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Ibragim A, Issatayeva B, Kuanzhanova K, Mandykayeva A, Mambetalina A. Psychological rehabilitation of individuals with alcohol use disorder, drug addiction, gambling disorder, and codependency. Acta Psychol (Amst) 2025; 257:105052. [PMID: 40381539 DOI: 10.1016/j.actpsy.2025.105052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Revised: 04/28/2025] [Accepted: 04/29/2025] [Indexed: 05/20/2025] Open
Abstract
The objective of this study was to assess the impact of a 12-month course of cognitive behavioral therapy (CBT) on individuals diagnosed with alcohol use disorder, drug addiction, gambling disorder, and codependency, with a focus on improving quality of life and reducing symptom severity. A quantitative design was employed, involving both control and experimental groups, each initially comprising 100 participants. By the end of the study, the final sample sizes in the experimental groups were 72 (alcohol use disorder), 70 (drug addiction), 74 (gambling disorder), and 73 (codependent behavior) individuals. An equal number of participants in the corresponding control groups were reassessed. Quality of life was measured using the World Health Organization Quality of Life BREF instrument, which measures physical health, psychological health, social relationships, and environmental conditions. The results indicated a significant improvement in quality-of-life scores in the experimental groups compared to the control groups. The Wilcoxon signed-rank test confirmed statistically significant improvements (p < 0.001) across all addiction categories, while the Mann-Whitney U test demonstrated substantial post-intervention differences between control and experimental groups (p < 0.001). Participants in the experimental group showed marked reductions in addiction severity, as indicated by AUDIT, DAST, G-SAS, and Spann-Fisher Codependency Scale assessments. Effect sizes (Cohen's d) ranged from 2.83 to 3.47, confirming the strong impact of psychotherapy. These findings underscore the effectiveness of CBT in reducing addiction severity and enhancing quality of life, supporting its broader integration into addiction treatment programs. The study provides valuable evidence for addiction rehabilitation efforts in Kazakhstan. From a practical perspective, these findings highlight the importance of structured psychotherapeutic interventions in addressing addiction-related issues. The study underscores the need to expand access to CBT in rehabilitation centers, particularly in regions with high addiction rates. Future policy initiatives should prioritize the development of therapist training programs and the implementation of evidence-based treatment methods. Moreover, the results emphasize the necessity for continuous post-treatment support to maintain long-term recovery and prevent relapse. By incorporating CBT into standardized rehabilitation protocols, policymakers and healthcare providers can enhance the overall effectiveness of addiction treatment services.
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Affiliation(s)
- Aidos Ibragim
- Department of Psychology, Faculty of Social Sciences, L.N. Gumilyov Eurasian National University, Astana, Kazakhstan
| | - Bakytgul Issatayeva
- Department of Psychology and Special Education, K. Zhubanov Aktobe Regional University, Aktobe, Kazakhstan
| | - Kundyz Kuanzhanova
- Department of General Pedagogy and Educational Management, K. Zhubanov Aktobe Regional University, Aktobe, Kazakhstan
| | - Almagul Mandykayeva
- Department of Psychology, Faculty of Social Sciences, L.N. Gumilyov Eurasian National University, Astana, Kazakhstan
| | - Aliya Mambetalina
- Department of Psychology, Faculty of Social Sciences, L.N. Gumilyov Eurasian National University, Astana, Kazakhstan.
