scholarly journals POS1241 THE IMPACT OF THE COVID-19 PANDEMIC ON PHYSICAL FUNCTIONING AND MENTAL WELLBEING IN 824 PATIENTS WITH RHEUMATIC DISEASE OVER 8 MONTHS: PHYSICAL FUNCTIONING DECLINES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 903.2-904
Author(s):  
N. Cleaton ◽  
S. Raizada ◽  
T. Sheeran ◽  
J. Bateman

Background:Worldwide the detrimental consequences of the COVID-19 pandemic on physical and psychological health have been recognised. Social distancing and isolation measures have negatively impacted physical functioning (PF) and mental health (MH), and are known to have reduced physical activity (PA) generally within the population. A significant proportion of patients with autoimmune rheumatic disease (ARD) are considered ‘clinically extremely vulnerable’ (CEV), at high risk from COVID19 and been advised to follow stricter social distancing precautions than the general population. Evidence in ARD patients highlights the importance of PA in maintaining physical and psychological wellbeing. Prior to the pandemic limitations in both PF and MH in patients with ARD were recognised and early in the pandemic MH was noted to be impacted by distancing measures in this population.Objectives:This is an interim report of a research study (clinicaltrials.gov NCT04542031) exploring the impact of the COVID19 pandemic on the physical and psychological wellbeing of patients with rheumatic disease, to inform guidelines and target service provision as the pandemic continues.Methods:We distributed two web-based surveys, eight months apart during the first (April-2020) and second wave (December-2020) of the pandemic. Surveys were communicated via a linked mobile-phone SMS message, to all rheumatology patients with a validated mobile number under follow-up at the Royal Wolverhampton Trust. We assessed patients using the Short Form-12 version 2 made up of mental (MCS) and physical component scores (PCS). For each survey, data were collected 4-weeks following distribution; comparative analysis was conducted using SPSS version-27.Results:Initial surveys were sent to 7911 active follow up patients; 1694/7911 (21.4%) responded and consented for further follow up, of which 1636 were linked to a validated mobile number. 899/1636 (55.0%) responded to the second survey and 824/899 (91.7%) responses were linked across both surveys. These 824 patients were predominately female (69.5%), aged 61 years and 76.3% had an ARD; 388/824 patients were CEV, 436 were in the comparator group. For the CEV group, scores remained significantly lower than the comparator for PCS (survey 1: 36.40 vs 39.61 [P<0.001], survey 2: 36.11 vs 38.66 [P<0.001]) and MCS (41.61 vs 43.44 P<0.001; 41.19 vs 43.60 [P<0.001]); there was no deterioration in CEV scores. In the comparator group, while MCS did not differ in patients with ARD, PCS significantly decreased (1.39; 95% CI: 0.69, 2.08; P<0.001); PCS in the non-inflammatory group did not significantly change (-0.23, P=0.65).Conclusion:These preliminary data suggest that while the physical and mental health of CEV patients is significantly lower in this cohort, surprisingly, neither aspects of health have been worsened by the impacts of the pandemic over an 8-month period. However, the physical functioning of patients with ARD significantly decreased in this time, which may reflect the reduction in PA faced by society, and reduced contact with secondary care services. These data suggest services need to adapt to provide additional support to patients with ARD to maintain physical functioning during the pandemic. Further work exploring the evolving pattern of the physical and psychological responses to the pandemic is ongoing.Acknowledgements:We would like to thank the Hibbs Lupus Trust.Disclosure of Interests:None declared

2018 ◽  
Vol 74 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Melissa Y Wei ◽  
Mohammed U Kabeto ◽  
Andrzej T Galecki ◽  
Kenneth M Langa

