Impact of educational intervention on willingness-to-pay for suicide prevention: a quasi-experimental study among university students in Japan

Many individuals show negative attitudes toward the use of taxes for suicide prevention. Activities that enhance knowledge and awareness of suicide and suicide prevention may increase willingness to pay (WTP) for suicide prevention. WTP is the amount that a consumer will pay for a product or service. The present study examined the influence of educational activities on enhancing knowledge and awareness of suicide and its prevention on WTP. We conducted a quasi-experimental study to examine the influence of lectures on suicide by comparing the amount of change in WTP between two groups over the same period: an intervention group (n = 92) comprising students who participated in the lectures and a control group (n = 128) comprising general university students recruited through an Internet-based survey. A t-test showed that the amount of change was significantly larger in the intervention group (t (152.31) = 2.25, p = .026). Ordinal logistic regression analysis showed that increased WTP was significantly correlated with an annual household income of JPY 4–6 million or higher. It may be appropriate to conclude that participation in lectures about suicide is effective in increasing WTP for suicide prevention.     

Stigma,Attitudes, and Help‐Seeking Intentions for Psychological Problems in Relation to Regional Suicide Rates

In this ecological study, we investigated whether help‐seeking related to stigma, intentions, and attitudes toward suicide are associated with the suicide rates of 20 regions within the Netherlands and Belgium. Significant associations were found between regional suicide rates and the intention to seek informal help (β = ?1.47, p = .001), self‐stigma (β = 1.33, p = .038), and shame (β = .71, p = .030). The association between self‐stigma and suicide rate was mediated by intentions to seek informal help. These results suggest that to promote suicide prevention at the level of the regional population, stigma, shame, and intentions to seek help should be targeted in the public domain.     

Factors associated with school nurses’ HPV vaccine attitudes for school-aged youth

School nurses are at the intersection of the healthcare and school communities, thus, they can be considered opinion leaders in providing health advice – including information about the human papillomavirus (HPV) vaccine – to parents and students. This study examined school nurses’ attitudes toward the HPV vaccine based on age, years as a school nurse, geographic location, urban vs. rural work setting, HPV and vaccine knowledge, perception of role as opinion leaders, and school district support in providing health education. Participants (n = 413) were systematically sampled from the National Association of School Nurses’ membership and completed a web-based survey. Multiple regression was used to predict positive HPV vaccine attitudes. The model was statistically significant accounting for 50.8% of the variance (F [9, 400] = 45.96, p < .001). Positive attitudes regarding the HPV vaccine were predicted by higher HPV and vaccine knowledge (β = .096, p < .001) and stronger perceptions of role as opinion leaders for the vaccine (β = .665, p < .001). No other variables were found to be statistically significant. These results suggest knowledge is essential in predicting positive attitudes, but not the strongest predictor as perceptions of role as opinion leaders was more crucial in terms of predicting school nurses’ positive attitudes towards HPV vaccine. Despite school nurses being seen as champions for adolescent vaccines, they need additional professional development to increase their HPV vaccine knowledge and attitudes to encourage parents and adolescents to consider the uptake of HPV vaccination. To engage school nurses’ in promoting HPV vaccine uptake, interventions need to focus on increasing school nurses’ perception of their role as opinion leaders for HPV vaccine and knowledge to increase positive attitudes towards HPV vaccination for youth.     

Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

This meta-analysis summarizes the findings of outcome research on the degree to which telehealth treatments reduce posttraumatic stress disorder (PTSD)-related symptoms. In a search of the literature, 13 studies were identified for inclusion in the meta-analysis and were coded for relevant variables. A total of 725 participants were included. Results indicate that telehealth treatments are associated with significant pre- to postreduction in PTSD symptoms (d = 0.99, 95% confidence interval [CI]: 0.87–1.11, p < .001), and result in superior treatment effects relative to a wait-list comparison condition (d = 1.01, 95% CI: 0.76–1.26, p < .001). However, no significant findings were obtained for telehealth intervention relative to a supportive counseling telehealth comparison condition (d = 0.11, 95% CI: ? 0.38 to 0.60, p = .67), and telehealth intervention produced an inferior outcome relative to a face-to-face intervention (d = ? 0.68, 95% CI: ? 0.39 to ? 0.98, p < .001). Findings for depression symptom severity outcome were generally consistent with those for PTSD outcome. Telehealth interventions produced a significant within-group effect size (d = 0.98, 95% CI: 0.86 to 1.10, p < .001) and superior effect relative to wait-list comparison condition (d = 0.80, 95% CI: 0.56–1.05, p < .001). Relative to face-to-face interventions, telehealth treatments produced comparable depression outcome effects (d = 0.13, 95% CI: ? 0.55 to 0.28, p = .53). Taken together, these findings support the use of telehealth treatments for individuals with PTSD-related symptoms.     

