AIMS Public Health最新文献

Victimization in the United States is common and has long lasting negative impacts for individuals, often disproportionately impacting those of color and from low socioeconomic communities. The Trauma Recovery Center (TRC) model aims to provide comprehensive mental health and wrap-around case management services for underserved victims of crime. Following PRISMA-ScR guidelines, we sought to further our knowledge about the impact of the TRC model. Twelve studies met the inclusion criteria. Studies were based at three sites. Access to treatment ranged from 55.7% to 72.3%; treatment completion rates ranged from 40.4% to 43.0%. Individuals who completed mental health services showed improvement in PTSD, anxiety, and depression symptoms, while experiencing lower rates of injury recidivism. Several studies demonstrated improvement in mental health symptoms and social needs in individuals from underserved communities. Researchers should focus on expanding and diversifying upon current knowledge to better understand the impact of the TRC model.

Context and purpose: Persons enduring serious mental illness (SMI) and living in supported housing facilities often receive inadequate care, which can negatively impact their health outcomes. To address these challenges, it is crucial to prioritize interventions that promote personal recovery and address the unique needs of this group. When developing effective, equitable, and relevant interventions, it is essential to consider the experiences of persons with an SMI. By incorporating their perspectives, we can enhance the understanding, and thereby, the design and implementation of activity- and recovery-oriented interventions that promote health, quality of life, and social connectedness in this vulnerable population. Thus, the aim of this study is to explore the stories of participants partaking in Everyday Life Rehabilitation and how they make sense of their engagements in everyday life activities and their recovery processes.

Methods: Applying a narrative analysis, this study explores the stories of seven individuals with an SMI residing in Swedish supported housing facilities, participating in the Everyday Life Rehabilitation (ELR) program during six months, and how they retrospectively make meaning of their engagement in everyday life activities and recovery processes.

Findings: The participants' stories about their rehabilitation and personal recovery pathways elucidate how the inherent power of the activity, as well as the support the participants received to get started and succeed, had a significant impact on their self-identity, confidence, motivation, mattering, life prospects, and vitality. The participants valued the transparent steps along the process, weekly meetings, the signals, beliefs, and feedback communicated throughout, and the persistent, adaptive, and yet supporting approach in their personal progress.

Significance: This study underscores the need for interventions that prioritize meaningful activities and are sensitive to the complexity of the personal recovery process, especially in supported housing facilities. Future research should further explore effective strategies and mechanisms to promote personal recovery and to reduce the stigma associated with SMI.

Background: Symptoms of anxiety and depression are very common among healthcare workers (HCWs) and could impact the quality of care.

Objective: This study aimed to evaluate the prevalence of these disorders in a public health company and their association with work ability and work-related stress.

Methods: A cross-sectional study involved 80 HCWs being treated for mental disorders (MD), 55 HCWs who said they suffered from MD but were not being treated, and 824 healthy colleagues. All workers completed the Work Ability Index (WAI), the Siegrist's Effort/Reward Imbalance questionnaire (ERI), the Goldberg's scales of anxiety and depression (GADS), and the Warr's scale of job satisfaction.

Results: Three-quarters of workers with MD suffered from anxiety and/or depression. Workers who declared at the periodic medical examination in the workplace that they were being treated for MD had significantly lower levels of work ability than those of their colleagues who declared good mental health. They also reported greater work stress (high effort, low rewards, high overcommitment) and lower job satisfaction than their healthy colleagues. Symptomatic but untreated workers reported significantly lower work ability, lower satisfaction, and greater occupational stress than their healthy colleagues. In the entire sample, there were many workers with symptoms of anxiety or depression who did not declare these disorders during the examination. Overall, there were 328 suspected cases of anxiety (34.2%) and 334 cases of depression (34.8%). Anxious workers [OR = 8.11, 95% confidence interval (CI) = 3.74-17.58] and depressed workers (OR = 4.49, 95% CI = 2.22-9.10) had an increased risk of being classified as having "poor work ability".

Conclusion: The negative association between psychological symptoms and work ability even in undiagnosed/untreated workers demonstrates the usefulness of screening for these symptoms in work environments.

Background: The Family Income-to-Poverty-Ratio (FIPR) is a recognized indicator of socioeconomic status, and influences a wide range of health and behavioral outcomes. Yet, marginalized and racialized groups, particularly Black individuals, may not reap comparable health benefits from their socioeconomic advancements as their non-Hispanic, White counterparts. This discrepancy is indicative of a phenomenon known as the minorities' diminished returns.

Aims: This study investigates the differential impact of the FIPR on depression, obesity, tobacco use, and e-cigarette use between Black and White adults.

Methods: Using data from the 2022 National Health Interview Survey (NHIS), which included 21,354 non-Hispanic adults from both White and Black racial groups, this research employed structural equation modeling to assess the relationship between the FIPR and health outcomes, including depression, obesity, and e-cigarette use.

