World Health Organization Well-Being Index Research Articles

The significant association between quick return and depressive symptoms and sleep disturbances in paid workers: A nationwide survey.

ObjectivesAlthough many studies have examined the association between shift work and depression or insomnia, few studies have examined the relationship between quick return (QR) to work and depressive symptoms, regardless of shift work. Thus, in this study, we aimed to assess the association between depressive symptoms (DS)/sleep disturbances (SDs) and QR.MethodsData from the 6th Korean Working Conditions Survey (2020) were used for this study. Paid workers aged between 20 and 65 years were included. DS were defined using the World Health Organization Well-Being Index (WHO-5) with a cut-off 50, and SD was defined as the occurrence of the following symptoms several times per month: difficulty in falling asleep, waking up in the middle of the night, or feeling tired even after waking up. QR was defined as “at least one case where the working interval between leaving work and the next day's work was < 11 h in the past month.” Multivariable logistic regression was performed to estimate the adjusted odd ratios (aORs) and 95% confidence intervals (CIs). Mediation analysis was conducted to examine whether SD was a significant mediator in the association between QR and DS.ResultsAmong the 27,554 participants, DS occurred in 8,277 patients, while SD occurred in 6,264 patients. The aORs (95% CIs) of DS and SD by QR were 2.01 (1.78–2.27) and 3.24 (2.87–3.66), respectively, after adjusting for age, gender, income, education, working hours, job status, working duration, region, shift work, and occupation. SD was a significant mediator in the association between QR and DS.ConclusionQR is significantly associated with DS or SD regardless of demographic factors and the working environment. The significant relationship between QR and DS may be mediated by SD.

High Expressed Emotion and Warmth among Families of Patients with Schizophrenia in Greece.

Expressed emotion (EE) is an established prognostic factor for relapse in schizophrenia. Through critical comments (CC), hostility (H) and emotional overinvolvement (EOI), a relative can be rated as high or low EE, but the role of warmth should also be evaluated in order to consider the influence of a positive affect within the family context. In this study, EE was assessed in a sample of 48 relatives of patients with schizophrenia using the Camberwell Family Interview (CFI). Questionnaires assessing coping (brief-COPE), their wellbeing (World Health Organization Well-Being Index WHO-5) and the socio-demographic variables were also administered. Relatives who expressed a higher level of warmth were found to make fewer CC (5.2 ± 4.6 vs. 8.4 ± 4.6, p = 0.009) and have, on average, higher EOI scores (3.2 ± 1.0 vs. 1.9 ± 1.1, p = 0.002) than those who expressed no or very little warmth. High EE was found to be associated with having fewer family members (p = 0.035), while relatives with a higher level of education expressed less warmth (p = 0.007). Relatives with a low level of warmth had higher maladaptive coping scores and tended to score worse for their overall wellbeing in comparison to relatives who showed a higher level of warmth (28.4 ± 5.0 vs. 24.1 ± 5.2, p = 0.006 and 39.1 ± 20.4 vs. 51.3 ± 22.0, p = 0.073, respectively). Since the role of warmth is important, it should be taken into account when designing family interventions, independently from lowering EE. Customized interventions to promote warmth and the routine screening of relatives are recommended.

Success4life Youth Empowerment for Promoting Well-being and Boosting Mental Health: Protocol for an Experimental Study.

BackgroundThere is an increasingly alarming worsening of mental health among the youth. There remain significant unmet needs for developing innovative, evidence-based technology–enhanced, positive psychology interventions (PPIs) all-inclusive in targeting psychological distress and risk factors related to high-risk behavior commonly encountered in adolescents.ObjectiveWe aim to assess the effectiveness of a hybrid (incorporating both synchronous and asynchronous learning) and holistic (targeting social and emotional learning and tackling risk factors unique for this age group) PPI, “success4life youth empowerment,” in improving well-being in the youth.MethodsStudents’ well-being will be assessed by the 5-item World Health Organization Well-Being Index, and hope will be assessed by the 6-item Children’s Hope Scale at week 0, week 8, and week 10, month 6, and month 12. Any improvement in well-being and hope will be measured, estimating the difference in postintervention (week 8 and week 10) and preintervention (week 0) scores by determining the P value and effect size using appropriate statistical tests.ResultsThis study includes 2 phases: pilot phase 1, delivered by the creators of the succcess4life youth empowerment modules and platform, and phase 2, which will consist of the estimation of scalability through the recruitment of trainers. We hope to start student recruitment by 2022 and aim to complete the results for phase 1 pilot testing by 2023.ConclusionsWe anticipate that a primarily web-based, 10-week holistic PPI can support improvement in the mental wellness of the youth and has the potential for effective scalability.International Registered Report Identifier (IRRID)PRR1-10.2196/38463

Validating the Five-Item World Health Organization Well-Being Index.

