Drivers of COVID-19 Vaccine Intent Among Survivors of Adolescent and Young Adult Cancer: a Mixed Method Study.

BACKGROUND: Survivors of adolescent and young adult (AYA) cancer are susceptible to severe COVID-19 outcomes due to their cancer history. Drivers of COVID-19 vaccine hesitancy and willingness are largely unexplored among AYA cancer survivors. METHODS: We surveyed survivors of AYA cancer from October 2020-February 2021 who received services through an AYA cancer care program. Survey measures included vaccine hesitancy on a five-point Likert scale and an open-ended question on vaccine intent. Open-ended responses were content analyzed through two cycles of structured coding. Quantitative vaccine intent and qualitative drivers of intent were integrated during data analysis. RESULTS: Of participants who responded to the open-ended vaccine intent question (N = 300), 39.0% reported COVID-19 vaccine hesitancy. Qualitative content analysis resulted in N = 517 codes and seven content categories. The most common content category associated with hesitancy included COVID-19 vaccine development, approval, and efficacy (34.5%; p value ≤ 0.001), as well as content areas including presence of misinformation about COVID-19 in the response (4.8%; p value = 0.04), the desire for more information about COVID-19/COVID-19 vaccine (6.0%; p value ≤ 0.001), and reference to political influence on participants' intent to get the vaccine (2.5%; p value = 0.005). The most common category associated with vaccine willingness was personal perceptions of COVID-19 vaccination including protecting oneself and others (36.6% of codes; p value ≤ 0.001), followed by pro-vaccine beliefs (8.3%; p value ≤ 0.001) and trust in science (3.9%; p value ≤ 0.001). CONCLUSIONS: Common drivers of COVID-19 vaccine hesitancy among survivors of AYA cancer include concern about vaccine side effects and approval process, and misinformation. Cancer survivors COVID-19 vaccine uptake could be improved by focusing communication on drivers of willingness, motivational interviewing, and physician recommendations.

Posttraumatic Stress Symptoms, Anxiety, and Depression Among COVID-19 Survivors After Discharge from Hospital

Background: The coronavirus disease 2019 (COVID-19) pandemic can lead to psychological issues;however, few studies have evalu-ated the mental health status of COVID-19 patients after discharge from the hospital. Objectives: This study aimed to assess the psychological status of COVID-19 survivors and determine the risk factors associated with adverse psychological outcomes. Methods: Through a web-based cross-sectional survey, the data were collected from 158 COVID-19 survivors one month after discharge from the hospital using demographic information, the Hospital Anxiety and Depression Scale (HADS), and the Posttraumatic Stress Disorder Checklist for the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (PCL-5). Data analysis was conducted in SPSS software (version 24) using logistic regression modeling. Results: The mean age of the participants was 42.02 ±10.56 years, and the majority of patients were male (58.2%) and married (79.1%). According to the HADS, 32 (20.3%) and 21 (13.3%) patients had anxiety and depression, respectively. Using the PCL-5, 45 (28.5%) patients experienced posttraumatic stress disorder (PTSD) after discharge from the hospital. A positive history of psychiatric disorders, sub-stance abuse, and smoking were the related risk factors for depression, anxiety, and PTSD (P < 0.05). Conclusions: Based on the results, it might be concluded that COVID-19 survivors, especially the aforementioned groups, need more targeted interventions regarding psychological health during and after discharge to avoid COVID-19-related psychiatric injuries. © 2022, Author(s).

Investigating the perceived effectiveness of eye movement desensitisation reprocessing (EMDR) treatment in adult survivors of childhood sexual abuse and the impact on neuropsychological, emotional and behavioural functioning and quality of life: A case series analysis

