World Health Organization Well-Being Index Research Articles

Study of Rates and Factors Associated to Psychosomatic Syndromes Assessed Using the Diagnostic Criteria for Psychosomatic Research across Different Clinical Settings

Introduction: Diagnostic Criteria for Psychosomatic Research (DCPR) serve as an instrument for identifying and classifying specific psychosomatic syndromes that are not adequately encompassed in standard nosography. The present study aimed at measuring the prevalence of DCPR syndromes in different clinical settings and exploring factors associated to such diagnoses. Methods: A cross-sectional and nationwide study recruited 6,647 patients in different clinical settings: 306 were diagnosed with fibromyalgia (FM), 333 with irritable bowel syndrome, 1,109 with migraine, 2,550 with coronary heart disease (CHD), and 2,349 with type 2 diabetes (T2D). Participants underwent DCPR diagnostic interview and were assessed for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder 7-Item Scale), and subjective well-being (World Health Organization-5 Well-Being Index). The PsychoSocial Index was used to evaluate global well-being, stress, and abnormal illness behavior. The prevalence of DCPR diagnoses was calculated, and factors associated to such diagnoses were analyzed by logistic regression. Results: Alexithymia (64.47%), irritable mood (20.55%), and demoralization (15.60%) were the most prevalent psychosomatic syndromes, with demoralization being most common in FM (49.02%). The factors associated to DCPR diagnoses encompassed high anxiety or abnormal illness behavior, and poor well-being. Notably, stress was found to be associated specifically to FM and T2D, with OR of 1.24 (95% CI: 1.06–1.46) and 1.26 (95% CI: 1.18–1.36), respectively. Conclusion: DCPR is a clinically helpful complementary assessment tool in need of being widely implemented in clinical settings in order to have a comprehensive picture of the patients.

A Behavioral Change-Based Mobile Intervention for Promoting Regular Physical Activity in Medical Rehabilitation Maintenance of Patients With Coronary Artery Disease: Controlled Trial.

Cardiac rehabilitation is known to reduce coronary artery disease (CAD) severity and symptoms, but adoption of a healthy postrehabilitation lifestyle remains challenging. Innovative eHealth solutions could help, but behavioral change-based eHealth maintenance programs for patients with CAD are scarce. RehaPlus+ aims to improve postrehabilitation outcomes with a personalized eHealth intervention built on behavioral change concepts emphasizing healthy lifestyle changes, especially regular physical activity (PA). This study aims to evaluate the effectiveness of the personalized eHealth program RehaPlus+ for promoting regular PA against usual care. A total of 169 patients with CAD who had undergone stent implantation or bypass surgery were recruited after completing center-based phase II rehabilitation. They were then divided, without blinding, into 2 groups using a quasi-experimental approach: a case manager-assisted 24-week eHealth program (RehaPlus+; n=84) and a conventional physician-assisted outpatient program (usual care; n=85). The study was designed as a noninferiority trial. RehaPlus+ participants received motivational messages twice weekly for 6 months, and the usual care group engaged in a 6-month outpatient program (twenty-four 90-minute strength and endurance training sessions). The primary outcomes, evaluated using the self-assessed Bewegungs- und Sportaktivität questionnaire, were regular PA (≥150 min/wk) and weekly activities of daily living (ADLs) 6 months after rehabilitation. Secondary outcomes involved PA during work and floors climbed weekly (measured by Bewegungs- und Sportaktivität questionnaire), psychological well-being (assessed by the 5-item World Health Organization Well-Being Index), cardiac self-efficacy, health-related quality of life (measured by the 36-Item Short Form Survey), and work ability (using the Work Ability Index). Data of 105 patients (RehaPlus+: n=44, 41.9%; usual care: n=61, 58.1%; male patients: n=80, 76.2%; female patients: n=25, 23.8%; mean age 56.0, SD 7.3 years) were available at the 6-month follow-up. At 6 months after discharge from phase II cardiac rehabilitation, the RehaPlus+ group exhibited 182 (SD 208) minutes per week of PA and the usual care group exhibited 119 (SD 175) minutes per week of PA (P=.15), with no interaction effect (P=.12). The RehaPlus+ group showed an ADL level of 443 (SD 538) minutes per week compared to the usual care group with 308 (SD 412) minutes per week at the 6-month follow-up, with no interaction effect (P=.84). The differences observed in PA and ADL levels between the RehaPlus+ and usual care groups were within the predefined 1-sided noninferiority margin, indicating that the RehaPlus+ intervention is not inferior to usual care based on these outcomes. There were no differences between the groups for all secondary outcomes (P>.05). RehaPlus+ is not inferior to the usual care program, as both groups improved PA and ADLs to a similar extent. These findings emphasize the potential of eHealth interventions to assist in maintaining healthy lifestyles after rehabilitation. ClinicalTrials.gov NCT06162793; https://clinicaltrials.gov/study/NCT06162793.

Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study.

Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.

The role of supervisor support in the association between night work and depressive symptoms: a gender-stratified analysis of 22,422 full-time wage workers in South Korea.

This study investigated the relationship between night work, supervisor support, and depressive symptoms among full-time wage workers, with a focus on gender differences. A nationwide sample of 22,422 full-time wage workers from the Sixth Korean Working Conditions Survey (2020-2021) was analyzed. Experiences of night work were categorized into 5 groups based on the number of night work days per month: 0, 1-5, 6-10, 11-15, and 16-31. Depressive symptoms were evaluated using the 5-item World Health Organization Well-Being Index. Supervisor support was assessed with 5 items. Workers who engaged in 1-5 days (prevalence ratio [PR], 1.23; 95% CI, 1.12-1.36) and 6-10 days (PR, 1.17; 95% CI, 1.06-1.30) of night work per month exhibited a higher prevalence of depressive symptoms than those without night work. After stratifying by supervisor support levels, workers with 1-5, 6-10 and 11-15 days of night work per month were more likely to experience depressive symptoms compared to those without night work in the low supervisor support group. In contrast, no association was found between night work (≥ 6 days) and depressive symptoms in the high supervisor support group. Furthermore, gender differences were notable: female workers with 6-10 days (PR, 1.45; 95% CI, 1.23-1.70), and 11-15 days (PR, 1.43; 95% CI, 1.08-1.90) of night work per month exhibited a higher prevalence of depressive symptoms, whereas their male counterparts did not. This pattern of gender difference was also found among those with low supervisor support. Supervisor support may mitigate the adverse effects of night work on depressive symptoms among full-time wage workers, with differences manifested across genders.

Comparing Email Versus Text Messaging as Delivery Platforms for Supporting Patients With Major Depressive Disorder: Noninferiority Randomized Controlled Trial.

The prevalence of major depressive disorder (MDD) poses significant global health challenges, with available treatments often insufficient in achieving remission for many patients. Digital health technologies, such as SMS text messaging-based cognitive behavioral therapy, offer accessible alternatives but may not reach all individuals. Email communication presents a secure avenue for health communication, yet its effectiveness compared to SMS text messaging in providing mental health support for patients with MDD remains uncertain. This study aims to compare the efficacy of email versus SMS text messaging as delivery platforms for supporting patients with MDD, addressing a critical gap in understanding optimal digital interventions for mental health care. A randomized noninferiority pilot trial was conducted, comparing outcomes for patients receiving 6-week daily supportive messages via email with those receiving messages via SMS text message. This duration corresponds to a minimum of 180 days of message delivery. The supportive messages maintained consistent length and structure across both delivery methods. Participants (N=66) were recruited from the Access 24/7 clinic in Edmonton, Alberta, among those who were diagnosed with MDD. The outcomes were measured at baseline and 6 months after enrollment using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the World Health Organization Well-Being Index (WHO-5). Most of the participants were females (n=43, 65%), aged between 26 and 40 years (n=34, 55%), had high school education (n=35, 58%), employed (n=33, 50%), and single (n=24, 36%). Again, most participants had had no history of any major physical illness (n=56, 85%) and (n=61, 92%) responded "No" to having a history of admission for treatment of mood disorders. There was no statistically significant difference in the mean changes in PHQ-9, GAD-7, and WHO-5 scores between the email and SMS text messaging groups (mean difference, 95% CI: -1.90, 95% CI -6.53 to 2.74; 5.78, 95% CI -1.94 to 13.50; and 11.85, 95% CI -3.81 to 27.51), respectively. Both supportive modalities showed potential in reducing depressive symptoms and improving quality of life. The study's findings suggest that both email and SMS text messaging interventions have equivalent effectiveness in reducing depression symptoms among individuals with MDD. As digital technology continues to evolve, harnessing the power of multiple digital platforms for mental health interventions can significantly contribute to bridging the existing treatment gaps and improving the overall well-being of individuals with depressive conditions. Further research is needed with a larger sample size to confirm and expand upon these findings. ClinicalTrials.gov NCT04638231; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552095/.

Single-Item Assessment of Quality of Life: Associations with Well-Being, Mood, Health Correlates, and Lifestyle.

