Worsened Financial Situation During the COVID-19 Pandemic Was Associated With Depressive Symptomatology Among University Students in Germany: Results of the COVID-19 International Student Well-Being Study

Background: Previous findings suggest that university students are at an elevated risk to experience financial hardship and to suffer from depressive symptoms. This vulnerability may have substantially increased during the coronavirus disease 19 (COVID-19) pandemic which might have affected students' socio-economic situation but possibly also their mental well-being. We examined whether the financial situation changed during the COVID-19 pandemic among German university students, and whether changes were associated with mental well-being.Methods: We conducted a cross-sectional online survey in May and July 2020 at five German universities. Participants were asked, if they had sufficient financial resources to cover monthly expenses before and during the pandemic. The answer options were dichotomized into worsened and no change/better financial situation compared to before the COVID-19 pandemic. Depressive symptoms were assessed using the CES-D 8 scale. For examining associations between sociodemographic, study-related, and financial factors and “worsened financial situation,” we ran a generalized linear mixed model. To assess associations between depressive symptoms and worsened financial situation, we performed a linear mixed model.Results: We included 7,199 participants in the analyses (69% female, 30% male, 1% diverse, mean age: 24 years, standard deviation: 4.7). Overall, 25% of the participants reported to have a worsened financial situation at the time of the survey than in the time before COVID-19. Factors associated with a worsened financial situation were migration background, parents not being academics, not being able to borrow money, and payment of tuition fee by student and loan [odds ratios (OR) ranging from 1.20 to 2.35]. Factors associated with lower odds were: being single, living with others, studying a health-related field, being enrolled in a doctoral/Ph.D. or state exam program, and publicly funded tuition/tuition paid with a scholarship (OR ranging from 0.42 to 0.80). A worsened financial situation was associated with 1.02 points more on the CES-D 8 scale (95% CI: 0.80–1.24).Conclusion: Our results suggest that the pandemic put a number of students under financial strain with detrimental consequences for their mental well-being. Renewed attention must be paid to this vulnerable group to prevent the potentially damaging effects on their mental health.

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Perceptions of Study Conditions and Depressive Symptoms During the COVID-19 Pandemic Among University Students in Germany: Results of the International COVID-19 Student Well-Being Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.674665 ◽

2021 ◽

Vol 9 ◽

Author(s):

Paula Mayara Matos Fialho ◽

Franca Spatafora ◽

Lisa Kühne ◽

Heide Busse ◽

Stefanie M. Helmer ◽

...

Keyword(s):

Depressive Symptoms ◽

University Students ◽

Online Survey ◽

Positive Association ◽

Well Being ◽

Cross Sectional ◽

German Student ◽

The University ◽

The Impact ◽

Mental Well Being

Background: Results of previous studies examining the impact of the SARS-CoV-1 epidemic in 2003 on university students' mental well-being indicated severe mental health consequences. It is unclear how the current COVID-19 pandemic and the changes in study conditions due to federal regulations affected mental well-being in the German student population. We examined university students' perceptions of study conditions during the COVID-19 pandemic and investigated associations between study conditions and depressive symptoms.Methods: A cross-sectional online survey was conducted in Germany in May 2020 at four universities (N = 5,021, 69% female, mean age: 24 years, SD: 5.1). Perceived study conditions, as well as sociodemographic information, were assessed with self-generated items and the CES-D 8 scale was used to determine depressive symptoms. Associations between perceived study conditions (academic stress and academic satisfaction), in general, and confidence to complete the semester, in particular, and depressive symptoms were analyzed using generalized linear regressions.Results: Fifty-four percent of survey participants felt that the university workload had significantly increased since the COVID-19 pandemic; 48% were worried that they would not be able to successfully complete the academic year; 47% agreed that the change in teaching methods caused significant stress. Regarding depressive symptoms, the mean score of the CES-D 8 scale was 9.25. Further, a positive association between perceived study conditions and depressive symptoms was found (p < 0.001), indicating that better study conditions were associated with fewer depressive symptoms. Results of the generalized linear regression suggest that better student mental well-being was related to higher confidence in completing the semester.Conclusions: This study provides first insights into perceived study conditions and associations with depressive symptoms among students during the COVID-19 pandemic in Germany. Findings underline the need for universities to provide intervention strategies targeting students' mental well-being during the course of the pandemic.

