Search

This paper investigates the potential of the Gamified Metaverse as a platform for promoting library services. The study compares the effectiveness of a traditional library program with a Metaverse- based library program in terms of knowledge acquisition and library anxiety. The research also examines students' perceptions of implementing gamification within the context of the Gamified Metaverse platform. A mixed-methods approach was adopted, including pre- and post-test analysis, statistical analysis, and qualitative data collection. The results indicate that both the traditional and Metaverse-based library programs effectively increased the participants' knowledge, with no significant difference between the two approaches. However, the Metaverse-based program was found to be less effective in facilitating interaction with librarians and reducing library anxiety. Additionally, students expressed positive perceptions of implementing gamification in the Gamified Metaverse platform, finding it engaging and motivating. These findings contribute to the understanding of the effect of the Metaverse as a tool for promoting library services and enhancing knowledge acquisition. However, it is not as effective in reducing library anxiety, particularly in terms of interaction with librarians and staff. It should be noted that the platform may have limitations such as high costs and potential side effects of virtual reality, making it more suitable as an additional tool for promoting library services, taking into account its feasibility and potential benefits for specific student populations and larger libraries. [ABSTRACT FROM AUTHOR]

Background: Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied, and no tailored interventions have been developed for the vascular surgical patient population. Objectives: We aimed to design a perioperative MBI that specifically targeted vascular surgical patients undergoing PVIs under PSA. We sought to perform this in a scientifically rigorous, multi-disciplinary collaborative manner. Methods: Following the Obesity-Related Behavioral Intervention Trials (ORBIT) model, we designed (Phase 1a) and then refined (Phase 1b) a MBI for patients undergoing PVIs under PSA to decrease perioperative anxiety and sedation and facilitate patient intraoperative compliance. Phase 1a involved a literature review, informal information gathering and synthesis, and drafting a preliminary protocol for a perioperative MBI. Phase 1b involved assembling a multi-disciplinary expert panel of perioperative and mind-body clinicians and researchers to improve the MBI using an iterative, modified Delphi approach. Results: The modified Delphi process was completed, and a consensus was reached after three iterations. The resulting MBI consisted of two seven-minute preoperative guided meditations on the day of surgery, including diaphragmatic breathing, body scans, and guided imagery emphasizing awareness of the ipsilateral leg where the vascular surgery was performed. A document delineating the integration of the MBI into the operating room workflow was produced, including details regarding the intervention's timing, duration, and modality. Conclusion: Using a multi-specialty expert panel, we designed a novel MBI in the form of a guided meditation with elements of mindfulness and guided imagery to decrease anxiety and increase intraoperative compliance for patients undergoing PVIs under PSA. A prospective pilot study is being planned to test the program's feasibility. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate whether and to what extent perioperative hypnosis and relaxation techniques are used in German anaesthesia departments, what they are, where any difficulties in their application lie and how great the interest in this type of therapy is. Another research question was to find out whether there are specialist areas in which these methods are used more frequently than in other specialist areas. Methods: A descriptive survey was conducted by means of a questionnaire in all hospitals with anaesthesia departments in Germany. 1124 questionnaires were sent out by post. The survey period was five months from 27/02/2023 to 31/07/2023. The clinic directors of all anaesthesiology departments in German hospitals were surveyed. Results: 476 departments (42%) responded by pre-paid envelope. Of these, only 39 (8%) use hypnosis and relaxation techniques perioperatively. These are mostly progressive muscle relaxation, hypnotic trance according to Erickson, calming words and suggestions or the use of virtual reality (e.g. using VR-glasses). Conclusions: Hypnosis techniques have been shown in many studies to be effective in increasing patient comfort (less anxiety and stress) and reducing both the need for medication and perioperative pain. The therapy is rarely used in Germany, although once established it can be easily integrated into perioperative procedures. Many departments have shown great interest in the topic. In the interests of patients, a structural change should be considered to promote the use of hypnotic procedures. [ABSTRACT FROM AUTHOR]

Background: The Covid Connected Care Center (C4), a low-barrier telephone nurse hotline, was developed at an academic medical center to increase access to healthcare information and services across the state of Oregon, including to those without a usual source of care. Other studies have demonstrated that telephone triage services can positively influence health behaviors, but it is not known how this effect is maintained across racial/ethnic groups. The objective of this study was to show that the C4 reached throughout the state of Oregon, was valuable to callers, and that recommendations given affected callers' subsequent health-related behaviors. Methods: This mixed-methods study, informed by the RE-AIM (Reach, Effectiveness, Addoption, Implementation and Maintenance) framework, assessed caller demographics and clinical care from March 30 2020 until September 8, 2021. Descriptive statistics, multivariable risk models and Zou's modified Poisson modeling were applied to electronic health record and call system data; An inductive approach was used for patient and staff experience surveys and semi-structured interviews. Approval was obtained from the OHSU Institutional Review Board (Study 00021413). Results: 145,537 telephone calls and 92,100 text-based contacts (61% and 39%, respectively) were included. Callers tended to not have a usual source of primary care and utilized recommended services. Emergency department utilization was minimal (1.5%). Racial or ethnic disparities were not detected in the recommendations, but Black (RR 0.92, CI 0.86–0.98) and Multiracial (RR 0.90 CI 0.81–0.99) callers were less likely than non-Hispanic white callers to receive a COVID-19 test. Participants in the post-call survey (n = 50) would recommend this service to friends or family. Interviews with callers (n = 9) revealed this was because they valued assistance translating general recommendations into a personalized care plan. C4 staff interviewed (n = 9) valued the opportunity to serve the public. The C4 was a trusted resource to the public and reached the intended audiences. However, disparities in access to COVID-19 testing persisted. Conclusions: Nursing triage hotlines can guide caller behavior and be an effective part of a robust public health information infrastructure. [ABSTRACT FROM AUTHOR]

Background: The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW). Factors such as the culture of perfectionism, excessive workloads, and stigma against seeking help exacerbate this issue. This umbrella review synthesizes the existing literature on HCW suicide, exploring the prevalence, causes, and potential preventive strategies. Methods: This study conducted a search of the literature from PubMed/Medline, Scopus, Web of Science, Cochrane Library, PsycINFO, and Google Scholar until April 2, 2024. The non-exhaustive search terms used were "doctor suicide," "physician suicide," "medical professional suicide," "suicide in healthcare," "healthcare worker suicide prevention," and "causes of healthcare worker suicide." Hand-searches were also conducted. Of the 487 studies initially identified, a total of 10 systematic reviews/meta-analyses were included. Results: This umbrella review collates findings from 400 primary clinical studies conducted between the years 2004 and 2023. With a focus on mental health factors contributing to suicide in HCW, there are regional and specialty-specific variations in stress prevalence in the populace. Further, anesthesiologists and psychiatrics depicted higher rates of burnout compared to other HCW; causative factors such as seeking perfection and challenging work-life balance were key when assessing suicidal behaviors in these groups. Job demand level was found to correlate directly with suicidal thoughts, specifically among psychiatric ward HCW, where access to drugs and sharp instruments is readily available. In specific contexts, female HCWs showed a standardized mortality ratio (SMR), indicating that the rate of suicide was higher among them as compared to the general female population. Interventions such as cognitive behavioral therapy (CBT) and mindfulness were effective in decreasing depression, psychological distress, and anxiety in several included studies. This umbrella review also identified major obstacles to seeking help, including stigma and the fear of professional consequences. Conclusion: To reduce suicide rates among HCWs, it is the need of the hour to implement evidence-based interventions and create supportive work environments that encourage mutual care for each other's emotional health. Further research is necessary to determine the effectiveness of various measures in preventing suicide among HCW. [ABSTRACT FROM AUTHOR]