Abstract Background Multimorbidity is common among older adults and strongly associated with physical functioning decline and increased mortality. However, the full spectrum of direct and indirect effects of multimorbidity on physical functioning and survival has not been quantified. We aimed to determine the longitudinal relationship of multimorbidity on physical functioning and quantify the impact of multimorbidity and multimorbidity-attributed changes in physical functioning on mortality risk. Methods The Health and Retirement Study (HRS) is a nationally representative population-based prospective cohort of adults aged 51 or older. In 2000, participants were interviewed about physician-diagnosed chronic conditions, from which their multimorbidity-weighted index (MWI) was computed. Between 2000 and 2011, participants reported their current physical functioning using a modified Short Form-36. With MWI as a time-varying exposure, we jointly modeled its associations with physical functioning and survival. Results The final sample included 74,037 observations from 18,174 participants. At baseline, participants had a weighted mean MWI of 4.6 ± 4.2 (range 0–36.8). During follow-up, physical functioning declined: −1.72 (95% confidence interval [CI] −1.77, −1.67, p < .001) HRS physical functioning units per point MWI in adjusted models. Over follow-up, 6,362 (34%) participants died. Mortality risk increased 8% (hazard ratio 1.08, 95% CI 1.07–1.08, p < .001) per point MWI in adjusted models. Across all population subgroups, MWI was associated with greater physical functioning decline and mortality risk. Conclusions Multimorbidity and its associated decline in physical functioning were significantly associated with increased mortality. These associations can be predicted with an easily interpreted and applied multimorbidity index that can better identify and target adults at increased risk for disability and death.


Author(s):  
M. Naveed Uddin ◽  
Mohsin Uddin

Infectious outbreaks have stirred the psychological health and mental wellbeing of individuals on a global basis. It is evident from the 1918 influenza in addition to the current COVID-19. Psychological factors are significant for comprehension and overseeing cultural issues related with pandemics, like the spreading of extreme dread, anxiety, and xenophobia that happen when individuals are compromised with infection. The research aims to identify how the COVID-19 pandemic has affected individual’s psychological wellbeing and how the psychodynamic approach can resolve such an issue. Developing a sense of detachment from oneself and the growing fear of being infected significantly affects an individual psychological wellbeing. This analysis concentrates predominantly on applying the psychodynamic approach to ascertain individual’s psychological threats during the COVID-19 crisis. This research focuses on revealing the variations generated from the psyche of individuals due to the COVID-19. It also aims to highlight the impact that COVID-19 have created on the mental health of individual beings. Moreover, the pandemic consequence on the individual’s overall lifestyle has discussed in the study.


2013 ◽  
Vol 28 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Tim R. Wind ◽  
Pooran C. Joshi ◽  
Rolf J. Kleber ◽  
Ivan H. Komproe

AbstractIntroductionVery little is known on the impact of recurrent disasters on mental health.AimThe present study examines the immediate impact of a recurrent flood on mental health and functioning among an affected population in the rural district of Bahraich, Uttar Pradesh, India, compared with a population in the same region that is not affected by floods.MethodsThe study compared 318 affected respondents with 308 individuals who were not affected by floods. Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25). Psychological and physical functioning was assessed by using the Short Form-12 (SF-12).ResultsThe affected group showed large to very large differences with the comparison group on symptoms of anxiety (D = .92) and depression (D = 1.22). The affected group scored significantly lower on psychological and physical functioning than the comparison group (respectively D = .33 and D = .80). However, hierarchical linear regressions showed no significant relationship between mental health and the domains of functioning in the affected group, whereas mental health and the domains of functioning were significantly related in the comparison group.ConclusionThis study found a large negative impact of the recurrent floods on mental health outcomes and psychological and physical functioning. However, in a context with recurrent floods, disaster mental health status is not a relevant predictor of functioning. The findings suggest that the observed mental health status and impaired functioning in this context are also outcomes of another mechanism: Both outcomes are likely to be related to the erosion of the social and environmental and material context. As such, the findings refer to a need to implement psychosocial context-oriented interventions to address the erosion of the context rather than specific mental health interventions.WindTR, JoshiPC, KleberRJ, KomproeIH. The impact of recurrent disasters on mental health: a study on seasonal floods in northern India. Prehosp Disaster Med. 2013;28(3):1-7.


2020 ◽  
Vol 41 (8) ◽  
pp. 893-900
Author(s):  
John R. Steele ◽  
Daniel J. Cunningham ◽  
Cynthia L. Green ◽  
Thomas J. Risoli ◽  
James K. DeOrio ◽  
...  

