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The intersection of technology and mental health: enhancing access and care. 技术与心理健康的交叉点:加强获取和护理。
Pub Date : 2023-08-22 eCollection Date: 2023-10-01 DOI: 10.1515/ijamh-2023-0113
Mohd Altaf Dar, Mudasir Maqbool, Irfat Ara, Mehrukh Zehravi

In recent times, technology has increasingly become a central force in shaping the landscape of mental health care. The integration of various technological advancements, such as teletherapy, virtual care platforms, mental health apps, and wearable devices, holds great promise in improving access to mental health services and enhancing overall care. Technology's impact on mental health care is multi-faceted. Teletherapy and virtual care have brought about a revolution in service delivery, eliminating geographical barriers and offering individuals convenient and flexible access to therapy. Mobile mental health apps empower users to monitor their emotional well-being, practice mindfulness, and access self-help resources on the move. Furthermore, wearable devices equipped with biometric data can provide valuable insights into stress levels and sleep patterns, potentially serving as valuable indicators of mental health status. However, integrating technology into mental health care comes with several challenges and ethical considerations. Bridging the digital divide is a concern, as not everyone has equal access to technology or the necessary digital literacy. Ensuring privacy and data security is crucial to safeguard sensitive client information. The rapid proliferation of mental health apps calls for careful assessment and regulation to promote evidence-based practices and ensure the delivery of quality interventions. Looking ahead, it is vital to consider future implications and adopt relevant recommendations to fully harness technology's potential in mental health care. Continuous research is essential to evaluate the efficacy and safety of digital interventions, fostering collaboration between researchers, mental health professionals, and technology developers. Proper training on ethical technology utilization is necessary for mental health practitioners to maintain therapeutic boundaries while leveraging technological advancements responsibly.

近年来,技术越来越成为塑造心理健康护理格局的核心力量。远程治疗、虚拟护理平台、心理健康应用程序和可穿戴设备等各种技术进步的融合,在改善心理健康服务的获取和加强整体护理方面具有巨大的前景。科技对心理健康护理的影响是多方面的。远程治疗和虚拟护理带来了服务提供的革命,消除了地理障碍,为个人提供了方便和灵活的治疗途径。移动心理健康应用程序使用户能够监控自己的情绪健康,练习正念,并在移动中访问自助资源。此外,配备生物特征数据的可穿戴设备可以对压力水平和睡眠模式提供有价值的见解,有可能成为心理健康状况的有价值指标。然而,将技术融入心理健康护理带来了一些挑战和伦理考虑。弥合数字鸿沟是一个令人担忧的问题,因为并非每个人都能平等地获得技术或必要的数字素养。确保隐私和数据安全对于保护敏感客户信息至关重要。心理健康应用程序的迅速普及要求进行仔细的评估和监管,以促进循证实践,并确保提供高质量的干预措施。展望未来,至关重要的是要考虑未来的影响并采纳相关建议,以充分利用技术在心理健康护理中的潜力。持续的研究对于评估数字干预的有效性和安全性至关重要,促进研究人员、心理健康专业人员和技术开发人员之间的合作。对心理健康从业者来说,在负责任地利用技术进步的同时,保持治疗界限,有必要对道德技术利用进行适当的培训。
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引用次数: 0
Prevalence and predictors of tobacco, alcohol and illicit drug experimentation among Tunisian middle and high school-adolescents. 突尼斯初中和高中青少年尝试烟草、酒精和非法药物的普遍程度和预测因素。
Pub Date : 2023-08-10 eCollection Date: 2023-08-01 DOI: 10.1515/ijamh-2022-0117
Amel Amara, Nihel Omri, Jihene Sahli, Chakib Zedini, Tasnim El Ouni, Ali Mtiraoui, Manel Mallouli, Mariem Ghardalou

Objectives: Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia.

Methods: We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019-2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors.

Results: Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8-18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1-3.9 %)] and 2 % [CI 95 %: (1.1-2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents.

Conclusions: A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed.

