Introduction: The Hospital Anxiety and Depression Scale (HADS) is widely used to predict and diagnose hospital anxiety and depression. It has been translated and validated in many languages, but the existing Arabic version was not validated in hospitalized patients. The aim was to translate, culturally adapt, and validate the HADS Questionnaire into Arabic language for in-patient use, especially for surgical wards. Methods: A systematic translation process was used to translate the original English HADS into Arabic. After the pilot study, we validated our version in surgical patients at two tertiary care centers. We tested the reliability of our version using internal consistency. We examined the validity by assessing construct validity, concurrent validity (by testing the associations between HADS, Generalized Anxiety Disorder 7-item scale [GAD-7], and Major Depression Inventory [MDI]), and face validity. The questionnaire was administered before and after surgery to examine responsiveness. Results: A total of 110 patients (22 men, 88 women) were included in the study. Cronbach's αs for the HADS anxiety subscale were 0.83 (95% confidence interval: 0.79– 0.88) and for the HADS depression subscale were 0.77 (0.7–0.83). Nearly 36% of the patients reported symptoms indicative of borderline or case anxiety before surgery, which decreased to 25% 1 week after surgery. HADS anxiety score was strongly correlated with GAD-7, and HADS depression score was strongly associated with MDI. Patients with higher American Society of Anesthesiologists Physical Status and those who remained hospitalized for more than 5 days were more likely to report depression symptoms. Most patients found the HADS questions to be clear and easy to understand, and thought the questionnaire items covered all their problem areas regarding their hospital anxiety and depression. Conclusions: Our Arabic version of HADS is a reliable and valid tool to assess the mood states in hospitalized patients.

Development and validation of Arabic version of the Hospital Anxiety and Depression Scale.

Prevalence of depression and anxiety in end-stage renal disease: A survey of patients undergoing hemodialysis

Background Anxiety and depression are common among nursing students due to different factors. When they are minimal and not persistent, they work as stimuli for good achievement. However, when they are high or persistent they have negative consequences (i.e. low academic achievement and higher absenteeism rates). Objective The purpose of this study was to check the effect of persistent anxiety and depression on nursing student academic achievement and absenteeism rate. Methods A prospective observational correlational design with a convenience sample of 170 students enrolled in the undergraduate and graduate programs-college of nursing at a private university in Amman, Jordan. Anxiety and depression were measured twice at the beginning of the semester and then two months later by Hospital Anxiety and Depression Scale. Data regarding grade point average, number of absenteeism and the gender of the students; were collected from the electronic system of the university. Results Persistently anxious group has lower grade point average than persistently non-anxious group (mean [SD], 64.1 [13.8] vs. 73.1 [12.3], P< .001). Moreover, they have higher absenteeism rate than persistently non-anxious group (7.62 [5.7] vs. 4.0 [3.4], P< .001) and higher than transiently anxious group (7.62 [5.7] vs. 4.7 [4.6], P< .05). Persistently depressed group has lower grade point average than persistently non-depressed group (64.0 [13.8] vs. 73.2 [13.0], P< .001) and lower than transiently depressed (64.0 [13.8] vs. 71.7 [10.6], P< .01). Conclusion Nursing administrators should search for the underlying causes for these negative emotions. Furthermore, setting strategies to control these negative emotions is highly recommended.

/pdf/persistent-anxiety-and-depression-affected-academic-2w5kiodw9n.pdf

Persistent (Anxiety and Depression) Affected Academic Achievement and Absenteeism in Nursing Students.

PURPOSE To investigate psychological distress among parents of children with autism spectrum disorder and the associated sociodemographic factors influencing parents' distress. DESIGN AND METHODS A cross-sectional design with a sample of 123 Jordanian parents providing care to children with autism spectrum disorder was used. A sociodemographic questionnaire, the Oberst Caregiving Burden Scale, the Bakas Caregiving Outcomes Scale, and the Hospital Anxiety and Depression Scale were utilized for data collection. FINDINGS Parents reported moderate levels of burden, negative life changes, and borderline depression and anxiety. The perceived burden related to caregiving task difficulty positively correlated with that related to time spent on tasks and negatively correlated with caregivers' caregiving-related outcomes. The perceived burden of caregiving tasks was negatively correlated with depression and anxiety and anxiety levels were positively correlated with depression (P < 0.001). PRACTICE IMPLICATION Healthcare providers, advanced practice nurses, and policy makers should be aware of the burden, anxiety, and depression experienced by caregivers of children with autism spectrum disorder.

Psychological distress and perceived burden in caregivers of persons with autism spectrum disorder.