The relationship among resilience,rumination and posttraumatic growth in hemodialysis patients in North China

Research has indicated that clinical serious disease may lead to posttraumatic growth (PTG). However, little is known about PTG among hemodialysis (HD) patients. The study examined the relationship among resilience, rumination and PTG among Chinese HD patients. 196 HD patients were recruited from a tertiary hospital in a Northern city of China between 1 June 2015 and 30 May 2016. Patients were surveyed using the Posttraumatic Growth Inventory-Chinese version, Connor-Davidson Resilience Scale, and Chinese Event Related Rumination Inventory. Correlation analyses showed that resilience was most highly positively correlated with PTG (r = .70, p < .001), deliberate rumination moderately correlated to PTG (r = .50, p < .001), and intrusive rumination was lower negatively related to PTG (r = –.26, p < .001). Regression analyses showed that age, gender, duration of dialysis, resilience and deliberate rumination had significant associations with PTG (β = ?.31, p ＜ .0001; β = –.14, p = .002; β = .10, p = .032; β = .44, p < .001; β = .20, p < .001). They together explained 65% of the total variance in PTG (F [8,195] = 46.74, p < .001). However, intrusive rumination was not associated with PTG (p > .05). The results suggested that resilience and deliberate rumination may be instrumental for PTG improvement.     

The development of parental monitoring during adolescence: A meta-analysis

Abstract

As adolescents grow up, one of the important developmental tasks is to individuate themselves and to become more autonomous from parents. This requires a realignment of the parent-adolescent communication. The current meta-analytic study aims at identifying developmental changes in parent-adolescent communication, conceptualized within the parental monitoring framework, as entailing parental solicitation, control and knowledge, and adolescent’s disclosure and secrecy. Thirty-one longitudinal studies published between 2000 and 2015 were identified and included in the current meta-analysis. Informants, age at assessment and study duration were tested as moderators. Results showed a low to medium normative decline in parental control (Cohen’s d = ?.395, 95% CI [?.541, ?.249]), knowledge (d = ?.245,95% CI [?.331, ?.160] and adolescence disclosure (d = ?.147, 95% CI [?.204, ?.090]), and an increase in adolescent’s secrecy (d = .194, CI [031, .356]). Parental solicitation decreased based on parents’ (d = ?.242, 95% CI[?.376, ?.109]) but not on adolescents’ reports (d = .038, 95% CI[?.099, .175]). Another significant moderator was the duration of the study, with studies longer than 2 years being able to detect a more pronounced change in parental control than studies lasting less than 2 years (≤2 years, d = ?.139 vs. duration > 2 years, d = ?.581). Limitations of the current knowledge and new directions of studies are discussed.     

Predictors of Diabetes Fatalism Among Arabs: A Cross-Sectional Study of Lebanese Adults with Type 2 Diabetes

Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716–724, 2011). The purpose of this study is to identify predictors of diabetes fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes fatalism and demographic and patient characteristics. Age (β = ?.14, 95% CI ?.27, ?.002), BMI (β = .35, 95% CI .15; .54), level of education (β = ?3.98, 95% CI ?7.64; ?.32) and number of diabetes problems (β = ?5.03, 95% CI ?9.89; ?.18) were significantly associated with diabetes fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes fatalism scores’ change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes fatalism with larger sample and non-Lebanese Arabic population.     

