1.Validity and Reliability Measurement of the Knowledge and Attitude Survey Regarding Pain Tool Mongolian Version
Battsetseg T ; Nyamaa D ; Enkhtuul Ch ; Bayarjargal Kh ; Enkhtuvshin S ; Orgilmaa R
Mongolian Journal of Health Sciences 2025;85(1):102-105
Background:
Nurses spend the most time with patients when providing medical care, making them a crucial factor in
ensuring appropriate and effective treatment. Their assessment skills play a vital role in pain management.
Aim:
This study aims to determine the validity and reliability of the Mongolian version of the Knowledge and Attitudes
Survey Regarding Pain (KASRP).
Materials and Methods:
A cross-sectional, quantitative study was conducted using the Knowledge and Attitudes Survey
Regarding Pain (KASRP) questionnaire. A total of 145 nurses from the surgical, emergency, and intensive care units of
the National Trauma and Orthopedic Research Center (NTORC), the National Cancer Center of Mongolia (NCCM), and
the National Center for Maternal and Child Health (NCMCH) participated in the study. Statistical analysis was performed
using SPSS-25 software.
Results:
The study included 115 female and 30 male nurses, with an average age of 37.21±7.50 years and an average
work experience of 13.43±7.57 years. The face validity index (FVI) for each item ranged from 0.81 to 1.00. The content
validity index (CVI) for each item ranged from 0.66 to 1.00. The internal consistency of the questionnaire was assessed
using Cronbach’s alpha, which was found to be 0.88.
Conclusion
The Mongolian version of the KASRP demonstrates satisfactory face validity, content validity, and reliability, making it suitable for practical application.
2.Neuroticism as a risk factor for anxiety, depression, and insomnia during the covid-19 pandemic
Enkhtuvshin R ; Mongoljin A ; Munkhzul E ; Uranchimeg M ; Oyundari G ; Yerkibulan A ; Khishigsuren Z
Diagnosis 2025;115(4):36-42
Background:
The COVID-19 pandemic has profoundly impacted global mental health, exacerbating anxiety, depression, and insomnia, with prevalence rates of 25–30%, 27–32%, and 30–45%, respectively—2–3 times higher than pre-pandemic levels. Neuroticism, a key personality trait from the Big Five model, characterized by heightened negative emotions and stress reactivity, has been linked to increased vulnerability. Meta-analyses show neuroticism triples anxiety risk (OR=3.21; 95% CI: 2.35–4.39) and correlates strongly with insomnia (r=0.46, p<0.001) and depression during the pandemic. In Mongolia, empirical data on neuroticism's role remains limited.
Objective:
This study examines whether neuroticism acts as a risk factor for anxiety, depression, and insomnia among hospitalized patients during COVID-19.
Methods:
A cross-sectional descriptive study enrolled 552 patients (72.3% COVID-19 cases, 27.7% controls) from tertiary hospitals in Mongolia (2024). Participants (mean age 52.8±15.5 years; 60.5% female) completed self-reported questionnaires: Eysenck Personality Inventory (EPI) for neuroticism, PHQ-9 for depression, GAD 7 for anxiety, ISI for insomnia, and PCL 5 for PTSD. Sociodemographics were assessed. Data were analyzed using SPSS 26.0 with chi-square tests (p<0.05 significance). Instruments showed high reliability (Cronbach’s α=0.81–0.89). Ethical approval was obtained from MNUMS Ethics Committee (No. 2024-Psy-17).
Results:
Overall, 79.5% were depression free, 84.8% anxiety-free, and 77.5% insomnia-free. High neuroticism (n=381) was significantly associated with depression (24.4% vs. 11.7%, p<0.001), anxiety (18.6% vs. 7.6%, p<0.001), insomnia (28.3% vs. 9.4%, p<0.001), and any mental disorder (21.3% vs. 7%, p<0.001), but not PTSD (p=0.472). Cholerics (n=200) showed elevated risks (depression 29.5%, insomnia 34.5%, p<0.001), while sanguines/phlegmatics were protective. Verbal expression and trust levels showed no significant associations.