目的:突尼斯青少年尝试使用精神药物仍然是最具威胁性的公共卫生问题之一。尽管如此,人们对这些行为在突尼斯的流行程度和预测因素知之甚少。本研究旨在评估突尼斯苏塞省恩菲达(Nfidha)代表团青少年尝试烟草、酒精和非法药物的普遍程度及其预测因素:在2019-2020学年的前三个月,我们在突尼斯苏塞省恩菲达代表团的初中和高中开展了一项横断面研究,采用匿名问卷调查的方式,随机抽取具有代表性的1352名学生作为样本。收集的数据包括社会人口特征、在校青少年尝试药物的情况、学习成绩以及家庭和同伴因素:结果:烟草是最常见的尝试药物,流行率为 17.5 %(CI 95 %:14.8-18.8 %)。酒精和非法药物的使用率分别为 3.3 % [CI 95 %:(2.1-3.9%)] 和 2 % [CI 95 %:(1.1-2.6%)]。男性(调整后 (AOR)=4.09, p结论:大量社会人口和环境因素被认为与青少年时期尝试精神活性物质有关。因此,不仅需要针对青少年,还需要针对所有风险因素开展进一步的预防计划。
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引用次数: 0
The PCOS puzzle: putting the pieces together for optimal care. 多囊卵巢综合征的难题:将碎片拼凑在一起以获得最佳护理。
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-0102
Mohd Altaf Dar, Mudasir Maqbool, Irfat Ara

Polycystic ovary syndrome (PCOS) is a multifaceted hormonal disorder that has significant ramifications for both women's reproductive and metabolic well-being. This analysis aims to offer a thorough comprehension of PCOS by investigating the various contributing factors that are crucial for its effective management. We delve into the topic of hormonal imbalances, such as elevated androgens and disrupted estrogen-progesterone dynamics, and their effects on reproductive and metabolic health. Furthermore, we explore the intricate connection between insulin resistance, hyperinsulinemia, and PCOS, highlighting their pivotal role in metabolic dysfunction. Additionally, we examine fertility challenges, irregular menstrual patterns, and metabolic complications while also reviewing current treatment methodologies. Moreover, we address the latest research concerning genetic, environmental, and epigenetic influences on PCOS. By piecing together these essential elements, healthcare professionals can attain a comprehensive understanding of PCOS and deliver optimal care for those affected by the condition.

多囊卵巢综合征(PCOS)是一种多方面的激素紊乱,对女性的生殖和代谢健康都有重大影响。本分析旨在通过调查对多囊卵巢综合征有效管理至关重要的各种影响因素,提供对多囊卵巢综合征的全面理解。我们深入研究了激素失衡的主题,如雄激素升高和雌激素-孕酮动力学中断,以及它们对生殖和代谢健康的影响。此外,我们探讨了胰岛素抵抗、高胰岛素血症和多囊卵巢综合征之间的复杂联系,强调了它们在代谢功能障碍中的关键作用。此外,我们检查生育挑战,不规则的月经模式和代谢并发症,同时也回顾了目前的治疗方法。此外,我们还介绍了遗传、环境和表观遗传对多囊卵巢综合征影响的最新研究。通过将这些基本要素拼凑在一起,医疗保健专业人员可以全面了解多囊卵巢综合征,并为受其影响的患者提供最佳护理。
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引用次数: 0
Priority strategic directions in adolescent health in Iran based on the WHO's Global Accelerated Action for the Health of Adolescents. 根据世卫组织《促进青少年健康全球加速行动》,伊朗青少年健康优先战略方向。
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-0023
Afsaneh Omidimorad, Maryam Nazari, Najmeh Bahmanziari, Mohammad Haddad Soleymani, Seyyed Hamed Barakati, Gelayol Ardalan, Tahereh Aminaee, Rahim Taghizadeh, Mohammad Esmail Motlagh, Abtin Heidarzadeh

Objectives: In line with the World Health Organization's Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance, the goal of the current research was to identify critical strategies for adolescents' health and to determine the role and distribution of responsibilities among the leading players in the field of adolescent health in Iran.

Methods: The current qualitative and applied study is part of the Ministry of Health and Medical Education's "Adolescent, Youth and School Health" plan to develop the "National Adolescent Health Plan Document" in 2020. First, stakeholder analysis was done, then a pool of nationally appropriate strategies was selected from the list of priority strategies recommended by the WHO in the AA-HA! through several group sessions. After that, the experts selected priority strategies based on the criteria of feasibility, acceptability, effectiveness, guaranteed resources, coordination with other plans and temporal priority, scoring, and executive priorities. Eventually, the priority strategies were assigned to different players/stakeholders in the field over several sessions bearing in mind the methods of implementation and the target groups.