Background: Quality of life (QoL) is traditionally assessed using multiple-item questionnaires. These can be either general, global assessments of QoL or disease-specific questionnaires. However, the use of single-item QoL scales is becoming increasingly popular, as these are more time- and cost-effective, with a readily available and easy-to-interpret outcome. In particular, these are often preferred for quick assessments (e.g., 'at home' testing and mobile phone assessments), and other cases when time constraints are common (e.g., clinical trials and clinical practice). Previous research revealed that multiple-item questionnaires and single-item assessments of QoL have the same validity and reliability. Here we further evaluate the relationship of QoL, assessed with a single-item QoL scale, with well-being, mood, health correlates (e.g., immune fitness, and having underlying diseases), and lifestyle (e.g., sleep, nutrition). Methods: Data from two online surveys are presented. In Study 1, 100 students participated. The single-item QoL score was compared with the World Health Organization Well-Being Index (WHO-5), a single-item score of sleep quality, the Regensburg Insomnia Scale (RIS) score, and the Healthy Diet Scale (HDS). Study 2 comprised a survey among 1415 Dutch adults. Single-item QoL was evaluated and compared with assessments of mood, health correlates (immune fitness and disease status), and lifestyle factors (e.g., sleep, nutrition, stress). Results: The first study revealed significant correlations between QoL and well-being, sleep quality, insomnia ratings, and attaining a healthy diet. The second study revealed significant correlations between QoL and mood, health status, and lifestyle factors (e.g., the ability to cope with stress). Conclusions: The results presented here demonstrate that the single-item QoL scale is an effective and easy-to-implement assessment tool that can be used in both clinical practice and research.

Validation of the Danish Version of the Overall Depression Severity and Impairment Scale (ODSIS): A Reliable Instrument for Assessing Depression Symptoms and Functional Impairment.

In psychotherapy, having a reliable tracking tool is vital for effective treatment. We have validated the Danish version of the 'Overall Depression Severity and Impairment Scale' (ODSIS), which is used in the Unified Protocol for Emotional Disorders (UP) and other cognitive behavioural therapies. This five-item self-rating scale is expected to correspond closely to the gold-standard Beck Depression Inventory-II (BDI-II), but also to self-rating scales addressing daily functioning and well-being. Internal consistency is assessed using Cronbach's alpha and McDonald's omega. Criterion validity is explored through Pearson's correlation coefficient with BDI-II, the Work and Social Adjustment Scale (WSAS), the Five-Item World Health Organization Well-Being Index (WHO-5) and scatter plots, and an optimal cut-off score is determined using a receiver operating characteristic curve. The study included 340 respondents: 234 from a recent clinical trial, 56 psychiatric patients from inpatient/outpatient units and 50 healthy volunteers. ODSIS demonstrates strong internal consistency (Cronbach's alpha: 0.887-0.956, McDonald's omega: 0.888-0.957). Correlations with BDI-II, WSAS and WHO-5 highlight its strong criterion validity (BDI-II: 0.847, WSAS: 0.751, WHO-5: 0.771). The optimal cut-off score (> 7.5) for detecting depression shows great sensitivity (0.862) and specificity (0.731). The Danish version of ODSIS proves to be a reliable instrument for quantification of a combination of depression level and functional impairment from the symptoms. Its high correlation with established BDI-II makes it a brief and handy tool for repeated measurement in clinical and research settings.

Predicting psychological well-being based on attitudes toward aging and social support mediated by hope in life

ABSTRACT Given the increasing size and share of older population and the various mental and psychological challenges that individuals face with on the path of life to reach old age, it is crucial to investigate the factors affecting psychological well-being. Therefore, the present study aimed to predict psychological well-being based on attitudes toward aging and social support by meditating on hope in life. This study employed a correlational design with path analysis to explore the relationships between the variables of focus. The sample comprised 468 individuals aged 15 or older residing in Qom, Iran. Participants were recruited randomly using a systematic approach from 2021 to 2022. The participants completed the demographic profile questionnaire, Kogan’s Attitudes Toward Older People Scale, Snyder’s Adult Hope Scale, Vaux et al. Social Support Appraisals Scale, and the World Health Organization Well-Being Index. The data were analyzed using descriptive and inferential statistical tests of Spearman’s correlation and the structural equation model in SPSS24 and AMOS24. The hypothesized research model demonstrated an acceptable fit to the data (CMIN = 0.424, GFI = 1.000, CFI = 1.000, RMSEA = 0.001). Moreover, the variables of attitudes toward aging (β = 0.178, p < .01) and social support (β = 0.366, p < .001) jointly accounted for 19.3% of the variance in hope in life. Additionally, social support (β = 0.356, p < .001) and hope in life (β = 0.214, p < .001) collectively explained 23.6% of the variance in psychological well-being. The mediating role of hope in life in the relationship between attitudes toward aging and social support with individuals’ psychological well-being should be emphasized. Positive education programs appear to be essential for improving attitudes toward aging, increasing hope in life, and ultimately promoting psychological well-being in society.

