The prevalence of type 2 diabetes mellitus (T2DM) is growing worldwide. T2DM is often complicated by a range of psychological disorders that interfere with glycemic control and self-care. Previous studies have reported diabetes distress, depression, and anxiety among patients with T2DM; however; little is known about the burden of these comorbid mental disorders in primary care patients with T2DM treated in Egypt during the COVID-19 era. Participants were selected by convenient sampling from eight rural primary healthcare facilities from Ismailia in Egypt. Symptoms of diabetes distress, depression and anxiety were assessed by using the Arabic version of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9, and Generalized Anxiety Disorder Scales, respectively. Multiple hierarchical logistic regression models were used to estimate the significant factors associated with diabetes distress, depression, and anxiety. A total of 403 individuals with T2DM were interviewed. The prevalence of severe diabetes distress was 13.4% (95% CI: 10.1–16.7), while prevalence of depressive and anxiety symptoms was 9.2% (95% CI: 6.4–12.0%), and 4.0% (95% CI: 2.1–5.9), respectively. In a series of hierarchical logistic regression models, significant predictors for diabetes distress were being married, illiterate, not-working, living with insufficient income, and having multi-comorbidities. Likewise, the significant predictors for depression and anxiety were elevated glycated hemoglobin level and the higher PAID total score, while having multi-comorbidities was a significant predictor for anxiety only. Diabetes distress was more prevalent than depressive and anxiety symptoms in this study population. Several sociodemographic and clinical characteristics were identified to be related with psychological problems among patients with T2DM, which necessitate a multidisciplinary team-based approach for optimal screening and management.

BackgroundThe Problem Areas in Diabetes (PAID) scale is a reliable and valid tool that is widely used for diabetes-distress screening, but the Arabic version of the scale lacks validity and reliability analysis in primary healthcare (PHC) patients. Our study aimed to evaluate the psychometric properties of the Arabic version of the PAID (AR-PAID) scale among Egyptian patients with type 2 diabetes mellitus (T2DM) in PHC settings.MethodsWe conducted a cross-sectional study on a convenience sample of 200 patients from six rural PHC settings in the Ismailia governorate. The confirmatory factor analysis (CFA) was performed to test the goodness-of-fit to the predefined models of the PAID. Convergent construct was evaluated through correlations with the Arabic versions of the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and 5-item World Health Organization Well-Being Index (WHO-5), additionally glycated hemoglobin (HbA1c) levels. Discriminant validity was evaluated through associations with patients' sociodemographic and clinical characteristics. Reliability was evaluated through internal consistency (Cronbach's α) and test-retest reliability analysis (intraclass correlation coefficient, ICC).ResultsThe CFA demonstrated the best fit for a four-factor model. The AR-PAID was significantly correlated with the following measures: PHQ-9 (rho = 0.71, p < 0.001), GAD-7 (rho = 0.50, p < 0.001), WHO-5 (rho = −0.69, p < 0.001), and HbA1c (rho = 0.36, p < 0.001), supporting sound convergent validity. Discriminant validity was satisfactory demonstrated. Internal consistency was excellent (α = 0.96) and test-retest reliability was stable (ICC = 0.97).ConclusionsThe AR-PAID scale is a valid and reliable instrument for diabetes-distress screening in primary care patients with T2DM that can be used in clinical settings and research. Further research is needed to validate short forms of the AR-PAID scale.

The COVID-19 pandemic presented a challenge to the care of patients with rheumatic and musculoskeletal diseases (RMDs). The objective of this study was to evaluate the impact of the pandemic on the care of RMDs patients and their health and well-being. This cross-sectional study involved 120 RMDs patients at the rheumatology department at Suez Canal University Hospital in Ismailia, Egypt, in July 2020. Patients were interviewed for sociodemographic and disease-related history. Further assessments were performed using Kessler 6-items, fears of COVID-19, and COV19–impact on quality of life scales. Rheumatoid arthritis and systemic lupus erythematosus represented the majority of our sample of RMDs patients (72.5% and 19.2%, respectively). About 50% of patients reported experiencing limitations in the access to rheumatologic care, and a similar percentage had changed or discontinued their medications. Disease-modifying antirheumatic drugs shortage and concerns about the increased risk of COVID-19 infection due to immunosuppressive drugs were the most frequently reported reasons for nonadherence. The percentage of patients with uncontrolled disease had significantly increased from 8.3% prior to the COVID-19 pandemic to 20% during the pandemic. About 60% of patients reported a high level of psychological distress. In conclusion, the pandemic negatively influenced mental health, quality of life, adherence to medications, access to rheumatology care, and the degree of disease control of RMDs patients.

BackgroundBurnout has been endorsed with serious negative health- and work-related outcomes. This study is aimed to assess the prevalence of burnout and its association with work productivity among academic staff.MethodsThis cross-sectional study involved 240 academic staff working at a public university in Egypt. Participants were invited to complete a web-based questionnaire involving basic personal, health, and work-related characteristics. Besides, Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to assess occupational burnout dimensions (i.e., emotional exhaustion “EE,” depersonalization “DP,” and personal accomplishment “PA”), while work productivity was assessed with the Health and Work Performance Questionnaire (HPQ).ResultsIn total, 28% of respondents scored high in EE [95% confidence interval (CI): 22.5–33.8%], 18.3% high in DP (95% CI: 13.8–3.6%), and 88.3% scored low in PA (95% CI: 83.8–91.9%). Seventy percent of respondents scored high in only one burnout dimension, 21.7% scored high in two dimensions, while 7.1% scored high in all three dimensions. Multivariable analysis showed that EE was the only burnout dimension that showed a statistically significant association between absenteeism and presenteeism rates. The absenteeism rates among respondents with moderate and high EE were 2.1 and 3.3 times the rates among those with low EE, respectively. Likewise, the presenteeism rates among respondents with moderate and high EE were 2.4 and 4.7 times the rates among those with low EE, respectively.ConclusionsAcademic staff showed a high prevalence of at least one burnout dimension. Moderate and high EE scores were significantly associated with increased productivity loss when compared to low EE.

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