Abstract
A prominent issue associated with HIV is the stigma around it owing to a lack of awareness. This study aimed to find the association between HIV and AIDS-related knowledge and discriminatory ...attitudes amongst Pakistani women of reproductive age using the 2017–18 Pakistani Demographic Health Survey (PDHS) data. We analyzed a sample of 3381 Pakistani women of reproductive age using ordinal logistic regression for complex survey data. Two composite variables were created using the HIV module to denote the respondents’ HIV-related knowledge and their attitude toward people living with HIV (PLHIV) and calculated using a scoring method. Additional variables included the respondents’ age, education level, socioeconomic status, residential setting, and HIV testing history. More than half (58.8%) of the respondents presented with a negative attitude toward PLHIV and 64.3% of the respondents had poor knowledge regarding the illness. In the multivariable analysis, knowledge about HIV and level of education reported significant associations with discriminatory attitudes. We concluded that the odds of individuals living in a rural setting and hailing from a low socioeconomic background presenting with a negative attitude towards PLHIV were 2.52 times (95% CI 1.07–5.89) higher as compared to those living in an urban setting from a high socioeconomic background.
A pilot quasi‐experimental study was conducted in which participants in the intervention group (n = 31) received positive learning environment through Positive Disciplining (PLEPD) module, while ...those in the control group (n = 29) received routine training. Teachers' knowledge and attitude regarding corporal punishment (CP) and Beck Depression Inventory‐II (BDI‐II) were measured before (T0), immediately after (T1) and 3 months after the intervention (T2). Descriptive analysis and analysis of variance (ANOVA) were used to describe participants' characteristics and mean scores for knowledge and attitude among teachers. A total of 60 teachers completed the 16 hours training module. The overall response rate was >90%. Most participants recommended increasing the overall duration of the programme by reducing 4 to 2 hours per day, thus, increasing the period from 4 to 8 days of training. There were no differences between control and intervention groups at baseline regarding participant characteristics (p= > .05). The difference in depression (F = .0863, p = .357) and knowledge and attitude (F = 1.589, p = .213) scores among groups were not statistically significant. However, the mean score for knowledge and attitude followed a positive trend, increasing depression mean scores at T1 and T2. A positive disciplining programme is a feasible school intervention for public schools and may effectively reduce depression to ensure overall well‐being.
In Pakistan there is a dire need to explore the quality of life in infertile males and females and its undesirable psychological outcomes. This, study aimed to compare the quality of life (QoL) of ...males and females visiting an infertility centre for treatment and to assess its association with resilience, depression, and other socio-demographic factors.
An Analytical Cross-Sectional study was conducted amongst infertile males and females at the Australian Concept Infertility Medical Centre (ACIMC), Karachi, Pakistan. The non-probability (purposive) sampling strategy was used to recruit the participants. The sample size was 668. Data was analysed using STATA version 12. FertiQoL tool, Beck II Depression Inventory Tool and Resilience Scale 14 (RS-14) were used for assessing the quality of life, depression and resilience respectively of infertile patients.
Total 668 infertile patients, 334 males and 334 females participated in the study. The mean age was 35.53 ± 6.72, among males, and 30.87 ± 6.12 among females. The mean resilience scores were significantly higher among males, (77.64 ± 8.56), as compared to females (76.19 ± 8.69) (95% CI; - 2.757, - 0.1347). However, a significantly higher proportion of females were depressed (13.8%) as compared to males (6%). The mean QoL scores for the general health domain, emotional domain, mind and body domain, and relational domain, and the total QoL were significantly higher in males as compared to females (p value< 0.001); however, QoL for the social domain was not significantly different in both the groups. On multivariable linear regression resilience and depression among males had a significant association with QoL, after adjusting for the covariates educational status, monthly income, and number of friends. Similar association was observed among females after adjusting for the covariate monthly income only.
Fertility related QoL of men and women has a significant association with no formal education, number of friends, income, depression and resilience. Therefore, health care professionals in the field of infertility must be adequately trained to respond to the needs of individuals going through these psychological problems.
The objective of this study was to assess the psychological impact of isolation on individuals with Covid-19 and determine the experiences of people in isolation. All adults with Covid-19 who ...reported to the infectious disease tele-clinic were included in the study; participants were sent the survey form via email. The email was sent to 146 people and 47 responses were received. IES-R questionnaire was submitted to all individuals on Day 7 of quarantine, along with a qualitative questionnaire. The mean score on IES-R for all the respondents was 18.77. Out of 47 participants, for 6 (12.8%) PTSD was a clinical concern, 3 (6.4%) participants had a probable diagnosis of PTSD, and 6 (12.8%) participants scored high enough to suppress immune function. The majority of participants reported stress due to confinement in an isolated space and interruption in daily routine, specifically work-related routine. Praying, meditation, and having social support helped the participants cope with the isolation.
