Psychological Burden and Associated Factors of the COVID-19 Pandemic on People in Quarantine and Isolation Centers in Ethiopia: A Cross-Sectional Study

Background: Globally, a lot of countries put into practice early quarantine measures as an essential COVID-19 prevention mechanism. Other than physical effects, quarantine has a major result on mental health and well-being at both the individual as well as the community level at large. Therefore, this study aimed to assess the psychological burden of COVID-19 on the people in quarantine and isolation centers and to identify associated factors for early and effective psychosocial intervention during the pandemic and beyond.Method: A cross-sectional study was done among 392 suspected cases of COVID-19 that were in quarantine and isolation centers found in Eastern Ethiopia in 2020. Participants were selected by the convenience sampling method. The common mental disorder was measured by the Self Reporting Questionnaire-20 (SRQ-20). Logistic regression was done to identify predictive factors, and a P < 0.05 was considered statistically significant.Results: The common mental disorder among suspected cases of COVID-19 in Ethiopia was found to be 13.5% (95% CI: 10.2, 17.1%). Female (AOR = 1.52, 95% CI: 1.1, 2.92), known chronic medical illness (AOR = 7.0, 95% CI: 2.2, 21.8), inadequate accessibility of personal protective equipment (AOR = 6.1, 95% CI: 2.8, 13.3), poor awareness about the pandemic (AOR = 2.90, 95% CI: 2.71, 7.54), presence of symptoms of the disease (AOR = 5.3, 95% CI: 2.57, 11.1), and substance use (AOR = 2.7, 95% CI: 1.2, 6.1) were found to be associated with a common mental disorder.Conclusion: The current study revealed that the common mental disorder was relatively high among suspected cases of COVID-19 in quarantine and isolation centers as compared with the general population. The results of the present study demonstrate that some subpopulations are more vulnerable to the pandemic's deleterious effects on mental health. Therefore, providing appropriate psychosocial intervention for the populations at risk is important to decrease the effect of common mental disorders among suspected cases of COVID-19.

Ehlers-Danlos Syndrome in the Field of Psychiatry: A Review

Ehlers-Danlos syndrome (EDS) comprises a series of rare hereditary connective tissue diseases characterized by joint hypermobility, joint dislocation, and hyperextensibility of the skin, as well as cardiovascular involvement. EDS is often associated with chronic widespread physical pain, which can lead to psychological pain. Poor awareness and limited diagnosis of EDS and related symptoms result in decreased self-esteem and confusion regarding physical sensation. Furthermore, EDS imposes substantial psychological burden on patients due to exercise restriction, scars, keloids, and subcutaneous fat accumulation on the extremities, which leads to parental overprotection and bullying experiences from other children at school age. Recent large-scale studies have suggested that patients with EDS have a higher risk of mood disorders than the general population. Other cohort studies indicated high prevalence of anorexia nervosa, addiction, obsessive compulsive disorder, and anxiety disorder were found in patients with EDS. Case reports instead indicated that some psychiatric disorders were secondary symptoms due to physical problems from EDS. Therefore, psychiatrists must be more knowledgeable and proactive about EDS in their practice. We review the previous case reports and literature for patients with EDS, along with our own case of complicated psychiatric problems, which are strongly related to early stressful situations through childhood and adolescence. This is to aid general psychiatrists in the discussion of appropriate medical management in such infrequent, yet challenging conditions.

Psychosocial concerns in a context of prolonged political oppression: Gaza mental health providers’ perceptions

In this qualitative exploratory study, we investigated the perspectives of mental health providers in Gaza, Palestine, regarding the primary concerns of their clients who are exposed to low-intensity warfare and structural violence. We conducted qualitative interviews with 30 psychologists, social workers, psychiatric nurses, and psychiatrists providing services to communities in Gaza. Participants were asked to discuss their clients’ most commonly occurring mental health problems, diagnoses, and psychosocial conditions. Thematic analysis identified one superordinate theme (Impact of the Blockade on Mental Health and Quality of Life) and four second-order themes (Concerns about Social Problems, General Concerns about Quality of Life, Concerns about the Mental Health of the Community, and Concerns Related to Children's Mental Health). Participants indicated that the social and political dimensions of mental health and the economic, educational, and health-related consequences of the ongoing blockade of Gaza were the main determinants of psychological burden among their clients. Findings demonstrated the importance of adopting an approach to mental health that includes understanding psychological indicators in a broader framework informed by human rights and social justice. Implications for research and clinical work are discussed, including the role of investments in social capital that may provide individuals with access to resources such as social support, which may in turn promote overall mental health.

Caregiver burden among family members of patients diagnosed with cancer in Jimma medical center oncology unit, south west Ethiopia.

