eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study

Association between health literacy and risk of depression: A systematic review and meta-analysis of observational studies

OBJECTIVES

Depression, one of the most prevalent mental disorders, constitutes a pressing threat to global population health. In recent years, an increasing number of observational studies have explored the association between health literacy (HL) and depression risk; however, their results are inconsistent. Furthermore, no study has yet systematically synthesized this association based on findings from observational studies.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

A systematic literature search was performed to identify eligible studies from five databases (PubMed, MEDLINE, EMBASE, PsycINFO, and the Cochrane Library). The overall odds ratios (ORs) with 95 % confidence intervals (CIs) were estimated to evaluate the role of HL in the development and progression of depression using random-effects models. Subgroup analyses were conducted to explore the potential sources of heterogeneity.

RESULTS

Eleven observational studies, including nine cross-sectional and two longitudinal studies, were included in the current review. Meta-analysis revealed that higher levels of HL were associated with lower risk of depression (OR = 0.90, 95 % CI: 0.86-0.94). Subgroup analysis demonstrated that studies of adolescent individuals using the Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ) to quantify HL exhibited stronger associations (OR = 0.43, 95 % CI: 0.34-0.54).

CONCLUSIONS

Our meta-analysis demonstrated a statistically significant negative association between adequate levels of HL and the likelihood of depression, especially among adolescents. More longitudinal studies with rigorous design are needed to further explore the causal relationship and long-term associations.

Individuals' positive gains from the COVID-19 pandemic: a qualitative study across 30 countries

Background

Given the limited understanding of individuals' positive gains, this study aimed to identify these gains that could be leveraged by policymakers to enhance future health and societal resilience.

Methods

We used a global qualitative approach to survey adults over 18 from 30 countries across six World Health Organization (WHO) regions, who detailed up to three personal positive gains from COVID-19 pandemic via an open-ended question. Inductive thematic analysis was employed to identify main themes, and quantitative methods were used for demographic and regional comparisons based on the percentage of responses for each theme.

Results

From 35 911 valid responses provided by 13 853 participants, six main themes (one negative theme), 39 subthemes, and 673 codes were identified. Five positive gain themes emerged, ordered by response frequency: 1) improved health awareness and practices; 2) strengthened social bonds and trust; 3) multi-dimensional personal growth; 4) resilience and preparedness building; 5) accelerated digital transformation. The percentage of responses under these themes consistently appeared in the same order across various demographic groups and economic development levels. However, there were variations in the predominant theme across WHO regions and countries, with either Theme 1, Theme 2, or Theme 3 having the highest percentage of responses. Although our study primarily focused on positive gains, unexpectedly, 12% of responses (4304) revealed 'negative gains', leading to an unforeseen theme: 'Distrust and emerging vulnerabilities.' While this deviates from our main topic, we retained it as it provides valuable insights. Notably, these 'negative gains' had a higher percentage of responses in areas like Burundi (94.1%), Rwanda (31.8%), Canada (26.9%), and in the African Region (37.7%) and low-income (43.9%) countries, as well as among non-binary individuals, those with lower education, and those facing employment challenges.

Conclusions

Globally, the identified diverse positive gains guide the domains in which health policies and practices can transform these transient benefits into enduring improvements for a healthier, more resilient society. However, variations in thematic responses across demographics, countries, and regions highlights need for tailored health strategies.

Family guidance regarding internet mitigates older adults' ehealth literacy inequality due to educational attainment through internet use

OBJECTIVES

To explore whether family guidance regarding Internet (FGI) mitigates the effect of educational attainment on older adults' eHealth literacy through different Internet uses and identify which types of FGI improve eHealth literacy among low-educated older adults effectively.

METHODS

A total of 490 Chinese adults aged 60 and above completed the eHealth Literacy Scale, an Internet use checklist, and self-reported their educational attainment and FGI frequency.

RESULTS

With adequate FGI, educational attainment was not related to informational Internet use, recreational Internet use, and eHealth literacy. Instrumental, informational, and recreational FGI predicted low-educated older adults' Internet uses and eHealth literacy positively.

CONCLUSIONS

FGI mitigates older adults' eHealth literacy inequality due to educational attainment and indirectly narrows this gap through the mediations of informational and recreational Internet use. Informational, instrumental, and recreational FGI play key roles in improving eHealth literacy among low-educated older adults.

Development and feasibility of an mHealth intervention for psychoeducational support of Nigerian women diagnosed with breast cancer undergoing chemotherapy: A pilot randomized controlled trial

BACKGROUND

Breast cancer (BC) remains a significant health burden globally, with high incidence and mortality rates, particularly in Nigeria. Chemotherapy, a common treatment modality for BC, often leads to various physical and psychological side effects, impacting patients' quality of life. Despite the growing use of mobile health (mHealth) interventions to provide psychoeducational support, there is a paucity of evidence regarding their feasibility and acceptability among Nigerian women with BC.