Purpose: Research on the psychological well-being of caregivers of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) suggests that the well-being of parents and caregivers has been negatively affected by the COVID-19 pandemic. Although the psychological well-being of caregivers is a major concern, few validated well-being measures exist for caregivers of children diagnosed with ADHD. Therefore, a valid self-report scale is needed to assess well-being during the pandemic. The brief Five-Item World Health Organization Well-Being Index (WHO-5) has previously been used in studies on caregivers. However, its validity in this population remains unknown. This study aimed to evaluate the reliability and construct validity of the WHO-5 with caregivers of children with ADHD. Methods: A cross-sectional anonymous online survey was conducted in Norway. The study recruited caregivers from a community sample during the COVID-19 pandemic. This was carried out to investigate the construct validity by exploring the relationship between well-being, quality of life, social support, self-reported psychological distress, and perceived stress. Results: The findings of unidimensionality and high internal consistency, together with the results from the hypothesis testing, demonstrate the reliability and construct validity of the Norwegian version of the WHO-5 in this population. Conclusions: This study provides the first empirical evidence of the validity and reliability of the WHO-5 from a sample of Norwegian caregivers of children diagnosed with ADHD, with excellent reliability and construct validity. The scale can be used to systematize the measurement of well-being in caregivers because of its brevity and good psychometric properties, making it a valuable resource in research settings and assisting healthcare professionals in their crucial work of caring for caregivers.

Feasibility randomized controlled trial of a self-guided online intervention to promote psychosocial adjustment to unmet parenthood goals.

STUDY QUESTIONIs it feasible to implement and evaluate an online self-guided psychosocial intervention for people with an unmet parenthood goal (UPG), aimed to improve well-being, in an online randomized controlled trial (RCT)?SUMMARY ANSWERThe evaluation of an online bilingual self-guided psychosocial intervention for people with a UPG is feasible, reflected by high demand, good acceptability, good adaptation and promise of efficacy, but minor adjustments to the intervention and study design of the RCT should be made to enhance practicality.WHAT IS KNOWN ALREADYSelf-identifying as having a UPG, defined as being unable to have children or as many as desired, is associated with impaired well-being and mental health. Practice guidelines and regulatory bodies have highlighted the need to address the lack of evidence-based support for this population. It is unknown if MyJourney (www.myjourney.pt), the first online self-guided intervention for people with UPGs, can be implemented and evaluated in an RCT.STUDY DESIGN, SIZE, DURATIONTo evaluate the feasibility of MyJourney, we conducted a registered, two-arm, parallel group, non-blinded feasibility RCT, with a 1:1 computer-generated randomized allocation and embedded qualitative process evaluation. Participants were included between November 2020 and March 2021. Assessments were made before randomization (T1), 10 weeks (T2) and 6 months after (T3, intervention group only). Participants allocated to the intervention group received an email to access MyJourney immediately after randomization. Participants in the waitlist control group were given access to MyJourney after completing the 10-week assessment (T2).PARTICIPANTS/MATERIALS, SETTING, METHODSParticipants were recruited via social media advertising of MyJourney and its feasibility study. People who self-identified as having a UPG could click on a link to participate, and of these 235 were randomized. Outcome measures related to demand, acceptability, implementation, practicality, adaptation and limited efficacy were assessed via online surveys. The primary outcome in limited efficacy testing was hedonic well-being, measured with the World Health Organisation Wellbeing Index (WHO-5).MAIN RESULTS AND THE ROLE OF CHANCEParticipation and retention rates were 58.3%, 31.7% (T2) and 45.2% (T3, intervention group only), respectively. Of participants invited to register with MyJourney, 91 (76.5%) set up an account, 51 (47.2%) completed the first Step of MyJourney, 12 (11.1%) completed six Steps (sufficient dose) and 6 (5.6%) completed all Steps within the 10-week recommended period. Acceptability ranged from 2.79 (successful at supporting) to 4.42 (easy to understand) on a 1 (not at all) to 5 (extremely acceptable) scale. Average time to complete sufficient dose was 15.6 h (SD = 18.15) and to complete all Steps was 12.4 h (SD = 18.15), with no differences found for participants using MyJourney in Portuguese and English. Modified intention-to-treat analysis showed a moderate increase in well-being from T1 to T2 in the intervention group (ηp2 = 0.156, mean difference (MD) = 9.300 (2.285, 16.315)) and no changes in the control group (ηp2 = 0.000, MD = 0.047 (−3.265, 3.358)). Participants in the process evaluation reported MyJourney was needed and answered their needs for support (reflecting high demand and acceptability), the recommended period to engage with MyJourney was short, and their engagement was influenced by multiple factors, including personal (e.g. lack of time) and MyJourney related (e.g. reminders).LIMITATIONS, REASONS FOR CAUTIONParticipants were mostly white, well-educated, employed, childless women. Non-blinded allocation, use of self-reported questionnaire assessments and high attrition in the intervention group could have triggered bias favourable to positive evaluations of MyJourney and resulted in low power to detect T2 to T3 changes in limited efficacy outcomes.WIDER IMPLICATIONS OF THE FINDINGSMyJourney can proceed to efficacy testing, but future work should eliminate barriers for engagement and explore strategies to maximize adherence. Entities wanting to support people with UPGs now have a freely accessible and promising resource that can be further tested and evaluated in different settings.STUDY FUNDING/COMPETING INTEREST(S)MyJourney’s development was funded by the charity Portuguese Fertility Association, Cardiff University and University of Coimbra (CINEICC). Dr S.G. reports consultancy fees from Ferring Pharmaceuticals A/S, speaker fees from Access Fertility, SONA-Pharm LLC, Meridiano Congress International and Gedeon Richter and grants from Merck Serono Ltd. Bethan Rowbottom holds a PhD scholarship funded by the School of Psychology, Cardiff University. The other authors have no conflicts of interest.TRIAL REGISTRATION NUMBERClinical Trials.gov NCT04850482.

