PTSD prevalence and factors in intern nursing students after COVID-19 full liberalization in China: a cross-sectional study.

Objective: This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) and its influencing factors among intern nursing students after the full liberalization of the COVID-19 prevention and control policy in China. Methods: Participants completed the online survey from January 14 to January 19, 2023. A demographic questionnaire, COVID-19 and internship-related questionnaire, the Fear of COVID-19 scale, the Primary Care PTSD Screen, and the Connor-Davidson Resilience Scale were used to conduct the online survey. Results: Of 438 participants, 88.4% tested positive for COVID-19 in the last 6 months. The prevalence of fear, resilience, and PTSD was 16.9, 15.5, and 11.2%, respectively. Direct care of COVID patients in hospital (OR = 2.084, 95%CI 1.034 ~ 4.202), the experience of occupational exposure (OR = 2.856, 95%CI 1.436 ~ 5.681), working with an experienced team (OR = 2.120, 95%CI 1.070 ~ 4.198), and fear COVID-19 (OR = 8.269, 95%CI 4.150 ~ 16.479) were significantly and positively associated with PTSD in nursing internship students. Conclusion: After COVID-19 full liberalization in China, intern nursing students still experienced pandemic-related mental distress, which can bring PTSD. Adequate support and counseling should be provided, as needed, to intern nursing students who are about to enter the workforce and have experienced severe PTSD symptoms related to COVID-19. Our findings indicated that should understand the importance of screening, formulate intervention strategies and preventive measures to address psychosocial problems, and provide coping skills training to intern nursing students.

[The professional burnout of medical workers and its determining factors].

The study was carried out using survey technique applied to sampling of workers of the first three polyclinics of Moscow. The method was based on international questionnaire Maslach Burnout Inventory (MBI) that permitted to consider characteristics of activity of medical professionals. The analysis of results of study demonstrated that overall prevalence of burnout among doctors is 17%,among nursing personnel - 21%, among non-medical personnel - 19%. The average age of workers with professional burnout is 34-49 years. Among workers with burnout more than half of them had higher education and 30% had specialized secondary education. The workers consider as main factors of professional burnout necessity to spend most of working time at the computer (up to 92%), unrealistic expectations of patients from received medical care (up to 88%), deficiency of time for reception of patients and personal life. The majority of employees had an average (35%) and low (43%) level of reduction in personal achievements that testifies well-being of work environment. The conclusion is made that in polyclinic section of Moscow health care there are no serious conflicts in collectives and existing conflicts are within limits of working relationships.

Consistently increased dorsolateral prefrontal cortex activity during the exposure to acute stressors.

Stress has a major impact on our mental health. Nonetheless, it is still not fully understood how the human brain responds to ongoing stressful events. Here, we aimed to determine the cortical dynamics during the exposure to ecologically valid, standardized stressors. To this end, we conducted 3 experiments in which healthy participants underwent the Trier Social Stress Test (experiments 1 and 2) and the Socially Evaluated Cold Pressor Test (experiment 3) or a respective control manipulation, while we measured their cortical activity using functional near-infrared spectroscopy. Increases in salivary cortisol and subjective stress levels confirmed the successful stress induction in all experiments. Results of experiment 1 showed significantly increased cortical activity, in particular in the dorsolateral prefrontal cortex, during the exposure to the Trier Social Stress Test. Experiment 2 replicated this finding and showed further that this stress-related increase in dorsolateral prefrontal cortex activity was transient and limited to the period of the Trier Social Stress Test. Experiment 3 demonstrated the increased dorsolateral prefrontal cortex activity during the Socially Evaluated Cold Pressor Test, suggesting that this increase is generalizable and not specific to the Trier Social Stress Test. Together, these data show consistently that dorsolateral prefrontal cortex activity is not reduced, as commonly assumed, but increased under stress, which may promote coping with the ongoing stressor.

Mental Health and Quality of Life in Chronic Kidney Disease Patients with Mild-to-Moderate Depression: A Retrospective Cohort Study of Mindfulness-Based Stress Reduction Therapy.