Objectives: Care for community‐dwelling people with dementia is frequently delegated to relatives, who find themselves in the role of informal caregivers with no practical management knowledge. This situation exposes caregivers to increased risk for emotional wellbeing. The current study aims to test whether the integration of the efficacy of an immersive virtual reality (VR) experience into an online psychoeducational program impacts caregiver empathy and therefore emotional wellbeing. Methods: One‐hundred informal caregivers of mild‐to‐moderate Alzheimer's disease (AD) patients will be enrolled and randomly assigned to (i) an online psychoeducational program (control arm); or (ii) an online psychoeducational program integrated with VR (experimental arm). VR will consist of 360‐degree videos involving the caregivers to an immersive experience of dementia symptoms from the patient's perspective. Before, after the intervention and after 2 months, all participants will complete validated clinical scales for caregiver burden and anxiety (primary outcomes) and sense of competence and dispositional empathy (secondary outcomes). A subsample of 50 participants will also undergo MRI exam, including structural and functional (resting‐state and task‐functional MRI [fMRI]) sequences. The fMRI task paradigm will use emotional stimuli to evaluate the neural correlate of empathy, by stressing its cognitive and affective components. The main outcome will be the change in the clinical assessment; the secondary outcome will be the change in brain connectivity of networks subserving the empathic and emotional functioning. Results: We expect that the psychoeducational program will decrease anxiety and stress, enabling caregivers to perceive themselves capable of managing AD patients at home, educating them on symptom handling and boosting their cognitive empathy. In the experimental intervention, the VR‐based experience will act as an add‐on to psychoeducation, leading to greater improvement in the assessed clinical dimensions. VR should, in fact, enable a deeper understanding of disease symptoms and improve caregivers' cognitive empathy. We expect that the experimental intervention will result in deeper comprehension of disease symptoms and further strengthen caregivers' cognitive empathy. At the neural level, we expect to observe increased activation in circuits subserving cognitive empathy and decreased activation in circuits underlying affective empathy. Conclusions: To the best of our knowledge, this will be the first randomized controlled trial assessing the effect of combining psychoeducational interventions with VR‐based experience in caregivers, and assessing both clinical and imaging outcomes. Trial Registration: Registered in ClinicalTrials.gov (NCT05780476) [ABSTRACT FROM AUTHOR]

There is growing awareness of the significant mental health impacts of the COVID-19 pandemic on many Americans. Less is known about the effects on individuals who were living with mental health conditions prior to the pandemic's onset. In addition, little research has explored how this group is coping positively with the challenges of COVID-19. Understanding the strengths these individuals bring to pandemic demands and disruptions can inform recovery for these individuals in the aftermath of this public health emergency. Using results from a cross-sectional, online survey administered during April and May 2020, we use qualitative methods to examine how individuals with symptoms of depression and anxiety were coping with COVID-19. Participants were recruited from two networks of statewide behavioral health community programs in New Jersey and New York. Data come from 48 participants who reported current symptoms of anxiety assessed by the Generalized Anxiety Disorder-2 Scale and/or depression assessed by the Patient Health Questionnaire-2. These respondents demonstrated resilience in navigating disruptions brought on by COVID-19 and reported a range of healthy coping strategies. We identified three themes characterizing successful coping strategies, including utilizing social support systems, practicing self-care, and adjusting one's mindset to deal with challenging experiences. When designing programs, policies, and clinical approaches to support people with mental health conditions, it is essential to focus on strengths. The coping strategies shared by the individuals in this study demonstrate and build on their resilience. More research is needed to discover the strengths people exhibit to deal with the challenges caused by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

A theoretical paper which considers the previous multiple attempts by nursing to engage with and usefully apply the theories of psychoanalysis to varying aspects of the nursing role. References to psychoanalysis within the nursing literature of the last century are reviewed and the legitimacy of the use of psychoanalytic theory 'outside the clinic' explored with reference to general hospital nursing in the UK's National Health Service. Themes explored include unconscious motivation behind nursing as a career choice, with associated risks of stress and burnout when the unconscious drive to heal is thwarted. Psychoanalytic consideration of nurse-patient relationships provides insight into the patient experience on hospital wards, whilst exploration of other aspects of the nursing role was found to be limited. From a wider perspective, psychoanalysis offers nursing an insight into societal changes impacting the profession. The systems and processes of the healthcare institution have also been explored, particularly in relation to containment of anxiety, though limited practical impact has resulted from the psychoanalytic insight encountered in the literature. The limited engagement between psychoanalysis and general nursing is considered from both a psychoanalytic and nursing perspective; ongoing potentiality for enriching dialogue between the disciplines is established and potential barriers explored. [ABSTRACT FROM AUTHOR]

Introduction: Traditional, 8-week, mindfulness-based interventions can effectively treat chronic pain, but require a time and resource investment too burdensome for many patients and providers. The solution to this logistical challenge may be to distill the core, therapeutic elements of an efficacious 8-week, mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), into a 2-h, single-session intervention. Methods: In this study, the authors conducted a waitlist-controlled, randomized clinical trial to assess the impact of a 2-h, single-session adaptation of MORE (i.e., One MORE) on chronic pain patients' (N = 40) pain-related outcomes through 3-month follow-up. Results: Results indicated that One MORE significantly improved chronic pain patients' pain catastrophizing (i.e., primary outcome; F = 9.97, p = 0.002), pain intensity (F = 26.58, p < 0.001), pain interference (F = 39.43, p < 0.001), physical function (F = 16.29, p < 0.001), sleep (F = 16.66, p < 0.001), anxiety (F = 12.54, p < 0.001), and depression (F = 17.48, p < 0.001). One MORE also significantly increased theoretically indicated therapeutic mechanisms through the 3-month follow-up: mindfulness, positive reappraisal, savoring, self-transcendence. Discussion: Study results are promising, and if replicated, would suggest that One MORE is a highly scalable, low-cost (e.g., sustainable), nonpharmacologic treatment for chronic pain. Clinical Trial Registration: NCT05194241. [ABSTRACT FROM AUTHOR]

To examine associations between regular statin use and the incidence of depression and anxiety. This cohort was based on UK Biobank participants without depression/anxiety recruited between 2006 and 2010. The self-reported regular statin use was collected at baseline. Depression and anxiety outcomes were assessed by diagnostic interviews (international classification of diseases codes) and nondiagnostic scales (mental well-being questionnaires). Cox proportional hazards models adjusted for a wide range of confounders were used to estimate associations of statins with incident depression/anxiety. Among 363,551 eligible participants, 55,838 reported regular statin use. During a 13-year follow-up, 14,765 cases of depression and 15,494 cases of anxiety were identified. Compared with non-statin users, statin use was associated with reduced risk of depression (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.81, 0.94) and anxiety (HR: 0.90, 95% CI: 0.84, 0.97). Effects of statins on depression were consistent in sensitivity analyses and may be less influenced by unmeasured confounders. However, results of online survey data showed that statin use might not be associated with incident anxiety (HR: 0.96, 95% CI: 0.85, 1.09). Regular statin use was associated with a lower risk of depression. No clear associations between statin use and anxiety were found. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the effect of aromatherapy with an essential oil blend containing lavender, bergamot, ylangylang, and sweet orange, compared with placebo, on perceptions of anxiety in ICU RNs. Methods: Nurses recruited from six adult ICUs and a neonatal ICU participated in this blinded, randomized, placebo-controlled study, which took place over a 30-day intervention period. Results: Although there were no statistically significant changes in anxiety pre- to postintervention or between the intervention and placebo groups, there were also no adverse events or untoward effects. Conclusion: The results of this study may support aromatherapy as an evidence-based strategy to reduce anxiety in ICU nurses. Additional research is needed. [ABSTRACT FROM AUTHOR]