A pilot study using a pre-post interventional design, was carried out to evaluate the effectiveness of a resilience-based training workshop on the self-efficacy and resilience of schoolteachers in a ...peri-urban area of Karachi, Pakistan. Four in person workshops were held at the school's location during January to June 2022.
A total of 14 teachers participated in the workshop. The effectiveness of interventions was evaluated by assessing self-efficacy and resilience in pre- and post-teaching modules. The Wilcoxon Signed Rank Test determined a significant difference between the pre- to post-module scores of Self Efficacy (p = 0.016) and resilience (p = 0.006). The pre-median scores with IQR of Self-Efficacy were 28 (10), and Resilience scores 76 (12); and post-scores for Self-Efficacy and Resilience scores increased to 35 (5.5) and 88 (14) respectively. This indicated significant improvement in general self-efficacy and resilience skills after four weeks of training. This pilot study showed that building knowledge regarding mental health struggles in students and oneself, learning ways to cope with stress and manage student behavior, and forming a peer support system are crucial in building self-efficacy and resilience in teachers.
Introduction The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC) such as Pakistan. Methods An ...analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding their resilience scores was collected through Wagnild and Young's Resilience scale that comprises of 14 items (RS-14). Moreover, depression and anxiety were also assessed via Hospital Anxiety and Depression Scale (HADS) and social support was assessed by Enriched Social Support Instrument (ESSI). Results The data was analyzed by linear regression modeling. Unadjusted and adjusted beta coefficients with 95% CI were reported. A total of 250 head and neck cancer patients were recruited, 79% of them were males. Mean age of the patients was 51.59 years with 93% having high social support and only 8% having severe depression and 3% having severe anxiety. After adjusting for the covariates in multivariable analysis resilience was associated with severe depression (- 17- 20.98,-12.93) or borderline depression (- 4- 8.41,-0.39), severe anxiety (- 11 - 17.88,-4.18), low social support (- 6- 9.62,-1.71), having family members of > 6 in the household (- 2- 4.31,-0.29), smokeless tobacco users post- treatment (105.79, 14.45), and those who underwent tracheotomy (- 4- 7.67,-0.21). There was a significant interaction between education and role in the family (decision maker). Conclusion In Pakistan, a South Asian LMIC, collectivist culture prevails, family ties are greatly promoted thus resilience and social support is highly prevalent in head and neck cancer patients resulting in lower prevalence of depression and anxiety. Our study highlights that higher resilience is prevalent among small families less than six members, as the welfare of the individual is prioritized over multiple needs of the family. Formal Education and role in household/decision making power are effect modifiers in our study, demonstrating its protective effect on the mental health of head and neck cancer patients. High resilience scores were reported among current smokeless tobacco users as compared to quitters post treatment. Resilience-building interventions should be formulated to aid head and neck cancer patients to cope with the disease and its sequel. Keywords: Anxiety, Developing countries, Depression, Head and neck cancer, mental health, Psycho-oncology, Resilience, Social support, Oncology
Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible ...to developing stress-reactions. This study assesses symptoms of post-traumatic stress disorder and its predictors among the personnel of a selected EMS in Karachi, Pakistan.
Data were gathered from 518 personnel working in an EMS setting from February to May 2014. Participants were screened for post-traumatic stress symptoms using the Impact of Event Scale-Revised (IES-R). Demographic and work-related characteristics, coping styles and the social support systems of the participants were assessed. Linear regression was used on the IES-R to identify predictors of post-traumatic stress symptoms.
The mean score of the IES-R was 23.9 ± 12.1. EMS personnel with a dysfunctional coping style (β = 0.67 CI 0.39 - 0.95), anxiety, and depression (β = 0.64 CI 0.52 - 0.75) were more likely to have increased severity of post-traumatic stress symptoms. Age was found to have an inverse relationship with stress symptoms (β = -0.17 CI 0.33 - -0.023), indicating the susceptibility of younger EMS personnel to stress.
The EMS personnel in this setting were found to have a moderate level of post-traumatic stress symptoms. The significant predictors of post-traumatic stress symptoms in this EMS population were age, coping style, and levels of anxiety and depression. These predicting factors can be a potential avenue for interventions to improve the mental health of these frontline workers.
Objectives
This study assessed resilience in brain tumor patients at a tertiary care hospital in Pakistan (a lower middle‐income country; LMIC) and explored its relationship with patients' ...sociodemographic factors, clinical characteristics, social support, and mental health.
Methods
A cross‐sectional survey was conducted amongst adult (≥18 years) patients with brain tumor at the Aga Khan University Hospital, Pakistan. Resilience was assessed by Wagnild and Young's Resilience Scale, and patients' psychosocial characteristics by the Hospital Anxiety and Depression Scale and the Enriched Social Support Instrument.
