Experiences of family caregivers in dealing with cases of advanced breast cancer: a qualitative study of the sociocultural context in Punjab, Pakistan.

BACKGROUND: Patients with advanced breast cancer require consistent help and support from family caregivers. These caregivers often endure financial burdens and psychological stress, with their experiences significantly influenced by sociocultural factors. This study aims to explore the experiences of family caregivers of advanced breast cancer patients in Punjab province, Pakistan. METHODS: Data was collected through in-depth interviews with fifteen family caregivers of advanced breast cancer patients in three major cities of Punjab, Pakistan. Caregivers, who had been in close contact with the patient for the last two years, were purposively sampled from five major hospitals. The data was analyzed using thematic analysis. RESULTS: The study revealed that the experiences of family caregivers are deeply rooted in the sociocultural context. Key themes identified include social responsibility and cultural reciprocity norms; limited awareness and mobility options for caregivers; financial responsibility and strain; impacts of beauty myths and shyness on caregiving attitudes and decisions; the stressful and emotional nature of caregiving; treatment perspectives influenced by social groups; challenges in consulting male physicians and associated stigma; the role of religious beliefs in caregiving; and stress management, with religion often being a coping mechanism. These factors can contribute to delayed treatment decisions for patients. CONCLUSIONS: Family caregivers are crucial in facilitating timely treatment decisions for advanced breast cancer patients in the Pakistani context. To minimize treatment delays and alleviate caregiver stress, addressing sociocultural barriers in care-seeking is essential. A tailored approach, considering sociocultural and religious factors, is imperative for the management and early diagnosis of breast cancer, necessitating appropriate policymaking and implementation.

Aetiology, Diagnosis and Treatment of Arterial Occlusions of the Retina-A Narrative Review.

Arterial occlusions of the retina are potentially sight-threatening diseases which often result in profound visual loss. The aim of this narrative review is to provide an overview of the aetiology, discuss major risk factors, describe the management and systemic assessments and evaluate existing therapies. For this review, an extensive literature search in PubMed was performed. Emboli from the heart or the carotid arteries can cause ophthalmic artery occlusion (OAO), central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). Most patients with arterial occlusions have vascular risk factors such as arterial hypertension, hyperhomocysteinaemia, carotid stenosis and atrial fibrillation, which also increase the risk of cerebral stroke and myocardial infarction. Therapies such as ocular massage, thrombolysis and anterior chamber paracentesis have been suggested but are still equivocal. However, it is evident that retinal artery occlusion should be immediately treated and accompanied by interdisciplinary collaboration, since early diagnosis and the proper treatment of possible risk factors are important to reduce the risk of further damage, recurrences, other vascular diseases and mortality.

[How much digital public health is in public health degree programs? A systematic analysis of module handbooks in German full-time study programs at public colleges and universities]. / Wie viel Digital Public Health steckt in Public-Health-Studiengängen? Eine systematische Modulhandbuchanalyse von Vollzeitstudiengängen an öffentlichen Hochschulen und Universitäten in Deutschland.

BACKGROUND: Professionals, especially in the field of digital public health (DiPH), are crucial for a successful digital transformation in social and health care. However, it is still unclear to what extent academic professionals are taught DiPH-related content in their public health (PH) studies. METHODS: This study used a systematic module handbook analysis to analyze accredited full-time PH-oriented degree programs at public colleges and universities in Germany for DiPH-related module content. Through the "Hochschulkompass" platform and the member programs of the German Public Health Association (DGPH), 422 programs were identified. Included module handbooks were evaluated by content analysis using MAXQDA. RESULTS: Only 10 bachelor and 6 master programs contain DiPH. They are heterogeneous in their focus and belong to different subfields of public health ("methods, definition, history, and social medicine" = 5; "health management" = 5; "digital health" = 3; "health services research" = 2; "health communication" = 1). Differences were found between the common understanding of DiPH in academia and the content in the module handbooks. The content identified in the analysis focuses mainly on technical areas. Social and health science content is only marginally present. DISCUSSION: The heterogeneous study programs with a connection to DiPH allow academic PH specialists to develop specific profiles. To achieve comprehensive competencies in DiPH, there is a need for further development of modules with relevance to the respective degree program. The results could be used for the (further) development of relevant modules and a core curriculum in DiPH.

Exploring the reasons for defaulting from childhood immunization: a qualitative study in Pakistan.

