Low self-esteem is related to depression and anxiety during recovery from an ectopic pregnancy

A New Situation-Specific Theoretical Framework to Guide Ectopic Pregnancy Research in Nursing

Ectopic pregnancy (EP) is a serious and increasing health concern that remains poorly understood despite identified risk factors. This article introduces the N-GEM Theoretical Framework, a novel approach that integrates genomic, epigenomic, environmental, and microbiome factors to address the complex and multifactorial etiology of EP. By offering a comprehensive and dynamic model, the N-GEM framework supports the development of personalized prevention strategies and can enhance early detection methods. This situation-specific theoretical framework not only positions nursing at the forefront of EP research but also fosters interdisciplinary collaboration that can drive significant advancements in clinical practice and ultimately reduce EP-related morbidity and mortality.

Insomnia and anxiety among COVID-19 patients in China: the chain mediating effect of psychological capital and self-esteem

BACKGROUND

The outbreak of Corona Virus Disease (COVID-19) in 2019 has continued until now, posing a huge threat to the public's physical and mental health, resulting in different degrees of mental health problems. As a vulnerable segment of the public, anxiety is one of the most common mental health problems among COVID-19 patients. Excessive anxiety aggravates the physical and psychological symptoms of COVID-19 patients, which is detrimental to their treatment and recovery, increases financial expenditure, affects family relations, and adds to the medical burden.

OBJECTIVE

This study aimed to explore the role of psychological capital and self-esteem in the relationship between insomnia and anxiety, thereby shedding light on the mechanism of the effect of insomnia on anxiety in COVID-19 patients.

METHODS

A cross-sectional study was conducted from April to May 2022 in Fangcang hospital in Shanghai, China. The self-administered questionnaires were distributed to 718 COVID-19 patients via cell phone using the Internet platform "Questionnaire Star", which included Athens Insomnia Scale, Psychological Capital Questionnaire, Self-esteem Scale, Self-Rating Anxiety Scale, gender, age, marital status, education. Data analysis was performed using descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analysis, ordinary least-squares regression, and bootstrap method.

RESULTS

Education background had significant impact on anxiety in COVID-19 patients (F = 7.70, P < 0.001). Insomnia, psychological capital, self-esteem and anxiety were significantly correlated, respectively (P < 0.001). And Regression analysis showed that insomnia had a direct negative predictive effect on psychological capital (β = -0.70, P < 0.001) and self-esteem (β = -0.13, P < 0.001). Psychological capital had a direct positive predictive effect on self-esteem (β = 0.12, P < 0.001). Insomnia had a direct positive predictive effect on anxiety (β = 0.61, P < 0.001). Both psychological capital and self-esteem had significant negative predictive effects on anxiety (β = -0.06, P < 0.05; β = -0.72, P < 0.001). The results showed that the mediating effect of psychological capital and self-esteem was significant, and the mediating effect value was 0.21. First, the indirect effect consisting of insomnia - psychological capital - anxiety was 0.04, showing that psychological capital had a significant mediating effect. Second, the indirect effect consisting of insomnia-self-esteem-anxiety had a value of 0.10, indicating that self-esteem had a significant mediating effect. Third, the indirect effect consisting of insomnia-psychological capital-self-esteem-anxiety had a value of 0.06, suggesting that psychological capital and self-esteem had a significant chain mediating effect between insomnia and anxiety.

CONCLUSIONS

Insomnia had a significant positive predictive effect on anxiety. Insomnia was first associated with a decrease in psychological capital, followed by a sequential decrease in self-esteem, which in turn was associated with increased anxiety symptoms in COVID-19 patients. Therefore, focusing on improving the psychological capital and self-esteem of patients can help alleviate the anxiety caused by insomnia in COVID-19 patients. It is recommended that patients and health care professionals increase the psychological capital and Self-esteem of COVID-19 patients through various methods to counter the effects of insomnia on anxiety.

Influence of physical education on anxiety, depression, and self-esteem among college students

BACKGROUND

Physical education is pivotal in our country's education reform. Urban schools have notably enhanced the intensity of physical education in recent years. However, the effects of physical education on students' anxiety, depression, and self-esteem levels, as well as their interrelations, remain unexplored.

AIM

To analyze the influence of physical education on students' anxiety, depression, and self-esteem.

METHODS

This study employed a cross-sectional design. A stratified cluster sampling method was used to select 478 first-year university students. Self-administered questionnaires were used to investigate the physical education status and basic information of college students. We used the Physical Activity Rank Scale-3 (PARS-3), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Self-Esteem Scale (SES) to assess the level of exercise, anxiety, depression, and self-esteem. Multiple Logistic regression was used to analyze the factors influencing anxiety, depression, and low self-esteem. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the predictive ability of PARS-3 scores for anxiety, depression, and low self-esteem. Spearman's correlation was used to analyze the correlations among the PARS-3, SAS, SDS, and SES.

