INTRODUCTION: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre. METHODS: This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress. RESULTS: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome. CONCLUSION A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.
Adult ; Anxiety/etiology* ; COVID-19/psychology* ; Depression/etiology* ; Female ; Health Surveys ; Hospitals, Pediatric ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Diseases/etiology* ; Pandemics ; Personnel, Hospital/psychology* ; Prevalence ; Risk Factors ; Self Report ; Severity of Illness Index ; Singapore/epidemiology* ; Stress, Psychological/etiology*

INTRODUCTION: Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks. METHODS: We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks. RESULTS: A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation. CONCLUSION Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self-care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.
Adaptation, Psychological ; physiology ; Betacoronavirus ; Coronavirus Infections ; epidemiology ; psychology ; Health Personnel ; psychology ; Humans ; Mental Health ; Pandemics ; Pneumonia, Viral ; epidemiology ; psychology ; Stress, Psychological ; epidemiology ; etiology ; psychology

PURPOSE: The purpose of this study was to test the mediating effect of psychological distress in the relationship between chemotherapy related cognitive impairment (CRCI) and quality of life (QOL) in people with cancer. METHODS: A purposive sample of 130 patients undergoing chemotherapy was recruited for the cross-sectional survey design. Data were collected from November 2014 to June 2015. The instruments were K-MMSE (Korean Mini-Mental State Examination), Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, correlation, and multiple regression using Baron and Kenny steps for mediation. RESULTS: The mean score for objective cognitive function was 27.95 and 69.32 for perceived cognitive decline. Overall quality of life was 91.74. The mean score was 17.52 for psychological distress. The prevalence was 56.2% for anxiety and 63.1% for depression, and 20.0% for CRCI. There were significant correlations among the variables, objective cognitive function and self-reported cognitive decline, psychological distress, and quality of life. Psychological distress was directly affected by CRCI. (R2=29%). QOL was directly affected by CRCI. Psychological distress and CRCI effected QOL (R2=43%). Psychological distress had a partial mediating effect (beta= -.56, p <.001) in the relationship between self-reported cognitive decline and quality of life (Sobel test: Z= -5.08, p <.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on managing cognitive decline, and decreasing psychological distress are highly recommended to improve quality of life in cancer patients.
Adult ; Aged ; Antineoplastic Agents/therapeutic use ; Anxiety/epidemiology/etiology ; Cognitive Dysfunction/epidemiology/*etiology ; Colonic Neoplasms/drug therapy/*psychology ; Cross-Sectional Studies ; Depression/epidemiology/etiology ; Female ; Humans ; Middle Aged ; *Quality of Life ; *Stress, Psychological ; Surveys and Questionnaires

PURPOSE: This study was conducted to assess predictor variables of husbands in multicultural families and examine the relationship among variables after setting up a hypothetical model including influencing factors, so as to provide a framework necessary for developing nursing interventions of domestic violence. METHODS: The participants were 260 husbands in multicultural families in four cities in Korea. Data were analyzed using SPSS 22.0 and AMOS 20.0. RESULTS: Self-control, social support, family of origin violence experience and stress on cultural adaptation directly affected to dysfunctional communication, and the explanatory power of the variables was 64.7%. Family of origin violence experience in domestic stress on cultural adaptation, and dysfunctional communication were directly related to domestic violence in multicultural families, and the explanatory power of the variables was 64.6%. We found out that all variables in the model had mediation effects to domestic violence through dysfunctional communication. In other words, self-control and social support had complete mediation effects, and family of origin violence experience in domestic violence and stress on cultural adaptation had partial mediation effects. CONCLUSIONS: The variables explained in this study should be considered as predictive factors of domestic violence in multicultural families, and used to provide preventive nursing intervention. Our resutls can be taken into account for developing and implementing programs on alleviating dysfunctional communication in multicultural families in Korea.
Acculturation ; Communication ; Cross-Sectional Studies ; *Cultural Diversity ; Domestic Violence/ethnology/*statistics & numerical data ; Emigrants and Immigrants/psychology/statistics & numerical data ; Female ; Humans ; Male ; Models, Psychological ; Republic of Korea/epidemiology ; Self-Control/psychology ; Social Support ; Spouses/ethnology/psychology/statistics & numerical data ; Stress, Psychological/ethnology/etiology