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Şahin G, Yuksel HC, Acar C, Açar P, Sertöz ÖÖ. Assessment of the fear of progression in Turkish cancer patients: a validation and reliability study fear of progression questionnaire short form. BMC Psychol 2025; 13:394. [PMID: 40247427 PMCID: PMC12004705 DOI: 10.1186/s40359-025-02650-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Accepted: 03/25/2025] [Indexed: 04/19/2025] Open
Abstract
BACKGROUND This study sought to translate and validate the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for use in assessing the FoP among Turkish cancer patients. METHODS A sample of 185 cancer patients who were undergoing active treatment at Ege University Oncology Clinic participated in this study. The FoP-Q-SF was translated into Turkish and its psychometric properties were assessed. The questionnaire's reliability was evaluated using Cronbach's alpha and McDonald's omega, while its validity was tested via confirmatory factor analysis (CFA) and correlation with established measures such as the Hospital Anxiety and Depression Scale (HADS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). RESULTS The FoP-Q-SF demonstrated high internal consistency (Cronbach's alpha = 0.89, McDonald's omega = 0.89) and a strong unidimensional structure based on CFA (CFI = 0.987, TLI = 0.984, RMSEA = 0.078, SRMR = 0.076). Significant correlations were found between the FoP-Q-SF scores and related anxiety measures, including the HADS-D, HADS-A and EORTC QLQ-C30 emotional and total scores (0.395-0.578, p < 0.01). The known-groups validity analysis revealed that the FoP-Q-SF scores were higher among female cancer patients (p < 0.001), which was consistent with the findings of previous studies, while no significant associations were observed with cancer patients' age, marital status, perceived income, educational status or psychiatric history. CONCLUSIONS The FoP-Q-SF is a valid and reliable tool for assessing the FoP among Turkish cancer patients, which renders it suitable for clinical and research applications in this population.
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Affiliation(s)
- Gökhan Şahin
- Department of Medical Oncology, Ege University Medical Faculty, Izmir, 35100, Turkey.
| | - Haydar C Yuksel
- Department of Medical Oncology, Ege University Medical Faculty, Izmir, 35100, Turkey
| | - Caner Acar
- Department of Medical Oncology, Ege University Medical Faculty, Izmir, 35100, Turkey
| | - Pınar Açar
- Department of Medical Oncology, Ege University Medical Faculty, Izmir, 35100, Turkey
| | - Özen Ö Sertöz
- Department of Psychiatry, Ege University Medical Faculty, Izmir, 35100, Turkey
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Carneiro L, Vaičekauskaitė R, Kowalczyk O, Ćwirynkało K. Breaking barriers: a commentary on research gaps in cancer and depression among individuals with intellectual disabilities. Int J Equity Health 2025; 24:3. [PMID: 39762883 PMCID: PMC11706092 DOI: 10.1186/s12939-024-02366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Accepted: 12/23/2024] [Indexed: 01/11/2025] Open
Abstract
The European Commission's Strategy for the Rights of Persons with Disabilities 2021-2030 aims to ensure equal opportunities and rights for all individuals, including those with intellectual disabilities. People with intellectual disabilities are often underrepresented in cancer prevention and screening policies, leading to disparities in health outcomes and early mortality. The intersection of intellectual disability, cancer, and depression represents an underexplored area in healthcare research. Individuals with intellectual disability diagnosed with both cancer and depression face compounded challenges impacting their quality of life, proper access to medical care, and treatment outcomes. To address these gaps in the systems globally, a focused effort is indispensable to understand their unique needs and better tailor care strategies for this target group. Therefore, this commentary outlines the challenges in researching individuals with intellectual disabilities who have a dual diagnosis of cancer and depression. Challenges include providing informed consent, ethical researcher-participant relationships, and maintaining confidentiality and autonomy. Strategies for improvement include creating accessible procedures, raising awareness, and involving individuals with intellectual disabilities in research ethics committees.
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Affiliation(s)
- Lara Carneiro
- Physical Education Department, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates.
