Academic Burnout, Family Functionality, Perceived Social Support and Coping among Graduate Students during the COVID-19 Pandemic.

Academic burnout and the COVID-19 pandemic have greatly impacted the academic life and mental health of graduate students. This study aims to address the mental health issue in graduate students by relating it to family functionality, perceived social support, and coping with academic burnout during the COVID-19 pandemic. Data were gathered from a cross-sectional study with 519 graduate students across universities in Hungary and other European countries. The Copenhagen Burnout Inventory Student, Family APGAR Index, the brief form of the Perceived Social Support Questionnaire, and the Brief Resilient Coping Scale were used to measure academic burnout, family functionality, perceived social support, and coping, respectively. Structural equations modeling was used for statistical analysis. The results revealed a negative effect of family functionality, perceived social support, and coping on academic burnout. The inverse relationship between perceived social support and the Copenhagen Burnout Inventory was identified, and mediated by coping and family functionality. These findings may offer patterns and predictors for future graduate students and higher-education institutions to identify outside factors that are implicated in academic burnout, especially in outbreaks such as the COVID-19 pandemic.

Academic burnout among master and doctoral students during the COVID-19 pandemic.

The COVID-19 outbreak has had an immense impact on academic life and public health. Graduate students had experienced obligatory curfews and quarantines due to the COVID-19 outbreak directly impacting their mental health and triggering academic burnout. In this cross-sectional study, we address the issue of mental health in graduate students by relating it to the factors associated with burnout syndrome during the COVID-19 pandemic. A total of 519 graduate students from master's and Ph.D./DLA degrees across universities in Hungary and other European countries participated in this study. The Copenhagen burnout inventory student version was used to evaluate burnout syndrome as an outcome. Our findings displayed burnout significantly lower among graduate students who had good sleep quality, receive high levels of support from their university, and were satisfied with how their university dealt with the pandemic. The excessive consumption of alcohol, the use of antidepressants, being single, and thinking about dropping out showed as predictive factors of burnout. The results add to emergent evidence on the impact of the COVID-19 pandemic on mental health and the predicted factors of academic burnout among master and doctoral students.

Country-level mentoring for advanced practice nursing: A case study.

AIM: To describe the mentoring process between the ICN Advanced Practice Nurse Network practice subgroup and the University of Pécs to support the emerging advanced practice role in Hungary, and explore the creation of a mentoring algorithm for faculty and other key stakeholders worldwide who wish to develop advanced practice nursing programs. BACKGROUND: Advanced practice nurses provide comprehensive clinical care and expand access to care in more than 70 countries. In March of 2017, a representative of the Faculty of Health Sciences of the University of Pécs requested assistance in curricula development for the inaugural advanced practice nursing program in Hungary. METHODS: A mixed-methods single case study was undertaken. The sources of evidence include interviews, e-mails, review of the literature, and related documents. Qualitative data were analyzed for content, and frequencies were calculated for quantitative indicators. FINDINGS AND DISCUSSION: The findings highlight the importance of clear communication, development of shared goals, and determination to see the project through. Enriching information was provided by colleagues from diverse global settings. Credibility was gained in Hungary from the support of national and international experts. CONCLUSION: The mentoring foundation and process facilitated the role development in Hungary and contributed to an increased understanding of advanced practice nurses' scope of practice. The intentional approach and the careful ongoing reflection may lead to future successful endeavors. Multinational engagement and collaborations will promote advanced practice nursing contributions globally. IMPLICATIONS FOR NURSING POLICY: Mentoring can effectively empower nurses and advanced practice nurses to work to their full capacity. The shared experiences of international mentoring colleagues can contribute to and support the development and acceptance of national policies for the advanced practice nursing roles.

Experience and Attitude of Colorectal Screening Pilot Program Participants Regarding Screening and Screening Programs in Hungary.

Background: In 2015, in Csongrád County (Hungary), a general practitioner based colorectal screening model program was implemented by the financial support of the European Union. Our aim was to evaluate the indicators of screening program and to analyze the experiences and attitude of participants of colorectal screening pilot program. Methods: The colon cancer screening pilot programme was carried out in 2015 involving an average-risk population aged 50-69 in Csongrád county, Hungary (invited 22 130 persons). The screening method was iFOBT, the attendance rate was 51.2%. Overall, 5580 patients out of the 10374 participants completed the self-compiled questionnaire concerning socio-demographic data, current screening programs, stool sampling problems, invitation letters, information sources and future willingness of participation. Results: The response rate was 53%. 46.7% of the respondents had not heard about colorectal screening prior to the screening program. Participants with elementary education level mostly indicated physicians as primary information sources [OR: 2.72 (CI: 1.59-4.66)] than patients higher education level. 67.5% of patients decided alone about participation on screening. Among women, decisions supported by acquaintances were specific [OR: 2.05 (1.06-3.95]. 82.6% determined the iFOB test as an entirely accepted screening method. Medical advice is an important predictor of screening participation. If respondents were to receive an invitation after two years, 91.5% would be involved in the screening. Conclusion: The respondents were satisfied with the screening program. Awareness raising of men, lower educated patients, those living in major cities, and recommendation of the family physician may increase the participation rate in the future.

