Search Results (165)

Background/Objectives: Pain and psychosocial distress are highly prevalent across acute and chronic medical conditions and may negatively affect quality of life, treatment adherence, and clinical outcomes. Green light therapy has emerged as a non-pharmacological intervention that may modulate neural, inflammatory, and sensory pathways involved in nociception and affective processing. This systematic review evaluated the current human evidence on green light therapy for pain, with consideration of pain-related psychosocial outcomes. Methods: A systematic search was conducted in PubMed, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO for English-language human interventional studies of green light therapy reporting pain. Records were screened in Covidence by independent reviewers using predefined eligibility criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for randomized studies and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) for non-randomized studies. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: Of 2040 citations identified, 13 studies met inclusion criteria (9 randomized controlled trials, 4 non-randomized studies; 668 participants). Clinical populations included migraine, dental anxiety, fibromyalgia, autism spectrum disorder, and retinal examination discomfort. Most studies reported findings favoring green light, providing an encouraging evidence base that would be strengthened by future blinded, controlled designs. Certainty of evidence was very low for all outcomes across both comparisons. Conclusions: Preliminary evidence suggests green light therapy is a promising and accessible nonpharmacological approach for pain or pain-related psychosocial outcomes but remains insufficient to establish the efficacy of green light therapy. Well-designed, adequately powered, pre-registered, sham-controlled trials with blinded outcome assessment represent a clear and achievable path toward establishing its clinical role. Full article

The COVID-19 pandemic transformed online and distance learning from a supplementary educational option into a central component of education systems, bringing anxiety, stress, and psychological well-being to the forefront of digital learning research. This study traces the two-decade evolution of research on anxiety and stress in online and distance learning between 2005 and February 2026 and examines the thematic reorientation associated with the COVID-19 period. Bibliometric mapping of 243 Web of Science (WoS) records was used to identify publication trends, intellectual structures, international collaboration patterns, and thematic developments. Piecewise analysis indicated a significant post-2020 break in annual scientific output, with the growth rate increasing nearly eightfold (p = 0.0015). Thematic evolution showed that pre-pandemic studies mainly focused on technology acceptance, computer anxiety, and learner adaptation, whereas pandemic and post-pandemic research shifted toward mental health, psychological well-being, social isolation, technostress, and resilience. China and the United States dominated scientific production, while Australia and Saudi Arabia showed notable mobility in collaboration networks. Overall, the findings suggest that the COVID-19 period was associated with a field-level reorientation toward an interdisciplinary psychosocial agenda for future online education. Full article

Despite heightened physical risks during the COVID-19 pandemic, older adults often reported better mental health than younger adults, suggesting significant resilience. We used longitudinal qualitative data to examine how difficulties and positive experiences contributed to this resilience. Weekly COVID-related difficulties and positive experiences were collected using internet surveys over eight weeks from 247 respondents aged 51–95 (M = 71.1, SD = 7.3). Nearly all identified at least one difficulty, and 76% had problems three or more times. Longitudinal thematic analysis (LTA) revealed that most were consistent in how they described they difficulties, including problems with everyday protective activities, psychological distress, social isolation, and cultural divide (disagreements over public health policy). Although 78% identified at least one positive, less than half (42%) did so at three or more time points. Positive experiences were more diverse across time, but some reported greater interpersonal connection by utilizing technology to increase social contacts. LTA revealed three stances towards positive experiences: active efforts, appreciative efforts (observation), and mixed efforts. While trait resilience was unrelated to the themes, the mixed approach towards positive experiences was associated with lower anxiety at the last assessment, emphasizing the importance of positive experiences during stress. Full article

