Psychometric Properties of the SAS, BAI, and S-AI in Chinese University Students

Assessment of psychometric properties of the union physio-psycho-social assessment questionnaire (UPPSAQ-70) in a large sample of general hospital psychiatric outpatients

OBJECTIVE

To evaluate the psychometric properties of the Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70) among general hospital psychiatric outpatients.

METHODS

A total of 2000 participants responded to the survey. Factor analyses were used to test the construct validity of the scale. Convergent validity was evaluated by the correlation between UPPSAQ-70 and symptoms measured using the Chinese versions of Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Patient Health Questionnaire-15 (PHQ-15), Somatic Symptom Disorder - B Criteria Scale (SSD-12) and Pittsburgh Sleep Quality Index (PSQI).

RESULTS

The nine-factor model was supported (χ2 = 8816.395, df = 2309, χ2/df = 3.818, RMSEA = 0.053, CFI = 0.929). The UPPSAQ-70 showed significant correlation with the SAS (r = 0.396, P < .001), SDS (r = 0.451, P < .001), PHQ-15 (r = 0.381, P < .001), SSD-12 (r = 0.324, P < .001) and PSQI (r = 0.220, P < .001). UPPSAQ-70 and its subscales showed good internal consistency with Cronbach's alpha coefficients ranging from 0.79 to 0.96.

CONCLUSIONS

The UPPSAQ-70 was a rating scale with good construct validity and reliability, which can measure overall health in the biological, psychological, and social domains for Chinese psychiatric outpatients, but its convergent validity still requires further empirical research.

Correlation Between Pituitary Adenoma Surgery and Anxiety Disorder: Systematic Review and Meta-Analysis

OBJECTIVE

This study aims to evaluate the impact of surgical intervention on anxiety levels in patients with various types of pituitary adenoma (PA).

METHOD

A systematic review was conducted following PRISMA guidelines until October 2022, searching Embase, PubMed, Web of Sciences, and Scopus.

RESULTS

A total of 32 studies were included, encompassing 2,681 patients with the mean age of 53.33 ± 6.48 years (43.4% male). Among all subtypes, 664 diagnosed with Cushing's disease (25.8%), 612 with acromegaly (23.8%), 282 with prolactinoma (10.9%), and 969 with nonfunctional pituitary adenomas (37.6%). Pituitary insufficiency was the most common complication. Considering therapeutic modalities, 515 patients (29.8%) underwent endoscopic trans-sphenoidal surgery, while 222 (12.9%) underwent microscopic trans-sphenoidal surgery. The type of trans-sphenoidal surgery was not specified in 977 (56.6%) patients. A total of 17 studies including 1510 patients which mostly assessed anxiety using the Hospital Anxiety and Depression Scale (HADS) and Zung Self-Rating Anxiety Scale (SAS) were included in the meta-analysis. Preoperative evaluation using Hospital Anxiety and Depression Scale (HADS) questionnaire showed a pooled score of 8.27 (95%CI 4.54-12.01), while postoperative evaluation yielded a pooled score of 6.49 (95%CI 5.35-7.63), indicating no significant difference. Preoperative SAS assessment resulted in a pooled score of 50.43 (95%CI 37.40-63.45), with postoperative pooled score of 55.91 (95%CI 49.40-62.41), showing no significant difference.

CONCLUSIONS

Our analysis revealed no significant difference in anxiety scores pre- and postoperatively. While our findings suggest stability in anxiety levels following surgical intervention, it is imperative to recognize the limitations of the current evidence base. The observed lack of consensus may be influenced by factors such as the heterogeneous nature of the patient population, variations in the characteristics of pituitary adenomas, diverse therapeutic approaches, and potential confounding variables such as pre-existing mental health conditions and coping mechanisms. Further research is warranted to elucidate the nuanced relationship between surgical intervention for PA and anxiety outcomes, considering these complex interactions and employing rigorous methodologies to address potential sources of bias.

Prevalence and correlates of mental health problems among different occupations of medical workers during COVID-19 outbreak in China

Background

Health workers involved in the fight to prevent the COVID-19 outbreak were exposed to hazards. Detailed information on mental health problems in different medical occupations is crucial. To examined the prevalence of mental health issues in three medical occupations as well as the relationships between mental health problems and correlates in each occupation.