Starving for independence. Anorexia nervosa in an adolescent with type 1 diabetes / Önállóságra éhezve. Az 1-es típusú diabetes mellitus és az anorexia nervosa együttes elofordulása egy serdülo leányban.

Összefoglaló. Az 1-es típusú diabetes mellitus (T1DM-) betegek körében az evészavarok elofordulása az átlagpopulációhoz képest körülbelül kétszeresre teheto. Ez a komorbiditás különösen veszélyes mind a magas mortalitási rizikó, mind a súlyos szövodmények lehetosége miatt. Az evészavarban szenvedo, T1DM-mel élo gyermekek és fiatalok hatékony kezelése a diabetológusok, pszichiáterek, pszichológusok, novérek és dietetikusok összehangolt munkájával valósítható meg. Közleményünkben egy 14,5 éves, T1DM-mel élo, anorexia nervosával diagnosztizált páciensünk multidiszciplináris terápiáját mutatjuk be, kiemelve a különbözo szakemberek együttmuködésének fobb metszéspontjait. A szoros diabetológiai gondozással párhuzamosan az anorexia nervosa terápiájában a protokollok ajánlásaival megegyezoen családterápiát és kognitív viselkedésterápiás elemekkel bovített egyéni terápiát alkalmaztunk. A terápiás folyamat összesen 18 hónapig tartott. Esetünk korábban le nem írt diabetológiai érdekessége, hogy a számottevo súlycsökkenéssel párhuzamosan betegünk inzulinigénye a töredékére csökkent, ami jelentos mértékben érintette a bazálisinzulin-szükségletet is. Orv Hetil. 2021; 162(33): 1341-1346. Summary. The incidence of eating disorders is approximately twice as high in type 1 diabetes mellitus (T1DM) compared to the general population. Comorbidity is related to potentially severe organ complications and consequently higher mortality risk. The effective treatment of eating disorders in T1DM is provided by the teamwork of diabetologists, psychiatrists, psychologists, nurses and dietitians. The purpose of this paper is to present the multidisciplinary treatment of a 14.5-year-old adolescent with T1DM and diagnosed with anorexia nervosa, focusing on the cooperation of the professionals. In line with the current guidelines, both family therapy and cognitive behavioral therapy-informed individual psychotherapy were applied beside the strict diabetes control. Her therapy process lasted 18 months. The unusual diabetological aspect of our case is that the significant weight loss was associated with highly decreased insulin requirement affecting also the basal insulin requirements. Orv Hetil. 2021; 162(33): 1341-1346.

Multicausal analysis on psychosocial and lifestyle factors among patients undergoing assisted reproductive therapy - with special regard to self-reported and objective measures of pre-treatment habitual physical activity.

BACKGROUND: National, regional and global trends in prevalence of infertility indicate its public health importance, however it effects various life dimensions of individuals and couples as well. Lifestyle habits may counteract with these factors. The aim of the study was the multicausal analysis of psychosocial and lifestyle factors undergoing assisted reproductive therapy (ART) with special regard to pre-treatment habitual physical activity (PA). METHODS: In a cross-sectional, observational cohort study on ART patients (N = 60, age 34.6 ± 5.2 years, BMI 24.2 ± 4.9 kg/m2) with follow up on outcome measures a detailed description was given on PA patterns (ActriGraph GT3X, GPAQ-H) and on general and infertility related distress (BDI-13, FPI). RESULTS: Respondents reported normal mood state (BDI-13) but moderately high infertility-related distress (FPI) in Social- and very high distress in Sexual Concern. It was revealed that time spent with recreational PA (RPA) could counteract with infertility-related distress (Social Concern R = -0.378, p = 0.013; Relationship Concern R = -0.365, p = 0.019). In the presence of clinical pregnancy GPAQ-H RPA MET was significantly higher (p = 0.048), in the non-pregnant group cumulative values and work-related PA were higher. Correlations could be found between RPA time and the number of oocytes (R = 0.315, p = 0.045), matured oocytes (R = 0.339, p = 0.030) and embryos (R = 0.294, p = 0.062) by women who reached at least 150 min RPA (GPAQ-H). Multivariate linear regression revealed that the number of oocytes was positively influenced by the GPAQ-H recreation MET (R2 = 0.367; F = 10.994, p = 0.004; B = 0.005, p = 0.004, B Constant = 4.604). Regarding the number of embryos (R2 = 0.757, F = 17.692, p < 0.001, B Constant = 1.342) positive relationship was found with GPAQ-H RPA MET (B = 0.004, p < 0.001) and negative with BMI (B = -0.167, p = 0.038). It was disclosed (R2 = 0.958, F = 408.479, p < 0.001) that higher Very Vigorous Activity (ActiGraph) was accompanied with higher hCG (B = 63.703, p ≤ 0.001). However, time spent with moderate PA (GPAQ-H) (B = 0.002, SE = 0.001, Wald = 3.944, p = 0.047, OR = 1.002) was significantly associated with live births. CONCLUSIONS: Amount of PA alone did not have a positive effect on outcome of ART. Type and intensity seemed to be more significant. Existing differences in response to infertility due to recreational PA suggest the importance of the development of a specific intervention. The robust overestimation of PA in self-reports highlights the need to improve physical literacy of women undergoing ART.

