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During the first COVID-19 wave, we conducted a Zoom and WhatsApp digital group intervention that promoted community-dwelling seniors' mental health. A total of 82 community-dwelling adults participated in this intervention. Based on the media richness theory (MRT) and the affordances approach, we used netnography to explore how group moderators and technical support team members (n = 9), but not the seniors themselves, perceived the ways Zoom and WhatsApp technological affordances/constraints matched intervention tasks and increased intervention performance. We identified four Zoom and WhatsApp affordances: temporality, interactivity, multimediality, and portability. Empirically, our findings represent a first step in creating a conceptual framework for analyzing digital intervention performances that addresses users' perceptions of technologies and intervention goals. Theoretically, our synergic analysis of MRT and the affordances approach offers a cohesive framework that shifts from a focus on users' interactions with one type of media to their interactions with all media that are used in attaining intervention goals.
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COVID-19 , Saúde Mental , Adulto , Humanos , PandemiasRESUMO
BACKGROUND: Postpartum depression (PPD) may have adverse outcomes for mothers, their infants, and families. Despite the negative consequences of PPD many women hesitate to seek treatment. The theoretical concepts of this study were based on the health belief model, which focuses on the individual's attitudes, beliefs, and intentions to seek treatment. AIM: The aim of the study was to examine whether health beliefs and social support mediate the links between sociodemographic variables and treatment preferences for PPD. METHOD: Cross-sectional survey, including 1,000 Jewish mothers attending the maternal and child health clinics in Israel for their infant's medical exam, 4 weeks to 6 months postpartum. RESULTS: Mother's age and years of education correlated positively with preferences to receive treatment in the private sector and from professionals working in mental health clinics. The greater the number of children, the less likely new mothers were to favor these preferences. Structural equation modeling showed several mediating pathways: social support mediated the links between sociodemographic variables to health belief model components such as perceived benefits, barriers, and environmental cues. Health belief model components also mediated the links between sociodemographic factors and preferences for place of treatment, professionals, and modes of treatment for PPD. CONCLUSIONS: Health belief model components and social support are important mediating components that help explain mothers' PPD treatment preferences. Health professionals such as psychiatric or public health nurses should increase awareness of women at risk for PPD and elicit their preferred treatment options.
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Depressão Pós-Parto , Mães , Lactente , Criança , Feminino , Humanos , Mães/psicologia , Depressão Pós-Parto/terapia , Depressão Pós-Parto/psicologia , Israel , Estudos Transversais , Período Pós-Parto , Apoio SocialRESUMO
Osteoporosis and its related fractures are major public health concerns. Physical activity (PA) is crucial for bone density preservation and fractures prevention. Yet, gaps in understanding exist regarding how ethno-cultural backgrounds might shape attitudes, intentions and actual PA participation. Based on the theory of planned behaviour (TPB) for predicting PA, the aims of this study were: (i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across four ethno-cultural groups; (ii) to evaluate the fit of the model we constructed across four ethno-cultural groups of women: Israeli-born Jews and Israeli-born Bedouin-Muslims, immigrants from the Former Soviet Union (FSU) and Ethiopian immigrants. Four hundred women (one hundred from each group), aged >65, completed valid and reliable questionnaires assessing knowledge, TPB components and actual PA. The level of knowledge on osteoporosis was relatively low among all four ethno-cultural groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control and actual PA. The structural equation models (SEMs) revealed that among Israeli-born Jews and Ethiopian immigrants, TPB components mediated the link between knowledge and intention to participate in PA. Among FSU immigrants and Israeli Bedouin-Muslims, the knowledge variable was not included in the final model, as its contribution was not significant. It is essential to better understand and augment interventions that enhance PA in the community, and to address the unique needs of each ethno-cultural group.
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Emigrantes e Imigrantes , Exercício Físico , Idoso , Cultura , Feminino , Humanos , Israel , Inquéritos e Questionários , U.R.S.S.RESUMO
Incorporating the needs of at-risk populations into national health care initiatives is essential. Israel has identified ultra-Orthodox Jewish, or Haredi, women, as at risk of increased morbidity and mortality, yet actual data on this insular community are lacking. We reviewed published research on Israeli Haredi women's health status, behaviors and health care access and examined methodologies. Of 273 articles identified, 14 publications and four government reports were included. More research is needed on this community, essential not only to Israeli health care policy, but to that of the USA and the UK, who share the largest percentages of Haredi Jews.
