Re-examining the Role of Coping Strategies in the Associations Between Infertility-Related Stress Dimensions and State-Anxiety: Implications for Clinical Interventions With Infertile Couples

Research has shown a direct relationship between infertility-related stress and anxiety in infertile patients. The present study goes into this relationship in depth, testing the moderating role of coping strategies (Seeking Social Support, Avoidant, Positive Attitude, Problem-Solving, Turning to Religion) in the associations between specific infertility-related stress dimensions (Social Concern, Need for Parenthood, Rejection of Childfree Lifestyle, Couple’s Relationship Concern) and State-Anxiety among male and female partners of infertile couples. Gender differences were also explored. Both members of 254 infertile couples completed a questionnaire consisting of Socio-demographics, Fertility Problem Inventory–Short Form (FPI-SF), Coping Orientation to Problem Experienced–New Italian Version (COPE-NIV), and State-Trait Anxiety Inventory-Y (STAI-Y). The results revealed that Social Concern and Couple’s Relationship Concern, in both partners, and Need for Parenthood, in female partners, had positive correlations with State-Anxiety. Seeking Social Support and Avoidant coping were related to increasing levels of State-Anxiety in both partners, whereas Positive Attitude coping strategies were related to lower levels of State-Anxiety in female partners. Problem-Solving and Avoidant coping played moderating roles between specific infertility-related stress dimensions and State-Anxiety in unexpected directions. Problem-Solving exacerbated the negative effects of Social Concern, whereas Avoidant coping buffered the negative effects of several infertility-related stress dimensions in both partners. Interventions to improve stress management and psychological health in infertile couples should consider that the adequacy of coping strategies is inherently situation specific. It therefore follows that patient-centered clinical interventions should consider the potential inadequacy of promoting Problem-Solving strategies, and that even Avoidance can be an efficient strategy for dealing with specific infertility-related stress dimensions

COVID-19 Student Stress Questionnaire: Development and Validation of a Questionnaire to Evaluate Students’ Stressors Related to the Coronavirus Pandemic Lockdown

Clinical observations suggest that during times of COVID-19 pandemic lockdown university students exhibit stress-related responses to fear of contagion and to limitations of personal and relational life. The study aims to describe the development and validation of the 7-item COVID-19 Student Stress Questionnaire (CSSQ), a measurement tool to assess COVID-19-related sources of stress among university students. The CSSQ was developed and validated with 514 Italian university students. Exploratory Factor Analysis (EFA) was conducted with one split-half sub-sample to investigate the underlining dimensional structure, suggesting a three-component solution, which was confirmed by the Confirmatory Factor Analysis (CFA) with the second one split-half sub-sample (CFI = 0.95; TLI = 0.95; RMSEA = 0.06). The CSSQ three subscales measure COVID-19 students’ stressors related to (1) Relationships and Academic Life (i.e., relationships with relatives, colleagues, professors, and academic studying); (2) Isolation (i.e., social isolation and couple’s relationship, intimacy and sexual life); (3) Fear of Contagion. A Global Stress score was also provided. The questionnaire revealed a satisfactory internal consistency (Cronbach’s alpha = 0.71; McDonald’s omega = 0.71). Evidence was also provided for convergent and discriminant validity. The study provided a brief, valid and reliable measure to assess perceived stress to be used for understanding the impact of the COVID-19 pandemic lockdown among university students and for developing tailored interventions fostering their wellbeing

The COVID-19 Student Stress Questionnaire: Validation in Spanish university students from health sciences

This study aimed to validate the Spanish version of the COVID-19 Student Stress Questionnaire (CSSQ), a 7-item tool assessing COVID-19-related stressors among university students, namely, Relationships and Academic Life, Isolation, and Fear of Contagion. Participants were 331 Spanish university students. Factor analyses sustained the three factor solution of the original tool. Data also revealed satisfactory convergent and discriminant validity, suitable internal consistency, and significant associations with psychological symptoms, as measured by the Symptom Checklist-90-Revised. The Spanish version of the CSSQ represents a valid tool to be used in clinical settings to timely identify students at high psychological risk and to develop evidence-based interventions during/after the pandemic