OBJECTIVE

To develop and investigate the feasibility and acceptability of a mHealth psychoeducational intervention (mPEI) named the ChEmo Nurse Breast cancer Application (CENBA) programme.

METHODS

A multi-centre, assessor-blinded, parallel-group pilot randomised controlled trial (RCT) was conducted at Lagos State University Teaching Hospital (LASUTH) and Lagos University Teaching Hospital (LUTH). Thirty women newly diagnosed with BC and undergoing chemotherapy were randomly assigned to an intervention or a control group. The intervention group received the CENBA programme, which included BC education, coping skills training, a discussion forum, and nurse-led consultations, delivered via a mobile application and phone calls over six weeks. The control group received standard care. Feasibility was assessed through consent, attrition, and completion rates, while acceptability was explored via qualitative interviews.

RESULTS

The completion rate was 93.3%. Qualitative data indicated that participants found the intervention beneficial, particularly appreciating the educational content and the emotional support provided through the discussion forum and nurse consultations.

CONCLUSION

The CENBA programme was perceived as a feasible and acceptable mHealth intervention for providing psychoeducational support to Nigerian women with BC undergoing chemotherapy. These findings suggest that the CENBA programme could be a valuable tool in addressing the psychoeducational needs of this population, warranting further investigation in a full-scale RCT.

TRIAL REGISTRATION

This manuscript reports a feasibility study preceding the full trial, which was registered with the United States Clinical Trials registry (number NCT05489354).

The impact of exercise self-efficacy on college students' emotion management ability: an analysis of the mediating effects based on exercise behavior and screen media use

Objective

To explore the impact of exercise self-efficacy on college students' emotion management ability and to analyze the mediating effects of exercise behavior and screen media use between exercise self-efficacy and emotion management ability.

Methods

This study adopted stratified, whole-cluster, and staged sampling methods, using an online questionnaire that included demographic information, exercise self-efficacy, exercise behavior, screen media use, and other relevant aspects, obtaining a total of 12,687 valid questionnaires.

Results

The study indicated a significant positive correlation between exercise self-efficacy and emotion management ability (r = 0.349, p < 0.01). There was also a positive correlation between physical exercise and emotion management ability (r = 0.128, p < 0.01). In contrast, smartphone use showed a significant negative correlation with emotion management ability (r = -0.102, p < 0.01). Additionally, exercise persistence and electronic health literacy presented significant positive correlations with emotion management ability (r = 0.370, p < 0.01; r = 0.502, p < 0.01). Chain-mediated effect analysis revealed that exercise self-efficacy positively affected emotion management ability by enhancing physical exercise and reducing smartphone use (95% CI: [0.001, 0.002]). Furthermore, exercise self-efficacy positively influenced emotion management ability by enhancing exercise persistence and e-health literacy (95% CI: [0.029, 0.042]). These two variables acted as chain mediators, demonstrating the pathways through which exercise self-efficacy affects emotion management ability.

Conclusion

This study deepened the understanding of the interplay between exercise behavior, screen media use, and emotion management ability. It suggested that emotion management ability could be enhanced through strategies of improving exercise persistence, physical exercise, electronic health literacy, and reducing smartphone use while considering differences in gender, academic year, and regional factors in intervention programs.

Effectiveness of a family violence prevention program on mental health outcomes for adult men and women in North Kivu, Democratic Republic of Congo: Insights from a pilot trial

The eastern Democratic Republic of Congo (DRC) has faced dual burdens of poor mental health and heightened levels of violence against women and children within the home. Interventions addressing family violence prevention may offer a path to mitigate mental distress within the eastern DRC. This exploratory analysis uses data from a pilot cluster randomized controlled trial conducted in North Kivu, DRC, assessing the impact of Safe at Home, a violence prevention intervention. Mental health was assessed at endline using the Patient Health Questionnaire-4. Statistical analyses employed multilevel linear regression. Assuming successful randomization, impact of the Safe at Home intervention on mental health differed by participant gender. Women enrolled in the Safe at Home intervention reported statistically significant decreases in mental distress symptoms [β (95%CI) = -1.01 (-1.85, -0.17)], whereas men enrolled in Safe at Home had similar scores in mental distress to the control group [β (95%CI) = -0.12 (-1.32, 1.06)]. Ultimately, this exploratory analysis provides evidence of the potential for a family violence prevention model to improve women's mental health in a low-resource, conflict-affected setting, although further research is needed to understand the impact on men's mental health.

