional Scale of Perceived Social Support, the WHO Wellbeing Index, and the revised Jefferson Scale of Physician's Lifelong Learning were used. Results: Burnout was measured in terms of emotional exhaustion, depersonalization, and personal accomplishment. Medical personnel registered higher values of personal accomplishment (38.66 ± 0.39 vs. 35.87 ± 0.69), while non-medical personnel registered higher values of depersonalization (6.59 ± 0.52 vs. 4.43 ± 0.26) and emotional exhaustion (27.33 ± 1.24 vs. 19.67 ± 0.71). In terms of organizational justice, higher scores were observed for medical staff, while non-medical staff recorded lower values (24.28 ± 0.24 vs. 22.14 ± 0.38). For wellbeing, higher scores were also registered for medical staff (11.95 ± 0.21 vs. 10.33 ± 0.37). Conclusions: For lifelong learning and social support, no statistically significant differences were found. In the case of the proposed parallel moderated mediation model, the moderated mediation effects of organizational justice, lifelong learning, and burnout on the relationship between social support and wellbeing were valid for every dimension of burnout (emotional exhaustion, depersonalization, and personal accomplishment), but lifelong learning was not found to be a viable mediating variable, even if high levels of social support correspond to high levels of lifelong learning and wellbeing.

Translation and population-based validation of the Arabic version of the brief resilience scale

Purpose This study aimed to translate the Brief Resilience Scale (BRS) into the Arabic language and to assess the reliability and validity of the translated version of the scale among a sample of the Saudi population. Material and methods The internal consistency and test–retest reliability of the translated BRS were analyzed. Factor analyses were conducted to examine the factor structure of the scale. Convergent validity was measured by correlating BRS scores with those from the Hospital Anxiety and Depression Scale (HADS), Satisfaction with Life Scale (SWLS), Perceived Stress Scale (PSS), and WHO-5 Well-Being Index (WHO-5). Results A total of 1072 participants were included in the analysis. The score of the Arabic version showed excellent internal consistency (alpha = 0.98) and good test–retest reliability (ICC = 0.88, 95% CI: 0.82–0.92, p ≤ 0.0001). The results of factor analyses showed that the two-factor model is a good model fit with [CMIN/DF = 9.105; GFI = 0.97; CFI = 0.99; RMSEA = 0.09]. The BRS scores were negatively correlated with levels of anxiety (r = −0.61), depression (r = −0.6), and stress (r = −0.53) and positively correlated with levels of satisfaction with life (r = 0.44) and mental well-being (r = 0.58). Conclusions Our findings firmly support the reliability and validity of the Arabic version of the BRS to be used in research and clinical settings with the Saudi population.

Spiritual Connection and Well-Being at Work: The Impact of Meditation and Pranic Healing

This study investigated the relationship between spiritual intelligence (SQ) and subjective well-being (SWB) in the workplace. The research used a sample of 216 participants who completed the Spiritual Intelligence Self-Report Inventory-24 (SISRI-24), Workplace PERMA Profiler, and WHO-5 Well-being Index. Descriptive statistics and paired t-tests were used to assess the data. Multiple regression analysis found that spiritual practices such as meditation, yoga, and Pranic healing can be applied to promote workplace performance by helping employees feel more connected to their workplace environments. The results demonstrated a large positive link between SQ and SWB, indicating that those with a higher SQ tend to engage in SWB at work. Moreover, the study found that the use of meditation, yoga, and pranic healing was analogous to higher SWB levels among participants, which can help employees cope with stress, enhance their emotional resilience, and improve their well-being. The findings indicate that adopting spiritual tools and techniques into employee well-being initiatives may result in enhanced workplace happiness and well-being.