Olfactory dysfunction (OD) is a common sequela of SARS-CoV-2 infection, but its prevalence and associated factors beyond 2 years remain unclear. In this multicenter observational study, we assessed 155 recovered COVID-19 patients approximately three years after infection and included 170 age-matched healthy controls as a reference group. Demographic, clinical, psychological, and sleep-related data were collected through structured interviews. Olfactory function at the 3-year assessment was objectively evaluated using Toyota–Takagi (T&T) olfactometry. Paired baseline-to-follow-up T&T data were available only for a small exploratory subgroup of nine patients and were analyzed descriptively. At follow-up, 7 of 155 recovered patients (4.5%) met our T&T-based definition of persistent quantitative olfactory dysfunction, all of whom were older than 50 years. Emotional and sleep disturbances were also common, with descriptive trends toward higher frequencies among women and older individuals. Exploratory analyses suggested that insomnia (AIS > 6; OR 5.35, 95% CI 1.07–26.60; p = 0.033) and anxiety (HAMA ≥ 7; OR 10.54, 95% CI 1.21–91.82; p = 0.04) were associated with persistent T&T-defined quantitative OD, although the small number of outcome events limited statistical precision. These findings indicate that a small proportion of COVID-19 survivors have persistent objective OD 3 years after infection and that persistent OD is associated with anxiety and insomnia. Full article

Background: Neuropsychiatric manifestations are a recognized complication of COVID-19, yet their temporal evolution across pandemic waves remains poorly characterized in hospitalized cohorts. This study examined whether their prevalence and composition changed across five successive waves. Methods: We conducted a retrospective observational study of 1471 hospitalized adults with confirmed Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at Sibiu County Emergency Clinical Hospital, Romania (March 2020–January 2025), spanning ancestral through Omicron variants. A custom natural language processing pipeline extracted symptoms, medications, and International Classification of Diseases, 10th Revision (ICD-10) codes from electronic medical records. Nine hierarchical clinical clusters were defined; temporal trends were assessed using multivariable logistic regression with age-stratified replication. Results: Severe neurological presentations (stroke, seizures, hemiparesis) increased six-fold from 3.5% in Wave 1 to 20.1% in Wave 5, while psychiatric symptoms (anxiety, insomnia) declined from 13.3% to 4.3%. Overall, neuropsychiatric burden remained stable (~40–45%), revealing a compositional shift. This neurological trend persisted after multivariable adjustment (adjusted odds ratio 4.34, for Wave 5 vs. Wave 1) and within age-stratified subgroups, was inversely associated with respiratory severity and could not be attributed to vaccination status. The composite neurological severity index independently predicted mortality and intensive care unit admission. Conclusions: Neuropsychiatric manifestations in hospitalized Coronavirus disease of 2019 (COVID-19) patients underwent a compositional shift from psychiatric dominance in early waves to severe neurological dominance in later waves, consistent with a transition from reactive psychiatric presentations toward progressive neurological injury. This pattern, largely independent of measured confounders, underscores the need for sustained neurological surveillance beyond the acute respiratory phase. Full article

The Coronavirus Disease 2019 (COVID-19) pandemic and its prolonged effects have been widely discussed on social media, and these discussions have been analyzed in various studies. A long-term analysis of Twitter (now “X”) posts regarding COVID-19 vaccination is essential for informing policy and improving public health communication strategies. In addition, to prevent the spread of infectious diseases, it is crucial to rapidly promote vaccination while mitigating the impact of negative sentiment toward vaccination on social media platforms. Therefore, identifying the key factors behind negative discussions is important for guiding policy decisions and shaping responses. In this study, we collected Japanese tweets (posts) containing the words “Corona” and “vaccine” that were posted from February 2021 to December 2022. The results indicate that negative sentiment was primarily driven by concerns about adverse reactions and general fear and anxiety, which were particularly prominent before vaccination for the general public began, as well as mentions of pain during and after vaccination. While concerns about adverse reactions persisted throughout the analysis period, their prominence decreased over time as positive reactions became more frequent. Our findings provide insights into the characteristics and key factors behind negative discussions on COVID-19 vaccination in the Japanese context and may help improve public health communication strategies. Full article