Results: The analysis identified significant interactions between FIPR and race across all the examined outcomes. Contrary to expectations, the findings suggest that the protective effects of higher income levels on health and healthy behaviors are less pronounced for Black individuals compared to White individuals.

Conclusion: The study underscores the substantial societal and environmental barriers that hinder Black families and individuals from converting their FIPR and socioeconomic resources into concrete health benefits, such as an enhanced mental and physical well-being. To redress these racial health disparities, targeted interventions are crucial, particularly those that focus on bridging the employment and marriage rate gaps caused by educational disparities among Black communities. A comprehensive approach that extends beyond simple access to education is imperative to eliminate the societal obstacles that limit the socioeconomic benefits for Black populations.

Background: There is an absence of valid and specific psychometric tools to assess TikTok addiction. Considering that the use of TikTok is increasing rapidly and the fact that TikTok addiction may be a different form of social media addiction, there is an urge for a valid tool to measure TikTok addiction.

Objective: To develop and validate a tool to measure TikTok addiction.

Methods: First, we performed an extensive literature review to create a pool of items to measure TikTok addiction. Then, we employed a panel of experts from different backgrounds to examine the content validity of the initial set of items. We examined face validity by performing cognitive interviews with TikTok users and calculating the item-level face validity index. Our study population included 429 adults who have been TikTok users for at least the last 12 months. We employed exploratory and confirmatory factor analysis to examine the construct validity of the TikTok Addiction Scale (TTAS). We examined the concurrent validity by using the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionnaire-4 (PHQ-4), and the Big Five Inventory-10 (BFI-10). We used Cronbach's alpha, McDonald's Omega, Cohen's kappa, and intraclass correlation coefficient to examine reliability.

Results: We found that the TTAS is a six-factor 15-item scale with robust psychometric properties. Factor analysis revealed a six-factor structure, (1) salience, (2) mood modification, (3) tolerance, (4) withdrawal symptoms, (5) conflict, and (6) relapse, which accounted for 80.70% of the total variance. The concurrent validity of the TTAS was excellent since we found significant correlations between TTAS and BSMAS, PHQ-4, and BFI-10. Cronbach's alpha and McDonald's Omega for the TTAS were 0.911 and 0.914, respectively.

Conclusion: The TTAS appears to be a short, easy-to-use, and valid scale to measure TikTok addiction. Considering the limitations of our study, we recommend the translation and validation of the TTAS in other languages and populations to further examine the validity of the scale.

Background: Violence against healthcare workers in psychiatric settings is a concern in the literature. Violence effects for healthcare professionals and organizations include an absence from work due to injury or illness, a decreased job satisfaction, and a lower quality of work. The aim of this study is to identify the consequences of violence on the health, work habits, and performance of nurses working with psychiatric patients.

Methods: The study was conducted using semi-structured interviews with 18 nurses from different hospitals and territorial psychiatric settings in Southern Italy. The interviews were conducted from July to December 2020 by telephone and were recorded with the consent of the participants. The collected data were transcribed and analyzed.

Results: The narratives revealed five main themes: (1) Feelings about the violence experienced; (2) the effects of violent incidents on nurses; (3) features of the mental health setting related to the phenomenon of the assault; (4) the care and organizational aspects to prevent the assault; and (5) the care in psychiatric settings during the COVID-19 pandemic. The aggressions resulted in a change in the nurses' work habits and performances; they were more careful after the aggression and modified their approach to the patient. Additionally, the nurses discussed developing skills and strategies to protect themselves and avoid aggression.

Conclusions: Aggression has a negative impact on the health and work performance of nurses. Adopting personal and nursing strategies in place to prevent aggression allows them to improve the patient care and to protect themselves from such incidents. The creation of a safer work environment by healthcare organizations in which professionals work can improve their health, job performance, and the effectiveness of psychiatric nursing care.

Background: Underinsured patients with advanced head and neck cancer experience worse outcomes compared to their well-insured peers.

Methods: Retrospective logistic regression analysis testing associations between demographic, geospatial, transportation, disease, and treatment factors in 50 government insured or uninsured patients receiving curative-intent, multidisciplinary cancer care.

Results: Forty percent of patients missed at least one treatment or surveillance appointment within the first year. Thirty-two percent reported using public transportation; 42% relied on caregivers. Patients who used public transportation were 3.3 and 4.6 times more likely to miss treatment (p = 0.001) and surveillance (p = 0.014) visits, respectively. The median one-way travel duration for such routes was 52 minutes (range: 16-232 minutes) and included 0.7 miles of walking. Physical distance to care was not associated with transportation type, missed appointments, or disease recurrence.

Conclusions: Underserved, underinsured patient populations face significant logistical challenges with transportation, which may be mitigated by alternative models of care delivery, such as multidisciplinary clinics.