Purpose: Major depressive disorder (MDD) is frequently accompanied by the symptoms of clinical anxiety. Since our previous research has found that n-3 PUFA supplementation alleviates anxiety in MDD, this study was aimed to further explore whether n-3 PUFA supplementation improves anxiety symptoms in depression by directly manipulating fatty acid levels. Methods: A secondary analysis of biomarker data (erythrocyte fatty acid composition) collected as part of the randomized clinical trial which investigated the adjunctive effect of n-3 PUFAs was conducted on 72 venlafaxine-treated outpatients with first-diagnosed, drug-naïve depression. All participants with longitudinal biomarker data were included in the association analysis to determine how n-3 PUFA supplementation influences fatty acid composition and alleviates anxiety symptoms in depression. Results: Decreases of the C20:3n6 were found in all participants at both follow-up time points (χ2 = 96.36, p = 0.000). The n-3 index (χ2 = 10.59, p = 0.001), EPA (χ2 = 24.31, p = 0.000), and C22:5n3/C20:5n3 ratio (χ2 = 10.71, p = 0.001) were increased, while C22:4n6 (χ2 = 7.703, p = 0.006) was decreased in n-3 PUFA group compared to the placebo group. The improvement in anxiety symptoms positively correlates with the extent of reduction of C16:0, C18:0, and total fatty acid levels as well as D5 desaturase activity (p < 0.05). Conclusion: These data suggest that the anxiolytic effect exerted by n-3 PUFAs in first-diagnosed, drug-naïve depression is manipulated by erythrocyte fatty acid levels. Saturated fatty acid levels have an important role in predicting the severity of anxiety symptoms. [ABSTRACT FROM AUTHOR]

Dog therapy is implemented in various healthcare fields because of its unique ability to reduce perceived anxiety and hormonal stress, increase positive patient relationships with practitioners, and assist with demonstrating procedures. However, implementation of dog therapy in a clinical athletic training setting is not frequently discussed in relevant literature. This article outlines recommendations for the use and efficacy of therapy dogs in an athletic training facility, based on data from several studies across various healthcare fields. We provide information regarding best practice recommendations to incorporate therapy dogs into athletic training services, as well as the necessary administrative aspects and safeguards. Athletic trainers can use these recommendations and framework to explore the implementation of dog therapy into clinical practice. [ABSTRACT FROM AUTHOR]

In this study, we aimed to inform implementation of an animal-assisted intervention (AAI) in an Australian university setting by exploring previously implemented university AAIs. Universities internationally have attempted to address growing concerns around student and staff stress and anxiety by adopting AAIs. However, despite stress and anxiety being common among Australian students and staff, studies are yet to investigate the implementation of an AAI as a strategy to promote health and well-being in this context. Twelve academics who had previously implemented AAIs were recruited via purposeful intensity sampling, with data collected via semistructured interviews. Our findings highlight several facilitators to successful implementation of an AAI, along with strategies used to overcome barriers. Understanding how to amplify strengths and minimize challenges will support Australian universities to implement successful AAIs on campus and, in turn, assist in promoting improved student and staff well-being. [ABSTRACT FROM AUTHOR]

Purpose: Stress during pregnancy has many negative repercussions on maternal and foetal health. It is therefore important to understand which therapies are effective in reducing stress levels and which variables influence the outcomes of these therapies. In this line, psychological resilience could play a key role. Thus, the aim of the study was to check whether pregnant women with different levels of resilience have different benefits in reducing cortisol levels, perceived stress, pregnancy worries, stress vulnerability, anxiety or depression through Cognitive Behavioural Stress Management Therapy. Method: The total sample consisted of 56 pregnant women: one group of pregnant women with high levels of resilience (n = 35); and another group with low levels of resilience (n = 21). Participants' cortisol concentration levels, perceived stress, pregnancy concerns, stress vulnerability, anxiety and depressive symptoms were assessed before and after therapy. Linear mixed models were performed to compare the two groups, which showed a group x time interaction for perceived stress. Results: The low resilience group showed a reduction in their perceived stress levels with a medium effect after the intervention compared to the high resilience group, but no reduction was found in this group. No differences were found between the two groups on the other variables. Conclusion: Knowing which variables have a differential effect on the results of psychological therapy would allow delimiting the groups that obtain greater benefits from the therapy. This may lead to more efficient implementation of effective intervention programmes. [ABSTRACT FROM AUTHOR]

This review aims to systematically summarize existing evidence to determine the effectiveness of cognitive-based interventions (CBIs) on psychological health and well-being among parents of children with developmental disabilities (DD). Six databases were searched to identify eligible randomized controlled trials (RCTs) from their inception to April 2023. The revised Cochrane Risk of Bias tool for RCTs was applied to assess the risk of bias and the certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation. Meta-analyses were conducted using a random-effects model. Twenty-five RCTs involving 1915 participants were identified. The results indicated that CBIs reduced parental stress levels (Hedges' g = − 0.69), depressive symptoms (g = − 0.95), anxiety levels (g = − 0.78), and parental distress (g = − 0.29), and improved parental well-being (g = 0.62) and parent‒child relationships (g = 0.43) postintervention compared with the active/inactive control groups. Subgroup analysis of the effectiveness of interventions using mindfulness-based interventions and cognitive behavioural therapy showed positive effects. The favourable intervention duration and participant targets were also identified in this review. Furthermore, the effects of CBIs were impacted by the different types of DD among the children. This review highlighted the positive effects of CBIs on parental stress levels, depressive symptoms, anxiety levels, parental distress levels, parental well-being levels, and parent‒child relationships. Future well-designed RCTs are needed to further investigate the effects of MBIs and CBT interventions on children with DD and their parents, as well as the factors and mechanisms of action affecting the efficacy of these interventions. [ABSTRACT FROM AUTHOR]

A stay in hospital and an operation are always an exceptional situation for children and their parents, which is accompanied by great uncertainty and fear. The aim of this article is to show what possibilities exist as a caring anesthetist to accompany a child and the parents through the operation and that anesthesia remains a good memory. The effect of communication on a verbal and nonverbal level is discussed. The focus is on dealing with children and their parents, taking the influence of the psychological developmental stages of children into account and on presenting helpful coping strategies in exceptional situations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the effects of music intervention on quality of life, anxiety, and fatigue among patients with breast cancer. SAMPLE & SETTING: 170 individuals from the general surgery unit of Kaohsiung Chang Gung Memorial Hospital in Taiwan. METHODS & VARIABLES: Individuals who had received a mastectomy were randomly assigned to a treatment group or control group. In the treatment group, participants received music intervention for an hour each week, totaling 12 hours during 12 consecutive weeks. The primary variable was quality of life, and secondary variables were anxiety and fatigue. RESULTS: Greater quality of life was seen in the treatment group at 12 weeks. In the treatment group, participants showed significant improvement in State-Trait Anxiety Inventory (trait), which was most significant at eight weeks. No statistically significant difference was observed in fatigue levels after 4, 8, and 12 weeks of music intervention. IMPLICATIONS FOR NURSING: Music intervention may improve anxiety and quality of life of patients with breast cancer. Music intervention could be established following mastectomy and continued throughout recovery. [ABSTRACT FROM AUTHOR]

Objectives: To compare idiographic change during two formats of guided self‐help (GSH); cognitive‐behavioural therapy guided self‐help (CBT‐GSH) and cognitive analytic therapy guided self‐help (CAT‐GSH). Design: Qualitative inductive thematic analysis. Methods: Semi‐structured interviews with N = 17 participants with a reliable change outcome on the GAD‐7 after completing GSH for anxiety. Changes were categorised and themes extracted. Results: No differences between CAT‐GSH and CBT‐GSH were found regarding types of change reported. The five overarching themes found were personal qualities of success, enlightenment through understanding, specific tools and techniques, changes to relationships and tailoring support. Four themes maximally differentiated between the two different types of GSH; CAT‐GSH enabled relational insight and change whilst CBT‐GSH enabled better understanding of anxiety, new coping techniques and supportive relationships. Conclusions: Both common and model‐specific factors contribute to patient change during GSH. Whilst all forms of GSH are grounded in the psychoeducational approach, separate theoretical foundations and associated methods facilitate different types of ideographic change. [ABSTRACT FROM AUTHOR]