Background/Objectives: The COVID-19 pandemic accelerated the shift toward community- and home-based care models. Within this transformation, Family and Community Nurses (FCNs) have become key in bridging hospital and primary care, supporting continuity, self-care, and quality of life (QoL). Despite increasing recognition, evidence on FCN-led interventions remains fragmented. This systematic review and meta-analysis aimed to synthesize evidence on the impact of FCN interventions on QoL and clinical outcomes in post-COVID and people living with chronic conditions managed in community and home settings. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, CINAHL, PsycINFO, Embase, and Cochrane Library (January 2020–November 2024). Eligible studies were randomized controlled trials evaluating FCN-led interventions. Primary outcomes were QoL (measured with validated tools) and glycemic control (HbA1c). Secondary outcomes included hospital readmissions, anxiety, depression, and self-care abilities. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials. Random-effects meta-analyses were performed, with heterogeneity evaluated by I². The protocol was prospectively registered in PROSPERO (CRD42024567890) before data extraction. Results: Seventy-one studies (n = 19,390) were included. Interventions comprised home visits, telehealth, patient education, and case management. Pooled analyses demonstrated significant improvement in QoL (SMD 0.34, 95% CI 0.18–0.50) and reduction in HbA1c (−0.47%, 95% CI −0.69 to −0.25). FCN interventions also reduced hospital readmissions (RR 0.74, 95% CI 0.62–0.89) and improved mental health outcomes. Most studies were judged at low to moderate risk of bias. Conclusions: FCN-led interventions significantly enhance QoL, mental health, and clinical outcomes while reducing hospital readmissions. These findings highlight the strategic importance of integrating FCNs into community-based healthcare models. Full article

Many experienced isolation and restricted behaviors due to the rapid onset of the COVID-19 pandemic in 2020. Investigations related to the psychological factors such as stress along with the danger of spread and contamination are scarce. The COVID-19 stress scale (CSS) was developed in order to evaluate such stress and anxiety related to the COVID-19 pandemic. The current study investigated the psychometric properties of the CSS, using a survey to provide evidence towards its continued use as a scientifically sound measuring instrument for future acute health crises in a sample of 615 college students (78.80% female, 18.60% male, 1.30% trans male, 1.00% non-binary), with a mean age of 19.10 years. The study partially supported the original measure’s factor structure. The main modification suggests a five-factor structure and removal of items related to less frequently used methods of banking and postal mail. The authors provide suggestions for future validation directions, use of the CSS and development of stress response strategies for students. Full article

School refusal behavior, defined as a child’s prolonged voluntary absence from school for reasons unrelated to illness and/or economic hardship, is a growing concern in Japan. The COVID-19 pandemic has worsened this issue by disrupting children’s lives. This review summarizes the prevalence, contributing factors, and health implications of school refusal, particularly in the context of COVID-19. A literature review of government reports and PubMed-indexed studies indicates that school refusal in Japan has been rising for eleven years, reaching a record 340,000 cases in 2023. Middle school students (6.7%) were the most affected, followed by elementary school students (2.1%). The pandemic intensified school-related, family-related, and child-related risk factors. School closures disrupted routines, reduced peer interactions, and increased social isolation, contributing to higher rates of anxiety and depression. Reports of suicides and mental health disorders among children have also surged. Family stressors, including economic hardship and parental mental health struggles, further exacerbate school refusal. Additionally, remote learning has widened socioeconomic disparities in access to education, leaving vulnerable children at greater risk. Addressing school refusal requires a multifaceted approach involving schools, families, healthcare providers, and policymakers. School-based interventions, mental health approach, and flexible educational programs would be essential. The Japanese government’s “COCOLO Plan” represents progress toward a more inclusive education system, and a comprehensive, interdisciplinary strategy is needed. Ensuring all children receive the necessary support to reengage with education is critical to overcoming the long-term challenges posed by school refusal. Full article