Results
A total of 250 patients were included (mean age: 44 years; 68% males), with majority (97.6%) having high social support and only 4.4% and 2% having symptomatic depression and anxiety, respectively. On multivariable linear regression adjusted for covariates, lower resilience was associated with not being involved in household decision‐making (Adjusted Beta Coefficient: 4.58 95% Confidence Interval:−7.59, −1.56), not currently working (−2.80 −4.61, −0.99), undergoing multiple neurosurgical interventions such as tumor biopsies or resections (−8.64 −13.11, −4.16), receiving chemotherapy (−5.17 −9.51, −0.83) or combination adjuvant therapy (−2.91 −5.14, −0.67), low social support (−7.77 −13.73, 1.81), mild depression (−13.00 ‐17.00,‐8.99) or symptomatic depression (−19.79 −24.69, −14.89), and mild anxiety (−4.24 −7.98, −0.50).
Conclusion
Our study highlights the function of familial/household role and working status in mediating resilience, and demonstrates the well‐known protective effect of resilience for mental health in brain tumor patients in Pakistan, a South‐Asian LMIC. These findings are of clinical relevance with regards to the development of culture‐specific evidence‐based resilience‐building interventions that may help patients with brain tumors to cope with the psychological distress of cancer.
IntroductionSuicide is a major global public health problem. Low-income and middle-income countries contribute 78% of all suicidal deaths. Pakistan, a South Asian country, lacks official statistics ...on suicides at national level. Statistics on suicide are neither collected nationally nor published in the annual national morbidity and mortality surveys. Medicolegal reports on suicides and self-harm are extremely rich and important source of information but greatly underused in Pakistan. We aim to examine the patterns of suicides and self-harm retrospectively in patients who were registered with medicolegal centres (MLCs) in Karachi, during the period January 2017 to December 2021.Methods and analysisUsing retrospective descriptive design, the data will be collected from the medical records maintained at the main office of the Karachi police surgeon. Data from all nine MLCs of Karachi are collated and stored at the main office of Police surgeon. Information on suicide and self-harm cases will be extracted from records of all MLCs. The data will be collected using structured proforma and it will be analysed using descriptive and inferential analysis.Ethics and disseminationThe study was approved for exemption from Aga Khan University, Ethical Review Committee. The findings of the study will be disseminated by conducting seminars for healthcare professionals and stakeholders including psychiatrists, psychologists, counsellors, medicolegal officers, police surgeons, mental health nurses, general and public health physicians and policy makers. Findings will be published in local and international peer-reviewed scientific journals.
Background
Infertility is a major reproductive health problem in Pakistan. It has the potential to cause serious negative impact on a couple's marital life and psychological health.
Aim
This study ...aimed to assess the factors associated with maladjustment among infertile couples.
Method
An analytical cross‐sectional design was employed. Validated scales were used to assess marital adjustment, depression, resilience and quality of life among infertile couples. Purposive sampling was employed to enrol 334 infertile couples from a private infertility medical centre, of Karachi, Pakistan.
Results
Among couples, marital adjustment scores were comparable, but resilience and quality of life were significantly low among wives whereas depression was significantly high among wives compared with husbands. Wives' marital adjustment was positively correlated with husband's resilience and quality of life and negatively related with his depression. After employing adjusted actor–partner interdependence modelling, wives' own depression and resilience had significant effect on their marital adjustment and their partner's resilience, depression and quality of life did not have any impact on their outcome. On the contrary, wives' resilience had a significant effect in increasing the marital adjustment of their husband.
Conclusion
This study highlights the need to promote psychological support (resilience building skills) or couples' therapy to all those couples undergoing infertility treatment.
Summary statement
What is already known about this topic?
Infertility has an unequal impact on women and men. Women tend to have marital distress and more negative psychological impact than men.
Infertility is ignominy for families of the infertile couple. Constant pressure from families to conceive increases psychological distress in the infertile couple.
Infertility is a public health issue that impacts both couples therefore, a dyadic solution must be considered.
What this paper adds?
This is the first study to look at infertile couples' marital maladjustment, depression, resilience and quality of life, as well as their impact on other partners.
According to the findings, depression was found to be significantly higher in wives than in their husbands, while resilience and quality of life were significantly lower in wives compared with their husbands. Depression and resilience had a significant actor effect on the wife's marital adjustment, whereas the husband's depression, quality of life and resilience had no discernible effect. Wives' resilience, on the other hand, has a significant impact on husbands' marital adjustment.
The implications of this paper:
Every infertile couple should be assessed for the risk of mental illnesses along with positive psychological contrast like resilience; mental health support should be available for couples.
Couples should be given training module on resilience building skills in order to improve their mental health and positive healthy coping.
Basic couple counselling should be introduced and implemented in all medical and nursing institutes, and medical and nursing students should be trained to provide infertile couples with basic counselling sessions.
PDF