Emotional eating and depression during the pandemic: QuarantEat, an Italian nationwide survey

ObjectivesThis study aimed to explore the consequences of the pandemic lockdown among the Italian general population by focusing on depression and emotional overeating (EO). MethodsQuarantEat was an Italian, nationwide, cross-sectional study conducted using a computer-assisted web interview method (May 6-31, 2020). The 40-item questionnaire included the five-item World Health Organization Wellbeing Index and EO Questionnaire-5. Multivariable logistic regressions were performed. ResultsA total of 1865 adults participated in the study. Depression and EO were reported by 57.6% and 49.3%, respectively, of the sample. When considering multivariable models, women, students, participants who smoked more/equal during lockdown, and individuals with EO were more likely to report depression. Following a healthier diet or exercising during lockdown reduced the probability of depression. The likelihood of EO was higher for participants who were female, consumed more food, had a less healthy diet, were overweight and obese, consumed more chocolate, consumed more snacks between meals or before going to sleep/during the night, and were at risk for depression. Increasing age, having a relationship, and not having increased television/computer watching time while eating reduced the odds of EO. ConclusionsQuarantEat highlighted high levels of depression and EO right after the end of pandemic lockdown measures, and outlined the importance of the relationships between mental health and health risk behaviors, such as smoking, exercise, diet, and changes in eating behaviors due to the pandemic lockdown. Planning interventions using a holistic approach and reaching every individual to overcome the limits caused by the restrictive lockdown measures is essential.

Factors associated with community commitment among older adults: a stratified analysis of community group leaders and members

BackgroundCommunity commitment through group activities in the community is associated with improved health outcomes in older adults and has a ripple effect on community development. However, factors associated with community commitment through group activities in the community have not been examined. The purpose of this study was to examine individual factors and group-related factors in association with community commitment among older adult leaders and members of community groups in Japan.MethodsWe mailed self-administered questionnaires to all older adults participating in a community group (N = 1,898) in a ward of Yokohama city, the largest designated city in Japan. Variables included demographic characteristics, community commitment (Community Commitment Scale), individual factors, and group-related factors. We used logistic regression analysis to assess the association among study variables.ResultsA total of 1,154 people completed the questionnaire. The valid response rate was 48.8%. Respondents’ mean age was 78.3 years (standard deviation [SD] = 6.1, range 65–100 years), 79.6% were women, 55.9% were married, and 10.0% were employed. Factors associated with community commitment among group leaders were scores for self-efficacy in the health promotion scale (SF-15; mean ± SD: 48.5 ± 7.1), 5-item World Health Organization Well-Being Index (mean ± SD: 17.9 ± 4.3), and Lubben Social Network Scale, Japanese version (mean ± SD: 19.5 ± 6.9), as well as a perception of deriving pleasure from group participation (mean ± SD: 91.2 ± 9.4). Factors associated with community commitment among group members were economic status (Sufficient; n [%]: 749 [85.9]), frequency of going out (mean ± SD: 5.1 ± 1.8), years of group participation (mean ± SD: 6.2 ± 5.0), and perceptions of their role in the group (Yes; n [%]: 254 [30.4]) as well as the above factors for leaders. A supplementary qualitative analysis of participants’ free-text responses extracted seven categories: community support, resource mobilization, partnership action, asset management, participatory decision-making, linkages and networking, and community dissemination, related to perception of a role in the group.ConclusionOur results emphasize the importance of considering the different associations of community commitment through group activities in the community between group leaders and members, including the role of older adults in community groups, and suggest different approaches for group leaders and members.