Locus of control,anxiety, and depression in infertile patients

This study aimed to examine the relationship of locus of control (LoC) with anxiety and depression disorders, applying multivariate statistical techniques to control for the effects of demographic/fertility variables. This cross-sectional study included 312 infertile patients in a referral fertility center in Tehran, Iran via convenience sampling. The Hospital Anxiety and Depression Scale and the Levenson’s Locus of Control Scale were administered to all participants. Hierarchical multiple linear regressions were used to identify factors associated with anxiety and depression. After controlling for demographic/fertility variables, hierarchical regression analyses showed that internal LoC was negatively associated with anxiety (β = –.213, p < .001) and depression (β = –.269, p < .001). Powerful others subscale was positively associated with anxiety (β = .176, p < .001), but there was no significant relationship between this subscale and depression (β = .047, p = .467). The findings of this study merit the understanding of the role of demographic/fertility characteristics and LoC orientations in anxiety and depression of infertile patients to identify beforehand those patients who might be at risk of experiencing high anxiety and depression and in need of support.     

Relations between symptom severity,illness perceptions,visceral sensitivity,coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ² (8) = 11.91, p = .16, χ²/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.     

Menopausal Symptoms: Is Spirituality Associated with the Severity of Symptoms?

The aim of this study was to explore whether spirituality was associated with menopausal symptoms. Menopausal symptoms, spirituality, health and menopausal status, and socio-demographic variables were assessed in a community sample of 710 peri- and postmenopausal women. A structural model was explored using structural equation modeling. The results evidence spirituality as a significant contributor regarding the severity of most menopausal symptoms. Among others, spirituality had a significant weight in depressive mood (β = ?.414; p < .001), anxiety (β = ?.308; p < .001), cognitive impairment (β = ?.287; p < .001), aches/pain (β = ?.148; p < .001), vasomotor (β = ?.125; p = .005) and sexual symptoms (β = ?.211; p < .001). Some socio-demographic variables, as well as perceived health, also predicted the menopausal symptoms’ severity. Therefore, spirituality can have a positive impact on the menopausal symptoms’ reporting.     

Tan and thin? Associations between attitudes toward thinness,motives to tan and tanning behaviors in adolescent girls

Tanning during adolescence increases skin cancer risk. Relatively few studies have examined the association between thinness attitudes and tanning attitudes and behaviors. The purpose of the current study was to examine psychosocial predictors of sunbathing and tanning bed use, specifically thin ideal internalization (TII) and motives for tanning among high school girls. Adolescent girls (N = 229) completed a 10-minute questionnaire designed to assess sunbathing and indoor tanning, TII and motives to tan (appearance, social and well-being). Hierarchical regression analyses showed that TII, β = .05, p < .05, appearance motives, β = .11, p < .01 and well-being motives, β = .11, p < .01 were all independently positively associated with sunbathing. Social motives were negatively associated with sunbathing, β = ?.07, p < .05. A three-way interaction was found between the three types of motives on indoor tanning, in that appearance and well-being motives interacted to increase indoor tanning levels, especially among those who strongly endorsed social motives for tanning, β = .22, p < .05. Motives for tanning, specifically those associated with appearance and well-being, can interact to increase tanning bed use. When designing tailored interventions for skin cancer prevention in young people, researchers should consider tailoring based on motivation. Researchers and healthcare professionals who work with adolescents should attend to tanners who are motivated for both appearance and mood-related reasons, as they may be most at risk for tanning dependence and skin cancer.     

Effects of telephone support on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease: a meta-analysis

The aim of this meta-analysis was to evaluate the effects of disease education or pulmonary rehabilitation programs assisted with telephone support on physical capacity and quality of life (QOL) in chronic obstructive pulmonary disease (COPD) patients. A systematic search of PubMed, Embase, Web of Science and The Cochrane Library was conducted until May 2017. Randomized controlled trials (RCTs) examining the effects of telephone-assisted intervention versus a control group on exercise tolerance and QOL in patients with COPD were included. Two independent authors assessed the methodological quality of the trials using the Cochrane risk of bias tool. A meta-analysis was conducted with the Revman5.3 to quantify the effects of telephone-assisted interventions on walking capacity and QOL. In total, 10 studies involving 1037 participants were included. Due to the effect of telephone-assisted interventions, statistically significant results were found on Saint-George’s Respiratory Questionnaire (SGRQ) symptom scores [standard mean difference (SMD) ?.18, 95% confidence interval (CI) ?.33, ?.03, p-value .02)], SGRQ impact scores [SMD ?.35, 95% CI ?.60, ?.10, p-value .006)], SGRQ activity scores [SMD ?.30, 95% CI ?.45, ?.15, p-value < .0001)], SGRQ total score [SMD ?.36, 95% CI ?.51, ?.21, p-value < .00001)]. The effects on 6-min walk test (6MWT) and all Chronic Respiratory Questionnaire (CRQ) subscales were not significant (p > .05) based on the insufficient evidence. In conclusion, the role of telephone-assisted interventions in the management of COPD remains equivocal. Some encouraging results were seen with regard to SGRQ symptom, SGRQ impact, SGRQ activity and SGRQ total score. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