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FACTORS INFLUENCING STAFF-RESIDENT INTERACTIONS IN NURSING HOMES

Innovation in Aging ◽

10.1093/geroni/igz038.1860 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S503-S503

Author(s):

Anju Paudel ◽

Elizabeth Galik ◽

Barbara Resnick

Keyword(s):

Nursing Homes ◽

Marital Status ◽

Mixed Model ◽

Linear Mixed Model ◽

Nursing Home Residents ◽

Well Being ◽

Positive Interactions ◽

Positive Interaction ◽

Factors Associated ◽

Profit Status

Abstract Staff-resident interaction is an integral part of daily life of nursing home residents and has an influence on residents’ well-being. However, less is known about the factors that influence these interactions. The purpose of this study was to describe the quality of interaction between staff and residents with dementia in nursing homes, and explore the factors associated with ‘positive’ and ‘negative/neutral’ interactions. This cross-sectional analysis utilized baseline data from the first two cohorts in a randomized clinical trial, EIT-4-BPSD, including 338 residents from 35 nursing homes. Generalized linear mixed model (GLMM) was used to explore the factors associated with interactions. It was hypothesized that the resident factors (age, gender, race, marital status, cognition, comorbidities, depressive symptoms, agitation, functional status) and facility factors (facility ownership, facility size, RN hours, LPN hours, CNA hours, and star rating) would be associated with staff-resident interactions. The staff-resident interactions were mostly positive. Overall, the models for ‘positive interactions’ and ‘negative/neutral interactions’ correctly classified 82.8% and 85.3% of the cases respectively. Both ‘positive’ and ‘negative/neutral’ interactions were significantly associated with marital status, and profit status of the facility. Being married and living in a not for profit facility was associated with lower odds of positive interaction and higher odds of negative/neutral interaction. There is some evidence that marital status influences staff-resident interactions and that profit status of facilities are associated with staff resident interactions. Future studies could explore staff factors such as consistent assignment, job satisfaction, staff characteristics, and training.

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Assessment of depressive symptoms in severe smokers with minimal-mild depressive symptomatology receiving pre-smoking abstinence for integrated treatment: a randomized clinical trial

Salud Mental ◽

10.17711/sm.0185-3325.2015.058 ◽

2015 ◽

Vol 38 (6) ◽

pp. 433-439 ◽

Cited By ~ 2

Author(s):

A Moreno-Coutiño ◽

◽

Fabiola García-Anguiano ◽

S Ruiz-Velasco ◽

María Elena Medina-Mora ◽

...

Keyword(s):

Depressive Symptoms ◽

Mixed Model ◽

Linear Mixed Model ◽

Depressive Symptomatology ◽

Psychological Treatment ◽

Nicotine Patch ◽

Random Effect ◽

Integrated Treatment ◽

Smoking Abstinence ◽

Treatment Settings

Abstract Introduction. Smoking and depression have a long-history documented of comorbidity. Objective. The objective of this study was to develop and test a treatment that could simultaneously achieve smoking abstinence and decrease depressive symptoms in a group of heavy smokers with minimal/mild depressive symptomatology. Method. Sixty smokers were randomly assigned to three different treatment settings. Treatment included a pre-abstinence phase, a psychological treatment phase, a pharmacotherapy phase and a follow-up stage. Smokers began the psychological treatment and the pharmacotherapy two weeks before the day they chosen to quit smoking, and monitoring was conducted over a year. Abstinence was confirmed by assessing the levels of urinary cotinine. Results. Using a linear mixed model with individual random effect, baseline data was compared with subsequent assessments; 46% of the patients achieved abstinence. For men, the three treatment settings significantly reduced depressive symptoms and helped smokers to achieve abstinence. For women, only the nicotine patch showed to be effective in the reducing depressive symptoms. Discussion and conclusion. Integral pre-abstinence treatment is effective in aiding smokers to achieve smoking abstinence and improve depressive symptoms.

