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Psychological counseling needs among middle and high school
students with separated/divorced parents in Hue city
Tran Binh Thang
1
, Ho Uyen Phuong
1
, Dinh Thi Lieu
1
, Pham Thi Thu Ha
1
, Chau Nguyen Dan
1
,
Nguyen Ngo Bao Khuyen
1
, Luong Thi Thu Tham
1
, Tran Thi Tra My
1
, Vo Nu Hong Duc
1
, Nguyen Thanh Gia
1
,
Nguyen Van Thong
1
, Nguyen Minh Tam
1
, Nguyen Minh Tu
1*
(1) University of Medicine and Pharmacy, Hue University
Abstract
Background: Adolescents who live in incomplete families may be vulnerable to various psychological e
昀昀 ects, ranging from mild to complex. This study aims to examine the need for psychological counseling
among high school students whose parents are separated/divorced, and to iden 琀椀 fy factors associated
with this need. Methods: A cross-sec 琀椀 onal descrip 琀椀 ve study was conducted on 309 high school
students with separated/separated/divorced parents in Hue City. Results: The percentage of high school
students with separated/divorced parents who need psychological counseling accounted for 40.5%. The
need for psychological consulta 琀椀 on about life skills and future orienta 琀椀 on accounted for 54.4%,
appearance and physicality accounted for 37.9%, family rela 琀椀 onships accounted for 33.0% and problems
with reproduc 琀椀 ve health and heterosexual friendship accounted for 31.4%. Factors related to the need
for psychological counseling include the 琀椀 me of parents’ divorce, close friendship rela 琀椀 onship,
problems with friends, behavioral problems, violence, family quality and school quality, with a signi 昀椀
cance level of p < 0.05. Conclusion: High school students with separated/divorced parents need
psychological counseling, so it is necessary to combine family and school to create a healthy environment
for children.
Keywords: psychological counseling, needs, students, parents separated/divorced.
1. INTRODUCTION
Nowadays, issues related to mental health
among adolescents are increasing, especially for
children in separated or separated/divorced families
[1]. According to a study by Nguyen Thi Nhu Thuy and
colleagues (2019) on the psychological injury of
teenagers in disintegrated families in Ho Chi Minh
City, 16.1% of minors have psychological manifesta
琀椀 ons [2]. Another study by Phillip A. Radetzki and
colleagues (2020) also found that children whose
parents were separated/divorced were more likely
to be a 昀昀 ected by adverse mental health
outcomes than other children [3]. Children a 昀昀
ected by separated/divorced parents are at high risk
for a variety of mental health condi 琀椀 ons
including emo 琀椀 onal and behavioral disorders,
poor school performance, depression, anxiety,
suicidal idea 琀椀 on, suicide a 琀琀 empt, distress,
smoking, and substance abuse [4].
The fact shows that parents’ divorce has signi
cantly impacted teenagers’ percep 琀椀 on of the
value of family and life. Teenagers tend to develop
more emo 琀椀 ons and behavior during the
postdivorce period rather than before [5]. Di 昀昀
erent psychosocial, physical, and transi 琀椀 onal
disorders can occur in children a 昀昀 ected by
separated/divorced parents [4]. Notably, at an older
age, children tend to seek emo 琀椀 onal compensa
琀椀 on and sharing with a tendency to look outside
of society, which can lead to many other
psychosocial problems [6]. The behavior of children
caused by divorce and con ict between parents
Corresponding author: Nguyen Minh Tu, email: nmtu@huemed-univ.edu.vn
Recieved: 2/2/2023; Accepted: 15/5/2023; Published: 10/6/2023
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depends on the child’s age and stage of development
of the child, and it is important to recognize them to
intervene appropriately [7]. A study of psychology in
the UK on adolescents with psychological distress
showed that those who were advised had signi 昀椀
cantly reduced levels of psychological su 昀昀 ering
than those in the control group [8]. Psychological
counseling is an interac 琀椀 ve process between a
professional with counseling skills and ethics of the
counseling profession and a person with mental
health di cul 琀椀 es in need of assistance.
Through the exchange, in 琀椀 mate sharing,
empathy, and acceptance of reality, self-discovery of
one’s poten 琀椀 al to solve one’s problems is
achieved [9]. In Vietnam, there has been no research
on the mental health counseling needs of
adolescents with separated/divorced parents. That is
why we conducted research “Psychological
counseling needs among middle and high school
students with separated/divorced parents in Hue
city” with two objec 琀椀 ves: (1) To examine the
need for psychological counseling among high school
students whose parents are separated/divorced in
Hue city; (2) iden
琀椀
fy factors associated with this
need.
