COVID-19 pandemic has affected human communities around the world, and there is fear that people with chronic diseases such as Multiple sclerosis(MS) are more vulnerable to negative psychological effects.

The aim of the present study was to assess the quality of sleep in patients with (MS) in comparison with healthy controls(HCs), during the COVID-19 pandemic and to identify its associated factors.

This was a cross-sectional survey study conducted with patients followed at the neurology department of Hbib bourguiba university hospital in sfax(Tunisia), during the month of november2020. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI). The PSQI is a questionnaire assessing participants’ sleep quality, sleep duration, and sleep disturbances and their severity during the past month.Participants with a PSQI ≤5 are classified as ‘good sleepers’.

Fifty two patients were included in the study. The mean age was 33.69 years(SD=9.21 years)and the sex ratio(F/H)was 4.77. Overall, our patients had higher scores of(PSQI)compared to HC and these différences were statistically significant(p < 0.05). The mean score of(PSQI)was 11.04(SD=3.003)and 11.53%were classified as ‘good sleepers’. Unemployment was related to a poor sleep quality(p=0.0001). Patients with high EDSS(r=0.7;p=0.0001), high number of relapses(r=0.58 ;p=0.0001)were more likely to have sleep disturbance. There was a positive correlation between a poor sleep quality and the duration of disease(r=0.38;p=0.005).

We identified that during the COVID-19pandemic patients with(MS)had a worse sleep quality. The COVID-19pandemic poses a challenge to psychological resilience. More studies are warranted to better understand the long-term consequences of the pandemic on mental health of vulnerable people.

No significant relationships.

Vaccine hesitancy is a serious issue and it affects the scientific achievements of health. This phenomenon has begun to be studied more often in health care workers, to find its determining factors.

The aim was to determine the percentage of hospital workers who got vaccinated against the infection with SARS-CoV-2.

Beginning with October 2021, we conducted an online questionnaire in which 57 hospital workers participated. Preliminary results allowed us to assess the rate of vaccine hesitancy among this group.

Out of the 57 hospital workers, the majority were vaccinated (n=45, 78.94%) in comparison to less than a quarter (n=12, 21.05%) that refused vaccination. The group of hospital workers included mostly nurses ( n=21, 36.84%). Also, 12 psychologists (21.05%), 11 doctors (19.29%), and 10 students (17.54%) were included. Among the cases that did not accept getting vaccinated against COVID-19, the highest percentage was occupied by nurses (n=9, 15.78%). Moreover, there were only one doctor and one psychologist who did not get vaccinated.

In the current pandemic times, the hesitancy and refusal of vaccination prove to be very challenging. It is important to explore their reasons and to promote health education programs.

No significant relationships.

After Russia decided to start COVID-19 vaccination of international students who are getting their education on its territory, they received an opportunity to get a single dose of COVID-19 Sputnik Light vaccine. What motives can such international students have for being vaccinated in the situation of uncertainty?

Our goal is to define the structure of motivation for COVID-19 vaccination among international students who are getting education at different departments of the university.

In October 2021, we surveyed 409 international students getting education at Ulianov Chuvash State University in Cheboksary, who agreed to COVID-19 vaccination.

Those who applied for vaccination were mostly 3rd year students (32.03%) and 4th year ones (21.52%). 8 students out of the surveyed (1.96%) had been vaccinated outside Russia, 4 – in Russia (0.98%). 8.56% of the pool had had COVID-19, 57.7% had not, 33.74% could not give a certain answer. Main motives for COVID-19 vaccination were: unwillingness to be ill (57.21%), unwillingness to have any limitations imposed (22.98%), unwillingness, especially of medical students, to have problems in their studies (12.22%), inclination towards following their relatives’ advice (5.13%), desire to follow the surrounding people’s example (1.98%). In personal conversations, the students often expressed their wish for being vaccinated with a 2-component Sputnik V vaccine for a better protection from illness.

The survey of the international students’ motives showed that most of them have positive attitude to COVID-19 vaccination and feel inclined to be vaccinated with a Russian vaccine in order to reduce the risk of getting ill.

No significant relationships.

The neurotropic valence of SARS-CoV-2 has been revealed in several studies. Depressive and anxiety symptoms are more frequent in the perinatal period leading to maternal and neonatal negative outcomes. Accordingly, depressive and anxiety symptoms are more frequent in the perinatal period leading to negative consequences in both mothers and their neonates.

