脑瘫患儿主要照顾者疾病不确定感与社会支持及心理弹性的相关性研究

目的 探讨脑瘫患儿主要照顾者的疾病不确定感现状,及其与社会支持、心理弹性的相关性。 方法 采取方便抽样,选取300例脑瘫患儿的主要照顾者进行疾病不确定感量表、社会支持评定量表和心理弹性量表的调查。 结果 脑瘫患儿主要照顾者的疾病不确定感得分为(71.25±8.38)分,社会支持得分为(28.12±5.56)分,心理弹性得分为(62.98±4.22)分;疾病不确定感总分及信息缺乏维度与社会支持总分及支持利用度维度,与心理弹性总分及乐观性维度均呈负相关(P<0.05)。 结论 脑瘫患儿主要照顾者的疾病不确定感处于中等水平。医护人员在关注脑瘫患儿治疗和护理时,需评估患儿主要照顾者的社会支持状况和心理弹性状况,引导其建立有效的社会支持系统,降低疾病不确定感。     

结直肠癌根治术后患者复发恐惧现状及其影响因素分析

目的 调查结直肠癌根治术后患者复发恐惧现状及其影响因素,为针对性干预措施的制定提供参考。方法 采用一般资料调查表、疾病进展恐惧简化量表、心理弹性简化量表和领悟社会支持量表对胃肠外科就诊的146例结直肠癌根治术后患者进行调查。结果 结直肠癌根治术后患者的复发恐惧得分为(31.05±7.74)分,得分≥34分者占患者总数46.57%;心理弹性与领悟社会支持得分分别为(32.53±6.83)、(58.44±9.41)分。多元线性回归分析显示,性别、年龄、心理弹性和领悟社会支持是结直肠癌根治术后患者复发恐惧的独立影响因素(F=30.482,P<0.001),共解释43.5%的变异量。结论 结直肠癌根治术后患者复发恐惧状况不容乐观,医护人员除需多关注女性、年龄低的患者外,还需注重多角度挖掘结直肠癌根治术后患者的正向积极心理,充分调动患者社会支持系统,以有效改善患者的复发恐惧。     

Predicting self-compassion in UK nursing students: Relationships with resilience,engagement, motivation,and mental wellbeing

Self-compassion, being kind towards oneself, has been identified as a key protective factor of mental health. This is consistent with students’ experiences in the study of nursing, which attracts many students in the United Kingdom. Despite the importance of self-compassion, knowledge in how to enhance self-compassion is under-researched: approaches commonly entail meditative exercises. To suggest alternative approaches, relationships between self-compassion and more established constructs need to be appraised. Accordingly, this study evaluated predictors of self-compassion, examining its relationships with more established constructs examined in other healthcare student populations: resilience, engagement, motivation and mental well-being. An opportunity sample of 182 UK nursing students at a university in East Midlands completed self-report measures about these constructs. Correlation and regression analyses were conducted. Self-compassion was positively related to resilience, engagement, intrinsic motivation and mental well-being, while negatively related to amotivation. Resilience and mental well-being were identified as significant predictors of self-compassion. As resilience and mental well-being are relatively familiar to many nursing lecturers and students, educators can incorporate a self-compassion component into the existing resilience training and/or mental well-being practices.     

抗击新冠肺炎的临床一线医务人员心理韧性与焦虑抑郁现状及相关性研究

目的调查抗击新冠肺炎临床一线医务人员心理韧性与焦虑、抑郁的状况,并了解疫情中临床一线医务人员心理韧性与焦虑、抑郁相关性。方法采用心理韧性量表(CD-RISC)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对抗击新冠肺炎临床一线医务人员进行问卷调查,并用Pearson分析其相关性。结果90名抗击新冠肺炎临床一线医务人员的心理韧性总分为(87.178±16.639)分,坚韧性、自强性、乐观性三个维度得分为(44.022±9.236)分、(29.800±5.773)分和(13.356±3.014)分,在性别、年龄、学历、婚姻状况、工作年限、职称、月收入上无统计学意义(P>0.05);焦虑自评量表得分为(45.333±10.539)分,抑郁自评量表得分为(51.956±11.777)分,未达到焦虑、抑郁水平,但略高于全国常模,但在性别、年龄、学历、婚姻状况、工作年限、职称、月收入上均无统计学意义(P>0.05);Pearson相关分析显示:心理韧性与焦虑、抑郁呈负相关,相关性具有统计学意义(P<0.05)。结论抗击新冠肺炎临床一线医务人员心理韧性与焦虑、抑郁呈负相关,心理韧性水平越高,焦虑、抑郁程度越低。     