COVID-19 STRESSORS AND PSYCHOLOGICAL HEALTH CONDITIONS AMONG UNIVERSITY STUDENTS OVER TWO YEARS OF THE COVID-19 PANDEMIC: A REPEATED CROSS-SECTIONAL STUDY

The study aims at comparing university students’ perceived COVID-19-related stressors (Relationships and Academic Life, Isolation, Fear of Contagion) and psychological health over three times during the pandemic: April 2020-T1, April 2021-T2, April 2022-T3. COVID-19-related stressors predictivity of psychological disease was also evaluated three times. 567 students completed COVID-19 Student Stress -questionnaire and SCL-90-R (T1 n=197; T2 n=200; T3 n=170). Data revealed significantly higher levels of all COVID-19-related stressors from T1 to T2 and signi$cantly lower levels from T2 to T3. Psychological disease increased from T1 to T2 but remained unchanged from T2 to T3. All COVID-19-related stressors predicted psychological disease at T1 and T2. At T3 Relationships and Academic Life retained its full predictivity, while Isolation lost predictive power with respect to Anxiety and Hostility, and Fear of Contagion lost predictive power with respect to all psychological disorders except Somatization and Phobic-Anxiety. Despite a significant reduction, the impact of COVID-19-stressor related to changes in relationships has enduring effects on students’ psychological health and should be carefully considered to develop evidence-based interventions in the current post-pandemic period

COVID-19-RELATED STRESSORS AND ICTS USE AMONG UNIVERSITY STUDENTS: RISK AND PROTECTIVE FACTORS FOR ANXIETY AND DEPRESSION

Although the COVID-19-emergency is slowly weakening globally, the drastic changes imposed (including the massive use of Information and Communication Technologies-ICTs) are expected to have enduring effects on mental health. Within the branch of research evaluating the impact of pandemic on university students’ psychological health, this study aimed to explore main and mediating effects of COVID-19-related stressors (Relationships and Academic Life, Isolation, Fear of Contagion) and ICTs use dimensions (ICTs-Overuse, Working-from-Home-Overload, Ease-of-Use, Techno-Sociality) on Anxiety and Depression reported by 344 university students. Hayes-PROCESS was used to test main/mediating effects. Findings suggested that ICTs-Overuse and Working-from-Home-Overload significantly exacerbated perceived stress related to Relationships and Academic Life and Isolation, resulting in higher levels of Anxiety and Depression. Conversely, Ease-of-Use and Techno-Sociality indirectly enhanced students’ psychological health by decreasing perceived stress related to Relationships and Academic Life. The study highlighted key risks but also key resources able to counteract perceived stress related to the challenges imposed by the pandemic in students’ relational life

Albumin replacement in patients with severe sepsis or septic shock

BACKGROUND: Although previous studies have suggested the potential advantages of albumin administration in patients with severe sepsis, its efficacy has not been fully established. METHODS: In this multicenter, open-label trial, we randomly assigned 1818 patients with severe sepsis, in 100 intensive care units (ICUs), to receive either 20% albumin and crystalloid solution or crystalloid solution alone. In the albumin group, the target serum albumin concentration was 30 g per liter or more until discharge from the ICU or 28 days after randomization. The primary outcome was death from any cause at 28 days. Secondary outcomes were death from any cause at 90 days, the number of patients with organ dysfunction and the degree of dysfunction, and length of stay in the ICU and the hospital. RESULTS: During the first 7 days, patients in the albumin group, as compared with those in the crystalloid group, had a higher mean arterial pressure (P=0.03) and lower net fluid balance (P<0.001). The total daily amount of administered fluid did not differ significantly between the two groups (P=0.10). At 28 days, 285 of 895 patients (31.8%) in the albumin group and 288 of 900 (32.0%) in the crystalloid group had died (relative risk in the albumin group, 1.00; 95% confidence interval [CI], 0.87 to 1.14; P=0.94). At 90 days, 365 of 888 patients (41.1%) in the albumin group and 389 of 893 (43.6%) in the crystalloid group had died (relative risk, 0.94; 95% CI, 0.85 to 1.05; P=0.29). No significant differences in other secondary outcomes were observed between the two groups. CONCLUSIONS: In patients with severe sepsis, albumin replacement in addition to crystalloids, as compared with crystalloids alone, did not improve the rate of survival at 28 and 90 days