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Purpose Parents often accompany adolescent and young adult (AYA) pediatric cancer survivors to follow-up oncology clinic visits and remain involved in their care, although little is known about their reasons for doing so. Method This mixed methods (qualitative–quantitative) study of 76 mothers of AYA survivors of childhood cancer uses content analysis and logistic regression to identify and explore reasons mothers provided for coming to the visit. Demographic and treatment data are examined as potentially explanatory factors. Results Ten reasons (in decreasing order of frequency) were derived: Concern for Child’s Health and Well-Being, Practical Support, Transportation, Familial Experience, General Support, Companionship, Personal Interest in Follow-up Care, Characteristics of their Child, Emotional Support, and Parental Duty. The reasons were not related to demographic or treatment factors. Conclusion Mothers accompany AYAs to survivorship clinic for both maternal/family-focused and survivor-focused reasons that can be incorporated in survivorship and transition care to reflect ongoing communications among survivors, parents, and health care teams.

Background Adolescent and young adult survivors of childhood cancer are a vulnerable population. Health beliefs may be related to necessary follow-up care. Purpose This study seeks to develop a measure of health beliefs for adolescents and young adults with and without a history of cancer. Methods Inductive and deductive methods and focus groups were used to develop the Health Competence Beliefs Inventory. Cancer survivors (n=138) and comparison participants (n=130) completed the Health Competence Beliefs Inventory and other measures. Healthcare providers reported current medical problems. Results A series of iterative exploratory factor analyses generated a 21-item four-factor solution: (1) Health Perceptions; (2) Satisfaction with Healthcare; (3) Cognitive Competence; and (4) Autonomy. Survivors reported significantly different Health Competence Beliefs Inventory scale scores than comparisons (p<.05). The Health Competence Beliefs Inventory was associated with beliefs, affect, quality of life, posttraumatic stress symptoms, and medical problems. Conclusions The Health Competence Beliefs Inventory is a promising measure of adolescent and young adult perceptions of health and well-being.

Mindfulness based training (MBT) is becoming increasingly popular as a means to improve general wellbeing through developing enhanced control over metacognitive processes. In this preliminary study, we tested a cohort of 36 nurses (mean age = 30.3, SD = 8.52; 2 male) who participated in an 8-week MBT intervention to examine the improvements in sustained attention and its energetic costs that may result from MBT. Changes in sustained attention were measured using the psychomotor vigilance task (PVT) and electroencephalography (EEG) was collected both during PVT performance, and during a brief period of meditation. As there was substantial variability in training attendance, this variable was used a covariate in all analyses. Following the MBT program, we observed changes in alpha power across all scalp regions during meditation that were correlated with attendance. Similarly, PVT performance worsened over the 8-week period, but that this decline was mitigated by good attendance on the MBT program. The subjective energy depletion due to PVT performance (measured using self-report on Likert-type scales) was also less in regular attendees. Finally, changes in known EEG markers of attention during PVT performance (P300 and alpha-band event-related desynchronization) paralleled these behavioral shifts. Taken together, our data suggest that sustained attention and its associated costs may be negatively affected over time in the nursing profession, but that regular attendance of MBT may help to attenuate these effects. However, as this study contained no control condition, we cannot rule out that other factors (e.g., motivation, placebo effects) may also account for our findings.

Introduction Worldwide, COVID-19 clusters have emerged within communities of international migrant workers operating in high-density work and living environments. Despite their increased vulnerability, no study has documented the mental health burden of COVID-19 amongst these groups. To address this gap, we conducted a survey of migrant workers involved in large-scale dormitory outbreaks within Singapore. Methods Between 22 June to 11 October 2020, questionnaires were distributed to 1011 migrant workers undergoing extended movement restrictions. Mental health symptoms were measured using the 21-item Depression, Anxiety and Stress Scale (DASS-21). As covariates, we assessed participants’ socio-demographics, quarantine status, COVID-19 health concerns, financial stability, and exposure to news and misinformation. Linear regression models were fitted to identify factors associated with DASS-21 scores. Results Complete movement restrictions were associated with increased depression and stress symptoms, while being diagnosed with COVID-19 was associated with increased anxiety. Participants who harboured fears about their health or job, perceived their health to be poorer, or had greater exposure to COVID-19 rumours reported higher depression, anxiety, and stress levels. Across the cohort, rates of severe or extremely severe depression (3.1%, 95% CI: 2.1-4.3%), anxiety (4.1%, 95% CI: 2.9-5.5%), and stress (1.3%, 95% CI: 0.7-2.2%) were similar to those observed in the general population for the host country (Singapore). Conclusions As the first mental health survey of low-waged migrant workers during the pandemic, our findings provide a basis to identify and support at-risk individuals. This is critical as migrant workers often have limited access to healthcare services. At the same time, we documented resilience within the cohort as a whole.

Background Mindfulness-based intervention (MBI) has not been evaluated for its feasibility and effectiveness in reducing stress and anxiety among family caregivers of patients on peritoneal dialysis (PD). Objectives (1) To evaluate the feasibility to include MBI during PD training for family caregivers. (2) To determine the effect of MBI on the caregivers’ levels of stress (perceived stress scale, PSS), anxiety state-trait anxiety inventory, STAI), QOL (short-form 36) and reactions to caregiving (caregiver reaction assessment, CRA). (3) To determine differences in the health-related QOL (Kidney Disease Quality of Life Instrument-Short Form, KDQOL PCS and SF-36 MCS) of care recipients with caregivers receiving MBI at 1 month, 3 months and 6 months when compared to those with caregivers receiving routine training. (4) To gather the caregiver’s feedback on the MBI. Methods This feasibility study recruited family caregivers to receive either mindfulness training (MT) or treatment-as-usual (TAU) group. Both groups received 4.5-days of structured PD training, but only caregivers in the MT group received 4 days of MT sessions, audio-guided mindfulness practice at home and weekly telephone follow-up. Results Forty-four family caregivers participated in this study. Including MBI as part of the PD training was feasible. There was a trend towards lower scores for PSS and T-STAI in the MT group compared to the TAU group. The baseline score of both PSS and T-STAI were positively correlated with post-intervention outcome scores. Conclusions Mindfulness-based intervention has the potential to improve psychological symptoms among caregivers of patients with PD.

Objective Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. Methods We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50–80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI (n = 65) or SHEEP (n = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Results Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size d = −1.27, 95% confidence interval (CI) −1.61 to −0.89; SHEEP: d = −0.69, 95% CI −0.96 to −0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: d = −1.19; SHEEP: d = −1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASOactigraphy (MBTI: d = −0.30; SHEEP: d = 0.02), SOLactigraphy (MBTI: d = −0.25; SHEEP: d = −0.09), and WASOPSG (MBTI: d = −0.26; SHEEP (d = −0.18). There was no change in SOLPSG. No participants withdrew because of adverse effects. Conclusions MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

Childhood cancer has long-term implications for survivors and their family members. While the impact of cancer on the family continues into adulthood, little research exists on family-related issues during this important developmental period. In order to advance our understanding of families of adolescent and young adult (AYA) childhood cancer survivors, a measure of health-related beliefs for parents of AYA cancer survivors was developed. Exploratory factor analysis based on the mothers' data was used to identify four factors among 23 items: Social Competence, Satisfaction with Healthcare, Health Perceptions, and Health Apprehension. The scales are associated with psychological distress, quality of life, and posttraumatic stress symptoms but unrelated to age of the child at diagnosis and cancer treatment intensity. The beliefs identified in this study are consistent with clinical observations of families of young adult survivors and provide indications for the importance of ongoing attention to the families of childhood cancer survivors.