The Depression Anxiety Stress Scale 8: investigating its cutoff scores in relevance to loneliness and burnout among dementia family caregivers.

The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.

Relationship of stigmatization and social support with depression and anxiety among cognitively intact older adults.

Aims and objectives: This study aimed to assess depression and anxiety symptoms among older adult residents of long-term care facilities (LTCFs) in Jordan and to examine the relationships between stigmatization and social support with depression and anxiety. Methods: Data was collected between December 2019 and March 2020 using a cross-sectional design. A total of 90 LTCF residents responded to measures of cognition, anxiety, depression, stigmatization, and social support. Descriptive statistics and multiple regression analyses were used in this study. Results: The average scores of depression and anxiety were high among the participants, with 81.1% of the participants found to be at risk of developing clinical depression. Stigmatization was positively correlated with depression and anxiety, whereas social support was negatively correlated with depression. Stigmatization was a significant predictor of both anxiety and depression scores (ß = .19, p = .03; ß = .32, p = .001, respectively). Conclusions: Older adults residing in LTCFs in Jordan suffer from many psychological distress symptoms, which place them at risk of serious mental problems. Reducing stigmatization would improve the psychological well-being of LTCF residents. Relevance to clinical practice: Caregivers working at LTCFs should be aware that with the longer stay, older adult residents are expected to complain of psychological distress symptoms. Thus, frequent assessment of the residents is highly recommended. In addition, caregivers should provide the residents with appropriate social support to mitigate the negative impact of a lengthy stay.

Social Support, Self-Efficacy, and Psychological Wellbeing of Adults with Type 2 Diabetes.

Social support improves self-efficacy, which in turns enhances self-management that lead to better psychological outcomes of persons with type 2 diabetes (T2D). The purpose of this study was to examine the relationship between social support and psychological outcomes of adults with T2D. A cross-sectional design was used to recruit a sample of 339 participants from a diabetes clinic. The participants responded to a series of questionnaires on demographics, social support dimensions, and self-management; self-efficacy; and psychological outcomes. The function and quality of social support were positively associated with self-efficacy. Self-efficacy was significantly associated with both self-management and psychological outcomes. In addition, self-efficacy demonstrated successful mediation role in the relationship between social support and psychological outcomes of T2D, however, self-management failed to mediate this relationship. The quality and functionality of social support are distinctive variables that should be recognized to promote social support interventions to reduce or prevent T2D-related psychological outcomes.

The relationship between social networking sites usage and psychological distress among undergraduate students during COVID-19 lockdown.

During the outbreak of the COVID-19 pandemic, interpersonal interactions are restricted to social networks. Undergraduate students are isolated in their homes and dorms. Loneliness is closely related to psychological distress. Fear of contracting the disease will worsen psychological distress. The purpose of this study was to assess the severity of depression, anxiety, and stress symptoms among undergraduate students and their relationships with social networking sites usage during the COVID-19 lockdown. An online survey was used to recruit 456 participants for this cross-sectional descriptive study. Self-reported questionnaires were used to collect data on students' demographics, depression, anxiety, stress, and social networking usage. The results revealed that the majority of students had symptoms of depression (74.1%), anxiety (59.6%), and stress (61.2%). Female students had higher depression and anxiety symptoms than males. Senior-level students' psychological distress symptoms were significantly different from those of junior level. The largest percentage of students (91.9%) used social networking sites for entertainment. The academic usage of social networking sites was negatively (p < .05) correlated with depression and stress scores, while entertainment usage was positively correlated with anxiety. Age was not found to be significantly correlated with psychological distress. Academic and entertainment use of social networking sites were successfully associated with psychological distress symptoms after controlling for demographics. During this unprecedented time of undergraduate students' course of study, they were experiencing higher than average distress symptoms. These symptoms could be mitigated by continuing the regular academic activities and delivering the most accurate up-to-date information on the COVID-19 through social networking sites.

Nursing Empowerment: How Job Performance Is Affected by a Structurally Empowered Work Environment.

OBJECTIVE: The purpose of this study is to investigate the level of structural empowerment and explore its relationship with job performance among nurses. BACKGROUND: Empowered nurses display more authority and an awareness of the accomplishment of their contribution to organizational goals. METHODS: A cross-sectional study was conducted with a convenience sample of nurses in 4 hospitals in Jordan. Data were collected using a self-administered questionnaire. RESULTS: A total of 195 nurses responded to the questionnaires, including 88 males (45.1%) and 107 females (54.9%). Overall, participants perceived their work environment to be moderately empowering. There is a significant positive correlation between structural empowerment and job performance. CONCLUSIONS: Highly empowered nurses display higher performance than less empowered nurses. Nurse managers must create an empowering work environment that supports nurses' job performance positively through structural empowerment. Applying structural empowerment in the work setting is crucial for ensuring the highest quality of patient care, improving nurses' performance, and reaching the organizational goals.

