Analysis of social and psychological factors influencing the treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019.

Objective To explore the sociodemographic and psychological factors influencing the continuity of treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019 (COVID-19). Methods A total of 277 patients with chronic kidney disease who were admitted to Department of Nephrology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. 2020 to Mar. 2021 were enrolled and divided into 3 groups: non-dialysis group (n=102), hemodialysis (HD) group (n=108), and peritoneal dialysis (PD) group (n=67). All patients were investigated by online and offline questionnaires, including self-designed basic situation questionnaire, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). The general sociodemographic data, anxiety and depression of the 3 groups were compared, and the influence of sociodemographic and psychological factors on the interruption or delay of treatment was analyzed by binary logistic regression model. Results There were significant differences in age distribution, marital status, occupation, medical insurance type, caregiver type, whether there was an urgent need for hospitalization and whether treatment was delayed or interrupted among the 3 groups (all P0.05). The average SAS score of 65 PD patients was 38.15+/-15.83, including 53 (81.5%) patients without anxiety, 7 (10.8%) patients with mild anxiety, and 5 (7.7%) patients with moderate to severe anxiety. The average SAS score of 104 patients in the HD group was 36.86+/-14.03, including 81 (77.9%) patients without anxiety, 18 (17.3%) patients with mild anxiety, and 5 (4.8%) patients with moderate to severe anxiety. There were no significant differences in the mean score of SAS or anxiety severity grading between the 2 groups (both P0.05). The mean SDS scores of 65 PD patients were 53.42+/-13.30, including 22 (33.8%) patients without depression, 21 (32.3%) patients with mild depression, and 22 (33.8%) patients with moderate to severe depression. The mean SDS scores of 104 patients in the HD group were 50.79+/-10.76, including 36 (34.6%) patients without depression, 56 (53.8%) patients with mild depression, and 12 (11.6%) patients with moderate to severe depression. There were no significant differences in mean SDS scores or depression severity grading between the 2 groups (both P0.05). The results of intra-group comparison showed that the incidence and severity of depression were higher than those of anxiety in both groups. Multivariate binary logistic regression analysis showed that high school education level (odds ratio OR=5.618, 95% confidence interval CI) 2.136-14.776, P0.01), and unmarried (OR=6.916, 95% CI 1.441-33.185, P=0.016), divorced (OR= 5.588, 95% CI 1.442-21.664, P=0.013), urgent need for hospitalization (OR=8.655, 95% CI 3.847-19.476, P0.01) could positively promote the continuity of treatment in maintenance dialysis patients under the regular epidemic prevention and control of COVID-19. In the non-dialysis group, no sociodemographic and psychological factors were found to be associated with the interruption or delay of treatment (P0.05). Conclusion Education, marital status, and urgent need for hospitalization are correlated with the continuity of treatment in patients with chronic kidney disease on maintenance dialysis.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Analysis of social and psychological factors influencing the treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019

Objective To explore the sociodemographic and psychological factors influencing the continuity of treatment of patients with chronic kidney disease under the regular epidemic prevention and control of coronavirus disease 2019 (COVID-19). Methods A total of 277 patients with chronic kidney disease who were admitted to Department of Nephrology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. 2020 to Mar. 2021 were enrolled and divided into 3 groups: non-dialysis group (n=102), hemodialysis (HD) group (n=108), and peritoneal dialysis (PD) group (n=67). All patients were investigated by online and offline questionnaires, including self-designed basic situation questionnaire, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). The general sociodemographic data, anxiety and depression of the 3 groups were compared, and the influence of sociodemographic and psychological factors on the interruption or delay of treatment was analyzed by binary logistic regression model. Results There were significant differences in age distribution, marital status, occupation, medical insurance type, caregiver type, whether there was an urgent need for hospitalization and whether treatment was delayed or interrupted among the 3 groups (all P<0.05). The average SAS score of 65 PD patients was 38.15+/-15.83, including 53 (81.5%) patients without anxiety, 7 (10.8%) patients with mild anxiety, and 5 (7.7%) patients with moderate to severe anxiety. The average SAS score of 104 patients in the HD group was 36.86+/-14.03, including 81 (77.9%) patients without anxiety, 18 (17.3%) patients with mild anxiety, and 5 (4.8%) patients with moderate to severe anxiety. There were no significant differences in the mean score of SAS or anxiety severity grading between the 2 groups (both P>0.05). The mean SDS scores of 65 PD patients were 53.42+/-13.30, including 22 (33.8%) patients without depression, 21 (32.3%) patients with mild depression, and 22 (33.8%) patients with moderate to severe depression. The mean SDS scores of 104 patients in the HD group were 50.79+/-10.76, including 36 (34.6%) patients without depression, 56 (53.8%) patients with mild depression, and 12 (11.6%) patients with moderate to severe depression. There were no significant differences in mean SDS scores or depression severity grading between the 2 groups (both P>0.05). The results of intra-group comparison showed that the incidence and severity of depression were higher than those of anxiety in both groups. Multivariate binary logistic regression analysis showed that high school education level (odds ratio [OR]=5.618, 95% confidence interval [CI]) 2.136-14.776, P<0.01), and unmarried (OR=6.916, 95% CI 1.441-33.185, P=0.016), divorced (OR= 5.588, 95% CI 1.442-21.664, P=0.013), urgent need for hospitalization (OR=8.655, 95% CI 3.847-19.476, P<0.01) could positively promote the continuity of treatment in maintenance dialysis patients under the regular epidemic prevention and control of COVID-19. In the non-dialysis group, no sociodemographic and psychological factors were found to be associated with the interruption or delay of treatment (P>0.05). Conclusion Education, marital status, and urgent need for hospitalization are correlated with the continuity of treatment in patients with chronic kidney disease on maintenance dialysis.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Mental health outcomes in patients discharged after COVID-19 hospitalization: the case report of a male nurse in the context of occupational surveillance program of health care workers