AIM The aim of this study was to examine the effects of mentoring programs on undergraduate nursing students’ mental health. BACKGROUND The study of nursing has been cited as stressful, with negative effects on academic and physical wellbeing and mental health in nursing students. METHOD An integrative review of the literature using the method of Whittemore and Knafl was performed on mentoring programs designed to mitigate student stress. Electronic databases searched included CINAHL, Medline, PubMed, Embase, ERIC, and Scopus. RESULTS The eight studies included in this review suggest that mentoring has positive impacts on nursing students’ mental health, reducing stress and anxiety and enhancing well-being and sense of belonging. CONCLUSION Mentoring programs have positive effects on mental health outcomes in undergraduate nursing students. Implementation of structured programs at the start of undergraduate studies can facilitate increased mental and physical well-being and decrease stress and anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Innovative technologies, including virtual reality (VR), can be used for conducting VR exposure therapy (VRET) for individuals with psychiatric disorders, including claustrophobia. Unfortunately, there is a lack of studies on the effect of VR in treating claustrophobia in Arab countries, including Jordan. Therefore, this study aimed to evaluate the effect of VRET on minimising anxiety symptoms at 1 week post‐therapy and the physiological arousal measures (heart rate, O2 saturation and mean arterial pressure) of participants before and following therapy. Methods: A pre‐/post‐test one‐group design was used, and participants (N = 44) who suffered from claustrophobia from Al‐Zaytoonah University of Jordan were recruited. VRET was conducted using the Cave experience, which consists of four stages and was carried out in 4 to 6 sessions during the period from April to September 2023. Results: The findings revealed a significant difference between pre‐ and post‐VR simulation intervention for anxiety symptoms and physiological measures; in addition, the participants perceived the usability of VR therapy. Conclusion: This study suggested that VRET was effective in managing claustrophobia, particularly in minimising anxiety symptoms. Therefore, VRET can be integrated into the therapeutic methods for individuals with claustrophobia. Also, healthcare professionals, including mental health counsellors, can adopt such therapy in their management and treatment plan. [ABSTRACT FROM AUTHOR]

Background: Up to one in five women experience perinatal depression and/or anxiety with profound negative consequences for mothers and families. Peer support interventions have the potential to effectively prevent perinatal mental health conditions. Meanwhile, mobile health has gained popularity and plays a significant role in enhancing maternal health services. However, little is known about the availability of mobile health combined with peer support for supporting perinatal mental health. This scoping review aimed to map the relevant literature and gain insights into the available evidence on mobile health and peer support for perinatal mental health, to identify gaps and inform opportunities for future research. Methods: A scoping review of the literature was conducted. The search strategy included five databases: CIANHL, Scopus, PsycInfo, PubMed, and ScienceDirect for the period from 2007 to 2022. Results: Eight studies met the inclusion criteria, including features of online support strategies, effectiveness, and attitudes of women about peer support with mobile health. The results showed decreased depressive scores and provided a positive experience for women. Strong satisfaction with accessibility and flexibility of mobile health was found when combined with the peer support features. Additional emotional support tools (e.g., mindfulness‐based activities) were likely to be acceptable to women and beneficial to mobile health. Conclusions: Understanding the context of peer support and mobile health informs the potential to support perinatal mental health. Further research in this growing area is needed to test the effectiveness of peer support in combination with mobile health intervention for supporting perinatal mental health. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of high‐intensity interval training (HIIT) on periodontitis (PD) progression and behavioural outcomes. Materials and Methods: Forty‐eight Wistar rats were divided into four groups: non‐trained (NT); non‐trained with PD; HIIT with PD; and HIIT. The HIIT protocol, involving daily treadmill sessions, spanned 8 weeks, with PD induced by ligature after the 6th week. Behavioural tests were conducted to assess anxiety and memory. Post euthanasia, we evaluated the systemic inflammatory profile and oxidative stress markers in the hippocampus and amygdala. A morphological evaluation and elemental composition analysis of the mandibular alveolar bone were performed. Results: PD exacerbated alveolar bone level, bone surface damage and alterations in calcium and phosphorus percentages on the bone surface (p <.05), while HIIT attenuated these changes (p <.05). HIIT improved systemic inflammatory markers altered by PD (tumour necrosis factor [TNF]‐α, interleukin [IL]‐10, TNF‐α/IL‐10 and IL‐1β/IL‐10 ratios, p <.05). PD animals exhibited lower total antioxidant capacity and levels of thiobarbituric acid reactive substances in the amygdala and hippocampus, respectively (p <.05). HIIT maintained these parameters at levels similar to those in NT animals. HIIT improved anxiety and memory outcomes altered by PD (p <.05). Conclusions: HIIT attenuates systemic inflammation, anxiety and memory outcomes promoted by PD. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) is an innovative teaching strategy for professional development using computer-generated, threedimensional images in an interactive virtual environment. Self-reported survey responses of nurses who used VR in orientation and the nurse residency program demonstrated improved knowledge, skills, and confidence. VR provides an innovative and engaging educational medium for learning that may have implications for future clinical practice and research. [ABSTRACT FROM AUTHOR]

Background: Although simulation-based education plays a vital role in nursing education, it consistently induces high levels of anxiety among nursing students. This study aimed to implement a mindfulness intervention to alleviate anxiety in nursing students during simulation sessions. Method: This randomized controlled trial study included 54 nursing students. Both survey and emotion track system data were collected and analyzed using multivariate analysis of covariance. Results: The intervention effectively reduced anxiety among students in the experimental group compared with students in the control group during simulation sessions. The frequency (F[1, 53] = 6.145, p =.016), intensity (F[1, 51] = 3.771, p =.050), and duration of anxiety felt by students (F[1, 50] = 4.223, p =.017) decreased after the intervention. However, no long-term effects of the intervention were identified. Conclusion: The implementation of a mindfulness intervention successfully alleviated anxiety among nursing students during simulation. [J Nurs Educ. 2024;63(9):577–583.] [ABSTRACT FROM AUTHOR]

Why you should read this article: • To read about the experiences of people with chronic cancer in developing expertise in their condition • To be aware of areas in which CNSs can support people with chronic cancer to develop expertise in their condition • To recognise the need for specialised nurse-led services to support people with chronic cancer to manage and understand their condition. Background: The lifting of the coronavirus disease 2019 (COVID-19) pandemic restrictions in the UK has meant a near-full return to normal life for the general population. However, for patients with chronic cancer, the risk of severe illness from COVID-19 remains high because they are immunocompromised, and they may have various unmet support needs. Aim: To identify areas in which clinical nurse specialists (CNSs) can support people with chronic cancer in the UK to develop expertise in their condition, acting to minimise the risks of anxiety and depression in this population. Method: Narrative online interviews were conducted with seven people with chronic lymphocytic leukaemia. Transcripts were analysed using thematic and narrative methodologies. Findings: Two themes were identified. The first theme, holes in the system, explored the perceived position of chronic cancers at the bottom of the cancer hierarchy, which can cause patients to feel overlooked in terms of NHS service provision. The second theme, co-developed expertise, explored the mechanisms used by patients with chronic cancer to develop expertise in their condition and the role of specialised healthcare professionals in co-developing this expertise. Conclusion: Although the participants often felt let down by the healthcare system, support from CNSs was beneficial and empowered them to develop expertise in their condition. This indicates that there is a need for dedicated nurse-led chronic cancer pathways to minimise the risk of cancer-related anxiety and depression. [ABSTRACT FROM AUTHOR]

Background: More than 60% children exhibit anxiety before undergoing an anesthetic‐surgical procedure, particularly among pre‐school paediatric patients. Oral midazolam can provide procedural sedation for children prior to anesthesia. However, extemporaneous solutions of midazolam are usually prepared from injectable drug solutions, leading to inconsistent efficacy due to variable preparation methods. Xiaoerjing® is the first commercially available oral formulation of midazolam for procedural sedation in children in China. Despite the recommended dosage range of 0.25–0.5 mg/kg, its effective dose is still largely unknown. Aim: To determine the 95% effective dose (ED95) of midazolam oral solution (Xiaoerjing®) for alleviating preoperative anxiety in children prior to mask induction of general anesthesia. Design: The study included 61 children between the ages of 1 and 6 years undergoing elective surgery under general anesthesia. The first patient received a single dose of 0.5 mg/kg midazolam oral solution, which was adjusted for subsequent patients using the biased coin design method based on their response to the previous dose. Doses were increased or decreased at the rate of 0.1 mg/kg. An effective response was defined as having a modified Ramsay sedation score ≥3a, separation anxiety score ≤2, and mask acceptance score ≤2 during inhalational anesthesia induction. Results: Fifty‐six children were included in the final analysis. Of those, sedation was successful in 50 patients, with a median separation time of 15 (IQR: 25) min. Midazolam oral solution has an ED95 of 0.8254 mg/kg (95% CI: 0.6915–0.8700 mg/kg) for relieving preoperative anxiety in children. No adverse events occurred following drug administration. Conclusion: Midazolam oral solution is a safe and effective medication for relieving preoperative anxiety in children. The ED95 of a single oral dose of midazolam oral solution is 0.8254 mg/kg (95% CI: 0.6915–0.8700 mg/kg). [ABSTRACT FROM AUTHOR]

