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JMIR Research Protocols Jun 2024Depression poses a major threat to public health with an increasing prevalence in the United States. Mindfulness-based interventions, such as mindfulness-based cognitive...
BACKGROUND
Depression poses a major threat to public health with an increasing prevalence in the United States. Mindfulness-based interventions, such as mindfulness-based cognitive therapy (MBCT), are effective methods for managing depression symptoms and may help fortify existing efforts to address the current disease burden. The in-person group format of MBCT, however, incurs barriers to care such as expenses, childcare needs, and transportation issues. Alternate delivery modalities such as MBCT delivered via the web can be investigated for their capacity to overcome these barriers and still reduce symptoms of depression with adequate feasibility and efficacy.
OBJECTIVE
This study protocol aims to examine the feasibility and efficacy of MBCT delivered via the web for the treatment of depression.
METHODS
To attain study aims, 2 phases will be implemented using a waitlist control design. A total of 128 eligible participants will be randomized into either an 8-week MBCT intervention group plus treatment as usual (MBCT + TAU; group 1) or an 8-week waitlist control group (group 2). In phase I (8 weeks), group 1 will complete the intervention and group 2 will proceed with TAU. In phase II (8 weeks), group 2 will complete the intervention and group 1 will continue with TAU until reaching an 8-week follow-up. TAU may consist of receiving psychotherapy, pharmacotherapy, or combined treatment. Data collection will be completed at baseline, 8 weeks (postintervention for group 1 and preintervention for group 2), and 16 weeks (follow-up for group 1, postintervention for group 2). The primary outcomes will include (1) current, residual, or chronic depression symptoms and (2) psychiatric distress. Secondary outcomes will include perceived stress and facets of mindfulness. The feasibility will be measured by assessing protocol adherence, retention, attendance, and engagement. Finally, the extent of mindfulness self-practice and executive functioning skills will be assessed as mediators of intervention outcomes.
RESULTS
This study began screening and recruitment in December 2022. Data collection from the first cohort occurred in January 2023. By November 2023, a total of 30 participants were enrolled out of 224 who received screening. Data analysis began in February 2024, with an approximate publication of results by August 2024. Institutional review board approval took place on September 11, 2019.
CONCLUSIONS
This trial will contribute to examining mindfulness-based interventions, delivered via the web, for improving current, residual, or chronic depression symptoms. It will (1) address the feasibility of MBCT delivered via the web; (2) contribute evidence regarding MBCT's efficacy in reducing depression symptoms and psychiatric distress; and (3) assess the impact of MBCT on several important secondary outcomes. Findings from this study will develop the understanding of the causal pathways between MBCT delivered via the web and depression symptoms further, elucidating the potential for future larger-scale designs.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05347719; https://www.clinicaltrials.gov/ct2/show/NCT05347719.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/53966.
Topics: Adult; Female; Humans; Male; Middle Aged; Cognitive Behavioral Therapy; Depression; Internet; Internet-Based Intervention; Mindfulness; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38888958
DOI: 10.2196/53966 -
BMC Infectious Diseases Jun 2024As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in... (Observational Study)
Observational Study
Compliance of healthcare workers in a psychiatric inpatient ward to infection control practices during the COVID-19 pandemic: a participant observation study supplemented with a self-reported survey.
BACKGROUND
As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic.
METHODS
A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison.
RESULTS
A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%.
CONCLUSION
The compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary.
Topics: Humans; COVID-19; Cross-Sectional Studies; Infection Control; Health Personnel; Guideline Adherence; Self Report; Surveys and Questionnaires; Male; SARS-CoV-2; Female; Cross Infection; Hand Hygiene; Adult; Middle Aged; Psychiatric Department, Hospital; Personal Protective Equipment
PubMed: 38886634
DOI: 10.1186/s12879-024-09429-3 -
BMC Public Health Jun 2024Sleep disturbance is the most common concern of patients with schizophrenia and can lead to a poor prognosis, a low survival rate and aggressive behaviour, posing a...