Health behavior of Hungarian prostate cancer patients / Prosztatarákkal diagnosztizált betegek egészségmagatartásának vizsgálata.

Összefoglaló. Bevezetés: A férfiakat érinto egyik leggyakoribb malignus ráktípus a prosztatarák. A Nemzeti Rákregiszter adatai alapján hazánkban évente több mint 4600 új eset kerül diagnosztizálásra. Célkituzés: A rákbetegek pszichoszociális háttere napjainkig alulvizsgált terület Magyarországon. A szerzok célja a magyar prosztatarákos férfiak szociodemográfiai, egészségi, mentális állapotának vizsgálata volt. Módszer: A vizsgálatban 100 prosztatarákos férfi vett részt, akiknek más urológiai betegsége nem volt, továbbá más daganatos betegségbol kifolyó kezelésben nem részesültek a kérdoív kitöltésekor. A részvétel anonim és önkéntes volt. A standard validált tesztek mellett - mint a Beck Depresszió Kérdoív, Rosenberg Önértékelés Skála - szociodemográfiai, egészségmagatartás- és életmód-kérdéscsoportokat tartalmazott kérdoívünk. Statisztikai analízis: Leíró statisztikát, khi-négyzet-próbát, lineáris regresszió analízist, Fisher-egzakt tesztet, kétmintás t-próbát végeztünk 95%-os valószínuségi szinten az SPSS 20.0 és a Microsoft Excel 2016-os programban. Eredmények: Az egészségi állapotot a lakhely településcsoportja (p = 0,024), az anyagi helyzet (p = 0,001), a krónikus betegség (p = 0,000), a fizikai aktivitás (p = 0,000) és az alkoholfogyasztás (p = 0,001) befolyásolta. A társas támogatás (p = 0,726) ellenben nem bizonyult befolyásoló tényezonek. A megkérdezettek 66%-a volt elhízott a BMI alapján. Helyesen csupán a megkérdezettek egyharmada táplálkozott a ma érvényes MDOSZ-ajánlás alapján. 62%-uk enyhén depressziósnak volt mondható a Beck Depresszió Kérdoív alapján, 73%-uk önértékelése azonban a Rosenberg Önértékelés Skála alapján átlagosnak volt mondható. Az életkorral nem nott sem a Depresszió Kérdoív pontszáma, sem az Önértékelés Skála pontszáma. Következtetés: Eredményeink alátámasztják, amit a hazai és a külföldi szakirodalom is mutat: az egészséget befolyásoló tényezoknek meghatározó szerepük van a daganatos megbetegedéssel éloknél is. A depresszió és az önértékelés közti összefüggés nem igazolódott a mintánkban. Orv Hetil. 2021; 162(10): 383-391. INTRODUCTION: Prostate cancer is one of the most common malignant cancers amongst men. More than 4600 men are diagnosed with prostate cancer every year in Hungary. OBJECTIVE: The psychosocial background of cancer patients is an underexamined area in Hungary. The aim of the authors was to obtain information on the sociodemographic status, health and mental status of Hungarian men with prostate cancer. METHOD: 100 prostate cancer patiens were included in the study who did not have any urologic diseases and did not go under any therapy due to any other type of cancer. The applied questionnaire was put together by the authors about sociodemographic and health status, lifestyle. The Beck's Depression Inventory and the Rosenberg Self-Esteem Scale were also used. STATISTICAL ANALYSIS: We used descriptive statistics, chi-square test, linear regression, Fisher's exact test, independent t-sample test on a 95% probability level in the SPSS 20.0 and Microsoft Excel 2016 softwers. RESULTS: The settlement classification (p = 0.024), financial status (p = 0.001), chronic illnesses (p = 0.000), physical activity (p = 0.000) and alcohol consumption (p = 0.001) affected the health status. Only one third of the respondents ate healthy according to the recommendations of the MDOSZ. 66% of the respondents were overweight. 62% of the respondents were depressed according to the Beck's Depression Inventory, however, 73% of them had average self-esteem measured by the Rosenberg Scale. We proved that with age either the depression score or the self-esteem score did not increase. CONCLUSION: Our results roughly mirror the national and international literature about health behavior. No connection was found between self-esteem and depression. Orv Hetil. 2021; 162(10): 383-391.