This case study draws attention on mental health sequelae that emerged in the context of the COVID-19 outbreak after recovery from hospitalization, even in subjects without personal psychiatric history. The case involves a 65-year-old male shift nurse who took SARS-COV-2 infection through a co-worker and that had been hospitalized for interstitial pneumonia from April 6 to April 17. After recovery, he developed psychiatric symptoms overlapping between different dimensions of psychiatric disorders and started to be followed by the Occupational Health Department of a Major University Hospital in central Italy. He reported a score of 28 at the Peritraumatic Distress Inventory and of 39 at the Self-Rating Anxiety State. He was treated with a combination therapy of SSRI and NaSSA antidepressants with clinical remission. In this case study, authors discuss the possible overlapping role of post-traumatic stress and anxiety symptoms in patients discharged after COVID-19 hospitalization that may deserve appropriate classification, treatment and follow up with the future goal to refine clinical management of post and long COVID syndromes of subjects who present low abnormalities in other specialty investigations.Copyright © 2022 EDIZIONI MINERVA MEDICA.

Analysis of influencing factors of blood glucose levels in diabetic patients during epidemic of COVID-19.

Objective: To investigate the blood glucose control of diabetic patients during the Coronavirus disease 2019 (COVID-19) epidemic, and to explore the factors affecting blood glucose. Method(s): Three hundred and fifty patients with diabetes mellitus hospitalized in the Endocrinology Department of the Second Affiliated Hospital of Air Force Military Medical University from 2017 to 2019 were selected, and we send questionnaires (a self-made questionnaire containing 39 questions, Zung anxiety self-assessment scale, Zung depression self-assessment scale) to the patients through WeChat group. After the effective questionnaires were collected, the patients were divided into good blood glucose control group (fasting blood glucose <=7 mmol/L and 2 h postprandial blood glucose <=10 mmol/L) and poor blood glucose control group (fasting blood glucose>7 mmol/L and/or 2 hours postprandial blood glucose>10 mmol/L). Chi square test or Fisher exact probability method and t test were used to compare the differences between the two groups. In Multi-factor logistic regression, the backward regression method was performed. Result(s): A total of 310 questionnaires were collected, 4 of which did not meet the requirements were eliminated, and a total of 306 valid questionnaires were analyzed. There were 108 cases (35.3%) in the well-controlled group and 198 cases (64.7%) in the poorly controlled group. Compared with well-controlled group, there was a higher percentage of patients with aged >=45 years, diabetes course >=5 years, combined with chronic complications of diabetes, weekly exercise time during the epidemic period<150 min,weekly monitoring of blood glucose frequency <=1 to 2 times and sleep disorders during the epidemic, anxiety, and depression in poorly controlled group, and there were statistically significant differences (P<0.05).The above 8 factors with P<0.05 were included in the logistic regression model. Diabetes course >=5 years, weekly exercise time during the epidemic<150 min, sleep disturbance during the epidemic, weekly monitoring of blood glucose frequency <= 1 to 2 times, depression were risk factors for poor blood glucose control (P<0.05). Conclusion(s): During the epidemic period, the blood glucose level of diabetes patients was generally high. The factors that affected blood glucose control included a long course of diabetes, short exercise time, low monitoring frequency of blood glucose, sleep disorders, and depression.Copyright © 2020 by the Chinese Medical Association.