Background: Characteristics of responders, or those who achieve a clinical improvement above the level of a minimal clinically important difference, have not been defined for total ankle arthroplasty (TAA). The purpose of this study was to determine patient characteristics that distinguish possible responders from possible nonresponders after TAA using criteria established for other arthroplasty surgeries. Methods: Patients undergoing TAA who were enrolled into a prospective study at a single academic center evaluating patient-reported outcomes were included. Patients were characterized as possible responders if the relative or absolute improvement in their 2-year follow-up Short Musculoskeletal Function Assessment (SMFA) function score was at least 50% or 20, respectively, compared with their preoperative score, consistent with Outcome Measures in Rheumatoid Arthritis Clinical Trials and the Osteoarthritis Research Society International (OMERACT-OARSI) responder criteria. Patient factors were then associated with possible responder or nonresponder status and a multivariable analysis was performed. A total of 491 patients with complete data and 2-year follow-up were included in this study. Results: Multivariable analysis demonstrated that a higher baseline 36-Item Short-Form Survey (SF-36) mental component summary (MCS) score (OR [95% CI], 1.02 [1.01, 1.04]; P = .003), indicating better mental health, was associated with being a possible responder to TAA. The presence of rheumatic disease (OR [95% CI], 0.38 [0.22, 0.67]; P = .001) was a significant predictor of being a possible nonresponder. Conclusion: Our data reveal that a higher baseline SF-36 MCS score was associated with increased improvement in SMFA function scores, while rheumatic disease was associated with worse improvement in SMFA function scores after TAA. Patients with rheumatic disease or poor mental health may not achieve as favorable results after TAA and should be counseled appropriately. Level of Evidence: Level III, retrospective comparative study.


Author(s):  
N.M. Gamage ◽  
C. Darker ◽  
B.P. Smyth

Objectives: Adolescents with substance use disorders (SUDs) exhibit high rates of comorbid psychological problems. This study aimed to examine the impact of an outpatient substance use treatment programme upon the psychological wellbeing of adolescents. Methods: A prospective study was carried out examining psychological symptoms in a group of adolescents attending the Youth Drug and Alcohol (YoDA) Addiction Service in Dublin. Participants were treated with evidenced based psychological models such as cognitive behavioural therapy, motivational interviewing and systemic family therapy. The Becks Youth Inventory was utilised to assess psychological symptoms at treatment entry and repeated three months later at follow up. Results: Among 36 adolescents who were included in this study, poly-substance misuse was the norm. Almost three-quarter had a cannabis use disorder (CUD). There were significant reductions in mean subscale scores of depression (56.0 to 50.8, p = 0.003), anger (55.2 to 49.5, p < 0.001) and disruptive behaviour (61.6 to 56.5, p = 0.002) at follow up. Although there wasn’t a statistically significant reduction in mean scores for anxiety, we observed a significant proportion of participants (p = 0.008) improving and moving out of a moderate to severe symptom range when examined by category. This was also the case for self-concept (p = 0.04). Furthermore this study revealed a positive correlation between the reduction in days of cannabis use and reduction in depressive scores (Pearson correlation 0.49, p = 0.01) among those with a CUD. Conclusion: The findings indicate that substance use treatment for adolescents is associated with important psychological and behavioural improvements.


Author(s):  
Panagiotis Zis ◽  
Artemios Artemiadis ◽  
Panagiotis Bargiotas ◽  
Antonios Nteveros ◽  
Georgios M. Hadjigeorgiou

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.


Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 414
Author(s):  
Maria Melania Lica ◽  
Annamaria Papai ◽  
Andreea Salcudean ◽  
Maria Crainic ◽  
Cristina Georgeta Covaciu ◽  
...  

Assessing mental health in children and adolescents with insulin-dependent diabetes (IDD) is an issue that is underperformed in clinical practice and outpatient clinics. The evaluation of their thoughts, emotions and behaviors has an important role in understanding the interaction between the individual and the disease, the factors that can influence this interaction, as well as the effective methods of intervention. The aim of this study is to identify psychopathology in adolescents with diabetes and the impact on treatment management. A total of 54 adolescents with IDD and 52 adolescents without diabetes, aged 12–18 years, completed APS–SF (Adolescent Psychopathology Scale–Short Form) for the evaluation of psychopathology and adjustment problems. There were no significant differences between adolescents with diabetes and control group regarding psychopathology. Between adolescents with good treatment adherence (HbA1c < 7.6) and those with low treatment adherence (HbA1c > 7.6), significant differences were found. In addition, results showed higher scores in girls compared with boys with IDD with regard to anxiety (GAD), Major Depression (DEP), Post-Traumatic Stress Disorder (PTSD), Eating Disturbance (EAT), Suicide (SUI) and Interpersonal Problems (IPP). No significant differences were found regarding the duration of the disease. Strategies such as maladaptive coping, passivity, distorted conception of the self and the surrounding world and using the negative problem-solving strategies of non-involvement and abandonment had positive correlation with poor glycemic control (bad management of the disease). The study highlighted the importance of promoting mental health in insulin-dependent diabetes management.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.


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