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Atenção à Saúde/organização & administração , Comportamentos Relacionados com a Saúde/etnologia , Acessibilidade aos Serviços de Saúde , Judeus/estatística & dados numéricos , Judaísmo , Saúde da Mulher/etnologia , Adulto , Atitude Frente a Saúde/etnologia , Características Culturais , Feminino , Humanos , Israel , Judeus/psicologiaRESUMO
AIMS AND OBJECTIVE: To examine whether nurses' assessment of their relationships and communication with lesbian women seeking perinatal care is associated with their personal and professional characteristics and knowledge of homosexuality. BACKGROUND: Recently, there has been a growing incidence of same-sex parenthood. Nurses administer health care to lesbian women from pregnancy planning through birth, providing consultation. Although there has been a shift in attitudes towards homosexuality, discrimination is still quite common. DESIGN: This research is part of a larger cross-sectional study carried out at women's healthcare centres, concerning nurses' perceived quality of perinatal care provided to lesbian women. METHODS: The study was conducted from December 2015-April 2016 at women's health centres in Israel encompassing 184 registered nurses who completed self-report questionnaires. They were assessed as to their knowledge of homosexuality and nurse-patient relationships and communication. The Squire checklist was used. RESULTS: Most (73.4%) had prior acquaintance with lesbian women; only 17.9% had been educated as to lesbian women's unique health needs; of these, 66.7% thought that they had been given professional tools for working with lesbian women; 60.4% were unaware of the importance of knowing the patient's sexual orientation. The average score on a homosexuality knowledge questionnaire was 10.4 on a scale of 0-17, indicating moderate levels of factual knowledge about homosexuality. A significant positive correlation was found between nurses' knowledge of homosexuality and assessment of their relationships and communication with lesbian women seeking perinatal care. In addition, nurses' personal and professional characteristics, such as place of birth, religiosity and familiarity with lesbian women, were related to their assessment of their relationships and communication. CONCLUSION: Nurses' knowledge of homosexuality and personal and professional characteristics were associated with their perceptions regarding relationships and communication with lesbian women seeking perinatal care. RELEVANCE TO CLINICAL PRACTICE: Further training might broaden, refine rigid perceptions and contribute to advancing equal perinatal nursing care of lesbian women.
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Conhecimentos, Atitudes e Prática em Saúde , Relações Enfermeiro-Paciente , Assistência Perinatal/normas , Minorias Sexuais e de Gênero , Adulto , Estudos Transversais , Feminino , Humanos , Israel , Masculino , Gravidez , Inquéritos e QuestionáriosRESUMO
PURPOSE: How psycho-social variables affect the degree of disease activity in patients with ulcerative colitis (UC) or Crohn's disease (CD) is incompletely understood. Therefore, we measured and compared the impact of psycho-social variables on the active disease state in UC and CD. METHOD: One hundred and twenty-two UC and 305 CD patients with active disease completed questionnaires detailing their psychological symptoms, threatening experiences, disease-coping strategies, satisfaction with life, quality of life, and demographics. RESULTS: UC and CD patients were aged (mean, SD) 38.6 ± 14.0 and 45.2 ± 15.1 years, respectively. The psychological symptom index (median, IQR) was greater in UC 1.24 (0.8) than CD 0.9 (0.8), p < 0.001. UC used more emotion-focused strategies, 24.5 (5.7) than CD, 23.0 (5.7), p < 0.03; problem-focused strategies, 16.4 (4.5) vs. 15.4 (4.2), p < 0.04; and dysfunctional strategies, 23.7 (5.7) vs. 22.0 (5.0), p < 0.01. UC activity correlated with gender, age, economic status, psychological symptoms, threatening experiences, all coping strategies, satisfaction with life, and quality of life (p < 0.02-0.001). CD activity correlated with economic status, psychological symptoms, threatening experiences, dysfunctional strategies, satisfaction with life, and quality of life (p < 0.05-0.001). UC activity was predicted by psychological symptoms (9.1% variance), economic status (6.9%), problem-focused strategies (4.2%), and threatening experiences (1.3%); CD activity by threatening experiences (5% variance) and psychological symptoms (4%). In path analysis, psychological symptoms and problem-focused strategies mediated the effects of economic status, age, and threatening experiences on UC activity. In CD, the dominant pathway was threatening experiences impacting on psychological symptoms. CONCLUSION: The impact of psycho-social variables on the active disease state differs between UC and CD, thus indicating a need for specifically tailored psychotherapies.