Evaluation of low vagally-mediated heart rate variability as an early marker of depression risk

BackgroundBoth low vagally-mediated heart rate variability (HRV) and depression have been shown to be risk factors for cardiovascular disease (CVD). We recently identified an HRV cutpoint below which persons have an increased risk for several cardiometabolic disorders. However, no cutpoint exists to identify those at risk for depression. MethodsThe association between daytime HRV and diagnostically validated depression cutoffs using the five-item World Health Organization Well-being Index (WHO-5) was examined in adults from the Mannheim Industrial Cohort Study (n = 9973; Mage = 41.9[10.9]; 20 % women [n = 1934]). The aim was to identify HRV cutpoints for individuals who may have clinical depression. ResultsRegression adjusting for age, sex, and linear trend showed a significant quadratic association between depression, indexed by WHO-5 scores and HRV, indexed by the root mean square successive differences (RMSSD) in milliseconds (ms) (p < 0.001). Logistic regression models adjusting for age, sex, and heart period (i.e., inter-beat intervals) compared the clinically depressed (WHO-5 ≤ 28) and those with a screening diagnosis of depression (WHO-5 ≤ 50) to the rest of the population. Significant odds ratios suggested two RMSSD values 25 ± 2 ms (OR = 1.39 [1.17, 1.64]) and 35 ± 2 ms (OR = 1.17 [1.02, 1.34]) that may be used to identify those with an elevated risk for depression. LimitationsThe sample was primarily German men. Fitness and anti-depressant use were not available. ConclusionsAs HRV is a brief measure that can be used in clinical settings, our HRV cutpoints have implications for the early detection of those at risk for psychological and cardiometabolic disorders.

A Pilot Study Investigating the Feasibility, Reach-Out, Acceptability, Fidelity, and Efficacy of a Group Laughie Prescription on the Well-Being of Earthquake Survivors in Türkiye

Mental health and quality of life may be negatively impacted among earthquake survivors. This pilot study evaluates the use of and reports on the preliminary effects of participating in a 1-minute Laughie (Laugh Intentionally Everyday) Laughter Prescription on well-being in earthquake survivors in Türkiye. A Group Laughie intervention was delivered using a within-subject (n = 20; M age = 34.78 ± 6.65; 14 female) pretest-posttest design. Group Laughies were delivered once a day over 2 weeks with participants prescribed to further laugh with the Group Laughie recording twice a day, resulting in 3 minutes of intentional laughter daily. Data were collected using a range of questionnaires to track feasibility, reach-out, acceptability, fidelity, and efficacy, including Laughie Checklists, a Post-Intervention Perceived Impact Measure (PIPIM) in the form of the Positive Psychology One-off Post-intervention measure (PPOP), and the World Health Organization (WHO-5) well-being index. Results indicated high intervention fidelity using Laughie Checklists and positive post-intervention perceived impact using the 11-point Likert-scaled PPOP (x = 7.62 ± 1.44). After the intervention, a statistically significant difference (p < 0.001) was found between WHO-5 well-being index pretest scores (x = 2.16 ± 1.00) and post-test (x = 4.08 ± 0.24). This study demonstrated beneficial effects of the Laughie prescription on earthquake survivors. This is the first intervention to explore an online Group Laughie intervention. Health professionals and especially nurses can use the 1-minute Laughie prescription in the form of a Group Laughie intervention to increase the well-being of individuals and improve perceived mental health.

Sociodemographic and Psychosocial Factors Affecting the Psychological Well-being of Preoperative Surgical Patients

PurposeThis study aimed to determine the subjective psychological well-being levels and sociodemographic and psychosocial factors affecting the psychological well-being of preoperative surgical patients. DesignThis was a cross-sectional study. MethodsThis study was conducted between January 15, 2021 and July 15, 2021. The sample consisted of 236 surgical patients in a public hospital in the Thrace region of Turkey. Data were collected using a personal information form and the five-item World Health Organization Well-Being Index (WHO-5). The data were analyzed using numbers, percentages, mean, standard deviation, independent samples t test, one-way analysis of variance, Tukey's multiple comparison test, and linear regression analysis. FindingsParticipants had a mean WHO-5 score of 10.76 ± 6.21, indicating low subjective psychological well-being. Economic status, chronic disease status, history of surgery, having been on psychiatric medication or receiving professional psychological support, tobacco use, experiencing a significant life change in the last 3 months, and reporting experiencing frequent stress in everyday life were significant predictors of WHO-5 scores. ConclusionsPreoperative surgical patients have low subjective psychological well-being, and their sociodemographic and psychosocial factors affect their psychological well-being.