OBJECTIVE
Sleep disturbance is the most common concern of patients with schizophrenia and can lead to a poor prognosis, a low survival rate and aggressive behaviour, posing a significant threat to social security and stability. The aim of this study was to explore the mediating role of depression in the relationship between sleep disturbance and aggressive behaviour in people with schizophrenia living in the community, as well as the regulatory role of family intimacy and adaptability. These findings, in turn, may provide a theoretical basis and constructive suggestions for addressing the physical and mental health problems of these patients.
METHOD
From September 2020 to August 2021, a convenience sampling method was used to select schizophrenia patients from the community attending follow-up appointments at the Fourth People's Hospital of Pengzhou City, China. The researchers conducted a survey in the form of a star questionnaire. The survey included questions about general demographic data and disease-related questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the revised Chinese version of the Modified Over Aggression Scale (MOAS), the Self-Rating Depression Scale (SDS), and the Family Adaptability and Cohesion Scale, Second Edition. FACES-II and SPSS 21.0 were used to organize and analyse the data.
RESULTS
A total of 818 schizophrenia patients living in the community participated in the survey, and 785 valid questionnaires were ultimately collected, for a response rate of 95.97%. The results of multivariate analysis indicated that sex, number of psychiatric medications used, outpatient follow-up, history of hospitalization for mental disorders and sleep disturbances were factors influencing aggressive behaviour. Depression played a partial mediating role between sleep disturbance and aggressive behaviour, and the indirect effect size was 0.043 (57.33% of the total). In addition to sleep disturbance, family intimacy (β=-0.009, P < 0.01) and adaptability (β=-0.145, P < 0.001) can significantly predict depression.
CONCLUSION
The findings indicate that sleep disturbance in schizophrenia patients in the community is a risk factor for aggressive behaviour, and depression plays a partial mediating role in the relationship among sleep disturbance, aggressive behaviour and family intimacy. In addition, adaptability plays a regulatory role in the relationship between depression and sleep disturbance.
Topics: Humans; Female; Male; Aggression; Schizophrenia; Sleep Wake Disorders; Adult; China; Middle Aged; Independent Living; Surveys and Questionnaires; Depression; Young Adult; Schizophrenic Psychology
PubMed: 38879495
DOI: 10.1186/s12889-024-19090-9 -
BMC Psychiatry Jun 2024The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of brief family psychoeducation on family caregiver burden of people with schizophrenia provided by psychiatric visiting nurses: a cluster randomised controlled trial.
BACKGROUND
The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of family caregivers of people with schizophrenia through a cluster randomised controlled trial (cRCT).
METHODS
The study was a two-arm, parallel-group cRCT. Forty-seven psychiatric visiting nurse agencies were randomly allocated to the BFP programme group (intervention group) or treatment as usual group (TAU; control group). Caregivers of people with schizophrenia were recruited by psychiatric visiting nurses using a randomly ordered list. The primary outcome was caregiver burden, measured using the Japanese version of the Zarit Burden Interview. Outcome assessments were conducted at baseline, 1-month follow-up, and 6-month follow-up. Intention-to-treat analysis was conducted to examine the effects of the BFP programme on caregiver burden.
RESULTS
Thirty-four psychiatric visiting nurse agencies and 83 family caregivers of people with schizophrenia participated in the study. The participant attrition rate was less than 20%. Adherence to the program was 100%. Compared with TAU group, the BFP programme group had decreased caregiver burden. However, this improvement was not significant at 1-month follow-up (adjusted mean difference [aMD] = 0.27, 95% CI = - 5.48 to 6.03, p = 0.93, d = 0.01) or 6-month follow-up (aMD = - 2.12, 95% CI = - 7.80 to 3.56, p = 0.45, d = 0.11).
CONCLUSIONS
The BFP programme provided by psychiatric visiting nurses did not achieve significant decreases in caregiver burden. This result may be attributed to the difficulty in continuing the research due to the COVID-19 pandemic, which prevented us from achieving the targeted sample size necessary to meet the statistical power requirements, as well as to the participation of caregivers with relatively low burden. However, the program had the advantage of high adherence to treatment plan. Further studies should be conducted with a larger sample size and a more diverse sample that includes caregivers with a higher care burden.
TRIAL REGISTRATION
The study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000038044) on 2019/09/18.