Methods

This study utilizing the Questionnaire Star program was conducted among medical workers working at medical institutions in China from February 17 to 24, 2020. The Self-Reporting Questionnaire (SRQ-20), the Zung Self-rating Anxiety Scale (SAS), and the Zung Self-rating Depression Scale (SDS) were used to assess mental health problems.

Results

The prevalence of any mental health problems in the three occupations was 43.6, 34.6, and 32.9% for nurses, paramedical workers (PMWs), and doctors, respectively. Three occupations shared some correlates, such as being overworked, not having enough time to rest, support from colleagues, and previous mental health status. There were specific factors for each occupation. For doctors, age, educational level, living status, support from family, and previous physical status were related factors in mental health problems. Working in a designated hospital for treating COVID-19, having COVID-19 event exposures, and receiving support from family were associated with the mental health problems of the nurses. PMWs' mental health problems was linked to educational level and care from supervisors or heads of department.

Conclusion

Different medical occupations have distinct impacts on mental health issues. Policy makers and mental health professionals working to prepare for potential disease outbreaks should be aware of multiple factors in different occupations.

Personality and psychological profile for patients with and without halitosis: A case-control study

OBJECTIVE

To compare the personalities, social avoidance and distress, and anxiety status of Chinese patients with and without objective halitosis, and investigate the association among these psychological disorders.

METHODS

Patients who complained of bad breath and diagnosed with objective halitosis were enrolled into the halitosis group, while patients without objective halitosis were enrolled into the control group. The questionnaires included the sociodemographic profile of the participants, Eysenck Personality Questionnaire (EPQ), Social Avoidance and Distress Scale (SAD), and Beck Anxiety Inventory (BAI).

RESULTS

A total of 280 patients were assigned into objective halitosis group (n = 146) and control group (n = 134). The extraversion subscales (E) score of the EPQ in the halitosis group were significantly lower than that in the control group (p = 0.001). The total SAD score and proportion of patients with anxiety symptoms in the BAI scale in the objective halitosis was significantly higher than that in the control group (p < 0.05). There was a negative correlation between the extraversion subscale and the total SAD score, Social Avoidance and Social Distress subscales (p < 0.001).

CONCLUSION

Patients with objective halitosis have more introverted personality traits and are more likely to have social avoidance and distress than the nonhalitosis population.

The effect of quiet eye training on golf putting performance in pressure situation

To explores the effect and mechanism of quiet eye training on the accuracy of golfers´ putts in pressure situations and provides methods and basis for targeted attention training and control. 22 young golfers in China golf team aged from 13 to 18 were randomly assigned to the experimental group (quiet eye training group) and the control group (technical guidance group) according to gender. Both groups of participants underwent two consecutive weeks of push training (3 sets per day, 20 golf putts per set, rest for 3 min between sets) separately in accordance with the guidance of a professional psychological research group and an expert coach. Eye tracking technology, biofeedback technology, and subjective evaluation methods were used to test and analyze the push process of the two groups of participants before and after training under pressure situations (Eye movement behaviors and the heart rate were recorded by ASL Mobile Eye-XG and NeXus-2 biofeedback, pressure and state anxiety were evaluated by self-rating pressure scale and S-AI. Golf putting performance was recorded by a research graduate assistant). A higher hit ratio as well as lower pressure and SAI level was founded in quiet eye training group in the pressure situation, the quiet eye movement time and total fixation time was longer than technical group. The quiet eye training group has a better putting performance. Quiet eye training can improve the golf putting performance in pressure situations. After quiet eye training, the state anxiety decreased, the quiet eye movement time and the total fixation time increased in pressure situations.

The mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer

Caring for children with cancer is stressful for parents and leads to psychological distress, which is mainly manifested as depressive symptoms and anxiety. This study explored the mediating role of resilience in the relationship between stress and psychological distress in parents of children with cancer. We recruited 258 parents of children with cancer in three tertiary hospitals in Mainland China. The results revealed that the mediating effect of resilience for the relationships between stress and depressive symptoms and between stress and anxiety accounted for 23.4% and 11.4%, respectively, of the total effect. Resilience was confirmed as a protective factor that can be incorporated into future intervention programmes to improve the psychological well-being of parents of children with cancer. Future studies could develop resilience training programmes to enhance the resilience of parents of children with cancer to alleviate parents' psychological distress.

