Factors affecting anxiety, depression, and stress among patients with hepatocellular carcinoma during COVID-19 pandemic.

OBJECTIVE: Patients with chronic disease whose treatments are limited may experience depression, anxiety, and stress-related symptoms, as well as an increase in the levels of these conditions. This study aims to determine the factors affecting the depression, stress, and anxiety levels of hepatocellular carcinoma (HCC) patients due to the fear of COVID-19 exposure. PATIENTS AND METHODS: 118 patients with advanced HCC treated with non-transplant treatment options or on the waiting list due to the lack of a donor were enrolled. To evaluate the stress, depression, and anxiety levels during the COVID-19 process, Depression Anxiety Stress Scales (DASS-21) and the Coronavirus Anxiety Scale (CAS) were administered to 118 patients through a face-to-face interview. Sociodemographic and clinical characteristics were recorded, and the primary endpoint measure was the total score of DASS. In addition, the multilayer perceptron (MLP) model was constructed to predict the scores of the DASS-21 total. RESULTS: There were significant differences between DASS depression (p=0.010; p=0.030) DASS anxiety (p=0.010; p=0.010) and DASS total (p=0.046; p=0.023) scores in terms of gender and protective effect of the vaccine. Also, a significant difference between gender for the CAS scale was determined (p=0.044). The median score of the DASS total in the COVID-19 group was higher than in the non-COVID-19 group; however, the increase was not significant. MLP model revealed that chronic disease, gender, age, place of residence, smoking, type of vaccine, and COVID-19 exposure were the most important predictors for the DASS total. CONCLUSIONS: Chronic disease, gender, and age were prominent factors in predicting the DASS-21 total score in HCC patients. Therefore, the crucial factors were clinically considered for managing depression, stress, and anxiety in HCC patients.

Investigating Engagement and Achievement in an Online Teacher Education Course during the Compulsory Distance Education Period

The primary purpose of this study is to investigate ways of improving preservice teachers' engagement in a teacher education course designed for online delivery and offered during the COVID-19 pandemic. While online teaching is a prominent research area, descriptions of online learning environments based on sound frameworks are typically missing in the literature. Addressing this gap, we investigated the role of online instruction, whose design was guided by the National Survey of Student Engagement (NSSE) framework, and supporting different types of interaction on students' engagement and course achievement. We designed two versions of the same course differing only in terms of the level of learner-learner and learner-content interaction support provided. The participants were 38 preservice teachers from a range of departments, who were in two different sections of the course, randomly assigned to one of the versions. Data were collected using a modified version of the NSSE survey at the beginning and at the end of the course. The analysis showed that online course design based on the NSSE framework was effective for improving students' engagement in a project-based teacher education course even in the COVID-19 pandemic period. Meanwhile, the participants did not differ in terms of their engagement scores in time regarding the course version they attended. And, there was no difference regarding students' achievement scores as measured by their final course grades. The findings highlighted the need to design online courses based on sound theory and provided insight into prioritizing different types of interactions in project-based online courses.