2. MATERIALS AND METHODS
2.1. Par 琀椀 cipants
- The criteria of choice: High school students
with separated/divorced parents are studying in
Hue city and are approved by their guardians.
- Exclusion criteria: Subjects experiencing
health problems, are unlikely to par 琀椀 cipate in
the survey.
2.2. Time and place
The study was conducted at three schools (2
secondary schools and 2 high schools) in Hue from
June 2022 to December 2022. 2.3. Study design
Cross-sec 琀椀 onal study 2.4
Sample size and sampling method
Sample size according to the
formula:
n Z
= 12 p(1
2 p)
d
In which:
n: is the smallest reasonable sample size.
z: is the value depending on the desired level of
reliability of the es 琀椀 mate; desired con 昀椀
dence level is 95% when z = 1.96. p: the es 琀椀
mated ra 琀椀 o of the popula 琀椀 on p = 0.273,
the percentage of students who want to set up a
school psychology consul 琀椀 ng room according
to research by Bui Thi Hoa [10].
d: is the desired tolerable devia 琀椀 on or the
di 昀昀 erence between the p ra 琀椀 o obtained
on the sample and the actual p ra 琀椀 o in the
popula 琀椀 on; d = 0.05.
From the formula and the facts above we
calculate n = 305.
In fact, in this study, we collected 309 students
who agreed to par 琀椀 cipate. Method of selec
ng the sample Selec 琀椀 on of mul 琀椀 ple
stages.
Stage 1: Randomly selected two secondary
schools out of 26 schools and two high schools out
of 11 schools in the city of Hue.
Stage 2: Take the sample of all students living in
a family whose parents are separated/divorced.
Stage 3: Conduct interviews with all students
selected to collect research informa 琀椀 on.
2.5. Data collec 琀椀 on
- Data collec 琀椀 on tools: The toolkit is
designed based on built-in variables.
- Inves 琀椀 gators are trained and instructed
on the toolkit and approach, interviewing research
subjects.
2.6. Measurements
- Dependent variable: the need for
psychological counseling of secondary school and
high school students.
We assessed based on seven ques 琀椀 ons about
the need for psychological counseling support in
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seven areas: emo 琀椀 onal, behavioral, school rela
琀椀 ons, family rela 琀椀 ons, appearance and
physical, reproduc 琀椀 ve health and friendship, life
skills and future orienta 琀椀 on. The ques 琀椀 ons
are scored, 0 = no need and 1 = need, so the highest
total score is 7, the lowest is 0 and from 3 points
above is the need for psychological support [11].
- Independence variables: Demographic
factors: age, gender; family factors: family economy,
琀椀 me of divorce of parents; psychosocial-
behavioral factors: internet usage status, bullying
status, state of violence, behavioral problems,
having problems with friends, close friends rela 琀椀
onships; school quality; family quality.
- Assessment of school violence and school
bullying based on the GSHS 2019 ques 琀椀 onnaire
[39].
+ Harassed experience: Divided into two groups
and measured over the last 30 days (no bullying and
harassment).
+ Violence experience: Divided into two groups
and measured over the past 12 months (no violence
and violence).
- There are behavioral problems and
problems with friends: Assessment of student
mental health based on the SDQ-25 ques 琀椀
onnaire: Ques 琀椀 onnaire assessing strengths and
di cul 琀椀 es (Strength and Di cul 琀椀 es
Ques琀椀 onnaire) 25 ques琀椀 ons were evaluated
over 5 aspects of emo 琀椀 onal problems,
behavioral problems, problems of increased a 琀琀
en 琀椀 on, friend’s problems, posi 琀椀 ve social
problems and scored as follows: 0 - wrong, 1 - par
ally right, 2 - right. Excluding sentences 7, 11, 14,
21, 25 each corresponding answer: 2 - not correct, 1
- par 琀椀 ally correct, 0 - surely correct. In our study,
children were assessed as having mental health
problems (MHP) when the total score was abnormal
and children were not assessed with MHP when
there was a normal and boundary total score.
Therefore, the behavioral problems were divided
into two groups in the analysis process: having
behavior problems (from 5-10 points) and no
behavioral problems (from 0-4 points); friend’s
problems were classi 昀椀 ed into two categories in
the process of analysis including having friend’s
problems: (from 6-10 points), and no friend’s issues
(from 0-5 points).
