COVID-19 Pandemic-Related Distress and Self-Efficacy to Manage Dementia Care Among Family Caregivers

The COVID-19 pandemic posed numerous challenges to persons with dementia (PWD) and their caregivers. To better understand these challenges, we conducted a mixed methods study analyzing data from interviews with family caregivers participating in an ongoing intervention study. Telephone interviews were conducted with 58 family caregivers of PWD diagnosed within the past two years. Participants reported self-efficacy (SE) using a 5-item scale (e.g. handle problems with memory, keep PWD at home) and rated pandemic-related distress on a 1-10 scale. They also qualitatively described effects of the pandemic on care recipients and themselves. Qualitative data were coded and organized by concepts from the Stress Process Model. Distress level ranged from 1-9 and was negatively associated with SE to manage dementia care (r=-316, p=0.036). Caregivers described distress related to primary stressors such as loss of services (respite care, assistance with daily tasks) and resistance to mask wearing by PWD due to behavioral symptoms. Secondary stressors included managing work or supervising children’s schoolwork at home while providing care. Caregivers most often expressed distress related to inability to access coping resources such as family or friends, and worried that PWD were not able to rely on their support systems. At all reported levels of distress, inability to interact with members of support networks (e.g., family, friends, service providers) was identified as most distressing. This was compounded by lower self-efficacy to manage dementia care. Efforts to decrease pandemic impacts must consider strategies to safely keep PWD and caregivers connected with family, friends, and service providers.

Distress, Health-Related Quality of Life (HQOL) and Confidence in Survivorship Information (CSI) in Older (≥60 Years) Hematopoietic Cell Transplant (HCT) Patients

Background: The use of HCT to treat older (≥60 years) patients with hematological malignancies has markedly increased in recent years, however, the long-term effects of HCT on distress, psychosocial functioning, and HQOL in older HCT survivors is largely unknown. Though older HCT survivors have a higher risk of disease recurrence, they may have less access to resources and subsequently experience more pronounced late effects of disease and treatment. Confidence in Survivorship Information (CSI) in this specific age group has not been reported. Methods: We conducted a secondary analysis on a subgroup of patients enrolled in INSPIRE (NCT01602211) and PCORI-SCP (NCT02200133) clinical trials. Eligibility criteria for inclusion include HCT patients who were ≥ 60 years at time of transplant performed in 2003-2014, survived ≥ 1 year post-transplant with no evidence of disease relapse or secondary cancers. Patients were eligible for inclusion irrespective of transplant type (autologous or allogeneic), diagnosis, donor source or conditioning regimen. Primary endpoint was distress level in older HCT survivors; secondary endpoints included CSI and HQOL outcomes. We collected baseline distress level as measured by Cancer and Treatment Distress (CTXD) score, HQOL (measured by SF-12 Mental and Physical Component Summaries (PCS/MCS) and CSI (measured by a 15-item CSI questionnaire). Sociodemographic, disease and transplant factors were extracted from medical databases. Nonparametric (Wilcoxon rank sum/Kruskal-Wallis) test was conducted for comparing 2 or 3 groups. Spearman correlation and univariate linear regression model were used to evaluate associations between CTXD/CSI and PCS/MCS. Bonferroni correlation was used to adjust for multiple pairwise comparisons within age group. Results: A total of 567 patients satisfied the eligibility criteria and were included in this analysis. Median age at time of HCT was 69 years with 57% male; two-thirds were autologous HCT recipients. Table 1 details patient characteristics. The median CTXD score for older HCT survivors was 0.7 (range 0-2.7, SD 0.6) indicating low/insignificant level of distress post-HCT. 20-30% of HCT survivors reported moderate distress when asked about concerns regarding relapse risk, loss of energy and functional decline. Type of transplant (auto vs allo), age group (<65 years, 65-70 years, ≥70 years), and time from HCT (≤2 years vs > 2 years) showed no apparent effect on reported distress level. CSI median score was 1.4 (range 0-2) which remains consistent with the score reported previously by the original trial including all age groups, indicating that older HCT survivors may have similar level of confidence in their survivorship information as their younger counterparts. Of note, close to 20% of the older HCT survivors reported poor CSI when asked about strategies for prevention and treatment of long-term effects of HCT and when asked about their confidence in availability of community resources to deal with long-term HCT complications. No statistically significant correlation was identified between CSI in older survivors and transplant type, time from HCT, or age group. HQOL outcomes indicated a median PCS of 48.2 (range 21.1 - 62.9) and a median MCS of 54.7 (range of 14.9 - 67.2). Interestingly, even though not reflected on the overall median CTXD and CSI scores for this cohort, a significant individual association between CTXD/CSI and PCS/MCS measures of HQOL was found (Figure 1). A subgroup analysis conducted on older alloHCT recipients confirmed the same findings of clinically insignificant distress level (mean CTXD ≤1.1) while having a similar level of CSI when compared to all age groups. Interestingly, time from HCT (≤2 years vs > 2 years) showed no significant effect on distress level reported by older alloHCT survivors, and cGVHD status did not correlate with CTXD or CSI scores nor with PCS/MCS in older alloHCT survivors. Conclusion: This is the largest study to date to investigate patient-reported distress, CSI and HQOL in older HCT survivors. Our data indicate that older HCT survivors have low levels of stress after HCT and had confidence in survivorship information in most aspects of their care. However, targeted interventions should focus on improving strategies for prevention, treatment and availability of community resources to deal with late effects of HCT; aspects reported as points of low CSI by older HCT survivors. Figure 1 Figure 1. Disclosures Farhadfar: Incyte: Consultancy. Shaw: Orca bio: Consultancy; mallinkrodt: Other: payments. Devine: Be the Match: Current Employment; Orca Bio: Consultancy, Research Funding; Johnsonand Johnson: Consultancy, Research Funding; Sanofi: Consultancy, Research Funding; Magenta Therapeutics: Current Employment, Research Funding; Tmunity: Current Employment, Research Funding; Vor Bio: Research Funding; Kiadis: Consultancy, Research Funding. Majhail: Anthem, Inc: Consultancy; Incyte Corporation: Consultancy. Wingard: Merck: Consultancy; AlloVir: Consultancy; Celgene: Consultancy; Shire: Consultancy; Janssen: Consultancy; Cidara Therapeutics: Consultancy.