To determine the level of depression, anxiety, and obsessive-compulsive symptoms depending on the severity of SARS-CoV-2 infection of pregnant women.

Based on the RT-PCR test, thirty-eight pregnant women with SARS-CoV-2 infection, hospitalized in Bega Clinic in Timisoara, were assessed concerning the presence of psychopathology. The severity of infection was dichotomized based on the presence or absence of the symptoms. The Edinburgh Postnatal Depression Scale, State and Trait Anxiety Inventory, and the Obsessive-Compulsive Inventory were administered to all participants.

Of 38 recruited pregnant women, 12 (31,5%) had symptomatic SARS-CoV-2 infection. Symptomatic SARS-CoV-2 infected pregnant women had a higher average score of depression (p = 0.001) and state and trait anxiety (p = 0.002 and p < 0.001, respectively) compared to their asymptomatic counterparts. There were no differences in obsessive-compulsive symptoms (p > 0.05) in relation to the severity of SARS-CoV-2 infection.

The SARS-CoV-2 infection significantly interferes with the psychological status, thus jeopardizing the mental health of pregnant women. Therefore, SARS-CoV-2 infection should be considered an additional risk factor for anxiety and affective disorders during pregnancy.

No significant relationships.

The article is devoted to the study of adaptation to the covid-19 pandemic conditions in Russian men and women in the first part of 2020. Respondents assessed the degree of potential danger of various types of social threats caused by the pandemic, as well as the level of their adaptation to changed living conditions during the first lockdown.

The purpose of this study was to identify key differences in adaptation to pandemic conditions in groups of men and women.

The author’s methodology was developed to assess the level of adaptation to COVID-19. The questionnaire included 6 scales on different aspects of life during the lockdown (for example, physical and emotional state, communication, employment during the pandemic, etc.). The sample was N = 80 (residents of Russia age 18-37).

Men significantly higher estimated the potential danger of an epidemic threat to themselves than women. The level of adaptation to conditions caused by the COVID-19 pandemic also differed in two gender groups according to t-test on the scale “Employment in a pandemic”: men were better adapted to work or study in conditions caused by the COVID-19 pandemic than women.

This can be interpreted from the point of view of the stereotype existing in Russian culture which postulates the performance of household duties and child care is more perceived as a woman’s responsibility. The adaptation of women to remote work during the lockdown was forced to be combined with an increased workload in the family and household sphere.

No significant relationships.

The dynamics of search queries in large random samples may reflect both the reaction of the population to the statements of power subjects, and the presence of certain mechanisms of emotional self-regulation.

Studying the dynamics of information search queries in the situation of experiencing an objective global threat-the spread of COVID-19.

Quantitative methods of the Data Mining class were used for data collection. Qualitative methods of the Data Mining class and contextual analysis were used for data analysis. Search queries related to COVID-19 and the introduction of self-isolation were analyzed: 5 million queries were randomly selected.

The number of information requests on the topic of the pandemic increased sharply after V. Putin’s first address, and then steadily decreased, but the overall picture of the content dynamics of search queries, depending on official statements of the authorities, was not observed; requests about the current level of morbidity are constantly presented to the greatest extent, and to the minimum-about the possibilities of psychological assistance and the state of the Russian economy. During the whole time of the study the contents of the Internet search shifted towards positive emotional information.

. To the maximum extent, the relationship between the experience of a pandemic and self-isolation with the nature of search queries manifests itself at the initial stages and tends to decrease in the future. The dynamics of the content of requests is ambiguously related to official statements of power subjects, influenced by the effect of counter-regulation.

No significant relationships.

The first cases of COVID-19 in Switzerland were related to the Milan cluster in February 2020. Border crossing restrictions were imposed and economic support measures worth 40 billion Swiss francs were announced. By 24th September 2021 Switzerland achieved a fully vaccination rate of 54%, confirmed 836’000 cases and 11’060 deaths.

The objective was to describe and analyse the mental health of the general Swiss population under the ongoing COVID-19 pandemic and it’s social changes: including a case description, transgenerational influence and psychosocial treatment opportunities

To answer the research question, I used deepened internet research, population interviews among different age gropus and colloquies with healthcare providers and federal authorities.