The Sensitivity to Change of the ASAS Health Index in an Observational Real-Life Cohort Study.

The Assessment of Spondyloarthritis international Society Health Index (ASAS HI) measures global functioning and health in patients with axial spondyloarthritis (axSpA) covering domains of physical, emotional, and social functioning. The main aim of this study was to investigate the sensitivity to change of ASAS HI in comparison with established variables of disease activity, function, and mental health. Patients with axSpA from the disease register RABBIT-SpA with follow-up time of at least 12 months and available ASAS HI questionnaires were included. Patients received questionnaires addressing disease activity (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score [ASDAS]), physical function (Bath Ankylosing Spondylitis Functional Index [BASFI]), mental health (5-item World Health Organization Well-Being Index [WHO-5]), and global functioning (ASAS HI). Standardized response means (SRMs) were calculated to compare the sensitivity to change of different variables. Six hundred and sixty-seven patients were included, 552 treated with biologic disease-modifying antirheumatic drugs (bDMARDs) and 115 with conventional synthetic DMARDs and/or nonsteroidal antiinflammatory drugs (control group). Between baseline and month 12, the mean ASAS HI declined from 6.9 to 5.1 in the bDMARD group and from 5.9 to 5.6 in the conventionally treated group. In the bDMARD group, the SRM of ASAS HI was 0.52, compared to 0.59 for BASFI, 0.65 for WHO-5, 0.73 for BASDAI, and 0.90 for ASDAS. The following ASAS HI domains were most frequently affected: pain (78% agreed), maintaining body position (75%), and energy/drive (73%). In the patients receiving bDMARDs, there was an improvement in all items. In the control group, the largest improvement was seen in pain. As expected, ASDAS and BASDAI as disease activity scores showed high sensitivity to change, whereas changes in physical function (BASFI), mental health (WHO-5), and the broader concept of functioning and health (ASAS HI) were moderate.

Symptom severity and well-being of patients with mental illness during the COVID-19 pandemic: a two-wave survey

Purpose of the article To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness. Materials and methods In February 2021, we conducted a follow-up questionnaire-based survey among adults with mental illness, who responded to a similar survey on mental health in June 2020. The participants completed the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in mental health using the pre-pandemic period as reference. The survey data were merged with sociodemographic and clinical data from the medical records of all invitees to the first survey, enabling analysis of attrition and weighting of the results. Results A total of 613 of 992 (62%) invitees participated in the follow-up wave of the survey. The weighted mean WHO-5 and BSI-18 scores were 38 and 27, respectively, and did not differ statistically significantly from the first wave. Multivariate logistic regression showed that having a vocational education (skilled worker/craftsman) was positively associated with reporting deterioration in psychological well-being (OR: 2.95, 95%CI: 1.14–7.81), while being unemployed was negatively associated with reporting deterioration in psychological well-being (OR: 0.20, 95%CI: 0.07–0.56) from the first to the second survey wave. The most common reason for self-reported deterioration in mental health was loneliness (70%). Conclusions Approximately one year into the COVID-19 pandemic, the level of symptoms remained high, whereas the level of psychological well-being remained low among patients with mental illness.

The Mediating Role of Psychological Well-Being in the Relationship between Self-Care Knowledge and Disease Self-Management in Patients with Hypertensive Nephropathy.

