Research on predictors of psychological distress and willingness to seek professional psychological help among Belgrade university students

Primarni cilj istraživanja bio je utvrđivanje intenziteta i kvaliteta psihološkog distresa u populaciji studenata, kao i njegove povezanosti sa različitim faktorima uključujući socio-demografske osobine, radno angažovanje ispitanika, dimenzije profesionalne adaptibilnosti, i afektivne i fizičke karakteristike radnog konteksta. Sekundarni ciljevi odnosili su se na prevod, lingvističku i kulturnu adaptaciju i psihometrijsku validaciju instrumenata i utvrđivanje prediktora spremnosti za traženje profesionalne psihološke pomoći. Istraživanje je izvedeno po principu deskriptivne eksplorativne studije preseka, a diseminacija upitnika odvijala se u periodu mart-jun 2018. godine. Formirana su četiri različita uzorka od ukupno 3310 ispitanika; po jedan u svrhu validacije svakog od instrumenata i jedan u svrhu utvrđivanja prediktora psihološkog distresa i spremnosti na traženje profesionalne psihološke pomoći. Ispitanici su u sva četiri slučaja selektovani prema principu višefaznog proporcionalnog stratifikovanog uzorka. U statističkoj obradi podataka korišćene su deskriptivne statističke mere, Pirsonov i Spirmanov koeficijent korelacije, multipla linearna regresiona analiza i univarijatna i multipla ordinalna i Firtova logistička regresiona analiza. Psihomerijske karakteristike instrumenata u procesu validacije utvrđivane su uz pomoć eksploratorne i konfirmatorne faktorske analize i analizom pouzdanosti. Rezultati psihometrijske validacije Instrumenta za procenu psiholoških simptoma u savetovalištu, Dinamske skale za procenu u domenu profesije i Skale za procenu simboličke radne motivacije potvrdili su postojanje originalnih faktorskih struktura i visoku pouzdanost skala i subskala. Analiza intenziteta i kvaliteta psihološkog distresa ukazala je da najizraženiju dimenziju predstavlja samopoštovanje (AS=2.74, SD=0.80). Kao najizraženiji simptomi javljaju se simptomi akademskog distresa (AS=1.82, SD=1.07) i socijalne anksioznosti (AS=1.35, SD=1.04). Najslabije su bili izraženi simptomi zloupotrebe alkohola (AS=0.69, SD=0.94) i generalizovane anksioznosti (AS=0.63, SD=0.84). Dalja analiza rezultata ukazuje da se studenti razlikuju po polu, godini i tipu studija, religioznosti i obrazovanju roditelja, kao i po vremenu koje posvećuju studiranju kada se posmatraju različiti aspekti distresa. Nadalje, rezultati ukazuju da u okviru dimenzija profesionale adaptibilnosti mehanizmi istinske i manične reparacije imaju adaptivnu funkciju, dok je funkcija mehanizama manije i zavisti maladaptivna. Afektivne dimenzije radnog konteksta predstavljaju dodatni činilac u objašnjenju psiholoških simptoma; studenti koji su kontekst procenjivali kao zadovoljavajuć i vredan očuvanja imali su izraženije samopoštovanje i manje izražene sve dimenzije psihološkog distresa. Spremnost na traženje profesionalne psihološke pomoći ispitivali smo skalom Stavova prema traženju profesionalne psihološke pomoći. Ovi stavovi bili su pozitivniji kod devojaka, kod studenata medicinskih nauka, kod onih koji su se u većoj meri oslanjali na mehanizam istinske reparacije a u manjoj meri na mehanizam manije, i kod onih koji su imali izraženije simptome akademskog distresa i socijalne anksioznosti. Zaključak ovog doktorskog istraživanja ukazuje da je instumente čije smo psihometrijske karakteristike proveravali moguće primeniti u različitim sredinama, kao i da se studenti nalaze pred izazovima mentalnog zdravlja uz spremnost da koriste odgovarajuće službe koje u našoj zemlji još uvek nisu dovoljno razvijene.The primary aim of this research was to determine the intensity and quality of the psychological distress in student population, as well as its relationship to the various factors including socio-demographic variables, work engagement, career adaptability, and affective and physical characteristics of the work context. The secondary goals were translation, linguistic and cultural adaptation, and psychometric validation of the instruments, and the examination of the predictors of willingness for seeking professional psychological help. The research was organized as a cross-sectional study and the questionnaire dissemination took place in the period from March to June, 2018. Four different samples comprising of 3310 respondents in total were formed; one for the purpose of validation of each of the instruments and one for the purpose of determination of the predictors of psychological distress and willingness to seek professional psychological help.In all four cases, the subjects were selected according to the principle of multistage proportional stratified sampling. The statistical analysis comprised descriptive statics, Pearson’s and Spearman’s correlation coefficients, multiple linear regression analysis, univariate and multiple ordinal regression analysis and Firth’s logistic regression analysis. Psychometric characteristics of the instruments were assessed using exploratory and confirmatory factor analysis and analysis of reliability. The results of psychometric validation of the Counseling Center Assessment of Psychological Symptoms scale, the Dynamic Career Scale, and the Work Symbolic Motivation Scale confirmed the original factor structures and high reliability of the scales and subscales. The analysis of the intensity and quality of the psychological distress showed that the highest scores were obtained at Self-esteem (AS=2.74, SD=0.80). Symptoms of Academic distress (AS = 1.82, SD = 1.07) and Social anxiety (AS = 1.35, SD = 1.04) appear as the most pronounced symptoms. The least pronounced were Alcohol Abuse (AS = 0.69, SD = 0.94) and Generalized Anxiety (AS = 0.63, SD = 0.84) symptoms. Further analysis indicates that students differ in gender, age and type of study, religiosity and parental education, as well as in the time they devote to studying when different aspects of distress are observed. Furthermore, the results indicate that, within the dimensions of professional adaptability, the true and manic reparation are adaptive, while mania and envy are maladaptive mechanisms. Affective dimensions of the work context are an additional factor in the explanation of psychological symptoms; the students who perceived their context as more satisfying and worth of preservation had higher self-esteem and lower levels of all the aspects of psychological distress. The willingness to seek professional psychological help was examined by the Attitudes towards seeking professional psychological help scale.These attitudes were more positive in females, in medical students, in those who relied more on true reparation and less on mania, and in those who had more pronounced symptoms of academic distress and social anxiety. In conclusion, this doctoral research indicates that the instruments whose psychometric characteristics were tested can be applied in different environments, as well as that students face mental health challenges with a willingess to use appropriate services that are not yet sufficiently developed in our country