Background: Emerging evidence indicates that some individuals recovering from COVID-19 develop persistent symptoms, including fatigue, pain, cognitive difficulties, and psychological distress, commonly known as Long COVID. These symptoms often overlap with those seen in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME), underscoring the need for integrative, non-pharmacological interventions. This Phase II controlled trial aimed to evaluate the feasibility and preliminary efficacy of Heart Rate Variability Biofeedback (HRV-BF) in individuals with Long COVID who meet the diagnostic criteria for CFS/ME. Specific objectives included assessing feasibility indicators (drop-out rates, side effects, participant satisfaction) and changes in fatigue, depression, anxiety, pain, and health-related quality of life. Methods: Participants were assigned alternately and consecutively to the HRV-BF intervention or Treatment-as-usual (TAU), in a predefined 1:1 sequence (quasirandom assignment). The intervention consisted of 10 HRV-BF sessions, held twice weekly over 5 weeks, with each session including a 10 min respiratory preparation and 40 min of active training. Results: The overall drop-out rate was low (5.56%), and participants reported a generally high level of satisfaction. Regarding side effects, the mean total Simulator Sickness Questionnaire score was 24.31 (SD = 35.42), decreasing to 12.82 (SD = 15.24) after excluding an outlier. A significantly greater improvement in severe fatigue was observed in the experimental group (H = 4.083, p = 0.043). When considering all outcomes collectively, a tendency toward improvement was detected in the experimental group (binomial test, p < 0.0001). Conclusions: HRV-BF appears feasible and well tolerated. Findings support the need for Phase III trials to confirm its potential in mitigating fatigue in Long COVID. Full article

Background: Social isolation, national turmoil, and an adolescent mental health crisis in the wake of the COVID-19 pandemic have resulted in a significant uptick in inpatient admissions and re-admissions for high-risk patients. This trend persists even as the pandemic wanes. Intensive outpatient programs (IOPs) serve as a critical steppingstone between the community and inpatient mental health services, providing comprehensive psychiatric care for at-risk youth. Significant research has identified family engagement as a key element of successful collaborative care in adolescents. Objectives: This article provides models of family-centered care in the adolescent IOP through a case study detailing the six-week course of care of an adolescent struggling with increased emotionality and distress intolerance in the context of family conflicts. Methods: This case highlights five family engagement components, including (1) family-centered psychiatric medication management, (2) individualized case management, parental education, and peer support, (3) Measurement Based Care (MBC) family assessment and feedback sessions, (4) Dialectical Behavior Therapy (DBT) multi-family skill groups, and (5) Compassionate Home Action Together (CHATogether) family intervention to address teen–parent relational health and communication. Results: This case showed improvement in depressive and anxiety symptoms, family conflict behaviors, self-reported suicide risk, and help-seeking attitudes towards parents/adults. The case family, along with others (n = 26), endorsed the parent peer support groups’ acceptability and feasibility implemented in the adolescent IOP. Conclusions: This article emphasizes the importance of family engagement during clinical care and provides a practical guide to implement collaborative family-centered therapeutic interventions in intensive outpatient services. Full article

This study investigated whether young adults’ social media use and subjective well-being (SWB) changed during the COVID-19 pandemic. It examined the possible relationships between social media use, SWB, and personality traits. It included generalized trust, self-consciousness, friendship, and desire for self-presentation and admiration, in relation to different patterns of social media use and genders. Data were collected from university students in Japan from 2021 to 2023 and were analyzed based on different social media use patterns. The conceptual model was based on the cognitive bias and social network mediation models. Data were analyzed using ANOVA and regression analyses. The findings revealed that, over time, young adults’ anxiety toward COVID-19 decreased, while their SWB improved and their social support increased. Depression tendencies showed a negative association, whereas social support was positively related to improvement of SWB for all three patterns of social media use. Furthermore, online communication skills had a positive relationship with improvements in students’ SWB in Patterns 1 (LINE + Twitter + Instagram) and 2 (LINE + Twitter + Instagram + TikTok). The self-indeterminate factor had a positive relationship with students’ SWB for all patterns in 2022 and 2023, and the praise acquisition factor had a positive relationship with improvements in students’ SWB in Patterns 1 and 2. These results suggest that young adults maintained their mental health through different social media usage patterns, considering their personality traits and social situations associated with COVID-19. Particularly, receiving social support, decreasing people’s depression tendencies, and displaying different aspects of the “self” online can improve SWB. This study elucidates the mental health situations of university students in Japan and will help public health authorities develop new support programs that help digital natives improve their mental health in the context of social environmental changes. Full article