Different psychosocial phenomena lead to the transgenerational influence. Unfortunately, vaccination rate is slowed down by this pandemic’s impacts on public mental health. While during the first wave the positive feelings of cohesion and trust dominated, the mood changed afterwards to anxiousness and reactive individualism. Among all generations the fear of infection was shown to be a general booster of anxiety and distress. In fact, Swiss experts perceive the corona crisis as a catalysator for depression and anxiety disorders.

Specific psychosocial treatment has to address general and individual vulnerability factors. However, staying in touch with family members, pursuing meaningful activities and being physically active can all help to overcome COVID-19 related mental health issues.

No significant relationships.

A major increase in mental health issues was noted since the outbreak of the covid-19 pandemic even in patients with no history of mental health illness, specifically brief psychotic disorders.

Establish the covid-19 pandemic circumstances as precipitating factors of psychosis independently from other stressors

This is a cross-sectional and descriptive study carried out in the psychiatric department of the University Hospital of Mahdia including two groups of patients over a period of 15 months: From October 2018 to December 2019 are pre-covid cases, and the second group consists of the ones admitted between June 2020 and August 2021. We have collected the data of patients diagnosed with brief psychotic disorder according to DSM-5. We have focused on two clinical characteristics of the psychotic episodes (theme of delusions, stressors).

We have collected 19 patients, 12 among them during the pre-covid period. In our pre-covid period, brief psychotic disorder presented mostly with marked stressors (33.3%) whilst in the middle of the pandemic, marked stressors are present in only 14.3% of the cases. Which could suggest that this state of alarm can singlehandedly trigger psychosis. For the theme of delusions, in the pre-covid period, the religious theme appeared to be the most frequent (58.3%), whilst during the pandemic, persecution became the most prevalent (71.4%), showing how living in fear of contracting the virus could manifest itself in delusional content.

Living in a prolonged state of alarm is, in itself, a marked stressor, theoretically capable of increasing the psychosis rate and altering its characteristics.

No significant relationships.

COVID-19, caused by the most recently discovered corona virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2), has already reached pandemic scale worldwide. And it is expected for health care workers to feel stressed and worried during these times due to their exposure to infected individuals.

This study aims to identify the relationship between the demographic profile and health-related traits of EAMC employees, and their perceived stressors that aggravate psychologic distress experienced during the COVID-19 pandemic.

In this cross-sectional study of 390 health care workers, we use two brief mental health screening tools, namely Patient Health Questionnaire-9 (PHQ-9), a validated tool for depression, and Generalized Anxiety Disorder Scale-7 (GAD-7) a validated tool for anxiety.

Factors such as marital status, occupation and employment status appear to have association with the development of depressive and anxiety symptoms. Perceived stressors during the COVID-19 pandemic include long working hours, inconsistent administrative policies, exposure to Covid-19 positive individuals, inadequate time off from work and increasing number of patients but without commensurate additional work force. For our sample population, 31.8% did not have depressive symptoms, 35.6% had mild, 21% moderate, 9.7% moderately severe and 1.8% had severe depressive symptoms. While for anxiety, 57.7% had no to minimal symptoms, 26.9% mild, 9.7% moderate and 5.6% had severe anxiety symptoms.

It is therefore concluded that the Covid-19 pandemic indeed caused significant anxiety and depressive symptoms among health care workers. Measures to increase the work force should be put in place to decrease work burden and employee fatigue.

No significant relationships.

The COVID pandemic had a heavy impact on the mental health of people in general and healthcare professionals in particular.

Our study aimed to examine the the prevalence of post-traumatic stress symptoms among healthcare professionals working in COVID departments, and assess their professional quality of life.

Our sample consisted of 23 healthcare professionals who are working in the COVID departments of the Hospitals of Sfax. We collected their sociodemographic data, their medical history and COVID-related details. Their mental health was assessed by the Impact of Event scale (IES-R) and the professional quality of life scale (ProQOL-5)

The sex ratio in our study was 17:6, with a mean age of 31.79 years. They carried out 5.43 nightshifts per month, 57 hours of work per week including 27.38 hours of direct contact with COVID positive patients. A rate of 21.74% of the patients had a high IES-R score, indicating severe post traumatic stress symptoms. As for the subscales of the professional quality of life score, 21.73% of the participants had a low compassion satisfaction score, 65.21% of the participants had a moderate one and 13% had a high one. A rate of 91.3% of the participants had a moderate burnout score, the mean was 29.39. The secondary traumatization score was low in 26% of the cases, moderate in 60.86%, high in 13% and the mean was 27.91.