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

publishedVersio

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries.

BackgroundThe COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.MethodsThe Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.ResultsAmong the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.InterpretationHealth policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs

Research on predictors of psychological distress and willingness to seek professional psychological help among Belgrade university students

Primarni cilj istraživanja bio je utvrđivanje intenziteta i kvaliteta psihološkog distresa u populaciji studenata, kao i njegove povezanosti sa različitim faktorima uključujući socio-demografske osobine, radno angažovanje ispitanika, dimenzije profesionalne adaptibilnosti, i afektivne i fizičke karakteristike radnog konteksta. Sekundarni ciljevi odnosili su se na prevod, lingvističku i kulturnu adaptaciju i psihometrijsku validaciju instrumenata i utvrđivanje prediktora spremnosti za traženje profesionalne psihološke pomoći. Istraživanje je izvedeno po principu deskriptivne eksplorativne studije preseka, a diseminacija upitnika odvijala se u periodu mart-jun 2018. godine. Formirana su četiri različita uzorka od ukupno 3310 ispitanika; po jedan u svrhu validacije svakog od instrumenata i jedan u svrhu utvrđivanja prediktora psihološkog distresa i spremnosti na traženje profesionalne psihološke pomoći. Ispitanici su u sva četiri slučaja selektovani prema principu višefaznog proporcionalnog stratifikovanog uzorka. U statističkoj obradi podataka korišćene su deskriptivne statističke mere, Pirsonov i Spirmanov koeficijent korelacije, multipla linearna regresiona analiza i univarijatna i multipla ordinalna i Firtova logistička regresiona analiza. Psihomerijske karakteristike instrumenata u procesu validacije utvrđivane su uz pomoć eksploratorne i konfirmatorne faktorske analize i analizom pouzdanosti. Rezultati psihometrijske validacije Instrumenta za procenu psiholoških simptoma u savetovalištu, Dinamske skale za procenu u domenu profesije i Skale za procenu simboličke radne motivacije potvrdili su postojanje originalnih faktorskih struktura i visoku pouzdanost skala i subskala. Analiza intenziteta i kvaliteta psihološkog distresa ukazala je da najizraženiju dimenziju predstavlja samopoštovanje (AS=2.74, SD=0.80). Kao najizraženiji simptomi javljaju se simptomi akademskog distresa (AS=1.82, SD=1.07) i socijalne anksioznosti (AS=1.35, SD=1.04). Najslabije su bili izraženi simptomi zloupotrebe alkohola (AS=0.69, SD=0.94) i generalizovane anksioznosti (AS=0.63, SD=0.84). Dalja analiza rezultata ukazuje da se studenti razlikuju po polu, godini i tipu studija, religioznosti i obrazovanju roditelja, kao i po vremenu koje posvećuju studiranju kada se posmatraju različiti aspekti distresa. Nadalje, rezultati ukazuju da u okviru dimenzija profesionale adaptibilnosti mehanizmi istinske i manične reparacije imaju adaptivnu funkciju, dok je funkcija mehanizama manije i zavisti maladaptivna. Afektivne dimenzije radnog konteksta predstavljaju dodatni činilac u objašnjenju psiholoških simptoma; studenti koji su kontekst procenjivali kao zadovoljavajuć i vredan očuvanja imali su izraženije samopoštovanje i manje izražene sve dimenzije psihološkog distresa. Spremnost na traženje profesionalne psihološke pomoći ispitivali smo skalom Stavova prema traženju profesionalne psihološke pomoći. Ovi stavovi bili su pozitivniji kod devojaka, kod studenata medicinskih nauka, kod onih koji su se u većoj meri oslanjali na mehanizam istinske reparacije a u manjoj meri na mehanizam manije, i kod onih koji su imali izraženije simptome akademskog distresa i socijalne anksioznosti. Zaključak ovog doktorskog