Topics: Humans; Schizophrenia; Female; Male; Caregivers; Middle Aged; Adult; Caregiver Burden; Nurses, Community Health; Psychiatric Nursing
PubMed: 38877468
DOI: 10.1186/s12888-024-05884-z -
BMC Psychiatry Jun 2024The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However,...
BACKGROUND
The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However, there is still a lack of targeted tools for screening PSD in the rehabilitation stage. Therefore, the aim of this study was to evaluate the factor structure and reliability of a measurement instrument to screen for PSD in the rehabilitation stage.
METHODS
A cross-sectional study was conducted on 780 hospitalized stroke patients who were within the rehabilitation stage from May to August 2020. Exploratory factor analysis (EFA) as well as first- and second-order confirmatory factor analysis (CFA) were performed to evaluate the factor structure of the newly developed Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS). The reliability and validity of the SMPSD-RS were also verified using several statistical methods.
RESULTS
EFA extracted a 24-item, five-factor (cognition, sleep, behavior, emotion, and obsession) model that can clinically explain the symptoms of PSD during the rehabilitation stage. A first-order CFA confirmed the EFA model with good model fit indices, and the second-order CFA further confirmed the five-factor structure model and showed acceptable model fit indices. Acceptable reliability and validity were also achieved by the corresponding indicators.
CONCLUSION
The SMPSD-RS was proven to have a stable factor structure and was confirmed to be reliable and valid for assessing PSD symptoms in stroke patients during the rehabilitation stage.
Topics: Humans; Male; Female; Reproducibility of Results; Middle Aged; Cross-Sectional Studies; Stroke; Aged; Stroke Rehabilitation; Factor Analysis, Statistical; Depression; Psychiatric Status Rating Scales; Psychometrics; Adult
PubMed: 38877421
DOI: 10.1186/s12888-024-05906-w -
Medicine Jun 2024To explore the effect of dance art on the treatment of hospitalized patients with chronic schizophrenia. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
To explore the effect of dance art on the treatment of hospitalized patients with chronic schizophrenia.
METHODS
In a prospective randomized controlled study conducted from June 2019 to June 2020, 120 patients from Shanghai Pudong New Area Mental Health Center were divided into intervention (n = 60) and control (n = 60) groups using a random number table. Control patients received standard drug treatment and nursing care, while the intervention group underwent dance art therapy sessions for 90 minutes twice weekly, in addition to standard care. Treatment outcomes after 6 and 12 weeks were measured using the positive and negative symptom scale (PANSS), Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MoCA), and body mass index (BMI).
RESULTS
This study involved 120 male patients with chronic schizophrenia, aged 30 to 60 years. After 6 and 12 weeks, the intervention group showed a greater reduction in PANSS scores (intervention group: from 49.02 ± 2.53 to 37.02 ± 1.83, control group: from 49.08 ± 2.59 to 44.91 ± 2.35, P < .05). In the WCST, the intervention group exhibited a higher increase in classification completion and correct answers, and a greater decrease in errors (P < .05). MoCA scores improved significantly in the intervention group compared to the control group (P < .05). BMI decreased in both groups, with a more pronounced reduction in the intervention group (intervention group: from 26.47 ± 1.05 kg/m² to 22.87 ± 0.73 kg/m², control group: from 26.50 ± 1.03 kg/m² to 26.22 ± 0.80 kg/m², P < .05).
CONCLUSION
Based on routine drug treatment and routine nursing care, dance art has a better clinical effect in treating hospitalized patients with chronic schizophrenia, which can improve cognitive function, alleviate clinical symptoms, and reduce BMI.
Topics: Humans; Schizophrenia; Male; Adult; Middle Aged; Prospective Studies; Dance Therapy; Chronic Disease; Treatment Outcome; Hospitalization; China; Body Mass Index; Psychiatric Status Rating Scales
PubMed: 38875423
DOI: 10.1097/MD.0000000000037393 -
PCN Reports : Psychiatry and Clinical... Mar 2024The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health-related stigma, mental...
AIM
The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health-related stigma, mental health literacy, and knowledge about mental health difficulties and support techniques among program participants.
