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Stanton AM, Blyler AP, Mosery N, Goodman GR, Vanderkruik R, Sithole K, Bedoya CA, Smit J, Psaros C. "I am scared, I do not want to lie": exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa. BMC Pregnancy Childbirth 2023; 23:223. [PMID: 37013509 PMCID: PMC10068701 DOI: 10.1186/s12884-023-05520-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND COVID-19 and efforts to manage widespread infection may compromise HIV care engagement. The COVID-19-related factors linked to reduced HIV engagement have not been assessed among postpartum women with HIV, who are at heightened risk of attrition under non-pandemic circumstances. To mitigate the effects of the pandemic on care engagement and to prepare for future public health crises, it is critical to understand how COVID-19 has impacted (1) engagement in care and (2) factors that may act as barriers to care engagement. METHODS A quantitative assessment of COVID-19-related experiences was added to a longitudinal cohort study assessing predictors of postpartum attrition from HIV care among women in South Africa. Participants (N = 266) completed the assessment at 6, 12, 18, or 24 months postpartum between June and November of 2020. Those who endorsed one or more challenge related to engagement in care (making or keeping HIV care appointments, procuring HIV medications, procuring contraception, and/or accessing immunization services for infants; n = 55) were invited to complete a brief qualitative interview, which explored the specific factors driving these challenges, as well as other impacts of COVID-19 on care engagement. Within this subset, 53 participants completed an interview; qualitative data were analyzed via rapid analysis. RESULTS Participants described key challenges that reduced their engagement in HIV care and identified four other domains of COVID-19-related impacts: physical health, mental health, relationship with a partner or with the father of the baby, and motherhood/caring for the new baby. Within these domains, specific themes and subthemes emerged, with some positive impacts of COVID-19 also reported (e.g., increased quality time, improved communication with partner, HIV disclosure). Coping strategies for COVID-19-related challenges (e.g., acceptance, spirituality, distraction) were also discussed. CONCLUSIONS About one in five participants reported challenges accessing HIV care, medications, or services, and they faced complex, multilayered barriers to remaining engaged. Physical health, mental health, relationships with partners, and ability to care for their infant were also affected. Given the dynamic nature of the pandemic and general uncertainty about its course, ongoing assessment of pandemic-related challenges among postpartum women is needed to avoid HIV care disruptions and to support wellbeing.
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Affiliation(s)
- Amelia M Stanton
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Abigail P Blyler
- Department of Psychology, Positive Psychology Center, University of Pennsylvania, Pennsylvania, PA, USA
| | - Nzwakie Mosery
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Georgia R Goodman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Rachel Vanderkruik
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Kedibone Sithole
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - C Andres Bedoya
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jennifer Smit
- Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Zhang L, Li L, Zheng W, Zhang Y, Gao X, Tan L, Wang X, Chen Q, Xu J, Tang J, Luo X, Chen X, Zhang X, He L, Liu J, Cheng P, Xu L, Tian Y, Wen C, Li W. Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2023; 48:92-105. [PMID: 36935182 PMCID: PMC10930552 DOI: 10.11817/j.issn.1672-7347.2023.210803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Indexed: 03/21/2023]
Abstract
OBJECTIVES Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model. METHODS The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention. RESULTS The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful. CONCLUSIONS Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.
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Affiliation(s)
- Li Zhang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China.
| | - Lingjiang Li
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Wanhong Zheng
- Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown 26505, WV, United States
| | - Yan Zhang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xueping Gao
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Liwen Tan
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xiaoping Wang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Qiongni Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Junmei Xu
- Department of Anesthesiology, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Juanjuan Tang
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xingwei Luo
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xudong Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Xiaocui Zhang
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Li He
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Jin Liu
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Peng Cheng
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Lizhi Xu
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China
| | - Yi Tian
- Department of Infection, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Chuan Wen
- Department of Pediatrics, Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Weihui Li
- Department of Psychiatry, Second Xiangya Hospital, Central South University; China National Clinical Research Center on Mental Disorders (Xiangya); China National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha 410011, China.
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Stanton AM, Blyler AP, Mosery N, Goodman GR, Vanderkruik R, Sithole K, Bedoya CA, Smit J, Psaros C. "I am scared, I do not want to lie": Exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa. RESEARCH SQUARE 2023:rs.3.rs-2463315. [PMID: 36711876 PMCID: PMC9882635 DOI: 10.21203/rs.3.rs-2463315/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background COVID-19 and efforts to manage widespread infection may compromise HIV care engagement. The COVID-19-related factors linked to reduced HIV engagement have not been assessed among postpartum women with HIV, who are at heightened risk of attrition under non-pandemic circumstances. To mitigate the effects of the pandemic on care engagement and to prepare for future public health crises, it is critical to understand how COVID-19 has impacted (1) engagement in care and (2) factors that may act as barriers to care engagement. Methods A quantitative assessment of COVID-19-related experiences was added to a longitudinal cohort study assessing predictors of postpartum attrition from HIV care among women in South Africa. Participants (N = 266) completed the assessment at 6, 12, 18, or 24 months postpartum between June and November of 2020. Those who endorsed one or more challenge related to engagement in care (making or keeping HIV care appointments, procuring HIV medications, procuring contraception, and/or accessing immunization services for infants; n = 55) were invited to complete a brief qualitative interview, which explored the specific factors driving these challenges, as well as other impacts of COVID-19 on care engagement. Within this subset, 53 participants completed an interview; qualitative data were analyzed via rapid analysis. Results Participants described key challenges that reduced their engagement in HIV care and identified four other domains of COVID-19-related impacts: physical health, mental health, relationship with a partner or with the father of the baby, and motherhood/caring for the new baby. Within these domains, specific themes and subthemes emerged, with some positive impacts of COVID-19 also reported (e.g., increased quality time, improved communication with partner, HIV disclosure). Coping strategies for COVID-19-related challenges (e.g., acceptance, spirituality, distraction) were also discussed. Conclusions About one in five participants reported challenges accessing HIV care, medications, or services, and they faced complex, multilayered barriers to remaining engaged. Physical health, mental health, relationships with partners, and ability to care for their infant were also affected. Given the dynamic nature of the pandemic and general uncertainty about its course, ongoing assessment of pandemic-related challenges among postpartum women is needed to avoid HIV care disruptions and to support wellbeing.