Background: Co-occurring physical and mental health conditions are common, but effective and sustainable interventions are needed for primary care settings. Purpose: Our paper analyzes the effectiveness of a Solution-Focused Brief Therapy (SFBT) intervention for treating depression and co-occurring health conditions in primary care. We hypothesized that individuals receiving the SFBT intervention would have statistically significant reductions in depressive and anxiety symptoms, systolic blood pressure (SBP), hemoglobin A1C (HbA1c), and body mass index (BMI) when compared to those in the control group. Additionally, we hypothesized that the SFBT group would have increased well-being scores compared to the control group. Methods: A randomized clinical trial was conducted at a rural federally qualified health center. Eligible participants scored ≥ 10 on the Patient Health Questionnaire (PHQ-9) and met criteria for co-occurring health conditions (hypertension, obesity, diabetes) evidenced by chart review. SFBT participants (n = 40) received three SFBT interventions over three weeks in addition to treatment as usual (TAU). The control group (n = 40) received TAU over three weeks. Measures included depression (PHQ-9) and anxiety (GAD-7), well-being (Human Flourishing Index), and SFBT scores, along with physical health outcomes (blood pressure, body mass index, and hemoglobin A1c). Results: Of 80 consented participants, 69 completed all measures and were included in the final analysis. 80% identified as female and the mean age was 38.1 years (SD = 14.5). Most participants were white (72%) followed by Hispanic (15%) and Black (13%). When compared to TAU, SFBT intervention participants had significantly greater reductions in depression (baseline: M = 18.17, SD = 3.97, outcome: M = 9.71, SD = 3.71) and anxiety (baseline: M = 14.69, SD = 4.9, outcome: M = 8.43, SD = 3.79). SFBT intervention participants also had significantly increased well-being scores (baseline: M = 58.37, SD = 16.36, outcome: M = 73.43, SD = 14.70) when compared to TAU. Changes in BMI and blood pressure were not statistically significant. Conclusion: The SFBT intervention demonstrated efficacy in reducing depressive and anxiety symptoms and increasing well-being but did not affect cardio-metabolic parameters over a short period of intervention. Trial Registration: The study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 4/20/2023. *M = Mean, SD = Standard deviation. [ABSTRACT FROM AUTHOR]

Background: Fear-avoidance in COPD can have detrimental effects on pulmonary rehabilitation (PR) outcomes and is therefore important to address. This prospective study examined changes in and management of COPDrelated anxiety symptoms over the course of a PR program. Methods: Patients with COPD referred to 9-weeks of PR in the municipality of Vejle, Denmark from January to December 2022 completed a six-minute walk test (6MWT) and the following questionnaires, both before and after PR: COPD Anxiety Questionnaire 20-item version (CAF-R), measuring COPDrelated anxiety; COPD Assessment Test (CAT), measuring COPD-related disability; 12-Item Short-Form Health Survey (SF-12), measuring health-related quality of life (HR-QoL); sociodemographic and disease-related information. After PR, a subsample of the patients took part in semi-structured interviews exploring their understanding of how they managed COPD-related anxiety during PR. Pre- and post-assessment of COPD-related anxiety and other PR outcomes were analysed with t-tests and correlation analyses. Qualitative interviews were analysed using a thematic analysis approach. Results: A total of 72 patients with COPD (mean ± SD age 71 ± 8, 53% female) were included in the study, and 13 took part in qualitative interviews. A significant decrease in COPD-related anxiety was observed from before to after PR, corresponding to a small effect size (Cohen's d = 0.32; p = 0.018). Reductions in COPD-related anxiety were not associated with improvements in COPD-related disability, HR-QOL, or functional exercise capacity. The qualitative findings identified four anxiety management strategies, i.e., "planning", "problem-solving", "accepting", and "confronting", which were influenced by interactions with healthcare professionals and co-patients as well as patients' own perception. Conclusions: COPD-related anxiety symptoms was reduced after PR, potentially through the use of various management strategies. The strategies appeared to be influenced by interactional factors during the PR program. [ABSTRACT FROM AUTHOR]

Background: Nursing students are faced with multiple challenges and have a higher probability of suffering from anxiety. The current study aims to explore the relation between empathy and anxiety, examining the mediation and moderation effects of insomnia and self-compassion, respectively. Methods: This study employed a convenient sampling method, recruiting 1,161 nursing students (female = 923, male = 238, Meanage = 18.37, SDage = 2.38) from three universities in China. These students completed the questionnaires online, including General Anxiety Disorder -7 (GAD-7), Jefferson Scale of Physician Empathy-Nursing student (JSPE-NS), Youth Self-rating Insomnia Scale -8 (YSIS-8), and Self-Compassion Scale (SCS). The study employed latent variable structural equation models to analyze the relation and mechanisms between empathy and anxiety. Then, the mediated role of insomnia and the moderated role of self-compassion were examined. Results: The prevalence rates of anxiety and insomnia in the current sample are 18.24% and 26.76%, respectively. The results showed that empathy could negatively predict anxiety, with a significant mediating effect of insomnia between them (B = -0.081, p < 0.05, 95% CI [-0.197, -0.063]). Additionally, it was proven that self-compassion moderated the positive relation between insomnia and anxiety. With a higher level of self-compassion, the indirect effect of empathy on anxiety through insomnia was weaker (B = -0.053, p < 0.01, 95% CI [-0.095, -0.019]). When individuals showed a lower level of self-compassion, the indirect effect of empathy on anxiety through insomnia was stronger (B = -0.144, p < 0.01, 95% CI [-0.255, -0.059]). Conclusion: The analysis of this research proved that empathy was negatively related to anxiety, and insomnia served as a mediator between empathy and anxiety. Besides, the protective role of self-compassion on individuals' mental health was identified. The findings of the study suggest that the education of nursing students should highlight the significance of fostering empathy and self-compassion. The intervention on insomnia may be helpful in reducing the levels of anxiety since insomnia is a risky factor for anxiety. [ABSTRACT FROM AUTHOR]

Background/Objective: Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes. Method: Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3 months post intervention). Results: All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (−3.6 (CI -6.9, −0.2), P =.04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep. Conclusion: This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer. Trial Registration: ClinicalTrials.gov ID# NCT04834154. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of Balint Group in improving stress, negative mood and empathy of psychiatric nurses. Method: In March 2022-March 2023, 150 psychiatric nurses from four hospitals in Lanzhou were selected for the study, randomly grouped into experimental group and control groups (75 per group), the experimental group participated the Balint Group activities biweekly, the control group only attended mental health knowledge lectures. Job stress, negative emotion and empathy of the two groups before and after the intervention were evaluated and compared by using job stressor Scale, coping style Assessment Scale, self-assessment scale for depression, self-assessment Scale for anxiety and Jefferson Empathy Scale. Results: After intervention, the job stressor scale and coping style evaluation of nurses in the two groups were significantly decreased, and the experimental group was lower than the control group (P < 0.05). The depression and anxiety of nurses in the two groups were significantly improved, and the experimental group was better than the control group (P < 0.05). The differences in the total score and dimensions of Jefferson Empathy scale in the experimental group after intervention were higher than those in the control group (P < 0.05). Conclusion: Balint group activities can effectively relieve the stress, depression and anxiety of psychiatric nurses, and improve the ability of empathy at work. [ABSTRACT FROM AUTHOR]