Positive affect mediates the relationships between resilience,social support and posttraumatic growth of women with infertility

This study aims to explore the relationship between resilience, social support, positive affect and posttraumatic growth among Chinese women with infertility, and to examine the mediating role of positive affect. A convenience sample of 1733 women diagnosed with infertility was recruited from the infertility outpatient clinics at three reproductive hospitals in Shandong Province of China between May 2015 and April 2016. They completed a background questionnaire, the Posttraumatic Growth Inventory, the Perceived Social Support Questionnaire, the Connor-Davidson Resilience Scale, the Positive and Negative Affect Schedule. Individuals reported high levels of PTG (M = 64.81; SD = 16.20). Perceived social support (β = .11, p < .001), resilience (β = .18, p < .001) and positive affect (β = .46, p < .001) were related to PTG. Positive affect may play a mediating role in the relationships between resilience (.125, .201, p < .001), social support (.055, .121, p < .001) and PTG. This study examines the effects of resilience, social support, and positive affect on PTG among Chinese infertile women. Wherein, positive affect may play a mediating role in the relationships between resilience, social support and PTG.     

Early motor development and cognitive abilities among Mexican preschoolers

Psychomotricity plays a very important role in children’s development, especially for learning involving reading–writing and mathematical calculations. Evaluate motor development in children 3 years old and its relationship with their cognitive abilities at the age of 5 years. Based on a cohort study, we analyzed the information about motor performance evaluated at 3 years old by Peabody Motor Scale and cognitive abilities at 5 years old. The association was estimated using linear regression models adjusted by mother’s intelligence quotient, sex, Bayley mental development index at 18 months, and quality of the environment at home (HOME scale). 148 children whose motor performance was determined at age 3 and was evaluated later at age 5 to determine their cognitive abilities. Cognitive abilities (verbal, quantitative, and memory) measured by McCarthy Scales. Significant positive associations were observed between stationary balance at age 3 with verbal abilities (β = 0.67, p = .04) and memory (β = 0.81, p = .02) at 5 years. Grasping and visual-motor integration were significant and positively associated with quantitative abilities (β = 0.74, p = .005; β = 0.61, p = .01) and memory (β = 2.11, p = .001; β = 1.74, p = .004). The results suggest that early motor performance contributes to the establishment of cognitive abilities at 5 years. Evaluation and early motor stimulation before the child is faced with formal learning likely helps to create neuronal networks that facilitate the acquisition of academic knowledge.     

Resilience,religiosity and treatment adherence in hemodialysis patients: a prospective study