PURPOSE: The purpose of this study was to find the relationship and conceptual model of discrimination, stress, support, and depression among the elderly in South Korea. METHODS: This was a cross-sectional descriptive study involving 207 community-dwelling elders. Data were collected through questionnaires from May 5 to May 31, 2014 in community senior centers, and analyzed using descriptive statistics, t test, analysis of variance, Scheffè test, and structural equation modeling. RESULTS: There were significant effects of discrimination on stress, support on stress and stress on depression. Moreover, there were two significant indirect effects observed between discrimination and depression, and between support and depression. For each indirect effect, the mediating factor was stress. Additionally, there was no direct effect between discrimination and depression or support. CONCLUSIONS: This study found that social support and discrimination had indirect effects on depression through stress. More specifically, decreased stress led to a reduction of depression. Therefore, social support based on a thorough understanding of stress is very important for caring elderly who are depressive.
Aged ; Cross-Sectional Studies ; Depressive Disorder/epidemiology/*psychology ; Female ; Humans ; Models, Psychological ; Prejudice/psychology ; Republic of Korea/epidemiology ; Rural Health ; Social Class ; Social Discrimination/*psychology ; Social Support ; Stress, Psychological/epidemiology/*etiology

OBJECTIVETo study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population.

METHODS250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk.

RESULTSGreen vegetables and green tea were associated with a decreased risk of PCa (OR=0.39, 95% CI: 0.28-0.53; OR=0.59, 95% CI: 0.40-0.87, respectively). Family history of PCa (OR=7.16, 95% CI: 2.01-25.49), history of prostate diseases (OR=2.28, 95% CI: 1.53-3.41), alcohol consumption (OR=1.97, 95% CI: 1.33-2.90), red meat consumption (OR=1.74, 95% CI: 1.20-2.52), barbecued (OR=2.29, 95% CI: 1.11-4.73) or fried (OR=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (OR=1.61, 95% CI: 1.00-2.59), marital separation (OR=1.94, 95% CI: 1.29-2.91), self-contained suffering (OR=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (OR=1.73, 95% CI: 1.18-2.54) were related to PCa.

CONCLUSIONRegular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.

Aged ; Aged, 80 and over ; Animals ; Case-Control Studies ; China ; epidemiology ; Food ; statistics & numerical data ; Humans ; Life Style ; Male ; Middle Aged ; Prostatic Neoplasms ; epidemiology ; etiology ; psychology ; Stress, Psychological ; complications

PURPOSE: Bell's phenomenon (BP), which may disturb screening examinations for retinopathy of prematurity (ROP), is known to present infrequently in premature babies. Stress associated with the examinations can influence expression of BP. The authors of the present study evaluated BP during examinations for ROP. METHODS: The present study included 102 eyes of 51 premature babies. Expression of BP was assessed at 3 steps of the examination in the following order: after insertion of a speculum, after illumination of an indirect ophthalmoscope and after scleral depression. The relationship between the expression of BP and the gestational age at the examination was analyzed in each step of the examination. RESULTS: The frequency of BP after the speculum insertion and the illumination was 77% to 92% in infants 32 weeks of age or younger, and decreased significantly to 16% to 57% in infants 42 weeks of age or older (p < 0.005). BP after the scleral depression had no significant association with the gestational age. Frequency of BP increased significantly as the steps of the examination proceeded (p < 0.01). CONCLUSIONS: BP was frequent in premature infants during ROP examination in spite of neurological immaturity. The examiner should take BP into consideration, which frequently occurs in younger infants.
Gestational Age ; Humans ; Incidence ; Infant, Newborn ; *Infant, Premature ; Korea/epidemiology ; Mass Screening/adverse effects/*methods/psychology ; Ophthalmoscopy/*psychology ; Retinopathy of Prematurity/*diagnosis/epidemiology ; Retrospective Studies ; Risk Factors ; Stress, Psychological/*epidemiology/etiology ; Vision Screening/adverse effects/*psychology

BACKGROUNDMost data about psychological factors relating to acute myocardial infarction (AMI) were obtained from studies carried out in western countries. Results from small descriptive cross-sectional studies in China were inconclusive. The aim of this study was to explore possible associations between psychological risk factors and AMI among the Chinese population with a large-scale case-control study.

METHODSThis study was part of the INTER-HEART China study, itself part of the large international INTER-HEART study of cardiovascular risk factors. In this case-control study, 2909 cases and 2947 controls were recruited from 17 cities. Psychological stress, negative life events, depression and controllability of life circumstances were assessed.