Depression and Anxiety in Medical Students during the COVID-19 Pandemic

Medical students are prone to anxiety and depression, largely due to the nature of their coursework. During the COVID-19 pandemic, many medical students were required to study from home without being involved in clinical practice. The aim of this study was to investigate depression and generalized anxiety disorder (GAD), plus possible risk factors in medical students around the world during the pandemic. A primary search was conducted using PubMed, limited to the period 2020-2021. A second search was conducted to acquire studies published before the pandemic, aiming to have a baseline prevalence value for these disorders in medical students. During the pandemic, the prevalence of depression in the USA (31.7%, 12.5%, and 10.8% for mild, moderate, and severe depression, respectively) was higher than the reported prevalence in Pakistan, Nepal, and Iran, although the four countries used different psychiatric instruments, making comparison difficult (9-item Patient Health Questionnaire, Self-rating Depression Scale, Hospital Anxiety and Depression Scale-Depression [HADS-D], and Beck Depression Inventory [BDI-II). The prevalence of GAD in the USA was also higher (35.3%, 19.5%, and 11.1%, for mild, moderate, and severe GAD) than the prevalence in China (21.3%, 2.7%, and 0.9%, for mild, moderate, and severe anxiety), and the overall prevalence in Brazil, (46.2%), using the same instrument (GAD-7). The prevalence of GAD in the USA was also higher than the prevalence in Nepal, Pakistan, and Iran, although the researchers used a different psychiatric instrument (HADS-A, Self-rating Anxiety Scale, and Beck Anxiety Inventory instruments, respectively). Before the pandemic, the reported prevalence of depression in the USA was lower (11.6%, 9.0%, and 3.0% for mild, moderate, and severe depression), than in Pakistan (31.0%, 13.6%, and 4.8%), using the BDI instrument. In Nepal, the prevalence of depression (5.2%) was higher than in Portugal (2.3%), ascertained with the HADS-D instrument. The prevalence in Egypt (65% using Depression Anxiety Stress Scale DASS-21]) and India (14.7%, 19%, and 17.5% mild, moderate, and severe depression, using DASS 42) were the highest prevalence values reported before the pandemic. For anxiety, the prevalence of overall GAD in Nepal (16.2%) was comparable to the one reported in Portugal (14.2%), both identified with the HADS-A instrument. The prevalence of GAD reported in India and in Egypt were the highest values, determined with the DASS 42 and DASS 21, respectively. Studies have reported that general social isolation and loneliness are risk factors contributing factors toward depression. Other risk factors identified with depression and/or anxiety disorders were being female, having a lower GPA, lower COVID-19 awareness, and having more experience with COVID symptoms. High prevalence of depression and GAD was identified in medical students in various countries. It is imperative that during any crisis such as the one experienced in the present COVID-19 pandemic, vulnerable populations to mental health disorders, such as medical students, are identified and supported. Further research needs to be done to explore other possible factors, such as living conditions, marital status, social-cultural influences, financial issues, and their relationship to depression and anxiety in this population, to further understand the best interventions to support this population.Copyright ©2022 Published by Scientific Scholar on behalf of Global Journal of Medical, Pharmaceutical, and Biomedical Update.

Analysis of influencing factors of blood glucose levels in diabetic patients during epidemic of COVID-19.

Objective: To investigate the blood glucose control of diabetic patients during the Coronavirus disease 2019 (COVID-19) epidemic, and to explore the factors affecting blood glucose. Method(s): Three hundred and fifty patients with diabetes mellitus hospitalized in the Endocrinology Department of the Second Affiliated Hospital of Air Force Military Medical University from 2017 to 2019 were selected, and we send questionnaires (a self-made questionnaire containing 39 questions, Zung anxiety self-assessment scale, Zung depression self-assessment scale) to the patients through WeChat group. After the effective questionnaires were collected, the patients were divided into good blood glucose control group (fasting blood glucose <=7 mmol/L and 2 h postprandial blood glucose <=10 mmol/L) and poor blood glucose control group (fasting blood glucose>7 mmol/L and/or 2 hours postprandial blood glucose>10 mmol/L). Chi square test or Fisher exact probability method and t test were used to compare the differences between the two groups. In Multi-factor logistic regression, the backward regression method was performed. Result(s): A total of 310 questionnaires were collected, 4 of which did not meet the requirements were eliminated, and a total of 306 valid questionnaires were analyzed. There were 108 cases (35.3%) in the well-controlled group and 198 cases (64.7%) in the poorly controlled group. Compared with well-controlled group, there was a higher percentage of patients with aged >=45 years, diabetes course >=5 years, combined with chronic complications of diabetes, weekly exercise time during the epidemic period<150 min,weekly monitoring of blood glucose frequency <=1 to 2 times and sleep disorders during the epidemic, anxiety, and depression in poorly controlled group, and there were statistically significant differences (P<0.05).The above 8 factors with P<0.05 were included in the logistic regression model. Diabetes course >=5 years, weekly exercise time during the epidemic<150 min, sleep disturbance during the epidemic, weekly monitoring of blood glucose frequency <= 1 to 2 times, depression were risk factors for poor blood glucose control (P<0.05). Conclusion(s): During the epidemic period, the blood glucose level of diabetes patients was generally high. The factors that affected blood glucose control included a long course of diabetes, short exercise time, low monitoring frequency of blood glucose, sleep disorders, and depression.Copyright © 2020 by the Chinese Medical Association.