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STIGMATIZATION AND QUALITY OF LIFE OF MALE-TO-FEMALE- TRANSGENDER UNIVERSITY STUDENTS IN THE NORTHEAST OF THAILAND

Journal of Southwest Jiaotong University ◽

10.35741/issn.0258-2724.56.5.43 ◽

2021 ◽

Vol 56 (5) ◽

pp. 476-484

Author(s):

Phattarapon Ponprisan ◽

Wongsa Loahasiriwong ◽

Thitima Nutrawong ◽

Nopparat Senahad

Keyword(s):

Quality Of Life ◽

University Students ◽

Mixed Model ◽

Linear Mixed Model ◽

Generalized Linear Mixed Model ◽

Cross Sectional ◽

Factors Associated ◽

Transgender Students ◽

Male To Female

Transgender students are vulnerable to mental and physical health problems, impacting their quality of life (QOL). This research aims to study the stigma influence on the QOL of male-to-female transgender university students in Northeastern Thailand. This cross-sectional study was conducted among 765 male-to-female transgender students selected from 17 universities of the Northeast of Thailand using a multistage random sampling to respond to a self-administered structured questionnaire. The generalized linear mixed model (GLMM) was performed to identify factors associated with quality of life when controlling the effects of covariates, presenting adjusted OR and 95% confidence intervals. Among 765 male-to-female transgender students, more than half of them had good QOL (52.81%; 95%CI = 49.25-56.33). The generalized linear mixed model (GLMM) observed that factors associated with good QOL including moderate-low stigmatization (adj.OR=6.39; 95%CI = 2.72-15.02), good health behaviors (adj.OR=1.88; 95%1.47-2.86), no stress problem (adj.OR=1.81; 95%CI = 1.30-2.51), good self-acceptance (adj.OR=1.67; 95%CI = 1.37-2.03) and good social environment (adj.OR=1.41; 95%CI = 1.13-1.76). These findings could provide data to support evidence for family, community, societal and relevant sectors under the Ministry of Public Health and Ministry of Education and local administration organizations to promote the quality of life in transgender people effectively.

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Factors associated with professional identity formation within psychiatry residency training: A longitudinal study

Perspectives on Medical Education ◽

10.1007/s40037-021-00673-w ◽

2021 ◽

Author(s):

Qian Hui Chew ◽

Yvonne Steinert ◽

Kang Sim

Keyword(s):

Professional Identity ◽

Identity Formation ◽

Psychiatry Residency ◽

Mixed Model ◽

Linear Mixed Model ◽

Developmental Stages ◽

Rate Of Change ◽

Psychiatry Residents ◽

Factors Associated ◽

Over Time

Abstract Introduction Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Based on extant literature and clinical impressions, the authors aimed to explore factors associated with PI formation in psychiatry residents over time, and hypothesized that time in training, seniority status, and duration of exposure to psychiatry prior to residency would be associated with PI formation. Methods Eighty out of 96 psychiatry residents (response rate, 83.3%) from the National Psychiatry Residency Program in Singapore participated and rated their PI development using the Professional Self Identity Questionnaire (PSIQ) across four timepoints from January 2016–December 2019. The residents were classified as junior (first 3 years) or senior residents (years 4–5). Linear mixed model analyses were conducted, with time in training, seniority status (junior versus senior residents), duration of psychiatry postings prior to residency, and their interaction as associated factors with PI over time. Results Time in training, seniority, and duration of psychiatry postings before residency (all p < 0.01) were significantly associated with higher PSIQ scores at baseline. Over time, although all residents had increases in PSIQ scores, this rate of change did not differ significantly between junior and senior residents. Discussion Exposure to psychiatry postings before residency, time in learning, and seniority are factors which influence PI development in residents. This has implications for psychiatry residency selection and training, adequate clinical exposure during training rotations, and continual support for new and senior residents to foster PI formation over time.