COVID healthcare professionals are at a relatively high risk of developing burnout and post-traumatic stress symptoms.

No significant relationships.

The ongoing global pandemic of Covid_19 had a huge pressure to accelerate the development process of Covid_19 vaccine. This acceleration of the vaccine appearance raised many concerns regarding the effectiveness and the adequate safety of the vaccine among general population.

The aim of the study is to determine the reasons behind vaccine refusal among general population.

Online questionnaire with the subjects’ agreement; The study included 61 participants aged between 18 and 40 years old. The study was effectuated in October 2021.

Most of the participants (n=60, 98.36%) declared that they knew some persons who have refused the Covid_19 vaccine. Moreover, a number of 29 participants (48.33%) declared that vaccine refusal among the people who refused the vaccine was due to personal believes.

The success of the vaccination programs mainly depends on the proportion of the population that receive the vaccine. It is crucial to implement new strategies to increase the acceptability of Covid_19 vaccine.

No significant relationships.

Working at Covid-19 frontline may threaten physical and mental health healthcare workers (HCWs). Assessing perceived Stress in HCWs is important to prevent serious mental illness

Assess the association between perceived stress and risk perception among healthcare workers working in the Covid-19 unit.

We conducted a cross-sectional study among healthcare workers working in a COVID-19 unit between March and July 2021 through a self-administered questionnaire. The Perceived Stress Scale (PSS-10) was used to assess perceived stress. The perceived risk of getting infected was assessed by a 5-item Likert Scale. The perceived risk of family members’ infection was evaluated by a Scale from 0 to 10.

A total of 85 participants were included. The mean age was 31±6 years. About 87% of participants lived with their families. Seventy-six per cent of HCWs rated their health status greater than or equal to 8/10. A percentage of 18,8% of HCWs have been infected with the Covid-19. Our population consisted of 44.7% technicians and 24,7% nurses, and 80% of the participants reported direct contact with COVID-19 confirmed patients. The level of the perceived risk of getting infected was high to very high in 95% of the HCWs. The mean score of the perceived risk of family members contracting the virus was 5.7 and 27,1% rated it greater than or equal to 8. The PSS-10 showed moderate and high perceived stress in 82,3% and 7,1% of participants, respectively. Only 10,6% of HCWs presented low-stress perception.

Frontline healthcare providers have high perceived stress and are at risk of mental health disorders

No significant relationships.

Discovered in December 2019, COVID has affected the entire planet, through direct exposure to its virus; SARS-COV-2, or indirectly through the media, Indeed, on January 20, 2020, the World Health Organization declared COVID-19 to be “a public health emergency of international concern.” Along with other public health crises and other collective trauma (terrorism, H1N1 epidemic or SARS-COV), exposure to publicized information on this virus generates psychiatric disorders, in particular anxiety and absence of well-being.

To link exposure to information about this pandemic through social media and anxiety and lack of well-being.

Use of a questionnaire consisting of three sections, individual status and conditions, the French versions of the GAD-7 scale for anxiety (Generalized anxiety scale of 7items) and the WHO-5 (five well-being index). This questionnaire is dedicated to the general population who have not been in direct contact with the virus, but through the media.

We were able to collect 209 participants, they were essentially females with a mean age of 28yo, 17,7% had psychiatric history of anxiety and depression, the median use of social medias was 5.7 hours per day. And they were essentially getting their information about the pandemic from Instagram, Facebook, the Moroccan ministry of health’s website and electronic newspapers. 31,1% of our participants had anxiety which was above a Chinese study, and had a poor well-being.

the use of social media to get information about the pandemic had an impact on well-being and anxiety..

No significant relationships.

The covid pandemic has become a unique phenomenon in world history with great impact on mental health.