Results: The experts identified 58 priority strategies/actions for adolescent health under the seven priority areas of positive development, sexual protection, reproductive health, mental health, substance abuse, self-harm, violence, unintentional injury, communicable and non-communicable diseases, nutrition, and physical activity.

Conclusions: The highest identified priority areas were in the areas of vaccination; special health care package for service providers; training and education to promote health literacy and self-care, life skills, sexual awareness, and prevention/protection against violence; community-based mental health services, planning for adolescents' spare time, substance use prevention.

目标:根据世界卫生组织的《促进青少年健康全球加速行动》指南,目前研究的目标是确定青少年健康的关键战略,并确定伊朗青少年健康领域主要参与者的作用和责任分配。方法:本研究为国家卫生和医学教育部“青少年、青年和学校健康”计划的一部分,旨在制定2020年“国家青少年健康计划文件”。首先,进行了利益相关者分析,然后从世卫组织在AA-HA中推荐的优先战略清单中选择了一组适合国家的战略!通过几个小组会议。之后,专家根据可行性、可接受性、有效性、保证资源、与其他计划的协调和时间优先级、评分和执行优先级等标准选择优先策略。最后,在考虑到执行方法和目标群体的情况下,在几届会议上将优先战略分配给实地的不同参与者/利益攸关方。结果:专家们在积极发展、性保护、生殖健康、精神健康、滥用药物、自残、暴力、意外伤害、传染性和非传染性疾病、营养和体育活动等七个优先领域确定了58项青少年健康优先战略/行动。结论:确定的最高优先领域是疫苗接种领域;为服务提供者提供的特别保健一揽子计划;培训和教育,以促进卫生知识和自我保健、生活技能、性意识以及预防/保护暴力;以社区为基础的精神卫生服务,规划青少年的业余时间,预防药物使用。
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引用次数: 6
Barriers to adequate nutrition in pregnant adolescent Colombian females. 哥伦比亚怀孕少女营养不足的障碍。
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-0060
Erin L Sherer, Ana Maria Bello Trujillo

Pregnant adolescent females face nutritional challenges. The nutritional demands of a growing fetus, when added to the requirements for growing adolescent bodies, are risk factors for undernutrition. An adolescent expectant mother's nutritional status therefore affects both the mother's and the child's future growth, development, and potential development of diseases later in life. In Colombia, the rate of female adolescent pregnancies is higher than neighboring countries and the global average. The most recent data suggest that approximately 21 % of all pregnant adolescent females in Colombia are underweight, 27 % suffer from anemia, 20 % suffer from vitamin D deficiency, and 19 % suffer from vitamin B12 deficiency. Contributing factors to these nutritional deficiencies during pregnancy may be the region in which the female lives, the female's ethnicity, and the female's socioeconomic and educational status. In rural parts of Colombia, limitations regarding access to prenatal care and food choices that include animal source proteins may also contribute to nutritional deficiencies. To help remedy this, recommendations include encouraging nutrient dense food sources with higher protein content, eating one additional meal per day, and taking a prenatal vitamin throughout the pregnancy. Making healthy eating choices can be difficult for adolescent females with limited resources and education; therefore, it is recommended that discussions about nutrition begin at the first prenatal visit for optimum benefits. These factors should be considered for the development of future health policies and interventions in Colombia and other low-income and middle-income countries where pregnant adolescent females may be experiencing similar nutritional deficiencies.