BACKGROUND: Childhood vaccination is widely recognized as the most effective means to prevent various diseases. However, a considerable amount of children still miss out on their vaccination schedules. Therefore, this study explores the reasons for defaulting from the expanded program on immunization in district Swat, Pakistan. METHODS: A qualitative phenomenological approach was used. Data collection took place from March to September 2022. Thirty-six in-depth interviews were conducted with participants who had defaulter children. The collected qualitative data were analysed thematically to identify key patterns and themes related to the reasons for defaulting from childhood vaccination schedules. RESULTS: Six themes emerged, i.e., illness of the defaulter child at the scheduled time, perceived side effects of the vaccination, factors related to caregivers, myths and misconceptions, vaccinators attitudes and crowed vaccination centres, as well as poor immunization service arrangements. Four subthemes arose related to caregivers, such as lack of clear understanding about completion of vaccination, least priority for child's vaccination, cultural restriction on mothers, and the loss of vaccination card. CONCLUSION: According to the study's findings, caregivers have their own perceptions regarding the non-completion of their children's vaccination schedule. The childhood immunization defaulting arises from various factors including child illness, Adverse Events Following Immunization (AEFIs) concerns, misconceptions, improper injection techniques, and negative vaccinator attitudes. The vaccination completion rate may be increased if the concerns of the caregivers are appropriately addressed.

[Participation in primary care research - From the idea to the constitution of a citizens advisory board]. / Partizipation in der allgemeinmedizinischen Forschung ­ Von der Idee bis zur Gründung eines Bürger*innenbeirats.

INTRODUCTION: Public participation in research processes is becoming increasingly important and is justified with positive effects for research. The first successful initiatives can also be found in general practice and health services research. The transparent presentation of these projects is essential to the discussion about participation. The aim of this article is to present and discuss the conception and implementation of the initiative at the Institute of General Practice and Health Services Research at the Technical University of Munich and the kick-off event for the participation of patients, citizens and patient representatives. METHODS: This article reports the planning, recruitment, implementation, and evaluation of the kick-off event. Frameworks for future events are described. RESULTS: In total, twelve persons were recruited through various recruitment channels to participate in the kick-off event. The participants showed a diverse structure of motives with regard to participation in research. All participants shared the essential goal of improving research and care by adding their perspectives to research processes. However, the specific opportunities for participation and the role of patients and citizens in research processes were unclear. During the event, future workshops were planned to address these challenges. The focus was on strengthening relationships and communicating the basics of primary care research in order to enable sustainable participation. DISCUSSION: The participants' different motivations resulted in the need to explore the concrete possibilities of participation. One of the specific requirements was to focus on role identification and the structure of the initiative. The question of self-description and -identification as a patient and/or citizen seemed crucial. Furthermore, a concise introduction to the topic of participation in research processes, as well as patient and citizen qualifications, is considered necessary. CONCLUSION: Establishing an advisory board for patients and citizens in primary care research is associated with specific requirements. In addition to fundamental necessities such as the joint clarification of the possibilities of participation, defining the role and establishing the identity of the initiative should be promoted.

[Analysing the Need for Long-Term Care: Potential of Data from Long-Term Care Assessments of the Bavarian Medical Service for Public Health Research and Practice]. / Pflegebedürftigkeit analysieren ­ Potential der Daten aus Pflegebegutachtungen des Medizinischen Dienstes Bayern für Public Health-Forschung und -Praxis.

BACKGROUND: Despite demographic changes, there is still no systematic and comparable differentiation of nursing care reporting on a small-scale level in Germany, where outpatient long-term care is depicted. This article presents findings of care assessment data of the Medical Service of Bavaria and draws conclusions for future reporting on nursing. METHODS: For the analysis, anonymised initial long-term care assessments of the Bavarian Medical Service of 2019 were evaluated exemplarily using descriptive methods. The study describes the characteristics of persons with a care level recommendation, the distribution of care level categories, medical diagnoses and degree of independence in the areas of life. RESULTS: The persons assessed were on average 80 years old. At the time of the initial assessment, the largest proportion of persons with an assigned care level lived in an outpatient setting. Care level (PG) 1 (slight impairment of independence or abilities) was assigned to 35.1% of the insured, PG 2 (considerable impairment) to 43.1%, PG 3 (severe impairment) to 16.6%, PG 4 and 5 (most severe impairment) were each rarely assigned at the time of the initial assessment (3.9% and 1.4%, respectively). Medical diagnoses were dominated by gait and mobility disorders, unspecified dementia, heart failure and senility. In particular, there were impairments in the areas of 'mobility' and 'organisation of everyday life and social contacts'. CONCLUSIONS: The data available from the German Medical Service may be highly relevant to health research and policy and may provide a basis for planning interventions in long-term care.

Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: a scoping review.

BACKGROUND: Though still a young field of research, gamified digital interventions have demonstrated potential in exerting a favourable impact on health and overall well-being. With the increasing use of the internet and digital devices, the integration of game elements presents novel opportunities for preventing mental disorders and enhancing mental health. Hence, this review aims to assess the effectiveness of gamified interventions focusing on preventing mental disorders or promoting mental health among adults. METHODS: Based on a scoping review across four databases (MEDLINE, Embase, PsycInfo and Web of Science), 7,953 studies were initially identified. After removing duplicates and screening titles, abstracts and full texts, 16 studies were identified as suitable for inclusion in a narrative synthesis of findings. We included interventional studies encompassing an intervention and a control group aiming to investigate the effectiveness of the use of gamified digital mental health interventions and the use of gamified digital elements. RESULTS: Overall, positive effects of gamified interventions on mental health-related outcomes were identified. In particular, beneficial consequences for psychological well-being and depressive symptoms were observed in all studies. However, further outcomes, such as resilience, anxiety, stress or satisfaction with life, showed heterogenous findings. Most game elements used were reward, sensation and progress, whilst the quantity of elements was not consistent and, therefore, no substantiated conclusion regarding the (optimal) quantity or composition of game elements can be drawn. Further, the outcomes, measurements and analyses differed greatly between the 16 included studies making comparisons difficult. CONCLUSION: In summary, this review demonstrates the potential of integrating digital game elements on mental health and well-being with still a great gap of research. A taxonomy is needed to adequately address relevant game elements in the field of mental health promotion and prevention of mental disorders. Therefore, future studies should explicitly focus on the mechanisms of effect and apply rigorous study designs.

Comparison of physical activity levels and dietary habits between women with polycystic ovarian syndrome and healthy controls of reproductive age: a case-control study.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a reproductive hormonal anomaly prevalent among women of reproductive age, with an alarmingly high prevalence of 52% among Pakistani women. This study aims to compare the daily physical activity and dietary habits of women with PCOS with age-matched healthy controls living in Lahore, Pakistan. METHODS: A case-control study design was used to collect data from a private hospital situated in Lahore, Pakistan. Data was collected from 115 participants of reproductive age (18-45 years) using a researcher-administered questionnaire. Demographic variables, reproductive characteristics, anthropometric measurements, and seven days of physical activity levels using the international physical activity questionnaire (IPAQ-Short version) and seven days of dietary intake using the food frequency questionnaire (7 days-FFQ) were used to measure the dietary habits of the participants. Mosby's Nutritac v4.0 software was used to estimate the macronutrients, vitamins, and minerals present in dietary intake. The glycaemic index and glycaemic load were calculated to compare the quality and quantity of carbohydrate consumption between the two groups. RESULTS: The 49 PCOS cases, newly identified using the Rotterdam criteria, mean age 24.63 years (SD ± 4.76), and 66 healthy controls, mean age 23.24 years (SD ± 5.45), were compared. A significant difference (p ≤ 0.05) was found for reproductive characteristics, daily physical activity, and polyunsaturated fat and vitamin intake between the two groups. A binary logistic regression analysis showed that food with a low glycaemic index (GI ≤ 40) reduced the odds of PCOS occurrence by OR = 1.94. Similarly, food nutrients with a low glycaemic load (GL ≤ 10) can reduce PCOS occurrence by OR = 1.60. CONCLUSION: The daily physical activity levels and dietary habits of women of reproductive age can influence their reproductive characteristics and polycystic ovarian morphology. A diet with a low glycaemic load and index can produce beneficial reproductive health effects among women of reproductive age.

Application of the Boruta algorithm to assess the multidimensional determinants of malnutrition among children under five years living in southern Punjab, Pakistan.