| | | | - Oliwia Kowalczyk
- Department of Oncology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland
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Belayneh Z, Chavulak J, Lee DCA, Petrakis M, Haines TP. Prevalence and variability of restrictive care practice use (physical restraint, seclusion and chemical restraint) in adult mental health inpatient settings: A systematic review and meta-analysis. J Clin Nurs 2024; 33:1256-1281. [PMID: 38304928 DOI: 10.1111/jocn.17041] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/15/2023] [Accepted: 01/07/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND There is a growing consensus to reduce the use of restrictive care practices in mental health settings to minimise the physical and psychological complications for patients. However, data regarding restrictive care practice use and factors contributing to variations in the proportion estimates has not previously been synthesised. AIMS This study aimed to synthesise evidence on (1) the pooled proportions of physical restraint, seclusion or chemical restraint in adult mental health inpatients and (2) sources of variability in these proportion estimates. METHODS Studies were identified from Scopus, MEDLINE, PsycINFO, Web of Science, Embase and CINAHL databases following the PRISMA 2020 guidelines. We conducted a meta-analysis of studies published in English language from 1 January 2010 to 15 August 2022. Binomial data were pooled using a random effect model, with 95% confidence intervals. Meta-regression was also computed to identify factors that may contribute to variations in the proportion estimates. RESULTS A total of 77 studies were included in this meta-analysis. The pooled prevalence of physical restraint, seclusion and chemical restraint was 14.4%, 15.8% and 25.7%, respectively. Data were heterogeneous across studies (I2 > 99%). Reporting practices and geographical locations contributed to the variability in the reported estimates of restrictive care practices, with studies from Asian countries reporting higher proportions. CONCLUSION There appear differences between geographical locations in the proportion of restrictive practices in mental health inpatients; however, this is complicated by how these prevalence data have been measured and defined. Consistency in the reporting of restrictive care practices in mental health is required to make valid comparisons between geographical regions, policy settings and practice innovations. RELEVANCE TO CLINICAL PRACTICE Efforts are needed to develop training programmes and policy changes to ensure consistency in defining and reporting of restrictive care practices in mental health facilities. PATIENT/PUBLIC CONTRIBUTION This is a systematic review that analysed data from previously published studies, and there was no patient/public contribution in this study. PROTOCOL REGISTRATION The protocol for this review has been registered to PROSPERO: CRD42022335167.
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Affiliation(s)
- Zelalem Belayneh
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University Peninsula Campus, Melbourne, Victoria, Australia
- Department of Psychiatry, College of Health, and Medical Sciences, Dilla University, Dila, Ethiopia
| | - Jacinta Chavulak
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University Peninsula Campus, Melbourne, Victoria, Australia
| | - Den-Ching A Lee
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University Peninsula Campus, Melbourne, Victoria, Australia
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University (Peninsula Campus), Frankston, Victoria, Australia
- National Centre for Healthy Ageing, Monash University, Frankston, Victoria, Australia
| | - Melissa Petrakis
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University Peninsula Campus, Melbourne, Victoria, Australia
- St Vincent's Hospital Mental Health Service, Melbourne, Victoria, Australia
| | - Terry P Haines
- Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University Peninsula Campus, Melbourne, Victoria, Australia
- National Centre for Healthy Ageing, Monash University, Frankston, Victoria, Australia
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Korzeniewski K, Shkilna M, Huk M, Shevchuk O, Marchelek-Myśliwiec M. Ukrainian war refugees and migrants in Poland: implications for public health. J Travel Med 2024; 31:taad119. [PMID: 37682064 PMCID: PMC10823480 DOI: 10.1093/jtm/taad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Krzysztof Korzeniewski
- Department of Epidemiology and Tropical Medicine, Military Institute of Medicine – National Research Institute, 128 Szaserów St., 04-141 Warsaw, Poland
| | - Mariia Shkilna
- Department of Infectious Diseases and Epidemiology, Dermatology and Venereology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
| | - Mariana Huk
- Department of Infectious Diseases and Epidemiology, Dermatology and Venereology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
| | - Oksana Shevchuk
- Department of Pharmacology and Clinical Pharmacology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine
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Asanov AM, Asanov I, Buenstorf G. Mental health and stress level of Ukrainians seeking psychological help online. Heliyon 2023; 9:e21933. [PMID: 38027618 PMCID: PMC10658344 DOI: 10.1016/j.heliyon.2023.e21933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/19/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Due to the Russian invasion of Ukraine on February 24th, 2022, more than 8 million Ukrainians have been displaced from their homes. Ukrainians exposed to armed conflict and migration are likely to have low levels of mental health status and seek help. We provide a uniform quantitative assessment of the mental health conditions of Ukrainians seeking help soon after the invasion and resettlement. We screen the mental well-being and psychological distress of 1165 refugees, migrants, internally displaced, and non-displaced individuals from Ukraine who seek psychological help online in Ukraine and across 24 countries of the European Union. We surveyed participants in the study as a part of our online program for adult Ukrainians from June 22nd to July 6th, 2022. We report descriptive results of mental-health status for the aggregate sample and the sub-groups. More than half of the respondents exhibit low levels of mental well-being and high psychological distress, with 81 % being at risk of depression; 57 % having severe psychological distress. Refugees and internally displaced participants show a particularly high risk of depression and severe psychological distress in our sample. Many Ukrainians seeking psychological help work, study, or volunteer, and those who engage in these activities have relatively alleviated mental well-being. Our results indicate a considerable psychological burden on Ukrainians. Although our analysis focuses on Ukrainians seeking help, it shows that the displaced soon after resettlement require particular attention and can be reached in a short time across borders, irrespective of their (officially documented) migration status.