怀孕的青春期女性面临营养方面的挑战。成长中的胎儿的营养需求,加上成长中的青少年身体的需求,是营养不良的危险因素。因此,青春期准妈妈的营养状况会影响母亲和孩子未来的成长、发育以及以后可能患上的疾病。在哥伦比亚,少女怀孕率高于邻国和全球平均水平。最近的数据表明,哥伦比亚所有怀孕少女中约有21% %体重不足,27% %患有贫血,20% %缺乏维生素D, 19% %缺乏维生素B12。造成怀孕期间营养缺乏的因素可能是女性生活的地区、女性的种族以及女性的社会经济和教育地位。在哥伦比亚农村地区,获得产前护理和食物选择(包括动物源蛋白质)方面的限制也可能导致营养缺乏。为了解决这个问题,建议包括鼓励营养丰富、蛋白质含量高的食物来源,每天多吃一顿饭,并在怀孕期间服用产前维生素。对于资源和教育有限的青春期女性来说,做出健康的饮食选择可能很困难;因此,建议在第一次产前检查时就开始讨论营养问题,以获得最佳效益。在哥伦比亚和其他低收入和中等收入国家制定未来的卫生政策和干预措施时,应考虑到这些因素,因为这些国家的怀孕少女可能也有类似的营养缺乏症。
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引用次数: 0
Comprehensive sexual assessments should include conversations about sexual function and pleasure. 全面的性评估应该包括关于性功能和性快感的对话。
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-0095
Alon Coret
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引用次数: 0
Adolescents and young adults communicating with gastroenterologists: variation in inflammatory bowel disease clinical communication. 青少年和年轻人与胃肠病学家交流:炎症性肠病临床交流的变化。
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-0078
Neda Karimi, Annabelle Lukin, Alison R Moore, Joseph L Pipicella, Ria Kanazaki, Astrid-Jane Williams, Watson Ng, Viraj Kariyawasam, Nikola Mitrev, Keval Pandya, Susan J Connor

Objectives: This study explored the variation in emerging adults' communication with gastroenterologists around the management of inflammatory bowel disease (IBD).

Methods: Nineteen emerging adults with IBD aged 18-25 and seven gastroenterologists participated in the study. Outpatient specialist consultations of consenting participants were audio-recorded and transcribed. Transcribed consultations were analysed in terms of the linguistic structure of the consultations and the gastroenterologist-patient role relationship.

Results: Variations in the emerging adults' communication with their gastroenterologists stem partly from variation in their ability, opportunity, or need to contribute to the different phases of the consultation and partly from variations in the gastroenterologists' style of communication. Gastroenterologists differed in the construction of their role relationship with the patient, resulting in variations in employing empowering strategies including eliciting, exploring, and clarifying the patient's concerns, sharing clinical reasoning, and validating the patient experience. Variations were also observed in the length of appointments and the gastroenterologists' assessment and addressing of adherence issues. Techniques used by the gastroenterologist varied (1) from simply confirming adherence, to a comprehensive assessment of the patient's understanding of their management plan and their feedback, and (2) from use of persuasion to values calibration.

Conclusions: Evidence-based consumer interventions and communication guidelines for clinicians are needed to address the identified variations in providing care to emerging adults living with chronic conditions.

目的:本研究探讨了新兴成人在炎症性肠病(IBD)管理方面与胃肠病学家沟通的差异。方法:19名18-25岁的IBD新发成人和7名胃肠病学家参与了这项研究。门诊专家会诊的同意参与者录音和转录。根据会诊的语言结构和胃肠科医生与患者的角色关系对转录会诊进行分析。结果:新生成人与胃肠科医生沟通的差异部分源于他们在不同咨询阶段的能力、机会或需要的差异,部分源于胃肠科医生沟通方式的差异。胃肠病学家在与患者的角色关系构建上存在差异,这导致他们在使用授权策略方面存在差异,包括引出、探索和澄清患者的担忧、分享临床推理和验证患者经验。在预约时间长短和胃肠病学家对依从性问题的评估和解决方面也观察到变化。胃肠病学家使用的技术各不相同:(1)从简单地确认依从性,到全面评估患者对其管理计划及其反馈的理解,以及(2)从使用说服到值校准。结论:需要为临床医生提供循证消费者干预和沟通指南,以解决在为患有慢性疾病的新生成人提供护理时发现的差异。
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引用次数: 0
Frontmatter 头版头条
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-frontmatter4
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引用次数: 0
The effect of education based on health belief model on high-risk health behaviors in youth: an interventional quasi-experimental study. 基于健康信念模型的教育对青少年高危健康行为的影响:一项干预性准实验研究
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2022-0070
Nasrin Zahmatkesh Rokhi, Samira Ebrahimzadeh Zagami, Maryam Moradi, Seyed Reza Mazloum

Objectives: The present study was designed to determine the effect of education based on health belief model (HBM) on high-risk health behaviors in youth.

Methods: This interventional quasi-experimental study was conducted in 2020-2021 with the participation of 62 students living in the dormitories of University of Mashhad Medical Sciences with available sampling and random allocation in two experimental and control groups. The experimental group received six training sessions. The research instruments included: demographic information, researcher-made questionnaire including HBM constructs, youth high-risk behaviors questionnaire (2019) that were used before, immediately and one month after the educations. The collected data were analyzed using t-test, Mann-Whitney, and ANOVA with SPSS 21.