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Kurt Z, Sice P, Krajewska K, Elvin G, Xie H, Ogwu S, Wang P, Turgut SS. A pilot study on the impacts of lung-strengthening Qigong on wellbeing. Complement Ther Med 2022; 71:102891. [PMID: 36179803 DOI: 10.1016/j.ctim.2022.102891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Qigong embraces a range of self-care exercises originating from China. Lung-Strengthening Qigong (LSQ) is a specific technique for maintaining and improving physical and mental wellbeing. METHODS We recruited 170 practitioners and 42 non-practitioner/control samples to investigate the impacts of LSQ practice on body, mind, thoughts, and feelings. This is a pilot study pursued to plan for an adequately powered, non-clinical randomized controlled trials (RCT) on overall wellbeing and health and to evaluate the adequacy of delivering the physical activity intervention with fidelity. Self-evaluation-based data collection schemes were developed by regularly requesting completion of a questionnaire from both practitioner and control group, and an online diary and end of study survey (EOS) completion only from the practitioners. Diverse types of analyses were conducted, including statistical tests, machine learning, and qualitative thematic models. RESULTS We evaluated all different data resources together and observed that (a)the impacts are diverse, including improvements in physical (e.g., elevated sleep quality, physical energy, reduced fatigue), mental (e.g., increased positivity, reduced stress), and relational (e.g., enhanced connections to self and nature) wellbeing, which were not observed in control group; (b)measured by the level-of-effectiveness, four distinct clusters were identified, from no-effect to a high-level of effect; (c)a majority (84 %) of the LSQ practitioners experienced an improvement in wellbeing; (d)qualitative and quantitative analyses of the diary entries, questionnaires, and EOS were all found to be consistent, (e)majority of the positively impacted practitioners had no or some little prior experience with LSQ. CONCLUSIONS Novel features of this study include (i)an increased sample size vis-à-vis other related studies; (ii)provision of weekly live-streamed LSQ sessions; (iii)integration of quantitative and qualitative type of analyses. The pilot study indicated that the proportion of practitioners who continued to engage in completing the regular-interval questionnaires over time was higher for practitioners compared to the control group. The engagement of practitioners may have been sustained by participation in the regular live LSQ sessions. To fully understand the impacts of LSQ on clinical/physiological outcomes, especially for specific patient groups, more objective biomarkers (e.g. respiratory rate, heart rate variation) could be tracked in future studies.
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Affiliation(s)
- Zeyneb Kurt
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK.
| | - Petia Sice
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK
| | - Krystyna Krajewska
- Confucius Institute, University of Wales Trinity Saint David, Lampeter, Ceredigion, UK
| | - Garry Elvin
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK
| | - Hailun Xie
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK; University of Exeter, Penryn Campus, Penryn, Cornwall, UK
| | - Suzannah Ogwu
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK; University of Wales Trinity Saint David, Sparkhill Centre, Birmingham, UK
| | - Pingfan Wang
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK
| | - Sultan Sevgi Turgut
- Department of Computer Engineering, Yildiz Technical University, Istanbul, Turkey
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Coustals N, Moscoso A, Pommepuy N, Sibeoni J. Integration of Mental Health Support Teams in COVID-19 Units within French General Hospitals: A Qualitative Study. Int J Integr Care 2022; 22:14. [PMID: 36483484 PMCID: PMC9717344 DOI: 10.5334/ijic.6454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 10/28/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction This study aimed to explore the lived experience of mental health professionals (mhPs) who had been redeployed on support teams (MHSTs) implemented in general hospital for patients with coronavirus disease 2019 (COVID-19) and their families, in order to scale up mental and physical health care integration in times of epidemic crisis. Methods This multicentered qualitative study followed an IPSE (Inductive Process to analyze the Structure of lived Experience) research design. MhPs' recruitment took place in three general hospitals of Seine-Seine-Denis department, in Paris suburbs (France). Results Twenty-two participants were included. Data analysis produced three central axes: 1) the mhP in the epidemic crisis, underlying how participants confronted the unknown and adapted; 2) retrieving fundamentals of support therapy, that were: being present and listening, bonding with patients' families, and ensuring care continuity; and 3) moving forward with other health professionals, highlighting the collaborative work they developed and experienced. Discussion The epidemic prompted mhPs to rethink the values likely to guide the integration of their intervention with other individual and organizational care stakeholders, at different levels of health system. Normative integration based on shared appraisal of patients' and families' needs is highly required to overcome the multiple and sometimes contradictory health issues inherent in the crisis. Conclusion Person- and family-centered approach of integrated care (IC) is essential to address fragmentation between mental and physical health care in times of epidemic crisis. Hospital and political leaders should support and draw from bottom-up mental health IC initiatives such as MHSTs, that embody this vision, in order to improve health systems preparedness for future crises.
