Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and inc...Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and increased the workload for CHWs.The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic.We searched PubMed for published literature,from January 1,2020 to December 31,2022 that focused on documenting the experiences of burnout,distress,and mental health symptoms among CHWs in LMICs.The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.Included studies were grouped into the follow-ing broad thematic categories:(1)symptoms experienced;(2)drivers of different mental health symptoms;and(3)strategies for coping with different symptoms.We identified 10 cross-sectional,qualitative,and observational studies from 11 LMICs in South and Southeast Asia,South America,and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic.The studies identified disorders and symptoms such as depression,anxiety,fear,burnout,worsened stress,and fatigue.Contributing factors included increased work-load,financial constraints,and an understaffed and underequipped workplace.CHWs reported using different adaptive responses like humor,support from family and colleagues,denial,and substance use,and asked for recommended regular mental health checkups and counseling.More research and policies should be targeted to-wards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.展开更多
AIM：To evaluate the association between visual impairment（VI） and mental health or social engagement in older adults living in rural Thailand.METHODS：Data for this cross-sectional study were drawn from a community...AIM：To evaluate the association between visual impairment（VI） and mental health or social engagement in older adults living in rural Thailand.METHODS：Data for this cross-sectional study were drawn from a community survey conducted in 2015 in Saraburi Province,Thailand.Participants were 327 adults aged ≥50 y.VI was assessed using presenting distance visual acuity.Mental health and social engagement were evaluated in face-to-face interviews using validated questionnaires.After determining the prevalence of VI and relevant sociodemographic characteristics,multivariate regression analysis was used to evaluate the impact of VI on mental health and social engagement.RESULTS：The prevalence of VI was 18.3%.Major causes were refractive error（58.3%） and cataract（35%）.Factors associated with VI in the crude analysis were：older age [odds ratio（OR） 8.08],unemployment（OR 2.72）,widowhood（OR 2.47）,being divorced/separated（OR 3.27）,smoking（OR 2.09） and disability in activities of daily living（OR 2.35）.Protective factors were undergoing eye screening at least once a year（P=0.029） and obesity（P=0.005）.VI was significantly associated with low social engagement（adjusted OR 4.13） but not with poor mental health（P〉0.05）.CONCLUSION：Although VI older adults reported less participation in social activities,there is no significant association between VI and poor mental health.Annual eye examinations may prevent VI in older adults.Information about employment and anti-smoking should be targeted to older adults with VI.展开更多
Tremendous progress has been made in the past decade surrounding the underlying mechanisms and treatment of neuropsychiatric disease. Technological advancements and a broadened research paradigm have contributed to th...Tremendous progress has been made in the past decade surrounding the underlying mechanisms and treatment of neuropsychiatric disease. Technological advancements and a broadened research paradigm have contributed to the understanding of the neurochemistry, brain function and brain circuitry involved in neuropsychiatric disorders. The predominant area of unmet medical need in the United States is major psychiatric disorders, and major depressive disorder is the leading cause of disability for ages 15-44. Total spending on research and development by the pharmaceutical industry has grown exponentially during the past decade, but fewer new molecular entities(NME) for the treatment of major psychiatric disorders have received regulatory approvals compared to other therapeutic areas. Though significant expansion has occurred during the "decade of the brain", the translation of clinical trials outcomes into the community mental health setting is deficient. Randomized controlled trials(RCTs) have been the standard approach to clinical evaluation of the safety and efficacy of NMEs for the past 60 years; however, there are significant barriers and skepticism in the implementation of evidence-based outcomes into clinical practice. Recruitment of patients, shortages of experiencedclinical researchers, regulatory requirements and later translation of outcomes into clinical practice are ever growing problems faced by investigators. The community mental health setting presents particular barriers in the replication of therapeutic outcomes from RCTs. The diagnostic complexity of major psychiatric diseases and the highly selective patient populations involved in clinical trials lend to the gap in translation from the "bench to the bedside". The community mental health setting lends to a diverse patient population with numerous co-morbidities and environmental factors that are unaccounted in the average RCT. While we acknowledge the enormous complexity in developing novel and innovative treatments for major psychiatric disorders, we must continue to improve the translatability of clinical trials to real world settings. Progress has been rather slow but as the gap in treatment effectiveness is reduced, so will costs and barriers in community mental health.展开更多