How Society Anxiety Influences Attention Control in College Students: The Moderated Mediation Effect of Cognitive Flexibility and Resting-state Electroencephalography Activity

Social anxiety is a prevalent issue among college students, adversely affecting their overall well-being. Drawing from the cognitive model of social anxiety and attention control theory, heightened levels of social anxiety may correspond to poorer attention control ability. However, little is known about the underlying cognitive mechanisms of the relationship between social anxiety and attention control. To address this research gap, the current study recruited a sample of 156 college students (56 women) who underwent self-report measures of social anxiety, cognitive flexibility, and attention control, followed by a resting-state EEG recording. The results revealed a significant negative predictive effect of social anxiety on attention control, with cognitive flexibility partially mediating this relationship. Furthermore, resting-state theta power emerged as a significant moderator, accentuating the negative impact of social anxiety on cognitive flexibility among individuals with lower theta power. In addition, frontal alpha asymmetry (FAA) demonstrated a moderating effect, with lower FAA intensifying the predictive influence of cognitive flexibility on attention control. Taken together, these results suggested that social anxiety can predict attention control either directly or indirectly via the mediating role of cognitive flexibility, and lower theta power and FAA has a risk amplification effect, which provide novel insights into the treatment and prevention of social anxiety and its negative impact on college students.

Neuroimaging profiles of the negative affective network predict anxiety severity in patients with chronic insomnia disorder: A machine learning study

BACKGROUND

Sleep is instrumental in safeguarding emotional well-being. While the susceptibility to both insomnia and anxiety has been demonstrated to involve intricate brain systems, the neuroimaging profile of chronic insomnia disorder with comorbid anxiety symptoms (CID-A) remains unexplored. Employing machine learning methodologies, this study aims to elucidate the distinct neural substrates underlying CID-A and to investigate whether these cerebral markers can prognosticate anxiety symptoms in patients with insomnia.

METHODS

Functional magnetic resonance imaging (fMRI) data were procured from a relatively large cohort (dataset 1) comprised of 47 CID-A patients, 49 CID patients without anxiety (CID-NA), and 48 good sleeper controls (GSC). Aberrant cerebral functional alterations were assessed through functional connectivity strength (FCS) and resting-state functional connectivity (rsFC). Subsequently, Support Vector Regression (SVR) models were constructed to predict anxiety symptoms in CID patients based on neuroimaging features, which were validated utilizing an external cohort (dataset 2).

RESULTS

In comparison to CID-NA and GSC subjects, CID-A patients exhibited heightened FCS in the right dorsomedial prefrontal cortex (DMPFC), a central hub within the negative affective network. Moreover, the SVR models revealed that DMPFC-related rsFC/FCS features could be employed to predict anxiety symptoms in two independent cohorts of CID patients.

LIMITATION

Modifications in brain functionality might vary across insomnia subtypes.

CONCLUSION

The present findings suggest a potential negative affective network model for the neuropathophysiology of CID accompanied by anxiety. Importantly, the negative affective network pattern may serve as a predictor for anxiety symptoms in CID patients.

Mindfulness-based interventions to reduce anxiety among Chinese college students: A systematic review and meta-analysis

Mindfulness-based interventions are found to have a positive effect on an individual's mental health. Using a meta-analysis method, this study examined the effects of mindfulness-based interventions on alleviating anxiety among Chinese college students. Using six international and two Chinese electronic databases, we comprehensively researched literature published between 1 January 2012 and 31 December 2021. The literature was then carefully selected and classified. The literature selection, data extraction, and quality assessment were all independently conducted by two members of the research team; any disagreements were resolved through consultation with a third researcher. A total of 11 original articles met all the eligibility criteria and were included in the meta-analysis. The meta-analysis revealed that mindfulness-based interventions have a positive effect on the remission of anxiety among Chinese college students. This confirms the need to generalize mindfulness-based interventions as a form of treatment and prevention for anxiety among Chinese college students.