Introduction: Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan. Methods: Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes. Results: At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved. Conclusion: Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of prolonged inhalation of nature-derived odors indoors on humans. Twenty-six women participated in this study. Heart rate variability, heart rate, blood pressure, pulse rate, estradiol, testosterone, and cortisol were used as indicators of autonomic nervous system and endocrine system activities. Profile of mood state, state–trait anxiety inventory, menopause rating scale and general sleep disturbance scale were used as psychological indicators. The order was as follows: After the participants relaxed in a chair for 5 min, their heart rate variability and heart rate were measured for 3 min with their eyes closed. Subsequently, blood pressure and pulse rate were measured, salivary samples were collected for estradiol, testosterone, and cortisol analyses, and a subjective assessment was conducted. The participants received a diffuser containing fir essential oil and were instructed on its usage and precautions. Subsequently, they returned home and inhaled the fir oil for a week. After 7 days, participants revisited the laboratory for posttest measurements, conducted at the same time as the pretest. Prolonged inhalation of the fir essential oil resulted in increased estradiol concentration, decreased systolic and diastolic blood pressure, relief of menopausal symptoms, reduced anxiety levels, improved sleep quality and mood states. Prolonged inhalation of the fir essential oil induced physiological and psychological relaxation on menopausal women. [ABSTRACT FROM AUTHOR]

Depression is one of the most prevalent mental disorders worldwide. This study examined the effect of a spiritual connectivity intervention on individuals with depression in a randomized waitlist-controlled trial. Fifty-seven participants with mild or moderate depressive symptoms were randomly assigned to either the intervention group (n = 28) or the waitlist control group (n = 29). The intervention comprised eight weekly sessions focusing on divine connection, forgiveness and freedom, suffering and transcendence, hope, gratitude, and relapse prevention. The outcome measures included depressive symptoms, anxiety, hope, meaning in life, self-esteem, and social support. Participants completed self-administered questionnaires at baseline (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Repeated-measures ANOVA and one-way ANCOVA were used to compare the within-group and between-group differences in the changes in outcome variables. Participants in the intervention group showed significant improvements in depression, anxiety, spiritual experience, hope, self-esteem, and perceived social support after the intervention. Effect size statistics showed small to large differences (Cohen's d, 0.308 to −1.452). Moreover, 85.71% of participants in the intervention group also experienced clinically significant reductions in PHQ-9 scores from baseline to immediate post-intervention. This study highlights the effectiveness of a low-cost, accessible intervention suitable for community implementation by clergy and faith-based organizations. [ABSTRACT FROM AUTHOR]

Background: Pain management is an important part of nursing care for children. The objective of this study was to systematically assess the impact of virtual reality (VR) technology on alleviating the pain and anxiety experienced by children during venipuncture procedures. Methods: This study searched Pubmed, Web of Sciences, Scopus, The Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu and China biomedical databases on the randomized controlled trials (RCTs) of virtual reality technology for relieving pain and anxiety associated with venous puncture for children up to July 6, 2024. Risk of bias tool recommended by Cochrane library was used to evaluate the RCT quality. RevMan 5.3 software was used for statistical analysis. Results: A total of 10 RCTs involving 874 children were included. 429 children received VR intervention during vein puncture. VR was beneficial to reduce the children's self-reported pain scores [SMD=-0.48, 95% CI (− 0.61, − 0.35)], children's caregivers reported needle-related pain level [SMD=-0.93, 95% CI (-1.45, − 0.42)], children's self-reported anxiety scores [SMD=-0.45, 95% CI (− 0.65, − 0.25)], children's caregivers reported needle-related anxiety level [SMD=-0.47, 95% CI (− 0.73, − 0.21)]. Egger regression tests indicated that there were no publication biases in the synthesized outcomes (all P > 0.05). Conclusions: VR technology has been shown to effectively mitigate the pain and anxiety experienced by children during venipuncture. Despite the positive findings, more research is needed to better understand the role of VR in children undergoing venipuncture. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative pain management and postoperative nausea and vomiting are a persistent challenge for both health care providers and patients. Acupuncture is an effective and safe modality for the management of pain and nausea, and has the potential to play a key role in postoperative pain management. This study explores the utility and feasibility of acupuncture in the immediate postoperative setting. Methods: In a retrospective case–control study, 22 patients who underwent elective surgeries and received acupuncture in the post-anesthesia care unit (PACU) were compared with 88 case controls. Indications for acupuncture therapy included persistent pain, nausea, or anxiety. Patient satisfaction and symptom improvement after acupuncture were assessed. PACU nurses and patients were queried on their perspectives on using this therapy. Demographic data, perioperative opioid consumption, pain score in the PACU, incidence of postoperative nausea, PACU length of stay, and unintended hospital admission were assessed. The groups with/without acupuncture were compared using Wilcoxon rank sum test or Fisher's exact test as appropriate. Results: A total of 78.9% of patients receiving acupuncture felt improvement in their symptoms. 94.7% of recovery nurses who cared for patients who received acupuncture felt that it was helpful and 78.9% did not believe it was disruptive. Patients who opted for acupuncture had a statistically significant higher overall median (interquartile range) pain score in the PACU (7.0 [5.2, 9.5] vs. 5.0 [3.0, 7.0], p = 0.009) and higher postoperative opioid consumption (22.5 [9.8, 44.8] vs. 15.0 [0.0, 30.0], p = 0. 03). There was no difference between total perioperative opioid consumption between groups (p = 0.94). Conclusions: Most patients who received acupuncture therapy in the PACU were satisfied with their therapy and would recommend it to future patients undergoing surgery. Most recovery nurses felt it was helpful, was not disruptive, and would like to see it utilized in the PACU. [ABSTRACT FROM AUTHOR]

Problem: The objective of this study was to investigate the impact of bubble‐blowing and ball‐squeezing interventions on children's levels of anxiety, fear, and pain during venipuncture procedures. Methods: This study was designed as a randomized controlled trial. Out of 108 children aged 5−10 years, 72 were allocated to the two experimental groups, while 36 were assigned to the control group. The levels of anxiety, fear, and pain experienced by the children were assessed using the "Wong‐Baker FACES® Pain Rating Scale," "Child Anxiety Scale‐State," and "Child Fear Scale," respectively. Intergroup comparisons were analyzed using one‐way ANOVA, while intragroup comparisons were conducted using Wilks' Lambda analysis. Findings: It was observed that 50% of the children in the control group, 47.2% in the bubble‐blowing group, and 47.2% in the ball‐queezing group did not receive information about the painful procedure. Anxiety, fear, and pain scores of all groups were statistically similar in the initial measurement without any intervention. Children in the bubble‐blowing and ball‐squeezing groups experienced lower anxiety, fear, and pain during and at the end of the painful procedures. Conclusions: The study discovered that interventions involving bubble blowing and ball squeezing significantly decreased children's levels of anxiety, fear, and pain both during and after intravenous procedures. Information on procedures, alongside interactive techniques like bubble blowing and ball squeezing, helps pediatric nurses calm children, easing anxiety, fear, and pain. Implementing these strategies enhances treatment experiences and confidence in healthcare. Key points: Nonpharmacological behavior guidance techniques (BGTs), such as distraction, are effective in nursing care, offering alternatives to medication.Distraction techniques are particularly beneficial in pediatric care, aiding in the reduction of procedural pain experienced by children.Bubble blowing and ball squeezing during the intervention decrease anxiety, fear, and pain.Implementing distraction strategies enables nurses to alleviate children's pain and anxiety, thereby fostering a more comfortable and effective treatment process.It was determined that both methods used were effective and could be used safely in children. [ABSTRACT FROM AUTHOR]