Objective: The aim of our study was to evaluate of oxidative stress between the schizophrenic patients who regularly continued to Community Mental Health Centers (CMHC) and the patients who did not continue to CMHC. B...Objective: The aim of our study was to evaluate of oxidative stress between the schizophrenic patients who regularly continued to Community Mental Health Centers (CMHC) and the patients who did not continue to CMHC. By this study, the effects of CMHC on oxidative stress between these two group of patients were assessed. Methods: Total number of 86 volunteers were enrolled in this study;43 (27 males, 16 females) patients who regularly continued (average 2 years, at least 3 days a week) to CMHC and 43 (25 males, 18 females) patients who regularly did not continue to CMHC. Total antioxidative stress (TAS), total oxidative stress (TOS), oxidative stress index (OSI), paraoxanase (PON1), arylesterase (ARE) and total thiol (T.Thl) levels were measured with a novel automated method. Positive and Negative Syndrome Scale (PANSS) was used to assess the patients. Results: TOS, PANSS-Negative subscale and PANSS-Total subscale were found to be significantly higher in the group of patients who were not continuing to CMHC, than the group of patients who were continuing to CMHC. ARE and T.thl were found significantly lower in the group of patients who were not continuing to CMHC. There was a significant positive correlation between PANSS-Negative Subscale and TOS, OSI in the group of patients who were not continuing to CMHC. There was a positive correlation between PANSS-Negative Subscale and TOS in the group of patients who were continuing to CMHC. Conclusions: Oxidative stress and negative symptoms of schizophrenia in the group of patients who were continuing to CMHC were less than in the group of patients who were not continuing to CMHC. Thus, regular follow up at CMHC is very important in the treatment of schizophrenia patients.展开更多
This study sought to identify and describe existing forensic mental health aftercare facilities in Zimbabwe. A descriptive qualitative research design was applied to the study. Twenty-nine participants were purposivel...This study sought to identify and describe existing forensic mental health aftercare facilities in Zimbabwe. A descriptive qualitative research design was applied to the study. Twenty-nine participants were purposively sampled. Semi-structured interviews were conducted. Thematic analysis of data was done. Three aftercare centers were identified. The link between special institutions where patients are discharged from and these centers is dependent on the Mental Health Review Tribunal. Models of care in these centers revolve around agro based livelihood activities. Social workers, nurses, nurse aides and volunteers from various medical background constitute care teams in the forensic mental health aftercare facilities. There is however, poor engagement within the identified aftercare facilities and also with mainstream psychiatric services.展开更多
With the aging of the population and the change of family structure, the physical and mental health of the elderly has become the focus of attention at home and abroad. The traditional mental health service in our cou...With the aging of the population and the change of family structure, the physical and mental health of the elderly has become the focus of attention at home and abroad. The traditional mental health service in our country is narrow and the form is single, which can not meet the needs of the elderly. This paper based on the analysis of characteristics of community, community mental health services with respect to the unique advantages of Chinese traditional psychological service mode in the maintenance of the mental health of the elderly, with a unique entry point to analyze the problems of psychological services in community elderly, puts forward a sound proposal, summed up the community mental health service is suitable to China＇s national conditions, the practical significance of the road,展开更多
Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety i...Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.展开更多
Sufferers’mental illnesses experience changes in communication,cognition,and behavior,exposing differences in social behavior and relationships.Many who suffer from mental health problems notice that the reduced comm...Sufferers’mental illnesses experience changes in communication,cognition,and behavior,exposing differences in social behavior and relationships.Many who suffer from mental health problems notice that the reduced communication ability leads to social inclusion and distrust of others.Online Mental Health Communities(OMHCs)facilitate a new means of communication between patients and physicians.Based on the trust source credibility framework,trust transitivity theory,social resources and physician-patient interactions,this study aims to evaluate the factors that influence patients’trust in OMHCs.We crawled the data from Haodf.com,the leading healthcare community platform in China,to study the factors that influence patients’trust using the ordinary least squares regression method.725 psychologists’records were collected on 19 November,2019,20 December,2019,and 20 May,2020.Compared with face-to-face physician appointments,Chief Physicians are more likely to gain patients’initial trust online.Further,psychologists’integrity,online reputation,and group size have significant positive impact on the initial trust of patients.Similarly,patients’online initial trust and efforts have significantly positive influences on their continuous trust online.To improve relationships between physicians and patients,physicians must strengthen their clinical abilities and be honest with patients.The findings of this study provide insights into the factors that influence patients’trust in OMHCs.展开更多
Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and st...Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.展开更多