Gender differences in symptoms and psychological burden in Long Covid patients: results of a comprehensive multidimensional assessment protocol

Aim: To assess impairment in health status and psychological burden, subjects with Long Covid enrolled in a multidisciplinary follow-up outpatient programme underwent a multidimensional psychological assessment including Zung's Self-rating Anxiety Scale (SAS), Impact of Event Scale-Revised (IES-R), Beck Depression Inventory-II (BDIII), Functional Assessment of Chronic Illness Therapy, Fatigue subscale (FACIT-F), 12-Item Short-Form Health Survey (SF-12). Result(s): Ninety-nine subjects (36M;age 52.6+/-14.5) participated to a self-administered multidimensional psychological evaluation from january2021 to january 2022 (5.5+/-4.4 months after acute infection). Sixty-one out of 99 (61.6%) subjects (20M, age 48.7+/-14.5y) were treated at home during acute SARS-CoV-2 infection. Thirtyfive patients (35.4%) had symptoms of post-traumatic stress disorder (PTSD), 21 patients (21.2%) had moderate to severe depressive symptoms, 47 (47.4%) exhibited clinically significative anxiety. No significant differences in symptoms and psychological evaluation were found in home treated, compared with the subgroup of 38 (38.3%) hospitalized subjects (16M, age59.0+/-13.0y). Irrespective of hospitalization, persistent asthenia was reported in 34 out of 63 females (54.0%), and in 11 males (30.6%) (p=.005);Clinically significant anxiety was found in 37(58.7%) females and in 7(19.4%) males (p=.001). Gender associated significant differences were found as well in FACIT-F, SAS, SF-12, but not in BDI-II and IES-R scores. Conclusion(s): Among a cohort of long covid subjects, gender differences were observed in symptoms reported and in psychological well-being.

Pregnant women: psychology, cognitive and behavioral responses, and solutions towards COVID-19.

COVID-19 (Corona Virus Disease 2019) has spread globally and is highly infectious, causing psychological disturbances such as anxiety, depression, or both. Pregnant women, as a vulnerable population, need further attention. This study aims to evaluate the psychological impact of pregnant women during COVID-19 to constitute base data for solution guidance. Using a self-designed questionnaire, self-rated anxiety scale (SAS), and self-rated depression scale (SDS), we conducted a web-based survey on 1160 pregnant women from February 20 to April 30, 2020. The prevalence of anxiety and depression during pregnancy was shown to be 12.93% and 31.21%, respectively. Besides, younger age, housewives, lower education level, and early pregnancy all contributed to psychological disturbance during the COVID-19 pandemic. The results revealed significant variations in cognitive and behavioral responses based on the levels of the COVID-19 pandemic concerns, perceptions of life impacts and family concerns, preparation of personal protection equipment and motherhood, and the need for psychological counseling (P < 0.05). Regarding their primary concerns, 73.2% of the participants worried about the health and safety of childbirth. And 90.6% of respondents anticipated scheduling prenatal appointments to avoid crowds. Pregnant women are susceptible to anxiety/depression during the COVID-19 outbreak, necessitating immediate psychological care and intervention.

Qur’anic Bibliotherapy Intervention in Pregnant Women Experiencing Anxiety During the COVID-19 Pandemic in Indonesia: A Qualitative Exploratory Study

BACKGROUND: The disease caused by coronavirus-19 (COVID-19) has been stated as a global epidemic by the WHO. The COVID-19 pandemic adds many risk factors to maternal mental health during the perinatal period. The impact of anxiety during pregnancy is adverse obstetric consequences such as premature birth, inadequate antenatal care, requests for elective cesarean delivery, low APGAR scores of infants, and postpartum depression. Nursing interventions to overcome anxiety can be done through spiritual and religious intervention approaches. One of the spiritual interventions for the Muslim population to improve religious coping is Qur’anic Bibliotherapy (QB) as Islamic bibliotherapy. AIM: This study aimed to explore the use of QB interventions for pregnant women experiencing anxiety during the COVID-19 pandemic. METHODS: A qualitative exploratory study was conducted to explore the experience of the intervention given to the informant. The qualitative samples were ten respondents with moderate-to-severe anxiety levels. The anxiety instrument used was the Zung Anxiety Scale. RESULTS: The themes obtained from in-depth interviews with semi-structured interviews were recognizing COVID-19 and its perceived impact, the impetus for changing resilience to the COVID-19 pandemic, parents’ role, and the benefits of QB for pregnant women in the COVID-19 pandemic. CONCLUSIONS: QB encourages informants’ positive thinking, feeling, spiritual, and attitude patterns. QB can be used as a complementary Islamic intervention for health workers, especially nurses, in providing nursing care to Muslim patients.