Objective: This study aimed to investigate the correlation between self-care knowledge, psychological well-being, and disease self-management in patients with hypertensive nephropathy, and to assess the effect of psychological well-being as a mediator of self-care knowledge and disease self-management. Methods: This is a cross-sectional study. The 220 patients with hypertensive nephropathy were recruited from a teaching hospital in Taiwan using purposive sampling. The average age was 70.14 (SD = 11.96) years old. Among them, 128 (58.2%) were male and 92 (41.8%) were female. Instruments included a hypertensive nephropathy self-care knowledge scale, the World Health Organization-5 Well-Being Index, and the chronic kidney disease self-management instrument. The mediating effect was determined with linear regression models and the Sobel test. Results: The total explanatory variation of age, systolic blood pressure, psychological well-being, and self-care knowledge on the disease self-management was 27.7%. Psychological well-being was the most important explanatory factor and alone explains 16%. Psychological well-being was a partial mediator of self-care knowledge and quality of life in patients with hypertensive nephropathy, with a total effect of 23.2%. Conclusions: This study showed that older patients with hypertensive nephropathy and those with a higher systolic blood pressure had lower levels of disease self-management. The higher the patients’ self-care knowledge and psychological well-being, the better their disease self-management.

The Association between Working Hours Flexibility and Well-Being Prior to and during COVID-19 in South Korea.

Objective: This study examined the relationship between the flexibility of work schedule arrangements and well-being among full-time workers prior to and after the coronavirus disease (COVID-19) outbreak in South Korea. Methods: Data from the fifth 2017 and sixth 2020–2021 Korean Working Conditions Survey, including a final sample of 45,137 participants (22,460 males; 22,677 females), were used. Multiple logistic regression was performed to establish the association between schedule arrangement types and the 5-item World Health Organization Well-Being Index. Results: The study found an association between flexible schedule arrangements and good well-being in 2017: “little flexibility” (odds ratio (OR), 1.33; 95% confidence interval (CI), 1.27–1.48), “moderate flexibility” (OR, 1.48; 95% CI, 1.28–1.71), and “high flexibility” (OR, 1.35; 95% CI, 1.06–1.72). During COVID-19, only workers with “high flexibility” were likely to have good well-being (OR, 1.49; 95% CI, 1.18–1.88), while the association between well-being and “low flexibility” (OR, 1.06; 95% CI, 0.96–1.17) and “moderate flexibility” types (OR, 0.66; 95% CI 0.59–0.75) decreased. This study found that flexible working hours may contribute to better well-being among full-time workers. However, the impact of the COVID-19 pandemic on working conditions and employee well-being should be addressed while setting working hours.

The Efficacy of "Foundations," a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial.

BackgroundAgainst a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being.ObjectiveThe aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomized control trial that took place during the first wave of the COVID-19 pandemic in the United Kingdom.MethodsAdults with mild to severe anxiety and moderate to high levels of perceived stress were randomized to either the intervention or control arm. Participants in the intervention arm were given access to the Foundations app for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10], 7-item Generalized Anxiety Disorder scale [GAD-7], Office of National Statistics Four Subjective Well-being Questions [ONS-4], World Health Organization-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and at weeks 2 and 4. The self-reported measures of perceived stress (10-item Perceived Stress Score [PSS-10]) were obtained weekly.ResultsA total of 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety, with a mean GAD-7 score change from baseline of –1.35 (SD 4.43) and –0.23 (SD 3.24), respectively (t134=1.71, P=.04); resilience, with a mean change in CD-RISC score of 1.79 (SD 4.08) and –0.31 (SD 3.16), respectively (t134=–3.37, P<.001); sleep, with a mean MISS score change of –1.16 (SD 2.67) and –0.26 (SD 2.29), respectively (t134=2.13, P=.01); and mental well-being, with a mean WHO-5 score change of 1.53 (SD 5.30) and –0.23 (SD 4.20), respectively (t134=–2.16, P=.02), within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the difference did not reach statistical significance relative to the control group, with a PSS score change from baseline to week 2 of –2.94 (SD 6.84) and –2.05 (SD 5.34), respectively (t134= 0.84, P=.20).ConclusionsThis study provides a proof of principle that the digital mental health app Foundations can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. Foundations therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.Trial RegistrationOSF Registries osf.io/f6djb; https://osf.io/vm3xq

The use of online social network sites during the COVID-19 pandemic as a protective or risk factor for well-being of university students

During the COVID-19 period, the use of social network sites (SNSs) has been reported to increase. The present study aimed to explore whether, on balance, their use serves the well-being of university students positively as a source of social capital and entertainment, or negatively as a source of information about the COVID-19 pandemic. It focused on a sample of 339 university students, a group which is known to have a high risk of well-being problems. Students completed the demographic information form, the use of SNSs form, and the World Health Organization Well-Being Index. The use of SNSs form included items on SNS use in terms of daily duration, usage patterns (active and passive use) and reasons with regard to social capital (bridging and bonding social capital) and entertainment, and the perceived change in these quantitative and qualitative aspects of SNS use compared to the pre-COVID period. It also measured the level of exposure to COVID-19 related information on SNSs. It was found that the increase in the duration of SNS use predicted the well-being score negatively whereas the increase in active use and use for bonding social capital related reasons predicted it positively. These findings suggest that the quantity and the quality of SNS use are differently related to the well-being of university students. The active use of SNSs, particularly for the purpose of connecting with the close networks might constitute protective factors for student well-being in the case of health emergencies like the COVID-19 pandemic.