BACKGROUND What factors affected the levels of anger and emotional distress experienced during the coronavirus disease 2019(COVID-19)pandemic?We hypothesized that(1)sociodemographic factors and resiliency factors woul...BACKGROUND What factors affected the levels of anger and emotional distress experienced during the coronavirus disease 2019(COVID-19)pandemic?We hypothesized that(1)sociodemographic factors and resiliency factors would partially explain psychological distress and anger,with stronger resiliency associated with lower levels of distress and anger;(2)women would report more trust in national leadership,as well as more psychological problems;(3)individuals of low socioeconomic status would report less resiliency,less trust in national leadership,and greater distress than individuals of higher socioeconomic status;and(4)hope would mediate the relationships between the other resiliency factors and both anger and distress.AIM To explore whether community resilience,hope,and trust in leaders were associated with lower levels of anger and emotional distress during the COVID-19 pandemic.METHODS For this observational study,data were gathered in Israel during the second wave of the COVID-19 pandemic,just before the Jewish New Year(mid-September 2020),as a second lockdown was announced.Data were gathered from 636 Israeli adults,who were recruited by the Midgam research panel.The participants filled out self-reported questionnaires including one on state anger,the Brief Symptom Inventory as a measure of mental-health problems(i.e.,somatization,depression,and anxiety),and questionnaires about trust in the state’s leaders,community resilience(CCRAM),and hope as measures of coping resources and resiliency.t-tests were used to explore differences between men and women and between those of lower and higher socioeconomic status.A hierarchical multiple regression analysis was then used to examine whether and how the sociodemographic and resiliency variables explained state anger and psychological distress.A Sobel test was used to evaluate the possible effects of hope on community resilience and trust in leadership in the context of both distress and anger.RESULTS Our results revealed differences between women and men in terms of anger and mental-health problems,but not in terms of coping resources.Women reported higher levels of both anger and mental-health problems.Participants of lower socioeconomic status reported more mental-health problems,more anger,and greater trust in the state’s leaders;whereas those of higher socioeconomic status reported greater hope.Furthermore,hierarchical multiple regression analyses revealed that the sociodemographic factors of gender,age,and socioeconomic status,as well as community resilience,trust in the state’s leaders,and hope explained mental health with a total of 19% of the variance and anger with a total of 33% of the variance.The Sobel tests showed that hope mediated the relationships between community resilience and mental health(z=3.46,P<0.001),community resilience and anger(z=2.90,P<0.01),and trust in leaders and anger(z=3.26,P<0.01),but did not affect the relationship between trust in leaders and mental health(z=1.53,P>0.05).CONCLUSION Personal and communal factors affect psychological distress.Personal resilience is an important factor that should be strengthened throughout life.Trust in leadership is important for citizens’mental health.展开更多
This study aimed to explain factors affecting health-related quality of life among community-dwelling elderly individuals living in Japan. We conducted a questionnaire survey of 898 individuals at senior citizens club...This study aimed to explain factors affecting health-related quality of life among community-dwelling elderly individuals living in Japan. We conducted a questionnaire survey of 898 individuals at senior citizens clubs in a rural area near the Tokyo metropolitan area in 2015, and analyzed the responses of 715 who provided valid responses. The survey questions included basic attributes (e.g., age, economic affluence), state of health (e.g., whether s/he has heart disease or not), the Spirituality Rating Scale Related to Health in the Elderly (SP Health Scale, composed of, e.g., meaning and purpose of living, self-transcendence), the Abbreviated Lubben Social Network Scale, and the MOS 8-Item Short Form Health Survey (SF-8). Multiple regression analyses were performed using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 as dependent variables and all others as independent variables. Factors associated with improved PCS were economic affluence and SP Health Scale (meaning and purpose of living), while the factors associated with reduced PCS were age and state of health (heart disease, gastrointestinal disease, osteoarthritis, lower back pain, knee pain, and eligible for long-term care). Meanwhile, factors associated with improved MCS were economic affluence, while those that were associated with reduced MCS were state of health (cancer and headache) and SP Health Scale (self-transcendence). These results suggest the need to understand spirituality in addition to the subjective economic situation, age, and medical condition of elderly individuals in order to improve their physical and mental health.展开更多
Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers...Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.展开更多
BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT ...BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT combined with mental health education as a treatment for schizophrenia compared with mental health education alone.METHODS In all,120 schizophrenia out-patients were randomized into CBGT combined with mental health education or single mental health education.The primary outcomes were positive and negative symptoms,cognitive function,excitatory factor,anxiety and depression symptom improvements on the positive and negative syndrome scale score.Secondary outcome measures included social function and drug compliance.RESULTS There were significant differences between CBGT combined with mental health education and single mental health education on measures of positive and negative symptoms,cognitive functions,excitatory factor,anxiety and depression symptoms,and social functions.No other significant difference in outcomes was observed.CONCLUSION CBGT combined with mental health education may be relevant beneficial treatment method in reducing symptoms,cognitive and social functions of patients with schizophrenia.展开更多
This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the me...This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.展开更多
