A national study of the mental health literacy of community pharmacists

BackgroundCommunity pharmacists are in a prime position to communicate with and assist those with mental health needs. However, mental health literacy, which includes beliefs and knowledge of mental health conditions, can impact the provision of pharmacy services. The mental health literacy of community pharmacists in New Zealand is currently unknown.ObjectivesTo assess the mental health literacy of community pharmacists in New Zealand.MethodsWe employed a national cross-sectional online survey, evaluating attitudes towards mental illness, ability to recognise depression using a vignette and followed by questions related to the helpfulness of various interventions, and willingness to provide pharmacy services for people with mental illness in comparison to cardiovascular diseases. Additionally, opportunities for mental health training were explored. Participants were community pharmacists working in New Zealand contacted via mailing lists of professional bodies.ResultsWe received responses from 346 participants. The majority of participants showed positive attitudes towards mental illness and correctly identified depression in the vignette (87%). Participants rated counsellors (84%) and physical activity (92%) as the most helpful professionals and intervention respectively while only 43% considered antidepressants as helpful for depression. When compared to other people in the community, long-term functioning of the individual described in the vignette was rated poorly, especially in terms of increased likelihood to attempt suicide (85%) and reduced likelihood to be a productive worker (64%). Approximately 30% of participants reported reduced confidence/comfort while approximately half of participants reported greater interest in providing mental health-related care compared to cardiovascular disease. The participants also highlighted several areas for future mental health training they wished to undertake.ConclusionsWe have identified positive attitudes towards mental illness in our study. Participants correctly identified and supported evidence-based interventions for mild to moderate depression. However, we highlighted the need for ongoing mental health training to address knowledge gaps and enhance the confidence in providing mental health-related care.     

‘You need to know in order to help’: how HIV-related stigma obstructs pastoral care in Kenyan primary schools

ABSTRACT

In low-resource and high HIV prevalence settings, schools are increasingly called upon as sites of care and support for vulnerable children. It is therefore crucial to understand the processes through which teachers take on pastoral care roles in response to the needs of vulnerable learners. As pastoral care is often contingent on teacher’s being aware of learner’s vulnerabilities and needs, we examine information-sharing between learners, their parents, and teachers. We draw on eight individual interviews conducted with teachers from three rural primary schools located in high HIV prevalence settings of the Siaya district of Western Kenya. The interviews were recorded, transcribed, and analysed using thematic network analysis. Our analysis revealed that HIV-related stigma made it difficult for vulnerable learners to disclose their vulnerabilities to teachers, fearing the repercussions of what might happen if other members of the school community would become aware of their association with HIV. When teachers sought out parents for more information, they were often met with denial of their vulnerabilities. This paper provides valuable insights into some of the difficulties primary school teachers face in ascertaining the pastoral care needs of vulnerable learners. It highlights that HIV-related stigma is a critical barrier for teachers to adopt a pastoral care role in high HIV prevalence communities of western Kenya.     

中学生专业心理帮助有效性、归因方式与心理污名关系

目的:了解中学生的心理健康素养状况,并研究心理健康素养各构成间的关系。方法:采用分层抽样抽取382名初高中生,采用一般资料调查表、知识测量、污名化量表、心理疾病病因观问卷和专业心理健康服务有效性问卷为工具。结果:1对短文主人公主要问题的识别在人口学上差异没有统计学意义;2污名化与归因(r=0.353,P0.01)和有效性(r=-0.140,P0.01)上也存在显著相关;3回归分析显示内因(U=0.051,P0.01)、外因(U=0.048,P0.01)和有效性(U=0.050,P0.01)对污名化有预测作用。结论:中学生的心理健康素养水平有待提高;各构成之间不是孤立的存在,尤其是污名化会导致中学生对专业心理帮助的有效性产生怀疑。     

Effects of weight stigma in news media on physical activity,dietary and weight loss intentions and behaviour

ObjectivesTo investigate the effect of weight stigma in news media on (a) intentions to increase physical activity (PA), improve diet quality and lose weight, and (b) changes in PA, diet quality and body mass index (BMI) over one month, in (i) women of all weight categories and (ii) a subsample of women living with obesity.MethodsUK-based women (N = 172; subgroup with obesity N = 81) were assigned to read an experimental (weight stigma; N = 75) or control (smoking stigma; N = 97) news article. Questionnaires were administered immediately after, and one month subsequently to collect information on BMI, PA, diet quality, intentions, past stigma, and diet and PA self-efficacy. Logistic and linear regression analyses were used to assess the effect of weight stigma on all outcome variables.ResultsIn the whole sample, there was no significant effect of weight stigma on any primary or secondary outcome. In women with obesity, there was no significant effect of weight stigma on diet quality (0.26 units, 95% CI: ?0.36 to 0.87) or PA (?1.83 units, 95% CI: ?11.11 to 7.44) at follow up, but exposure to weight stigma was associated with a significant increase in BMI at 1-month follow-up (1.15 kg/m², 95% CI: 0.38 to 1.92) compared with the control group.ConclusionsIn people with obesity, exposure to weight-stigmatising media may contribute to increased BMI over time. Larger trials with longer follow-up are needed to confirm these findings.     

