Self-perceptions of aging, physical activity, and depressive symptoms in older community residents with varied neighborhood walkability in Taiwan.

BACKGROUND: Prior research has identified the mediating effect of physical activity in the relationship between self-perceptions of aging and physical health. However, this impact on mental health is unknown, and the influence of environmental contexts proposed by ecological models in this regard remains largely unexplored. Therefore, this study aimed to investigate the role of physical activity in the relationship between self-perceptions of aging and depressive symptoms in older adults, and compare the impact across four levels of neighborhood walkability. METHODS: A sample of 1,055 community-dwelling older adults aged 65 or above was obtained through random-digit-dialing computer-assisted telephone interviewing. The individual's neighborhood walkability was calculated using Walk Score®, and categorized into four levels: car-dependent, somewhat walkable, very walkable, and walker's paradise. Partial least squares structural equation modelling was employed. RESULTS: We found that more positive self-perceptions of aging were associated with fewer depressive symptoms and a mediation effect of physical activity in this relationship. Among the four levels of neighborhood walkability, the mediation effect of physical activity was only statistically significant in the lowest level (car-dependent). The findings supported our hypotheses regarding the mediating effect of self-perceptions of aging on depressive symptoms via physical activity. Neighborhood walkability might potentially influence the mediating role of physical activity. CONCLUSIONS: This study emphasizes key areas on intervention programs and policy formulation to promote mental health in older adults.

Challenging mental illness stigma in healthcare professionals and students: a systematic review and network meta-analysis.

OBJECTIVE: Stigma among healthcare professionals may lead to poor quality of healthcare services for patients with mental illness. This study conducts a network meta-analysis to estimate the relative efficacy between different types of anti-stigma interventions for healthcare professionals. DESIGN: Network meta-analysis. MAIN OUTCOME MEASURES: The attitudes and behavior intension of healthcare professionals toward mental illness. RESULTS: A total of 18 studies (22 trials) from 9 countries are included in the analysis. In the network meta-analysis, rank probabilities show interventions with indirect contact plus lecture (SUCRA = 81.5%), direct contact plus problem-based learning workshop (SUCRA = 77.4%), and indirect contact (SUCRA = 72.2%) having the highest probability of being ranked first, second, and third, respectively. CONCLUSION: Our findings suggest that education combining social contact is the most effective anti-stigma intervention, which can be implemented in clinical practices to help reduce this stigma and improve healthcare services for patients with mental illness.

Mental Health Literacy in Healthcare Students: An Expansion of the Mental Health Literacy Scale.

OBJECTIVE: Although the recently developed mental health literacy scale showed significant score differences between general population and mental health professionals, to this date there is no published scale intended to specifically assess mental health literacy (MHL) in healthcare students. This study constructed a 26-item scale-based measure to assess multiple components of MHL and associated psychometric properties in a sample of medical and public health students of 11 universities in Taiwan. METHODS: The development and validation of the scale comprised three phases: measure development, pilot testing (n = 32), and psychometric properties examination (n = 1294). RESULTS: 26 items were generated for five factors: maintenance of positive mental health, recognition of mental illness, attitude to mental illness stigma, help-seeking efficacy, and help-seeking attitude. The scale demonstrated good content validity, internal consistency, and construct validity (factorial validity, convergent validity, discriminant validity, and known groups validity). CONCLUSIONS: The findings suggest that the Mental Health Literacy Scale for Healthcare Students (MHLS-HS) is a valid, reliable, and practical tool for identifying MHL gaps in medical and public health students. It has the potential to inform remedial curricular interventions for educators and evaluate intervention effectiveness.

Changes in Attitudes toward Mental Illness in Healthcare Professionals and Students.

Mental-illness-related stigma not only exists in the public but also in healthcare systems. Healthcare providers (HCPs) who have stigmatizing attitudes or behaviors might be thought of as a key barrier to mental health service use, and influence the quality of healthcare. Although cumulative projects have been conducted to reduce stigma related to mental illness among HCPs around the world, little is known about whether the attitudes of HCPs toward mental illness have changed over time. Research on this topic is mixed with respect to whether attitudes of HCPs toward mental illness have become more or less positive. The aim of the current study was to help clarify this issue using a cross-temporal meta-analysis of scores on the Social Distance Scale (SDS), Opinions about Mental Illness (OMI), and Community Attitudes towards Mental Illness (CAMI) measures among health care professionals and students (N = 15,653) from 1966 to 2016. Our results indicated that both social distance (ß = -0.32, p < 0.001) and attitudes (ß = 0.43, p = 0.007) of HCPs toward mental illness have become increasingly positive over time. These findings provide empirical evidence to support that the anti-stigma programs and courses have positive effects on HCPs and can inform future anti-stigma programs focusing on improving the attitudes of HCPs toward mental illness, thereby improving the quality of healthcare provided.

Effects of Acupressure on Sleep Quality and Psychological Distress in Nursing Home Residents: A Randomized Controlled Trial.

OBJECTIVE: To compare the efficacy of acupressure with sham acupressure in older-adult nursing home residents presenting with poor sleep quality and psychological distress. DESIGN: Prospective, randomized, double-blind, sham-controlled trial. SETTING AND PARTICIPANTS: Sixty-two nursing home residents with poor sleep quality and psychological distress participated in this study. Participants were randomly assigned to an experimental group (n = 31) receiving acupressure at true acupoints (Baihui, Juque, Neiguan, Tianzhu, and Yongchung) or control group (n = 31) receiving acupressure at sham points. All participants received 20 minutes of acupressure before sleeping 3 times a week for 8 weeks. All participants were blinded to group allocation. MEASURES: Sleep quality and psychological distress were measured using the Pittsburgh Sleep Quality Index and the Kessler Psychological Distress scale, respectively. Both groups' outcomes were assessed by assessors blinded to group allocation at the baseline, the end of the intervention, and 1 month after the intervention. RESULTS: The experimental group demonstrated significantly more improvement in sleep quality than did the control group at the end of the intervention (10.5 vs 13.3) and 1 month after the intervention (8.3 vs 14.2; both P ≤ .001). Moreover, the experimental group had lower psychological distress levels than did the control group at 1 month after the intervention (14.6 vs 17.9, P = .05). Furthermore, significant differences in mean sleep quality (F = 60.8, P < .001) and psychological distress (F = 24.6, P < .001) were observed in the experimental group between the measurements at baseline and after the intervention. CONCLUSIONS: Acupressure at true acupoints improves sleep quality, reduces psychological distress, and provides more clinically beneficial effects compared with that at sham points. Future studies should examine whether these effects are maintained in the long term.