BACKGROUND: Chronic kidney disease (CKD) patients may experience pessimism, and even despair, due to long-term nature of the condition, which increases the risk of depression. Mindfulness-based stress reduction (MBSR) can relieve depression. This retrospective cohort study aimed to investigate the effects of MBSR on mental health and quality of life in CKD patients with mild-to-moderate depression, so as to provide guidance for clinical nursing programs. METHODS: The clinical data of 100 CKD patients with mild-to-moderate depression who were treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences from January 2021 to March 2023 were retrospectively analyzed. Based on nursing method received, the patients were divided into the conventional group (conventional management) and the MBSR group (MBSR therapy was implemented in addition to conventional management). After matching, there were 35 cases in each group. The scores for the self-rating depression scale (SDS), Connor-Davidson Resilience Scale (CD-RISC), Five-factor Mindfulness Questionnaire (FFMQ), Pittsburgh Sleep Quality Index (PSQI), and 36-item Short Form Health Survey (SF-36) were compared between the two groups. RESULTS: After management, the SDS and PSQI scores of the MBSR group were lower than those of the conventional group, and the CD-RISC, FFMQ and SF-36 scores were higher than those of the conventional group (p < 0.05). CONCLUSION: MBSR can improve the mental health, sleep quality, and quality of life of CKD patients with mild-to-moderate depression, and improve psychological resilience and mindfulness.

Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren's syndromes patients - a cross-sectional study.

BACKGROUND: Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. METHODS: Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. RESULTS: The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8). CONCLUSIONS: Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

Physical manifestations of stress in women. Correlations between temporomandibular and pelvic floor disorders.

INTRODUCTION: Stress is characterized as a challenging occurrence that triggers a physiological and/or behavioral allostatic response, alongside the demands typically encountered throughout the natural course of life. A sustained state of stress gives rise to secondary effects, including insomnia and neck pain. Also, the risk of musculoskeletal problems in the cervical and lumbar spine can be increased due to a sustained state of stress. The present study main objective is to study the association between orofacial and pelvic floor muscles in women in Spain. METHODOLOGY: An observational, cross-sectional, retrospective analytical study was designed and carried out in the laboratories of the European University of Madrid. Sixty-five participants were recruited with a mean age of 29.9 ± 7.69. Measurements were taken by myotonometry on natural oscillation frequency (Hz), dynamic stiffness (N/m), elasticity (N/m2), mechanical stress relaxation time (ms) and creep, for the following muscles: right and left masseter, right and left temporalis and central fibrous nucleus of the perineum (CFPF). On the other hand, the subjects completed the following questionnaires: perceived stress scale (PSS-14), anxiety scale (STAI), self-reported bruxism questionnaire (CBA), Fonseca Anamnestic Index and the Pittsburgh Sleep Quality Scale (PSQI). RESULTS: Significant correlations were found in several parameters between the right temporalis and CFPF (p<0.05). Highlighting the correlation between TMDs and lubrication r = -0.254 (p = 0.041) and bruxism with pain in sexual intercourse r = 0.261 (p = 0.036). CONCLUSION: The results support the proposed hypothesis. To the author's knowledge, this is the first study which relates both locations, and it is suggested to continue with the research and expand the knowledge of it.

A cross-sectional study of university students' mental health and lifestyle practices amidst the COVID-19 pandemic.