Psychological Health and Sleep Quality of Medical Graduates During the Second Wave of COVID-19 Pandemic in Post-epidemic Era

Recently, a COVID-19 virus variant spread rapidly in Guangzhou, China, causing public panic. This study aimed to understand the psychological and sleep-related consequences of the secondary outbreak of the pandemic on medical students. In this cross-sectional survey-based study, participants anonymously completed structured questionnaires online from June 8–22, 2021. We collected participants' demographic and general information. Anxiety, depression, and sleep quality were measured using the Zung Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Protective factors were assessed using the Coping Style Questionnaire (CSQ). Uni- and multivariate logistic regression analyses were performed examining factors associated with mental health and sleep quality problems. During the second wave of the pandemic in local outbreak areas in Guangzhou, China, more than one-third of medical students' mental health and sleep quality were affected. The prevalence of anxiety, depression, and poor sleep quality were 27.54%, 27.58%, and 18.19%, respectively. Students belonging to the Class of 2019, aged over 29 years, those with siblings, and those whose hometowns were in other provinces were more prone to the three health problems. Factors associated with an increased risk of mental health problems were vaccination status (adjusted odds ratio 1.603–1.839) and diet status (adjusted odds ratio 1.62–1.929). Positive coping styles served as protective factors (p < 0.05). We discovered that completed vaccination status, good diet, and positive coping styles were related to good mental health and sleep quality.

Synergistic Impact of the Symptom Cluster on Health-Related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease: A Secondary Data Analysis

This study aimed to quantify the synergistic impact of symptom clusters on health-related quality of life (HRQoL) among patients with chronic obstructive pulmonary disease (COPD). We conducted a secondary analysis of a cross-sectional data collected via convenience sampling from patients with COPD. Multiple linear regressions were used to quantify the relationships between symptom clusters and HRQoL. The sample included 106 COPD patients from whom three symptom clusters were identified comprising of dyspnea depression, anxiety-sleep, and depression-anxiety. Depression-anxiety (psychological symptom cluster) was significantly associated with poorer HRQoL (β = 13.88, 95% CI [7.94, 19.82]), while no significant associations were detected with HRQoL for either depression or anxiety alone (β = 6.66, 95% CI [-2.99, 16.31]; β = 7.29, 95% CI [-0.78, 15.35]). Assessment and early intervention led by nurses targeting the psychological symptom cluster may represent an initial approach to improve HRQoL. Understanding the phenomenon of symptom clusters that are present in patients with COPD provides a breakthrough insight to devise strategies for their management.

Effect of adenotonsillectomy on the growth, development, and comprehensive cognitive abilities of children with obstructive sleep apnea: a prospective single-arm study

Background

Previous studies did not comprehensively examine the effect of adenotonsillectomy on growth and development, emotional state, quality of life, attention ability, and cognitive dysfunction in children with obstructive sleep apnea (OSA). This study aimed to explore the improvement effects of adenotonsillectomy on the growth, development, quality of life, and attention ability in children with OSA.

Methods

This prospective single-arm study involved children with OSA admitted at The No. 980 Hospital, Joint Logistics Support Force, PLA, China (02/2017–02/2018). The Myklebust Pupil Rating Scale (PRS), Inventory of Subjective Life Quality (ISLQ), Zung Self-rating Anxiety Scale (SAS), Conners Parent Symptom Questionnaire (PSQ), and Continuous Performance Task (CPT) were examined before and at 6 months after adenotonsillectomy.

Results

Forty-nine patients were enrolled. They all completed the 6-month follow-up. The body mass index increased after surgery (from 18.8 ± 4.9 to 19.3 ± 4.3 kg/m², P = 0.008). The total PRS score increased 6 months after surgery (from 73.8 ± 12.7 to 84.6 ± 10.3, P < 0.001). All aspects of the ISLQ, except anxiety experience and physical emotion, were improved at 6 months after adenotonsillectomy (all P < 0.01). The SAS score also decreased from 20.1 ± 10.0 to 12.8 ± 6.6 (P < 0.001). All six dimensions of the PSQ, as assessed by the legal guardians, decreased after adenotonsillectomy (all P < 0.01). The proportions of children with auditory and/or visual sustained attention abnormalities decreased after surgery.

Conclusions

After adenotonsillectomy, the PRS, ISLQ, and PSQ improved, and anxiety and auditory/visual sustained attention abnormalities decreased, suggesting positive impacts on the growth, development, quality of life, and comprehensive cognitive abilities of children with OSA.

Measurement of coronaphobia in older adults: Validation of the Spanish version of the Coronavirus Anxiety Scale

BACKGROUND AND OBJECTIVE

The Coronavirus Anxiety Scale (CAS) is an instrument that measures the severity of anxiety due to COVID-19 or coronaphobia. In the context of the COVID-19 pandemic, older adults are the most vulnerable age group; therefore, the aim of the study was to evaluate the psychometric properties of the CAS in this group.