Beta-thalassemia major (β-TM) is a genetic disorder, prevalent especially in the Mediterranean region, Southeast Asia, and the Indian subcontinent. With improvements in management over the years, β-TM has transitioned from a fatal childhood disease to a chronic condition. However, in Pakistan, there is still a lack of a comprehensive national policy and strategic plan, which has resulted in a growing number of β-TM patients, placing a substantial burden on individuals and the national healthcare system. This scoping review is aimed to understand obstacles faced by β-TM patients in Pakistan. For this review, 26 unique articles were identified by using the PRISMA flow guidelines. PubMed and Google Scholar were used with the MESH term Beta-Thalassemia Major AND Pakistan, and the duration was set between 2012-2022. Then, the reviewers created a spreadsheet using Microsoft Excel to add in the data from the studies selected. Inductive and deductive approaches were used for thematic analysis. Additionally, we critically analyzed the current landscape of β-TM in Pakistan. The main challenges in β-TM care in Pakistan are suboptimal transfusion services and a poor complication management. Due to the need of chronic blood transfusions, transfusion-transmitted infection (TTI) incidence within this patient population is high. These largely include hepatitis C, hepatitis B, and the Human immunodeficiency virus (HIV). TTIs impact the quality of life of these patients and their overall survival. Furthermore, psychosocial morbidities are also prevalent in β-TM patients, with increased levels of hostility, anxiety, and depressive symptoms, thus emphasizing the critical need for sustained psychological support. Access to quality treatments is constrained, with notable disparities between public and private sector hospitals. Additionally, the financial burden on β-TM patients is considerable, which contributes to economic strain and more hardships on the already suffering families. The review concludes that the absence of a unified national policy exacerbates these challenges, which results in an escalating burden of β-TM nationwide. To address these issues, essential recommendations include the following: the implementation of a standardized protocol for β-TM care, the enhancement of access to quality care, the provision of iron chelation therapy, and safeguarding safe blood transfusion practices. Prevention programs, along with increased public awareness and education about β-TM and carrier screening, are pivotal. Collaborative efforts with international partners and drawing insights from successful strategies in countries with similar β-TM burdens can aid in mitigating the overall impact of β-TM in Pakistan and improving the quality of life of the affected individuals.

The challenges of maintaining an effective and sustainable healthcare workforce include the recruitment and retention of skilled nurses. COVID-19 exacerbated these challenges, but they persist beyond the pandemic. We explored the impact of work-related quality of life and burnout on reported intentions to leave a variety of healthcare professions including nursing. We collected data at five time-points from November 2020 to February 2023 via an online survey. The validated measures used included the Copenhagen Burnout Inventory and Work-Related Quality of Life (WRQoL) scale; with subscales for Job-Career Satisfaction, General Wellbeing, Control at work, Stress at work, Working conditions, and Home-work interface. Our findings showed that 47.6% of nursing respondents (n = 1780) had considered changing their profession throughout the study period, with the 30-39-year age group most likely to express intentions to leave. Regression analysis reveale that for WRQoL, lower general wellbeing and job-career satisfaction scores predicted intentions to leave when controlling for demographic variables (p < 0.001). When burnout was added to the regression model, both work-related and client-related burnout were predictive of intentions to leave (p < 0.001). These findings highlighted that significant numbers of nurses considered leaving their profession during and shortly after the pandemic and the need for interventions to improve nurses' wellbeing and reduce burnout to improve their retention.

Background: The COVID-19 outbreak played a significant psychological impact on nurses, as they coped with intense emotional and cognitive demands, in a context in which the Health System was not prepared to face the emergency. Literature showed that pandemics influenced the nurses' stress and psychosocial health due to poor rest, high work overloads, a lack of control over the patient flows, and a frequent isolation from family. Under these circumstances, nurses experienced severe psychological and mental stressors that generated mental health problems. Recent literature showed that coping strategies, especially those that were positive, promoted mental health in workers and helped them to face stressors.

Objective: The study aimed to investigate the relationship between vicarious traumas and the impact of traumatic events on nurses' mental health. In addition, we analyzed the role of coping strategies in moderating the effect of vicarious traumas on mental health.

Methods: The study was performed in November 2020, during the first wave of the COVID-19 pandemic. A self-reported structured questionnaire was administered via an online method to reduce face-to-face contact. Logistic regressions were conducted to analyze the relationship between both vicarious traumas and the impact of traumatic events impact and mental health. An interaction analysis with the PROCESS macro was performed to analyze the role of coping strategies in moderating the relationship between vicarious traumas and mental health.

Results: A total of 183 nurses answered to the questionnaire. A moderation analysis showed that positive coping strategies such as physical activity, reading/music, and yoga/meditation showed to be protective in reducing the effect of vicarious traumas on the nurses' mental health problems. Conversely, negative coping strategies strengthened that relationship and may compromise their quality of working life.

Conclusion: These findings provide further support for considering positive coping strategies as an important resource to alleviate psychological distress, thus helping the professional to reduce the negative effects of stress.