Psychosocial health in pregnancy and postpartum among women living with - and without HIV and non-pregnant women living with HIV living in the Nordic countries – Results from a longitudinal survey study

Background The success of antiretroviral therapy has normalized pregnancy among women living with HIV (WWH) with a very low risk of perinatal transmission of HIV. Despite these advances, WWH still face complex medical and psychosocial issues during pregnancy and postpartum. The aim of this study was to assess differences in psychosocial health outcomes between pregnant WWH, non-pregnant WWH, and pregnant women without HIV, and further identify factors associated with probable depression in the third trimester and postpartum. Methods In a longitudinal survey study, participants were included from sites in Denmark, Finland, and Sweden during 2019–2020. Data was collected in the 3rd trimester, 3 and 6 months postpartum using standardized questionnaires assessing depression, perceived stress, loneliness, and social support. Mixed regression models were used to assess changes over time within and between groups. Logistic regression models were used to identify factors associated with depression in pregnancy and postpartum. Results A total of 47 pregnant WWH, 75 non-pregnant WWH, and 147 pregnant women without HIV were included. The prevalence of depression was high among both pregnant and non-pregnant WWH. There was no significant difference between pregnant and non-pregnant WWH in depression scores, perceived stress scores, or social support scores at any time point. Compared to pregnant women without HIV, pregnant WWH reported worse outcomes on all psychosocial scales. Social support and loneliness were associated with an increased odds of depressive symptoms in the adjusted analysis. Conclusions A high burden of adverse psychosocial outcomes was observed in both pregnant and non-pregnant women living with HIV compared to pregnant women without HIV. Loneliness and inadequate social support were associated with increased odds of depression in pregnancy and should be a focus in future support interventions.

Mediators of screening uptake in a colorectal cancer screening intervention among Hispanics

Background Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Although a number of CRC screening tests have been established as being effective for CRC prevention and early detection, rates of CRC screening test completion in the US population remain suboptimal, especially among the uninsured, recent immigrants and Hispanics. In this study, we used a structural equation modelling approach to identify factors influencing screening test completion in a successful CRC screening program that was implemented in an uninsured Hispanic population. This information will enhance our understanding of influences on CRC screening among historically underscreened populations. Methods We used generalized structural equation models (SEM) utilizing participant reported information collected through a series of surveys. We identified direct and indirect pathways through which cofactors, CRC knowledge and individual Health Belief Model constructs (perceived benefits, barriers, susceptibility, fatalism and self-efficacy) and a latent psychosocial health construct mediated screening in an effective prospective randomized CRC screening intervention that was tailored for uninsured Hispanic Americans. Results Seven hundred twenty-three participants were eligible for inclusion; mean age was 56 years, 79.7% were female, and 98.9% were Hispanic. The total intervention effect was comparable in both models, with both having a direct and indirect effect on screening completion (n = 715, Model 1: RC = 2.46 [95% CI: 2.20, 2.71, p < 0.001]; n = 699, Model 2 RC =2.45, [95% CI: 2.18, 2.72, p < 0.001]. In Model 1, 32% of the overall effect was mediated by the latent psychosocial health construct (RC = 0.79, p < 0.001) that was in turn mainly influenced by self-efficacy, perceived benefits and fatalism. In Model 2, the most important individual mediators were self-efficacy (RC = 0.24, p = 0.013), and fatalism (RC = 0.07, p = 0.033). Conclusion This study contributes to our understanding of mediators of CRC screening and suggests that targeting self-efficacy, perceived benefits and fatalism could maximize the effectiveness of CRC screening interventions particularly in Hispanic populations.

BENEFITS OF SPIRITUALITY FOR THE ELDERLY: LITERATURE REVIEW

Background: Aging is the final phase in the human life cycle; elderly people are at risk to face the problem as an impact loss of their roles. Objective: This study aimed to know that spirituality has an impact on providing the ability to face and accept the changes that occur with age. Methods: This literature review aimed to find out the benefits of spirituality for healthy elderly lives. Data Sources: This study searched articles published between 2010 to 2020, full-text and free articles. The search keywords consisted of “function” and “spirituality” and “elderly”. Review Methods: This literature review was conducted using analysis of the selected articles based on the inclusion criteria such full-text articles that were discussed about the benefits of spirituality for the elderly, published in the last 10 years. Result: Spirituality has an impact on influencing the incidence of depression; the main source of support for physical and psychosocial health, increasing self-awareness that they are no longer young and death will surely come for them; source of life force; coping strategies that help overcome difficult times in the elderly’s life. Conclusion: Spirituality has a positive impact on the elderly in terms of physical and mental well-being.