Childhood sexual abuse (CSA) is an ongoing issue (WHO, 2017) with 1 in 20 children annually reported as being abused in the UK (NSPCC, 2019;Radford et al, 2011). Many child survivors are of adolescent or young adult age before they request help from relevant services (HAVOCA, 2021;NSPCC, 2018;Noel, Dogaru, and Ellis, 2015;Flatley, 2017). The aim of this study was to investigate the perceived experiences of six young adult female survivors of CSA of their EMDR treatment as well as an assessment of the changes in the individual trauma stress response. This case series analysis explored (a) neuropsychological, emotional (namely low selfesteem, anxiety and depression), behavioural functioning and quality of life issues using descriptive statistics via outcome measures conducted before, during and after treatment and (b) client perspectives through qualitative interviewing at one-month follow-up to ensure adequate time was allowed to monitor changes using Thematic Analysis [TA]. The study setting was within the Improving Access to Psychological Therapies (IAPT) program framework, established to ensure service users accessing NHS treatment are presented with choice in their treatment.The triangulation of data in this study allowed for a deeper analysis of the experiences of adult CSA survivors undergoing EMDR treatment beyond an examination of differences in pre and post outcome measures. The descriptive statistics suggested overall positive changes in participant functioning in all measured domains (three positive, two moderate outcome cases and one sceptical no-improvement case;based on independent research rater feedback) however variable differences in neuropsychological processing from pre- to post-treatment. The descriptive statistics were limited in their generalisability because of certain limitations in data collection as inhibited by COVID-19 restrictions and because of the small sample size. Three key themes were identified in the qualitative analysis which contributed to the literature on treatment of adult CSA survivors by identifying which factors the clients identified as helpful and unhelpful to their treatment. These themes were identified as being an 'Unhelpful' process (service time restrictions, fear of the lack of confidentiality, fear of emotional reprocessing), 'Helpful' aspects of therapy (client choice in treatment, therapist interpersonal and professional skills, psychological resourcing, idiosyncratic approaches) and 'Mixed Responses' due to COVID-19 (face-to-face vs remote working). Overall, this study contributed to the literature about EMDR treatment for adult CSA survivors by shedding insight into the perceived experiences of clients and providing further evidence for the efficacy of this treatment.Importantly, further research could investigate a potentially larger sample, emphasis on neuropsychological functioning, and within differing settings, to understand deficits within the current study. A qualitative study of the perceptions and experiences of childhood sexual abuse survivors who opt for CBT over EMDR might lead to recommendations for changes in protocol that would make EMDR more acceptable. There is scope to further investigate EMDR as a reliable and valid treatment option within NHS IAPT settings, alongside essential service development in therapist training programmes to support the growing need for treatment of multiple-trauma and/or Complex-PTSD (ICD-11, International Classification of Diseases-11, 2018). (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Cardiac Magnetic Resonance Imaging Findings in 2954 COVID-19 Adult Survivors: A Comprehensive Systematic Review.

BACKGROUND: Recent studies have utilized MRI to determine the extent to which COVID-19 survivors may experience cardiac sequels after recovery. PURPOSE: To systematically review the main cardiac MRI findings in COVID-19 adult survivors. STUDY TYPE: Systematic review. SUBJECTS: A total of 2954 COVID-19 adult survivors from 16 studies. FIELD STRENGTH/SEQUENCE: Late gadolinium enhancement (LGE), parametric mapping (T1-native, T2, T1-post (extracellular volume fraction [ECV]), T2-weighted sequences (myocardium/pericardium), at 1.5 T and 3  T. ASSESSMENT: A systematic search was performed on PubMed, Embase, and Google scholar databases using Boolean operators and the relevant key terms covering COVID-19, cardiac injury, CMR, and follow-up. MRI data, including (if available) T1, T2, extra cellular volume, presence of myocardial or pericardial late gadolinium enhancement (LGE) and left and right ventricular ejection fraction were extracted. STATISTICAL TESTS: The main results of the included studies are summarized. No additional statistical analysis was performed. RESULTS: Of 1601 articles retrieved from the initial search, 12 cohorts and 10 case series met our eligibility criteria. The rate of raised T1 in COVID-19 adult survivors varied across studies from 0% to 73%. Raised T2 was detected in none of patients in 4 out of 15 studies, and in the remaining studies, its rate ranged from 2% to 60%. In most studies, LGE (myocardial or pericardial) was observed in COVID-19 survivors, the rate ranging from 4% to 100%. Myocardial LGE mainly had nonischemic patterns. None of the cohort studies observed myocardial LGE in "healthy" controls. Most studies found that patients who recovered from COVID-19 had a significantly greater T1 and T2 compared to participants in the corresponding control group. DATA CONCLUSION: Findings of MRI studies suggest the presence of myocardial and pericardial involvement in a notable number of patients recovered from COVID-19. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 3.

COVID-19 and how the wearing of face coverings can affect those with an experience of trauma.

WHAT IS KNOWN ON THE SUBJECT?: With the ongoing and possible evolving use of face coverings as a public health protection measure against the transmission of COVID-19, this is likely to be an ongoing challenge for those who find their use challenging. The wearing of face coverings following trauma is likely to be of ongoing relevance, making this an area that would benefit from further research. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The authors present their personal and professional experiences as a means of highlighting the difficulties that can be faced as a result of the use of face coverings. The window of tolerance helps to understand the difficulties that can be caused by wearing face coverings and provides a visual means of conceptualizing the cognitive, behavioural, physiological and emotional reactions that can occur as a result of their use. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper provides an awareness of the link between trauma and the wearing of face coverings, and how their use could be re-traumatizing for those accessing services. This topic is relevant across all sectors where it is only just beginning to be acknowledged that for many, particularly those with experiences of interpersonal trauma, difficulties can arise due to the use of face coverings. The sharing of grounding techniques and an introduction to the window of tolerance provides a means of collaboratively developing skills and developing a shared understanding of the difficulties associated with the use of face coverings.