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Affiliation(s)
- Nicolas Coustals
- Department of Child and Adolescent Psychiatry, Ville-Evrard Hospital, Neuilly-sur-Marne, France
| | - Ana Moscoso
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, Paris, France
| | - Noël Pommepuy
- Department of Child and Adolescent Psychiatry, Ville-Evrard Hospital, Neuilly-sur-Marne, France
| | - Jordan Sibeoni
- Service Universitaire de psychiatrie de l’adolescent SUPADO, Argenteuil Hospital Centre, Argenteuil, France
- ECSTRRA Team, UMR-1153, Inserm, Paris Cité University, Paris, France
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Yang G, Li X, Peel N, Klupp N, Liu JP, Bensoussan A, Kiat H, Chang D. Perceptions of Participants on Trial Participation and Adherence to Tai Chi: A Qualitative Study. Patient Prefer Adherence 2022; 16:2695-2707. [PMID: 36196067 PMCID: PMC9527000 DOI: 10.2147/ppa.s380780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Trial participation and adherence to interventions can directly influence the evaluation of outcomes in clinical trials for real world applications. The factors that influence trial participation and adherence to Tai Chi interventions in people with cardiovascular diseases remains unknown. This study aimed to explore participants' perceptions of influential factors on their trial participation and adherence to a Tai Chi intervention within a trial setting. PATIENTS AND METHODS Participants had coronary heart disease and/or hypertension in a randomized controlled trial comparing Tai Chi with a waitlist control. Data were collected via face-to-face, semi-structured interviews and analyzed using thematic analysis. RESULTS Thirty-four participants from the Tai Chi group who completed the randomized trial were interviewed. Six dominating themes and four sub-themes are discussed under the facilitators of internal and external motivation, positive feelings, benefits of Tai Chi and future practice with an overall internal motivation to improve health. Positive feelings had three sub-themes: positive feelings toward Tai Chi, the project, and the learning experience. The Tai Chi instructor(s) was found to be a crucial element in motivating participants' adherence to Tai Chi. CONCLUSION From the perception of participants, the facilitators to their trial participation and adherence to a Tai Chi intervention included internal and external motivation, positive feelings towards Tai Chi, the project and the learning experience, and perceived benefits of Tai Chi. Perceived barriers included concerns about the safety and complexity of Tai Chi practice, lack of group atmosphere outside of class, and scheduling conflicts. Future researchers can address these factors to improve trial recruitment and implementation of Tai Chi and other mind-body interventions in research and for real world applications.
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Affiliation(s)
- Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Xun Li
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Nicole Peel
- School of Health and Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Nerida Klupp
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
- School of Health and Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Alan Bensoussan
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Hosen Kiat
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
- Faculty of Medicine, Human and Health Sciences, Macquarie University, Macquarie, NSW, 2109, Australia
- ANU College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia
- Cardiac Health Institute, Sydney, NSW, 2122, Australia
| | - Dennis Chang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia
- Correspondence: Dennis Chang; Guoyan Yang, NICM Health Research Institute, Western Sydney University, Locked Bag, 1797, Penrith, NSW, 2751, Australia, Tel +61 2 9685 4725, Fax +61 2 9685 4760, Email ;
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Xu S, Baker JS, Ren F. The Positive Role of Tai Chi in Responding to the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7479. [PMID: 34299925 PMCID: PMC8307944 DOI: 10.3390/ijerph18147479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/14/2022]
Abstract
The ongoing coronavirus 2019 (COVID-19) pandemic has posed a significant threat to both people's physical and mental health. Physical inactivity, sedentary behavior, and negative emotions among the general population have been significantly increased because of COVID-19 home confinement. These are major risk factors associated with higher incidences of morbidity and mortality. Therefore, effective exercise management should be proposed as a prevention strategy to improve both physical and mental health while diminishing the effects of COVID-19. Tai Chi as a low-to-moderate aerobic exercise combines physical and mental training and plays a positive impact on human health. Here we aim to outline the effects of Tai Chi on the immune system, inflammatory responses, pulmonary function, and emotional control. The benefits of Tai Chi practice for individuals coping with COVID-19 are stated here which include immune system promotion, inflammation response reduction, rehabilitation in respiratory diseases, and emotional improvement. This statement has been supported by available clinical, physiological, and biological research. As a result, we hope to introduce Tai Chi as an effective exercise intervention for people coping with COVID-19 and as a beneficial exercise for maintaining an active lifestyle during a pandemic.