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Adaptação Psicológica , Colite Ulcerativa/psicologia , Doença de Crohn/psicologia , Qualidade de Vida , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To examine the associations of daily hassles with the somatic and psychological health of Crohn's disease (CD) patients. METHOD: A cross-sectional study of 400 self-selected adult CD patients was performed with completion of demographic, medical, and psychosocial questionnaires: economic status; Patient Harvey-Bradshaw Index of disease activity; Daily Hassles Scale (DHS); Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and Short-Form Health Survey (SF-36 Physical and Mental Health) quality of life measures; Brief Symptom Inventory of psychological stress with summary Global Severity Index (GSI); Family Assessment Device; and List of Threatening Life Experiences. Analyses included correlations, regressions, and Sobel test statistic. RESULTS: The patients were aged 38.7 ± 14.1 years, 61% female and 67% working. The Patient Harvey-Bradshaw Index was 5.52 ± 4.87. The DHS was 88.0 ± 23.2, similar in men and women, higher in smokers, and increased with greater disease activity (p < .001). The most commonly reported hassles were time, social, and work. DHS had significant negative correlations with age, disease duration, and economic status and positive correlations with GSI, SF-36, and SIBDQ. An increased Daily Hassles score was associated with reduced SIBDQ (p < .001) and SF-36 Mental Health (p < .001) and increased GSI (p < .001) and Patient Harvey-Bradshaw Index (p < .001). This effect of DHS on Patient Harvey-Bradshaw Index was mediated by GSI (Sobel t = 6.09, p < 0.001). CONCLUSION: Daily hassles in CD patients are shown for the first time to be associated with increased psychological stress and disease activity and reduced quality of life and lower economic status. This has psychotherapeutic implications.
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Doença de Crohn , Qualidade de Vida , Fatores Socioeconômicos , Estresse Psicológico , Adulto , Doença de Crohn/fisiopatologia , Doença de Crohn/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/fisiopatologiaRESUMO
Research exists about religiosity as a substance use protective factor. However, there is little attention of this issue regarding Israeli female college students. Undergraduate religious and secular students were studied. Religious students reported lower last month tobacco, alcohol, cannabis and non-medical prescription drug use. Secular females who smoked, missed class because of party habits and reported easy access to cannabis had a higher probability of binge drinking. This study contributes to knowledge about religiosity and college student substance use, and it provides useful information for their mental health and well-being.
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Consumo de Bebidas Alcoólicas/psicologia , Fatores de Proteção , Religião e Psicologia , Religião , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Valores Sociais , Transtornos Relacionados ao Uso de Substâncias/psicologia , Estados Unidos , UniversidadesRESUMO
This paper presents an overview of a combined, evaluated protocol, cognitive behavioural and art therapy treatment (CB-ART), for the treatment of women with perinatal mood and anxiety disorders (PMADs). The protocol integrates cognitive behavioural interventions and art therapy. CB-ART focuses on changing distressing image, symptom or memory (ISM) that interferes with functioning. The method directs clients to identify compositional elements that characterize their stressful ISM and to alter the element in their imagination, in bodily sensations and on the page. Examples are provided to illustrate the therapeutic process.