Influence of cognitive function and nurse support on malnutrition risk in nursing home residents.

AIM: To predict malnutrition risk of older residents by cognitive function, nurse support and self-care capacity as primary measures of interest. DESIGN: Cross-sectional, correlation design with linear regression analysis. METHODS: Older residents over 60 years of age were randomly selected from nursing homes. Mini Mental State Exam and the Mini Nutritional Assessment were used were as main measures. RESULTS: Lower malnutrition risk was associated with better cognitive functioning. Improved independence of self-feeding was also linked to reduced nutritional risk. Nurse support was positively related to BMI and cognitive impairment. General self-care capacity and 'appetite the week before' were key predictors of malnutrition risk; 1-point increase in both variables caused nutritional risk to decrease by 1.73 and 1.38 points, respectively. That is, a 1-point increase in self-care capacity and appetite would decrease malnutrition risk by 5.76% and 4.6%. The regression model explained significant amount (65.6%) of variance in malnutrition risk.

[Developmental Psychopathology Perspective of Attention Defi cit/Hyperactivity Disorder (ADHD)]. / A figyelemhiányos/hiperaktivitás zavar fejlodéspszichopatológiai szemlélete.

This review aims to give an insight into the developmental psychopathology perspective of attention-defi cit/hyperactivity disorder (ADHD). According to evolutionary theories, phenotypes associated with ADHD might have been adaptive in the past but became dysfunctional in modern life (mismatch theory). Genome-wide association studies have supported this theory. Multiple developmental pathways lead to ADHD (equifi nality), and risk factors associated with ADHD may lead to different outcomes (multifi nality). Heritability of ADHD is high; however, its aetiology is heterogeneous and multifactorial, including genetic factors, gene-environment interactions and correlations, as well as epigenetic mechanism. Core symptoms of ADHD - inattention, hyperactivity, and impulsivity - are the same throughout the lifespan, but their presentation, as well as the comorbid profile, show typical age-specific diff erences. ADHD is characterized by strong homotypic continuity, ADHD in children persists in a large proportion into adolescence and adulthood - underlying the importance of lifespan perspective. Heterotypic continuity of ADHD has been described with externalizing and internalizing disorders; research on the different developmental pathways contribute to the recognition and prevention of maladaptive outcomes.

Treatment of somatic symptom disorder in childhood: evidence-based psychotherapy interventions / Szomatizációs zavarok kezelése gyermekkorban: bizonyítottan hatékony pszichoterápiás módszerek

INTRODUCTION: About 25-30% of patients present themselves in general practice and specialized healthcare with medically unexplained somatic symptoms. The prevalence of these symptoms is the highest among the elderly, children and adolescents. Approximately 20% of patients in primary care and 47% of them in specialized clinics are children between the age of 7-12 who seem to have somatic symptom disorder (SSD). Somatization disorder most frequently occur with symptoms of headache, stomach ache or various kinds of pain in the limbs that show high comorbidity with other mental disorders, predominantly with anxiety. SSDs are always multicausal issues where biological, social-environmental and psychological factors are interconnected in a complex manner. According to our experience, somaziting patients are often drifting in the healthcare system for years, and instead of getting adequate treatment, they only receive medication, thus their symptoms may easily become chronic. Aim, method: Our aim was to review the current literature and guidelines concerning evidence-based treatments for SSD in childhood. Furthermore, to underline the importance of psychotherapy in SSD, we present the cognitive behavior therapy of a 16-year-old adolescent with vertigo, gastrointestinal symptoms and insomnia over a 8-month period. DISCUSSION: The results of effectiveness studies unequivocally recommend cognitive behavioral therapy in the treatment of SSD patients, accompained by family therapy or family consultation. The therapy should focus on reducing psychosocial stressors, health anxiety and catastrophizing thinking style in the family, while developing adequate coping and communication skills as well as maintaining the patient's age-appropriate activity level. CONCLUSION: Cognitive behavior therapy is the treatment of choice in SSD for children and young people. Applying the biopsychosocial approach is a key issue in the assessment of predisposing and maintaining factors, ensuring that only methods based on scientific evidence will be applied to help these children. Orv Hetil. 2020; 161(25): 1050-1058.