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Affiliation(s)
- Suodi Xu
- Department of Physical Education, Ningbo University of Finance and Economics, Ningbo 315175, China;
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China;
| | - Feng Ren
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
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Chau SWH, Wong OWH, Ramakrishnan R, Chan SSM, Wong EKY, Li PYT, Raymont V, Elliot K, Rathod S, Delanerolle G, Phiri P. History for some or lesson for all? A systematic review and meta-analysis on the immediate and long-term mental health impact of the 2002-2003 Severe Acute Respiratory Syndrome (SARS) outbreak. BMC Public Health 2021; 21:670. [PMID: 33827499 PMCID: PMC8025448 DOI: 10.1186/s12889-021-10701-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 03/24/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The aims of this systematic review and meta-analysis are to examine the prevalence of adverse mental health outcomes, both short-term and long-term, among SARS patients, healthcare workers and the general public of SARS-affected regions, and to examine the protective and risk factors associated with these mental health outcomes. METHODS We conducted a systematic search of the literature using databases such as Medline, Pubmed, Embase, PsycInfo, Web of Science Core Collection, CNKI, the National Central Library Online Catalog and dissertation databases to identify studies in the English or Chinese language published between January 2003 to May 2020 which reported psychological distress and mental health morbidities among SARS patients, healthcare workers, and the general public in regions with major SARS outbreaks. RESULTS The literature search yielded 6984 titles. Screening resulted in 80 papers for the review, 35 of which were included in the meta-analysis. The prevalence of post-recovery probable or clinician-diagnosed anxiety disorder, depressive disorder, and post-traumatic stress disorder (PTSD) among SARS survivors were 19, 20 and 28%, respectively. The prevalence of these outcomes among studies conducted within and beyond 6 months post-discharge was not significantly different. Certain aspects of mental health-related quality of life measures among SARS survivors remained impaired beyond 6 months post-discharge. The prevalence of probable depressive disorder and PTSD among healthcare workers post-SARS were 12 and 11%, respectively. The general public had increased anxiety levels during SARS, but whether there was a clinically significant population-wide mental health impact remained inconclusive. Narrative synthesis revealed occupational exposure to SARS patients and perceived stigmatisation to be risk factors for adverse mental health outcomes among healthcare workers, although causality could not be determined due to the limitations of the studies. CONCLUSIONS The chronicity of psychiatric morbidities among SARS survivors should alert us to the potential long-term mental health complications of covid-19 patients. Healthcare workers working in high-risk venues should be given adequate mental health support. Stigmatisation against patients and healthcare workers should be explored and addressed. The significant risk of bias and high degree of heterogeneity among included studies limited the certainty of the body of evidence of the review.
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Affiliation(s)
- Steven W. H. Chau
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Oscar W. H. Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Rema Ramakrishnan
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, UK
| | - Sandra S. M. Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Evelyn K. Y. Wong
- Department of Psychiatry, North District Hospital, Sheung Shui, Hong Kong
| | - Pinky Y. T. Li
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vanessa Raymont
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Kathryn Elliot
- Research & Development Department, Tom Rudd Unit, Clinical Trials Facility, Moorgreen Hospital, Southern Health NHS Foundation Trust, Southampton, SO30 3JB UK
| | - Shanaya Rathod
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Gayathri Delanerolle
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Peter Phiri
- Research & Development Department, Tom Rudd Unit, Clinical Trials Facility, Moorgreen Hospital, Southern Health NHS Foundation Trust, Southampton, SO30 3JB UK
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
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9
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Does Post-COVID-19 symptoms exist? A longitudinal study of COVID-19 sequelae in Wenzhou, China. ANNALES MEDICO-PSYCHOLOGIQUES 2021; 179:818-821. [PMID: 33688094 PMCID: PMC7934689 DOI: 10.1016/j.amp.2021.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/01/2021] [Indexed: 01/12/2023]
Abstract
Objective We conducted a cohort of tracing discharge patients of COVID-19. Materials and methods We used the Mann–Whitney U test, χ2 test, or Fisher's exact test to compare differences between age groups and gender groups where appropriate. Results Our study provides insights into the nature and severity of medical conditions specific to survivors of COVID-19. Conclusions It also highlights the potential mental health issues resulting from infectious disease outbreaks within communities.
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10
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Khoshaim HB, Al-Sukayt A, Chinna K, Nurunnabi M, Sundarasen S, Kamaludin K, Baloch GM, Hossain SFA. Anxiety Level of University Students During COVID-19 in Saudi Arabia. Front Psychiatry 2020; 11:579750. [PMID: 33362601 PMCID: PMC7759470 DOI: 10.3389/fpsyt.2020.579750] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
COVID-19 is the worst pandemic of this millennium, and it is considered to be the "public enemy number one." This catastrophe has changed the way we live in the blink of an eye. Not only has it threatened our existence and health status, but the damage associated with it could equally affect our economic, social, and educational systems. The focus of this study was on the anxiety level of university students during the COVID-19 pandemic in Saudi Arabia. The study was conducted between March and June 2020. A questionnaire was administered online, and 400 completed questionnaires were returned. In this study, the Zung self-rating anxiety scale was used to determine the anxiety levels among the respondents. The results indicated that about 35% of the students experienced moderate to extreme levels of anxiety. Anxiety was highly associated with age, sex, and level of education. These findings can enlighten government agencies and policy makers on the importance of making prompt, effective decisions to address students' anxiety during the COVID-19 pandemic. Researchers are encouraged to focus their future studies on how to develop strategies to boost students' resilience and enhance their adaptability skills for similar disasters in the future.
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Affiliation(s)
- Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, Riyadh, Saudi Arabia
| | - Areej Al-Sukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Gul Mohammad Baloch
- Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Syed Far Abid Hossain
- College of Business Administration, IUBAT - International University of Business Agriculture and Technology, Dhaka, Bangladesh
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11
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Tangkiatkumjai M, Boardman H, Walker DM. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther 2020; 20:363. [PMID: 33228697 PMCID: PMC7686746 DOI: 10.1186/s12906-020-03157-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. METHODS A literature search was performed on Pubmed, ScienceDirect and EMBASE. KEYWORDS 'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. RESULTS 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). CONCLUSIONS Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.