Results: The mean scores in the field of high-risk behaviors as well as all constructs of HBM were not statistically significant in the two groups before the intervention (p>0.05), but the mean scores immediately and one month after the educational intervention in all constructs of the HBM and the range of high-risk behaviors (other than smoking behavior) in the experimental group compared to the control group was statistically significant (p<0.001).

Conclusions: Education based on HBM was effective in reducing high-risk health behaviors, so this educational model can be used to reduce high-risk health behaviors in female students.

目的:探讨健康信念模型教育对青少年高危健康行为的影响。方法:本研究于2020-2021年开展介入性准实验研究,选取马什哈德医科大学学生宿舍62名学生,随机分为实验组和对照组。实验组接受6次训练。研究工具包括:人口统计资料、研究者自制的含HBM构式问卷、青少年高危行为问卷(2019),分别在教育前、教育时和教育后1个月使用。收集的数据采用t检验、Mann-Whitney检验和方差分析,并使用SPSS 21进行分析。结果:两组在干预前高危行为领域及所有HBM构式的平均得分均无统计学意义(p>0.05),但实验组在教育干预后即刻及1个月的HBM构式及高危行为范围(除吸烟行为外)的平均得分与对照组比较,差异均有统计学意义(p>0.05)。基于HBM的教育在减少高危健康行为方面是有效的,因此这种教育模式可以用于减少女学生的高危健康行为。
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引用次数: 0
Suicidal ideation, attempts and its determinants among young adults in Meghalaya: a cross sectional study. 梅加拉亚邦年轻人的自杀意念、企图及其决定因素:一项横断面研究。
Pub Date : 2023-08-01 DOI: 10.1515/ijamh-2023-0022
Markordor Lyngdoh, Shanthosh Priyan Sundaram, Joenna Devi Ningombam, Gajendra Kumar Medhi

Objectives: Suicide is a major health issue in India. With the advent of the COVID-19 pandemic, people have experienced loss on a tremendous scale. The impact of these losses on the youth will be massive leading to a rise in depression cases, suicidal ideation and ultimately suicidal attempts. Hence there is a need to determine the prevalence of suicidal ideation, suicide attempts and the predictors for both suicidal ideation and attempts among the young adults in Meghalaya.

Methods: This cross-sectional study was conducted among the students aged 18-25 years in NEIGRIHMS and Synod College in Shillong between March to April 2022. Data was collected by using questionnaire method.

Results: The prevalence of suicidal ideation and suicidal attempts was found to be 15.9 % (12.3-20.3) and 5.8 % (3.7-8.9) respectively. There was a strong relationship for suicidal ideation with urban students, with less family members, those who had unhealthy relationship with their parents, stress, complicated relationship/loss of loved ones and also those with experience of violence/abuse and behavioural problems. However, the attempts were found to be associated only with the loss of the loved ones.

Conclusions: The prevalence, though smaller is a serious concern considering the fact that the burden of suicides is on a rise and hence regular mental health counselling along with the management of the stress is needed at the educational institutional level which could prove to be beneficial to the students.

目标:自杀是印度的一个主要健康问题。随着COVID-19大流行的到来,人们遭受了巨大的损失。这些损失对青少年的影响将是巨大的,导致抑郁症病例、自杀意念和最终自杀企图的增加。因此,有必要确定自杀意念、自杀企图的流行程度,以及梅加拉亚邦年轻人自杀意念和自杀企图的预测因素。方法:采用横断面研究方法,于2022年3月至4月在西隆市NEIGRIHMS和Synod College进行18-25岁 年龄段的学生调查。采用问卷调查法收集资料。结果:自杀意念和自杀企图发生率分别为15.9 %(12.3 ~ 20.3)和5.8 %(3.7 ~ 8.9)。自杀意念与城市学生、家庭成员较少、与父母关系不健康、压力大、关系复杂/失去亲人以及有暴力/虐待经历和行为问题的学生有很强的关系。然而,研究发现,这些尝试只与失去亲人有关。结论:考虑到自杀的负担正在上升,因此需要在教育机构层面定期进行心理健康咨询和压力管理,这可能证明对学生有益,尽管患病率较小,但这是一个严重的问题。
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引用次数: 0
期刊
International Journal of Adolescent Medicine and Health
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