OBJECTIVES: University students are regarded as the backbone of society, and their mental health during a pandemic may have a substantial impact on their performance and life outcomes. The purpose of this study was to assess university students' mental health, specifically depression, anxiety, and stress, during Lebanon's extended COVID-19 pandemic, as well as the sociodemographic factors and lifestyle practices associated with it. METHODS: An online anonymous survey assessed the rates of mental health problems during COVID-19, controlling for socio-demographics and other lifestyle practices, in 329 undergraduate and graduate university students. Instruments utilized were the Patient Health Questionnaire (PHQ-9) for depression, the Beck Anxiety Inventory (21-BAI) for anxiety, and the Perceived Stress Scale (PSS-10) for stress. The study employed descriptive statistics and multiple logistic regression models to analyze the association between depression, anxiety, and stress with sociodemographic and lifestyle factors. Results were evaluated using adjusted odds ratios and confidence intervals, with a significance level of 0.05. RESULTS: Moderate to severe rates of depression, anxiety and stress among students were reported by 75.9%, 72.2%, and 89.3%, respectively. The odds of anxiety and stress were higher among women compared to men. Students who used private counseling services had higher odds of anxiety and stress than those who did not. Overall rated health was a major predictor of depression and anxiety, with the "poor" and "fair" overall-reported health groups having higher odds than the "Excellent" group. When compared to those who did not smoke, students who increased their smoking intake had higher odds of depression, anxiety and stress. Students who reduced their alcohol consumption had lower odds of anxiety compared to those who did not consume alcohol. Students who reduced their physical activity had higher odds than those who increased it. Finally, students who slept fewer than seven hours daily had higher odds of depression than those who slept seven to nine hours. CONCLUSION: Our findings indicate a national student mental health crisis, with exceptionally high rates of moderate to severe depression, anxiety, and stress. Factors such as gender, university program, overall rated health, importance of religion in daily decisions, private counseling, smoking cigarettes, alcohol consumption, physical activity, and sleeping, were all found to have an impact on mental health outcomes. Our study highlights the need for university administrators and mental health professionals to consider targeted mental health programming for students, particularly for women and those with poor or fair overall perceived health.

Association between burnout and empathy in medical residents.

BACKGROUND: Burnout is a work-related syndrome that can affect physicians' performance. Empathy is one of the clinical competencies in whose formation many factors play a role. Empathy and burnout are important topics of research in medical sciences, and both are related to the communication between the patient and the physician. This study investigated the relationship between occupational burnout and empathy among medical residents. METHOD: This cross-sectional study was conducted on 297 medical residents in Ahvaz Jundishapur University of Medical Sciences from January to March 2021. The data collection tools were the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI). The reliability of the instruments was measured by calculating Cronbach's alpha. Data were analyzed by SPSS-18, using the Pearson correlation test and linear regression models. RESULTS: The average age of the study population was 33.06 ±4.7 years, with more than half being females (57.6%) and married (51.9%). The residents' mean scores of empathy and overall burnout were 102.87 out of 140 and 55.90 out of 132, respectively. The burnout scores showed an inverse correlation with the overall empathy scores (r = -0.123, P = 0.035), and the score of standing in the patient's shoes (r = -0.165, P = 0.004). Linear regression test was used to detect which dimension of empathy was a better predictor for the reduction of burnout scores. Results showed that the best predictor was standing in the patient's shoes (P = 0.014). CONCLUSION: The findings showed a negative association between empathy and burnout among medical residents, which suggests the need for adjustment of the existing burnout management at the institutional level. Therefore, residents should be supported by managers to reduce burnout and improve their empathic behavior.

Design and Validation of a Health Literacy Assessment Tool for COVID-19 Among Iranian Workers.

BACKGROUND: The workforce is an organization's most important asset, and ensuring their health and safety is crucial for achieving the organization's mission and goals. OBJECTIVE: The objective of this study was to design and validate a health literacy tool for COVID-19 among Iranian workers. METHODS: This cross-sectional study involved a total of 201 participants. A personal information questionnaire was administered, and The Health Literacy Assessment (HLA) Tool was used to collect data specifically related to COVID-19. The HLA for COVID-19 was designed and developed, and the validity of the tool was evaluated through face, content, convergent, and construct validity analyses. To examine convergent validity, the Perceived Stress Scale was used. The reliability of the questionnaire was assessed using internal consistency measures, such as Cronbach's alpha coefficient. KEY RESULTS: The mean content validity index was 0.93, indicating high content validity. Confirmatory factor analysis results supported the five-dimensional structure of the tool. Significant correlations were found between the HLA for COVID-19 and perceived stress levels. The Cronbach's alpha coefficient for all items was 0.84, indicating high internal consistency. CONCLUSION: The HLA for COVID-19 is a concise, reliable tool for measuring health literacy related to COVID-19 among Iranian workers. Assessing COVID-19 health literacy in this population can be useful in evaluating the effectiveness of government officials, the media, and the medical and scientific community in providing necessary information. [HLRP: Health Literacy Research and Practice. 2024;8(2):e62-e68.].

