Policies and Practices Facilitating Access to and Uptake of HIV Testing Services among Adolescents in Sub-Sahara Africa: A Narrative Review.

PURPOSE OF REVIEW: Expanding access to HIV testing services and linking newly diagnosed positive adolescents to antiretroviral therapy is critical to epidemic control. However, testing coverage and treatment initiation rates continue to lag behind adult counterparts. This article synthesizes evidence on facilitative policies and service delivery practices focused on adolescents to inform programming. RECENT FINDINGS: Our narrative review found that national policies are growing more adolescent-inclusive but barriers around the age of consent, waiver frameworks and dissemination constrain translate into practice. Facility-based provider-initiated testing through integrated sexual health services and dedicated youth centres demonstrates uptake effectiveness if confidentiality and youth-friendly adaptations are assured. Supportive policies, youth-responsive adaptations across testing models and strengthening age-disaggregated monitoring are vital to improving adolescents' engagement across the HIV testing and treatment cascade. Further implementation research is imperative to expand the reach of adolescent HIV testing in sub-Saharan Africa.

Psychotic-like experiences and adverse life events in young people. Does gender matter?

BACKGROUND: Psychotic-like experiences (PLEs) and adverse life events (ALEs) are highly prevalent in sub-Saharan Africa where gendered practices are also common. There is, however, a paucity of data on how the relationship between PLEs and life adversities is influenced by gender. The current study addressed this gap. METHOD: Data were collected from 1886 school-based young people (1174 females) in Ghana, West Africa using a cross-sectional survey methodology and analyzed using Chi-square, independent t-test, Pearson correlation, and multivariate regression. RESULTS: The results showed that victimization experiences, school stress and having a family member with mental illness were significantly associated with PLEs in both males and females. In contrast, substance misuse and experiences of head trauma correlated significantly with PLEs in females only. CONCLUSION: Life adversities constitute major risk factors for PLEs among school-based young people in Ghana, who could benefit from gender neutral and gender-sensitive intervention programming to remediate the effects of life adversities on PLEs.

Work-related psychosocial challenges and coping strategies among nursing workforce during the COVID-19 pandemic: a scoping review.

BACKGROUND: Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O'Malley's review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them. METHODS: We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria. RESULTS: Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping. CONCLUSIONS: The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.

Strategies to adapt and implement health system guidelines and recommendations: a scoping review.

BACKGROUND: Evidence-based health system guidelines are pivotal tools to help outline the important financial, policy and service components recommended to achieve a sustainable and resilient health system. However, not all guidelines are readily translatable into practice and/or policy without effective and tailored implementation and adaptation techniques. This scoping review mapped the evidence related to the adaptation and implementation of health system guidelines in low- and middle-income countries. METHODS: We conducted a scoping review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was implemented in MEDLINE (Ovid), Embase, CINAHL, LILACS (VHL Regional Portal), and Web of Science databases in late August 2020. We also searched sources of grey literature and reference lists of potentially relevant reviews. All findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS: A total of 41 studies were included in the final set of papers. Common strategies were identified for adapting and implementing health system guidelines, related barriers and enablers, and indicators of success. The most common types of implementation strategies included education, clinical supervision, training and the formation of advisory groups. A paucity of reported information was also identified related to adaptation initiatives. Barriers to and enablers of implementation and adaptation were reported across studies, including the need for financial sustainability. Common approaches to evaluation were identified and included outcomes of interest at both the patient and health system level. CONCLUSIONS: The findings from this review suggest several themes in the literature and identify a need for future research to strengthen the evidence base for improving the implementation and adaptation of health system guidelines in low- and middle-income countries. The findings can serve as a future resource for researchers seeking to evaluate implementation and adaptation of health system guidelines. Our findings also suggest that more effort may be required across research, policy and practice sectors to support the adaptation and implementation of health system guidelines to local contexts and health system arrangements in low- and middle-income countries.

Validation of the Suicidal Behaviors Questionnaire-Revised in adolescents in Ghana.