BACKGROUND: Malnutrition causes nutrient deficiencies that have both physical and clinical consequences in severe acute malnutrition children. Globally, there were 47 million wasted children under the age of five in 2019. One in four were located in sub-Saharan Africa, with half being in South Asia. This study aims to apply the Boruta algorithm to identify the determinants of undernutrition among children under five living in Dera Ghazi Khan, one of the marginalized districts of densely populated Punjab Province in Pakistan. METHODS: A multicenter cross-sectional study design was used to collect data from 185 children with severe acute malnutrition aged under five years visiting the OTPs centers located in Dera Ghazi Khan, Punjab, Pakistan. A purposive sampling technique was used to collect data using a pretested structured questionnaire from parents/caregivers regarding family sociodemographic characteristics, child nutrition, and biological and healthcare characteristics. Anthropometric measurements, including height, weight, and mid-upper arm circumference, were collected. The Boruta models were used to incorporate the children's anthropometric, nutritional, and household factors to determine the important predictive variables for undernutrition using the Boruta package in R studio. RESULTS: This study included 185 children, with a mean age of 15.36 ± 10.23 months and an MUAC of 10.19 ± 0.96 cm. The Boruta analysis identifies age, mid-upper arm circumference, weaning practices, and immunization status as important predictors of undernutrition. Income per month, exclusive breastfeeding, and immunization status were found to be key factors of undernutrition in children under the age of five. CONCLUSION: This study highlights age, mid-upper arm circumference, weaning practices, and immunization status as key determinants of weight-for-height and weight-for-age in children under five years. It also suggests that economic context may influence undernutrition. The findings can guide targeted strategies for combating undernutrition.

Radiological age assessment based on clavicle ossification in CT: enhanced accuracy through deep learning.

BACKGROUND: Radiological age assessment using reference studies is inherently limited in accuracy due to a finite number of assignable skeletal maturation stages. To overcome this limitation, we present a deep learning approach for continuous age assessment based on clavicle ossification in computed tomography (CT). METHODS: Thoracic CT scans were retrospectively collected from the picture archiving and communication system. Individuals aged 15.0 to 30.0 years examined in routine clinical practice were included. All scans were automatically cropped around the medial clavicular epiphyseal cartilages. A deep learning model was trained to predict a person's chronological age based on these scans. Performance was evaluated using mean absolute error (MAE). Model performance was compared to an optimistic human reader performance estimate for an established reference study method. RESULTS: The deep learning model was trained on 4,400 scans of 1,935 patients (training set: mean age = 24.2 years ± 4.0, 1132 female) and evaluated on 300 scans of 300 patients with a balanced age and sex distribution (test set: mean age = 22.5 years ± 4.4, 150 female). Model MAE was 1.65 years, and the highest absolute error was 6.40 years for females and 7.32 years for males. However, performance could be attributed to norm-variants or pathologic disorders. Human reader estimate MAE was 1.84 years and the highest absolute error was 3.40 years for females and 3.78 years for males. CONCLUSIONS: We present a deep learning approach for continuous age predictions using CT volumes highlighting the medial clavicular epiphyseal cartilage with performance comparable to the human reader estimate.

Interhemispheric transfer time correlates with white matter integrity of the corpus callosum in healthy older adults.

The corpus callosum (CC) has been identified as an important structure in the context of cognitive aging (Fling et al., 2011). Interhemispheric transfer time (IHTT) is regularly used in order to estimate interhemispheric integration enabled by the CC (Marzi, 2010; Nowicka and Tacikowski, 2011). However, only little is known with regards to the relationship between IHTT and the structural properties of the CC with only few studies with specific samples and methods available (Whitford et al., 2011). Thus, the present study aimed at investigating this relationship applying an event-related potentials (ERP) based approach of estimating IHTT as well as diffusion weighted imaging (DWI) with fractional anisotropy (FA) as an indicator of white matter integrity (WMI) of the genu, corpus and splenium of the CC. 56 healthy older adults performed a Dimond Task while ERPs were recorded and underwent DWI scanning. IHTT derived from posterior electrode sites correlated significantly with FA of the splenium (r = -0.286*, p = .03) but not the corpus (r = -0.187, p = .08) or genu (r = -0.189, p = .18). The present results support the notion that IHTT is related to WMI of the posterior CC. It may be concluded that ERP based IHTT is a suitable indicator of CC structure and function, however, likely specific to the interhemispheric transfer of visual information. Future studies may wish to confirm these findings in a more divers sample further exploring the precise interrelation between IHTT and structural or functional properties of the CC.

Illustration of association between change in prostate-specific antigen (PSA) values and time to tumor status after treatment for prostate cancer patients: a joint modelling approach.

BACKGROUND: Prostate cancer (PCa) is the most prevalent tumor in men, and Prostate-Specific Antigen (PSA) serves as the primary marker for diagnosis, recurrence, and disease-free status. PSA levels post-treatment guide physicians in gauging disease progression and tumor status (low or high). Clinical follow-up relies on monitoring PSA over time, forming the basis for dynamic prediction. Our study proposes a joint model of longitudinal PSA and time to tumor shrinkage, incorporating baseline variables. The research aims to assess tumor status post-treatment for dynamic prediction, utilizing joint assessment of PSA measurements and time to tumor status. METHODS: We propose a joint model for longitudinal PSA and time to tumor shrinkage, taking into account baseline BMI and post-treatment factors, including external beam radiation therapy (EBRT), androgen deprivation therapy (ADT), prostatectomy, and various combinations of these interventions. The model employs a mixed-effect sub-model for longitudinal PSA and an event time sub-model for tumor shrinkage. RESULTS: Results emphasize the significance of baseline factors in understanding the relationship between PSA trajectories and tumor status. Patients with low tumor status consistently exhibit low PSA values, decreasing exponentially within one month post-treatment. The correlation between PSA levels and tumor shrinkage is evident, with the considered factors proving to be significant in both sub-models. CONCLUSIONS: Compared to other treatment options, ADT is the most effective in achieving a low tumor status, as evidenced by a decrease in PSA levels after months of treatment. Patients with an increased BMI were more likely to attain a low tumor status. The research enhances dynamic prediction for PCa patients, utilizing joint analysis of PSA and time to tumor shrinkage post-treatment. The developed model facilitates more effective and personalized decision-making in PCa care.

[Participatory Design of Health Technologies - Challenges and Requirements for Action from the Perspective of Health Services Research]. / Partizipatives Design im Kontext gesundheitsbezogener Technologien ­ Herausforderungen und Handlungserfordernisse aus Perspektive der Versorgungsforschung.

The use of participatory design (PD) provides a framework for involving users in the process of developing healthcare technologies. Within PD, theoretical and methodological decisions need to be made. However, these decisions are often not adequately described or justified. This can lead to limited interpretability of the results. This paper has three objectives: First, to provide an overview of the key theoretical and methodological decisions that must be made in PD from the perspective of health services research; second, to describe the associated challenges and third, to describe action requirements for the future development of PD in health services research.

[Implementation of fall sensors in long-term care : An interview study to identify promoting and inhibiting factors from the perspective of professional caregivers]. / Implementation einer Sturzsensorik in der Langzeitpflege : Eine Interviewstudie zur Betrachtung fördernder und hemmender Faktoren aus Sicht professionell Pflegender.

BACKGROUND AND OBJECTIVE: Digital support systems are becoming increasingly more important in long-term inpatient care facilities. Welfare technologies have the potential to make a valuable contribution to maintaining independence in advanced age. At the same time the technologies can support professional caregivers. The aim of the study was to describe the expectations and experiences with a new technology, using the example of a fall sensor system, from the perspective of professional caregivers. METHOD: We used a qualitative design with semistructured interviews in two long-term inpatient care facilities. In one facility, three individual interviews took place, while in the other long-term care facility, a group interview with three nursing professionals was conducted. Additionally, one individual interview was conducted with a person in a leadership role in each facility. The time from implementation of the fall sensors to the interviews was between 1 and 3 months. Data were analyzed using qualitative content analysis in MAXQDA. RESULTS AND DISCUSSION: The study demonstrated that there was a correspondence between expectations of and retrospective experiences with the new technology among professional nurses. The main facilitating factors of the implementation that were identified were timely information about the risk of falling or a fall that has occurred, maintenance of residents' autonomy and freedom of movement as well as the enhancement of the sense of security among nursing professionals and the associated psychological relief effect. The inhibiting factors of the implementation were compulsory presetting, false alarms and faulty handling of the technology due to missing knowledge.

Relationship of stunting with water, sanitation, and hygiene (WASH) practices among children under the age of five: a cross-sectional study in Southern Punjab, Pakistan.

BACKGROUND: Reasons for undernutrition are food insufficiency, impaired child care, limited access to healthcare, and maternal lack of health literacy. In addition, there are several environmental factors, such as drinking water quality, poor sanitation, and hygienic practices that can lead to poor nutritional status in children. The present study aimed to compare household-associated risk factors, including water, sanitation, and hygiene (WASH) practices of mothers, with children's stunting under the age of five. METHODS: A face-to-face cross-sectional survey was conducted with mothers of children under the age of five in the Dera Ghazi Khan district in southern Punjab, Pakistan. World Health Organization criteria for stunting were used to identify the participants. A sociodemographic questionnaire was used to collect information from consented parents/guardians on children's age, feeding, and WASH practices. Pearson's chi-square, simple regression, and hierarchical regression models were applied for data analysis. RESULTS: A total of 204 mothers of children of both genders participated in this study. The children's mean (SD) age was 15.67 (± 10.2) months, their weight was 5.44 (± 1.45) kg, their height was 67.69 (± 10.05), and their mid-upper arm circumference was 9.75 (± 1.30) cm. Children's stunting was mild (z-score > -2) at 17.6%, moderate (z-score - 2 to -3) at 16.7%, and severe (z-score < -3) at 65.7% of participants. A simple regression model showed a strong association, r2 = 0.062, p = 0.013, with age as the most significant sociodemographic factor. The hierarchical regression model showed a combined value of r2 = 0.0128, p = 0.027, with hand pump and tank water as the significant source of drinking water that was related to stunting among children. CONCLUSION: Stunting can be associated with several risk factors, including WASH parameters. This study concluded that children aged under five years are susceptible to stunting in southern Punjab, Pakistan. The contamination of hand pumps and tank water resources was found to be the major contributing factor to stunting.

[Sociotechnical innovations for caring communities : Conditions for success in participatory and integrative technology development]. / Soziotechnische Innovationen für Sorgegemeinschaften : Gelingensbedingungen für partizipative und integrative Technikentwicklung.

The increasing need for nursing support in the home environment is accompanied by a decline in the willingness and possibilities for family care (among other things, due to social fragmentation and individualization). New forms of social support networks (caring communities) are therefore needed in which professional players collaborate together with informal caregivers and volunteer helpers. In this context, digitalization can be an instrument that can support the design and coordination of care arrangements for older people at the sociospatial level; however, a fundamental prerequisite is that the corresponding technologies are developed in a participatory manner and integrated into existing structures. This means not only that the needs and requirements of future users are comprehensively included in the developmental process but also that they become active co-decision makers. Furthermore, the developed technology should be oriented to established care structures and sociospatial conditions. This conceptual contribution addresses these two requirements and uses a concrete case study from a participatory technology development project to show how sociotechnical innovations for and with caring communities can be developed, implemented and made usable in such a way that they become sustainably effective.

Development and validation of the Post-Pandemic Fear of Viral Disease scale and its relationship with general anxiety disorder: a cross-sectional survey from Pakistan.

BACKGROUND: Given the worldwide reach of COVID-19, media coverage has amplified the psychological and social effects of this pandemic causing a widespread fear. Despite substantial research on the short-term psychological impact of COVID-19, its long-term consequences on mental health remain relatively unexplored. This research aims to develop and validate a Post-Pandemic Fear of Viral Disease (PPFVD) scale and to see its relationship with general anxiety disorder among the Pakistani population. METHODS: A cross-sectional online-based survey was conducted with 457 respondents in August and September 2022. We adopted the modified fear of coronavirus scale (FCV-19 S) consisting of seven items and the Generalized Anxiety Disorder (GAD) questionnaire to measure anxiety disorder. Confirmatory factor analysis was applied using the maximum likelihood estimation method. Scale dimensions and item reliability were tested for their validity and goodness of fit. SPSS and AMOS were used for data management and analyses. RESULTS: All inter-item correlations were found to be significant and ranged between 0.30 and 0.70. The value of Cronbach's alpha was 0.887, indicating good reliability. Corrected item-total correlations ranged between 0.632 and 0.754. Factor loadings ranged from 0.664 to 0.810, indicating a good internal consistency. Overall, these results clearly demonstrate that the one-factor solution model for PPFVD presents a good fit to the data. The composite reliability (CR = 0.747) was also good. CONCLUSIONS: The COVID-19 pandemic has negatively affected the mental health of people globally. This measurement scale can be trusted and used to test the PPFVD in the post-pandemic situation. Prospective research might validate this instrument in newly emerging scenarios and test it with diverse ethnic groups.