MATERIALS AND METHOD

274 Peruvian older adults participated (Mage=67.86; SD=6.34, 64.6% women). In addition to the CAS, the 2-item Patient Health Questionnaire (PHQ-2), and 2-item Generalized Anxiety Disorder Scale (GAD-2) were applied. Confirmatory Factor Analysis (CFA) was used to assess the factor structure of the CAS and Item Response Theory was used to analyze item characteristics. A sequence of hierarchical variance models was used to evaluate the measurement invariance of the CAS according to age. To assess reliability, Cronbach's alpha coefficient (α) and the omega coefficient (ω) were used. The correlations between the CAS score and the scores of the PHQ-2 and GAD-2 scales were calculated with Pearson's correlation coefficient (r).

RESULTS

The results of the CFA indicated that the unidimensional model of the CAS fitted the data adequately and showed very good reliability (α and ω≥.83). Likewise, all items provided high information and adequate discrimination, which allowed for better detection of average and high levels of coronaphobia in the older adult population. However, the CAS did not show evidence of being strictly invariant between older adults aged 60-65 years and 66-86 years. The CAS showed significant correlations with anxiety (r=.72; [95%CI: .66, .87] p<.01) and depression (r=.53; [95%CI: .43, .76] p<.01).

CONCLUSION

The CAS in Spanish shows evidence of validity based on internal structure, convergent and divergent validity, as well as an adequate reliability estimate to assess coronaphobia in older adults. The CAS can be used to detect average and high levels of coronaphobia in the older adult population.

Effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients: A single-blind randomized controlled trial

OBJECTIVE

Psychological distress such as depression and anxiety resulted from coronavirus disease 2019 (COVID-19) have attracted increasing attention. The aim of this randomized controlled trial is to evaluate the effects and safety of auricular acupressure on depression and anxiety in isolated COVID-19 patients.

METHODS

68 participants diagnosed with COVID-19 pneumonia (18-80 years old, SDS ≥ 50, SAS ≥ 45) were recruited and randomly allocated to the auricular acupressure group and the sham auricular acupressure group by a computer-generated random number sequence from 9th June to 30th June 2022. The group allocation was only blinded to the participants. Those in the auricular acupressure group were attached magnetic beads against 4 auricular points Shenmen, Subcortex, Liver and Endocrine, while sham group used four irrelevant auricular points. Outcomes were measured by Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Depression Scale (SAS) before and after treatment in both groups through electronic questionnaire in mobile phones.

RESULTS

After treatment, statistically significant differences were found in scores of SAS in both groups (P < 0.001 in auricular acupressure group; P = 0.003 in sham group), and SDS scores reduced significantly in the auricular acupressure group (P = 0.002). Significant reduced SAS and SDS scores were achieved in the auricular acupressure group than that in the sham group (F = 4.008, P = 0.049, MD -7.70 95% CI: -9.00, -6.40, SMD -2.79 95% CI: -3.47, -2.11 in SDS; F = 10.186, P = 0.002, MD -14.00 95% CI: -15.47, -12.53, SMD -4.46 95% CI: -5.37, -3.56 in SAS). No adverse events were found in either group during the whole study.

CONCLUSION

Auricular acupressure is an effective and safe treatment for alleviating symptoms of depressive and anxiety in patients with COVID-19.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn//, identifier ChiCTR2200061351.

Relationship Between Negative Emotions and Job Burnout in Medical Staff During the Prevention and Control of the COVID-19 Epidemic: The Mediating Role of Psychological Resilience

We herein investigated the relationship between psychological status and the various emotions of medical staff during the prevention and control of coronavirus disease 2019 (COVID-19) epidemic. In this study, the convenience sampling method was used to select medical staff members as participants, and a cross-sectional study design was implemented. The instruments included the Burnout Clinical Subtype Questionnaire (BCSQ-36), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the self-rated 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16), and the Self-rating Anxiety Scale (SAS). In total, 876 medical staff members were selected in this study. The CD-RISC-10 was negatively correlated with all other scales (P < 0.01). The hierarchical regression coefficients of the SAS and QIDS-SR16 against the BCSQ-36 mediated by the CD-RISC-10 were P < 0.01, and the significance of the F values in all hierarchical regression equations was P < 0.01 (Sobel test, P < 0.01). Medical staff burnout during the COVID-19 epidemic was affected by anxiety and depression, and psychological resilience had a mediating role. Attending to changes in the negative emotions of medical staff and improving their psychological resilience are beneficial to alleviate job burnout.