Introduction: Hospitalisation and prolonged length of stay is associated with deconditioning that risks adverse outcomes after discharge. Less is known about the psychological impact on older people after hospital discharge. The purpose of this systematic review was to elucidate factors contributing to psychological stress in older patients post-discharge to inform better discharge planning. Methods: A systematic search for studies reporting poor discharge outcomes in older people between 2010 and 2022 was performed in Medline, CINAHL, and PsycINFO. Search terms were ‘older patients > 65 year’, ‘post-discharge’, ‘psychological distress’, ‘loneliness’, ‘anxiety’, ‘depression’, and ‘length of hospital stay’. Exclusion criteria included COVID-19 disease, dementia (±severe cognitive impairment), individuals aged <65, and those under palliative care services. Results: A total of 1666 records were identified, of which 878 were excluded as they were outside of our date limits or were not written in the English language, 681 were excluded after application of exclusion criteria, and 699 were excluded because of insufficient details. A total of 31 duplicates were removed, leaving 38 articles that were assessed for eligibility; 7 of these reports were found suitable, comprising 1131 patients. Three highly relevant themes identified relating to post-discharge outcomes were social isolation, lack of support, depression and anxiety. Older patients with a tendency toward depressive symptoms had an increased likelihood of death. Conclusions: It appears that the discharge process from hospital fails to address psychological factors that permit a successful transition from hospital. Pre-discharge screening of psychological symptoms and coping ability may assist in identifying older patients who are at risk of mental as well as subsequent physical deterioration. Better knowledge of positive and negative predictors of a successful transition from hospital to home would enable more holistic, effective, and inclusive discharge planning processes for older adults. Full article

This study was aimed at identifying the prevalence of concurrent experience, poor mental health and problematic substance use, and its associated factors, among Canadian adults during the COVID-19 pandemic. A nationwide repeated cross-sectional sample of 14,897 Canadian adults (quota-sampled, weighted) were recruited on ten occasions between October 2020 and March 2022 using online panels. Concurrent experience was defined as mild to severe symptoms of depression (Patient Health Questionnaire-9) and/or anxiety (Generalized Anxiety Disorder-7) AND meeting screening criteria for problematic cannabis (Cannabis Use Disorder Identification Test-Revised) and/or problematic alcohol use (Alcohol Use Disorder Identification Test). Multivariable binary logistic regression models were fitted to identify the associated factors of concurrent experience using Stata v14.2 SE software. The pooled prevalence of concurrent experience was 17.12%, and 45.54% of the participants reported at least one experience (mental health symptoms or problematic substance use). The highest prevalence of concurrent experience per province was reported in Saskatchewan (19.4%) and the lowest in Quebec (13.6%). Younger adults, male respondents, those identifying as 2SLGBTQ+, self-reporting ethnocultural minority status, diagnostic history of mental health and substance use disorder, suicidal ideation, and lower ability to handle unexpected/difficult situations were significantly associated with concurrent experience during the COVID-19 pandemic in Canada. This analysis showed that the COVID-19 pandemic significantly impacted mental health and substance use in interrelated ways. Data-driven province-specific interventions might be helpful toward a client-centered and integrated mental health and substance use care system in Canada. Full article

The COVID-19 pandemic had wide impacts and repercussions for the NHS in the UK beyond the acute medical sector. This qualitative study evaluates the experience of medical (4) and non-medical prescribers (7) plus other staff (2 recovery workers; 2 community pharmacists) involved in opioid substitution therapy (OST) in a southern English county during and following the COVID-19 pandemic. Remote contact and a shift to predominantly weekly OST pick-up were anxiety-producing for clinicians, especially during the first lockdown. Widespread negative consequences were anticipated, such as a rise in fatal overdoses, which largely failed to materialise. Some diversion of medication was noted as were negative mental health consequences of enforced social isolation. Following a hiatus, psychosocial therapies transitioned to fully digital and subsequently hybrid delivery before returning to in-person group work towards the close of the pandemic. Changing power dynamics between clinicians and those accessing OST services were reported particularly around the re-introduction of daily supervised consumption and associated surveillance. Implications for future OST service delivery and national clinical guidance are suggested by way of conclusions. Full article