Needs and experiences of postgraduate nursing students in Nigeria during the COVID-19 pandemic

AIM

To explore the experiences and needs of postgraduate nursing students within the Nigerian context.

DESIGN

This qualitative study was conducted using a descriptive phenomenological approach.

METHOD

Data were collected between February and April 2022 using a purposive sampling method and telephone semi-structured interviews. Colaizzi's method of Qualitative data Analysis was utilized. Twenty-two Nigerian postgraduate nursing students were interviewed.

RESULTS

Three themes emerged: challenges of Nigerian postgraduate students before the pandemic, the impact of the pandemic on postgraduate education, and innovations to improve postgraduate education in Nigeria. The challenges include the burden of physical lectures, lack of infrastructure, and poor mentorship of postgraduate nursing students. The impact of the pandemic on postgraduate education includes abrupt disruption of the academic program, a prolonged academic calendar, and a communication gap between students and their research supervisors. Innovations to improve postgraduate nursing education in Nigeria also include adoption and sustainability of e-learning, upgrading post-basic to postgraduate nursing programmes, proper structuring of postgraduate nursing education, commencement of postgraduate nursing programmes in more universities and provision of financial aid for students. Our primary finding is that funding, mentorship and infrastructure were issues peculiar to all the respondents.

CONCLUSION

This study concludes that efforts should be made to maintain a seamless educational program by ensuring an uninterrupted flow of learning through virtual means, thereby enhancing effective teaching and learning.

IMPLICATIONS

Graduate nursing studies is one of the suggested solutions in the WHO strategic direction for nursing and midwifery globally to achieve Universal Health Coverage . The reason is that nurses can practice with more and better skills in any work setting, thus improving the quality of health care services. Our study provides insights into the experiences of postgraduate students and how these could discourage other nurses who might have thought about furthering their studies. Efforts should be made to provide all the support that these students need, using evidence from this study and similar studies to ensure they have a good learning experience and others can be motivated to learn at the graduate level as well. This will increase the proportion of nurses and midwives honed with better skills to provide more standard quality services that will improve patient care outcomes.

Awareness and practice of breast self-examination among female staff at Babcock University, Nigeria

Background

Despite the ever-growing breast cancer awareness campaigns in Nigeria, the practice of breast self-examination (BSE) continues to vary widely among women. We aimed to assess breast cancer awareness and practice of BSE among female staff at Babcock University, Ogun State, Nigeria.

Methods

The cross-sectional descriptive design was adopted for this study. Data were collected using a structured questionnaire administered to 160 respondents. Data analysis was done using Statistical Package for Social Sciences version 23.

Results

Although the majority of the respondents were highly aware of breast cancer (78.12%) and had good knowledge about BSE (96.9%), their practice of BSE was low. Only 11.3% always examine their breasts in the mirror by raising their hands over their head, looking at their breasts and examining it in a circular motion; 56% rarely looked for puckering, colour changes and dimpling of the skin when examining their breasts in the mirror, although 53.8% sometimes squeezed their nipples and looked for discharge when they examined their breasts.

Conclusion

Knowledge and positive opinions toward preventive strategies for breast cancer should not be interpreted as readiness for practice. Educational intervention programs emphasising the importance of early detection in managing breast cancer should be reinforced to birth the desirable change.

'Research is the last thing on our minds, we are in crisis': Experiences of Lagos state nurses towards research and scholarly endeavours

AIM

To explore the experiences of Nigerian nurses in research and scholarly endeavours.

DESIGN

Descriptive phenomenological qualitative study design.

METHOD

In-depth interviews were conducted among 30 nurses until data saturation was reached. Data were analysed using the thematic analysis method, and consolidated criteria for reporting qualitative research guidelines (COREQ) were adhered to in reporting this study.

RESULTS

Three themes emerged: (1) challenges of nurses with research; (2) the state of nursing research in Lagos state; (3) strategies to improve the state of nursing research in Lagos state. Some challenges nurses in Lagos State encounter with research include heavy workload and nursing shortage due to brain drain, faulty research foundation, lack of continuing education in research and the stressful nature of conducting research in Lagos.

CONCLUSION

As research is essential in addressing healthcare challenges, policymakers are encouraged to employ more nurses to reduce the workload and provide time for research activities. Training and continuing education in research can be incorporated into professional development programmes. Lagos State will benefit from nursing research units in the hospitals, and a coordinating centre for the units should be provided with adequate funding. Support could be obtained from the Institute of Nursing Research Nigeria in establishing these structures. Hospital management should embrace and welcome research output from nurses and ensure such results are implemented to improve patients' care. Nurses who excel in research might be recognised with awards and other incentives to inspire their peers.