Enhancing Self-Esteem, Well-Being, and Relaxation in the Elderly through Nature-Based Interventions.

As the populations of many countries are aging, institutions providing support for the elderly increasingly often use nature-based interventions (NBIs) as part of their therapeutic activities. This study aimed to show the impact of 8-week active and passive NBI programs on self-esteem, well-being, and relaxation in the elderly. The NBI programs were conducted in two groups of elderly citizens of Poland: independent senior students and seniors requiring 24 h care. The Rosenberg's Self-Esteem Scale and the World Health Organization Well-Being Index were used to assess self-esteem and well-being before and after the programs. To assess relaxation, pre-post session measurements of pulse rate (PR) and blood oxygen saturation (SpO2) were used. Our study showed an improvement in the self-esteem, well-being, and relaxation of the participants of both active and passive NBI programs. In all study groups, self-esteem and well-being improved after the programs, regardless of the type of intervention, and after each NBI session, the elderly showed a decrease in PR and an increase in SpO2, which indicated a deeper state of relaxation. Our research showed a greater improvement in the tested parameters in the seniors participating in the passive programs in a garden. This confirms a key role of green spaces in residential areas for the elderly and in nursing homes.

Rationale, Design, and Baseline Characteristics of Participants in the Health@NUS mHealth Augmented Cohort Study Examining Student-to-Work Life Transition: Protocol for a Prospective Cohort Study.

Integration of mobile health data collection methods into cohort studies enables the collection of intensive longitudinal information, which gives deeper insights into individuals' health and lifestyle behavioral patterns over time, as compared to traditional cohort methods with less frequent data collection. These findings can then fill the gaps that remain in understanding how various lifestyle behaviors interact as students graduate from university and seek employment (student-to-work life transition), where the inability to adapt quickly to a changing environment greatly affects the mental well-being of young adults. This paper aims to provide an overview of the study methodology and baseline characteristics of participants in Health@NUS, a longitudinal study leveraging mobile health to examine the trajectories of health behaviors, physical health, and well-being, and their diverse determinants, for young adults during the student-to-work life transition. University students were recruited between August 2020 and June 2022 in Singapore. Participants would complete biometric assessments and questionnaires at 3 time points (baseline, 12-, and 24-month follow-up visits) and use a Fitbit smartwatch and smartphone app to continuously collect physical activity, sedentary behavior, sleep, and dietary data over the 2 years. Additionally, up to 12 two-week-long bursts of app-based ecological momentary surveys capturing lifestyle behaviors and well-being would be sent out among the 3 time points. Interested participants (n=1556) were screened for eligibility, and 776 participants were enrolled in the study between August 2020 and June 2022. Participants were mostly female (441/776, 56.8%), of Chinese ethnicity (741/776, 92%), undergraduate students (759/776, 97.8%), and had a mean BMI of 21.9 (SD 3.3) kg/m2, and a mean age of 22.7 (SD 1.7) years. A substantial proportion were overweight (202/776, 26.1%) or obese (42/776, 5.4%), had indicated poor mental well-being (World Health Organization-5 Well-Being Index ≤50; 291/776, 37.7%), or were at higher risk for psychological distress (Kessler Psychological Distress Scale ≥13; 109/776, 14.1%). The findings from this study will provide detailed insights into the determinants and trajectories of health behaviors, health, and well-being during the student-to-work life transition experienced by young adults. ClinicalTrials.gov NCT05154227; https://clinicaltrials.gov/study/NCT05154227. DERR1-10.2196/56749.

Promoting Self-Management in Adults with Type 2 Diabetes: Development of the Impact of Glucose Monitoring on Self-Management Scale