As industries develop,fire disasters and their associated damage are increasing.Investigating the mental health of victims is imperative because this is an essential issue for community recovery after a disaster.This ...As industries develop,fire disasters and their associated damage are increasing.Investigating the mental health of victims is imperative because this is an essential issue for community recovery after a disaster.This study was conducted to determine the efficacy of a program implemented by a community mental health center based on the investigation of the victims’depression and post-traumatic stress disorder(PTSD)levels immediately after the disaster and at one-year follow-up.As a result,victims’depression and PTSD recovered over time,and more changes were confirmed.In particular,the high-risk group for PTSD showed a high program participation rate,and there was significant recovery over time compared with the group without PTSD.Based on these results,community mental health programs are an effective way to increase community mental health after disasters.In the future,community-based recovery programs after disasters should be expanded,and administrative support for them should be developed.展开更多
Background:In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality,sustainable health systems,this paper presents findings from two complementary studies to...Background:In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality,sustainable health systems,this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town.Methods:This mixed-methods,cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town.Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers.The survey included demographic as well as effort-reward imbalance(ERI)and professional quality of life(PROQOL)questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life,as well as differences between lay and professional health workers.Qualitative data was analysed using a thematic content analysis approach.Quantitative data was analysed using STATA 12.Results:Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers.Corroborating these findings,our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work(61.1%of professional and 70.2%of lay health workers;p=0.302).There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers.Although Compassion Satisfaction was high for all health worker groups,lay health workers also showed elevated levels of burnout and compassion fatigue,with community-based health workers particularly affected.Conclusions:Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to‘re-engineer’South Africa’s Primary Health Care system.Furthermore,they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems.展开更多
Objective:This study investigated and discussed the current status of community mental health service in three northern areas of China(Beijing,Harbin,and Karamay)in an effort to improve the community mental health ser...Objective:This study investigated and discussed the current status of community mental health service in three northern areas of China(Beijing,Harbin,and Karamay)in an effort to improve the community mental health services in China.Methods:In this study 176 residents from communities of the three northern areas of China were involved and divided into 18 groups.The study was conducted according to a self-prepared structured interview outline.Results:The analysis was conducted based on the following four perspectives:1.commu-nity residents’understanding of the mental health problems and how they treated psychiatric patients;2.community residents’access to and application of mental health information;3.com-munity residents’attitude to accept mental health services and the factors influencing community residents to seek help from mental health services;and 4.community residents’attitude and will-ingness to participate in the activities of community mental health services.Conclusion:Based on the investigation and analysis regarding the current status of the com-munity mental health services in three northern areas of China,it is concluded that the residents do not have s clear and complete understanding of mental health.The characteristics of mental health services had a regional correlation.Currently,the mental health services do not work effectively,and the residents are somewhat passive in obtaining information about mental health.Community mental health services should be offered according to different individual needs of the residents and the actual situations of each region.展开更多
This study aimed to explore citizens’emotional responses and issues of interest in the context of the coronavirus disease 2019(COVID-19)pandemic.The dataset comprised 65,313 tweets with the location marked as New Yor...This study aimed to explore citizens’emotional responses and issues of interest in the context of the coronavirus disease 2019(COVID-19)pandemic.The dataset comprised 65,313 tweets with the location marked as New York State.The data collection period was four days of tweets when New York City imposed a lockdown order due to an increase in confirmed cases.Data analysis was performed using R Studio.The emotional responses in tweets were analyzed using the Bing and NRC(National Research Council Canada)dictionaries.The tweets’central issue was identified by Text Network Analysis.When tweets were classified as either positive or negative,the negative sentiment was higher.Using the NRC dictionary,eight emotional classifications were devised:“trust,”“fear,”“anticipation,”“sadness,”“anger,”“joy,”“surprise,”and“disgust.”These results indicated that citizens showed negative and trusting emotional reactions in the early days of the pandemic.Moreover,citizens showed a strong interest in overcoming and coping with other people such as social solidarity.Citizens were concerned about the confirmation of COVID-19 infection status and death.Efforts should be made to ensure citizens’psychological stability by promptly informing them of the status of infectious disease management and the route of infection.展开更多
Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this...Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.展开更多
基金supported by grants from the National Institute of Mental Health(U19MH113211-01)and the Harvard Global Health Institute Burke Fellowship.