PLAIN LANGUAGE SUMMARY: The workforce is an organization's most important asset, and ensuring their health and safety is crucial for achieving the organization's mission and goals. The objective of this study was to design and validate a health literacy tool for COVID-19 among Iranian workers.The HLA for COVID-19 is a concise, reliable tool for measuring health literacy related to COVID-19 among Iranian workers. Assessing COVID-19 health literacy in this population can be useful in evaluating the effectiveness of government officials, the media, and the medical and scientific community in providing necessary information. Health literacy plays a crucial role in disease prevention, including the control of epidemics. It can be particularly valuable in empowering societies affected by crises like the COVID-19 pandemic, which has had a profound impact on all aspects of human life. In international studies focused on assessing health literacy during the pandemic, researchers utilized public health literacy scales. However, only one study developed a specific scale to evaluate people's health literacy concerning COVID-19.

Exploring coping strategies among caregivers of children who have survived paediatric cancer in Jordan.

OBJECTIVE: To explore the coping strategies of caregivers of children who have survived paediatric cancer in Jordan. MATERIALS AND METHODS: This study used a cross-sectional survey design and convenient sampling. The sample included 102 caregivers of children who have survived cancer, and outcome measures included the Arabic-translated Brief COPE, and caregiver and child demographic and condition questionnaire. Data analyses included descriptive statistics, analysis of frequencies, Spearman-rank order correlations and linear regression. RESULTS: Caregivers most frequently used religion coping (mean=6.42, SD=1.85), followed by acceptance (mean=5.95, SD=1.96) and planning (mean=5.05, SD=1.94). The least used coping strategies were humour (mean=2.98, SD=1.24) and behavioural disengagement as coping strategies (mean=3.01, SD=1.42). Having a female child predicted more self-distraction utilisation (ß=0.265, p=0.007). CONCLUSION: Caregivers of children who have survived cancer in Jordan frequently use passive coping strategies like religion and acceptance coping to overcome daily life stressors. Caregivers might benefit from psychosocial occupational therapy interventions to support their engagement in more active or problem-focused coping strategies.

Interaction between anxiety symptoms and decreased meaning in life: One possible pathway linking childhood trauma and depression- evidence from the network analysis.

BACKGROUND: Robust evidence suggests that individuals exposed to childhood trauma are more vulnerable to suffering from later depression. However, the pathway connecting the experience of childhood trauma and depression remains unclear. PARTICIPANTS AND SETTINGS: A total of 3663 participants from six colleges in China completed the Childhood Trauma Questionnaire-Short Form, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, and Multidimensional Existential Meaning Scale. Among all participants, 3115 (Mage = 19.20, SDage = 1.38, males = 1384) participants met the selective standard of suffering from childhood trauma and were divided into the traumatized depressed group (the DT group) (n = 1432, Mage = 19.26, males = 700) and traumatized non-depressed group (the UDT group) (n = 1683, Mage = 19.15, males = 684). METHODS: In the present study, we examined the comorbidity of anxiety and the facets of meaning in the life network model. We then calculated the bridge symptoms and compared the networks of the DT group and the UDT group. RESULTS: The results of the t-test showed that the DT group scored significantly higher on all symptoms of anxiety and significantly lower on all dimensions of meaning in life compared to the UDT group. Meanwhile, the strongest bridge exists between "Mattering" and "Restlessness" in the symptom network of the DT group, while there is no bridge in the symptom network of the UDT group. The result of NCT indicates that the global strength and the EI value of "Mattering" are significantly higher in the symptom network of the DT group than in the UDT group. CONCLUSION: Intervention targeting improving the self-esteem of individuals suffering from childhood trauma may help to alleviate their depression and anxiety symptoms.

Factors affecting nurses' emergency competencies in public health emergency: A cross-sectional study based on the stress-coping adaptation model.

OBJECTIVES: To investigate the factors associated with stress, resilience, coping styles, and emergency competencies when nurses are faced with a public health emergency. DESIGN: This study used a cross-sectional design. SAMPLE: Study data came from a survey of 646 nurses who were from a tertiary hospital in Southern China in March-June 2022. METHODS: Participants responded to self-report questionnaires through a web-based survey. Stress, resilience, emergency competencies, and response to public emergencies were assessed using the Perceived Stress Scale, Connor-Davidson Resilience Scale, the core competencies of nurses in public health emergencies, and a simplified coping style questionnaire. RESULTS: A total of 646 nurses participated in this study. Slightly over half of the participants were ≤30 years old, and almost all were female. Resilience, positive coping, and negative coping were positively correlated with emergency competencies. Multiple linear regression analysis demonstrated that resilience, working years, and participation in the treatment of infectious diseases were significant predictors of emergency competencies. CONCLUSION: The findings suggest that nurses require additional training in emergency management and clinical practice to enhance their emergency competencies. More interventions and social support should be provided to improve nurses' resilience and positive coping strategies when they encounter public health emergencies.

Age-related differences in the impact of resilience on mental health outcomes during the COVID-19 pandemic in Hong Kong.

OBJECTIVE: This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, particularly the COVID-19 pandemic. METHODS: Complete data of interest from two telephone surveys conducted in 2020 (n = 1182) and 2021 (n = 1108) were analysed. Participants self-reported depressive and anxiety symptoms using the Patient Health Questionnaire 4-item version (PHQ), psychotic-like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor-Davidson Resilience Scale 2-item version (CD-RISC-2). RESULTS: We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between-year differences. Resilience and age interaction effects were significant when comparing the high PHQ-high PQB group to the low PHQ-low PQB group only in 2021 but not in 2020. CONCLUSIONS: This study provides valuable insights into the impact of the COVID-19 pandemic on mental health in Hong Kong, emphasising the age-dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well-being and identify ways to enhance resilience among older individuals during public health crises.

[The relationship between mentalizing, attachment and perceived stress]. / A mentalizáció, a kötodés és az észlelt stressz kapcsolata.

OBJECTIVE: The literature suggests that mentalizing deficits, insecure attachment, and higher levels of perceived stress are closely linked, however, the association between these constructs has not yet been investigated among Hungarian adults. In our study, we investigated the relationship between mentalization, attachment and perceived stress in a non-clinical adult sample. METHODS: In our study, 255 adults completed the Reflective Functioning Questionnaire (RFQ-R-7), the Experiences in Close Relationships questionnaire (ECR-R-HU) and the Perceived Stress Scale (PSS) after informed consent. In our analysis, we tested two simple mediation models. The independent variables differed in the two analyses, in the first one we used the attachment anxiety subscale, while in the second one, we used the attachment avoidance subscale of the ECR-R-HU questionnaire. In both of our models, the perceived stress (PSS) was the dependent variable, while hypomentalization was the mediator (RFQ7). RESULTS: The models were found to be significant. The direct path between attachment anxiety and perceived stress (c' = 0.11, p < .001, ß = 0.29) and indirect path through hypomentalizig also proved to be significant (∑ab = 0.04 [0.02 - 0.06], ß = 0.10). The direct path between attachment avoidance and perceived stress was significant (c' = 0.05, p = 0.04, ß = 0.12), however, the indirect path between attachment avoidance and perceived stress was not significant (∑ab = -0.004 [-0.02 - 0.01], ß = -0.01). CONCLUSIONS: Our results - taking our limitations into account - suggest that hypomentalization has a mediational effect on the relationship between attachment anxiety and perceived stress, while attachment avoidance is directly related to perceived stress. Our results have important practical implications for prevention and intervention.