istraživanja ukazuje da je instumente čije smo psihometrijske karakteristike proveravali moguće primeniti u različitim sredinama, kao i da se studenti nalaze pred izazovima mentalnog zdravlja uz spremnost da koriste odgovarajuće službe koje u našoj zemlji još uvek nisu dovoljno razvijene.The primary aim of this research was to determine the intensity and quality of the psychological distress in student population, as well as its relationship to the various factors including socio-demographic variables, work engagement, career adaptability, and affective and physical characteristics of the work context. The secondary goals were translation, linguistic and cultural adaptation, and psychometric validation of the instruments, and the examination of the predictors of willingness for seeking professional psychological help. The research was organized as a cross-sectional study and the questionnaire dissemination took place in the period from March to June, 2018. Four different samples comprising of 3310 respondents in total were formed; one for the purpose of validation of each of the instruments and one for the purpose of determination of the predictors of psychological distress and willingness to seek professional psychological help.In all four cases, the subjects were selected according to the principle of multistage proportional stratified sampling. The statistical analysis comprised descriptive statics, Pearson’s and Spearman’s correlation coefficients, multiple linear regression analysis, univariate and multiple ordinal regression analysis and Firth’s logistic regression analysis. Psychometric characteristics of the instruments were assessed using exploratory and confirmatory factor analysis and analysis of reliability. The results of psychometric validation of the Counseling Center Assessment of Psychological Symptoms scale, the Dynamic Career Scale, and the Work Symbolic Motivation Scale confirmed the original factor structures and high reliability of the scales and subscales. The analysis of the intensity and quality of the psychological distress showed that the highest scores were obtained at Self-esteem (AS=2.74, SD=0.80). Symptoms of Academic distress (AS = 1.82, SD = 1.07) and Social anxiety (AS = 1.35, SD = 1.04) appear as the most pronounced symptoms. The least pronounced were Alcohol Abuse (AS = 0.69, SD = 0.94) and Generalized Anxiety (AS = 0.63, SD = 0.84) symptoms. Further analysis indicates that students differ in gender, age and type of study, religiosity and parental education, as well as in the time they devote to studying when different aspects of distress are observed. Furthermore, the results indicate that, within the dimensions of professional adaptability, the true and manic reparation are adaptive, while mania and envy are maladaptive mechanisms. Affective dimensions of the work context are an additional factor in the explanation of psychological symptoms; the students who perceived their context as more satisfying and worth of preservation had higher self-esteem and lower levels of all the aspects of psychological distress. The willingness to seek professional psychological help was examined by the Attitudes towards seeking professional psychological help scale.These attitudes were more positive in females, in medical students, in those who relied more on true reparation and less on mania, and in those who had more pronounced symptoms of academic distress and social anxiety. In conclusion, this doctoral research indicates that the instruments whose psychometric characteristics were tested can be applied in different environments, as well as that students face mental health challenges with a willingess to use appropriate services that are not yet sufficiently developed in our country