文摘Community health workers(CHWs)represent the backbone of primary health systems,especially in many low-and middle-income countries(LMICs).The coronavirus disease 2019(COVID-19)pandemic stretched health sys-tems and increased the workload for CHWs.The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic.We searched PubMed for published literature,from January 1,2020 to December 31,2022 that focused on documenting the experiences of burnout,distress,and mental health symptoms among CHWs in LMICs.The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool.Included studies were grouped into the follow-ing broad thematic categories:(1)symptoms experienced;(2)drivers of different mental health symptoms;and(3)strategies for coping with different symptoms.We identified 10 cross-sectional,qualitative,and observational studies from 11 LMICs in South and Southeast Asia,South America,and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic.The studies identified disorders and symptoms such as depression,anxiety,fear,burnout,worsened stress,and fatigue.Contributing factors included increased work-load,financial constraints,and an understaffed and underequipped workplace.CHWs reported using different adaptive responses like humor,support from family and colleagues,denial,and substance use,and asked for recommended regular mental health checkups and counseling.More research and policies should be targeted to-wards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.
文摘AIM：To evaluate the association between visual impairment（VI） and mental health or social engagement in older adults living in rural Thailand.METHODS：Data for this cross-sectional study were drawn from a community survey conducted in 2015 in Saraburi Province,Thailand.Participants were 327 adults aged ≥50 y.VI was assessed using presenting distance visual acuity.Mental health and social engagement were evaluated in face-to-face interviews using validated questionnaires.After determining the prevalence of VI and relevant sociodemographic characteristics,multivariate regression analysis was used to evaluate the impact of VI on mental health and social engagement.RESULTS：The prevalence of VI was 18.3%.Major causes were refractive error（58.3%） and cataract（35%）.Factors associated with VI in the crude analysis were：older age [odds ratio（OR） 8.08],unemployment（OR 2.72）,widowhood（OR 2.47）,being divorced/separated（OR 3.27）,smoking（OR 2.09） and disability in activities of daily living（OR 2.35）.Protective factors were undergoing eye screening at least once a year（P=0.029） and obesity（P=0.005）.VI was significantly associated with low social engagement（adjusted OR 4.13） but not with poor mental health（P〉0.05）.CONCLUSION：Although VI older adults reported less participation in social activities,there is no significant association between VI and poor mental health.Annual eye examinations may prevent VI in older adults.Information about employment and anti-smoking should be targeted to older adults with VI.
文摘Tremendous progress has been made in the past decade surrounding the underlying mechanisms and treatment of neuropsychiatric disease. Technological advancements and a broadened research paradigm have contributed to the understanding of the neurochemistry, brain function and brain circuitry involved in neuropsychiatric disorders. The predominant area of unmet medical need in the United States is major psychiatric disorders, and major depressive disorder is the leading cause of disability for ages 15-44. Total spending on research and development by the pharmaceutical industry has grown exponentially during the past decade, but fewer new molecular entities(NME) for the treatment of major psychiatric disorders have received regulatory approvals compared to other therapeutic areas. Though significant expansion has occurred during the "decade of the brain", the translation of clinical trials outcomes into the community mental health setting is deficient. Randomized controlled trials(RCTs) have been the standard approach to clinical evaluation of the safety and efficacy of NMEs for the past 60 years; however, there are significant barriers and skepticism in the implementation of evidence-based outcomes into clinical practice. Recruitment of patients, shortages of experiencedclinical researchers, regulatory requirements and later translation of outcomes into clinical practice are ever growing problems faced by investigators. The community mental health setting presents particular barriers in the replication of therapeutic outcomes from RCTs. The diagnostic complexity of major psychiatric diseases and the highly selective patient populations involved in clinical trials lend to the gap in translation from the "bench to the bedside". The community mental health setting lends to a diverse patient population with numerous co-morbidities and environmental factors that are unaccounted in the average RCT. While we acknowledge the enormous complexity in developing novel and innovative treatments for major psychiatric disorders, we must continue to improve the translatability of clinical trials to real world settings. Progress has been rather slow but as the gap in treatment effectiveness is reduced, so will costs and barriers in community mental health.