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Transtornos de Ansiedade/terapia , Arteterapia , Terapia Cognitivo-Comportamental/métodos , Transtornos do Humor/terapia , Adulto , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Depressão/psicologia , Feminino , Humanos , Transtornos do Humor/psicologia , Gravidez , Resultado do TratamentoRESUMO
AIMS: 1. To examine the rate of WCV among mothers in four ethno-cultural groups: native-born Jewish, Bedouin and immigrants from the Former Soviet Union (FSU) and Ethiopia; 2. to test the relationship between WCV in the first and second year of the infant's life; 3. to assess the effect of sociodemographic variables on WCV. BACKGROUND: Consistent infant well-child visits (WCV) have been found to be related to better health status and a decrease in visits to the emergency room and hospitalizations. METHODS: The data were collected in the Beer Sheva district among community-dwelling women in the years 2010-2012. The quota sample comprised of 400 mothers: 100 from each group. The inclusion criteria were: age (18-35 years old), either first or second child, or age of the youngest child between 18- 24 months. Immigrant mothers lived in Israel for at least 10 years. The monitoring of WCV was evaluated according to the registered number of visits in the well-baby clinic registration card. RESULTS: Mothers from all groups completed fewer WCV than the recommended number. The highest rate of visits was observed among the immigrants from the FSU, and the lowest rate among the Bedouin mothers (p<.001). Mothers of higher economic status had a higher rate of WCV (b = 0.38, p < 0.001). The rate of WCV in the second year was a function of the rate of WCV in the first year (b = 0.51, p < 0.001). CONCLUSIONS: Medical personnel treating infants should address the ethno-cultural and economic background of mothers. It is important to give mothers information about preventive medicine at an early stage in the infant's life and to encourage mothers in general and Bedouin mothers in particular to comply with recommendations regarding WCV.
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Desenvolvimento Infantil , Comparação Transcultural , Adulto , Etiópia , Feminino , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Israel , Masculino , U.R.S.S.RESUMO
ABSTRACT Appraisal of anger terms is based on past experience recollections, social norms, and gender roles. The objectives of this study were to find combinations of emotional components presented by a new composite variable that will exhibit differences between genders and differentiate between anger terms in Hebrew. The sample was comprised of forty students, Hebrew native speakers who participated in a web based study. Participants were asked to rate eight anger terms in Hebrew on a number of features that comprised five emotional components: subjective feelings states body reactions, expressions, action tendencies, and cognitive evaluations. A two-factor between-subjects multivariate analysis of variance (MANOVA) was conducted. A simplified multivariate composite, defined as subjective experience minus regulation, explained 10% of the gender difference. Another simplified composite, which combines the additive effect of the subjective experience and the actions that accompany this emotional state, explained 14% of difference between the anger terms. The findings are discussed with respect to appraisal theory and social constructivist conceptualization.
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Ira , Feminilidade , Idioma , Masculinidade , Adulto , Feminino , Humanos , Israel/etnologia , Masculino , Fatores Sexuais , Adulto JovemRESUMO
This pilot study examined differences in plasma cell free DNA (CFD) levels based on practice of stress reduction techniques among 14 women undergoing in vitro fertilization (IVF) and embryo transfer (ET) treatment who had higher than normal levels of plasma CFD before beginning IVF treatment. Wilcoxon nonparametric tests were used to examine the significance of the rate of decline in CFD levels between the time points in each of the groups. A paired sample t-test examined the changes in CFD levels among each participant in each of the groups separately. We found that women who engaged in these techniques had reduced plasma CFD, below what is considered elevated in comparison to those who did not practice. High plasma CFD levels have been associated with IVF failure. Stress reduction techniques may facilitate physiological changes that lead to the reduction of plasma CFD levels.
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Terapia Cognitivo-Comportamental , DNA/sangue , Transferência Embrionária/métodos , Fertilização in vitro/métodos , Infertilidade Feminina/terapia , Estresse Psicológico/terapia , Adulto , Biomarcadores/sangue , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/psicologia , Indução da Ovulação , Projetos Piloto , Gravidez , Estresse Psicológico/etiologia , Estresse Psicológico/psicologiaRESUMO
This prospective repeated measures study was designed to examine the cell-free DNA (cfDNA) concentrations during ovarian stimulation and the relationship between cfDNA concentration and pregnancy rates in women undergoing IVF-embryo transfer. The study examined 37 women undergoing IVF treatment in an IVF unit in a university medical centre in southern Israel. cfDNA concentrations were measured by a direct fluorescence assay, pregnancy rates were identified by plasma ß human chorionic gonadotrophin (HCG) concentrations and verified by vaginal ultrasound to determine gestational sac and fetal heart beats. Throughout the IVF cycle, at the three time points measured, the mean concentration of plasma cfDNA among all participants did not statistically significantly change. However, on the day of ßHCG test in patients undergoing IVF-embryo transfer, plasma cfDNA concentrations were statistically significantly higher among women who did not conceive in comparison to those who conceived. Plasma cfDNA may reflect the presence of factors which interfere with embryo implantation. Further research is required to determine the usefulness of cfDNA as a biomarker of IVF outcome and to examine the underlying pathologies as potential sources for increased plasma cfDNA concentrations. Cell-free DNA (cfDNA) is particles of DNA which are released from the cell nucleus and are found in high concentrations during a variety of illnesses and injuries. This study was designed to examine the cfDNA concentrations during IVF treatment and the relationship between cfDNA concentration in the bloodstream and pregnancy rates in women undergoing IVF. This study examined 37 women in treatment at the IVF unit of the University Medical Centre in southern Israel. cfDNA concentrations in the bloodstream were measured at three time points by a direct test. Pregnancy rates were identified by pregnancy hormone concentrations in the bloodstream and verified by vaginal ultrasound to determine a pregnancy sac and fetal heart beats. Throughout the IVF cycle, at the three time points measured, the average concentration of cfDNA among all participants did not change. However, on the day of the pregnancy test, blood cfDNA concentrations were significantly higher among women who were not pregnant in comparison to those who were. Plasma cfDNA may reflect the presence of factors which interfere with embryo implantation. Further research is required to determine the usefulness of cfDNA as a biological marker of IVF outcome and examine underlying illnesses and problems as potentials sources for increased cfDNA concentrations.
