Coping strategies, resilience and quality of life: reaction to the COVID-19 pandemic among Romanian physicians.

BACKGROUND: The COVID-19 pandemic has presented multiple psychological challenges for healthcare workers, such as anxiety, depression, burnout, and substance use disorders. In this research, we investigate the different ways Romanian physicians dealt with the difficult period of the COVID-19 pandemic. We also analyze how positive and negative stress-reducing strategies, as well as demographic variables, affect their psychological resilience and quality of life. Our goal is to provide a comprehensive overview of how physicians coped with the unprecedented global health challenges. METHODS: We carried out a national cross-sectional study of 265 physicians in Romania between January 2021 and January 2022 using a web-based questionnaire. The study employed a web-based questionnaire to assess coping mechanisms using the COPE inventory, resilience through the Connor-Davidson Resilience Scale 25 (CD-RISC 25), and quality of life via the WHOQOL-BREF scale. The COPE inventory, consisting of 60 items across 15 subscales, categorizes coping strategies into problem-focused, emotion-focused, and dysfunctional types, with each item rated on a 4-point scale. The CD-RISC 25 measures resilience on a 5-point Likert scale, with total scores ranging from 0 to 100. WHOQOL-BREF assesses quality of life through 26 items in 4 domains: physical, mental, social relations, and environmental, scored from 1 to 5 and converted to a 0-100 scale for domain scores. Univariate and multivariate linear regression models were employed to discern the intricate relationships between coping strategies, resilience levels, quality of life dimensions, and pertinent demographic factors. RESULTS: The average CD-RISC score among participants was 66.2. The mean scores for the values for the QOL subscales were 64.0 for physical well-being, 61.7 for psychological well-being, 61.2 for social relationships, and 64.7 for environment. Individuals tend to use problem-focused and emotion-focused coping more than dysfunctional mechanisms, according to the COPE inventory. Problem-focused and emotion-focused coping are positively correlated with resilience, while dysfunctional coping is negatively correlated. Resilience is significantly influenced by gender and professional status, with males and senior specialists reporting higher levels while younger physicians and residents reporting lower levels. CONCLUSIONS: Our data points to specific protective characteristics and some detrimental factors on physicians' resilience and quality of life during the pandemic.

Implementation of National Nutrition Policies and Strategies to Reduce Unhealthy Diets: An Ecological Analysis of 194 Countries from 2017 to 2021.

This study investigates the implementation of national policies and strategies to control unhealthy diets, which are pivotal in the global surge of non-communicable diseases. Leveraging data from the World Health Organization's Non-Communicable Diseases Progress Monitors and Country Capacity Surveys, we calculated aggregate implementation scores for 13 diet-related policies across 194 countries from 2017 to 2021. We used descriptive statistics and linear regression to investigate the implementation trends and associations between key national-level factors and implementation scores. The mean score in 2021 was 52% (SD = 24), with no statistical differences in the 5-year period. Stark disparities in implementation efficacy were noted, ranging from comprehensive adoption in some nations to minimal application in others. Our analysis also highlights a shifting focus in policy adoption: notably, an increased commitment to taxing sugar-sweetened beverages juxtaposed with a decline in dietary awareness initiatives. Significant predictors of policy implementation include the Human Development Index, the cost of a healthy diet, and health service coverage. These findings suggest a complex interdependence of socioeconomic factors influencing policy implementation. Our research underscores the need for multifaceted, globally collaborative strategies to effectively combat diet-related diseases, emphasizing the importance of comprehensive policy frameworks in public health interventions.

Experiences of childbirth care in Lithuania and Romania: Insights from the European Babies Born Better survey.