Adult Attention Deficit Hyperactivity Disorder Symptoms, Perceived Stress, and Well-Being: The Role of Early Maladaptive Schemata.

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders, severely affecting the emotional well-being of children as well as of adults. It has been suggested that individuals who experience symptoms of ADHD develop maladaptive schemata of failure, impaired self-discipline, social isolation, and shame. These schemata may then contribute to impaired emotional well-being by increasing unhelpful responses to stressful life events. However, to date, no empirical research has tested this theoretical proposition. In a sample of 204 nonclinical adults, we conducted a serial multiple mediator analysis, which supported the proposed model. More severe ADHD symptoms were associated with higher levels of perceived stress both directly and indirectly through stronger maladaptive schemata, which, in turn, were related to lower levels of emotional well-being. Results suggest that identifying and modifying maladaptive schemata may be an important addition to psychotherapy for adult ADHD patients.

[Cognitive conceptualization of adult attention deficit hyperactivity disorder: a systematic review]. / A felnottkori figyelemhiányos/hiperaktivitás zavarra jellemzo kognitív struktúra: szisztematikus áttekinto tanulmány.

AIMS: Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders continuing from childhood into adulthood in 40-66% of cases. Though genetic underpinnings of the disorder are unquestionable, previous research underlie the fact that children with ADHD are faced with more adversities which might lead to maladaptive beliefs about self and world. Our aim was to provide a systematic review of ADHD studies focusing on cognitive conceptualization of the disorder. METHODS: A systematic literature search was conducted in three databases (PsychINFO, MEDLINE and Scopus) between years 2000 and 2013 with the keywords "ADHD, attention deficit hyperactivity disorder" and "core beliefs, belief system, schemas, schema therapy, dysfunctional attitude, compensatory strategies, negative automatic thoughts, case conceptualization". RESULTS: We were able to identify ten original papers. According to them, adult ADHD could be characterized by maladaptive schemata including failure, impaired self-control, being different from others and a sense of inadequacy. Dysfunctional attitudes in adult ADHD were related to comorbid mood disorders. Compensatory strategies, e.g. anticipatory avoidance, brinkmanship, juggling, pseudo efficiency were described. More negative automatic thoughts were found in adult patients with ADHD, especially with comorbid mood disorder. Cognitive distortions, such as overgeneralization, magical and comparative thinking were also reported. CONCLUSIONS: Though more empirical research is needed, converging results were reviewed about the cognitive characteristics of adult ADHD. Cognitive behavior therapy was showed to be effective in treatment of adult ADHD; the improvement of our knowledge about cognitive conceptualization of the disorder is a very important challenge for further research.

Barriers of antenatal folate-supplementation: The role of depression and trait-anxiety on periconceptional folate-intake.

Abstract Objective. The aim of the research was to reveal the effect of antenatal depressive symptoms and trait-anxiety on folate supplementation. Higher levels of depression, and trait-anxiety were hypothesized to be associated with insufficient folate intake among pregnant women in early pregnancy. Methods. Level of depressive symptoms, trait-anxiety, self-esteem, social capital, self-related health, and demographic factors (age, number of siblings, marital, educational, employment, and socioeconomic-status) were established among 185 Hungarian women in the first trimester of their pregnancies. Depressive symptoms and trait-anxiety were evaluated with the Short Hungarian Version of the Beck Depression Inventory and the Hungarian version of the Spielberger State-Trait Anxiety Inventory form Y (STAI-Y). Results. The higher levels of both trait-anxiety and self-esteem decreased the folate-intake significantly, OR=0.925 (95%CI=0.863-0.991; P=0.026) and OR=0.897 (95%CI=0.808-0.996; P=0.041) while depressive symptoms did not have an effect on it. The lower level of education (less than 8 elementary years) had similar effects (OR=0.228 [95%CI=0.064-0.817], P=0,023). The lack of trust had a significant role too (P=0.043): those, who were distrustful with other people, also had a lower chance of supplementation (OR=0.620; 95%CI=0.390-0.986). Conclusions. The way to increase the openness towards folate-supplementation leads through the treatment of psychological disturbances and the restoration of social trust.