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DNA/sangue , Taxa de Gravidez , Adulto , Biomarcadores/sangue , Transferência Embrionária , Feminino , Fertilização in vitro , Humanos , Masculino , Indução da Ovulação , Gravidez , Estudos ProspectivosRESUMO
While the evidence on the adverse impact of the COVID-19 pandemic on the well-being of frontline social workers is emerging, the research on the impact of the pandemic on their performance is scarce. The presented study explores how the relationship between work environment predictors and perceived stress explains the job performance of child welfare social workers during the pandemic using survey responses of 878 child welfare social workers. The findings revealed the mechanism through which environment predictors and perceived stress interacted in explaining job performance during a time of large-scale crisis. We found that C.W. social workers who experienced greater COVID-19-related service restrictions reported poorer job performance, that perceived stress disrupted workers' supervision and autonomy, and that supervision and job autonomy protected C.W. social workers from the adverse effects of perceived stress and workload on their job performance. Conclusions included the importance of autonomy and supervision in mitigating job-related stressors and the need to adapt and enhance child welfare supervision during times of national crisis.
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BACKGROUND: The period of pregnancy and early motherhood is a substantial life change associated with psychological turbulence. During this period, some women experience symptoms of anxiety and depression of sufficient severity to warrant professional psychological assistance. Psychosocial and psychological interventions are key therapeutic approaches for women at this life stage. There is growing evidence of the value of the arts in the prevention and treatment of mental health problems. Evidence suggests that women prefer psychological interventions that provide social support and shared space for reflection. Cognitive Behavioural and Art-based intervention (CB-ART) is a novel therapy for prevention and treatment of perinatal mental health problems. The aim of this study was to implement and evaluate CB-ART for acceptability, feasibility, safety and preliminary efficacy among women admitted to a residential early parenting unit. METHODS: The pilot study used a single-centre, mixed-methods pre- and post-test design to evaluate CB-ART among women admitted to a 5-day residential early parenting service in Melbourne, Australia. Participants completed questionnaires before and after attendance at two 1-h CB-ART group sessions on day 2 and day 5 of admission during which field notes were taken. Evaluation interviews were conducted by telephone 1 week after discharge. The Short Profile of Emotional Competence and the Edinburgh Postnatal Depression Scale were used to assess emotional insight and symptoms of depression, respectively. Feasibility, acceptability and safety were assessed using an analysis of field notes, with quantitative data collected by telephone questionnaire and qualitative data by telephone interviews. RESULTS: Nine participants enrolled in the program; eight provided complete data. Two CB-ART groups were conducted. Before and after comparisons showed that there was an improvement in symptoms of postnatal depression and a marginal improvement in emotional insight. Thematic analysis of qualitative data indicated CB-ART was a feasible and acceptable means of assisting reflection. CONCLUSION: The preliminary data indicate that the CB-ART program is a feasible, acceptable and safe addition to the 5-day residential program, with potentially therapeutic benefits. A larger randomised study is required to assess the effects of the CB-ART intervention on symptom measures in this and other postnatal settings. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN126220000354785 . Registered 1 January 2022-retrospectively registered.