文摘Objective: The aim of our study was to evaluate of oxidative stress between the schizophrenic patients who regularly continued to Community Mental Health Centers (CMHC) and the patients who did not continue to CMHC. By this study, the effects of CMHC on oxidative stress between these two group of patients were assessed. Methods: Total number of 86 volunteers were enrolled in this study;43 (27 males, 16 females) patients who regularly continued (average 2 years, at least 3 days a week) to CMHC and 43 (25 males, 18 females) patients who regularly did not continue to CMHC. Total antioxidative stress (TAS), total oxidative stress (TOS), oxidative stress index (OSI), paraoxanase (PON1), arylesterase (ARE) and total thiol (T.Thl) levels were measured with a novel automated method. Positive and Negative Syndrome Scale (PANSS) was used to assess the patients. Results: TOS, PANSS-Negative subscale and PANSS-Total subscale were found to be significantly higher in the group of patients who were not continuing to CMHC, than the group of patients who were continuing to CMHC. ARE and T.thl were found significantly lower in the group of patients who were not continuing to CMHC. There was a significant positive correlation between PANSS-Negative Subscale and TOS, OSI in the group of patients who were not continuing to CMHC. There was a positive correlation between PANSS-Negative Subscale and TOS in the group of patients who were continuing to CMHC. Conclusions: Oxidative stress and negative symptoms of schizophrenia in the group of patients who were continuing to CMHC were less than in the group of patients who were not continuing to CMHC. Thus, regular follow up at CMHC is very important in the treatment of schizophrenia patients.
文摘This study sought to identify and describe existing forensic mental health aftercare facilities in Zimbabwe. A descriptive qualitative research design was applied to the study. Twenty-nine participants were purposively sampled. Semi-structured interviews were conducted. Thematic analysis of data was done. Three aftercare centers were identified. The link between special institutions where patients are discharged from and these centers is dependent on the Mental Health Review Tribunal. Models of care in these centers revolve around agro based livelihood activities. Social workers, nurses, nurse aides and volunteers from various medical background constitute care teams in the forensic mental health aftercare facilities. There is however, poor engagement within the identified aftercare facilities and also with mainstream psychiatric services.
文摘With the aging of the population and the change of family structure, the physical and mental health of the elderly has become the focus of attention at home and abroad. The traditional mental health service in our country is narrow and the form is single, which can not meet the needs of the elderly. This paper based on the analysis of characteristics of community, community mental health services with respect to the unique advantages of Chinese traditional psychological service mode in the maintenance of the mental health of the elderly, with a unique entry point to analyze the problems of psychological services in community elderly, puts forward a sound proposal, summed up the community mental health service is suitable to China＇s national conditions, the practical significance of the road,
文摘Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.
基金supported by the National Natural Science Foundation of China(Grant Nos.:71971092 and 72001087).
文摘Sufferers’mental illnesses experience changes in communication,cognition,and behavior,exposing differences in social behavior and relationships.Many who suffer from mental health problems notice that the reduced communication ability leads to social inclusion and distrust of others.Online Mental Health Communities(OMHCs)facilitate a new means of communication between patients and physicians.Based on the trust source credibility framework,trust transitivity theory,social resources and physician-patient interactions,this study aims to evaluate the factors that influence patients’trust in OMHCs.We crawled the data from Haodf.com,the leading healthcare community platform in China,to study the factors that influence patients’trust using the ordinary least squares regression method.725 psychologists’records were collected on 19 November,2019,20 December,2019,and 20 May,2020.Compared with face-to-face physician appointments,Chief Physicians are more likely to gain patients’initial trust online.Further,psychologists’integrity,online reputation,and group size have significant positive impact on the initial trust of patients.Similarly,patients’online initial trust and efforts have significantly positive influences on their continuous trust online.To improve relationships between physicians and patients,physicians must strengthen their clinical abilities and be honest with patients.The findings of this study provide insights into the factors that influence patients’trust in OMHCs.
文摘Madness has attracted and frightened for centuries,and talking about this means discussing how this diversity was built and managed in different social contexts and historical periods.Not all societies have had,and still have,the same relationship with madness.It is only with the affirmation of the Modern State,and of Capitalism,that the idea of“normality”indispensable to be able to conceive diversity as something dangerously distant and different from the norm takes over.In our post-modern society,people with mental illness in Italy can resort to specialists and social-health services.But the heterogeneous answers given after the approval of law 180 appear to be increasingly diversified.In this research,much attention will be paid to how the social and health services,located in different areas of Italy(Messina,Rome,Trento)face the current growing risk of social,housing and economic isolation of these fragile subjects.The aim of the research is to explore the possibility of a new relationship between the social-health service and the local community.On the one hand,research investigates what the contribution of the services could be.On the other what the spaces of protagonism and participation of the community could be in inclusion process account.In order to better understand the differences between these two dimensions,a qualitative research approach was chosen through the conduct of in-depth interviews.In this way it was possible to investigate:(1)the partial representations characteristic of the single individual,family members,operators and stackholders in general;(2)the services around the topic dealt with is articulated.From the first results of the research it emerges that the territory can no longer be considered as an abstract entity,but becomes the social space within which the construction of a new community welfare can and must take place.
文摘BACKGROUND What factors affected the levels of anger and emotional distress experienced during the coronavirus disease 2019(COVID-19)pandemic?We hypothesized that(1)sociodemographic factors and resiliency factors would partially explain psychological distress and anger,with stronger resiliency associated with lower levels of distress and anger;(2)women would report more trust in national leadership,as well as more psychological problems;(3)individuals of low socioeconomic status would report less resiliency,less trust in national leadership,and greater distress than individuals of higher socioeconomic status;and(4)hope would mediate the relationships between the other resiliency factors and both anger and distress.AIM To explore whether community resilience,hope,and trust in leaders were associated with lower levels of anger and emotional distress during the COVID-19 pandemic.METHODS For this observational study,data were gathered in Israel during the second wave of the COVID-19 pandemic,just before the Jewish New Year(mid-September 2020),as a second lockdown was announced.Data were gathered from 636 Israeli adults,who were recruited by the Midgam research panel.The participants filled out self-reported questionnaires including one on state anger,the Brief Symptom Inventory as a measure of mental-health problems(i.e.,somatization,depression,and anxiety),and questionnaires about trust in the state’s leaders,community resilience(CCRAM),and hope as measures of coping resources and resiliency.t-tests were used to explore differences between men and women and between those of lower and higher socioeconomic status.A hierarchical multiple regression analysis was then used to examine whether and how the sociodemographic and resiliency variables explained state anger and psychological distress.A Sobel test was used to evaluate the possible effects of hope on community resilience and trust in leadership in the context of both distress and anger.RESULTS Our results revealed differences between women and men in terms of anger and mental-health problems,but not in terms of coping resources.Women reported higher levels of both anger and mental-health problems.Participants of lower socioeconomic status reported more mental-health problems,more anger,and greater trust in the state’s leaders;whereas those of higher socioeconomic status reported greater hope.Furthermore,hierarchical multiple regression analyses revealed that the sociodemographic factors of gender,age,and socioeconomic status,as well as community resilience,trust in the state’s leaders,and hope explained mental health with a total of 19% of the variance and anger with a total of 33% of the variance.The Sobel tests showed that hope mediated the relationships between community resilience and mental health(z=3.46,P<0.001),community resilience and anger(z=2.90,P<0.01),and trust in leaders and anger(z=3.26,P<0.01),but did not affect the relationship between trust in leaders and mental health(z=1.53,P>0.05).CONCLUSION Personal and communal factors affect psychological distress.Personal resilience is an important factor that should be strengthened throughout life.Trust in leadership is important for citizens’mental health.
文摘This study aimed to explain factors affecting health-related quality of life among community-dwelling elderly individuals living in Japan. We conducted a questionnaire survey of 898 individuals at senior citizens clubs in a rural area near the Tokyo metropolitan area in 2015, and analyzed the responses of 715 who provided valid responses. The survey questions included basic attributes (e.g., age, economic affluence), state of health (e.g., whether s/he has heart disease or not), the Spirituality Rating Scale Related to Health in the Elderly (SP Health Scale, composed of, e.g., meaning and purpose of living, self-transcendence), the Abbreviated Lubben Social Network Scale, and the MOS 8-Item Short Form Health Survey (SF-8). Multiple regression analyses were performed using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 as dependent variables and all others as independent variables. Factors associated with improved PCS were economic affluence and SP Health Scale (meaning and purpose of living), while the factors associated with reduced PCS were age and state of health (heart disease, gastrointestinal disease, osteoarthritis, lower back pain, knee pain, and eligible for long-term care). Meanwhile, factors associated with improved MCS were economic affluence, while those that were associated with reduced MCS were state of health (cancer and headache) and SP Health Scale (self-transcendence). These results suggest the need to understand spirituality in addition to the subjective economic situation, age, and medical condition of elderly individuals in order to improve their physical and mental health.
基金This research(study design,data collection and analysis)was funded by Program Riset Kolaborasi Indonesia(RKI)-World Class University(WCU)Lembaga Penelitian dan Pengabdian Masyarakat Universitas Airlangga Indonesia in 2023 with the number:974/UN3.LPPM/PT.01.03/2023.
文摘Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.
基金Supported by Science and Technology Innovation Bureau,Longhua District,Shenzhen,Guangdong Province,China,No.2020202.
文摘BACKGROUND The efficacy of cognitive behavioral group therapy(CBGT)for cognitive dysfunction and negative symptoms of schizophrenia is established,but more evidence is required.AIM To assess the effectiveness of CBGT combined with mental health education as a treatment for schizophrenia compared with mental health education alone.METHODS In all,120 schizophrenia out-patients were randomized into CBGT combined with mental health education or single mental health education.The primary outcomes were positive and negative symptoms,cognitive function,excitatory factor,anxiety and depression symptom improvements on the positive and negative syndrome scale score.Secondary outcome measures included social function and drug compliance.RESULTS There were significant differences between CBGT combined with mental health education and single mental health education on measures of positive and negative symptoms,cognitive functions,excitatory factor,anxiety and depression symptoms,and social functions.No other significant difference in outcomes was observed.CONCLUSION CBGT combined with mental health education may be relevant beneficial treatment method in reducing symptoms,cognitive and social functions of patients with schizophrenia.
文摘This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea Government(MEST)(No.2020R1A2B5B01002082).
文摘As industries develop,fire disasters and their associated damage are increasing.Investigating the mental health of victims is imperative because this is an essential issue for community recovery after a disaster.This study was conducted to determine the efficacy of a program implemented by a community mental health center based on the investigation of the victims’depression and post-traumatic stress disorder(PTSD)levels immediately after the disaster and at one-year follow-up.As a result,victims’depression and PTSD recovered over time,and more changes were confirmed.In particular,the high-risk group for PTSD showed a high program participation rate,and there was significant recovery over time compared with the group without PTSD.Based on these results,community mental health programs are an effective way to increase community mental health after disasters.In the future,community-based recovery programs after disasters should be expanded,and administrative support for them should be developed.
基金funded by the National Institute for Health Research(NIHR)Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa,King’s College London(GHRU 16/136/54)using UK aid from the UK Government to support global health research。
文摘Background:In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality,sustainable health systems,this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town.Methods:This mixed-methods,cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town.Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers.The survey included demographic as well as effort-reward imbalance(ERI)and professional quality of life(PROQOL)questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life,as well as differences between lay and professional health workers.Qualitative data was analysed using a thematic content analysis approach.Quantitative data was analysed using STATA 12.Results:Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers.Corroborating these findings,our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work(61.1%of professional and 70.2%of lay health workers;p=0.302).There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers.Although Compassion Satisfaction was high for all health worker groups,lay health workers also showed elevated levels of burnout and compassion fatigue,with community-based health workers particularly affected.Conclusions:Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to‘re-engineer’South Africa’s Primary Health Care system.Furthermore,they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems.
基金National Science and Technology Support Program:applied in the propaganda,education,intervention and demonstration of community mental health against the mental illness prevention and treatment[2009BA177B08].
文摘Objective:This study investigated and discussed the current status of community mental health service in three northern areas of China(Beijing,Harbin,and Karamay)in an effort to improve the community mental health services in China.Methods:In this study 176 residents from communities of the three northern areas of China were involved and divided into 18 groups.The study was conducted according to a self-prepared structured interview outline.Results:The analysis was conducted based on the following four perspectives:1.commu-nity residents’understanding of the mental health problems and how they treated psychiatric patients;2.community residents’access to and application of mental health information;3.com-munity residents’attitude to accept mental health services and the factors influencing community residents to seek help from mental health services;and 4.community residents’attitude and will-ingness to participate in the activities of community mental health services.Conclusion:Based on the investigation and analysis regarding the current status of the com-munity mental health services in three northern areas of China,it is concluded that the residents do not have s clear and complete understanding of mental health.The characteristics of mental health services had a regional correlation.Currently,the mental health services do not work effectively,and the residents are somewhat passive in obtaining information about mental health.Community mental health services should be offered according to different individual needs of the residents and the actual situations of each region.
基金supported by the National Research Foundation of Korea(NRF)Grant Funded by the Korea Government(MSIT)(NRF-2020R1A2B5B0100208).
文摘This study aimed to explore citizens’emotional responses and issues of interest in the context of the coronavirus disease 2019(COVID-19)pandemic.The dataset comprised 65,313 tweets with the location marked as New York State.The data collection period was four days of tweets when New York City imposed a lockdown order due to an increase in confirmed cases.Data analysis was performed using R Studio.The emotional responses in tweets were analyzed using the Bing and NRC(National Research Council Canada)dictionaries.The tweets’central issue was identified by Text Network Analysis.When tweets were classified as either positive or negative,the negative sentiment was higher.Using the NRC dictionary,eight emotional classifications were devised:“trust,”“fear,”“anticipation,”“sadness,”“anger,”“joy,”“surprise,”and“disgust.”These results indicated that citizens showed negative and trusting emotional reactions in the early days of the pandemic.Moreover,citizens showed a strong interest in overcoming and coping with other people such as social solidarity.Citizens were concerned about the confirmation of COVID-19 infection status and death.Efforts should be made to ensure citizens’psychological stability by promptly informing them of the status of infectious disease management and the route of infection.
文摘Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.