Prevalence of anxiety symptom and depressive symptom among college students during COVID-19 pandemic: A meta-analysis

BACKGROUND

The global pandemic of COVID-19 has brought huge changes to people's lifestyles, college students have also been affected seriously. Evidence about these significant changes indicated that college students were more prone to feel anxious and depressed. To derive a precise assessment of the prevalence of anxiety symptom and depressive symptom among college students worldwide, we conducted this meta-analysis.

METHODS

Based on the guidance of PRISMA, literature was searched in Pubmed, Web of Science, Embase, and PsycArticles (last search November 6, 2020). These articles after the screening were analyzed by a random-effects model to estimate the pooled prevalence of anxiety symptom and depressive symptom. Also, subgroup analysis, sensitivity analysis, and publication bias were performed in this meta-analysis.

RESULTS

The results showed that the pooled anxiety symptom prevalence was 31% (95% CI: 23-39%), pooled depressive symptom prevalence was 34% (95% CI: 27-41%). Subgroup analysis showed that the prevalence of anxiety symptom and depressive symptom among different countries' college students were different, and the pooled depressive symptom prevalence of females was higher compared with males.

LIMITATIONS

The prevalence of anxiety symptom and depressive symptom in worldwide college students could be better assessed by a standard and reliable questionnaire.

CONCLUSIONS

The results suggest that the prevalence of anxiety symptom and depressive symptom during the COVID-19 pandemic is relatively high. Except for interventions that should be taken to control the pandemic urgently, mental health services are also needed to decrease the risk of anxiety and depression among college students.

The pattern of hospital-community-home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: Is it feasible?

BACKGROUND

Tracheostomy is very common in patients with severe traumatic brain injury (TBI), long-term nursing care are needed for those patients. We aimed to evaluate the effects of hospital-community-home (HCH) nursing in those patients.

METHODS

This study was a before-after study design. Patients were divided into control groups (traditional nursing care) and HCH group(HCH nursing care). Tracheostomy patients with severe TBI needing long-term care were included. All patients underwent a two-month long follow-up. Glasgow coma score (GCS), Karnofsky, Self-Anxiety Scale (SAS) from caregiver and Barthel assessment at the discharge and two months after discharge were evaluated. The tracheostomy-related complications were recorded and compared.

RESULTS

A total of 60 patients were included. There were no significant differences between the two groups in the GCS, Karnofsky, SAS from caregiver and Barthel index at discharge((all P > .05); the GCS, Karnofsky and Barthel index were all significantly increased after two-month follow-up for the two groups (all P < .05), and the GCS, Karnofsky and Barthel index at two-month follow-up in HCH group were significantly higher than that of the control group(all P < .05), but the SAS from caregiver at two-month follow-up in HCH group was significantly less than that of the control group(P = .009). The incidence of block of artificial tracheal cannula and readmission in HCH group were significant less than that of control group (all P < .05).

CONCLUSION

HCH nursing care is feasible in tracheostomy patients with severe TBI, future studies are needed to further evaluate the role of HCH nursing care.

The Relationship Between Unmet Needs of Parents with Hospitalized Children and the Level of Parental Anxiety in Iran

PURPOSE

This study aimed to investigate the relationship between parents' unmet needs with hospitalized children and the level of parental anxiety.

DESIGN AND METHODS

This correlational study was conducted on 194 parents with hospitalized children. The data were collected using the questionnaires of "revised needs of parents with hospitalized children" and "Zung's anxiety scale". The data were then analyzed through descriptive and inferential statistics using SPSS software version 19.

RESULTS

There was a very weak positive relationship between the number of unmet needs of the sick child and the physical symptoms of anxiety (P = 0.038, r = 0.149) and overall anxiety score (P = 0.018, r = 0.17). However, there was no significant relationship between the number of unmet needs in other groups. Also, there was no significant relationship between the total number of unmet needs and parental anxiety. The most frequent unmet needs of parents, respectively, belonged to 1) support and guidance, 2) needs of other family members, and 3) comfort.

