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Background: Mental health literacy (MHL) is an essential competency for all healthcare professionals. In the United Arab Emirates, previous studies reported a low level of MHL among healthcare professionals working with vulnerable populations such as children and adolescents with chronic illnesses. Further in-depth exploration is necessary to build understanding of beliefs and knowledge about mental illness among pediatric health professionals. Methods: Written narratives exploring mental health knowledge were collected from pediatric nurses and analyzed using content analysis. These written narratives were extracted from responses to open-ended questions embedded in a questionnaire completed as part of previous studies. The Standards for Reporting Qualitative Research were followed in reporting this study. Results: The overarching theme that emerged from the data was that nurses struggled to negotiate the complexities of psychological distress and mental illness. Two overlapping sub-themes were identified: (1) professional knowledge was incomplete, confused, and lacking in clarity and (2) professional knowledge was impacted by cultural beliefs and stigma. A third sub-theme reflected how participants identified with others' suffering and felt powerless to help themselves or others. Participants described stress and mental exhaustion. Conclusions: Participants' narratives were characterized by struggles arising from insufficient knowledge, confusion, and deeply-held cultural and religious beliefs. Therefore, they were unable to resolve the conflict between professional knowledge, attitudes, and beliefs about mental illness and stigma arising from cultural and religious beliefs/attitudes. Culturally-specific education is needed for healthcare professionals that addresses contextual, cultural, and religious factors impacting on stigma while actively supporting the healthcare workforce and enabling access to mental health services. [ABSTRACT FROM AUTHOR]

Objective: To examine temporal trends in the burden of eating disorder (ED) features, as estimated by the composite of their prevalence and impact upon quality of life (QoL) over a period of 10 years. Methodology: Representative samples of 3010 participants in 1998 and 3034 participants in 2008 from the South Australian adult population were assessed for endorsement of ED features (objective binge eating, extreme dieting, and purging were assessed in both years; subjective binge eating and extreme weight/shape concerns were also assessed in 2008) and QoL using the Medical Outcomes Study Short Form (SF-36). Principal Findings: From 1998 to 2008 significant increases in the prevalence of objective binge eating (2.7% to 4.9%, p<0.01) and extreme dieting (1.5% to 3.3%, p<0.01), but not purging, were observed. Lower scores on the SF-36 were significantly associated with endorsement of any of these behaviors in both 1998 and 2008 (all p<0.001). No significant difference was observed in the effect of the endorsement of these ED behaviors on QoL between 1998 and 2008 (all p>0.05). Multiple linear regressions found that in 1998 only objective binge eating significantly predicted scores on the mental health scale of the SF-36; however, in 2008 extreme weight/shape concerns, extreme dieting, and subjective binge eating were also significant predictors. Objective binge eating and extreme dieting were significant predictors of scores on the physical health scale of the SF-36 in both 1998 and 2008. Conclusions and Significance: The prevalence of ED behaviors increased between 1998 and 2008, while their impact on QoL remained stable. This suggests an overall increase in the burden of disordered eating from 1998 to 2008. Given that binge eating and extreme dieting predict impairment in QoL, the necessity of interventions to prevent both under- and over-eating is reinforced. [ABSTRACT FROM AUTHOR]

Objective: Studies that have investigated quality of life (QoL) in eating disorders (EDs) have been focussed on the impact of the ED on QoL and little is known regarding the possible reciprocal impact of QoL on EDs. The aim of this study was to provide a first-time investigation of possible bidirectional relationships between EDs and both health-related QoL (HRQoL) and psychological distress (PD)., Method: Structural equation modeling was applied to longitudinal data collected from a community sample of Australian women (N = 828) surveyed at baseline, five annual follow-ups, and again after nine years. Participants reported height and weight (from which body mass index, BMI, was calculated) and completed measures of ED symptoms (Eating Disorder Examination Questionnaire), HRQoL (12-item Medical Outcomes Study Short Form), and PD (Kessler Psychological Distress Scale)., Results: Overall, evidence was found for a bidirectional relationship, whereby ED symptoms predicted reduced HRQoL and greater PD over time, while lower levels of HRQoL and greater PD in turn predicted increased levels of ED symptoms. These relationships were stable, observable within 12 months, and remained observable over a time period of at least four years. However, also observed were some inconsistent findings where ED symptoms predicted a short term (one year) improvement in mental HRQoL. This short term boost was not sustained at longer follow-ups., Conclusions: Not only do ED symptoms impact on HRQoL and PD, but perceived poor HRQoL and PD also contribute to ED symptom development or exacerbation. This supports a movement away from symptom-centric approaches whereby HRQoL is conceptualized as a passive outcome expected to be rectified by addressing ED symptoms. Improvement in QoL and PD might rather be viewed as targets to be pursued in their own right under broader approaches in the treatment of EDs.