P-495 A feasibility randomised controlled trial of MyJourney: a self-guided online intervention to promote psychosocial adjustment to unmet parenthood goals

Abstract Study question Is it feasible to implement and evaluate an online self-guided psychosocial intervention for people with unmet parenthood goals (UPG), aimed to improve wellbeing, in an online randomized controlled trial (RCT)? Summary answer The evaluation of an online bilingual self-guided psychosocial intervention for people with a UPG is feasible but minor adjustments should be made to enhance practicality. What is known already Self-identifying as having a UPG, defined as being unable to have children or as many as desired, is associated with impaired wellbeing and mental health. Practice guidelines and regulatory bodies have highlighted the need to address the lack of evidence-based support for this population. It is unknown if MyJourney (www.myjourney.pt), the first online self-guided intervention for people with UPGs, can be implemented and evaluated in an RCT. Study design, size, duration We conducted a pre-registered, two-arm, parallel group, non-blinded feasibility RCT, with a 1:1 computer-generated randomised allocation and embedded qualitative process evaluation. Recruitment run from November 2020 to March 2021. Assessments were made before randomisation (T1), 10-weeks (T2) and 6-months after (T3, intervention group only). Participants allocated to the intervention group received an email to access MyJourney immediately after randomization. Participants in the control group were given access to MyJourney after filling the 10-weeks assessment (T2). Participants/materials, setting, methods Participants were recruited via social media advertising of MyJourney and its feasibility study. People who self-identified as having a UPG could click on a link to participate and of these 235 were randomised. Outcome measures related to demand, acceptability, implementation, practicality, adaptation, and limited efficacy were assessed via online surveys. The primary outcome in limited efficacy testing was hedonic wellbeing, measured with the World Health Organisation Wellbeing Index (WHO-5). Main results and the role of chance Participation and retention rates were 58.3%, 31.7% (T2) and 45.2% (T3, intervention group only). Of participants invited to register with MyJourney, 91 (76.5%) set up account, 51 (47.2%) completed the first Step of MyJourney, 12 (11.1%) completed six Steps (sufficient dose) and six (5.6%) completed all Steps within the 10-week recommended period. Acceptability ranged from 2.79 (successful at supporting) to 4.42 (easy to understand) on a 1(not at all) to 5(extremely acceptable). Average time to complete sufficient dose was 5.6 hours (SD = 18.15) and all Steps was 12.4 hours (SD = 18.15), with no differences found for participants using MyJourney in Portuguese and English. Modified intention to treat analysis showed a moderate increase in wellbeing from T1 to T2 in the intervention group (ηp2 = .156, MD = 9.300 [2.285, 16.315]) and no changes in the control group (ηp2 = .000, MD = .047 [-3.265, 3.358]). Participants in the process evaluation reported that MyJourney was needed and answered their needs for support (reflecting high demand and acceptability). Participants thought the recommended period to engage with MyJourney was short and that their engagement was influenced by multiple factors, including personal (e.g., lack of time) and MyJourney related factors (e.g., reminders). Limitations, reasons for caution Participants were mostly white, well-educated, employed, childless women. Non-blinded allocation, use of self-reported questionnaire assessments and high attrition in the intervention group could have triggered bias favourable to positive evaluations MyJourney. Wider implications of the findings MyJourney can proceed to efficacy testing, but future work should eliminate barriers for engagement (e.g., enabling users to add MyJourney icon to device and remain logged in) and explore strategies to maximise adherence (e.g., reminders with personalised content, guidance and scheduling options for routine use). Trial registration number Clinical Trials.gov NCT04850482

Cyberchondria, Covid-19 phobia, and well-being: a relational study on teachers.