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Do opposite ends of same factors underlie life satisfaction vs. depressive symptoms among older people?

Aging Clinical and Experimental Research ◽

10.1007/s40520-020-01765-z ◽

2021 ◽

Author(s):

Katja Pynnönen ◽

Katja Kokko ◽

Milla Saajanaho ◽

Timo Törmäkangas ◽

Erja Portegijs ◽

...

Keyword(s):

Life Satisfaction ◽

Depressive Symptoms ◽

Older People ◽

Executive Functions ◽

Physical Performance ◽

Well Being ◽

Community Dwelling ◽

Satisfaction With Life Scale ◽

Financial Situation ◽

Self Acceptance

Abstract Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. Methods The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one’s life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling. Results Better physical performance, not perceiving loneliness, having special interests in one’s life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes. Discussion The opposite ends of the same factors underlie positive and negative dimensions of mental well-being. Conclusion Further studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.

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THE IMPACT OF HOSPITAL BASED INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS TRAINING ON PEDIATRIC NURSE COMPETENCY

Belitung Nursing Journal ◽

10.33546/bnj.362 ◽

2018 ◽

Vol 4 (1) ◽

pp. 16-23

Author(s):

Fitri Haryanti ◽

Mohammad Hakimi ◽

Yati Sunarto ◽

Yayi S Prabandari

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Integrated Management ◽

Well Being ◽

Childhood Illness ◽

Internal Conflict ◽

Child Health Services ◽

Management Support ◽

The Impact

Background: Although the WHO strategy integrated management of childhood illness (IMCI) for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies.Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004.Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities (nutritionist, pharmacist, laboratory) in Cut Nyak Dien (CND) Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis.Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up. The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster.Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a rebuilding process. The program requires strong management support and the emergency phase to be subsided. Other pre-requisites include the existence of standard operating procedures, adequate physical facilities and support for staff morale and well-being. Improving the quality of paediatric care requires more than just training and clinical guidelines; internal motivation and health worker support are essential.

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Socioeconomic gradients and mental health: implications for public health

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.147280 ◽

2015 ◽

Vol 206 (6) ◽

pp. 461-465 ◽

Cited By ~ 38

Author(s):

Sarah Stewart-Brown ◽

Preshila Chandimali Samaraweera ◽

Frances Taggart ◽

Ngianga-Bakwin Kandala ◽

Saverio Stranges

Keyword(s):

Mental Health ◽

Mental Illness ◽

Employment Status ◽

Linear Trend ◽

Well Being ◽

Odds Ratios ◽

Factors Associated ◽

Middle Range ◽

The Unemployed ◽

Mental Well Being

BackgroundResearch on mental well-being is relatively new and studies of its determinants are rare.AimsTo investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness.MethodUsing logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England.ResultsIndependent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01–2.10) and those aged 35–54 years (OR = 1.58, 95% CI 1.35–1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62–0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23–1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09–1.69); education where there was no association; and equivalised income for which the association was non-linear.ConclusionsOdds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.

