ABSTRACT
Background: There is evidence suggesting that quarantine might have undesirable psychological impacts on the patients. Therefore, it is important to seek for ways to increase the resilience and alleviate the psychological pressure of the patients who are quarantined due to infection with COVID-19. The present study was conducted to assess an online multimedia psychoeducational intervention regarding the feasibility, adherence, patient satisfaction and effectiveness on resilience and perceived stress of patients hospitalized with confirmed COVID-19. Method: This was a pilot cluster randomized parallel-controlled trial with hospital ward as the unit of randomization. Participants in this fully online trial were 50 consecutive patients who were hospitalized in 2 hospitals in Shiraz, after being diagnosed with COVID-19. Before the beginning of the intervention, four inpatient wards of the two hospitals were randomly assigned to either experimental or control conditions. All eligible participants in the wards allocated to the intervention condition received online multimedia psychoeducational interventions during 2 weeks, whilst the patients in the wards allocated to the control condition were offered the opportunity to receive telephone-based psychological counseling if needed. Psychoeducational interventions mainly included cognitive–behavioural techniques, stress management techniques, mindfulness-based stress reduction and positive psychotherapy. The patients were assessed regarding resilience and perceived stress at baseline and 2 weeks later. Results: : Of 27 patients starting multimedia psychoeducational interventions, 26 (96.29%) completed post-assessments. A high level of adherence (80.76%) and satisfaction (Mean=29.42; SD=4.18) with the online multimedia psychoeducational interventions was found. Compared with the control group, the patients who used online multimedia psychoeducational interventions reported greater resilience (Mean intervention =81.74; Mean control =72.86; adjusted t (46)=2.10; p=0.04; CI: 0.39 to 17.38; dppc2=0.83) and fewer perceived stress (Mean intervention =22.15; Mean control =29.45; adjusted t (46)=2.66; p=0.01; CI: -12.81 to -1.78; dppc2= - 0.77) after 2 weeks. Discussion: The findings of the present study provided a successful first attempt at implementing feasible online multimedia psychoeducational interventions to promote resilience and mitigate stress among the patients who were hospitalized due to infection with COVID-19. The present results could help mental health professionals to determine which psychological techniques should be emphasized to promote patients' resilience in the context of COVID-19 disease.
Subject(s)
COVID-19 , Intellectual DisabilityABSTRACT
BackgroundTo date, no specific vaccine or drug has been proven to be effective for SARS-CoV-2 infection. Therefore, we implemented immunoinformatics approach to design an efficient multi-epitopes vaccine against SARS-CoV-2. ResultsThe designed vaccine construct has several immunodominant epitopes from structural proteins of Spike, Nucleocapsid, Membrane and Envelope. These peptides promote cellular and humoral immunity and Interferon gamma responses. In addition, these epitopes have antigenicity ability and no allergenicity probability. To enhance the vaccine immunogenicity, we used three potent adjuvants; Flagellin, a driven peptide from high mobility group box 1 as HP-91 and human beta defensin 3 protein. The physicochemical and immunological properties of the vaccine structure were evaluated. Tertiary structure of the vaccine protein was predicted and refined by I-Tasser and galaxi refine and validated using Rampage and ERRAT. Results of Ellipro showed 242 residues from vaccine might be conformational B cell epitopes. Docking of vaccine with Toll-Like Receptors 3, 5 and 8 proved an appropriate interaction between the vaccine and receptor proteins. In silico cloning demonstrated that the vaccine can be efficiently expressed in Escherichia coli. ConclusionsThe designed multi epitope vaccine is potentially antigenic in nature and has the ability to induce humoral and cellular immune responses against SARS-CoV-2. This vaccine can interact appropriately with the TLR3, 5, and 8. Also, this vaccine has high quality structure and suitable characteristics such as high stability and potential for expression in Escherichia coli.