Psychological Distress of Testing Positive for Human Papillomavirus at Routine Prenatal Visits: A Prospective Observational Study among Chinese Pregnant Women with Normal Cytology

Background To explore the psychological impact of the positive HPV result on pregnant women with normal cytology. Methods The psychological distress level of HPV-positive women was compared with those of HPV-negative women before the results were notified. After the notification, the distress level of women in the HPV-positive group was assessed for the 2nd time and 3rd time before colposcopy and 2 weeks post-colposcopy. The lifestyle characteristics, knowledge of cervical cancer and screening behavior were compared between groups. Logistic regression was used to assess associations between socio-demographic, lifestyle, knowledge and risk of elevated distress level. Results No statistical difference of the distress level (as measured by PHQ-9 and GAD-7) was found between HPV-positive and -negative women. Within HPV-positive group, low distress level remained through all three time-points, regardless of HPV subtypes or colposcopy diagnoses. Half of the participants were suboptimally screened before this study conducted; 7.6% were aware of the causal relationship between HPV and cervical cancer. Post-graduate degree was associated with elevated PHQ-9 score. Conclusions HPV screening was unlikely to cause additional psychological distress among pregnant population in China.

The varying impacts of COVID-19 and its related measures in the UK: A year in review

We examine how the earnings, time use, and subjective wellbeing of different social groups changed at different stages/waves of the pandemic in the United Kingdom (UK). We analyze longitudinal data from the latest UK Household Longitudinal Survey (UKHLS) COVID study and the earlier waves of the UKHLS to investigate within-individual changes in labor income, paid work time, housework time, childcare time, and distress level during the three lockdown periods and the easing period between them (from April 2020 to late March 2021). We find that as the pandemic developed, COVID-19 and its related lockdown measures in the UK had unequal and varying impacts on people’s income, time use, and subjective well-being based on their gender, ethnicity, and educational level. In conclusion, the extent of the impacts of COVID-19 and COVID-induced measures as well as the speed at which these impacts developed, varied across social groups with different types of vulnerabilities.

Alcohol Misuse in a Treatment-Seeking Sample of Pathological Gamblers

We aimed to estimate the prevalence of alcohol misuse and examine its relationship with gambling severity and psychological distress in a UK treatment-seeking sample of pathological gamblers. Approximately one in four patients (27.1%) scored X 8 on the Alcohol Use Disorders Identification Test (AUDIT) screening tool indicating alcohol misuse, and one in four (28.1%) reported abstinence. There was no evidence of an association between alcohol misuse and gambling severity or psychological distress level. Compared to the UK general population a significantly higher proportion demonstrated probable alcohol dependence (1.2% vs. 6.3%, p < 0.001).