CONCLUSIONS

It might not be possible to obviate all the parental needs during the child's hospitalization. It is noteworthy that failure to meet those parental needs directly related to the child may cause anxiety for the parents.

PRACTICE IMPLICATIONS

Meeting the needs of parents regarding support and guidance, comfort, other family members, and needs directly related to the child is recommended to prioritize in pediatric nursing care.

The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis

Evidence from previous coronavirus outbreaks has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances. To construct a comprehensive picture of the mental health status in COVID-19 patients, we conducted a systematic review and random-effects meta-analysis to assess the prevalence of depression, anxiety, and sleep disturbances in this population. We searched MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, Wanfang Data, Wangfang Med Online, CNKI, and CQVIP for relevant articles, and we included 31 studies (n = 5153) in our analyses. We found that the pooled prevalence of depression was 45% (95% CI: 37-54%, I2  = 96%), the pooled prevalence of anxiety was 47% (95% CI: 37-57%, I2  = 97%), and the pooled prevalence of sleeping disturbances was 34% (95% CI: 19-50%, I2  = 98%). We did not find any significant differences in the prevalence estimates between different genders; however, the depression and anxiety prevalence estimates varied based on different screening tools. More observational studies assessing the mental wellness of COVID-19 outpatients and COVID-19 patients from countries other than China are needed to further examine the psychological implications of COVID-19 infections.

Coronavirus Anxiety Scale: New psychometric evidence for the Spanish version based on CFA and IRT models in a Peruvian sample

The aim of the study was to analyze the psychometric properties of the Spanish version of the Coronavirus Anxiety Scale (CAS), using Item Response Theory (IRT) and Confirmatory Factor Analysis (CFA). The participants were 790 Peruvians, selected through a convenience sampling, where the majority were women. The CFA models indicated that the one-dimensional structure better represents the data, is reliable and invariant between men and women. Likewise, IRT findings indicate that CAS is more informative for high levels of COVID-19 anxiety. The CAS in Spanish has adequate psychometric properties to be used as a short measure of COVID-19 anxiety.

Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents

BACKGROUND

Since the COVID-19 outbreak at the end of 2019, it has evolved into a global pandemic with tremendous mental health impact besides the threats to people's physical health.

OBJECTIVE

The aims were to examine whether exposure to COVID-19 predicts elevated levels of anxiety and post-traumatic stress symptoms and whether pre-pandemic maltreatment experiences exacerbate this impact on mental health in adolescents.

PARTICIPANTS AND SETTING

The survey was conducted online from February 8 st to February 27th, 2020, and the questionnaires were distributed and retrieved through a web-based platform. This study includes a total of 6196 subjects, aged range from 11 to 18 years old.

METHODS

Several multivariable linear regressions were used to analyse the data.

RESULTS

The largest variance in PTSS and anxiety problems was explained by ACEs, with more pre-pandemic maltreatment experiences predicting more PTSS (effect size beta = 0.16∼0.27), and more anxiety (effect size beta = 0.32∼0.47). Experienced or subjective fear of exposure to COVID-19 predicted statistically significant variance in PTSS and anxiety, and standardized betas ranged from 0.04 to 0.09. Participants who had adverse childhood experiences and had experienced exposure to COVID-19 showed elevated PTSS.

CONCLUSIONS

After pre-pandemic maltreatment experiences the impact of exposure to COVID-19 on mental health may be stronger. Scars from the past seem to be vulnerabilities during societal upheaval. We therefore suggest that when exposed to COVID-19 rural adolescents should get prioritized professional family support and mental health counseling in particular when they have experienced family abuse and neglect in childhood, even though such support is more difficult to organize in rural areas.

The Centrality of Depression and Anxiety Symptoms in Major Depressive Disorder Determined Using a Network Analysis

BACKGROUND

Comorbid anxiety symptoms are highly prevalent and closely linked with poorer treatment outcomes, chronicity, and hospitalization in major depressive disorder (MDD). Our study aimed to estimate the network of depression and anxiety symptoms that was developed based on a sample of MDD patients.

METHODS

We constructed a network of the 21 Beck Depression Inventory (BDI) symptoms and 21 Beck Anxiety Inventory (BAI) symptoms in 223 patients with MDD who were beginning psychiatric treatment. In addition, each of the depression and anxiety symptoms was considered to be an ordered categorical variable ranging in value from 0 to 3.