Physicians’ Attitudes toward Adolescent Confidentiality Services: Scale Development and Validation

Confidentiality is one of the oldest ethical principles in healthcare. However, confidentiality in adolescent healthcare is not a universally-accepted doctrine among scholars. The ethical acceptability of confidential services in adolescents’ healthcare is based on perceptions of adolescent maturity and an appreciation of its importance to adolescents’ access and utilization of healthcare services. Despite legal policies that promote adolescents’ rights, physicians’ attitudes toward adolescent confidentiality can be a determining factor in their ultimate decision to protect adolescents’ confidentiality

Detection and Molecular Characterization of Rotavirus Infections in Children and Adults with Gastroenteritis from Vojvodina, Serbia

Rotaviruses (RV) are the leading cause of gastroenteritis in infants, young children, and adults, responsible for serious disease burden. In the period 2012–2018, a cross-sectional study was conducted using stool samples collected from patients with acute gastroenteritis from Vojvodina, Serbia. We described age and gender distribution, as well as seasonal patterns of RV prevalence. Out of 1853 included stool samples, RV was detected in 29%. Hospitalized children between 1–2 years old were especially affected by RV infection (45%). The highest prevalence of infection was observed during the colder, winter/spring months. We compared sequenced representative G and P genotypes circulating in Serbia with vaccine strains and determined their genetic similarity. Genotype combination G2P[4] was the most prevalent (34.6%), followed by G2P[8] (24.1%) and G1P[8] (21.1%). Given that several epitopes were conserved, neutralization motifs among circulating strains can be characterized as sufficiently matching vaccine strains Rotarix™ and RotaTeq™, but existing antigenic disparities should not be overlooked. The present results contribute to a better insight into the prevalence of rotavirus infection in our region and point out the need for epidemiological surveillance of rotaviruses before the introduction of vaccines. These data can help formulate future vaccine strategies in Serbia

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Background The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs. Methods The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. Results Among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients’ needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts. Interpretation Health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs

Research priorities to reduce the impact of COVID-19 in low- and middle-income countries

Background: the COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.Methods: the Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity.Results: among the top 10 research priorities, research questions related to vaccination were prominent: health care system access barriers to equitable uptake of COVID-19 vaccination (ranked 1st), determinants of vaccine hesitancy (4th), development and evaluation of effective interventions to decrease vaccine hesitancy (5th), and vaccination impacts on vulnerable population/s (6th). Health care delivery questions also ranked highly, including: effective strategies to manage COVID-19 globally and in LMICs (2nd) and integrating health care for COVID-19 with other essential health services in LMICs (3rd). Additionally, the assessment of COVID-19 patients' needs in rural areas of LMICs was ranked 7th, and studying the leading socioeconomic determinants and consequences of the COVID-19 pandemic in LMICs using multi-faceted approaches was ranked 8th. The remaining questions in the top 10 were: clarifying paediatric case-fatality rates (CFR) in LMICs and identifying effective strategies for community engagement against COVID-19 in different LMIC contexts.Interpretation: health policy and systems research to inform COVID-19 vaccine uptake and equitable access to care are urgently needed, especially for rural, vulnerable, and/or marginalised populations. This research should occur in parallel with studies that will identify approaches to minimise vaccine hesitancy and effectively integrate care for COVID-19 with other essential health services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs