“The danger still hangs over my head” Fear of Recurrence among Israeli Breast Cancer Survivors

Introduction: Many breast cancer survivors report a fear of recurrence of the disease, which finds expression in anxieties that the original cancer will return or that another form of cancer will begin to develop. The present study evaluated perceptions of and feelings about the fear of recurrence from the point of view of breast cancer survivors, the impact of this fear on their lives, and their means of coping. Method: Qualitative research was conducted using the phenomenological approach. The sample included 13 breast cancer survivors aged 34-67 who were within 1 year after completion of chemotherapy. Participants included survivors who had been diagnosed with localized breast cancer, Stages I-III, without metastases, and without previous cancer diagnoses. Participants provided their personal details, while details of the disease and treatments were collected from the patients’ files. Results: Two main themes emerged: (1) Along with the desire to gradually return to normal life, the study participants described an ongoing sense of existential threat, a lack of security and a sense of being out of control when any follow-up tests or pain linked to potential cancer caused fear and anxiety and (2) their fears also concerned their family members as they were afraid their loved ones might get sick and go through the suffering they had experienced. Conclusions: The fear of cancer recurrence is a multidimensional phenomenon. This emotional response can arise as a result of physical symptoms causing suspicions that the disease has returned or as a result of external factors, such as follow-up tests or other people’s illnesses

Association of stigma with mental health and quality of life among Indonesian COVID-19 survivors

Abstract Background and objective Coronavirus disease 2019 (COVID-19) survivors face societal stigma. The study aims to analyze the association of this stigma with the mental health and quality of life of COVID-19 survivors. Methods In this cross-sectional study, we observed 547 adults who were previously documented as severe acute respiratory syndrome coronavirus (SARS-CoV-2) positive by a polymerase chain reaction (PCR) test, treated in a hospital or an emergency hospital and proven to be SARS-CoV-2 negative by their latest PCR test. We adopted the Berger HIV Stigma Scale to measure stigma; the World Health Organization Quality of Life Brief Form to measure quality of life; and the Mental Health Inventory-38 to measure mental health. The chi-square and binary logistic regression tests were used to find the correlation between the variables. Results The multivariate analysis revealed that medium stigma was more likely related to quality of life and mental health than low stigma. Females were less likely to experience stigma related to mental health than men, and respondents who worked as laborers and entrepreneurs were less likely to experience stigma related to mental health than those who worked as civil workers/army personnel/teachers/lecturers. COVID-19 survivors experienced medium stigma in society and lower quality of life and mental health status. We found that quality of life and mental health were affected by stigma, sex, and occupation. Conclusion COVID-19 survivors are a vulnerable group that is most at risk when they return to their communities. Creating a safe environment and providing respectful care, including addressing complex stigma factors, is vital for developing appropriate interventions

Growing up with a sibling with depression: A qualitative study in Israel.

Depression has major consequences for the entire family, among them emotional distress, disrupted daily routine and social damage caused by negative stigmas. The aim of this study was to explore the retrospective experiences of young adults who lived with a sibling with depression while they were adolescents. The present study adopted a qualitative-phenomenological approach. The research participants were recruited via purposive sampling on social networks across Israel from May to September 2022. Semi-structured interviews were conducted with 21 participants aged 18-29 who lived with a sibling with depression during their adolescence. Data collection continued until saturation of concepts was reached. The results underwent thematic analysis. Three themes emerged from the qualitative analyses: 1) "I felt like I was living in a minefield": Adolescence while living with a sibling with depression; 2) "One step forward and two steps back": Siblings' coping strategies; 3) "My parents were not there for me when I needed them": Participants' experiences with their parents during their adolescence. The research findings indicate that adolescents who grew up with a sibling affected by depression had to cope with an acute family crisis, whose serious ramifications required emotional and social support. Mental health professionals and counselors working within educational institutions and the broader community should provide support and intervention for adolescents who have siblings struggling with depression. This intervention may take the form of individual or group therapy that aims to foster a sense of belonging and help affected individuals. Creating a supportive environment that meets the needs of the affected siblings is also crucial in addressing this issue effectively

Suicide Risk Assessments Through the Eyes of ChatGPT-3.5 Versus ChatGPT-4: Vignette Study