BACKGROUND: Data on experience and satisfaction of users are essential for improvement of health care, especially in the field of childbirth. The aim of this study was to compare childbirth care experiences in Lithuania and Romania. METHODS: Data derived from the EU Babies Born Better online survey were analyzed. Parturients from Lithuania (N = 373) and Romania (N = 359) who had given birth within the last 5 years were included. Participants were asked to (1) describe the best things in childbirth care and (2) suggest changes in the care received at their birthplace. Qualitative data were analyzed using a previously developed deductive coding framework. RESULTS: In agreement with previous findings from Austria, positive experiences mainly addressed care experienced at an individual level (in particular healthcare practitioners' competence and personality traits) and suggested changes mainly addressed services at birthplace (issues related to infrastructure, information and counseling, and empowerment). Responses not initially included in the coding framework addressed aspects such as informal payment (in both countries), desire for home birth (particularly in Lithuania), or mistreatment of parturients (particularly in Romania). CONCLUSIONS: We conclude that similar trends in childbirth care exist in Lithuania and Romania with regard to parturients' personal experiences and psychosocial needs and that addressing the needs of parturients is important for improving service provision.

The Global Burden of Type 2 Diabetes Attributable to Dietary Risks: Insights from the Global Burden of Disease Study 2019.

The Global Burden of Disease Study (GBD) 2019 reveals an increasing prevalence of Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019. This study delves into the role of dietary risk factors across different demographic and socioeconomic groups. Utilizing data from the GBD 2019, it analyzes age-adjusted T2DM metrics-death counts, Disability-Adjusted Life Years (DALYs), and Age-Standardized Rates (ASRs)-stratified by age, sex, and region. The study employed Estimated Annual Percentage Changes (EAPCs) to track trends over time. The results show that in 2019, 26.07% of T2DM mortality and 27.08% of T2DM DALYs were attributable to poor diets, particularly those low in fruits and high in red and processed meats. There was a marked increase in both the death rate and DALY rate associated with dietary risks over this period, indicating the significant impact of dietary factors on the global T2DM landscape. Geographic variations in T2DM trends were significant, with regions like Southern Sub-Saharan Africa and Central Asia experiencing the most substantial increases in Age-Standardized Mortality Rate (ASMR) and Age-Standardized DALY Rate (ASDR). A positive correlation was noted between Socio-Demographic Index (SDI) and T2DM burden due to dietary risk factors. The study concludes that targeted public health initiatives promoting dietary changes could substantially reduce the global T2DM burden.

Exploring the Impact of Sociodemographic Characteristics and Health Literacy on Adherence to Dietary Recommendations and Food Literacy.

This study investigates food literacy-related abilities and adherence to dietary recommendations in relation to sociodemographic characteristics and health-related features (health literacy, self-rated health and morbidity) in the North-Western region of Romania. This is a secondary analysis of cross-sectional data collected in 2019 from a representative and randomised sample of 1572 individuals. A questionnaire was employed to record participants' sociodemographic characteristics, food-related and health-related features. Most participants were non-adherent to dietary recommendations for fruit and vegetables (83.5%), fish and seafood (61.3%), and water intake (67.9%). However, most participants reported an adequate ability to understand the connection between nutrition and health (89.1%), to distinguish between healthy and less healthy options (84.4%), and to acquire nutrition information (75.6%). Non-adherence to dietary recommendations and low food literacy abilities were more prevalent in disadvantaged groups (older age, rural settings, retirement or social welfare, low educational attainment, formerly married). Health literacy was negatively associated with not adhering to dietary recommendations and poor self-rated food literacy abilities. The study suggests that low socioeconomic status negatively impacts food literacy and adherence to dietary recommendations among Romanian adults. Identifying target populations to improve food-related abilities and health literacy can aid public health services in improving health outcomes.

Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire.

Objective: Empirical data on health literacy (HL) for Romania is almost inexistent. The present study aimed to validate the HLS-EU-Q16 questionnaire for the Romanian population and explore the predictors of HL in the North-West Region of the country. Methods: A non-experimental, cross-sectional study was conducted between March and November 2019 on a representative, stratified random sample of 1,622 participants from the North-Western Region of Romania. Exploratory Factor Analysis (EFA), Principal component analysis (PCA), Pearson correlations, and Chronbach's Alpha were used to validate the scale. Linear regressions were conducted to assess the determinants of health literacy. Results: Results obtained for the HL scale support its factorial component and reliability, with a Cronbach's alpha of α = 0.84. Age, gender, education and self-reported health status were identified as determinants of HL. Conclusion: Study findings indicate that the Romanian version of HLS-EU-Q16 is psychometrically sound and comparable to the original version. These results provide the first validated tool to measure HL in Romanian and the first population level data for Romania.