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BACKGROUND: Chronic abdominal pain and fatigue are characteristics of Crohn's disease (CD) and contribute to functional impairments. AIMS: To examine whether CD-tailored cognitive-behavioural and mindfulness intervention (COBMINDEX) is effective in reducing abdominal pain and fatigue in patients with CD and whether changes in abdominal pain and fatigue mediate any beneficial effects of COBMINDEX on impairments in work productivity and daily activities. METHODS: This is a secondary analysis of a parallel-group multicentre randomised controlled trial. Patients with mild-to-moderate CD (n = 142) were randomised into either intervention group receiving COBMINDEX, or control group receiving treatment-as-usual for 3 months followed by COBMINDEX. Complete data were collected from 120 patients (34.0 ± 10.7 years, 62.5% female, intervention = 60, control = 60). Analysis of covariance assessed group differences in 3-month follow-up scores, controlling for baseline scores. Multiple parallel mediation analysis assessed the proposed mechanisms for the entire sample. RESULTS: The intervention group demonstrated significantly lower levels of abdominal pain (F = 17.46, p < 0.001, η2 p = 0.13), fatigue (F = 7.26, p = 0.008, η2 p = 0.06) and impairments at work (F = 4.82, p = 0.032, η2 p = 0.07) and daily activities (F = 6.26, p = 0.014, η2 p = 0.05), compared with treatment-as-usual. Moreover, changes in abdominal pain and fatigue significantly mediated the beneficial effects of COBMINDEX on patients' work productivity (b = -9.90, SE = 2.86, 95% CI: -16.11 to -4.94) and daily activities (b = -9.65, SE = 1.91, 95% CI: -13.77 to 6.35), independent of changes in disease activity. CONCLUSIONS: COBMINDEX is effective at reducing abdominal pain and fatigue in patients with CD, which in turn leads to improvement in functioning. Clinicians should incorporate screening for severe abdominal pain and fatigue and consider offering cognitive-behavioural and mindfulness training. CLINICALTRIALS: gov, Number: NCT05085925. Ministry of Health in Israel (https://my.health.gov.il/CliniTrials/Pages/MOH_2020-02-24_008721.aspx).
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Doença de Crohn , Humanos , Feminino , Masculino , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Intervenção Psicossocial , Dor Abdominal/tratamento farmacológico , Dor Abdominal/etiologia , Fadiga/etiologia , Fadiga/terapia , Israel , Qualidade de VidaRESUMO
PURPOSE: This study describes the outcomes of a modified Manchester procedure on the quality of life and sexual functioning of women with elongation of the uterine cervix with or without pelvic organ prolapse (POP). METHODS: Data on medical and demographic variables were collected from medical files and then women were invited to for follow-up examination and data collection. RESULTS: Follow-up data were collected from 53 out of 87 women who underwent reconstructive surgery with modified Manchester procedure (60.9% of the women). Prior the surgery, all women in this sample (n = 53) were medically examined and found to have uterine cervix elongation, 40/53 (75.4%) women also had cystocele, 10/53 women (18.8%) had uterine prolapse and 8/53 women (15.1%) had rectocele (all stages II-IV). On follow-up examination, all the cervical stumps were satisfactorily situated, recurrent cystocele was found among 12/53 women (22.6%) women; 13/53 (24.5%) had rectocele; and none of these women had uterine prolapse. Women with POP (cystocele and rectocele) (24/53) had less operative satisfaction (p = 0.004), lower quality of life (p < 0.05 in 3 out of 8 domains), and poorer sexual function (p = 0.03) compared to women without POP (29/53). CONCLUSION: The modified Manchester procedure including reconstructive surgery for women with cervix elongation, with or without POP, prevented recurrent uterine prolapse and was well received in terms of patient's satisfaction, quality of life, and sexual function.
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Prolapso de Órgão Pélvico/cirurgia , Útero/cirurgia , Adulto , Idoso , Cistocele/cirurgia , Feminino , Seguimentos , Procedimentos Cirúrgicos em Ginecologia , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Qualidade de Vida , Retocele/cirurgia , Sexualidade , Resultado do TratamentoRESUMO
This study of 302 Israeli women sought to investigate the associations among stressful reproductive experiences (e.g. fertility problems, abortions, and traumatic births), chronic medical conditions, pain, and depression. The specific aims of the study were to examine (1) the effect of stressful reproductive experiences, chronic medical conditions, and pain on depressive symptoms and (2) the effect of stressful reproductive experiences, chronic medical conditions, and depressive symptoms on pain. Our findings corroborate with previous studies demonstrating that depression and pain are two interrelated, but different phenomena, which have both common and distinct risk factors. The findings are discussed in the light of stress and adaptation theories that point to the long-term effects of stressful life events on emotional and physiological aspects such as depression and pain.