[The role of personal strengths in the relationship between adult attention-deficit/hyperactivity symptoms and perceived stress]. / A személyes erosségek szerepe a felnottkori figyelemhiányos/hiperaktivitás tünetek és az észlelt stressz kapcsolatában.

BACKGROUND/OBJECTIVES: David P. Bernstein's model of personal strengths was born out of the interaction of schema theory and positive psychology. According to Bernstein, the strengths of a healthy adult self can be described along four dimensions: self-directedness, self-regulation, connectedness, and transcendence. Previous research has shown that attention- deficit/hyperactivity disorder (ADHD) in adults is associated with higher levels of perceived stress, but the role of personal strengths in this context has not yet been investigated. The aim of our study was to explore the role of Bernstein's strength dimensions in the relationship between adult ADHD symptoms and perceived stress, using a dimensional approach in a non-clinical sample. METHOD: Our online questionnaire, which included the Bernstein Strengths Scale (BSS), the Adult ADHD Self-Report Scale (ASRS), and a shortened version of the Perceived Stress Scale (PSS4), was completed by 100 adults (mean age 38.25 years, standard deviation 5.73 years) after informed consent. RESULTS: In the bivariate analysis, the ASRS showed a significant negative association with the BSS dimensions, with a large effect size for self-regulation and a medium effect size for the other dimensions. On the other hand, the PSS4 scale showed significant negative correlations with all four strength dimensions, with effect sizes large for self-direction and self-regulation and medium for the connection and transcendence dimensions. Personal strengths mediated the relationship between ADHD symptoms and perceived stress. DISCUSSION: Our results suggest that ADHD symptoms may be associated with a deficit in personal strengths, which may contribute to negative outcomes. Psychotherapeutic interventions that support the recognition, cultivation and mobilization of strengths may be useful in the treatment of adults diagnosed with ADHD.

[Summary Examining the relationship between mentalisation, attachment, and resilience in an adult sample]. / A mentalizáció, a kötodés és a reziliencia kapcsolata felnottek körében.

OBJECTIVE: We investigated the relationship between mentalisation, attachment and resilience in an adult sample. METHOD: 225 people completed the Reflective Function Questionnaire (RFQ-H), the Experiences in Close Relationships Questionnaire (ECR-R-HU), and the Connor-Davidson Resilience Questionnaire (CD-RISC) in our non-clinical study after informed consent. The analysis was controlled for gender of the respondents. RESULTS: The models were found to be significant in the mediator analysis. The path between attachment total score and hypomentalisation was significant (a=2.88, p<0.01, ß=0.32). The direct path between attachment total score and resilience was found to be significant (c'=-2.00, p<0.001, ß=-0.28). The relationship between hypomentalisation and resilience was also significant (b=-0.30, p<0.01, ß=-0.38). The indirect pathway between attachment and resilience through hypomentalisation was found to be significant (∑ab=-0.87 [-1.41 - -0.40], ß = 0.12). Thus, a high total attachment score through higher levels of hypomentalisation predicts lower resilience. Based on the standardized regression coefficients, hypomentalisation was the strongest predictor of resilience, and attachment was more strongly associated with resilience via direct than indirect means via hypomentalisation. CONCLUSIONS: Our results suggest - considering the limitations of our research - that attachment is related to resilience through mentalisation, and that mentalisation itself is a strong predictor of resilience. The practical implication of our results is that the use of mentalisation-based methods may be worth considering for individuals with lower levels of resilience.

Coping strategies and psychological distress among mothers during COVID-19 pandemic: The moderating role of social support.

The Indonesian government implemented a large-scale social restriction policy as part of the efforts to tackle the COVID-19 pandemic. This policy impacted the population, including mothers, and caused considerable psychological distress. Individual efforts to cope (avoidant and approach coping strategies) and support from significant persons might help handle the distress experienced by mothers. The purpose of this empirical study is to investigate the effect of individual coping strategies on psychological distress and the moderating role of social support among Indonesian mothers. An online survey was administered from 20th to 25th April 2020 to 1534 Indonesian mothers (Mean age 37.12 years; SD 6.63). Brief COPE (28 items), Depression Anxiety Stress Scale/DASS (18 items), and the Multidimensional Scale of Perceived Social Support/MSPSS (12 items) were used to measure coping strategies, psychological distress, and social support, respectively. IBM SPSS 24 software was used to analyze the data. The result showed that moderate and high levels of social support moderated the relationship between approach coping strategies and psychological distress (B = .041, CI .007-.075). When the mother uses approach coping, her psychological distress will decrease further whenever she receives moderate and high level social support. Any level of social support moderated the relationship between avoidant coping and psychological distress (B = -.100, CI -.138-.061). When mother used avoidant coping, her social support at any level served as buffer to her psychological distress. It can be concluded that mothers need to prioritize implementing approach coping strategies to lower their distress. Those who practiced avoidant coping strategies needed social support from their significant persons to decrease their distress.

Virtual reality to reduce periprocedural anxiety during invasive coronary angiography: rationale and design of the VR InCard trial.

INTRODUCTION: Patients undergoing invasive coronary angiography (ICA) experience anxiety due to various reasons. Procedural anxiety can lead to physiological and psychological complications, compromising patient comfort and overall procedural outcomes. Benzodiazepines are commonly used to reduce periprocedural anxiety, although the effect is modest. Virtual reality (VR) is a promising non-pharmacological intervention to reduce anxiety in patients undergoing ICA. METHODS AND ANALYSIS: A single-centre open-label randomised controlled trial is conducted assessing the effectiveness of add-on VR therapy on anxiety in 100 patients undergoing ICA and experiencing anxiety in a periprocedural setting. The primary outcome is the Numeric Rating Scale (NRS) anxiety score measured just before obtaining arterial access. Secondary outcomes include postarterial puncture and postprocedural anxiety, patient-reported outcome measures (PROMs) of anxiety and physiological measurements associated with anxiety. The NRS anxiety level and physiological measurements are assessed five times during the procedure. The PROM State-Trait Anxiety Inventory and Perceived Stress Scale are completed preprocedure, and the PROM STAI and the Igroup Presence Questionnaire are performed postprocedure. ETHICS AND DISSEMINATION: The protocol of this study has been approved by the Research Ethics Committee of the Radboud University Medical Centre, the Netherlands (CMO Arnhem-Nijmegen, 2023-16586). Informed consent is obtained from all patients. The trial is conducted according to the principles of the Helsinki Declaration and in accordance with Dutch guidelines, regulations, and acts (Medical Research involving Human Subjects Act, WMO). REGISTRATION DETAILS: Trial registration number: NCT06215456.

Resilience and mindfulness among radiological personnel in Norway, their relationship and their impact on quality and safety- a questionnaire study.

BACKGROUND: Stress and burnout are widespread problems among radiological personnel Individual and organizational resilience and mindfulness offer protection against burnout. AIM: To investigate the level of resilience and mindfulness among radiological personnel, the associations between organizational resilience, individual resilience, and mindfulness, and how these factors impact the quality of care provided in radiological departments. METHODS: An online questionnaire consisting of the Connor-Davidson Resilience Scale, the Mindful Attention Awareness Scale, the Benchmark Resilience Tool, and questions regarding burnout, and quality and safety was used. Data analysis consisted of descriptive statistics, bivariate correlation and standard multiple regression. RESULTS AND CONCLUSION: Few participants considered burnout a significant challenge. Individual and organizational resilience were low (30.40 ± 4.92 and 63.21 ± 13.63 respectively), and mindfulness was high (4.29 ± 0.88). There was a significant correlation between individual and organizational resilience (p = 0.004), between individual resilience and mindfulness (p = 0.03), and between organizational resilience and mindfulness (p = 0.02). Individual and organizational resilience affect each other. However; neither significantly affect quality and safety, nor mindfulness.