ObjectivesType 2 diabetes (T2D) management requires behavioural engagement to achieve optimal outcomes and continuous glucose monitoring (CGM) technologies may facilitate self-management. In this study we describe the development and validation of a self-report instrument, the Impact of Glucose Monitoring on Self-Management Scale (IGMSS), assessing the impact of device use (primarily CGM but also self-monitored blood glucose [SMBG]) on the capability, motivation, and opportunity to engage in self-management. MethodsPotential items were generated from 3 sources: themes and quotes from 13 adults with T2D motivated by CGM use who participated in a qualitative study; behaviour change theory identifying capability, opportunity, and motivation to self-manage; and expert committee review of items. An initial pool of 42 items were generated describing CGM as promoting personalized knowledge, improved health (Capability), improved relationships, having positive device characteristics (Opportunity), and improved engagement in self-management (Motivation). Based on expert committee consensus, items were written so as to be completed by those using any glucose-sensing device (SMBG and CGM). Psychometric evaluation was conducted with 514 English-speaking Canadians. Scale reduction (22 final items) was completed using item-response distribution, internal consistency, factor analysis, and expert opinion. Construct and convergent validity were evaluated using the Impact of Glucose Monitoring Satisfaction Scale, the Diabetes Self-Management Questionnaire, the Diabetes Distress Scale, the 5-item World Health Organization Well-Being Index, and the Centre for Epidemiology Depression Scale. Test–retest reliability was determined for 130 participants. ResultsInternal consistency was high for all scales, ranging from 0.73 to 0.91. Test–retest reliability ranged from 0.58 to 0.79, except for Device Characteristics. Construct and convergent validity indices were acceptable. There was substantial overlap between the IGMSS and established measures of CGM satisfaction. IGMSS findings were also predictive of self-management behaviour and emotional functioning. ConclusionsThe IGMSS has positive psychometric characteristics and has the potential to screen people with T2D for engagement in diabetes self-management using CGM or any sensing device. Scores can be determined for various aspects of Capability (Personalized Knowledge, Improved Health), Opportunity (Relationships and Device Characteristics), and Motivation.

Self-evaluation of appearance by female medicine students

Background and Study Aim. Nowadays western culture promotes appearance-wise the ideal of a slim body. The purpose of the research was to study body composition of female medicine students and compare these results with their self-evaluation on the problem. Material and Methods. Ninety-nine Casimir Pulaski Radom University in Radom females students (22.0±2.1 years old) who studied at a medicine faculty have been involved in the research. The study was conducted in accordance with the basic bioethical norms of the Helsinki Declaration of the World Medical Association on Ethical Principles for Conducting Scientific and Medical Research. Written informed consent was obtained from each study participant. The study was approved in advance by Ethical Committee of the Casimir Pulaski Radom University in Radom. The studies included survey research: The International Physical Activity Questionnaires (IPAQ) - Short Form, The 5-item World Health Organization Well-Being Index (WHO-5), Questionnaire of self-evaluation of appearance, body mass and height. According to the Three Sigma Rule border values, research samples were selected regarding compacted values of corresponding parameters. Pearson correlation has been used with a purpose to study an interaction between anthropometric parameters of subjects. Two pair t-test for arithmetic means was applied to compare mean values of the anthropometric parameters of the subjects. Factor analysis has been used with a purpose to study body building of students. Calculations were done using Data Analysis from MS Excel Offices and computer package Statistica. Results. Shapiro – Wilk method was used to determine normality of distribution of quantity parameters studied in the research (p&gt;0.4). Because Gauss distribution was noticed, parametric statistics were applied in mathematics elaboration of anthropometric parameters. According to the Method of Principal components, the Factor analysis has been done. A number of variables were reduced to twenty-three (11 – 33). Three Eigenvalues appeared greater than one (17.4; 3.3; 1.1). Number of factors extracted equals 3. Corresponding part of variation forms 94.7% of the total. The rest of variation (5.3%) presents other factors. The main factor (the first one) forms more than three quarters of variation – 75.7%. Conclusions. Accuracy of estimation of a body height among female subjects was determined as a difference between results of subject’s answer and results of measurement. Two groups of subjects have been formed: 58 subjects presented their knowledge of values of body height and 38 subjects – estimated their own hypothetic values.

Improvement and Maintenance of Clinical Outcomes in a Digital Mental Health Platform: Findings From a Longitudinal Observational Real-World Study.