RESULTS

The three depression symptoms including loss of energy, loss of interest, and worthlessness and the seven anxiety symptoms including faintness or lightheadedness, feeling of choking, feeling scared, fear of the worst happening, nervousness, inability to relax, and feeling shaky were identified as the ten most central nodes within a network of depression and anxiety symptoms. The inter-connection between irritability and nervousness was a strong trans-diagnostic edge within the network of depression and anxiety symptoms.

LIMITATIONS

Because our study was designed in a cross-sectional manner, the networks were estimated undirectionally.

CONCLUSIONS

Our findings show that depression symptoms are not more central than anxiety symptoms within an estimated network structure of symptoms in patients with MDD. Moreover, the inter-connection between irritability and nervousness may suggests a probable trans-diagnostic association in MDD symptomatology.

Can Flow Alleviate Anxiety? The Roles of Academic Self-Efficacy and Self-Esteem in Building Psychological Sustainability and Resilience

A growing number of studies suggest that flow experience is associated with life satisfaction, eudaimonic well-being, and the perceived strength of one’s social and place identity. However, little research has placed emphasis on flow and its relations with negative experiences such as anxiety. The current study investigated the relations between flow and anxiety by considering the roles of self-esteem and academic self-efficacy. The study sample included 590 Chinese university students, who were asked to complete a self-report questionnaire on flow, anxiety, self-esteem, and academic self-efficacy. Data were analyzed using structural equation modeling (SEM) with AMOS software, in which both factorial analysis and path analysis were performed. Results revealed that the experience of flow negatively predicted anxiety, and both self-esteem and academic self-efficacy fully mediated the path between flow and anxiety. Specifically, self-esteem played a crucial and complete mediating role in this relationship, while academic self-efficacy mediated the path between self-esteem and anxiety. Our findings enrich the literature on flow experience and help with identifying practical considerations for buffering anxiety and more broadly with fostering strategies for promoting psychological sustainability and resilience.

Factors associated with the general well-being of nurses in a tertiary Chinese hospital: A cross-sectional study

BACKGROUND

Good general well-being of nurses is associated with reduced burnout and improved patient safety. However, few studies explored the factors of nurses' general well-being.

AIM

The study aimed to assess general well-being and its predictors among hospital nurses.

METHODS

The study recruited 573 nurses working in a tertiary Chinese hospital to complete a survey of sociodemographic characteristics, DiSC^® personality profile, Self-Rating Anxiety Scale and general well-being. Multivariate linear regression was conducted to assess factors affecting nurses' general well-being.

RESULTS

Marital status and clinical rank had a positive impact on general well-being, especially when nurses were married or in the stage of assistant nursing manager. Conversely, source of stress, DiSC^® profile and SAS score had a negative effect on general well-being, especially when nurses' stress came from colleagues, nurses were characterized by steadiness and conscientiousness, and nurses had extreme anxiety.

CONCLUSION

Marital status, clinical rank, source of stress, DiSC^® profile and SAS score were main factors affecting hospital nurses' general well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

By giving careful attention to nurses' family life, career development, personality characteristics and applying appropriate interventions, nursing managers can improve general well-being of nurses and promote patient care.

Psychological nursing approach on anxiety and depression of patients with severe urinary incontinence after radical prostatectomy - a pilot study

Objective

To implement a psychological intervention programme and explore its effects on anxiety and depression in patients with severe urinary incontinence following radical prostatectomy.

Methods

This pilot randomized controlled trial recruited patients that underwent laparoscopic radical prostatectomy. Patients were randomized to conventional nursing and psychoeducation groups. The primary outcome was the levels of anxiety and depression evaluated by the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) at 3 months after urinary catheter removal. The quality of life (secondary outcome) was evaluated using the incontinence-specific quality of life scale (I-QOL).

Results

The study analysed 35 patients: 16 received conventional nursing and 19 received a psychoeducational intervention. There were no significant differences in the sociodemographic data and SAS, SDS and I-QOL scores between the two groups at baseline. At 3 months after catheter removal, the SAS and SDS scores in the psychoeducation group were significantly lower compared with the conventional nursing group; and the I-QOL score in the psychoeducation group was significantly higher compared with the conventional nursing group.

Conclusion

This pilot study suggests that the psychological nursing intervention improved the symptoms of anxiety and depression, and improved quality of life, in patients with severe urinary incontinence following radical prostatectomy.