What I felt as a diabetes fatigue survivor: a phenomenology study.

Purpose: Diabetes has resulted in an increase in diabetic fatigue syndrome, which has a negative influence on health, particularly the risk of worsening quality of life (QoL) due to physical and mental limitations. The purpose of this study was to evaluate the experiences of patients with unregulated type 2 diabetes mellitus (T2DM) and diabetes fatigue syndrome. Methods: This study used a qualitative phenomenological design and focused on patients from four primary health centers (PHCs) in Surabaya, Indonesia with higher incidents of unregulated T2DM. Thirty participants were recruited using purposive sampling with the following inclusion criteria: adult T2DM patients, willing to participate in the study, and able to recount experiences associated with their illness. Data collection took place between April and June 2020 across 36 interview sessions. Semi-structured interviews were carried out face-to-face with each participant with the principles of social distancing applied due to the COVID-19 pandemic. Results: Analysis identified five themes and thirteen subthemes. The first theme was participants' experiences during blood glucose imbalance. Other themes included experiences of boredom with diet, physical and psychological distress, financial problems during treatment, and sexual problems. Conclusion: Participants with T2DM who experienced diabetes fatigue reported negative effects on their life, especially on health, functional daily activity, and finances. The results of this study can provide information for nurses and other healthcare providers to promote interventions for patients with T2DM, such as modifying lifestyle, self-acceptance, and self-efficacy.

The Impact of Online Learning among Adolescents during the COVID-19 Pandemic: A Qualitative Study of Mothers' Perspectives.

Background: The COVID-19 pandemic changed the educational system from conventional learning in schools to online learning. The use of the internet as a learning medium can have positive and negative impacts on adolescents and cause concern for mothers. In this study, mothers' perspectives were explored with the phenomenological approach to assess their experience of the effect on line learning during the COVID-19 pandemic among adolescents. Materials and Methods: The qualitative study design: phenomenology was conducted on mothers with children at senior high school education levels. The data were collected using in-depth interviews from June to November 2020 in West Java, Indonesia. A total of 13 mothers were recruited using the purposive sampling technique. Data analysis was performed using the Colaizzi method and NVIVO software for managing the coding process. Results: We obtained four themes, namely (1) formation of adolescent behavior with the internet, (2) prevention of internet addiction, (3) disturbance of cognitive development, and (4) negative effect of online learning. Conclusions: The usage of the internet cannot be avoided. By guiding adolescents, the negative effects of the internet could be prevented. Developing learning programs, media, and online learning strategies according to students' needs should be promoted.

Resilience-based Islamic program as a promising intervention on diabetes fatigue and health-related quality of life.

Psychological problems commonly experienced by patients with type 2 diabetes mellitus (T2DM) cause diabetes fatigue conditions that can further worsen the treatment prognosis. We conducted this investigation to determine the effectiveness of a resilience-based Islamic program on diabetes fatigue and health-related quality of life (HRQoL) by measuring the biochemical indicators of T2DM. This was a quasi-experimental study performed from May to August 2021, in which 80 respondents aged 18-64 years diagnosed with T2DM were included through purposive sampling at a male:female sex ratio of 1:1 in the control group and 17:23 in the treatment group. A resilience-based Islamic program (a combination of stress management, mindfulness, prayer, and dhikr (the ritual formula of Sufi brotherhood recited devotionally in praise of Allah and as a means of attaining ecstatic experience)) was implemented in the treatment group for six sessions by blended online and offline interventions. Multidimensional Fatigue Inventory-20 and World Health Organization Quality of Life, Brief Form were used to evaluate diabetes fatigue and HRQoL. Blood tests were performed to measure HbA1c, total antioxidant serum, insulin, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels from baseline to 3 months. Statistical analyses were conducted using paired t test, Wilcoxon signed-rank test, independent t test, and Mann-Whitney U test. The resilience-based Islamic program had a beneficial impact on the levels of HbA1c (p < 0.001), lipid profile (triglyceride) (p = 0.011), HDL-c (p = 0.01), LDL-c (p < 0.001), total antioxidant serum (p = 0.001), insulin (p < 0.001), diabetes fatigue (p < 0.05), and HRQoL (p < 0.05) in patients of the treatment group. The results of biochemical tests related to T2DM also indicated a reduction in diabetes fatigue and an increase in HRQoL due to the resilience-based Islamic program. Considering that a patient's resilience to diabetes is an important factor in the management of diabetes fatigue, the resilience-based Islamic program can be applied at public health centers and community levels to increase T2DM resilience.

Efficacy of Internet-Based Cognitive Behavioral Therapy for Depression and Anxiety among Global Population during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial Study.

Background: Depression and anxiety have become the most common mental health disorders worldwide during the COVID-19 pandemic, and increasing interest in telemedicine has led to the innovation of using internet-based cognitive behavioral therapy (iCBT). Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of iCBT for depression and anxiety among the global population during the COVID-19 pandemic. Methods: A literature search was conducted on PubMed, Scopus, Cochrane, ProQuest, Wiley, and Web of Science using the PRISMA framework, and only randomized controlled trials (RCTs) were included in the study. A critical appraisal was also performed using Cochrane's Risk of Bias (RoB) 2. The meta-analysis used random-effects models to analyze pooled mean difference (MD) and its p-value. Results: Twelve RCTs were included for qualitative analysis and nine RCTs, which yielded 6778 patients with depression and 6556 patients with anxiety during the COVID-19 pandemic, were included for quantitative analysis. Despite high heterogeneity, all studies had a low risk of bias. Pre- and post-iCBT intervention in the depression forest plot depicts a significant effect (p < 0.00001) with a pooled MD of 4.73 (95% CI: 4.55-4.90), while the pre- and post-iCBT intervention depicts a significant effect (p < 0.00001) with a pooled MD of 4.50 (95% CI: 4.34-4.67). This demonstrates that iCBT was found to significantly decrease depression and anxiety scores in patients during the COVID-19 pandemic. However, substantial heterogeneity was also found (I2 = 93%; p < 0.00001 and I2 = 90%) for the pre-/post-depression and anxiety forest plots, respectively. Conclusions: This meta-analysis comprises an evidence-based result for iCBT to treat depression and anxiety in the COVID-19 population, as indicated by the significantly lower assessment scores. Delivering iCBT in this situation needs to be considered more extensively, as it has promising results and yields the benefits of technological advancement in psychotherapy.