METHODS
The target population was local residents of a wide range of generations in Japan. Outcomes were assessed at baseline (T1), immediately postintervention (T2), and at the 6-month follow-up (T3). A mixed model for repeated-measures conditional growth model analyses were employed to examine the effects of the intervention over time (T1, T2, T3). We also calculated effect sizes using Cohen's .
RESULTS
The program had a significantly favorable pooled effect on the Japanese version of the Reported and Intended Behaviour Scale score after adjusting for covariates (reported behavior [ = 3.20, = 0.001]; intended behavior [ = 8.04, < 0.001]). However, when compared at each time point, only intended behavior from T1 to T2 showed a significant difference ( = 8.37, < 0.001). Significant pooled effects were found for mental health literacy (knowledge: = 19.85, < 0.001; attitude: = 15.02, < 0.001), knowledge of mental health ( = 28.04, < 0.001), and psychological distress ( = -2.41, = 0.016).
CONCLUSION
The results suggest that the program might be effective for improving intended, but not reported, behavior in the short term and for improving mental health literacy, knowledge of mental health, and psychological distress.
PubMed: 38868483
DOI: 10.1002/pcn5.176 -
PCN Reports : Psychiatry and Clinical... Sep 2023Clinicians face difficulties in making treatment decisions for unspecified anxiety disorder due to the absence of any treatment guidelines. The objective of this study...
AIM
Clinicians face difficulties in making treatment decisions for unspecified anxiety disorder due to the absence of any treatment guidelines. The objective of this study was to investigate how familiar and how often primary care physicians use pharmacological and nonpharmacological approaches to manage the disorder.
METHODS
A survey was conducted among 117 primary care physicians in Japan who were asked to assess the familiarity of using each treatment option for unspecified anxiety disorder on a binary response scale (0 = "unfamiliar," 1 = "familiar") and the frequency on a nine-point Likert scale (1 = "never used," 9 = "frequently used").
RESULTS
While several benzodiazepine anxiolytics were familiar to primary care physicians, the frequencies of prescribing them, including alprazolam (4.6 ± 2.6), ethyl loflazepate (3.6 ± 2.4), and clotiazepam (3.5 ± 2.3), were low. In contrast, certain nonpharmacological options, including lifestyle changes (5.4 ± 2.3), coping strategies (5.1 ± 2.7), and psychoeducation for anxiety (5.1 ± 2.7), were more commonly utilized, but to a modest extent. When a benzodiazepine anxiolytic drug failed to be effective, primary care physicians selected the following management strategies to a relatively high degree: differential diagnosis (6.4 ± 2.4), referral to a specialist hospital (5.9 ± 2.5), lifestyle changes (5.2 ± 2.5), and switching to selective serotonin reuptake inhibitor (5.1 ± 2.4).
CONCLUSION
Primary care physicians exercise caution when prescribing benzodiazepine anxiolytics for unspecified anxiety disorder. Nonpharmacological interventions and switching to SSRI are modestly employed as primary treatment options and alternatives to benzodiazepine anxiolytics. To ensure the safe and effective treatment of unspecified anxiety disorder in primary care, more information should be provided from field experts.
PubMed: 38867823
DOI: 10.1002/pcn5.118 -
PCN Reports : Psychiatry and Clinical... Sep 2023This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors.
INTRODUCTION
This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors.
METHODS
A total of 242 women, 2-12 weeks postpartum, were randomly recruited for this cross-sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD.
RESULTS
The study showed that 34.7% of the postpartum mothers were within the age range of 25-29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9-56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66-49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23-11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6-8 weeks postpartum (aOR = 7.72, 95% CI 1.71-34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23-8.89, P = 0.018).
CONCLUSION
The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.
PubMed: 38867815
DOI: 10.1002/pcn5.143 -
BMC Women's Health Jun 2024Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and...
BACKGROUND
Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration.
METHODS
A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas.
RESULTS
The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma.
CONCLUSION
Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations.
Topics: Humans; Female; Sweden; Thailand; Emigrants and Immigrants; Marriage; Adult; Middle Aged; Qualitative Research; Spouses; Health Status; Stress, Psychological; Southeast Asian People
PubMed: 38867221
DOI: 10.1186/s12905-024-03071-6