Background Cancer is a type of disease defined by uncontrolled growth and spread of abnormal cells, which can result in death. Globally, around 25 million people are surviving with it. The burden of cancer is growing in developing countries and it frequently comprises patient’s vitality. In addition, it has emotional, economical, physical and psychological burden on family, friends, significant others, community and other social resource. Objective To assess caregiver burden of cancer patients in Jimma medical center oncology unit, South west Ethiopia. Method An institutional based cross-sectional study design was employed. The study was done on 141 respondents using simple random sampling. A pretested semi structured interviewer administered questionnaire was used to collect the data. The collected data was entered in to EPI data version 3.1 then transferred to SPSS version 23 for data analysis. Multivariable logistic regression model was fitted, Adjusted Odds Ratio (AOR) at 95% confidence interval and p-value <0.05 were estimated to determine statistically association between predictors and outcome variables. Results The data were collected from the total of 141 respondents with 100% response rate. The mean ±SD age of cancer patients and care givers were 46.4 ±12.406 and 32 ± 11.23 years, respectively. The general level of caregiver burden in this study was mild to moderate (71.6%) with ZBI total score of 30 and by using CBI114 (80.9%) had some burden. Caregivers whose their age is greater than 40 years were 4.01 times more likely have high burden than those age between 20-40 old age [AOR=4.01, 95%CI (1.58, 10.17)]. Conclusion The study disclosed a moderate level of caregiver burden among family caregivers.

Pre-surgery supportive and goal-oriented strategies are associated with lower post-surgery perceived distress in women diagnosed with breast cancer

Background Psycho-oncology literature pointed out that individual health outcomes may depend on patients’ propensity to adopt approach or, conversely, avoidant coping strategies. Nevertheless, coping factors associated with postoperative distress remain unclear, unfolding the lack of tailored procedures to help breast cancer patients manage the psychological burden of scheduled surgery. In view of this, the present study aimed at investigating: 1. pre-/post-surgery distress variations occurring among women diagnosed with breast cancer; 2. the predictivity of approach and avoidant coping strategies and factors in affecting post-surgery perceived distress. Methods N = 150 patients (mean age = 59.37; SD = ± 13.23) scheduled for breast cancer surgery were administered a screening protocol consisting of the Distress Thermometer (DT) and the Brief-COPE. The DT was used to monitor patients’ distress levels before and after surgery (± 7 days), whereas the Brief-COPE was adopted only preoperatively to evaluate patients’ coping responses to the forthcoming surgical intervention. Non-parametric tests allowed for the detection of pre-/post-surgery variations in patients’ perceived distress. Factor analysis involved the extraction and rotation of principal components derived from the Brief-COPE strategies. The predictivity of such coping factors was investigated through multiple regression (Backward Elimination). Results The Wilcoxon Signed-Rank Test yielded a significant variation in DT mean scores (TW = -5,68 < -zα/2 = -1,96; p < .001) indicative of lower perceived distress following surgery. The four coping factors extracted and Varimax-rotated were, respectively: 1. cognitive processing (i.e., planning + acceptance + active coping + positive reframing); 2. support provision (i.e., instrumental + emotional support); 3. emotion-oriented detachment (i.e., self-blame + behavioral disengagement + humor + denial); 4. goal-oriented detachment (i.e., self-distraction). Among these factors, support provision (B = .458; β = − .174; t = − 2.03; p = .045), encompassing two approach coping strategies, and goal-oriented detachment (B = .446; β = − .176; t = − 2.06; p = .042), consisting of one avoidant strategy, were strongly related to post-surgery distress reduction. Conclusion The present investigation revealed that the pre-surgery adoption of supportive and goal-oriented strategies led to postoperative distress reduction among breast cancer patients. These findings highlight the importance of timely psychosocial screening and proactive interventions in order to improve patients’ recovery and prognosis.

COVID-19 collateral damage—psychological burden and behavioural changes among older adults during the first outbreak in Stockholm, Sweden: a cross-sectional study

ObjectivesTo explore the indirect negative effects of COVID-19 restrictions (collateral damage) on the lives and health of older adults living in central Stockholm, and to characterise the sociodemographic profile of those with the highest susceptibility to this damage.DesignCross-sectional study.SettingDistrict of Kungsholmen in Stockholm, Sweden.ParticipantsOlder adults aged 68 years and above (n=1231) who participated in the ad hoc COVID-19-related phone questionnaire administered by trained staff between May and June 2020 and who had previously attended the regular follow-up assessment of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016–2019.Primary and secondary outcome measuresThree dimensions of collateral damage: psychological burden (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use since the beginning of the pandemic. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage.ResultsVast majority of participants adhered to the national public health recommendations, with over three-quarters practising self-isolation (n=928). Half of the sample reported psychological burden, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants (77.8%) were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of both individual and co-occurring dimensions of collateral damage.ConclusionsCOVID-19 and its restrictions during the first half of 2020 had a negative effect on the health and lives of a majority of the elderly living in central Stockholm. Women were at a higher risk of these negative consequences. We emphasise the need for predefined, evidence-based interventions to support those who are most susceptible to these consequences, both during the pandemic and once the outbreak is overcome.