The Impact of Community Generated PPE During the SARS-COV-2 Pandemic in Southeast Alabama and Gulfport Mississippi

Background: The early stages of the SARS-COV-2 pandemic left many hospital systems devoid of personal protective equipment. Community-driven groups manufactured Personal Protective Equipment (PPE) as a form of temporary replacement until supply could increase to frontline healthcare workers. The purpose of this study was to survey hospital systems in Alabama and Mississippi who requested and received PPE to determine recipient opinions concerning community involvement.Methods: A 15-question Qualtrics survey was distributed to hospital systems who requested and received community-generated PPE (CGPPE) from the group known as Alabama Fighting COVID. 275 responses were gathered over a period of 6 months.Results: Survey data showed that most respondents from healthcare and healthcare-associated professions responded that wearing community generated personal protective equipment provided them with the perception of added protection (55.31% of participants selected either “Agree” or “Strongly Agree”), and that it improved their outlook and desire to work during the pandemic (51.77% of participants selected either “Agree” or “Strongly Agree”).Conclusions: Most respondents reported that wearing community generated personal protective equipment not only provided them with the perception of added protection, but that it improved their outlook and desire to work during the pandemic. With these responses in mind, our study raises questions concerning whether local CGPPE distribution could improve well-ness outcomes of healthcare workers (HCWs) not only in relation to decreased viral transmission, but also in favorable psychosocial health assessments. Further implications for research concerning community involvement during future medical crises are indicated, especially with the current rise of the delta variant strain.

Lived Experiences of Survivors of COVID-19 Disease at Hwange Colliery Hospital, Zimbabwe

The COVID-19 pandemic is one of the worst global nightmares in the past decade for both healthcare workers and general public. The initial focus has been on the lifesaving and biomedical aspects, but COVID-19 has rapidly established itself as an illness that negatively impacts the psychosocial health of all affected individuals. The purpose of this study was to explore the lived experiences of survivors of COVID-19 disease with intent to identify gaps within the healthcare system in responding to the COVID-19 pandemic and therefore improve the patient care. A phenomenological approach was used and a purposive sampling technique employed to select 15 participants at Hwange Colliery hospital for the study. All the participants were individuals aged between 19 and 55 years who had recovered from COVID-19 disease. Participants were either Hwange Colliery Company Limited employees or dependents and resident of Hwange Colliery concession area. Analysis of data was done during data collection using the Braun and Clarke (2006) thematic analysis. Three themes with eleven subthemes emerged from data and these were: awareness of COVID-19 disease; sources of information and trust of sources of information, causes and origins of the COVID-19, health seeking; physical manifestations, specimen collection and experience, treatment and home remedies, interaction with healthcare workers, psychosocial dimension; isolation and experiences, fears and concerns, family and friends support, religious, job security. The study revealed the lived experiences of survivors of COVID-19 disease. The survivors’ fear and coping mechanisms were made plain. The age of participants ranged from 19 years to 55 years with a mean age of 36.3 and a standard deviation of 5.1

“You Just Have to Keep Going, You Can’t Give Up”: Coping mechanisms among young adults with lupus transferring to adult care

Introduction Coping mechanisms and emotional regulation are important contributors to psychosocial health during stressful life events. We sought to describe the coping and emotional responses of persons with childhood-onset systemic lupus erythematosus during the transfer from pediatric to adult healthcare. Methods Semi-structured in-depth one-on-one interviews were conducted with 13 young women aged 18–24 of minority background who had transferred to adult care in a public hospital system. Thematic analysis was used to identify themes motifs from the data. Results Participants described the use of (1) problem-focused coping such as the use of clear communication and self-education, (2) adaptive emotion-focused coping such as cognitive reframing and acceptance, (3) social coping including support-seeking, (4) meaning-making coping including positive religious framing and viewing events as learning opportunities for growth, and (5) disengaged coping including denial and social isolation. A range of emotional responses associated with the transfer were described including fear, anger, loss, and feelings of empowerment and excitement. Conclusion Effective coping and emotional regulation are modifiable factors that may impact transfer-related outcomes and psychosocial health. Addressing coping mechanisms is relevant to the optimized transfer to adult care.

Exploring the Mental, Social and Lifestyle Effects of COVID-19 Infection on Syrian Refugees in Jordan: A Qualitative Study

Background: The fear of testing positive for COVID-19 infection has created panic among patients and families and discouraged some people from being tested and receiving medical care. Migrants and refugees are among the vulnerable populations that suffered disproportionately from the COVID-19 crisis. However, their experiences with COVID-19 positivity status have not been investigated. This study aimed to explore the physical, mental, and psychosocial impact of a positive COVID-19 diagnosis on Syrian refugees living in Jordan.Methods: Using a qualitative approach, twenty phone interviews were conducted with ten adult Syrian refugees living within the camp and ten refugees living in non-camp (host-community) settings. A follow-up interviews with five health care providers in the refugee camp were conducted to explore the services and support given to the refugees with COVID-19 infection. The findings were thematically analysed using Braun & Clarke's six-phase framework. Results: Physical effects of a positive COVID-19 status varied according to the seriousness of the condition but affected most participants' lifestyle by adopting more precautionary measures and caring for their physical health. Self-isolation and fear to infect others were common themes identified among all participants living within community settings. Resorting to friends and family members for mental and psychological support was the only option available for all participants. Refugees living within the community preferred to manage their condition at home utilizing traditional remedies and avoided being tested for financial reasons, poor healthcare access and fear of being identified. Refugees living within camps had better access to testing, healthcare, and disease management and did not experience fear of being deported. They did not display worries and feelings of shame and guilt, which were feelings expressed by refugees living within the community. Both groups suffered mental and psychosocial health impacts, as well as social isolation and fear of death and disease complications.Conclusions: COVID-19 infection has negatively impacted refugees’ well-being with noticeable disparities across the different living conditions. While mental health impact seems to be standardized, refugees living within host-community may need more support into managing their condition, accessibility to free testing as well as treatment and healthcare services.