Background: Although most young people successfully manage the transition from childhood to adulthood, the speed and magnitude of these changes can cause stress that can exceed the coping abilities of many young people. Previous studies have suggested that adolescence is a vulnerable period for the development of psychiatric disorders; therefore, an adequate coping repertoire must be developed. Aims: Our aims were to develop and implement a coping skills training for young people and to evaluate the results of the training. Therefore, the components of the coping skills training programs in the existing literature were used. Methods: Young people from Turkey participated in this cluster randomised controlled trial (n = 89; mean age, 20.06 ± 1.44 years). Ten sessions of the coping skills training were applied in the study group (SG; n = 33), and one session was applied in the control group (CG; n = 56). To assess the effects of the coping skills training, all participants completed several psychological questionnaires (for stress, anxiety, coping and social problem-solving evaluations) at the beginning and end of the training. We performed an analysis of covariance (ANCOVA). In cases where ANCOVA assumptions could not be met, the efficacy of the intervention was determined using the mixed design/split-plot analysis of variance. Results: Compared with the CG, the SG had significantly reduced stress and anxiety levels and increased adaptive coping skills. Social problem-solving skills remained relatively similar between the groups. Conclusion: Complete and correct implementation of coping skills training among the youth may contribute positively to the development of adaptive coping skills by reducing their stress and anxiety levels. This online coping skills training program allowed young people to directly experience their response to stress and offered opportunities to try and develop different coping strategies. Coping skills should be considered for successful stress and anxiety management in everyday life. [ABSTRACT FROM AUTHOR]

We investigate sexual behaviours as a means of coping with negative emotions during the first covid19-related lockdown in France. We hypothesize that sexual behaviours have been used by the most psychologically fragile individuals to cope with the constraints, pressures, and threats associated with the health situation. We are interested in the overall use of sexual behaviours for coping purposes. We also distinguish dual relationships (with partners) from masturbatory behaviours. 2234 participants (mean age: 31.4yo, Female: 68.3%) participated to an on-line non-interventional survey during the first French covid-related lockdown. We assessed frequency of sexual behaviours in order to cope with stress, depression and anxiety. Main results show an increase in the use of sexuality as way of coping with negative emotions for 17.1% of the subjects (n = 382). Masturbatory behaviours were the most impacted (+12%, n = 269). Women differed from men both in the overall use of sexual behaviours as a coping strategy and in the more specific use of partnered sex. In line with our hypotheses, increasing use of sexual behaviours as a coping strategy during lockdown is more important when subjects present psychological vulnerabilities, such as anxiety symptoms or depressive symptoms. We investigate sexual behaviours as a way to coping with negative emotions during the first French covid19-related lockdown. We found an increase in coping with sex for one out of 6 participants. Increasing use of sexual behaviours as a coping strategy is more important when subjects present psychological vulnerabilities [ABSTRACT FROM AUTHOR]

Black, Indigenous, and Persons of Color (BIPOC) autistic transition-aged youth (TAY) report lower rates of competitive employment compared to White autistic TAY and even greater deficits with social skills associated with positive job interviewing. A virtual job interviewing program was adapted to support and improve the job interviewing skills of autistic TAY. The current study evaluates the effectiveness of an efficacious virtual interview training program on the job interview skills, interview anxiety, and likeliness to be hired, for a subsample of 32 BIPOC autistic TAY, ages 17–26 years old from a previous randomized control trial of the program. Bivariate analyses were used to evaluate between-group differences at pre-test related to background characteristics, and whether Virtual Interview Training for Transition-Age Youth (VIT-TAY) was associated with changes between pre-test and post-test measures of job interview skills. Additionally, a Firth logistic regression was conducted to examine the relationship between VIT-TAY and competitive integrative employment at 6 months, covarying for fluid cognition, having ever had a job interview, and baseline employment status. Participants receiving pre-employment services (Pre-ETS) and virtual interview training had better job interview skills (F = 12.7, ρ <.01; η ρ 2 =.32), lower job interview anxiety (F =.3.96, ρ <.05; η ρ 2 =.12), and a higher likeliness of receiving employment (F = 4.34, ρ <.05; η ρ 2 =.13 at the 6-month follow up compared to participants that only had Pre-ETS. Findings from this study suggest that virtual interview training for TAY is effective for BIPOC autistic TAY in improving their interview skills to gain competitive employment and lower their job interview anxiety. [ABSTRACT FROM AUTHOR]

Graduate students frequently experience anxiety, depression, and psychological distress. Counseling centers struggle to meet this need. Brief, skills-based treatments to mitigate burgeoning or mild mental health problems could alleviate this problem. Participants were 51 graduate students in years one through seven of their respective programs. We examined a single-session virtual cognitive behavioral workshop and outcomes up to 6-months later. The program was feasible, acceptable, and beneficial for mood, anxiety, and emotion regulation, even during the COVID-19 pandemic. A majority of participants reported ongoing skills use at follow-up. Primary barriers to more frequent use were forgetting, time constraints, and difficulty when experiencing strong emotions. Few participants endorsed expecting that skills would not be helpful or forgetting how to use skills. This intervention may provide scalable, much needed aid to graduate schools. Moreover, results highlight opportunities for further enhancing brief interventions. [ABSTRACT FROM AUTHOR]

This mixed-methods study was conducted to explore the role of faith in mental health among Latino women (Latinas) during the COVID-19 pandemic. As part of a lifestyle study, surveys were administered to 89 participants during the 1st year of the pandemic. Specifically, a focus group was conducted with participants (n = 6) directly affected by COVID-19 (i.e., self or family member). The results showed inverse correlations between religiosity and both depression and anxiety, as well as positive correlations among religious practices, religious coping, and religiosity. Given these associations, future interventions should explore the role of faith in supporting individuals during difficult times. [ABSTRACT FROM AUTHOR]

Background: The study examined the effects of Happy Mother—Healthy Baby (HMHB), a cognitive-behavioural therapy (CBT) intervention on breastfeeding outcomes for Pakistani women with prenatal anxiety. Methods: Breastfeeding practices were evaluated in a randomized controlled trial between 2019 and 2022 in a public hospital in Pakistan. The intervention group was randomized to receive six HMHB sessions targeted towards prenatal anxiety (with breastfeeding discussed in the final session), while both groups also received enhanced usual care. Breastfeeding was defined in four categories: early breastfeeding, exclusive early breastfeeding, recent breastfeeding, and exclusive recent breastfeeding. Early breastfeeding referred to the first 24 h after birth and recent breastfeeding referred to the last 24 h before an assessment at six-weeks postpartum. Potential confounders included were mother's age, baseline depression and anxiety levels, stress, social support, if the first pregnancy (or not) and history of stillbirth or miscarriage as well as child's gestational age, gender. Both intent-to-treat and per-protocol analyses were examined. Stratified analyses were also used to compare intervention efficacy for those with mild vs severe anxiety. Results: Out of the 1307 eligible women invited to participate, 107 declined to participate and 480 were lost to follow-up, resulting in 720 women who completed the postpartum assessment. Both intervention and control arms were similar on demographic characteristics (e.g. sex, age, income, family structure). In the primary intent-to-treat analysis, there was a marginal impact of the intervention on early breastfeeding (OR 1.38, 95% CI: 0.99–1.92; 75.4% (N = 273) vs. 69.0% (N = 247)) and a non-significant association with other breastfeeding outcomes (OR1.42, 95% CI: 0.89–2.27; (47) 12.9% vs. (34) 9.5%, exclusive early breastfeeding; OR 1.48, 95% CI: 0.94–2.35; 90% (N = 327) vs. 86% (N = 309), recent breastfeeding; OR1.01, 95% CI: 0.76–1.35; 49% (N = 178) vs 49% (N = 175) exclusive recent breastfeeding). Among those who completed the intervention's six core sessions, the intervention increased the odds of early breastfeeding (OR1.69, 95% CI:1.12–2.54; 79% (N = 154) vs. 69% (N = 247)) and recent breastfeeding (OR 2.05, 95% CI:1.10–3.81; 93% (N = 181) vs. 86% (N = 309)). For women with mild anxiety at enrolment, the intervention increased the odds of recent breastfeeding (OR 2.41, 95% CI:1.17–5.00; 92% (N = 137) vs. 83% (N = 123). Conclusions: The study highlights the potential of CBT-based interventions like HMHB to enhance breastfeeding among women with mild perinatal anxiety, contingent upon full participation in the intervention. Trial registration: ClinicalTrials.gov NCT03880032. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN. Method: Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed diagnostic interviews and self‐report questionnaires measuring eating disorder (ED), depression, and anxiety symptoms throughout treatment. Results: Premorbid weight loss did not differ between diagnoses. Individuals with atypical AN had more comorbid diagnoses, but groups did not differ on specific diagnoses. ED psychopathology and comorbid symptoms of depression/anxiety did not differ at admission between groups nor did rate of change in ED psychopathology and comorbid symptoms of depression/anxiety from admission to 1‐month. From admission to discharge, individuals with atypical AN had a faster reduction in ED psychopathology and comorbid symptoms of depression and anxiety (ps < 0.05; rs = 0.01–0.32); however, there were no group differences in ED psychopathology or depression symptoms at discharge (ps>.50; ds =.01–.30). Individuals with atypical AN had lower anxiety at discharge compared to individuals with AN (p = 0.05; d =.4). Length of stay did not differ between groups (p = 0.11; d =.21). Discussion: Groups had similar ED treatment trajectories, suggesting more similarities than differences. PHP may also be effective for AAN. Public Significance: This study supports previous research that individuals with AN and atypical AN have more similarities than differences. Results from this study indicate that individuals with AN and atypical AN have similar treatment outcomes for both ED psychopathology and depressive symptoms; however, individuals with atypical AN have lower anxiety symptoms at discharge compared to individuals with AN. AN and atypical AN also have more symptom similarity at admission and throughout treatment, which challenges their current designation as distinct disorders. [ABSTRACT FROM AUTHOR]