Background: Perinatal mental illness is a global health concern; however, many women with the illness do not get the treatment they need to recover. Interventions that reduce the stigma around perinatal mental illness have the potential to enable women to disclose their symptoms to health care providers and consequently access treatment. There are many online forums for perinatal mental illness and thousands of women use them. Preliminary research suggests that online forums may promote help-seeking behavior, potentially because they have a role in challenging stigma. This study draws from these findings and theoretical concepts to present a model of forum use, stigma, and disclosure. Objective: This study tested a model that measured the mediating role of stigma between online forum use and disclosure of affective symptoms to health care providers. Methods: A Web-based survey of 200 women who were pregnant or had a child younger than 5 years and considered themselves to be experiencing psychological distress was conducted. Women were recruited through social media and questions measured forum usage, perinatal mental illness stigma, disclosure to health care providers, depression and anxiety symptoms, barriers to disclosure, and demographic information. Results: There was a significant positive indirect effect of length of forum use on disclosure of symptoms through internal stigma, b=0.40, bias-corrected and accelerated (BCa) 95% CI 0.13-0.85. Long-term forum users reported higher levels of internal stigma, and higher internal stigma was associated with disclosure of symptoms to health care providers when controlling for symptoms of depression and anxiety. Conclusions: Internal stigma mediates the relationship between length of forum use and disclosure to health care providers. Findings suggest that forums have the potential to enable women to recognize and reveal their internal stigma, which may in turn lead to greater disclosure of symptoms to health care providers. Clinicians could refer clients to trustworthy and moderated online forums that facilitate expression of perinatal mental illness stigma and promote disclosure to health care providers. [JMIR Ment Health 2017;4(1):e6]

Use of Online Forums for Perinatal Mental Illness, Stigma, and Disclosure: An Exploratory Model.

Depression and anxiety are prevalent psychiatric comorbidities that are known to have a negative impact on a patient’s general prognosis. But screening for these potential comorbidities in a hospital’s accident and emergency department has seldom been undertaken, particularly in Saudi Arabia and elsewhere in the Middle East. The Hospital Anxiety and Depression Scale (HADS) has been extensively used to evaluate these psychiatric comorbidities in various clinical settings at all levels of health care services except for the accident and emergency department. This study therefore aimed to assess the reliability and validity of the HADS for anxiety and depression among patients at a hospital accident and emergency department in Saudi Arabia. This cross-sectional observational study was conducted from January to December 2012. The participants were 257 adult patients (aged 16 years and above) who presented at the accident and emergency department of King Khalid University Hospital, Riyadh, Saudi Arabia, who met our inclusion criteria. We used an Arabic translation of the HADS. We employed factor analysis to determine the underlying factor structure of that instrument in assessing reliability and validity. We found the Arabic version of the HADS to be acceptable for 95 % of the subjects. We used Cronbach’s alpha coefficient to evaluate reliability, and it indicated a significant correlation with both the anxiety (0.73) and depression (0.77) subscales of the HADS, thereby supporting the validity of the instrument. By means of factor analysis, we obtained a two-factor solution according to the two HADS subscales (anxiety and depression), and we observed a statistically significant correlation (r = 0.57; p < 0.0001) between the two subscales. The HADS can be used effectively in an accident and emergency department as an initial screening instrument for anxiety and depression. It thus has great potential as part of integrated multidisciplinary care.

/pdf/reliability-and-validity-of-the-hospital-anxiety-and-3syf5i8w38.pdf

Reliability and validity of the Hospital Anxiety and Depression Scale in an emergency department in Saudi Arabia: a cross-sectional observational study

Objectives: This study describes three surges of COVID-19 hypoxemic respiratory failure and our experience with using iCPAP in patients with cardiovascular diseases at a tertiary cardiac care centre.
Methodology: This observational study was conducted from March 23rd 2020 to May 31st 2021, at The National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. This is an analysis of data from the PRICE Network Registry. Data was collected for all adult patients with cardiovascular diseases admitted with acute hypoxemic respiratory failure and a confirmed diagnosis of SARS CoV-2.
Results: Among 362 patients with 'severe’ or 'critical’ COVID-19 were hospitalized; 163 (45%) in the 1st surge, 92 (25.4%) in the 2nd and 107 (29.6 %) in the 3rd surge. All-cause mortality was 118 (32.6%). iCPAP was used in 39% (141) patients, 19% (69) patients required oxygen only, 25.4% (92) were on BiPAP support and 16.6% (60) were intubated. ‘iCPAP failure’ occurred in 48/141 (34%) patients. iCPAP failure occurred in patients with higher APACHE II scores (16.3 ±5.7 v/s 21.3±6, p ≤0.001), lower ROX index on admission (5.0±2.2 vs. 10.4±5.4, p≤0.001), lesser degree of improvement in ROX index at 48 hours (Day 3 ROX 18.7±8.9 vs. 9.9±6.3, p≤0.001). Mortality rate on iCPAP was 44 (31.2%).
Conclusion: COVID-19 outcomes in a resource-limited setting in patients having cardiovascular diseases, appear comparable to global reports. A modification of standard CPAP (iCPAP) appeared to be safe and effective. This modification of standard CPAP (iCPAP) identifies an option for resource-limited or resource-exhausted critical care units.

/pdf/an-observational-study-on-the-effects-of-improvised-cpap-1jixgzju.pdf

An observational study on the effects of improvised cpap (icpap) in cardiovascular diseases with acute respiratory failure

https://doi.org/10.1016/j.lansea.2023.100163

Mapping of familial hypercholesterolemia and dyslipidemias basic management infrastructure in Pakistan: a cross-sectional study

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Reliability and validity of the Hospital Anxiety and Depression Scale in an emergency department in Saudi Arabia: a cross-sectional observational study

An observational study on the effects of improvised cpap (icpap) in cardiovascular diseases with acute respiratory failure

Mapping of familial hypercholesterolemia and dyslipidemias basic management infrastructure in Pakistan: a cross-sectional study