A great growth of anxious depressive pathology in relation to the Covid situation has appeared with the need to increase the psychiatric approach in the general population

A 58-year-old woman with no personal medical story of interest is referred to the high-resolution Covid program due to severe depressive symptoms: intense apathy, abulia, anhedonia, weight loss, insomnia and important social distancing after the beginning of the confinement due to the Covid Pandemic. 4 psychotherapy sessions are performed, with a maximum duration of 45 minutes. It is necessary to add antidepressant medication with sertraline up to 100mg to improve psychotherapeutic work.

A complete recovery of symptoms is achieved even their severity with normalization of daily life.

Small psychotherapeutic interventions have been shown, even with critically ill patients, to be very effective in helping patients regain their baseline status.

No significant relationships.

The Covid-19 pandemic has had a deleterious impact on populations across the world. Yet it remains unclear how this pandemic is affecting the psychological health of people with a previous history of mental illness.

This study aims to investigate the impact of Covid-19 on patients with established mental disorders.

The PubMed and science direct databases were systematically searched using the keywords combination “Covid-19” and “psychiatric disorders”, “the pandemic” and “mental disorders “, from inception up to November 2021. We adopted a broad inclusion criterion for the study requiring patients to have a pre-existing mental disorder, excluding narrative reviews and preclinical studies. In addition, a search of google scholar was conducted to identify any additional relevant publications.

We have found 26 studies but only 19 met our inclusion criteria. Included studies were published between 2020 and 2021. 2 major results were identified. Symptoms deterioration was reported in individuals with severe mental disorders and those with schizophrenia in particular, such as depressive or anxiety symptoms, substance use and suicidal ideation, due to the psychological stress and physical distancing measures associated with the Covid-19 outbreak. The symptomatic treatments used in Covid-19 had frequent interactions with the most used antipsychotic drugs leading to a substantial increase in relapse rates in people with mental disorders.

The Covid-19 pandemic has a serious impact on individuals with pre-existing mental illness reinforcing symptom severity and psychological stress. Additional studies are needed to strengthen current findings with pre-pandemic records.

No significant relationships.

The highly infectious novel coronavirus disease (COVID-19) emerged in Wuhan, China in late 2019 and soon became a global pandemic. COVID-19 is escalating medical staff psychological stress and creating an increasingly heavy professional burden. Fear of transmitting the virus to family, community perception of frontline workers as potential disease carriers, extreme workloads and moral dilemmas add additional stressors. In Novi Sad Clinical Centre of Vojvodina (CCV) for the past 2 years there has been a continuous struggle against the COVID-19 crisis. Both senior specialist doctors and newly hired young doctors, some without work experience, were hired immediately after completing their studies.

To investigate the mental health of clinical first-line medical staff in COVID-19 pandemic.

This is a cross-sectional study involving CCV staff who worked in the first line of patient treatment during the COVID-19 pandemic. They were given a self-administered questionnaire which included information on demographic and socio-economic characteristics and the validated Depression, Anxiety, and Stress Scales (DASS-21) and the Impact of Events Scale–Revised (IES-R) instrument. A total of 190 medical workers were involved.

Sixty-two (32,6%) participants screened positive for anxiety, 38 (20%) for depression, 68 (35,8%) for stress, and 22 (11,5%) for clinical concern of PTSD. The most endangered are young nurses and doctors with less than 6 months of previous work experience.

In conclusion, our results suggest frontline medical staff involved in treatment of COVID-19 patients should be closely monitored as a high-risk group for depression and anxiety, and given proper training before deployment.

No significant relationships.

The COVID pandemic brought an overwhelming impact on hospital systems and personnel in the world.

Our study aimed to examine the impact of the COVID pandemic on the attitude and mental health of healthcare professionals working in COVID departments.

We included 23 healthcare professionals working in the COVID departments of the Hospitals of Sfax. Sociodemographic data, medical history and COVID related details were collected from the participants. Their mental health was assessed by the Hospital anxiety and depression scale (HADS).

In our sample, 26.1% were men and 73.9% were women, they were aged from 26 to 52. They worked for 57 hours per week, including 27.38 hours of direct contact with COVID positive patients and 5.43 nightshifts per month. A rate of 52.2% of the participants claimed having enough protection tools and 13% confirmed having enough equipment for patient management. 30.4% feared the lack of equipment and 39.1% considered themselves trained enough to manage COVID patients. As for the protective measures, 95.7% reduced contact with family members, 30.4% stopped visiting their parents, 8.7% left the family house and 4.3% didn’t take any particular measure. The mean HADS depression score was 9.61, and 60.86% had a Depression score equal or greater than 8, indicating depression. As for the HADS Anxiety score, its mean was 10.61 and 69.56% had a score equal or greater than 8, indicating anxiety.

