Effects of visual aid on state anxiety, fear and stress level in patients undergoing endoscopy: a randomized controlled trial.

OBJECTIVES: The present study aimed to calculate the estimated size and confidence interval for the effects of adding visual aid to counselling on anxiety, stress and fear of patients undergoing upper gastrointestinal endoscopy. The secondary aim was to calculate confidence interval for endoscopy-related variables that predict which patients are likely to benefit from visual aids. METHOD: In a randomized, single-blind, two arm, parallel group, superiority trial, 232 consecutive patients who were scheduled to undergo either gastroscopy or colonoscopy were randomly divided into two intervention groups; counselling with video of endoscopic procedure and counselling with no-video (n = 116 in each group). Primary outcome was anxiety and secondary outcomes were stress and fear. RESULTS: One-way ANCOVA showed that there was significant between group differences of anxiety, stress and fear after controlling for the effect of covariates. Planned contrasts revealed that counselling along with visual aid of endoscopy procedure significantly decreased anxiety [Mean difference at post; -4.26 (-4.47, -4.05), p < .001, partial η2 = 0.88], stress [-5.35 (-5.63, -5.07), p < .001, partial η2 = 0.86] and fear [-2.82 (-2.97, -2.67), p < .001, partial η2 = 0.86] compared to counselling alone. Linear regression showed that gender, nature of complaints and concern over seniority of endoscopist were significant negative predictors, however, satisfaction on briefing of endoscopy procedure was significant positive predictor of outcome variables in visual aid condition. CONCLUSION: The increase in anxiety, acute stress and fear related to endoscopic procedures can be alleviated with psychological counselling coupled with visual aids before the procedure. Visual aid could lead to supplementary benefits in reducing anxiety scores. TRIAL REGISTRATION: ClinicalTrial.gov Number: NCT05241158. Registered 16/11/2022; https://clinicaltrials.gov/ct2/show/NCT05241158KEY MESSAGESCounselling along with visual aid of endoscopy procedure significantly decreased anxiety, stress and fear as compared to counselling alone.Male patients were less stressed after visual aid intervention as compared to female patients. Patients who had chronic GI symptoms were less stressed after visual aid intervention as compared to those who had acute GI symptoms. Patients who had concern over seniority of endoscopist were less stressed after visual aid intervention as compared to those who had no concerns over seniority.Satisfaction on briefing of endoscopy procedure was significant positive predictor of stress and fear.

Health Risk Factors among Doctors, Psychologists and Nurses of Pakistan during COVID-19 Pandemic.

The present study aimed to find out differences in health risk factors of COVID-19 among doctors, nurses and psychologists by determining the relationship of cognitive appraisal, coping styles, stress and fear among health professionals. Cross-sectional research design was used. Sample comprised of 3 groups; doctors, nurses and psychologists (n = 145 in each group) working in tertiary care hospitals. Stress appraisal measure, Brief COPE inventory, Perceived stress scale and Fear contracting COVID-19 questionnaire were used to assess cognitive appraisal, coping, stress and fear respectively. Results showed that nurses had high uncontrollable, stressfulness and primary appraisal, used more avoidant emotional and problem focused coping, were more stressed and fearful as compared to doctors and psychologists. Psychologists had a high appraisal of control-self and control-others as compared to doctors and nurses and were more fearful than doctors. Doctors and psychologists used more coping of humor as compared to nurses. Moreover, primary appraisal and avoidant emotional coping positively predicted stress whereas control-self appraisal negatively predicted stress among health professionals. Uncontrollable and stressfulness appraisal positively correlated with fear. This study will direct the administrative authorities to take effective measures to improve psychological wellbeing and to deal with fear and stress of health professionals.

Cognitive appraisal, Coping, Stress and Fear Contracting Covid-19 in Working People in Pakistan.

The present study aimed to examine the relationship and prediction of cognitive appraisal and coping with Stress and Fear contracting COVID-19 among the working population of Pakistan. Cross-sectional research design was employed. The data was collected from 980 participants of almost 39 different professions using the purposive sampling technique. Stress Appraisal Measure (Peacock et al., in Stress Med 6:227-236, 1990, http://www.drpaulwong.com/wp-content/uploads/2018/03/Stress-Appraisal-Measure-SAM-Peacock-Wong-1990-Paper.pdf). Brief COPE Inventory (Caver, in Int J Behav Med 4:92-100, 1997), and Perceived Stress Scale (Cohen et al., in J Health Soc Behav 24:385-396, 1983) were used to measure cognitive appraisal, coping, and stress, respectively. Fear was measured by using Fear contracting COVID-19 questionnaire (Ali et al., in J Pakistan Soc Int Med 2(2):140-144, 2021). Age, education, and previously attended stress management training were significantly positively correlated with stress and fear. Females were more stressed and fearful than males. Average time spent on social media was significantly positively correlated with stress. Participants, who were employed, had family members of the older age group above 50 years and had family members with the history of biological diseases were more fearful. Results of hierarchical multiple regression analyses showed that threat, centrality, stressfulness appraisal, and avoidant emotional coping significantly positively predicted stress, whereas control-self appraisal and active emotional coping significantly negatively predicted stress. Moreover, threat, challenge, centrality, stressfulness appraisal, and problem-focused coping significantly positively predicted fear contracting COVID-19, whereas control-self appraisal and active emotional coping significantly negatively predicted fear contracting COVID-19 after controlling for covariates. This study will address the administrative authorities and government institutions to provide first-aid mental health services for emergencies, epidemics, or pandemics in the future.

Difference in stress-related indicators between employees experiencing partial and complete lockdowns during the COVID-19 pandemic in Pakistan.

OBJECTIVES: The present study aimed to compare the stress experience of employees facing to differentiated types of lockdown situations: total vs. partial. It also aimed to identify the cognitive appraisal, coping, stress, and fear of contracting COVID-19 associated with lock down situations among employees. METHOD: A cross-sectional research design was employed. The sample comprises two groups (n = 490 in each group), complete lockdown (people working from home) and partial lockdown (people going to workplace), and was drawn from Pakistan using purposive sampling technique. Stress Appraisal Measure, Brief COPE Inventory, Perceived Stress Scale, and Fear of Contracting COVID-19 Questionnaire were used to measure cognitive appraisal, coping, stress, and fear, respectively. RESULTS: Independent sample t-test showed that the threat and uncontrollable appraisal was high in people going to workplace as compared to people working from home. Results of binary logistic regression showed that people going to workplace were more likely to cope with COVID-19 situation through seeking instrumental support, behavior disengagement, acceptance, and religion as compared to people working from home. Moreover, people working from home were 0.84 times more likely to cope through emotional support than people going to workplace. Fear was found to be 1.1 times more likely associated with people going to workplace than people working from home. CONCLUSION: This study would help administrative authorities and government institutions in designing mental health services for working population. It would help the emergency departments in devising first aid management plan to deal with the psychological needs of the workers under pandemic/lockdown situations.