This study aims at investigating level and contributor factors of Cyberchondria, Covid-19-related Phobia, and Well-Being in a sample of teachers in Turkey. The study was conducted on teachers (n=1000) working in a province in eastern Turkey. Data for the study were collected using a form that included participants' descriptive characteristics, the Covid-19 Phobia Scale (C19P-SE), the Cyberchondria Severity Scale, and the World Health Organization-5 Well-Being Index (WHO-5). Spearman correlation analysis, Mann-Whitney U test, and Kruskal Wallis analysis of variance were used to analyze the data. As participant's cyberchondria levels rose, C19P-SE scores increased (r=0.271, p<0.001), and WHO-5 scores decreased (r=-0.224, p<0.05). Corona-phobia was higher in those who used social media than in those who did not (p<0.05). Cyberchondria scale scores were higher among those who had taken medications without a physician's recommendation during the pandemic. Participants who had a disabled person or a person in need of care in their household had higher scores for distrust of the physician and C19P-SE than for the cyberchondria severity scale sub-dimension, and the WHO-5 mean scores were lower (p<0.001, P=0.016, and P=0.020, respectively). The study results show that increasing levels of cyberchondria trigger Covid-19 phobias in teachers during the Covid-19 pandemic and negatively affect their well-being. This descriptive study can help understand the risk group for cyberchondria, the influencing factors, and the health and economic consequences, and identify strategies for effective combating with cyberchondria.

Validity and reliability of the Danish version of the Pittsburgh Sleep Quality Index.

The Pittsburgh Sleep Quality Index is a widely used measure of sleep quality. The validity and reliability of the Danish version of the instrument has not yet been established. The aim of this study is to establish the internal consistency, test-retest reliability and convergent validity of the Danish version of the Pittsburgh Sleep Quality Index in adolescents. Data were collected from 719 students from 17 different upper secondary schools. The sample consisted of 55% women, and the mean age of the sample was 17.87 (2.52) years. Data was collected on two occasions approximately 6 weeks apart using online surveys. Apart from the Pittsburgh Sleep Quality Index, the students also completed the five-item World Health Organization Well-being Index and the 10-item Perceived Stress Scale. For internal consistency the Cronbach's alpha was calculated, for test-retest reliability the interclass correlation coefficient was computed, and for validity the Pearson's correlation was calculated. The mean global Pittsburgh Sleep Quality Index score among Danish adolescents was 5.86 (3.13). The internal consistency for the Pittsburgh Sleep Quality Index was satisfactory with a Cronbach's alpha of 0.72. Test-retest reliability was adequate with an interclass correlation coefficient of 0.68. Finally, the Pittsburgh Sleep Quality Index showed large positive correlation with the 10-item Perceived Stress Scale (0.55) and a large negative correlation with the five-item World Health Organization Well-being Index (-0.59). The Danish version of the Pittsburgh Sleep Quality Index showed adequate reliability and validity among Danish adolescents.

A Study on the Willingness to Use Meditation for Maintaining Psychological Well-Being During the COVID-19 Pandemic.

Background and objectiveSeveral studies have indicated an escalation in the stress and anxiety levels among all sections of the population at large during the ongoing coronavirus disease 2019 (COVID-19) pandemic. In this challenging environment, meditation or yoga can help in maintaining the quality of life. This pilot study aimed to assess the willingness to practice meditation as a tool to manage anxiety, perceived stress levels, and psychological well-being (quality of life) during the COVID-19 pandemic in India.Materials and methodsBivariate and multivariate logistic regression models were employed to characterize the attitude of healthy Indian adults toward meditation as a stress management tool and its impact on psychological well-being. Primary data of 241 participants were collected using Google Forms circulated via email and social media platforms through the snowball sampling technique. The self-reported data on four different psychosocial scales, viz., for anxiety measurement [the Seven-Item Generalized Anxiety Disorder Scale (GAD-7) and Coronavirus Anxiety Scale (CAS)], for stress measurement [Perceived Stress Scale (PSS)], and to quantify well-being levels [the Five-Item World Health Organization Well-Being Index (WHO-5)], along with those on their perception toward meditation were obtained.ResultsOur findings suggest that the anxiety and perceived stress scores are lower among those practicing some form of relaxation or meditation than those not practicing it, along with those who already report better psychological well-being and perceived stress. The bivariate results indicated that willingness to meditate among those who were practicing some form of meditation and those not mediating significantly differed based on their age, presence of comorbidities, and GAD and PSS levels. The multivariate logistic regression showed that only those individuals aged 35 years and above and those who have some comorbidity symptoms showed a significant level of willingness to opt for meditation.ConclusionsIn order to attain proper relief from psychological issues during a pandemic situation such as the current one, a more specific remedial module for meditation procedure needs to be devised as an intervention, and it should be kept in mind that age and comorbidity status also play a significant role with respect to individuals' attitude toward meditation as a tool for psychological relief.