MUSCULOSKELETAL PAIN AS A PART of the RHEUMATIC SPECTRUM in COVID-19

Background: Since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) (1), our understanding of the underlying pathophysiology is constantly evolving in order to explain the wide range of heterogenic clinical manifestations (2). Nevertheless, limited data are available for the severity and multifactorial causality of musculoskeletal pain in COVID-19 patients (3). Objectives: This study aimed to evaluate the prevalence and intensity of rheumatic pain symptoms-arthralgia and myalgia and their association with anxiety and depression in a cohort of COVID-19 patients, hospitalized at the COVID-19 rheumatology department of the University Hospital St. Marina, Varna, Bulgaria. Methods: In the present single-center cohort study, a prospective analysis was performed among COVID-19 patients who were hospitalized from 1 Oct 2021 to 20 Jan 2022 and self-reported for new-onset of musculoskeletal pain. All 226 patients (age 26-91 years) were treated for moderate or severe SARS-CoV-2 infection confrmed by laboratory tests, including positive antigen test or polymer-ase chain reaction (PCR) test, and imaging modality. Detailed disease history and clinical examination were carried out by a fully certifed rheumatologist. All patients who reported new-onset of musculoskeletal pain during the acute phase of the infection, participated on a voluntary basis in a questionnaire survey, by completed Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS) and visual analogue scale (VAS) for arthralgia and myalgia. The questionnaire form also elicited information on sociodemographic characteristics of the patients. In all patients, infammation and thrombotic biomarkers were assessed. The level of signifcance was set to 0.05. Results: Among all 226 COVID-19 patients with musculoskeletal pain, 46.5% (n =105) were women and 53.5% (n = 121), were men. Mean age was 65.6 years. We found a signifcant correlation of depression and anxiety scales scores with pain intensity (both arthralgia and myalgia), all < 0.001. A multiple regression analysis found that SDS and SAS accounted for signifcant variance in the prediction of muscle pain (β = 0.441, p < 0.001;β = 0.293, p = 0.003, respectively) while SDS signifcantly predicted joint pain (β = 0.341, p = 0.043). On the other hand, musculoskeletal pain does not correlate with any of infammation and thrombotic biomarkers assessed in SARS-CoV-2 patients (p > 0.05). Conclusion: Rheumatic pain manifestations are part of the heterogeneous spectrum of COVID-19 disease. The pain intensity is signifcantly associated with anxiety and depression symptoms and does not correlate with infammation and thrombotic biomarkers.

INFLUENCING FACTORS on WORK BURNOUT of PRE-EXAMINATION and TRIAGE NURSES under the NORMAL EPIDEMIC PREVENTION and CONTROL

Background: Nurse is a high-risk groups work fatigue feeling, which seriously affects the quality of conventional work efficiency and bureden pressures for contradiction between nurses and patients especially during the COVID-19 pandemic.Normalized epidemic prevention and control during the preview triage nurse need to all patients to the hospital and the accompanying personnel carries on the preliminary screening.COVID-19 fxed point hospital preview triage nurse with an infected person contact, more prone to anxiety,depression, results in the decrease of efficiency, to treat the service object formulation work sense of fatigue performance, etc. Objectives: To explore the influencing factors of work burnout of pre-test and triage nurses under normal epidemic prevention and control. Methods: A total of 110 pre-test and triage nurses from 4 Grade-A hospitals in Shanxi Province were enrolled in this study. The general data questionnaire, Nurse Job Burnout Scale, Pittsburgh Sleep Quality Index Scale, Self-Rating Anxiety Scale and Self-Rating Depression Scale were investigated towork burnout of pre-examination and triage nurses. Comparison between groups using two Independent sample t-test and single factor variance analysis. Multiple regression were applied to analysis factors affecting nurse fatigue feeling dimensions by SPSS22.0. P values<0.05 were considered signifcant. Results: As shown in Table 1, different professional title, department, and the sleep quality of preview triage nurses emotional exhaustion dimension com-parison(P<0.001), different department nurses to personalized level dimension comparison(P<0.05), nurse personal accomplishment dimension comparison of different cultural levels(P<0.05). Professional title, working department, sleep quality and educational level were the influencing factors of job burnout of pretest and triage nurses. Conclusion: In the COVID-19 epidemic, managers should pay more attention to the main factors that affect the sense of exhaustion of pre-test and triage nurses, and take targeted intervention measures to alleviate the sense of exhaustion of nurses, so as to ensure the safety of nursing.

Prevalence and influencing factors of anxiety in medical students during the COVID-19 pandemic.