The pandemic had a big impact on healthcare professionals working in COVID departments, as shows the relatively high depression and anxiety rate.

No significant relationships.

Vaccines are effective interventions that can reduce the high burden of COVID19 globally. However, public vaccine hesitancy is a pressing problem for public health authorities.

This study aimed to assess the prevalence of vaccination within mentally ill population and to point out the factors of acceptance and reticence.

We conducted a cross-sectional, descriptive and analytical study. It was carried out on a clinical population who consult in the psychiatry department in Sfax’s university hospital Hedi Chaker. Patients included in our study were aged between 21 and 69 years and were not in a decompensation phase of their psychiatric illness

Forty five patients were included. The mean age was 45±13 years old. Our population was made up of 3 women (6.7%) and 42 men (93.3%).A rate of 42.2% of the patients was of urban origin, 15.6% lived with a partner, 77.8% were unemployed and 46.7% were schizophrenic. In our study population, five patients had COVID 19 (11.1%), fourteen patients (31.1%) were vaccinated and eight patients (17.8%) asked their psychiatrist to vaccine. The main reasons of vaccination were their belief that vaccination decreases the chance of contracting COVID 19 and its complications (0.00) ,that COVID is lethal (0.002), and the fact that they trust it (0.001). Thirtyone patients (68.9%) refused vaccination, mainly due to reading or hearing negative information about vaccination (0.025). Vaccination wasn’t correlated neither to the fact that it could be a conspiracy nor to the diagnostic.

Our study reveals that one third of mentally ill patients are vaccinated. The reasons of acceptance of vaccination are multiple in opposite of the hesitancy factors

No significant relationships.

Since the beginning of the COVID-19 pandemic, sanitary context and e-learning has greatly modified students’ lifestyles. An increase of sedentary behaviors, a reduction in physical activity (PA) and a stronger tendency to move towards unhealthy diet have been demonstrated. Most of the research is largely descriptive and to date, no interventional studies have been conducted to prevent the deterioration of students’ health.

The objective of the present research aims to evaluate the effects of an intervention program on the lifestyle and psychological state of student. Its primary objective is to promote PA among students, to improve both physical condition and motivation to engage in physical activity for one’s health by promoting motivational levers. Its second objective is to reduce and/or prevent the deterioration of the health of university students.

Students from University of Nîmes were recruited and randomly assigned to one of the two following conditions: an experimental group and a control group. The experimental group participated to an 8-weeks program of PA (co-constructed by users during design-based innovative workshops) whereas the control group did not. For each group, measures of PA, sedentary time, anthropometric data, sleep, physical condition and psychological variables (anxiety, depression, motivation, body appreciation, perceived control, well-being, …) were carried out before (T1: october 2021) and after (T2: December 2021) these 8-weeks in order to evaluate the benefits from the PA program.

These assessments were performed in October 2021 (T1) and December 2021 (T2).

Data are still being collected and will be presented in April 2022.

No significant relationships.

Covid-19 vaccination in adults become a common behaviour nowadays. It may induce stress in some of the vaccinated patients.

This study aimed to evaluate perceived Stress among university teachers desiring to be vaccinated.

We conducted a cross-sectional study on Tunisian university teachers who participated in a COVID-19 vaccination campaign organized in June 2021. A self-administered questionnaire was administered. The survey dealt with socio-professional data and the level of stress assessed with the Perceived Stress Scale (PSS-10).

A total of 100 participants were included. The mean age was 51 years ±7. The Sex Ratio (M/F) was 1.7. The majority of participants were married and reported living with their families (96%). On a 0 to 10 scale, 71% of participants described an excellent health status and rated it greater than or equal to 8. The average job tenure was 15 years. The PSS-10 showed moderate and high perceived stress in 86% and 4% of participants, respectively. Only 10% of university teachers presented low-stress perception.

Getting vaccinated against Covid-19 is crucial in order to protect the population. This behaviour could be associated with a big amount of stress. Taking into account the psychiatric mental condition is crucial for the vaccinating health care providers in order to alleviate this experience.

No significant relationships.