2型糖尿病患者病耻感调查及其影响因素分析

目的探讨2型糖尿病患者病耻感现状,并分析病耻感的影响因素。方法2018年8月—2020年3月期间,采用便利抽样法,对该院就诊的135例2型糖尿病患者进行问卷调查。调查工具为一般情况调查表、2型糖尿病病耻感评估表。对病耻感的影响因素进行单因素分析和多因素分析。结果所有患者平均病耻感得分为(54.22±10.65)分。不同年龄、文化水平、是否接受胰岛素治疗、是否合并并发症等4个因素的单因素亚组分析显示,组间病耻感得分差异有统计学意义(P<0.05);采用逐步多元线性回归分析显示,只有年龄、是否合并并发症、文化水平是影响病耻感的独立因素。结论该次调查显示2型糖尿病患者普遍存在病耻感,年龄低、具有糖尿病并发症和文化水平较高的患者具有更明显的病耻感,应引起医务人员的重视,并及时给予治疗干预。     

西红花提取物对大鼠血小板聚集、软脑膜血流量和离体兔主动脉条的作用

经实验证明西红花提取物ＸＨＨ－１的小鼠灌胃ＬＤ５０大于１０ｇ／ｋｇ，毒性很小。ＸＨＨ－１的五个浓度（０．５、１、２、３、４ｍｇ／ｍｌＰＲＰ）均能显著地对抗由ＡＤＰ引起的大鼠体外血小板聚集，并缩短血小板最大聚集时间。ＸＨＨ－１浓度为４、８、１２ｍｇ／ｍｌ时，对ＫＣｌ引起的离体兔主动脉血管平滑肌的抑制作用与对照组相比都有非常显著的统计学意义。大鼠静注１０ｍｇ／ｋｇＸＨＨ－１后１０ｍｉｎ，软脑膜血流量增加５４％，２０ｍｉｎ时仍维持在相近水平，灌胃给药２５０ｍｇ／ｋｇ后３０ｍｉｎ。软脑膜血流量同给药前相比增加了３９％，至６０ｍｉｎ仍维持这一水平，均有显著统计学差异。     

Napiętnowanie społeczne w chorobach przewlekłych

Regardless of diagnosis, chronic disease usually stigmatizes any patient. Social stigmatizing is one of the major risk factors for the quality of an individual's psychosocial functioning. Because of label of disease, patient is often ostracized. Social rejection equals a decline in mood and self-esteem. It also threatens emotional, social and intellectual growth of patients, particularly in developmental age. Limitation of peer contacts and lack of self-esteem may contribute to a loss of motivation. Such a condition often leads to discontinuation of medical recommendations. The stigma of the disease exerts a strong influence on the whole family system. Both patient's parents and siblings struggle with burden, whose negative consequences are reflected in family's and social's relationships as well as daily functioning. This paper discusses the definition, mechanism of the phenomenon, and consequences of social stigma, as well as presents literature review relating to stigmatization in the context of selected chronic diseases and family burden.     

病耻感与首发卒中患者卒中后抑郁的相关性研究

背景　心理-社会因素是卒中后抑郁（PSD）重要的发病机制之一,病耻感给患者带来的认知、情绪和行为的改变可能与PSD的发生密切相关,却很少被重视。目的　探讨病耻感与首发卒中患者PSD的相关性。方法　采用横断面调查研究设计和便利抽样的方法,选取2019年7-12月就诊于南方医科大学南方医院、广东三九脑科医院神经内科和神经外科的首发卒中患者299例。记录患者人口学资料和卒中病史资料。使用卒中病耻感量表（SSS）、9条目患者健康量表（PHQ-9）、改良Rankin量表（mRS）评估患者卒中后1个月时病耻感、抑郁和神经功能恢复情况。结果　共纳入299例首发卒中患者,完整随访221例,脱落78例。根据PHQ-9评分分组,PSD组65例（29.4%,PHQ-9评分≥5分）,非PSD组156例（70.6%,PHQ-9评分为0~4分）。PSD组SSS总分及躯体障碍、社会交往、受歧视经历、自我感受、PHQ-9、mRS评分均高于非PSD组（P<0.05）。相关性分析结果显示,PHQ-9评分与SSS总分及躯体障碍、社会交往、受歧视经历、自我感受、mRS评分呈正相关（rs=0.606、0.319、0.441、0.369、0.616、0.389,P<0.05）。多因素Logistic回归分析结果显示,SSS总分是首发卒中患者发生PSD的影响因素〔OR=1.263,95%CI（1.158,1.379）,P<0.05〕。结论　首发卒中患者早期的病耻感对PSD具有一定的预测价值,医护人员和患者家属应采取相应措施,警惕PSD的发生。     

脑卒中患者社会疏离及影响因素研究

目的 探讨脑卒中患者社会疏离现状及影响因素,为干预性研究提供依据。方法 应用一般情况调查表、Lubben社会网络量表、孤独感量表、脑卒中病耻感量表、自我感受负担量表,于2022年9月采用整群随机取样对河南省脑卒中患者进行调查。应用t检验、单因素方差分析、多元逐步线性回归进行分析。结果 共纳入患者1 028名,其中27.7%患者存在客观社会疏离,10.6%患者存在家庭隔离,8.9%患者存在朋友隔离,41.0%存在高风险社会隔离,27.8%患者存在主观社会疏离。客观社会疏离总分为（15.61±5.37）分,主观社会疏离总分为（41.65±9.08）分,处于中等水平。自我感受负担、病耻感与主观社会疏离呈正相关。多元逐步分析结果显示,自我感受负担、病耻感、文化程度、脑卒中发作次数、TOAST分型是其主要影响因素（P<0.05）。结论 脑卒中患者客观社会疏离较常见,主观社会疏离处于中等水平。在护理工作中应重点关注文化程度低、病情重、复发、自我感受负担和病耻感高的患者,采取针对性的干预措施。