Psychometric evaluation of the Arabic version of the 5-item Problem Areas in Diabetes (AR-PAID-5) scale

BackgroundScreening for diabetes distress is recommended when caring for patients with type 2 diabetes mellitus (T2DM) in primary healthcare (PHC). The 5-item Problem Areas in Diabetes (PAID-5) scale is widely used to measure diabetes distress, but its Arabic validation studies are scarce, so this study was carried to assess the psychometric properties of the Arabic version of the PAID-5 (AR-PAID-5) in Egyptian PHC patients with T2DM.MethodsWe conducted a cross-sectional study including 260 participants from six rural PHC settings in Ismailia governorate, Egypt. Internal consistency using Cronbach’s α and one-month test-retest reliability using intraclass correlation coefficient (ICC) were investigated. Confirmatory factor analysis (CFA) was used to evaluate the one-factor structure of the AR-PAID-5. Correlations of the AR-PAID-5 with the Arabic versions of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), 5-item World Health Organization Well-Being Index (WHO-5) scales and glycated hemoglobin (HbA1c) were investigated for supporting the convergent validity. Associations of the PAID-5 with sociodemographic, and clinical characteristics were assessed for demonstrating the discriminant validity. Criterion validity was also evaluated.ResultsThere was a good internal consistency (α = 0.88) and a stable test-retest reliability (ICC = 0.74). The CFA confirmed the one-factor structure of the AR-PAID-5. Significant positive correlations existed between the AR-PAID-5 with diabetes distress evaluated by the Arabic version of the PAID (rho = 0.93, p < 0.001), depressive symptoms (PHQ-9) (rho = 0.56, p < 0.001), anxiety symptoms (GAD-7) (rho = 0.47, p < 0.001), emotional well-being (WHO-5) (rho = − 0.38, p < 0.001), and HbA1c (rho = 0.16, p = 0.003). A satisfactory discriminant validity, and an acceptable criterion validity were demonstrated.ConclusionsThe AR-PAID-5 scale is a reliable and valid tool that can be used for diabetes distress screening and in research in Arabic speaking PHC patients with T2DM.

The impact of COVID-19 on the quality of life of older adults: a cross-sectional study in Athens, Greece

IntroductionThe COVID-19 has affected both physical and mental health of the elderly.ObjectivesThe purpose of the present study was to estimate the impact of the second lockdown in Greece, on both quality of life and mental health in older people.MethodsA cross sectional study was conducted among older adults who visited a primary care physician, from 1st of March to April 30th. An anonymous questionnaire was administered to collect basic sociodemographic data and implementation of hygiene precaution measures. The 5-item World Health Organization Well-Being Index (WHO-5) to measure well-being, the Generalized Anxiety Disorder Assessment (GAD-7) instrument was used to assess the anxiety levels and Geriatric Depression Scale (GDS-15) depressive symptoms of the responders, respectively. Statistical analysis was performed with SPSS v.24.0Results 222 elderly took part in the study. 62.6% were female. According to the WHO-5, 37.4% present poor quality of life. GDS-15 reveals that 70.7% of the participants screened positive for moderate depression and 1.8% with severe symptoms. GAD-7 results estimated 32.9% of the participants to suffer from serious anxiety disorder and 37.4% from moderate. GAD-7 and GDS-15 were strongly associated (p &lt;0.05) with female gender, low educational level and with comorbidities (coronary disease, diabetes mellitus and skeletomuscular diseases). Health precaution measures were negative correlated with mental health of the elderly. However, in participants with frequent contact with family and friends, lower anxiety levels were detected.ConclusionsOur results highlight that older adult has experienced negative impact on both quality of life and mental health during 2nd Covid-19 lockdown in Greece.DisclosureNo significant relationships.

The impact of religiosity on the disability, psychological well-being, and somatic health of multiple sclerosis patients

ABSTRACT The aim of the study was to predict disability, psychological wellbeing, and somatic health in multiple sclerosis (MS) patients with the mediating variable of religiosity. A sample of 128 patients was recruited, and were administered the Expanded Disability Status Scale, the World Health Organization-5 Well-Being Index, the Patient Health Questionnaire-15, and a Self-Rating Scale of Religiosity. Religiosity did not predict disability, psychological well-being, or somatic health. Religiosity was positively associated with MS duration and disability, but only in male patients. The predictors for predicting psychological wellbeing were age, disability, and somatic health. Patients with moderate/severe MS (EDSS >3) obtained higher mean scores on religiosity compared to patients with mild MS (EDSS ≤3) and, therefore, the severity of MS was a significant moderator between religiosity and psychological well-being. The findings suggest the importance of focusing on the type of religiosity, God representation, and attachment to God for clarifying the link between psychological well-being and religiosity among patients.