Development and psychometric evaluation of Nurses and Midwives' Perceptions of their Roles in Primary Healthcare.

OBJECTIVE: This study aimed to develop Nurses and Midwives' Perceptions of their Roles in Primary Healthcare (NMPR-PHC) and evaluate its psychometric properties. METHODS: A cross-sectional survey was performed to recruit a convenient sample of 150 registered nurses and midwives from various primary healthcare settings in Jordan. Reliability was evaluated by examining the internal consistency and split-half reliability of the item. A exploratory factor analysis was performed to assess the factor structure of the NMPR-PHC. RESULTS: The final version of NMPR-PHC contained 18 items. Exploratory factor analysis revealed six factors (care coordination and interprofessional collaboration, workplace facilitators of the primary healthcare, management of care, research, workplace constraints of primary healthcare, and advanced education) for the questionnaire which explained 66.49% of the total variance. The Cronbach's α of the total scale was 0.834, the subscales Cronbach's α were ranging between 0.662 and 0.770, and the split-half reliability of the total scale was 0.734. CONCLUSION: The overall performance of the questionnaire showed promising sound psychometric properties. The NMPR-PHC can be recommended for use as a tool for the assessment of nurses and midwives' perceptions of their roles in primary healthcare.

The relationship between occupational stress, psychological distress symptoms, and social support among Jordanian healthcare professionals.

Occupational stress is a major problem for healthcare providers, with some professionals experiencing higher numbers of stressful situations than others. Although it is difficult to eliminate stress in professionals' daily lives, providing social support can lower psychological distress symptoms. This study aims to investigate the relationship between occupational stress and social support, and the effects of social support on psychological distress symptoms of healthcare professionals. A cross-sectional descriptive design was utilized. Self-administered questionnaires were completed by a convenience sample of 211 participants (physicians, nurses, and pharmacists) from a Jordanian hospital. Bivariate analyses were used to examine the relationships between the study variables. Multiple regression analyses were used to determine if occupational stress, demographic characteristics, and social support predict depression, anxiety, and stress. Results showed that healthcare professionals with more social support showed less depression than those with a lower score of social support. Females had higher scores of depression and anxiety than males. Pharmacists had significantly higher occupational stress than both nurses and physicians. Occupational stress negatively influences healthcare professionals' mental health. To improve the productivity and psychological wellbeing of healthcare professionals, occupational stress should be diminished by implementing effective management approaches to facilitate social support for healthcare professionals.

Self-Management as a Mediator of the Relationship between Social Support Dimensions and Health Outcomes of African American Adults with Type 2 Diabetes.

Social support promotes behavior change and self-management that leads to improved health outcomes. The purpose of this study was to evaluate the role of self-management in mediating the relationship between social support dimensions and health outcomes of African Americans with type 2 diabetes (T2D). Cross-sectional data were collected from 102 African Americans with T2D at an outpatient clinic. The majority of the participants were female, single, unemployed, and having low income. Functional support, the quality of the primary intimate relationship, and the number of support persons were negatively correlated with depression. Functional support and satisfaction with support explained a significant small amount of the variance in self-management. However, self-management did not mediate the relationships between social support dimensions and the health outcomes. The results of this study shed the light on the unique relationships of social support dimensions with health outcomes of African Americans with T2D.

Systematic Review and Critical Analysis of Measures of Social Support Used in Studies of Persons With Type 2 Diabetes.

BACKGROUND AND PURPOSE: Social support is linked to improved glycemic control and psychosocial well-being of patients diagnosed with Type 2 diabetes mellitus. The purpose was to critically evaluate the psychometric properties of social support measures used in this population. METHOD: A systematic review of measures of social support was performed using 5 databases. Two hundred and fifty-six studies were initially retrieved, and 48 studies met the inclusion criteria for review. RESULTS: The majority used general measures of perceived social support. Only 17% measured positive and negative social support; 92% used a single measure of social support. The Medical Outcomes Study Social Support Survey (MOS-SSS) was used in 25% of the studies. CONCLUSIONS: Using a combination of social support measures and further evaluation of their psychometric properties in this population is recommended.