Digital mental health services are increasingly being provided by employers as health benefit programs that can improve access to and remove barriers to mental health care. Stratified care models, in particular, offer personalized care recommendations that can offer clinically effective interventions while conserving resources. Nonetheless, clinical evaluation is needed to understand their benefits for mental health and their use in a real-world setting. This study aimed to examine the changes in clinical outcomes (ie, depressive and anxiety symptoms and well-being) and to evaluate the use of stratified blended care among members of an employer-sponsored digital mental health benefit. In a large prospective observational study, we examined the changes in depressive symptoms (9-item Patient Health Questionnaire), anxiety symptoms (7-item Generalized Anxiety Disorder scale), and well-being (5-item World Health Organization Well-Being Index) for 3 months in 509 participants (mean age 33.9, SD 8.7 years; women: n=312, 61.3%; men: n=175, 34.4%; nonbinary: n=22, 4.3%) who were newly enrolled and engaged in care with an employer-sponsored digital mental health platform (Modern Health Inc). We also investigated the extent to which participants followed the recommendations provided to them through a stratified blended care model. Participants with elevated baseline symptoms of depression and anxiety exhibited significant symptom improvements, with a 37% score improvement in depression and a 29% score improvement in anxiety (P values <.001). Participants with baseline scores indicative of poorer well-being also improved over the study period (90% score improvement; P=.002). Furthermore, over half exhibited clinical improvement or recovery for depressive symptoms (n=122, 65.2%), anxiety symptoms (n=127, 59.1%), and low well-being (n=82, 64.6%). Among participants with mild or no baseline symptoms, we found high rates of maintenance for low depressive (n=297, 92.2%) and anxiety (n=255, 86.7%) symptoms and high well-being (n=344, 90.1%). In total, two-thirds of the participants (n=343, 67.4%) used their recommended care, 16.9% (n=86) intensified their care beyond their initial recommendation, and 15.7% (n=80) of participants underused care by not engaging with the highest level of care recommended to them. Participants with elevated baseline depressive or anxiety symptoms improved their mental health significantly from baseline to follow-up, and most participants without symptoms or with mild symptoms at baseline maintained their mental health over time. In addition, engagement patterns indicate that the stratified blended care model was efficient in matching individuals with the most effective and least costly care while also allowing them to self-determine their care and use combinations of services that best fit their needs. Overall, the results of this study support the clinical effectiveness of the platform for improving and preserving mental health and support the utility and effectiveness of stratified blended care models to improve access to and use of digitally delivered mental health services.

Exploring the mediating influence of acceptance of change: A study on gerontechnology acceptance, mental well-being, and urban–rural disparities among older adults

BackgroundThe global aging population necessitates leveraging technology for older adults' independence and mental well-being. Gerontechnology, tailored for older users, thrives when accessible and accepted, with the pivotal role of acceptance of change shaping its adoption. AimsThis study investigates the mediating role of acceptance of change in the relationship between gerontechnology acceptance and mental well-being among older adults and explores disparities in urban and rural settings Design & MethodsA cross-sectional, correlational design adhering to STROBE guidelines collected data through an interview survey from 802 older adults. Instruments included the Older Adult Structured Survey, Short Version of Senior Technology Acceptance, Acceptance of Change Scale, and the World Health Organization Well-Being Index. ResultsThe results underscore a significant correlation between technology adoption, adaptability, and mental well-being among 60-year-olds and older. Notably, an individual's openness to change significantly influences the technology-mental well-being relationship, emphasizing its impact on overall health. Urban areas exhibit a stronger positive correlation between technology acceptance and mental well-being, whereas rural regions demonstrate a more pronounced negative correlation. ConclusionThis research contributes valuable knowledge for addressing the unique challenges older adults face in diverse geographic settings, paving the way for targeted and effective initiatives. ImplicationsNurses should prioritize understanding the nexus between gerontechnology acceptance, change adaptability, and mental wellness, integrating technology education and culturally sensitive interventions to enhance care strategies for older adults in diverse geographic settings. This study lays the groundwork for developing person-centered geriatric nursing care plans, underscoring the importance of harnessing technology for improved mental well-being.

The Effectiveness of Virtual Reality-Based Training on Cognitive, Social, and Physical Functioning in High-Functioning Older Adults (CoSoPhy FX): 2-Arm, Parallel-Group Randomized Controlled Trial.

Virtual reality (VR) has emerged as a promising technology for enhancing the health care of older individuals, particularly in the domains of cognition, physical activity, and social engagement. However, existing VR products and services have limited availability and affordability; hence, there is a need for a scientifically validated and personalized VR service to be used by older adults in their homes, which can improve their overall physical, cognitive, and social well-being. The main purpose of the CoSoPhy FX (Cognitive, Social, and Physical Effects) study was to analyze the effects of a VR-based digital therapeutics app on the cognitive, social, and physical performance abilities of healthy (high-functioning) older adults. This paper presents the study protocol and the results from the recruitment phase. A group of 188 healthy older adults aged 65-85 years, recruited at the Medical University of Lodz, Poland, were randomly allocated to the experimental group (VR dual-task training program) or to the control group (using a VR headset app showing nature videos). A total of 3 cognitive exercises were performed in various 360° nature environments delivered via a VR head-mounted display; the participants listened to their preferred music genre. Each patient received 3 sessions of 12 minutes per week for 12 weeks, totaling a minimum of 36 sessions per participant. Attention and working memory (Central Nervous System Vital Signs computerized cognitive battery) were used as primary outcomes, while other cognitive domains in the Central Nervous System Vital Signs battery, quality of life (World Health Organization-5 Well-Being Index), health-related quality of life (EQ-5D-5L), and anxiety (General Anxiety Disorder 7-item questionnaire) were the secondary outcomes. The group-by-time interaction was determined using linear mixed models with participants' individual slopes. In total, 122 (39%) of the initial 310 participants failed to meet the inclusion criteria, resulting in a recruitment rate of 61% (188/310). Among the participants, 68 successfully completed the intervention and 62 completed the control treatment. The data are currently being analyzed, and we plan to publish the results by the end of September 2024. VR interventions have significant potential among healthy older individuals. VR can address various aspects of well-being by stimulating cognitive functions, promoting physical activity, and facilitating social interaction. However, challenges such as physical discomfort, technology acceptance, safety concerns, and cost must be considered when implementing them for older adults. Further research is needed to determine the long-term effects of VR-based interventions, optimal intervention designs, and the specific populations that would benefit most. ClinicalTrials.gov NCT05369897; https://clinicaltrials.gov/study/NCT05369897. DERR1-10.2196/53261.