BackgroundChatGPT, a linguistic artificial intelligence (AI) model engineered by OpenAI, offers prospective contributions to mental health professionals. Although having significant theoretical implications, ChatGPT’s practical capabilities, particularly regarding suicide prevention, have not yet been substantiated. ObjectiveThe study’s aim was to evaluate ChatGPT’s ability to assess suicide risk, taking into consideration 2 discernable factors—perceived burdensomeness and thwarted belongingness—over a 2-month period. In addition, we evaluated whether ChatGPT-4 more accurately evaluated suicide risk than did ChatGPT-3.5. MethodsChatGPT was tasked with assessing a vignette that depicted a hypothetical patient exhibiting differing degrees of perceived burdensomeness and thwarted belongingness. The assessments generated by ChatGPT were subsequently contrasted with standard evaluations rendered by mental health professionals. Using both ChatGPT-3.5 and ChatGPT-4 (May 24, 2023), we executed 3 evaluative procedures in June and July 2023. Our intent was to scrutinize ChatGPT-4’s proficiency in assessing various facets of suicide risk in relation to the evaluative abilities of both mental health professionals and an earlier version of ChatGPT-3.5 (March 14 version). ResultsDuring the period of June and July 2023, we found that the likelihood of suicide attempts as evaluated by ChatGPT-4 was similar to the norms of mental health professionals (n=379) under all conditions (average Z score of 0.01). Nonetheless, a pronounced discrepancy was observed regarding the assessments performed by ChatGPT-3.5 (May version), which markedly underestimated the potential for suicide attempts, in comparison to the assessments carried out by the mental health professionals (average Z score of –0.83). The empirical evidence suggests that ChatGPT-4’s evaluation of the incidence of suicidal ideation and psychache was higher than that of the mental health professionals (average Z score of 0.47 and 1.00, respectively). Conversely, the level of resilience as assessed by both ChatGPT-4 and ChatGPT-3.5 (both versions) was observed to be lower in comparison to the assessments offered by mental health professionals (average Z score of –0.89 and –0.90, respectively). ConclusionsThe findings suggest that ChatGPT-4 estimates the likelihood of suicide attempts in a manner akin to evaluations provided by professionals. In terms of recognizing suicidal ideation, ChatGPT-4 appears to be more precise. However, regarding psychache, there was an observed overestimation by ChatGPT-4, indicating a need for further research. These results have implications regarding ChatGPT-4’s potential to support gatekeepers, patients, and even mental health professionals’ decision-making. Despite the clinical potential, intensive follow-up studies are necessary to establish the use of ChatGPT-4’s capabilities in clinical practice. The finding that ChatGPT-3.5 frequently underestimates suicide risk, especially in severe cases, is particularly troubling. It indicates that ChatGPT may downplay one’s actual suicide risk level

Are Personal Resources and Perceived Stress Associated with Psychological Outcomes among Israeli Teachers during the Third COVID-19 Lockdown?

Teachers’ psychological responses during a pandemic, such as COVID-19, play an important role in their adaptation to the new routine. This research aimed to explore the association between personal resources (sense of control, social support), perceived stress, and three psychological outcomes (resilience, depression, loneliness) among teachers during the third COVID-19 lockdown in Israel. A cross-sectional study was conducted among 208 teachers. Significant associations were found between perceived stress, resilience, depression, and loneliness. Sense of control was significantly associated with perceived social support. The research model was tested using Structural Equation Modeling. The model yielded appropriate indices of fit (χ2(10) = 10.31, χ2/df = 1.03, p = 0.413, NFI = 0.970, NNFI = 0.997, CFI = 0.999, RMSEA = 0.012, 95%CI RMSEA = 0.077), demonstrating that the model fits the data well. Findings suggest that in order to improve teachers’ psychological health during a virus outbreak, it is recommended to pay attention to their personal resources and perceived stress

When sex meets age: Family physicians’ perspectives about sexual dysfunction among older men and women: A qualitative study from Israel

Background: Gender differences in relation to sexual functioning among older adults have received very little research attention, although the ageing process is likely to be characterized by difficulties in sexual functioning among both women and men. Objectives: The purpose of this qualitative research is to examine and understand the perceptions of family physicians, and the differences in their attitudes regarding male and female patients. Method: Qualitative interviews with family physicians were conducted between August 2017 and December 2017. Sixteen family physicians participated in the study, aged 36–64; most were born in Israel and half of them were women. Twelve physicians were Jewish, two were Christian and two were Muslim. Nine work in rural practices and seven work in urban practices. We used in-depth, semi-structured, face-to-face interviews. The interviews were recorded, transcribed and analysed by three researchers using content analysis. Results: The analysis of the interviews revealed two main themes: (1) Differences as perceived by family physicians: men are perceived as being interested in engaging in full sexual relations, including penetration, while among women, the main need is focused on the relationship and intimacy. (2) Gender differences regarding seeking a solution through the family physician. Family physicians reported that most of the patients who seek solutions regarding sexual dysfunction in old age are men with impotence problems. Family physicians perceived that women seek out solutions less frequently, some because they are afraid their relationship will suffer if they do not continue having sex with their partners. Conclusion: Men and women were seen as having different motivations for engaging in sex and different needs from physicians

Rising Strong: The Interplay between Resilience, Social Support, and Post-Traumatic Growth among Teachers after the COVID-19 Pandemic

