Psychological distress as a predictor of the burden of care in family caregivers of COVID-19 patients in Iran: A community-based cross-sectional study.

Background and Aims: Coronavirus disease 2019 (COVID-19) has profoundly affected millions worldwide, including family caregivers of COVID-19 patients, in terms of caregiver burden and psychological distress. The present study aimed to evaluate the care burden and psychological distress among family caregivers, caring for a family member with COVID-19. Methods: The present study was performed with a cross-sectional design in the Shahroud community, northeast Iran using the convenience sampling method. A total of 297 family caregivers of COVID-19 patients were assessed using self-report scales including the depression, anxiety, and stress scale-21 and the Zarit burden interview to assess the symptoms of psychological distress (depression, anxiety, and stress) and caregiver burden. Data were analyzed using descriptive and inferential statistics (multivariate regression analysis). Results: Factors such as self-reported symptoms of depression (ß = 0.920, p < 0.001) and anxiety (ß = 0.712, p < 0.02) were significantly predicted care burden. Variables such as lower levels of education of the family member and caregivers and also the relationship between the caregiver and family member were additional predictive factors that aggravated the care burden. Conclusion: Caregivers of a family member with COVID-19 suffer significant levels of care burden that also results from psychological distress such as depression and anxiety. Therefore, appropriate psychoeducational interventions are highly recommended.

Evaluating the effect of online psychoeducational support group on perceived stress in family caregivers of COVID-19 survivors.

INTRODUCTION: This study aimed to determine the effect of an online psychoeducational support group on the perceived stress of caregivers of coronavirus disease 2019 (COVID-19) survivors. METHODS: This randomized clinical trial included 70 caregivers of COVID-19 survivors discharged from Imam Reza Hospital in Mashhad, Iran in 2021. The intervention group received a psychoeducational support training program for stress management through six online group sessions (each 35-45 minutes) in a week. An expert psychiatric nurse provided this program on WhatsApp immediately after the patient's discharge from the hospital. The participants completed the Perceived Stress Scale (PSS-14) before starting the intervention and 1 week after that. Data analysis was conducted by descriptive and inferential statistics, including Chi-square, Fisher's exact test, independent, and paired t-test. RESULTS: Both groups were homogeneous in terms of demographic variables of survivors and caregivers. In terms of the PSS, there was no significant difference between the two groups before the intervention (p=0.28). The pre- and post-intervention scores of PSS in the intervention group were 39.57 ± 5.89 and 35.48 ± 5.68, respectively, indicating a significant decrease (p<0.001). Also, the pre- and post-intervention differences between the intervention and control groups were -4.08 ± 3.52 and -0.11 ± 2.66, respectively, indicating a greater decrease in the total PSS of the intervention group (p < 0.001). CONCLUSION: The family caregivers of COVID-19 survivors suffered from psychological distress during their patient care. It is recommended to perform online psychoeducational support group interventions for these individuals based on psychological and educational support program.

Predictors of Self-Reported Compliance with COVID-19 Preventive Guidelines: A Quantile Regression Model.

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

Health Care Providers' Attitudes Toward Do-Not-Resuscitate Order in COVID-19 Patients: An Ethical Dilemma in Iran.

This study aimed to investigate the health care providers' attitudes toward the Do-Not-Resuscitate order (DNR) in COVID-19 patients. This study was conducted on 332 health care providers (HCPs) at the COVID-19 referral hospital in Shahroud, Iran by convenience sampling method. The study tools included a demographic information form and the DNR attitude questionnaire. Significance level was considered 0.05 for all tests. The mean scores of attitudes toward DNR order, the procedure of DNR, some aspects of passive euthanasia, and religious and cultural factors were 25.27 ± 2.78, 40.61 ± 5.99, 11.26 ± 2.51, and 6.12 ± 1.27, respectively. The death of relatives due to COVID-19 and female gender were associated with high and low scores of attitudes toward DNR order, respectively. Extended working hours and more work experience were correlated with high scores of DNR procedure. The history of COVID-19 increased the mean score of attitudes toward some aspects of passive euthanasia. In addition, an increase in following COVID-19 news decreased the score of religious and cultural factors affecting DNR order. Despite the legal ban on implementation of the DNR in Iran, the attitude of Iranian HCPs toward this was positive in COVID-19 patients.

One-year changes in the prevalence and positive psychological correlates of depressive symptoms during the COVID-19 pandemic among medical science students in northeast of Iran.

OBJECTIVES: The COVID-19 pandemic has imposed a significant psychological burden on many across society especially students studying medical sciences. This study intended to investigate the one-year changes in the prevalence and correlates of depressive symptoms during the COVID-19 pandemic among medical science students. METHODS: A cross-sectional study in Shahroud, Iran administering a convenience sampling method (January to February 2021). Online self-reported questionnaires included Rosenberg Self-Esteem Scale, Paloutzian-Ellison Spiritual Well-Being Questionnaire, Diener's Satisfaction with Life Scale and the University Student Depression Inventory. Data analyzed using descriptive and inferential statistics (Independent t-test and Multiple Regression Analysis). RESULTS: A total of 306 medical science students were investigated in this study. The mean scores 1 year after the outbreak of COVID-19 were for depression (81.25 ± 26.04), spiritual well-being (80.98 ± 18.06), self-esteem (26.89 ± 2.20), and life satisfaction (19.68 ± 6.81). The results indicated that depression mean score was significantly higher in post outbreak assessment (71.92 ± 22.94 vs 81.25 ± 26.04) (P < .001). Fifty percentage of changes in depression can be predicted by studied variables. A high score of depression was directly associated with a higher level of self-esteem. Moreover, increased interest in the field, scores of spiritual well-being, and life satisfaction were inversely and significantly associated with depression. CONCLUSIONS: Iran's education system has been significantly affected, with the addition to the COVID-19 pandemic imposing a psychological burden such as depression, exacerbating this within medical science students compared to a year ago. Spiritual well-being and life satisfaction as positive psychology constructs were recognized as protective factors against depression during the pandemic. Spiritual and social support should be integrated in psychological interventions within university settings for medical science students.