Prevalence of post-traumatic stress disorder during the COVID-19 pandemic in Saudi Arabia

BackgroundThe coronavirus diseases of 2019 (COVID-19) pandemic was classified as one of the worst pandemics in the 21st century. Its rapid transmission, unpredicted mortality rate, and the uncertainty surrounding its transmission method have evoked additional fear and anxiety. Nonetheless, to the best of our knowledge, no prior study has explored PTSD prevalence three months after the start of the quarantine procedures in Saudi Arabia nor has examined PTSD prevalence by three different methods.ObjectiveThis observational cross-sectional study aimed to identify the prevalence, severity, and influencing factors of PTSD in different regions of Saudi Arabia three months after the onset of the quarantine procedures related to the COVID-19 pandemic.MethodsThrough the month of June 2020, 1374 people (49.05% men and 50.95% women) completed a 35-item, 10-minute online. The prevalence of PTSD was measured using PCL-S (specific for COVID-19) that assesses the 17 symptoms of PTSD. Resilience was measured using 2-items Arabic version of the Connor-Davidson Resilience Scale 2 (CD-RISC 2).ResultsWe calculated the prevalence by three methods, namely, PTSD cut-off score, criteria, and combined, and the prevalence was 22.63%, 24.8%, and 19.6%, respectively. Female participants showed higher prevalence than male. As well, participants who were either tested positive or suspected of having been infected with COVID-19 showed higher PTSD prevalence. Higher resilience was associated with lower PTSD prevalence.ConclusionsThis was the first study to report PTSD prevalence by three differential methods three months after the onset of the quarantine procedures related to the COVID-19 pandemic in Saudi Arabia. We observed a significant impact of the COVID-19 pandemic in the Saudi population; therefore, great attention should be performed in implementing new procedures that deal with the highlighted risk factors, especially in vulnerable groups, to overcome the psychological impact of the COVID-19 pandemic.     

Maternal positive affect over the course of pregnancy is associated with the length of gestation and reduced risk of preterm delivery

Objective

The association between maternal psychological state during pregnancy and birth outcomes is well established. The focus of previous studies has been on the potentially detrimental consequences of maternal stress on pregnancy and birth outcomes, particularly shortened gestation and increased risk of preterm birth. Despite a growing literature linking positive affect with favorable health outcomes this construct has received little attention in the context of pregnancy. Therefore, in the current study, we tested the hypothesis that maternal positive affect during pregnancy is associated with beneficial consequences in terms of increased length of gestation and reduced risk of preterm birth above that of the absence of stress.

Methods

In 169 pregnant women maternal positive affect and perceived stress were serially assessed at 15.2±0.9 weeks (T1; mean ± SD), 19.7 ± 0.9 weeks (T2) and 30.7 ± 0.7 weeks (T3) gestation. Pregnancy and birth outcomes were abstracted from the medical record.

Results

Higher maternal positive affect and a steeper increase in maternal positive affect over pregnancy were positively associated with length of gestation (p < .05) and reduced risk of preterm delivery (p < .01), whereas maternal perceived stress was not significantly associated with shorter length of gestation (p > .10).

Conclusions

These findings suggest that maternal positive affect may be beneficial for outcomes related to the length gestation, and that this effect cannot be accounted for by the lower stress levels associated with higher positive affect. Interventions to increase maternal positive affect may be beneficial for fetal development.     

Identifying predictors of resilience at inpatient and 3-month post-spinal cord injury

Objectives

To identify (1) changes in psychosocial factors, (2) relationships between psychosocial factors, and (3) significant predictors of resilience in adults with spinal cord injury (SCI) during inpatient rehabilitation and at 3-month post-discharge.

Design

Cross sectional with convenience sample based on inclusion/exclusion criteria.

Setting

Inpatient rehabilitation hospital and community-based follow-up.

Participants

Individuals with a SCI.

Interventions

Not applicable.

Outcome measures

Demographic, resilience, self-efficacy for managing a chronic health issue, depression, social roles/activity limitations, and pain.