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Parente P, Melnyk A, Lombardo P, Villani L, Grossi A, Goletti M, Barbara A, Santone G. Demographic and epidemiological characteristics of Ukrainian refugees in an Italian Local Health Authority. Eur J Public Health 2023; 33:815-820. [PMID: 37552052 PMCID: PMC10567240 DOI: 10.1093/eurpub/ckad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The Russian invasion of Ukraine caused millions of Ukrainian refugees to flee to other nations. To provide the most appropriate assistance, host nations necessitate up-to-date information regarding Ukrainian refugee's demographic and epidemiological conditions. We aim to investigate the demographic composition, the COVID-19 vaccinations performed, specialist care provided and the prevalence of non-communicable diseases (NCDs) in refugees assisted by an Italian Local Health Authority (LHA). METHODS We conducted a retrospective cross-sectional analysis from March to June 2022, analyzing the demographic and epidemiological status of Ukrainians. Statistical analyses were carried out to assess possible associations between NCDs distribution, age and gender. RESULTS LHA Roma 1 assisted 9349 Ukrainian refugees. Of these, 2784 (29.8%) were males and 6565 (70.2%) were females, with a median age of 25 years. Two thousand four hundred and eighty-five Ukrainian refugees were vaccinated against COVID-19. Among them, 401 (16.1%) had at least one NCD. The most frequent groups of diseases were related to the circulatory system (50.6%), the endocrine system (24.9%), and mental and behavioral disorders (6.5%). CONCLUSION Refugees need healthcare services targeted mainly towards minors and females. It is essential to analyze and monitor the demographic and epidemiological conditions to provide evidence about patient management and the best care integrated into the health service of host countries.
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Affiliation(s)
| | - Andriy Melnyk
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Lombardo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Leonardo Villani
- Local Health Authority Roma 1, Rome, Italy
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Andrea Barbara
- Local Health Authority Roma 1, Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Coppini V, Ferraris G, Monzani D, Grasso R, Pravettoni G. Disparities and barriers in the assessment of psychological distress, access to and use of psycho-oncological support in Europe: current perspectives. Front Psychol 2023; 14:1252843. [PMID: 37794912 PMCID: PMC10546339 DOI: 10.3389/fpsyg.2023.1252843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
The implementation of psycho-oncological support has shown important results in positively influencing treatment outcomes and quality of life in cancer patients and survivors. In the last few decades, the importance of mental health has been brought to attention to the general public and healthcare professionals on a national, institutional and organisational level. Official guidelines, policies, and training programs have been developed suggesting that psycho-oncological support should be considered as a non-negotiable requirement for quality cancer care in many hospitals and clinical centres across Europe. Health organisations, associations, institutions, and societies, such as the International Psycho-Oncology Society (IPOS) and the European Partnership for Action Against Cancer (EPAAC), are forming alliances, funding research projects and organising congresses in order to study, understand, and discuss the reasons for barriers and disparities in psycho-oncological support and, eventually, to overcome the existing cancer divide. Nevertheless, the World Health Organization's (WHO) estimations indicate that the cancer burden is still increasing, and relevant barriers and disparities in accessing psycho-oncological support continue to exist and influence the health conditions and quality of life of cancer patients and survivors. The present work will present the current disparities and barriers regarding assessment, access to and use of psycho-oncological support in the countries of the European Union, making suggestions for further research and possible solutions.