Indonesian nursing students' intention to accept COVID-19 vaccines: an online, multicentre survey.

BACKGROUND: The determinants of intention to accept the COVID-19 vaccine and associated factors among nursing students during this pandemic need to be identified. AIMS: The study assessed nursing students' attitudes to vaccination, health engagement and trust in government, as well as their intention to have a COVID-19 vaccination. METHODS: A cross-sectional study was carried out among nursing students in three provinces of Java, Indonesia, from December 2020 to February 2021. Convenience sampling was used to gather primary data from 640 participants through a structured online survey. Multiple linear regression was used to analyse the results. FINDINGS: All items of vaccine attitude and health engagement as well as trust in government were positive predictors of vaccine acceptance after adjusting for confounding factors. CONCLUSION: Nursing students were more likely to accept vaccination if they had a positive attitude to vaccination, high levels of health engagement and trust in the government regarding tackling the COVID-19 pandemic.

Association of stigma with mental health and quality of life among Indonesian COVID-19 survivors.

BACKGROUND AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) survivors face societal stigma. The study aims to analyze the association of this stigma with the mental health and quality of life of COVID-19 survivors. METHODS: In this cross-sectional study, we observed 547 adults who were previously documented as severe acute respiratory syndrome coronavirus (SARS-CoV-2) positive by a polymerase chain reaction (PCR) test, treated in a hospital or an emergency hospital and proven to be SARS-CoV-2 negative by their latest PCR test. We adopted the Berger HIV Stigma Scale to measure stigma; the World Health Organization Quality of Life Brief Form to measure quality of life; and the Mental Health Inventory-38 to measure mental health. The chi-square and binary logistic regression tests were used to find the correlation between the variables. RESULTS: The multivariate analysis revealed that medium stigma was more likely related to quality of life and mental health than low stigma. Females were less likely to experience stigma related to mental health than men, and respondents who worked as laborers and entrepreneurs were less likely to experience stigma related to mental health than those who worked as civil workers/army personnel/teachers/lecturers. COVID-19 survivors experienced medium stigma in society and lower quality of life and mental health status. We found that quality of life and mental health were affected by stigma, sex, and occupation. CONCLUSION: COVID-19 survivors are a vulnerable group that is most at risk when they return to their communities. Creating a safe environment and providing respectful care, including addressing complex stigma factors, is vital for developing appropriate interventions.

Depression, anxiety, and stress among students amidst COVID-19 pandemic: A cross-sectional study in Philippines

COVID-19 considered a global health crisis, poses mental health problems among individuals and specifics to students. This study aimed to determine the depression, anxiety, and stress levels among students amidst COVID-19 pandemic in the Philippines. A cross-sectional study was undertaken in Region 8, Eastern Visayas Philippines. A total of 311 tertiary respondents randomly selected both private and government owned higher education institutions. The data compilation was done using online questionnaires through Google Forms with validated version of the Stress, Anxiety and Depression Scales 21 (DASS21) is used to calculate student’s level of stress, anxiety and, depression with their socio-demographic features. We revealed that depression, anxiety and stress are instituted in 18.6 %, 35.1 % and 2.85% of students, respectively, amidst the COVID-19 pandemics. The symptoms of disorders were moderate to extremely severe in 6.1%, 23.5%, and 0.6% of the study sample, respectively. Age, gender, marital status and family history of illness are significantly different with age group 20 and below, females, singles, and families with no history of illness displaying high levels of anxiety. Results also established an association between anxiety and family’s monthly income and history of illness. The higher the monthly income and no presence of illness of families, the more anxious the person. Finally, the variables used explained only 1.5% depression, 3.4% anxiety, and 1.4% stress in this time of COVID-19 outbreak. It is therefore recommended to essentially develop community-based mental health programs for preventive purposes. Keywords: anxiety;caring;COVID-19 pandemic;depression;nursing

Self-Fetal Wellbeing Monitoring and Ante-Natal Care during the COVID-19 Pandemic: A Qualitative Descriptive Study among Pregnant Women in Indonesia.

Pregnant women are expected to have a high level of awareness when it comes to checking their fetal health and ensuring their welfare. This study explored the experiences of pregnant women in Indonesia who were monitoring their fetal wellbeing during the COVID-19 pandemic. A qualitativedescriptive study design with a constructivist paradigm was used. Twenty-two pregnant women were recruited and participated in a semi-structured interview. Analysis of the transcribed interviews used a content, thematic and comparative process. Three themes emerged from the analysis: feelingsand responses, changes to the ante natal care service during the COVID-19 pandemic, and the fetal wellbeing monitoring, tools, and methods used. Advice on how pregnant women should conduct fetal wellbeing monitoring during COVID-19 is urgently needed. The results of this study indicate there is a need for interventions to help pregnant women carry out self-fetal wellbeing monitoring in times where they have fewer contacts with health professionals such as during the COVID-19 pandemic.