Background and objective: The novel coronavirus disease (COVID-19) pandemic has caused a traumatic impact on the whole world in all aspects including physical health, economic condition, and mental health. Psychological problems are commonly neglected for their inconspicuous symptoms. Little is known about the medical students' psychological status during the COVID-19 pandemic. Our study aimed to investigate the prevalence and influencing factors of anxiety among medical students during the COVID-19 pandemic. Methods: Two thousand and two medical students were investigated in this cross-sectional study. Zung's self-rating anxiety scale was used to evaluate their anxiety symptoms. A total of 1917 questionnaires were collected, and the response rate was 95.8%. Results: There were 1735 (90.5%) complete and valid questionnaires. The average SAS standard score was 42.8 ± 11.0. The results indicated that the prevalence of anxiety in medical students was 25.9%. Less social support (OR = 1.4, 95%CI 1.2-1.7) is an independent risk factor of anxiety syndrome, while the female (OR = 0.6, 95%CI 0.5-0.8) is less likely to have anxiety syndrome. Conclusion: The prevalence of anxiety in medical students is higher during the COVID-19 pandemic. Male students and students with less social support are more likely to have anxiety syndrome. Medical educators and students themselves should take serious steps to prevent, recognize and deal with the anxiety prevalence.

The impact of the COVID-19 pandemic and the coping strategies applied by healthcare professionals

OBJECTIVE To determine the impact of the COVID-19 pandemic on medical and nursing staff, and the management practices that they adopt for managing it appropriately. METHOD The study was conducted at the General Hospital of Thessaloniki “Hippokratio” from 3.3.2021 to 13.3.2021 with the participation of 200 respondents, all members of the medical and nursing staff of the two neonatal intensive care units (NICUs). The research tools used were two questionnaires, the Self-rating Anxiety Scale (SAS) of Zung (1971) and the Strategies for Handling Stressful Situations of Lazarus and Folkman (1984). Inductive statistical analysis was then applied to the responses. RESULTS The study showed that the scores on both the scale of emotional reactions and the scale of physical symptoms had mean and median values less than the mid-point of the range of the scale. The SAS index, which is calculated as the quotient of each participant’s score of 80 expressed as a percentage, showed a mean of 45.94% and a median of 43.75%. The scores on the three scales of occupational stress/anxiety were associated with the demographic characteristics of the sample, and specifically, gender, employment status, and educational level. Regarding management, positive reas-sessment was the most frequently applied coping practice. Analysis of the correlation between work stress/anxiety and coping strategies showed weak positive association in certain categories of strategies. CONCLUSIONS During the COVID-19 pandemic, health professionals are facing a new challenge that caused significantly stress, especially for female frontline employees, nursing staff and healthcare personnel of a lower educational level. Healthcare unit managers and, in general, chief executive officers should develop targeted preventive and managerial support in-terventions to support staff members and enhance their productivity during this crisis.

Study on relationship among social support, anxiety and sleep quality of residents in Shanghai under COVID-19 epidemic

Objective To describe the social support, anxiety, and sleep quality of residents in the District of Shanghai during the COVID-19 and to analyze the to correlation of these factors. Methods A structured questionnaire was used to investigate residents' social support, anxiety, and sleep quality. The questionnaire consisted of social support rate scale, the self-rating anxiety scale (SAS) and Pittsburgh sleep quality index (PSQI), investigated the social support, anxiety, and sleep quality of residents in the District of Shanghai under the COVID-19 epidemic and analyzed their potential influencing factors. Structural equation model was constructed to understand the relationship among these factors. Results A total of 258 questionnaires were collected, with 237 being eligible for analyzing. The results showed that there were statistically significant differences in sleep quality (P =0.004) and social support (P =0.009) among residents with different highest education levels. The structural equation model-fitting indices were CFI =0.929, NFI =0.891, IFI =0.930, NNFI =0.907, RMSEA =0.082, χ 2/df =2.599. It indicated that the fitting degree was good. The results showed that the social support of residents could affect their anxiety degree to some extent (r=-0.15). The higher the social support, the lower the anxiety degree they had. Moreover, the degree of anxiety could affect the sleep quality (r =0.72), and the higher the degree of anxiety, the worse the sleep quality they had. Conclusion During the epidemic of COVID-19, residents' social support is related to their anxiety level, and the anxiety level is related to their sleep quality. By improving residents' support, their degree of anxiety could be reduced to improve their sleep quality.

Assessment of Characteristics, Sources, and Anxiety Levels in Women with Single Parent Status during the COVID-19 Pandemic

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had an impact on people globally, including mothers living in coastal regions. Therefore, this study aims at identifying the psychological status of single mothers living in the coastal regions of Indonesia. METHODS: A descriptive quantitative cross-sectional design was used with non-probability sampling in coastal regions of West Java, Indonesia. Furthermore, the Zung Self Rating Anxiety Scale was used to assess the anxiety level of single mothers. RESULTS: The anxiety of single mothers during the COVID-19 pandemic was generally moderate (n = 45.77.59%), with 44.83% attributing it to health and the economy. Furthermore, previous results showed that this condition was observed in the elderly (n = 38.65.52%), though it lasted <5 years in the majority of cases (n = 33.56.90%). Symptoms associated with the anxiety of single mothers during the pandemic include an increase in restlessness, nervousness, and anxiety. CONCLUSION: The economy and health of single mothers were the primary sources of anxiety during the COVID-19 pandemic. A high percentage of these women suffer from mild anxiety and require immediate care to prevent the development of other health problems. Therefore, health cadres and community nurses are expected to take action to achieve optimal psychological welfare among single mothers during the pandemic. Further study can be conducted by focusing on the theme of defense mechanisms or resilience.

Analysis of risk factors for early clinical recurrence of inflammatory bowel disease after fecal microbiota transplantation

Objective: To explore the risk factors for early clinical recurrence of inflammatory bowel disease (IBD) after fecal microbiota transplantation (FMT). Methods: A retrospective study was conducted on 192 patients with IBD who received FMT treatment in the Colorectal Disease Specialty/Intestinal Microecology Treatment Center of the Tenth People’s Hospital Affiliated to Tongji University from February 2017 to June 2020. Univariate and multivariate logistic regression models were used to analyze the risk factors for early recurrence of inflammation. Feces from all participants were collected to extract the total bacterial genomic DNA. The V6-8 regions of the bacterial 16S rDNA gene were amplified by polymerase chain reaction (PCR), the PCR products were detected by the denaturing gradient gel electrophoresis (DGGE) method, and the intestinal flora was analyzed by DNA fingerprinting. Stool samples from all patients were tested for 9 bacteria, white blood cells (WBC) and platelet (PLT) counts, as well as the erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) level. Results: Of the 192 patients, 15 cases had inflammation recurrence during FMT and within one week after treatment, including 11 cases of ulcerative colitis (UC) and 4 cases of Crohn’s disease (CD), with a total recurrence rate of 7.8%. High Mayo inflammatory activity score, Mayo endoscopic sub-item score (MES) =3 points, CRP>10 mg/L, anemia, albumin <30 g/L, absolute value of peripheral blood lymphocytes (PBL) <500/mm3, and intolerance to enteral full nutrition were independent risk factors for recurrence during and after FMT in UC patients (P<0.05). Albumin <30 g/L and simultaneous use of immunosuppressive agents were associated with disease recurrence during and after FMT in CD patients. WBC, PLT, and CRP were all negatively correlated with Enterococcus (EC), and ESR was positively correlated with Saccharomyces boulardii (SB) (P<0.01). Conclusion: The low recurrence rate of IBD after FMT indicates the safety of FMT, but this procedure should be cautiously used in patients with severe intestinal barrier dysfunction and/or severe intestinal dysfunction.

Depression and anxiety in Malaysian population during third wave of the COVID-19 pandemic.

INTRODUCTION: The outbreak of coronavirus posits deleterious consequences on global healthcare system while affecting human life in every aspect. Despite several measures undertaken to limit the socio-economic effect of coronavirus, various challenges remain pervasive, and one such challenge is mental health, particularly depression and anxiety. Therefore, this study examines the prevalence and determinants of depression and anxiety in Malaysian population during third wave of COVID-19. METHODS: A cross-sectional online survey was carried out via social media platforms and 1544 Malaysians were selected. The level of depression was assessed by Patient Health Questionnaires (PHQ-9) and scored accordingly for categorization. Zung's Self-Rating Anxiety Scale (SAS) was used as a self-assessment survey to quantify the level of anxiety of persons experiencing anxiety-related symptoms. Percentage distribution and logistic regression analysis were used in the data analysis. RESULTS: Results showed that one-fourth (25.1%) of the participants had severe depressive symptoms. Almost one-sixth (18.7%) had mild depressive symptoms and one-third (34.1%) had mild to moderate anxiety symptoms. Age, gender, and friends infected with virus were the three important predictors of depression and anxiety. The odds of having depression (OR = 1.44; C·I. = 1.32-1.62) and anxiety (OR = 1.36; C·I. = 1.27-1.47) were significantly higher among females than in males. CONCLUSION: A significant proportion of the study participants were facing mild to severe depression and anxiety symptoms which is very alarming as the pandemic is still now increasing across the country. Immediate interventions including community counselling programmes, TV and social media campaigns are urgently needed to reduce the psychological stress among the Malaysian population.

Prevalence of self-reported anxiety and self-medication among upper and middle socioeconomic strata amidst COVID-19 pandemic.