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Affiliation(s)
- Veronica Coppini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Department of Psychology, Educational Science and Human Movement (SPPEFF), University of Palermo, Palermo, Italy
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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URISTEMOVA ASSEM, MYSSAYEV AYAN, MEIRMANOV SERIK, MIGINA LYUDMILA, PAK LAURA, BAIBUSSINOVA ASSEL. Prevalence and associated factors of depression, anxiety, and stress among academic medicine faculty in Kazakhstan: a Cross-sectional Study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E215-E225. [PMID: 37654854 PMCID: PMC10468191 DOI: 10.15167/2421-4248/jpmh2023.64.2.2932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/22/2023] [Indexed: 09/02/2023]
Abstract
Introduction Psychological distress refers to a set of painful mental and physical symptoms of anxiety and depression, which often coexist and coincide with common somatic complaints and chronic conditions. In Kazakhstan, mental disorders are the second leading cause of years lived with disability. Currently, medical education in Kazakhstan is undergoing comprehensive reform, which creates an additional burden on faculty, fostering mental health concerns. Methods A quantitative observational cross-sectional study was conducted in 6 large medical universities in Kazakhstan. Data were obtained from 715 faculty academics by using an online self-reported DASS-21. Statistical analysis was performed using the SPSS version 20.0. Bivariate and multivariate logistic regression analyses were applied to evaluate the relationship between predictor and outcome variables. Results The total prevalence of depression, anxiety, and stress was 40.6%, 41.3%, and 53.0%, respectively. Younger age (p = 0.002), female gender (p = 0.001), being single (p = 0.044) or in a relationship (p = 0.001), having chronic diseases (p < 0.001), holding Master (p = 0.036) or PhD degree (p = 0.040), employment status (p = 0.034), and being involved in additional activities (p = 0.049) were significantly associated with different dimensions of distress. Conclusions Nearly half of the study population reported symptoms of depression, anxiety, and stress. Due to the higher prevalence of psychological distress amongst academic medicine faculty, determined risk factors must be taken into consideration in developing policies for mental issues prevention.
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Affiliation(s)
- ASSEM URISTEMOVA
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - AYAN MYSSAYEV
- Department of Science and Human Resources, Ministry of Health of the Republic of Kazakhstan, Astana, Kazakhstan
| | - SERIK MEIRMANOV
- College of Asia Pacific Studies, Ritsumeikan Asia Pacific University, Beppu, Japan
| | - LYUDMILA MIGINA
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - LAURA PAK
- Department of Clinical Oncology and Nuclear Medicine, Semey Medical University, Semey, Kazakhstan
| | - ASSEL BAIBUSSINOVA
- Department of Epidemiology and Biostatistics, Semey Medical University, Semey, Kazakhstan
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Hook K, Sereda Y, Rossi S, Koberna S, Vetrova MV, Lodi S, Lunze K. HIV, substance use, and intersectional stigma: Associations with mental health among persons living with HIV who inject drugs in Russia. AIDS Behav 2023; 27:431-442. [PMID: 35913589 PMCID: PMC9889571 DOI: 10.1007/s10461-022-03778-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 02/03/2023]
Abstract
HIV stigma is associated with negative physical and mental health outcomes. Intersectional stigma among persons living with HIV (PLHIV) results from interrelated, synergistic impacts of experiencing multiple stigma forms. Its relation with mental health outcomes is still an emerging area of study in this key population. This study aimed to evaluate associations of intersectional stigma, defined as endorsing high levels of HIV and substance use stigmas, with depressive and anxiety symptoms in a cohort of 111 PLHIV who inject drugs in St. Petersburg, Russia. Over a third of participants (37%) reported experiencing intersectional stigma (i.e., both stigma scores above the median). In adjusted analysis, lower Patient Health Questionnaire depression scale (PHQ-9) scores (beta (β=-4.31, 95% CI: -7.11 - -1.51, p = 0.003) and Generalized Anxiety Disorders Scale (GAD-7) scores (β=-3.64, 95% CI: -5.57 - -1.71, p < 0.001) were associated with having low scores for both HIV and substance use stigmas. Lower PHQ-9 scores (β=-3.46, 95% CI: -5.72 - -1.19, p = 0.003) and GAD-7 scores (β=-3.06, 95% CI: -4.62 - -1.50, p < 0.001) were also associated with high stigma on either HIV or substance use stigma scales. Controlling for demographics, depressive symptoms approximately linearly increased from both forms of stigma low to experiencing either form of stigma high to experiencing intersectional stigma, while levels of anxiety symptoms were comparable among participants with both types of stigma low and one stigma high. Participants who experienced intersectional stigma reported the greatest severity of both depressive and anxiety symptoms, as compared to individuals who endorsed low stigma scores (i.e., low stigma on both HIV and substance use stigma scales) or high scores of only one form of stigma. This suggests that intersectional stigma in this population of PLHIV who inject drugs in Russia is linked with worsened mental health outcomes, exceeding the effects of experiencing one form of stigma alone. Interventions to help people cope with intersectional stigma need to consider affective symptoms and tailor coping strategies to address impacts of multiple forms of mental health distress.
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Affiliation(s)
- Kimberly Hook
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA.
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - Yuliia Sereda
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
| | - Sarah Rossi
- Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Sarah Koberna
- Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Marina V Vetrova
- First Pavlov State Medical, University of Saint Petersburg, St. Petersburg, Russia
| | - Sara Lodi
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Karsten Lunze
- Department of Medicine, Boston Medical Center, Boston, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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Issac A, Nayak SG, Yesodharan R, Sequira L. Needs, challenges, and coping strategies among primary caregivers of schizophrenia patient: A systematic review & meta-synthesis. Arch Psychiatr Nurs 2022; 41:317-332. [PMID: 36428067 DOI: 10.1016/j.apnu.2022.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/04/2022] [Accepted: 09/03/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Deinstitutionalization and rising psychiatric care in society have led to an increase in the role of caregivers of persons diagnosed with schizophrenia. OBJECTIVE The objective of this systematic review was to identify and synthesize qualitative research findings that explored the needs, challenges, and coping strategies among the primary caregivers of a schizophrenia patient. METHODOLOGY The electronic databases namely PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Scopus, Web of Science, ProQuest, and ClinicalKey were searched to identify relevant articles published from 2005 to October 2021. The quality of the included articles was independently appraised by two reviewers using Walsh and Downe criteria and was analysed thematically. The meta-synthesis was modelled on Lucas framework. RESULTS The richness of information across 38 papers involving 543 participants was noteworthy. The needs of the primary caregivers were rehabilitation and vocational centre, information and education, self-help groups, augmented healthcare services, and communication and collaboration. The challenges reported were treatment expenses, bizarre beliefs, self and other directed harm and violence, therapeutic noncompliance, onerous caregiving task, crumbling family relations, misconception and discrimination, and self-stigmatization. The coping strategies adopted were problem-focused coping, emotional coping, behavioural coping, coping through social support, religious coping and cognitive reappraisal. CONCLUSION The primary caregivers provide unparalleled service to the health system and for the patient. The healthcare providers need to give undue attention to the unmet needs and challenges of the caregivers, which would benefit the health system by enabling the caregivers in providing long-term care for the schizophrenic.
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Affiliation(s)
- Alwin Issac
- All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Shalini Ganesh Nayak
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Renjulal Yesodharan
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Leena Sequira
- Manipal School of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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