RESULTSCases reported more psychological stress at home or work and odds ratios (ORs) were 3.2 (95%CI 2.1 - 4.9) for permanent stress and 2.1 (95%CI 1.5 - 2.8) for several periods of stress respectively. More cases experienced depression compared with controls (19.6% vs. 9.3%) and ORs were 2.2 (95%CI 1.9 - 2.6). Subjects with 1, 2 and 3 or more depressive symptoms had increased risk of AMI by 2.1, 2.2 and 2.6 fold, respectively, i.e., more depressive symptoms were associated with higher risks of AMI (P for trend < 0.0001). Women had a greater risk of AMI from depression (OR 3.0, 95%CI 2.2 - 4.0) compared to men (OR 2.0, 95%CI 1.6 - 2.4), P for interaction = 0.0364. Negative life events in subjects were associated with increased risk of AMI, OR 1.7 (95%CI 1.4 - 2.0) for one event and 1.8 (95%CI 1.3 - 2.4) for two or more events. High levels of controllability of life circumstances reduced the risk for AMI (OR 0.8, 95%CI 0.7 - 1.0).

CONCLUSIONSSeveral psychological factors were closely associated with increased AMI risk among Chinese population. Psychological stress had a greater AMI risk in men but depression was more significant among women.

Aged ; Case-Control Studies ; China ; Depression ; complications ; epidemiology ; Female ; Humans ; Life Change Events ; Male ; Middle Aged ; Myocardial Infarction ; epidemiology ; etiology ; Risk Factors ; Stress, Psychological ; complications ; epidemiology

OBJECTIVEIdentifying the stressors, coping strategies, and psychosocial state of children with chronic illness would be very useful to help them to adapt to chronic medical conditions. This study aimed to investigate the stressors, coping strategies, and psychosocial state of Chinese children with chronic illness.

METHODSTwo hundred and three children with chronic illness and aged 8-16 years were administered a semi-structured interview for the identification of stressors. Children's coping strategies and psychosocial state were investigated by the Coping with a Disease (CODI) scale, the Screen for Child Anxiety Related Emotional Disorders (SCARED) scale, and the Depression Self-rating Scale for Children (DSRSC).

RESULTSThe stressors in children with chronic illness mainly included four aspects: school performance, medication and treatment, daily life, and peer relationships. "Wishful thinking" was the most common coping strategy, followed by "acceptance". "Negative emotional reaction" was rarely seen in children with chronic illness. The scores of anxiety and depression scales of children with chronic illness were higher than those of the norm. The prevalence of anxiety disorders was 43.8%, the prevalence of depression disorders was 30.0%, and 26.1% of the children had both anxiety and depression disorders.

CONCLUSIONSChildren with chronic illness have many stressors. Though they usually use active coping strategies, the prevalence of anxiety disorders and the prevalence of depression disorders were high.

Adaptation, Psychological ; Adolescent ; Anxiety ; epidemiology ; Child ; Chronic Disease ; psychology ; Depression ; epidemiology ; Female ; Humans ; Male ; Prevalence ; Stress, Psychological ; etiology

OBJECTIVETo identify the environmental risk factors during the first trimester responsible for nonsyndromic cleft lip with or without cleft palate to collect data for prevention of this congenital defect.

METHODSA hospital-based case-control study was conducted to identify the risk factors by means of field investigation with standardized questionnaires. Single factor analysis and logistic regression of the data are performed using SPSS 13.0 software.

RESULTSMultifactorial analysis revealed that folic acid was significantly associated with lowered incidence of nonsyndromic cleft lip with or without cleft palate (OR=0.100, 95%CI: 0.032-0.312), whereas maternal infection (OR=4.155, 95%CI: 2.166-7.970), poisonous chemical exposure (OR=6.816, 95%CI: 2.528-18.381) and emotional stress (OR=3.250, 95%CI: 1.477-7.154) were risk factors for this defect.

CONCLUSIONSSufficient follic acid intake and prevention of infection and poisonous chemical exposure during the first trimester are measures to reduce the risks of nonsyndromic cleft lip with or without cleft palate.

Case-Control Studies ; Cleft Lip ; epidemiology ; etiology ; prevention & control ; Cleft Palate ; epidemiology ; etiology ; prevention & control ; Female ; Folic Acid ; administration & dosage ; Humans ; Maternal Exposure ; Pregnancy ; Pregnancy Trimester, First ; Risk Factors ; Stress, Psychological