Resilience and religiosity have received attention as an important process in the experience and management of chronic comorbidities; however, there is no study evaluating resilience in hemodialysis patients and its association with other psychological dimensions or with treatment adherence. This observational prospective study assessed resilience (25 item Wagnild and Young Resilience Scale), religiosity under three dimensions (organizational, non-organizational and intrinsic) using DUREL scale, depressive symptoms (Patient Health Questionnaire-9) and health-related quality of life (Short Form-36 questionnaire). The main outcomes were medication adherence using the Morisky Medication Adherence Scale-8 (MMAR-8) and the missing/shortened dialysis sessions in the following six months. Of 208 patients approached, 202 (97.1%) agreed to participate. One hundred twenty-three patients (60.9%) were males and mean age was 52.8 ± 14.8 years-old. The median time on hemodialysis was 36 months (IQR, 12, 84). 82 (40.6%) patients obtained a MMAS-8 score <6 and were considered as having ‘poor adherence’. Overall, the mean score of medication adherence was low (5.7 ± 2.1). About adherence to hemodialysis sessions, patients missed a total of 234 (1.6%) hemodialysis sessions. Forty-eight patients (23.7%) missed an average of at least three sessions in six months. Regarding adherence to medication, there was no association in the uni- or multivariate analysis between religiosity dimensions and MMAS-8 score. After adjustment, resilience was positively associated with MMAS-8 score (standardized β coefficient .239, p = .016). Organized and intrinsic religiosity were associated with adherence to dialysis sessions (standardized β coefficient .258, p = .004 and .231, p = .026, respectively). Interestingly, opposite to medication adherence, more resilient patients were associated with less adherence to hemodialysis sessions (standardized β coefficient ?.296, p = .001). Religiosity was associated with dialysis adherence but not with medication adherence. Resilience was associated with higher medication adherence but lower adherence to dialysis sessions.     

Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study

Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = ?.479, p < .001) and resilience (β = ?.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = ?.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = ?.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = ?.032, p > .05) or anxiety symptoms (β = ?.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.     

State gratitude for one’s life and health after an acute coronary syndrome: Prospective associations with physical activity,medical adherence and re-hospitalizations

Abstract

Gratitude may be associated with beneficial health outcomes, but studies of this association have been mixed, and in these studies gratitude has often been conceptualized as a stable, unidimensional trait. We used four specific items to examine the prospective association of state- and domain-specific gratitude with medical outcomes among 152 patients with a recent acute coronary syndrome. State gratitude for one’s health 2 weeks post-event was associated with increased physical activity (measured via accelerometer) 6 months later, controlling for relevant demographic, social, medical and psychological factors (β = 340.9; 95% confidence interval = 53.4–628.4; p = .020). Gratitude for one’s life was associated with increased self-reported medical adherence at 6 months on the maximally adjusted model (β = .60; 95% confidence interval = .16–1.04; p = .008); no gratitude items were associated with rehospitalizations. In contrast, dispositional gratitude, measured by the Gratitude Questionnaire-6, was less dynamic and responsive to change over the 6-month period and was not associated with physical activity.     

Implicit attitudes and the improvement of exercise capacity during pulmonary rehabilitation

The aim of this study was to examine the role of explicit and implicit attitudes in the improvement of exercise capacity during a 5-week pulmonary rehabilitation (PR). A total of 105 patients performed walking tests at baseline and at the end of PR. Change between performances was computed at the end of PR, and Minimal-Clinically-Important-Difference (MCID) were used to categorize patients as responders (i.e. change above MCID, N = 54) or non-responders (i.e. change below MCID, N = 51). At baseline, implicit attitudes were measured through a physical activity versus sedentary behavior Implicit Association Test; explicit attitudes toward physical activity and sedentary behavior were measured by questionnaires. Only implicit attitudes significantly differed between the two groups (p = .015), responders displaying implicit attitudes significantly more in favor of physical activity (M = .91, SD = .54) than non-responders (M = .60, SD = .71) at baseline. Measuring implicit attitudes in PR could help to accurately estimate patients’ motivation, and design more individualized rehabilitation programs.     

Positive affectivity predicts successful and unsuccessful adaptation to stress

This study examined adaptation to work stress among public school teachers (n = 267). Regression analyses tested whether positive affect predicted successful and unsuccessful adaptation to stress (viz., resilience and burnout, respectively) after controlling for demographic characteristics and work stress. Positive affect was largely correlated with resilience (r = .65, p < .001) and burnout (r = ?.57, p < .001). The regression of resilience showed that positive affect had a direct effect (β = .66, p < .001) and the total model explained 44 % of the variance (R ² Change = 37 %). In the regression of burnout, positive affect also had a direct effect (β = ?.41, p < .001) and the total model explained 52 % of the variance (R ² Change = 14 %). Further analyses found no significant interaction between work stress and positive affect, but revealed that positive affect completely mediated the effect of work stress on resilience. Results provide support for the broaden-and-build theory of positive emotions, particularly the theory’s building and undoing effects.