Browsing by Author "Berzins, Sandra"
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- ItemOpen AccessDeterminants of Depression in Multiple Sclerosis(2014-08-25) Berzins, Sandra; Patten, Scott; Bulloch, AndrewMultiple sclerosis (MS) is considered the most common disabling neurological condition in young people, and it can significantly affect the quality of life of those living with the condition. Mental illness is an important dimension of MS (Feinstein, 2004; Rodgers & Bland, 1996). People with MS have an elevated prevalence of anxiety disorders (Korostil & Feinstein, 2007), psychotic and mood disorders (Patten, Svenson, & Metz, 2005b). The objectives of this study were to estimate the incidence and to conduct an exploratory analysis on the potential determinants of incidence of depression in MS. Participants in this prospective cohort study (n=188) were followed for six months, starting with two baseline risk factor assessments then completing a depression screening instrument, the PHQ-9, every 2 weeks. At monthly intervals, information was collected on potential risk factors, using standard items from existing validated scales and instruments. Associations were estimated using prevalence ratios (PR) and hazard ratios (HR). A response feature analysis used standard deviation of total depression scores to categorize participants in an alternative way to the typical depression high/low cut-point measures. Baseline cross-sectional analyses found a depression prevalence estimate of 22% using the traditional PHQ-9 cut-point of 10. Predictors of incidence included low self-esteem (HR=4.9), perceived inability to cope with demands of daily life (HR=5.4) low self-efficacy (HR=5.0) and task oriented coping (HR=0.2). The response feature analysis found there is a group of non-depressed participants with high PHQ-9 score variability that shares some risk factors with the depressed patients. These results indicate depression in MS exhibits a risk factor profile similar to that of depression in the general population, with the additional impact of MS illness-related factors. Depression in MS is often regarded as being neurologically induced due to brain lesions, inflammation or axonal loss. While these results do not obviate this possibility, they provide a clear indication that depression in MS exhibits a risk factor profile characterized prominently by psychological and social factors. Future research should adopt a greater focus on such determinants, particularly coping with stress style, which may provide unrecognized opportunities for prevention and/or treatment of depression in this population.
- ItemOpen AccessUnderstanding In-Person and Online Exercise Oncology Program Delivery: Participant Perspectives(2021-06-30) Duchek, Delaney; Culos-Reed, Nicole; McDonough, Meghan; Bridel, William; Berzins, SandraBackground: Alberta Cancer Exercise (ACE) is an exercise oncology program delivered in community-based settings until the onset of the COVID-19 pandemic, when ACE was forced to transition to an online platform for remote delivery. Purpose: To evaluate the perspectives of cancer survivors who have transitioned from an in-person to an online exercise oncology program. Specifically, survivors' exercise facilitators and barriers in both delivery modes, delivery mode preference, and experience with the program elements targeting behaviour change were gathered. Methods: A retrospective cohort design using explanatory sequential mixed-methods was used to assess participants' experiences with participation in both settings. Participants who have completed both in-person and online ACE classes were asked to complete a survey, with the option to complete a subsequent interview. Results: A total of 57 (response rate 46%) completed the survey and 19 interviews were conducted. Most participants indicated preferring in-person programs (58%), followed by online (32%), and no preference (10%). There were significantly fewer barriers (p<0.01), but also fewer facilitators/benefits (p<0.01), to exercising online. Qualitative data analysis supported survey findings, with participants frequently noting the convenience of attending online, but a lack of equivalent social connection gained. Content analysis (survey comments) and thematic analysis (interview analysis) demonstrated that the online setting was less conducive to providing behaviour change support, largely attributed to limitations inherent to the online platform. Conclusion: ACE participants experienced facilitators and barriers to both the online and in-person delivery modes. The transition to online was supported by participants' in-person experiences, and for future work that includes solely online (i.e., for rural and remote cancer survivor exercise program delivery), focusing on building social support and a sense of community will be critical to optimizing program benefits. Addressing the need for promoting and maintaining exercise in people with cancer using an online platform when standard exercise formats are restricted due to COVID-19 is timely and necessary. Beyond the COVID-19 pandemic, results of this research will remain relevant as we aim to increase the reach of online exercise oncology programming to more underserved populations of individuals living with cancer (i.e., rural/remote, immunocompromised, young adult populations).