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Affiliation(s)
- Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand
| | - Helen Boardman
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, UK
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12
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Khoshaim HB, Al-Sukayt A, Chinna K, Nurunnabi M, Sundarasen S, Kamaludin K, Mohammad Baloch G, Far Abid Hossain S. How students in the Kingdom of Saudi Arabia are coping with COVID-19 pandemic. J Public Health Res 2020; 9:1898. [PMID: 33437753 PMCID: PMC7789870 DOI: 10.4081/jphr.2020.1898] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/05/2020] [Indexed: 12/23/2022] Open
Abstract
The novel coronavirus is the worst pandemic of this century. Unfortunately, there is no clear solution for how to cope with such an epidemic. This study examines the coping strategies used by university students in the Kingdom of Saudi Arabia. From March to May 2020, a questionnaire was administered and completed by 400 students. This study used the Zung Self-rating Anxiety Scale (SAS) to examine the respondents' level of anxiety. The results indicate that 35% of students experienced some levels of anxiety. Moreover, there was a moderate use of four types of coping strategies: Seek social support, acceptance, mental disengagement, and humanitarian. These findings can guide policymakers on the importance of developing practical guidelines to handle such lethal diseases. Moreover, the results inform the Saudi community what strategies were used to cope so far with the pandemic. Future research is expected to address the validity and appropriateness of these strategies and encourage other approaches.
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Affiliation(s)
- Heba Bakr Khoshaim
- Deanship of Educational Services, Prince Sultan University, Riyadh, Saudi Arabia
| | - Areej Al-Sukayt
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Jalan Taylors, Subang Jaya, Selangor, Malaysia
| | - Mohammad Nurunnabi
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Sheela Sundarasen
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Kamilah Kamaludin
- Department of Accounting, Prince Sultan University, Riyadh, Saudi Arabia
| | - Gul Mohammad Baloch
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Jalan Taylors, Subang Jaya, Selangor, Malaysia
| | - Syed Far Abid Hossain
- College of Business Administration, IUBAT-International University of Business Agriculture and Technology, Dhaka, Bangladesh
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13
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Fu XW, Wu LN, Shan L. Review of possible psychological impacts of COVID-19 on frontline medical staff and reduction strategies. World J Clin Cases 2020; 8:3188-3196. [PMID: 32874973 PMCID: PMC7441266 DOI: 10.12998/wjcc.v8.i15.3188] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 02/05/2023] Open
Abstract
Like soldiers, frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019. It is important to acknowledge the considerable pressure placed on frontline medical staff in the face of a new type of coronavirus that is highly infectious and for which no specific treatment is available. Here, we review the various kinds of psychological problems afflicting frontline medical staff who are combatting the severe acute respiratory syndrome epidemic. These include anxiety, insomnia, depression, interpersonal difficulties, and post-traumatic stress disorder syndrome. We further present a summary of countermeasures for alleviating these problems based on our findings. These countermeasures include ensuring the provision of adequate protective gear for frontline medical staff, developing timely and clear guidelines, strengthening social support, and providing clear criteria and additional training, focusing on the choice of frontline medical staff. An understanding of the psychological impacts of an epidemic situation and of relevant countermeasures will contribute to reducing the psychological pressures on frontline medical staff. Consequently, they will be able to cope better with outbreaks of infectious diseases in the future, to reduce the psychological pressure of the front-line medical staff, and to improve the treatment level.
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Affiliation(s)
- Xiao-Wei Fu
- Department of Nursing, Lianyungang Maternal and Child Health Hospital, Lianyungang 222000, Jiangsu Province, China
| | - Li-Na Wu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Ling Shan
- Department of Nursing, Lianyungang Maternal and Child Health Hospital, Lianyungang 222000, Jiangsu Province, China
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14
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Feng F, Tuchman S, Denninger JW, Fricchione GL, Yeung A. Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults. Am J Geriatr Psychiatry 2020; 28:812-819. [PMID: 32425471 PMCID: PMC7227578 DOI: 10.1016/j.jagp.2020.05.012] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 01/25/2023]
Abstract
The elderly are at high risk of contracting respiratory infectious diseases, including COVID-19 infection. The recent pandemic has the potential to cause significant physical and mental damage in older adults. Similarly to other mind-body exercises in Traditional Chinese medicine, Qigong features regulation of breath rhythm and pattern, body movement and posture, and meditation. Given these traits, Qigong has the potential to play a role in the prevention, treatment, and rehabilitation of respiratory infections, such as COVID-19. Potential mechanisms of action include stress reduction, emotion regulation, strengthening of respiratory muscles, reduction of inflammation, and enhanced immune function. Three forms of Qigong; abdominal breathing, Ba Duan Jin and Liu Zi Jue, all of which are gentle, smooth, and simple for the elderly to practice, are recommended in this context.
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Affiliation(s)
- Fan Feng
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Sylvie Tuchman
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA
| | - John W. Denninger
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Gregory L. Fricchione
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA
| | - Albert Yeung
- Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA; Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA.