BACKGROUND: Amidst corona virus disease-2019 (COVID-19) pandemic, disruption to the usual ways of life can lead to anxiety and feeling of being unsafe, which may be associated with self-medication. The study was planned to investigate the prevalence of anxiety and self-medication during COVID-19 pandemic. MATERIALS AND METHODS: In this cross-sectional study, data were collected through an anonymous online survey with questionnaire consisting of four sections: demographic data of the participants, validated COVID-19 Anxiety Inventory Items, Self-rating Anxiety Scale, and self-medication practices during COVID-19 pandemic. The data were organized and analyzed using Windows Microsoft excel and SPSS software (Version 21). Descriptive statistics were calculated for all patient characteristics and survey responses. Analytical analysis included relationship between various parameters using Chi-square test. RESULTS: A total of 1100 responses were received. Approximately half of the participants were worried about getting severely ill. Majority reported reduced social contact (71.3%, n = 784) and also communicated that the pandemic has influenced their use of safety measures (86.5%, n = 951). The prevalence of mild-to-moderate, moderate-to severe, and extremely severe anxiety cases were 23.1%, 4.7%, and 0.54%, respectively. One-fourth of the responders reported self-medication, out of which 60% were found to be anxious. Nonsteroidal anti-inflammatory drugs were most commonly used. CONCLUSIONS: Rising to the present challenge will require integration across different sectors with the immediate aim of getting people safely through the pandemic. As the world focuses on containing and delaying the spread of the COVID-19, with burdened health-care systems, we should not miss out on people with anxiety disorders and self-medication problem, which may worsen with the pandemic.

The physical and mental health of the medical staff in Wuhan Huoshenshan Hospital during COVID-19 epidemic: A Structural Equation Modeling approach.

INTRODUCTION: Early in the epidemic of coronavirus disease 2019, the Chinese government recruited a proportion of healthcare workers to support the designated hospital (Huoshenshan Hospital) in Wuhan, China. The majority of front-line medical staff suffered from adverse effects, but their real health status during COVID-19 epidemic was still unknown. The aim of the study was to explore the latent relationship of the physical and mental health of front-line medical staff during this special period. METHODS: A total of 115 military medical staff were recruited between February 17th and February 29th, 2020 and asked to complete questionnaires assessing socio-demographic and clinical characteristics, self-reported sleep status, fatigue, resilience and anxiety. RESULTS: 55 medical staff worked within Intensive Care and 60 worked in Non-intensive Care, the two groups were significantly different in reported general fatigue, physical fatigue and tenacity (P<0.05). Gender, duration working in Wuhan, current perceived stress level and health status were associated with significant differences in fatigue scores (P<0.05), the current perceived health status (P<0.05) and impacted on the resilience and anxiety of participants. The structural equation modeling analysis revealed resilience was negatively associated with fatigue (ß=-0.52, P<0.01) and anxiety (ß=-0.24, P<0.01), and fatigue had a direct association with the physical burden (ß=0.65, P<0.01); Fatigue mediated the relationship between resilience and anxiety (ß=-0.305, P=0.039) as well as resilience and physical burden (ß=-0.276, P=0.02). CONCLUSION: During an explosive pandemic situation, motivating the effect of protective resilience and taking tailored interventions against fatigue are promising ways to protect the physical and mental health of the front-line medical staff.

[Investigation of anxiety and depression in patients from the emergency department during COVID-19 epidemic].

OBJECTIVE: To investigate the status of anxiety and depression in patients requiring emergency treatment during the epidemic of COVID-19 to identify the patients with acute psychological stress disorder. METHODS: During the COVID-19 epidemic, the medical staff divided the patients visiting the emergency department into suspected group, fever group and control group through interview of the patients at triage. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were distributed to each patient, and a trained medical staff was responsible for assisting the patient to complete the scales. RESULTS: A total of 557 sets of scales were distributed, including 211 in suspected COVID-19 case group, 167 in fever group and 179 in the control group. A total of 516 scales were retrieved, including 197 in suspected case group, 151 in fever group and 168 in control group. In the 3 groups, the incidence rates of anxiety and depression were 57.87% and 58.88%, 48.34% and 43.71%, and 18.31% and 18.99%, respectively, and the rates were significantly higher in suspected group and fever group than in the control group (P < 0.01), and significantly higher in suspected group than in fever group (P < 0.05). The standardized anxiety and depression scale scores in suspected case group, fever group and control group were 57.38±16.25 and 42.58±14.27, 51.23±15.29 and 38.32±15.39, and 32.58±17.8 and 12.25±12.94, respectively. Compared with the control group, both suspected case group and fever group had significantly higher standard scores for anxiety and depression (P < 0.01), and suspected case group had significantly higher standardized scores than fever group (P < 0.01). CONCLUSIONS: Among the patients visiting the emergency treatment, the patients with suspected COVID-19 and common fever are more likely to develop anxiety and depressive symptoms.