Conclusion
Neuroticism significantly heightens risks for anxiety, depression, and insomnia during COVID-19, underscoring the need for targeted psychological interventions. Temperament-informed screening could enhance prevention strategies in crisis settings.
3.Risk factors for common mental disorders in hospitalized patients during the covid-19 pandemic
Enkhtuvshin R ; Yerkyebulan M ; Munkh-Uchral D ; Enkhnaran T ; Mongoljin A ; Munkh E ; Uranchimeg M ; Maidar E ; Amarsaikhan A ; Amirlan B ; Otgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):32-38
Background:
The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions
such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized
patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized
patients affiliated with MNUMS, compared to a control group.
Aim:
To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress
disorder (PTSD), and to identify their associated risk factors.
Materials and Methods:
The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital,
Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case
group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia
(ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests
and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted
for group, age, and sex.
Results:
In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%,
p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%,
p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for
depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms
(difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]).
Conclusion
Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic,
clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.
4.Changes in mental health following COVID-19 infection: results of a prospective cohort study in mongolia
Enkhtuvshin R ; Mongoljin A ; Munkh.E ; Uranchimeg M ; Yerkyebulan A ; Munkh-Uchral D ; Enkhnaran T ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):39-44
Background:
COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the
WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first
case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus
affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways
(e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global
studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al.,
BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected
individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National
Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but
long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and
PTSD among COVID-19 patients over 12 months, compared to a control group.
Aim:
To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic
stress disorder (PTSD) among individuals who have had COVID-19
Materials and Methods:
In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited
from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021
and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12
months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases
were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and
multivariable logistic regression (p < 0.05).
Results:
Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12
months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p =
0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19
group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios
confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and
individuals aged 40–59 years were at elevated risk.
Conclusions
1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times
higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control
group.
2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected
after 12 months; this resolution is posited to be associated with the adaptive capacity of the population.
3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.
5.Efficacy of tenofovir alafenamide in the treatment of chronic hepatitis B infection
Tuvshinbayar N ; Amaraa R ; Burmaajav B ; Gegeebadrakh B ; Dulguun B ; Enkhtuvshin D
Mongolian Medical Sciences 2019;188(2):17-23
Introduction:
Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In this study, a representative group of Mongolian adults was tested for hepatitis B virus (HBV) in 2017. The prevalence estimates of HBV the general Mongolian adult population were found to be 11.1%, respectively.
In April 2017, EASL added a drug newly approved for treatment of CHB, tenofovir alafenamide (TAF) to
their list of recommended first-line therapies. The requirement for long-term therapy in chronic HBV highlights the importance of these efficacy and safety trends, however their true clinical relevance is yet to be established and further studies with long-term follow up and real-world clinical data are needed.
Goal:
Evaluate for result of tenofovir alafenamide in the treatment of chronic hepatitis B infection.
Materials and Methods:
The clinical trials have evaluated TAF in HBeAg-positive and HBeAg-negative chronic HBV
patients. The trials have similar designs and are randomized, double blind, non-inferiority studies.
The primary efficacy endpoint was the proportion of patients with HBV DNA<29 IU/ml at week
24 and 48. Other prespecified efficacy endpoints were the proportion of patients with HBsAg
seroncoversion to anti-HBs at week 24 and 48. Key secondary safety end- points at week 24 and 48
included the percentage change in T-score, and Z-score bone mineral density (BMD), percentage
change in BMD and change from baseline serum creatinine.
Results:
The primary efficacy endpoint, an HBV DNA level <29 IU/ml at week 24, was achieved by 120
(59.1%) of 203 patients receiving TAF, which was non-inferior to the 63 (55.2%) of 114 patients
receiving TDF who had an HBV DNA<29 IU/ml. After 24 weeks of treatment, patients receiving
TAF had significantly smaller reductions in bone mineral density (BMD) compared with patients
receiving TDF.
Conclusion
The development of TAF, specifically designed to deliver potent antiviral activity but with an
improved safety profile compared with TDF, is therefore timely.
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