Background: When schools reopened for face-to-face classroom instruction following the COVID-19 pandemic, teachers faced many professional challenges. Most studies examining teachers’ psychosocial condition after school reopening predominantly focused on negative aspects of their emotional well-being, leaving a gap in the understanding of the potential positive effects. This study is grounded in the theory of post-traumatic growth, which suggests that growth and development can occur alongside difficulties. Objectives: The purpose of this study was to shed light on the lesser explored associations between resilience, social support, and post-traumatic growth among teachers after the COVID-19 pandemic. It also examined the differences in post-traumatic growth between teachers in special education and those in general education. Methods: The participants in this cross-sectional study were recruited by convenience sampling. A self-report online survey was used to collect data from 208 Israeli teachers during November 2022. Results: Most of the participants (79.4%) reported experiences of post-traumatic growth during the pandemic. The findings revealed that post-traumatic growth exhibited a positive association with social support (r = 0.23, p r = 0.18, p p 0.001]. Finally, special education teachers exhibited higher levels of post-traumatic growth than general education teachers (t = −2.36, p < 0.05). Conclusions: Social support for teachers must be provided during and after traumas caused by crises and pandemics similar to COVID-19. Intervention programs and ongoing training should offer effective tools to help teachers balance their professional and personal lives. Promoting positive changes in teacher well-being must be a priority in the education system

Views of family physicians on heterosexual sexual function in older adults

Abstract Background Sexual functioning among older adults has received little attention in research and clinical practice, although it is an integral part of old age. As older adults tend to consume health services and to visit family physicians more frequently, these care-providers serve as gatekeepers in the case of sexual concerns. The present study evaluated the perceptions of family physicians regarding sexuality in older adults. Method Qualitative interviews with 16 family physicians were conducted. We used in-depth, semi-structured interviews. Results Three main themes emerged: 1. Family physicians described having difficulty in raising questions about sexuality to older patients. 2. Family physicians tended towards the biological side of the spectrum, focusing on the patient’s medical problem and asking physiological questions. 3. Family physicians mainly related to medication administered to their male patients, whereas a minority also described the guidance they provided to older individuals and couples. Conclusions The study shows that family physicians tend not to initiate discourse with older patients on sexuality, but rather discuss sexuality mostly in conjunction with other medical conditions. Implications for research and practice are discussed

Patient’s Utilization of Primary Care: A Profile of Clinical and Administrative Reasons for Visits in Israel

Background: Data on patients’ utilization of health services in primary care is relevant to planning healthcare. Data may be collected by numerous methods, but obtaining a true picture of content of care has practical difficulties. Objectives: To describe patient’s reasons for visits to primary care physicians (PCPs) as presented by the patient; and to examine the effect of patient-, doctor- and clinic-related variables on the reasons for the visit. Methods: Visits to PCPs were observed by peer doctors during 2014, at primary care clinics in Israel. Data were collected on characteristics of physicians, patients, clinics, type of visit, and reasons for visit. Results: Eleven physicians from 7 clinics participated in the study. Data were gathered from 327 visits. Patients visited for a wide variety of reasons. The most common acute complaints were upper respiratory symptoms, gastrointestinal, skin symptoms, and back and neck problems. The most common chronic complaints were hypertension and diabetes. Patients presented with administrative requests in 36% of visits; 15% were for solely administrative issues. A total of 26.6% of visits included requests for blood tests or discussion of tests. Patients initiated preventive medicine issues in 5% of visits. Visits for chronic problems were directly correlated with patient age and the extent of acquaintance with the physician. Gender-associated differences were also found: women were more likely to visit for a new medical problem than men, while men were more likely to visit for known or chronic problems. Conclusions: Patients visit their PCP for a wide variety of reasons, often during the same visit. Patients refer for administrative requests in about a third of visits. They initiate preventive care infrequently (1 out of 20 visits). To further characterize patient utilization of primary care, a broader study needs to be performed

Depression and Medicine Use among Older Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources and COVID-19 Perceived Susceptibility

A relationship was found between the COVID-19 pandemic and depression among older adults and between depressed mood and increased use of antidepressant medication among older adults during the pandemic. With the aim of broadening the understanding of these relationships, the study examined whether COVID-19 perceived susceptibility mediates the relationship between psychosocial resources (optimism and perceived social support) and depressive symptoms and medication use. Participants included 383 older adults (M = 71.75, SD = 6.77) reporting on socio-demographics, health characteristics, depression, optimism, social support, and COVID-19 perceived susceptibility. Medication use was retrieved from participants medical files. Lower optimism, lower social support, and higher COVID-19 perceived susceptibility were associated with greater depression, related with higher medication use. The findings emphasize the buffering effect of psychosocial resources on the adverse effects of depression affecting older adults during the COVID-19 pandemic, and consequently, the increased use of medication in this population. Practitioners should focus interventions on enhancing optimism and expanding social support among older adults. Moreover, interventions focused on alleviating depression among older adults should aim at improving perceptions of perceived susceptibility in the older population