BACKGROUND: According to the World Health Organization, 85% of global suicides occur in low- and middle-income countries (LMICs). A major factor contributing to the alarming rates of suicides in LMIC is the unavailability of standardized and validated screening measures to screen and identify individuals at heightened risk of suicidal tendencies for early intervention. AIM: To investigate the factorial validity, construct validity and gender invariance of the Suicidal Behavior Questionnaire-Revised (SBQ-R). METHODS: A cross-sectional self-report methodology was employed to gather data from 553 adolescents (average age = 16.85; girls = 322) in Ghana. RESULTS: The result of a multi-group confirmatory factor analysis supported a unidimensional structure of the SBQ-R that did not differ for boys and girls. The SBQ-R demonstrated construct validity for boys and girls by correlating significantly although moderately with measures of depression, anxiety and mental wellbeing. CONCLUSION: The findings of this preliminary study suggest that the SBQ-R can be administered as a valid screening measure for adolescents at high risk for suicide for further assessment and intervention planning in Ghana, regardless of gender. Additionally, the study contributes to the literature on the universality and assessment of suicidal behaviors using SBQ-R.

Nurses' and midwives' perspectives on participation in national policy development, review and reforms in Ghana: a qualitative study.

BACKGROUND: The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives' participation in policy development in Ghana. The current study explored nurses and midwives' participation in policy development, reviews and reforms in Ghana. METHODS: A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures. RESULTS: Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raised. CONCLUSION: The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.

Factorial and convergent validity of the Youth Psychopathic Traits Inventory-Short Version in Ghana.

Studies have shown the existence of psychopathy construct in Western cultures. However, there is a general lack of research on this topical issue in non-Western countries, specifically sub-Saharan Africa. Consequently, this study investigated the factorial and convergent validity of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) in 327 adolescents in Ghana. Confirmatory factor analysis supported a three-factor structure (interpersonal, behavioural and affective) of psychopathy that was invariant across gender. These results were replicated in a cross-validation sample comprising 363 adolescents. The YPI-S factors correlated significantly and positively with reactive and proactive aggression, thus bolstering its construct validity. The YPI-S and Big-Five domains were related differently, and where significant correlations were observed, their directions generally confirmed and extended previous studies. All in all, the result generally suggested the existence of psychopathy construct among Ghanaian youth which can be described along interpersonal, affective and behavioural domains. However, the alterations made to the YPI-S, coupled with its relatively low factor loadings and internal consistency largely, indicate cultural influences on the assessment of cross-cultural traits. This study illuminated the problem of exporting Western-based measures and their findings to non-Western contexts.

Predicting delinquency by self-reported impulsivity in adolescents in Ghana.

BACKGROUND: Impulsivity is one of several variables associated with delinquent and criminal acts, but its utility depends on the psychometric properties of the measure used. AIM: To investigate the latent structure of the abbreviated Barratt Impulsivity Scale (ABIS) and its convergent validity with measures of aggression and psychopathy in a Ghanaian sample. METHODS: In a cross-sectional survey, high school students were recruited from two randomly selected schools in Ghana and asked to respond to the ABIS and measures of delinquency, aggression and psychopathy. RESULTS: Three hundred and sixty-three young people, aged 15-19 were recruited, 149 (41%) boys. Findings supported a three-factor (attention, motor and non-planning) structure of impulsivity, which did not differ by sex. Motor and attentional impulsivity were associated with both violent and general delinquent behaviours. Impulsivity scores also correlated with aggression and psychopathy scores, thus providing evidence of convergent validity. CONCLUSION: The ABIS was shown to have sound psychometrics in a standard Ghanaian secondary school sample. Even in this group, where delinquency and antisocial behaviours were of low frequency, its motor and attention impulsivity scores were shown to have some relationship with violent and general delinquent behaviours, suggesting that the ABIS could be a useful tool across cultures for identifying adolescents at high risk of such problems and intervening early to limit damage. Copyright © 2017 John Wiley & Sons, Ltd.

Demographic factors, childhood maltreatment and psychological functioning among university students' in Ghana: A retrospective study.

This study retrospectively investigates the influence of child (i.e., gender), care-giver (e.g., who grew up with), household size (i.e., number of siblings grew up with) and community (i.e., rural versus urban) factors on childhood maltreatment, as well as the impacts of maltreatment on psychological functioning. A cross-sectional survey and self-report methodology is used to gather data from 300 students of the University of Ghana. The results show that being a male, growing up in rural areas, living with more than 3 siblings in the same household and being raised by both biological parents have significant main effects on childhood maltreatment. Analyses of the interaction effects show that living with more than 5 siblings in a rural household with "other" parents (i.e., non-biological parents) has a significant effect on physical abuse. Furthermore, males from rural households consisting of more than 3 siblings and who did not grow up with both biological parents endorsed significantly more physical abuse and physical neglect, compared with the females. With respect to the psychological outcome, childhood maltreatment significantly predicts and account for significant variance in depression (34%), self-efficacy (18%) and life satisfaction (22%). The findings and the implications of the study are briefly discussed.

Determination of Competency to Stand Trial (Fitness to Plead): An Exploratory Study in Hong Kong.

Competency to stand trial (CST) is related to the defendant's capacity to engage in a satisfactory level of participation in the court process. While the extant studies focus mainly on assessment-related issues such as assessment methods, guidelines for competency evaluations, and quality of competency evaluations, another area of considerable interest is the indicators of CST as well as legal decision-making relating to CST. This study canvasses some proposed indicators of CST from the literature and examines whether these psycho-legal abilities are relevant to finding a defendant incompetent to stand trial. Secondly, the study investigates factors likely to influence legal decision-making in competency determination. Using a cross-sectional survey and a self-report methodology, 197 participants from a legal Juris Doctoral course responded to measures of CST, punitiveness, and legal authoritarianism, anti-authoritarianism and egalitarianism. The results show that the majority of the items canvassed from the literature are considered relevant in finding the defendant incompetent to stand trial. With respect to factors influencing competent decision-making, females are more likely to regard defendants as incompetent. Additionally, participants with strong punishment-oriented attitudes (i.e. legal authoritarianism and punitiveness) are significantly more likely to find the defendant competent to stand trial, as opposed to those high in non-punishment-oriented attitudes (i.e. anti-authoritarianism and egalitarianism). The study concludes that biased legal decision-making can occur regardless of the background of the decision-makers, in this case participants undergoing legal training. The findings are discussed and implications of the study are proposed.

Mental health burden among females living with HIV and AIDS in sub-Saharan Africa: A systematic review.

Mental health problems, particularly depression and anxiety, are common in women and young girls living with HIV/ AIDS particularly in low- and middle-income (LMICs) countries where women's vulnerability to psychiatric symptoms is heightened due to the prevalent intersectional stressors such as stigma and intimate partner violence. However, no synthesized evidence exists on the mental health burden of females living with HIV/AIDS (FLWHA) in Africa. This systematic review aimed to synthesize the current evidence on the mental health burden among FLWHA in sub-Saharan Africa. A systematic literature review of articles published from 2013-2023 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Five electronic databases; PubMed, MEDLINE with full text, Scopus, Academic Search Complete, and Health Source: Nursing Academic Edition were searched for articles published in English. Nineteen articles (15 quantitative, 3 qualitative, and 1 case study) from over 7 African countries met the inclusion criteria. The majority of the studies' quality was determined to be moderate. The prevalence of depression ranged from 5.9 to 61% and anxiety from 28.9 to 61%. Mental health burden was a logical outcome of HIV diagnosis. Predictors of mental health outcomes in the context of HIV/AIDS were identified as intimate partner violence (IPV), stigma, childhood traumas, sexual abuse, poverty, unemployment, and social isolation. Social support and resilience were identified as protective factors against mental illness in FLWHA. Mental illness had a deleterious effect on viral suppression rates among FLWHA, resulting in delayed initiation of antiretroviral therapy treatment and increased mortality but had no impact on immune reconstitution in the face of ART adherence. Given the high prevalence rates of depression and anxiety and their relationship with HIV progression, it is crucial that mental health care services are integrated into routine HIV care.

Prevalence, assessment and correlates of mental health problems in neglected tropical diseases: a systematic review.

Neglected tropical diseases (NTDs) are a group of disease conditions that affect the world's poorest people in low- and middle-income countries. NTDs are associated with negative behavioural experiences, including discrimination, rejection and stigmatization, that predisposes those affected to mental health problems. Consequently, researchers have shown profound interest in elucidating the mental health burden associated with NTDs. To address pertinent issues in the burgeoning literature relating to the prevalence, assessment and correlates of mental health problems in NTDs, a systematic review methodology was used. Underpinned by the PRISMA guidelines, a search was conducted of electronic databases, individual journals and bibliographies for articles that were screened and subjected to predetermined inclusion and exclusion criteria. Sixteen articles from African, Asian and South American countries were included in the review. Depression was the most widely investigated mental health issue, followed by stress and anxiety, with prevalence estimates of 7-54%, 8-43% and 19-53%, respectively. The PHQ-9 and GAD-7 and Self-Reporting Questionnaire were the most widely administered mental health screening tools. The major correlates of mental health problems are lower education and economic status and female gender. We recommend multisectoral and multilayered mental health and related interventions to address the increasing burden of mental health in NTDs.

Prevalence and social determinants of anxiety and depression among adults in Ghana: a systematic review and meta-analysis protocol.

INTRODUCTION: Anxiety and depression pose a significant global health challenge, especially affecting adults in low-income and middle-income countries. In many low-income and middle-income countries, including those in sub-Saharan Africa, social determinants such as access to affordable health services, conflict, food insecurity, and poverty may be associated with the prevalence of anxiety and depression, further contributing to health disparities. To mitigate the burden of anxiety and depression in sub-Saharan Africa, it is essential to develop country-level tailored mental health policies and strategies. For example, Ghana is working towards improving mental health via its 12 year Mental Health policy launched in 2021. However, the prevalence of anxiety and depression among adults in Ghana, along with associated social determinants remains largely unknown, posing challenges for mental health planning, resource allocation and developing targeted interventions. This systematic review seeks to (1) examine the prevalence of anxiety and depression among adults in Ghana and (2) explore social determinants potentially associated with anxiety and depression. METHODS AND ANALYSIS: Electronic databases (eg, African Index Medicus, CINAHL, EMBASE, MEDLINE, and PsycINFO) will be searched with all screening steps conducted by two independent reviewers. Secondary search strategies, including grey literature searches, will be used. Studies reporting on the prevalence of anxiety, depression and/or a combined symptom measure (ie, psychological distress) among adults in Ghana, using validated instruments will be included. If data allows, random-effects-meta-analyses will be performed to estimate pooled prevalence rates of anxiety and depression. Potential clinical and methodological moderators will be examined using subgroup analyses and meta-regression. A narrative synthesis will explore social determinants potentially associated with anxiety and depression among adults in Ghana. ETHICS AND DISSEMINATION: Ethical approval is not required as no primary data will be collected. Results will be disseminated via a peer-reviewed publication and presentations at academic conferences. Plain language summaries will be provided to relevant non-governmental organisations working in Ghana. PROSPERO REGISTRATION NUMBER: CRD42023463078.

Seeking and receiving help for mental health services among pregnant women in Ghana.

OBJECTIVE: The heightened vulnerability of women to mental health issues during the period of pregnancy implies that seeking and receiving support for mental health services is a crucial factor in improving the emotional and mental well-being of pregnant women. The current study investigates the prevalence and correlates of seeking and receiving help for mental health services initiated by pregnant women and health professionals during pregnancy. DESIGN: Using a cross-sectional design and self-report questionnaires, data were collected from 702 pregnant women in the first, second and third trimesters from four health facilities in the Greater Accra region of Ghana. Data were analyzed using descriptive and inferential statistics. RESULTS: It was observed that 18.9% of pregnant women self-initiated help-seeking for mental health services whereas 64.8% reported that health professionals asked about their mental well-being, of which 67.7% were offered mental health support by health professionals. Diagnosis of medical conditions in pregnancy (i.e., hypertension and diabetes), partner abuse, low social support, sleep difficulty and suicidal ideation significantly predicted the initiation of help-seeking for mental health services by pregnant women. Fear of vaginal delivery and COVID-19 concerns predicted the provision of mental health support to pregnant women by health professionals. CONCLUSION: The low prevalence of individual-initiated help-seeking implies that health professionals have a high responsibility of supporting pregnant women achieve their mental health needs.

Achieving the UNAIDS 95-95-95 treatment target by 2025 in Ghana: a myth or a reality?

The United Nations Joint Programme on HIV/AIDS (UNAIDS) has set ambitious treatment targets known as Project 95-95-95, aiming to achieve 95% of people living with HIV knowing their status, 95% of diagnosed individuals on antiretroviral therapy (ART), and 95% of those on ART achieving viral suppression by 2025. Through a comprehensive analysis of Ghana's HIV/AIDS response, we evaluate the feasibility of Ghana's efforts in realising these targets. The discussion explores Ghana's achievements in HIV testing and diagnosis, ART coverage, and viral suppression rates, as well as challenges related to stigma, limited access to healthcare services, funding constraints, and data quality. Strategies such as strengthening prevention efforts, expanding access to ART, addressing stigma, and enhancing health systems are discussed as the way forward to advance Ghana's progress towards the UNAIDS 95-95-95 treatment targets. While Ghana has made significant strides in its HIV/AIDS response, achieving the 95-95-95 targets is a challenging yet realistic goal.

Interventions impacting the accessibility of sexual reproductive health services for head porters in sub-Saharan Africa- A scoping review protocol.

Head porters working in markets in sub-Saharan Africa (SSA) are one of the world's most vulnerable and socioeconomically disadvantaged groups. They consist predominantly of uneducated women and girls seeking to escape poverty, early marriage, and other issues of domestic violence. Most female head porters are in their reproductive years and often lack access to sexual reproductive health services (SRHS) despite being at high risk for sexually transmitted infections (STIs), unplanned pregnancies, and gender-based violence. The low priority for women and girls' SRH in many SSA countries highlights the need to explore the factors influencing the accessibility of services for failure to do so restrains human development. An initial search of the literature was conducted and revealed no current scoping or systematic reviews on the accessibility to SRHS for female head porters in SSA. We outline a scoping review protocol, using the Joanna Briggs Institute methodology, to determine the interventions that influence the accessibility of SRHS for female head porters in SSA. The protocol is registered with Open Science Framework (https://osf.io/hjfkd). Findings will not only be valuable for female head porters but for all vulnerable female groups in SSA who experience high SRH risks and social disparities.

Ghanaian nurses' and midwives' perspectives on technology adoption in nursing and midwifery education.

AIM: The purpose of this study was to explore the perceived benefits and challenges of online distance education and computer-based testing (CBT) among registered nurses and midwives in a sample of government-owned health facilities and health training institutions in Ghana. DESIGN: Exploratory descriptive qualitative design. METHODS: Individual semi-structured interviews were conducted with 45 participants (i.e. 25 nurses and 20 midwives). The data were manually processed and analysed using Braun and Clarke's thematic analysis approach (November 2019-February 2020). RESULTS: Nurses and midwives prefer online distance education for three reasons: convenience, cost-effectiveness and learning centre proximity to the workplace. The course schedule's flexibility allowed participants to work and study simultaneously. Others acknowledged online distance education as a viable option for overcoming the challenges of obtaining study leave. However, the lack of recognition of certificates by some employers, poor Internet connectivity and perceived excessive course load were noted as deterrents. Regarding the CBT, many of the participants said that it was useful. Among the advantages of CBT are: (1) a decrease in examination malpractices, (2) a decrease in examination costs and (3) a rise in students' interest in information, communication and technology (ICT). This finding emphasizes the necessity of integrating ICT into nursing and midwifery education and examinations, as well as maximizing its benefits.

Psychometric properties and development of the Chinese versions of Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A).

Currently, six instruments have been developed using the 11th revision of the International Classification of Diseases (ICD-11) criteria for Gaming Disorder (GD). Two of these are the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A). The present study validated both the GDT and GADIS-A among a large sample of Chinese emerging adults. Via an online survey, 3381 participants (56.6% females; mean age = 19.56 years) completed the Chinese versions of the GDT, GADIS-A, Internet Gaming Disorder-Short Form (IGDS9-SF), and Bergen Social Media Addiction Scale (BSMAS). Confirmatory factor analysis was used to examine the factor structure of the Chinese GDT and GADIS-A. Pearson correlations were computed to examine the convergent validity (with IGDS9-SF) and divergent validity (with BSMAS) of the Chinese GDT and Chinese GADIS-A. The GDT had a unidimensional structure, which was invariant across sex and disordered gaming severity subgroups. The GADIS-A had a two-factor structure, which was also invariant across gender and gaming severity subgroups. Both the GDT and GADIS-A had significant associations with both IGDS9-SF and with BSMAS. Both the Chinese GDT and GADIS-A are valid instruments to assess GD among emerging adults in mainland China, enabling healthcare providers to adopt these tools in their efforts to prevent and examine GD severity among Chinese youth.

Psychosis risk among pregnant women in Ghana.

INTRODUCTION: Psychotic illness, although is rare, has been reported in the perinatal period. Individuals diagnosed with psychotic illness tend to first exhibit psychotic-like experiences (PLEs), defined as subclinical psychotic symptoms that occur outside the context of sleep or drug use. However, there is a paucity of empirical data on PLEs in pregnancy to advance scholarly discourse and support professional practice. The current study investigated the prevalence and correlates of PLEs among pregnant women in Ghana, a West African state. DESIGN: A cross-sectional survey design was used to collect data from 702 pregnant women who responded to measures of PLEs, COVID-19 concerns and behavioral maladies such as anxiety and depressive symptoms. Descriptive and inferential statistics, namely chi square, exploratory factor analysis, MANOVA and multinomial logistic regression were used to analyze the data. RESULTS: The results showed that 54.2%, 27.3% and 18.5% of participants were at no/low, moderate and high risk for psychosis, respectively. A total of 44.4% participants were not distressed by PLEs, whereas 32.2% and 23.4% were a bit/quite and very distressed, respectively. Psychosis risk was elevated among pregnant women who were more concerned about the COVID-19 effects, scored high in suicidal ideation, depressive symptoms and sleep difficulties. CONCLUSION: The study showed that psychosis risk is present in pregnancy. IMPLICATIONS: Screening for psychosis risk in pregnancy should be prioritized for pregnant women with behavioral maladies, including suicidal tendencies, depressive symptoms, sleep difficulties and heightened concerns about COVID-19.

Post-Traumatic Growth and Resilience among Hospitalized COVID-19 Survivors: A Gendered Analysis.

The literature on behavioral outcomes associated with the COVID-19 pandemic is inundated with mental health burdens such as depression and stress disorders. The current study investigated gender invariance on resilience and post-traumatic growth (PTG) as positive psychological changes associated with the COVID-19 pandemic. A total of 381 survivors of the COVID-19 infection completed measurements of resilience, PTG, violence and stigma experience, and mental health problems like post-traumatic stress disorder (PTSD). The data were analyzed using descriptive statistics, correlation, multivariate regression, and a latent profile analysis. The results revealed that more than half of the participants had high scores on resilience (53.6%) and PTG (60.9%). The positive psychological changes, although independent of each other, were moderated by gender, and influenced by the negative experiences of participants such as stigma, violence, and PTSD. Latent profile analyses revealed three classes of participants, two of which were characterized by high scores on mental health problems and PTG. The clusters were invariant across gender. Surviving COVID-19 contributed to resilience and PTG. These can be targeted for intervention programs to mitigate the mental health burden occasioned by the pandemic.