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15
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Li Z, Zheng C, Duan C, Zhang Y, Li Q, Dou Z, Li J, Xia W. Rehabilitation needs of the first cohort of post-acute COVID-19 patients in Hubei, China. Eur J Phys Rehabil Med 2020; 56:339-344. [PMID: 32672029 DOI: 10.23736/s1973-9087.20.06298-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Corona Virus Disease-2019 (COVID-19) is an acute respiratory infectious disease. Despite being clinically cured, some patients still find it difficult to return to their normal life and work due to the varying degree of dysfunctions that they have, as part of the disease's aftereffect. Through this study, we aim to learn more about the dysfunctions and rehabilitation needs of COVID-19 patients. METHODS In this survey, the basic information, dysfunctions, and rehabilitation needs of the hospitalized COVID-19 patients, who were selected by convenience sampling in Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, were obtained using a self-designed questionnaire. The research was conducted from February 29, 2020 to March 2, 2020. RESULTS A total of 280 patients were finally included, who were mainly over 51 years of age (64.2%). The main physical dysfunctions that the patients had were sleep disorders (63.6%), decreased activity endurance (61.4%), and respiratory dysfunction (57.9%), while the main psychological dysfunctions included anxiety (62.1%) and fear (50.0%). Rehabilitation that mainly requested by the patients included exercise guidance, dietary instruction, traditional Chinese medicine therapy, physical therapy, and Chinese traditional health exercises. CONCLUSIONS The demand for rehabilitation is high among COVID-19 patients, which requires the quick establishment of a comprehensive and individualized rehabilitation program, to be fulfilled.
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Affiliation(s)
- Zhengliang Li
- Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China.,Hubei Provincial Clinical Research Center for Rehabilitation of Integrated Traditional Chinese and Western Medicine, Wuhan, China
| | - Chanjuan Zheng
- Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China.,Hubei Provincial Clinical Research Center for Rehabilitation of Integrated Traditional Chinese and Western Medicine, Wuhan, China
| | - Can Duan
- Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China.,Hubei Provincial Clinical Research Center for Rehabilitation of Integrated Traditional Chinese and Western Medicine, Wuhan, China
| | - Yangpu Zhang
- Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China.,Hubei Provincial Clinical Research Center for Rehabilitation of Integrated Traditional Chinese and Western Medicine, Wuhan, China
| | - Qinglin Li
- Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China.,Hubei Provincial Clinical Research Center for Rehabilitation of Integrated Traditional Chinese and Western Medicine, Wuhan, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenguang Xia
- Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China - .,Hubei Provincial Clinical Research Center for Rehabilitation of Integrated Traditional Chinese and Western Medicine, Wuhan, China
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16
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MacDonald CW, Osmotherly PG, Rivett DA. COVID-19 wash your hands but don't erase them from our profession - considerations on manual therapy past and present. J Man Manip Ther 2020; 28:127-131. [PMID: 32666913 PMCID: PMC7480463 DOI: 10.1080/10669817.2020.1766845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Peter G Osmotherly
- Senior Lecturer, School of Health Sciences (Physiotherapy), University of Newcastle, Australia
| | - Darren a Rivett
- Professor of Physiotherapy, The University of Newcastle, Australia
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17
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Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, Zandi MS, Lewis G, David AS. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020; 7:611-627. [PMID: 32437679 PMCID: PMC7234781 DOI: 10.1016/s2215-0366(20)30203-0] [Citation(s) in RCA: 1507] [Impact Index Per Article: 301.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Before the COVID-19 pandemic, coronaviruses caused two noteworthy outbreaks: severe acute respiratory syndrome (SARS), starting in 2002, and Middle East respiratory syndrome (MERS), starting in 2012. We aimed to assess the psychiatric and neuropsychiatric presentations of SARS, MERS, and COVID-19. METHODS In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature databases (from their inception until March 18, 2020), and medRxiv, bioRxiv, and PsyArXiv (between Jan 1, 2020, and April 10, 2020) were searched by two independent researchers for all English-language studies or preprints reporting data on the psychiatric and neuropsychiatric presentations of individuals with suspected or laboratory-confirmed coronavirus infection (SARS coronavirus, MERS coronavirus, or SARS coronavirus 2). We excluded studies limited to neurological complications without specified neuropsychiatric presentations and those investigating the indirect effects of coronavirus infections on the mental health of people who are not infected, such as those mediated through physical distancing measures such as self-isolation or quarantine. Outcomes were psychiatric signs or symptoms; symptom severity; diagnoses based on ICD-10, DSM-IV, or the Chinese Classification of Mental Disorders (third edition) or psychometric scales; quality of life; and employment. Both the systematic review and the meta-analysis stratified outcomes across illness stages (acute vs post-illness) for SARS and MERS. We used a random-effects model for the meta-analysis, and the meta-analytical effect size was prevalence for relevant outcomes, I2 statistics, and assessment of study quality. FINDINGS 1963 studies and 87 preprints were identified by the systematic search, of which 65 peer-reviewed studies and seven preprints met inclusion criteria. The number of coronavirus cases of the included studies was 3559, ranging from 1 to 997, and the mean age of participants in studies ranged from 12·2 years (SD 4·1) to 68·0 years (single case report). Studies were from China, Hong Kong, South