Relation between Burnout and Psychosocial Factors in Health Care Providers and Family Caregivers of Patients with Cancer

Abstract Introduction Burnout has been widely studied among oncology health care providers such as nurses and doctors. However, it is a less explored but highly prevalent factor in family caregivers of patients with cancer. Objective The study aimed to understand the construct of burnout among health care providers and family caregivers of patients with cancer, through three objectives: (1) to distinguish burnout between health care providers and family caregivers; (2) to predict burnout based on measurable characteristics, namely, perceived stress, psychological morbidity, well-being, problem-focused coping, emotion-focused coping, and avoidant coping; and (3) to find out the levels of burnout (low, medium, and high) in health care providers and family caregivers. Materials and Methods It is a cross-sectional study conducted among the health care providers and family caregivers of patients with cancer. The measures used in the study were the Professional Quality of Life scale, 12-Item General Health Questionnaire, Perceived Stress Scale, 5-Item World Health Organization Well-Being Index, Brief COPE inventory, and a sociodemographic details form. Results The study found a statistically significant difference in the mean burnout of health care providers (p = 0.027) and family caregivers. Study variables such as perceived stress and avoidant coping positively predicted burnout, whereas well-being and emotion-focused coping negatively predicted burnout. The study also found that a majority of the participants fell into the category of “medium” level of burnout. Conclusion While enhancing well-being and employing adaptive coping styles can act as the mitigating factors to burnout, the existence of stress and maladaptive styles of coping can prove counterproductive in dealing with burnout in work environments. This indicates that there is a need for psychosocial interventions to help the medical professionals deal with the burnout.

Validation and optimal cut-off score of the World Health Organization Well-being Index (WHO-5) as a screening tool for depression among patients with schizophrenia

BackgroundThe utility of the World Health Organization Wellbeing Index (WHO-5) as rapid screening tool for depression has not yet been researched in the context of schizophrenia. The goals of this study were twofold: (1) to test the psychometric properties of the WHO-5 in a sample of Arabic-speaking patients with schizophrenia from Lebanon, with particular emphasis on validating the WHO-5 as a screening tool for wellbeing and depression in patients with schizophrenia; and (2) to determine the optimal cut-off point to identify schizophrenia patients with depression.MethodsChronic, remitted patients with schizophrenia took part in this cross-sectional study between August and October 2023 (n = 117; mean age of 57.86 ± 10.88 years and 63.3% males). The Calgary Depression Scale for Schizophrenia (CDSS) was included as index of validity. For the validation of the WHO-5 scale, we performed a confirmatory factor analysis (CFA) using the original structure of the scale. To assess the discriminatory validity of the Arabic version of the WHO-5 as a screening tool for depression, we conducted a Receiver operating characteristic (ROC) curve analysis, taking the WHO-5 reversed score against the dichotomized CDSS score at a cut off value of 6.ResultsThe results of CFA supported the originally proposed unidimensional structure of the measure, with good internal consistency reliability (α = 0.80), concurrent validity, and cross-sex measurement invariance. The WHO-5 showed a sensitivity of 0.8 and a specificity of 0.7 in the detection of depression with a cut-off point of 9.5. The validity of the WHO-5 as a screening tool for depression was supported by the excellent discrimination AUC value of 0.838. Based on this WHO-5 cut-off value, 42.6% of the patients were screened as having a depression.ConclusionThe study contributes to the field by showing that the WHO-5 is a concise and convenient self-report measure for quickly screening and monitoring depressive symptoms in patients with schizophrenia. It is therefore highly recommended to apply this cut-off point for screening and follow-up assessments. The current findings will hopefully encourage clinicians and researchers working in Arab settings, who are often confronted with significant time and resource constraints, to start using the WHO-5 to aid their efforts in mitigating depression in this vulnerable population and fostering research in this under-researched area.