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Doença Crônica/psicologia , Depressão , Dor/psicologia , Reprodução , Aborto Induzido/psicologia , Aborto Espontâneo/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Infertilidade/psicologia , Israel , Parto/psicologia , Gravidez/psicologia , Complicações na Gravidez/psicologiaRESUMO
BACKGROUND: Older adults have been considered a primary at-risk population during the coronavirus disease 2019 (COVID-19) pandemic, and many efforts have been and still are directed toward supporting them and enhancing their capacity to cope with the pandemic. Evidence shows that by enhancing proactive coping abilities through psychological interventions, in which cognitive-behavioral and mindfulness techniques are taught and practiced effectively, these interventions have supported older adults throughout the pandemic. However, the underlying mechanisms by which specific intervention components affect various mental states such as distress, depression and loneliness among older adults remain unclear and warrant investigation. AIM: To determine the effect of an intervention using cognitive-behavioral and mindfulness techniques on changes in distress, depression and loneliness. METHODS: We performed a secondary analysis on data from a previous study in which community-dwelling older adults attended a short-term, internet-based intervention during the first COVID-19 wave in Israel. The intervention included seven sessions during which various cognitive-behavioral and mindfulness techniques were learned and practiced. In-session changes in psychological distress were measured using the Subjective Units of Distress Scale (SUDS), which participants rated at the beginning and end of each session. Participants also filled out questionnaires that evaluated levels of depression [Patient Health Ques-tionnaire (PHQ-9)] and loneliness (UCLA loneliness Scale) prior to and after the entire intervention process. The effect of in-session changes in the SUDS on changes in post-intervention depression and loneliness levels were assessed, as a proxy for distinct technique effectiveness. RESULTS: The findings indicated in-session differences in terms of a decrease in psychological distress (SUDS). Sessions that included relaxation exercises and guided imagery, as well as sessions that included cognitive restructuring and mindfulness meditation, demonstrated the largest decreases in in-session psychological distress (≥ 35%). Two multivariate regression models, one for levels of post-intervention depression (PHQ-9 score) and the other for levels of post-intervention loneliness (UCLA loneliness score), were fitted. The results revealed two statistically significant explanatory variables for depression: The SUDS difference for sessions in which cognitive restructuring and mindfulness meditation were practiced, beta = -0.25, 95%CI: -1.23 to -0.1, and the pre-intervention level of depression, beta = 0.62, 95%CI: 0.37-0.75. The second model for loneliness revealed only one significant explanatory variable: The SUDS difference for sessions in which relaxation and guided imagery were practiced, beta = 0.41, 95%CI: 0.14-0.65. CONCLUSION: Different psychological techniques seem to have different effects on distress, loneliness and depression. Understanding the pathways by which distinct techniques affect negative mental symptoms has implications for future intervention design.
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This study focused on the work preferences of young adults with physical disabilities (YAPD) in Israel and the variables that affect those preferences. The theory of planned behavior (TPB) was employed to explain work preferences. We examined direct and indirect links between education and socioeconomic status (SES) in a comprehensive model that tested the mediating role of the TPB and self-assessed health. A cross-sectional study was conducted throughout 2017. Participants included 348 YAPD aged 18-30 not yet integrated into the workforce. Exploratory factor analysis of work preferences yielded three dependent variables: 'intention to work', 'interest, security, and advancement at work', and 'willingness to work in the free market'. Data analysis included correlations and path analysis by structural equation modeling. Education was positively associated with all work preferences, while SES was positively associated with 'interest, security, and advancement at work'. Subjective norms mediated the relation between education and 'intention to work' and 'interest, security, and advancement at work'. Self-efficacy mediated the relation between SES and 'interest, security, and advancement at work'. Finally, self-assessed health mediated between SES and self-efficacy. Education is a crucial human capital in predicting work preferences of YAPD. The TPB components are important factors in predicting work preferences.