Korea, Canada, Saudi Arabia, France, Japan, Singapore, the UK, and the USA. Follow-up time for the post-illness studies varied between 60 days and 12 years. The systematic review revealed that during the acute illness, common symptoms among patients admitted to hospital for SARS or MERS included confusion (36 [27·9%; 95% CI 20·5-36·0] of 129 patients), depressed mood (42 [32·6%; 24·7-40·9] of 129), anxiety (46 [35·7%; 27·6-44·2] of 129), impaired memory (44 [34·1%; 26·2-42·5] of 129), and insomnia (54 [41·9%; 22·5-50·5] of 129). Steroid-induced mania and psychosis were reported in 13 (0·7%) of 1744 patients with SARS in the acute stage in one study. In the post-illness stage, depressed mood (35 [10·5%; 95% CI 7·5-14·1] of 332 patients), insomnia (34 [12·1%; 8·6-16·3] of 280), anxiety (21 [12·3%; 7·7-17·7] of 171), irritability (28 [12·8%; 8·7-17·6] of 218), memory impairment (44 [18·9%; 14·1-24·2] of 233), fatigue (61 [19·3%; 15·1-23·9] of 316), and in one study traumatic memories (55 [30·4%; 23·9-37·3] of 181) and sleep disorder (14 [100·0%; 88·0-100·0] of 14) were frequently reported. The meta-analysis indicated that in the post-illness stage the point prevalence of post-traumatic stress disorder was 32·2% (95% CI 23·7-42·0; 121 of 402 cases from four studies), that of depression was 14·9% (12·1-18·2; 77 of 517 cases from five studies), and that of anxiety disorders was 14·8% (11·1-19·4; 42 of 284 cases from three studies). 446 (76·9%; 95% CI 68·1-84·6) of 580 patients from six studies had returned to work at a mean follow-up time of 35·3 months (SD 40·1). When data for patients with COVID-19 were examined (including preprint data), there was evidence for delirium (confusion in 26 [65%] of 40 intensive care unit patients and agitation in 40 [69%] of 58 intensive care unit patients in one study, and altered consciousness in 17 [21%] of 82 patients who subsequently died in another study). At discharge, 15 (33%) of 45 patients with COVID-19 who were assessed had a dysexecutive syndrome in one study. At the time of writing, there were two reports of hypoxic encephalopathy and one report of encephalitis. 68 (94%) of the 72 studies were of either low or medium quality. INTERPRETATION If infection with SARS-CoV-2 follows a similar course to that with SARS-CoV or MERS-CoV, most patients should recover without experiencing mental illness. SARS-CoV-2 might cause delirium in a significant proportion of patients in the acute stage. Clinicians should be aware of the possibility of depression, anxiety, fatigue, post-traumatic stress disorder, and rarer neuropsychiatric syndromes in the longer term. FUNDING Wellcome Trust, UK National Institute for Health Research (NIHR), UK Medical Research Council, NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust and University College London.
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Affiliation(s)
| | - Edward Chesney
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychosis Studies, King's College London, London, UK
| | - Dominic Oliver
- Department of Psychosis Studies, King's College London, London, UK
| | - Thomas A Pollak
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychosis Studies, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Michael S Zandi
- UCL Queen Square Institute of Neurology, University College London, London, UK; University College London Hospitals NHS Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Anthony S David
- UCL Institute of Mental Health, University College London, London, UK
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18
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Zhao HM, Xie YX, Wang C. Recommendations for respiratory rehabilitation in adults with coronavirus disease 2019. Chin Med J (Engl) 2020; 133:1595-1602. [PMID: 32251002 PMCID: PMC7470013 DOI: 10.1097/cm9.0000000000000848] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Hong-Mei Zhao
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - Yu-Xiao Xie
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Chen Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100730, China
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19
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Liu J, Yu P, Lv W, Wang X. The 24-Form Tai Chi Improves Anxiety and Depression and Upregulates miR-17-92 in Coronary Heart Disease Patients After Percutaneous Coronary Intervention. Front Physiol 2020; 11:149. [PMID: 32218741 PMCID: PMC7078346 DOI: 10.3389/fphys.2020.00149] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 02/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background Anxiety and depression are common symptoms in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). The 24-form Tai Chi may exert a protective function for CHD patients after PCI by improving anxiety and depression. Methods Patients who received PCI after 1–4 days were randomly assigned to the 24-form Tai Chi group (TG) and the control group (CG). The differences in anxiety and depression, using the Medical Outcomes Study 36−item Short−Form Health Survey (SF-36), before and after an average of 10 months of Tai Chi intervention were compared in both groups to analyze the effects of Tai Chi on the emotion and the life quality of CHD patients. Meanwhile, the relative levels of miR-17-92 were measured by using real-time qPCR. The association between the relative levels of miR-17-92 and the anxiety and the depression of CHD patients after PCI was analyzed. Adjusted Cox models were used to explore the effect of Tai Chi exercise in CHD patients. Results After 10 months of intervention, the changes in the anxiety subscale (P = 0.002), in the depression subscale (P = 0.008), and in the stress (P = 0.015) scores were higher in the TG group when compared to those of the CG group. The proportion of anxious (P = 0.045) and depressed subjects (P = 0.042) in the TG group was lower than that in the CG group. On the other hand, the increase in the SF-36 scores and in the relative levels of miR-17-92 was significantly higher in the TG group when compared with that of the CG group (P < 0.05). The serum level of miR-17-92 had a negative correlation with the anxiety, the depression, and the stress scores (P < 0.01). Conclusion The 24-form Tai Chi improved the anxiety and the depression symptoms and upregulated the miR-17-92 levels in CHD patients after PCI.