Interprofessional Communication Team for Caregivers of Patients Hospitalized in the COVID-19 Wards: Results From an Italian Experience

Background: During the COVID-19 pandemic, emergency restrictions did not allow clinician family meetings and relatives' visits. In Molinette Hospital, a new communication model between healthcare providers and families of COVID-19 affected patients was developed by a team of physicians and psychologists. The study's aims were to investigate caregivers' distress and to analyse their satisfaction with the communications provided.Methods: A cross-sectional study was conducted among caregivers of patients of Molinette Hospital COVID wards. Between April and June 2020, all caregivers were contacted 2 weeks after the patient's discharge/death to assess their satisfaction with the communications received through an online survey.Results: A total of 155 caregivers completed the survey. Caregivers' distress level was found to be higher in women than men (p = 0.048) and in caregivers whose relative died compared to the caregivers whose relative was discharged (p &lt; 0.001). More than 85% of caregivers defined communication “excellent”/“very good”; being male was associated with higher satisfaction levels than women (β = −0.165, p = 0.046). Besides daily communication, 63 caregivers (40.6%) received additional support from a psychologist of the team.Conclusions: To our knowledge, this is the first study presenting, in an emergency, a new model of communication provided by a team of physicians and psychologists, and analyzing satisfaction with it. This model was highly appreciated by caregivers and it limited the discomfort caused by the restrictions on relatives' visits. It would be interesting to further evaluate the possibility of extending a communication model that includes doctors and psychologists in routine clinical practice.

Psychological Distress and Quality of Sleep among Urban Community People during COVID-19 Pandemic

Introduction: Corona Virus Disease (COVID-19) had spread all over the world resulting in a large number of deaths. As COVID-19 is highly contagious and directly threatens life, it has caused high level of distress around the globe and impacts quality of sleep as well. This study aimed to analyse psychological distress and quality of sleep during COVID-19pandemic among community people. Methods: A cross-sectional analytical study was conducted to find out psychological distress and sleep quality among 360 community people residing in Lalitpur, Nepal during COVID-19 pandemic from May to June 2021. Proportionate stratified and snowball sampling techniques were used to select the sample from each stratum. Data were collected through telephone interview using K6 Psychological Distress Scale and sleep quality scale. Data were analysed using descriptive and inferential statistics. Results: Moderate to high psychological distress was found among 40% and 79.7% had good to excellent sleep. Gender and marital status had significant association with distress and history of COVID-19 had significant association with sleep quality at 95% of significance level (p-value=.00, .00, .00) respectively. Psychological distress and sleep quality had significant negative relationship (r=-.46, p=.00). Conclusion: Based on the findings of this study, it can be concluded that urban community people had low distress and most of the respondents had good sleep quality. Gender, marital status and history of COVID-19 were associated with distress level and sleep quality. Negative relationship between distress level and sleep quality suggests that there is a need to take consideration of distress level of community people so that their sleep quality can be promoted. Key words: Community, COVID-19 pandemic, Nepal, Psychological distress, Sleep quality.

Measuring the effect of investor sentiment on financial distress

PurposeThis study examines the effect of firm-level investor sentiment on a firm's level of financial distress.Design/methodology/approachThe authors use Bloomberg's firm-level, daily investor sentiment scores derived from firm-level news and Twitter content in a beta-regression model to explain the variability in a firm's financial distress.FindingsThe results indicate that improvements (deterioration) in investor sentiment derived from both news articles and Twitter content lead to a decrease (increase) in the average firm's financial distress level. We also find that the effect of sentiment derived from Twitter on a firm's financial distress is significantly stronger than the sentiment derived from news articles.Research limitations/implicationsOur proxy for financial distress is Bloomberg's financial distress measures, which may be an imperfect measure of financial distress. Our results have important implications for market participants in assessing the determinants of financial distress.Practical implicationsOur sample period covers four years (2015–2019), which is determined by Bloomberg sentiment data availability.Social implicationsMarket participants are increasingly using social media to express views on firms and seek information that might be used to determine a firm's level of financial distress. Our study links investor sentiment derived from social media (Twitter) and traditional news articles to financial distress.Originality/valueBy examining the relationship between a firm's sentiment and its financial distress, this paper advances our understanding of the factors that drive a firm's financial distress. To our knowledge, this is the first study to link US firms' investor sentiment derived from firm-level news and Twitter content to a firm's financial distress.