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Pattern of Changes during Treatment: A Comparison between a Positive Psychology Intervention and a Cognitive Behavioral Treatment for Clinical Depression

The Spanish Journal of Psychology ◽

10.1017/sjp.2017.44 ◽

2017 ◽

Vol 20 ◽

Cited By ~ 3

Author(s):

Irene Lopez-Gomez ◽

Covadonga Chaves ◽

Gonzalo Hervas ◽

Carmelo Vazquez

Keyword(s):

Depressive Symptoms ◽

Positive Psychology ◽

Repeated Measures ◽

Behavioral Treatment ◽

Mixed Model ◽

Well Being ◽

Clinical Depression ◽

Cognitive Behavioral ◽

Cognitive Behavioral Treatment ◽

Gradual Improvement

AbstractResearch on psychotherapy has traditionally focused on analyzing changes between the beginning and the end of a treatment. Few studies have addressed the pattern of therapeutic change during treatment. The aim of this study was to examine the pattern of changes in clinical and well-being variables during a cognitive behavioral therapy (CBT) program compared with an integrative positive psychology interventions program for clinical depression IPPI-D. 128 women with a diagnosis of major depression or dysthymia were assigned to the CBT or PPI group. A measure of depressive symptoms (i.e., Beck Depression Inventory) and well-being (i.e., Pemberton Happiness Index) were administered four times: at the beginning and end of the treatment, as well as during treatment (at sessions 4 and 7). Through mixed-model repeated measures ANOVAs, both depressive symptoms (p < .001, partial η2 = .52) and well-being (p < .001, partial η2 = .29) showed a significant improvement through the four assessment times. No significant interactions between time and treatment modality were found (ps > .08). The percentage of improvement in depressive symptoms in the first treatment period was higher than in the later ones (ps < .005). On the contrary, well-being showed a more gradual improvement (p = .15). These results highlight the importance of assessing the pattern of changes in symptoms and well-being separately.

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Determinants of psychological well-being in axial spondyloarthritis: an analysis based on linked claims and patient-reported survey data

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-212629 ◽

2018 ◽

Vol 77 (7) ◽

pp. 1017-1024 ◽

Cited By ~ 17

Author(s):

Imke Redeker ◽

Falk Hoffmann ◽

Johanna Callhoff ◽

Hildrun Haibel ◽

Joachim Sieper ◽

...

Keyword(s):

Socioeconomic Status ◽

Depressive Symptoms ◽

Axial Spondyloarthritis ◽

Well Being ◽

Lifestyle Factors ◽

Postal Questionnaire ◽

Health Insurance Data ◽

Psychological Well Being ◽

Factors Associated ◽

Patient Reported

ObjectivesThe aim of this study was to assess the psychological well-being and to analyse factors associated with depressive symptoms in axial spondyloarthritis (axSpA).MethodsA stratified random sample of subjects with a diagnosis of axSpA (International Classification of Diseases, Tenth Revision, German Modification M45) was drawn from health insurance data in Germany. These persons received a postal questionnaire on disease-related, psychological and lifestyle factors as well as socioeconomic status. Additional information to verify the axSpA diagnosis was also collected. The psychological well-being was assessed by means of the 5-item WHO Well-Being Index (WHO-5), which is considered a screening tool for depression. The following established cut-offs on the WHO-5 were applied: >50: good well-being, no depressive symptoms; 29–50: mild depressive symptoms; ≤28: moderate-to-severe depressive symptoms. Information on comorbidities, drug prescriptions and non-pharmacological treatment was retrieved from claims data and linked to the questionnaire data.ResultsA total of 1736 persons with a confirmed axSpA diagnosis were included. Using the cut-offs on the WHO-5, 533 persons (31%) were found to have moderate-to-severe depressive symptoms, 479 (28%) had mild depressive symptoms and 724 (42%) had a good well-being. Multivariable logistic regression revealed that higher disease activity, higher level of functional impairment, lower income, self-reported stress and lack of exercise, and younger age represent factors associated with moderate-to-severe depressive symptoms.ConclusionsThe prevalence of depressive symptoms in axSpA subjects is high and associated with disease-related parameters, socioeconomic status and lifestyle factors. These findings highlight the need for the careful evaluation of depressive symptoms as a part of the management strategy for axSpA.

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