Results

The final sample consisted of 44 respondents (16 women and 28 men). Results of repeated measure analyses of variance indicated no significant changes in variables between inpatient and 3-month follow-up. Bivariate correlations revealed associations between resilience and self-efficacy at inpatient (r = 0.54, P < 0.001), and resilience and depression (r = −0.69, P < 0.001) and self-efficacy (r = 0.67, P < 0.001) at 3-month follow-up. Hierarchical regression analyses a significant model predicting resilience at inpatient stay (R = 0.61; adjusted R² = 0.24, P = 0.023), and at 3-month follow-up (R = 0.83; adjusted R² = 0.49, P = 0.022). Self-efficacy was the strongest predictor at inpatient stay (β = 0.46, P  =  0.006) and depression was strongest at 3-month follow-up (β = −0.80, P = 0.007).

Conclusion

Results suggest that although resilience appears to be stable from inpatient to 3-month follow-up, different factors are stronger predictors of resilience across time. Based on current results, an assessment of self-efficacy during inpatient rehabilitation and an identification of depression at 3-month follow-up may be important factors to help identify those at risk of health issues overtime.     

Exposition des enfants à la violence conjugale : troubles mentaux et facteurs de résilience. Étude transversale tunisienne

Conjugal violence is a social problem whose impact extends beyond the couple, to the children who are exposed.ObjectiveTo study the psychological impact of exposure to conjugal violence in children and adolescents in child psychiatry consultation and the factors associated with their capacity for resilience.Patients and methodsWe conducted a cross-sectional study on a sample of 30 children and adolescents, aged between 6 and 18 years and exposed to conjugal violence. Patients were recruited from the child psychiatry unit of the Hospital University of HediChaker of Sfax. We conducted clinical interviews to identify the psychological impact of conjugal violence on children. The resilience evaluation was done by self or hetero passation of the Child and Youth Resilience Measure (CYRM).ResultsChildren and adolescents exposed to conjugal violence suffered from trauma-related disorders and stressors in 40% of cases, mood disorders in 33.3% of cases and externalized disorders in 6.6% of cases. We found that children were more resilient than adolescents in the area of emotional care provided by their parents (12.66 ± 2.02 vs. 9.46 ± 2.69 among adolescents; P = 0.001). In contrast, adolescents were significantly more resilient than children in the area of contextual factors including spirituality (6.46 ± 1.4 vs. 4.53 ± 1.06; P = 0.000), education (11.13 ± 2.13 vs. 8.4 ± 1.54; P = 0.000) and culture (11.13 ± 2.13 vs. 8.4 ± 1.54; P = 0.000). The child's education and good mental health for the mother were associated with better resilience in the children. The child's exposure to conjugal violence by being both a witness and a victim was associated with a reduced capacity for resilience.ConclusionExposure to conjugal violence has a significant impact on the mental health of children exposed. The study of resilience and associated factors could thus be useful in order to limit the deleterious repercussions on children and provide them with harmonious development both on the somatic and psychological levels.     

Distinctive hippocampal and amygdalar cytoarchitectural changes underlie specific patterns of behavioral disruption following stress exposure in an animal model of PTSD

Alterations in cytoarchitecture and molecular signaling have been observed in adaptive and maladaptive responses to stress and presumably underlie the physiological and behavioral changes observed. The relationship between behavioral responses to stress exposure and changes in cytoarchitecture of subregions of the hippocampus and amygdala was investigated in an animal model of PTSD.Behaviors in elevated plus-maze and acoustic startle response tests were assessed in rats 7 days after exposure to predator scent stress. Brains were harvested 24 h later. Neurons from CA1, CA3, and dentate gyrus subregions and basolateral amygdala were reconstructed and subjected to Sholl analysis and spine density estimation. Glucocorticoid receptor, brain-derived neurotrophic factor, phospho-NR1-Ser-889, phospho-GluR1-Ser-845, phospho-calcium/calmodulin dependent protein kinase II-Thy-286, post-synaptic density protein 95 and phospho-CREB-Ser-133 were evaluated in the hippocampus. Data were analyzed by retrospective classification of individual rats into three behavioral response groups.The extent and distribution of changes in the morphology of hippocampal and amygdalar dendrites was significantly associated with stress-induced behavioral response classification. Extreme (PTSD-like) behavioral disruption was associated with extensive neuronal retraction in the hippocampus and proliferation in the amygdala. Neither structure displayed such changes in minimal behavioral responders. Partial behavioral response was associated with identical changes in the hippocampus only. Patterns of change in requisite molecular signaling genes and endophenotypic markers corresponded to the structural and behavioral responses. The extent and distribution of changes in the cytoarchitecture of hippocampal and amygdalar subregions is directly related to the pattern of behavioral response of the individual to stress exposure.