RESULTS

Compared with the domestic norms, SAS and SDS scores were higher, and SES scores were lower (P < 0.05). Among the participants, 210 (43.93%) had PARS-3 scores below 20, 94 (19.67%) had scores of 20-42, and 174 (36.40%) had scores above 42. After adjusting for daily sleep time, gender, being an only child, major, father's educational background, mother's educational background, and family residence, PARS-3 scores were independent influencing factors for anxiety, depression, and low self-esteem (P < 0.05). The AUC of PARS-3 scores predicting anxiety, depression, and low self-esteem were 0.805 (0.760-0.849), 0.799 (0.755-0.843), and 0.831 (0.788-0.874), respectively. The sensitivities were 0.799, 0.801, and 0.748, and the specificities were 0.743, 0.716, and 0.814, respectively. PARS-3 was negatively correlated with SAS and SDS scores (r = -0.566, -0.621, both P < 0.001) and positively correlated with SES scores (r = -0.621, P < 0.001). SES scores were negatively correlated with SAS and SDS scores (r = -0.508, r = -0.518, both P < 0.001).

CONCLUSION

The amount of physical activity is negatively correlated with anxiety and depression degree and positively correlated with self-esteem degree.

Research Progress on Psychological Distress in Patients with Ectopic Pregnancy in China

Ectopic pregnancy is a leading cause of death for child-bearing aged women. Most patients with ectopic pregnancy experience suffer psychological distress which seriously affects their physical and mental health. The psychological distress, influencing factors, measurement tools, and nursing interventions in patients with ectopic pregnancy in China are reviewed in this article. The results showed that the main psychological distress of patients with ectopic pregnancy is anxiety, depression, uncertainty sense of disease, and low self-esteem. The main factors affecting the psychological distress of ectopic pregnancy patients included life-threatening disease, different marital status, and reproductive needs. The main intervention methods for psychological distress in pregnant patients included: cognitive behavioral therapy, emotional therapy of traditional Chinese medicine, and family support. The majority of cross-sectional surveys in China focused on psychological conditions of the patients with ectopic pregnancy, and there are very few longitudinal studies. Large-sample, multi-center longitudinal studies should be conducted in the future to monitor the development of ectopic pregnancy. Qualitative research should be conducted on patient experience, to provide guidance and basis for the implementation of targeted nursing interventions and to further explore standardized, continuous, and generalizable psychological care protocols for distress interventions for patients with ectopic pregnancy, thereby minimizing psychological distress such as anxiety, depression, and uncertainty in patients with ectopic pregnancy.

Psychologic Sequelae in Early Pregnancy Complications

Early pregnancy complications, including miscarriage, ectopic pregnancies, and hyperemesis gravidarum, are common discomforts accounting for about 15% to 20% of all pregnancies. A proportion of women with early pregnancy complications will experience short- and long-term psychologic sequelae in the aftermath of pregnancy complications, including anxiety, depression, and post-traumatic stress disorder (PTSD) which are the most commonly reported psychologic reactions. This review will focus on the course and impact of these psychologic sequelae in early pregnancy complications, and the noninvasive interventions to improve mental health are also briefly discussed.

The Role of Self-Esteem in the Relationship Between Psychological Capital and Anxiety of Left-Behind Experience College Students During COVID-19 Pandemic: An Online Study

Background

There is growing evidence that the COVID-19 pandemic has had a dramatic impact on public mental health. However, less attention has been paid to left-behind experience college students (LBEs). This online study aimed to investigate the relationship between psychological capital (PsyCap) and anxiety among LBEs during COVID-19 pandemic, and further analyze the mediation role of self-esteem between them.

Methods

A total of 9990 students were chosen using the stratified cluster sampling method. Three self-reported questionnaires were used to assess the PsyCap, self-esteem, and anxiety, respectively. All the statistical analyses were conducted using SPSS 23.0 and R, and to further investigate the mediation effect of self-esteem in the association of PsyCap with anxiety, AMOS 23.0 was used to build a structural equation model.

Results

PsyCap, self-esteem, and anxiety were significantly correlated among LBEs during the COVID-19 pandemic. PsyCap affects anxiety directly (β = -0.22, SE = 0.051, 95% CI: -0.27, -0.17, P < 0.05). In addition, self-esteem partially mediated the relationship between PsyCap and anxiety (mediating effect value = -0.16, 95% CI: -0.20, -0.13, P < 0.05).

Conclusion

During the pandemic of COVID-19, left-behind experience had a negative influence on the PsyCap and self-esteem of college students. In addition, for LBEs, self-esteem plays an important mediating role between PsyCap and anxiety. Therefore, from the perspective of PsyCap and self-esteem, schools should translate them into practical educational strategies to enhance the mental health and mitigate the anxiety levels of LBEs.