Background: The study of the COVID-19 disease consequences on healthcare professionals' mental health has drawn a great interest in psychology and other behavioral sciences. Previous studies mainly focused on professionals' health in terms of psychopathology, therefore, there is no research examining their positive mental health during both the first and the second wave. Also, there is no research studying healthcare professionals' social recognition during the pandemic and the influence of this variable on professionals' positive health. Methods: Following the WHO's recommendations, our objective was to measure pathology (i.e., anxiety and traumatic intensity), positive health (i.e., Hedonic, Psychological and Social Well-being) and social recognition in a sample of 200 healthcare professionals in the frontline care of Covid-19 patients. Results: In both waves, participants showed high levels of anxiety and traumatic intensity, although, as expected, in the second (vs. the first) wave psychopathological symptoms decreased. Concerning positive health indicators, in the second wave, health professionals showed more hedonic and psychological well-being than in the first one. However, in the second wave social well-being was lower than in the first wave, an expected though apparently paradoxical result, linked to the decrease in healthcare professionals' social recognition between the first and the second wave. In fact, bootstrapping procedures and Sobel Test confirm the mediating role of social recognition on the effect of Covid-19 wave on social well-being. Conclusions: Public institutions, governments, and society in general, should recognize health professionals' work, given that social recognition is a fundamental protection factor for social well-being. [ABSTRACT FROM AUTHOR]

Background: Anxiety is prevalent in older people and is associated with adverse health outcomes. Early detection and intervention are imperative, yet clinically significant anxiety in older people is often under-diagnosed. When diagnosed, pharmacotherapy is often the initial treatment, but resistance due to stigma, polypharmacy concerns, and side effects are common among the elderly. Non-pharmacological interventions such as deep breathing and progressive muscle relaxation may offer more acceptable and cost-effective options to managing anxiety. While primary care is ideal for addressing anxiety in older adults, it is important to assess the feasibility and acceptability of nurse-led interventions in general practice. Objective: To explore the perspectives of General Practice Nurses (GPNs) on the feasibility and acceptability of implementing a guided relaxation intervention for older people living with symptoms of anxiety, in Australian metropolitan and regional settings. Methods: GPNs were trained and then administered a guided relaxation intervention to older people at three metropolitan general practices and one large rural practice encompassing four sites. Subsequently, five GPNs participated in semi-structured interviews exploring the acceptability and feasibility of implementing the intervention. Interviews were recorded, transcribed and findings were mapped to four key domains of interest: "Screening", "Training and Delivery", "Perceived impact of the Intervention" and "Barriers to the intervention". Results: Overall, GPNs reported that the intervention was easy to implement, was well received, helped build relationships and enabled conversations about mental health and well-being. They noted broader applicability of acquired knowledge and skills with other clients. Conclusion: The intervention shows promise in promoting and supporting healthcare capabilities in primary care. GPNs are ideally placed to detect clinical symptoms of anxiety among older people and deliver brief well-being initiatives. However, to sustain and scale well-being interventions structured skill development, commitment from general practices, and policy shifts such as government rebates for GPNs are required. [ABSTRACT FROM AUTHOR]

Early in the COVID-19 pandemic, studies documented a marked decline in mental health and well-being when compared with prepandemic levels. This study examined how different coping styles were associated with anxiety, depression, and sleep problems among U.S. adults March–April 2020 during the COVID-19 pandemic. Data from 535 U.S. adults across three time points were analyzed using longitudinal multilevel logistic and linear regression modeling. Avoidant-emotional coping was associated with greater odds of experiencing anxiety (OR = 1.65, p <.001). Both avoidant- and active-emotional coping were associated with greater odds of experiencing depression (OR = 1.67, p <.001, and OR = 1.09, p =.022, respectively) and sleep problems (b = 0.05, p <.001, and b = 0.01, p =.005, respectively). Alternatively, problem-focused coping was associated with lower odds of depression (OR = 0.86, p <.001). Results converge with previous evidence suggesting the perniciousness of avoidant-emotional coping during the pandemic, but also underscore that problem-focused coping strategies may represent one important source of resilience for adults to adapt despite such challenges. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the second most common cancer in humans. Its therapy procedures such as breast biopsy can cause anxiety and persistent pain in patients. Virtual reality (VR) has been applied to promote comfort in various populations. However, the effectiveness of VR in relieving pain and anxiety in patients undergoing breast cancer treatment is unclear. Purpose: This study was designed to examine the effect of VR on anxiety and pain in people undergoing treatment for breast cancer. Methods: PubMed, Cochrane, Embase, Scopus, Web of Science, and MEDLINE databases were searched for studies involving VR, pain, and anxiety in patients with breast cancer published up to March 2022. The Cochrane Handbook for Systems quality evaluation standard 6.3.0 was followed to assess risk of bias in the identified studies, with the results reported in line with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses statement. Subsequently, a meta-analysis of the included data was conducted using RevMan 5.3 software. Results: Six randomized controlled trials and one quasi-experimental study were included. The strength of the evidence ranged from moderate to high. Although VR was found to ameliorate anxiety in patients with breast cancer, only three studies showed statistically significant changes. All of the included studies reported statistically significant improvement in pain levels. In addition, two of the studies reported cybersickness symptoms as a common side effect of VR. Conclusions: VR has an important role to play in alleviating pain in patients with breast cancer. However, evidence demonstrating VR's importance in alleviating anxiety symptoms in this population is insufficient. Studies conducted with larger sample sizes and high-quality research methodologies will be necessary to clarify this issue. Clinical nurses should address the potential side effects of VR. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to conduct a pre-conception care program for women of childbearing age with inflammatory bowel disease (IBD) in Korea and verify its effects on self-efficacy for IBD management, IBD-related pregnancy knowledge, and IBD-related pregnancy anxiety. It also aimed to explore the changes in participants through the program. Methods: A convergent mixed-methods study design was adopted. In the quantitative phase, 35 women (17 and 18 in the intervention and control group, respectively) participated. The intervention group attended a program that included small-group sessions and individual tele-coaching. To confirm the effects, data were collected before and one and four weeks after the intervention. In the qualitative stage, focus group interviews and tele-coaching were conducted with the intervention group. Results: After the program ended, significant differences were observed over time between the intervention and control groups for self-efficacy for IBD management (Wald χ² = 4.41, p = .036), IBD-related pregnancy knowledge (Wald χ² = 13.80, p < .001) and IBD-related pregnancy anxiety (Wald χ² = 8.61, p = .003). Qualitative data analysis revealed the following themes: (1) improving confidence in IBD management and awareness for planned pregnancy; (2) improving IBD awareness related to pregnancy and childbirth; and (3) relieving anxiety about and actively facing pregnancy. Conclusion: This study is meaningful in that, to the best of our knowledge, it is the first to develop a pre-conception care program for women diagnosed with IBD and confirm its effectiveness. Furthermore, this program is expected to be suitable for patient counseling and education in clinical practice. [ABSTRACT FROM AUTHOR]