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Affiliation(s)
- Jia Liu
- Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
| | - Ping Yu
- Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
| | - Wei Lv
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, China
| | - Xinxin Wang
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, China
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20
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James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross-sectional study. BMC Public Health 2020; 20:182. [PMID: 32020858 PMCID: PMC7001224 DOI: 10.1186/s12889-020-8279-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We examined the magnitude and correlates of Ebola virus disease (EVD)-related stigma among EVD survivors in Sierra Leone since their return to their communities. In addition, we determined whether EVD-related stigma is a predictor of informal health care use among EVD survivors. METHODS We conducted a cross-sectional study among 358 EVD survivors in five districts across all four geographic regions (Western Area, Northern Province, Eastern Province and Southern Province) of Sierra Leone. Ebola-related stigma was measured by adapting the validated HIV related stigma for people living with HIV/AIDS instrument. We also measured traditional and complementary medicine (T&CM) use (as a measure of informal healthcare use). Data were analysed using descriptive statistics and regression analysis. RESULTS EVD survivors report higher levels of internalised stigma (0.92 ± 0.77) compared to total enacted stigma (0.71 ± 0.61). Social isolation (0.96 ± 0.88) was the highest reported enacted stigma subscale. Ebola survivors who identified as Christians [AOR = 2.51, 95%CI: 1.15-5.49, p = 0.021], who perceived their health to be fair/poor [AOR = 2.58, 95%CI: 1.39-4.77. p = 0.003] and who reside in the northern region of Sierra Leone [AOR = 2.80, 95%CI: 1.29-6.07, p = 0.009] were more likely to experience internalised stigma. Verbal abuse [AOR = 1.95, 95%CI: 1.09-3.49, p = 0.025] and healthcare neglect [AOR = 2.35, 95%CI: 1.37-4.02, p = 0.002] were independent predictors of T&CM use among EVD survivors. CONCLUSION Our findings suggest EVD-related stigma (internalised and enacted) is prevalent among EVD survivors since their return to their communities. Religiosity, perceived health status and region were identified as independent predictors of internalised stigma. Verbal abuse and healthcare neglect predict informal healthcare use. EVD survivor-centred and community-driven anti-stigma programs are needed to promote EVD survivors' recovery and community re-integration.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jonathan Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
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James PB, Wardle J, Steel A, Adams J. Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E387. [PMID: 31323758 PMCID: PMC6681324 DOI: 10.3390/medicina55070387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/27/2019] [Accepted: 07/12/2019] [Indexed: 12/29/2022]
Abstract
Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors' attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57-9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92-13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10-30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74-9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors' attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner-survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney 2007, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, 00232 Freetown, Sierra Leone.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney 2007, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney 2007, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney 2007, Australia
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James PB, Wardle J, Steel A, Adams J. Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review. Trop Med Int Health 2019; 24:671-691. [PMID: 30843627 DOI: 10.1111/tmi.13226] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE A myriad of physical and psychosocial sequelae have been reported among Ebola survivors from previous Ebola virus disease (EVD) outbreaks, including the most recent in West Africa. This review examines the various forms of psychological distress experienced by EVD survivors, family and community reactions to EVD survivors and EVD survivors' coping mechanisms. METHODS We conducted a literature search of original articles employing Medline (Ovid), PubMed, Web of Science, Scopus, CINAHL, EBSCO host academic search complete, PsycINFO (EBSCO) and Embase databases. RESULTS Our search identified 1890 articles of which 24 met our inclusion criteria. Various forms of psychological distress were prevalent among EVD survivors including depression, anxiety, anger, grief, guilt, flashbacks, sadness, worthlessness, substance addiction, suicidal tendencies and self-stigmatisation. Family and community responses to EVD survivors ranged from acceptance to rejection, isolation, stigmatisation and discrimination. EVD survivors' coping strategies included engagement with religious faith, EVD survivors associations and involvement in EVD prevention and control interventions. CONCLUSION Psychological distress, including that resulting from family and community stigma and discrimination, appears common among EVD survivors. Community-based mental health and psychosocial interventions integrated within a broader package of care for EVD survivors that also recognises the physical health challenges are required. Well-designed longitudinal studies can provide clear insights on the nature and trajectory of the psychosocial issues currently experienced by EVD survivors.
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Affiliation(s)
- P B James
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - J Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - A Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - J Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Malik A, Alsenaidy MA. MERS-CoV papain-like protease (PL pro): expression, purification, and spectroscopic/thermodynamic characterization. 3 Biotech 2017; 7:100. [PMID: 28560640 PMCID: PMC5449288 DOI: 10.1007/s13205-017-0744-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/06/2017] [Indexed: 12/20/2022] Open
Abstract
Within a decade, MERS-CoV emerged with nearly four times higher case fatality rate than an earlier outbreak of SARS-CoV and spread out in 27 countries in short span of time. As an emerging virus, combating it requires an in-depth understanding of its molecular machinery. Therefore, conformational characterization studies of coronavirus proteins are necessary to advance our knowledge of the matter for the development of antiviral therapies. In this study, MERS-CoV papain-like protease (PLpro) was recombinantly expressed and purified. Thermal folding pathway and thermodynamic properties were characterized using dynamic multimode spectroscopy (DMS) and thermal shift assay. DMS study showed that the PLpro undergoes a single thermal transition and follows a pathway of two-state folding with Tm and van’t Hoff enthalpy values of 54.4 ± 0.1 °C and 317.1 ± 3.9 kJ/mol, respectively. An orthogonal technique based on intrinsic tryptophan fluorescence also showed that MERS-CoV PLpro undergoes a single thermal transition and unfolds via a pathway of two-state folding with a Tm value of 51.4 °C. Our findings provide significant understandings of the thermodynamic and structural properties of MERS-CoV PLpro.
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Affiliation(s)
- Ajamaluddin Malik
- Department of Biochemistry, Protein Research Chair, College of Science, King Saud University, PO Box 2455, Riyadh, 11451, Saudi Arabia.
| | - Mohammad A Alsenaidy
- Vaccines and Biologics Research Unit, Department of Pharmaceutics, College of Pharmacy, King Saud University, PO Box 2457, Riyadh, 11451, Saudi Arabia
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