Digital learning for disadvantaged students during COVID-19

The digital learning instituted in Hungary in the spring of 2020 to halt the spread of the coronavirus there arguably encountered stumbling blocks as regards disadvantaged students. However, we have no information about the details, and mitigating these disadvantages is therefore fraught. The aim of our research is to shed light on the experience of digital learning among disadvantaged students. We analysed responses to an online questionnaire completed by teachers at 48 of Hungary’s after-school programmes (ASPs) who were in contact with over 1000, mostly disadvantaged children. We discussed the questionnaire-based analysis with ten ASP representatives in online workshops. In addition to ICT devices and Internet access, the lack of a learning space is also worth considering in promoting the establishment of objective conditions. In maintaining contact with parents, it is recommended that communication habits that differ from those of the middle class should be taken into account. Developing time management and other skills necessary for independent learning (e.g. reading comprehension, digital literacy) as well as alleviating the psychological burden represent a central task in similar situations. Our recommendations may be of use in the event of future school closures and in terms of facilitating digital learning among disadvantaged students.

A comparative study on the health status of caregivers between intensive and non-intensive care unit patients in a tertiary care hospital of urban Bengaluru

Background: Caregivers providing care to hospitalized family members are potentially at risk for declining physical and psychological health. To assess and compare physical and psychological burden of caregivers of Intensive care unit and non-Intensive care unit (non-ICU) patients.Methods: A descriptive, hospital-based, cross-sectional study was conducted among 256 caregivers (127 Intensive care unit and 129 non-ICU patients) in a tertiary care hospital in urban Bengaluru for 6 months (July-December, 2019). A modified Hospital anxiety and depression scale (HADS) and Perceived stress scale was used to assess the anxiety and stress burden among the caregivers, respectively.Results: Out of 256 caregivers, 196 (76.56%) experienced some form of physical burden, 112 (57.14%) belonged to ICU group and 84 (42.86%) non-ICU group (Z=2, p=0.045). Anxiety problem was observed in 54.29% caregivers, and was found statistically significant in caregivers of ICU (62.59%) patients than non-ICU (37.41%) patients (Z=2.969, p=0.002). Similarly, the burden of stress was observed in 203 (79.29%) caregivers, predominantly in ICU group (54.19%) compared to non-ICU (45.81%) group.Conclusions: Three-fourth of the caregivers had one or the other physical symptoms and nearly half of them had stress and anxiety irrespective of ICU or non-ICU admission. The financial burden was more among the ICU caregivers and the longer duration of stay had affected the health of the caregivers.

EXPERIENCES OF PEOPLE LIVING WITH HIV/AIDS IN SURVIVING LIFE

Background: Fear of contracting HIV in the community causes discrimination and stigma to people living with HIV/AIDS (PLWHA) because people still consider HIV/AIDS taboo. Many of the sufferers struggle to reveal their HIV status to others, but they get negative results such as rejection, stigmatization and even discrimination which can be a high psychological burden. Stigma and discrimination against PLWHA are the main obstacles to achieving a good quality of life. Objectives: This study is intended to explore the in-depth experiences of people living with HIV/AIDS in surviving life. Methods: This research is a phenomenological case study. The sample in this study amounted to three people who were recruited from Healthy Loving Care Foundation Semarang City. The sample was determined using a purposive sampling technique according to the inclusion criteria, that is age 20 and 50 years, diagnosed with HIV/AIDS, conscious, cooperative, not experiencing cognitive, hearing and speech disorders, willing to participate in the study by signing the informed consent. The data was collected by in-depth online interviews and then recorded in transcripts and analyzed using Amedeo Giorgi's data analysis technique. Results: This study showed that participants experience adversity due to HIV/AIDS but the participants get out of their slump by accepting their illness, taking treatment, finding a support system and becoming a positive people. The participants also in living their lives keep their illness a secret to survive so as not to experience bad stigma or discrimination. The results of this study reveal one main theme, Experiences of People living with HIV in Surviving life. Conclusion: This study found the support received by participants and the response of participants to their condition as an effort to survive their lives.