- Quality of school: We assessed based on
nine ques 琀椀 ons how o 昀琀 en behaviors have
occurred over the past six months, which revolved
around ques 琀椀 ons about students’ feelings about
school (pleasure at school; score pressure; safety in
school; being encouraged by the teacher; being
listened to by the professor; being treated fairly;
being able to get acquainted with new friends; being
cri 琀椀 cized by the master; being helped by
friends). Each sentence scores a minimum of 1 and a
maximum of 5 depending on the speci 昀椀 c
answer: 1 - never, 2 - rarely, 3 - occasionally, 4 -
frequently, 5 - always; the cri 琀椀 cal factor itself
scores the opposite. The score is calculated by
adding the total score of the answers, ranging from
9 to 45. And they were assessed based on cut points
with ≥30 points and not <30 points.
- Family Quality: On family quality
assessment, we assessed based on 7 ques 琀椀 ons
about the frequency of behavior over the past 6
months, the ques 琀椀 ons revolving around
problems of student feelings towards parents and
adults in the family (crying, insul 琀椀 ng, pressure
and expecta 琀椀 ons of learning; bea 琀椀 ng; not
feeling loved; not listening, caring, sharing;
comparing with friends; interest, encouragement,
praise, sharing). Each sentence scores a minimum of
1 and a maximum of 5 depending on the speci 昀椀
c answer
3. RESULTS
3.1. Common characteris 琀椀 cs of par 琀椀
cipants
as follows: 1 - always, 2 - frequently, 3 - occasionally,
4 - rarely, 5 - never; individual factors of interest,
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encouragement, sharing, and praise are scored the
opposite. The score is calculated based on the sum
of the total score of the answers, the score ranges
from 7 to 35 and is evaluated as follows. And they
were assessed based on cut points with ≥ 25 points
and not < 25 points.
2.7. Sta 琀椀 s 琀椀 cal Analysis
The data collected was imported using the
Epidata 3.1 so 昀琀 ware. Data processing with SPSS
20.0 so 昀琀 ware. Use descrip 琀椀 ve sta 琀椀 s
琀椀 cs (frequency and percentage %); use a logis
琀椀 cal mul 琀椀-variable regression model to iden
琀椀 fy factors related to the need for psychological
consulta 琀椀 on on the subject.
2.8. Ethics statement
The research was approved by the Ethics Council
in Biomedical Research of the University of
Medicine-Pharmacy, University of Hue and the
funding support of Hue University with code
DHH2021-04-155.
The study is carried out only with the approval
of the study subject and guardian. Research is
conducted in a spirit of respect for the privacy of the
subject of study.
Table 1. Common characteris 琀椀 cs of par 琀椀 cipants (n = 309)
Quality of school
Good
Not good
X
104
205
29.23 ± 5.13
33.7
66.3
Family quality
Good
Not good
X
148
161
24.79 ± 3.94
47.9
52.1
The results show 56.6% of students are male; 44.3% of students are over 15 years old. 3.6% of students
reported their family economics are poor/near poor. 77.3% of students have parents divorced/separated
Frequency (n)
Percentage (%)
Gender
Male
Female
175
134
56.6
43.4
Age group
≤ 15
>
15
172
137
55.7
44.3
Family economy
Poor/near poor
Not poor
11
298
3.6
96.4
Time of parents’ separa 琀椀 on/
divorce
≥ 5 year
5 year
<
70
239
22.7
77.3
Status of Internet Use
Use more than expected
Not used or used very li 琀琀 le
267
42
86.4
13.6
Best friend rela 琀椀 onship
Yes
No
284
25
91.9
8.1
Friend’s problems
Yes
No
47
262
15.2
84.8
Problem with behavior
Yes
No
53
256
17.2
82.8
Harassed experience
Yes
No
17
292
5.5
94.5
Violence experience
Yes
No
26
283
8.4
91.6
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less than 5 years. 86.4% of students reported using the internet more than expected. 8.1% of students have
no friends; 15.2% of students have problems with friends; 17.2% of students have problems with behavior.
5.5% of students reported being bullied; 8.4% of students reported being violent. 66.3% of students rated
the school quality inadequate; 52.1% of students rated family quality inadequate. 3.2. The need for
psychological consulta 琀椀 on in the subject of study
Chart 1. The need for psychological consulta 琀椀 on of the study subject
In the study sample, the percentage of high school students with separated/divorced parents who
needed psychological counseling was 40.5%.
Table 2. Some areas of study require psychological consulta 琀椀 on
Characteris 琀椀 c
Frequency (n)
Percentage (%)
Psychological Counseling on Emo 琀椀 ons
Yes
83
26,9
No
226
73,1
Psychological counseling on behavior
Yes
43
13,9
No
266
86,1
Psychological Advice on Rela 琀椀 onships at
School
Yes
No
48
261
15,5
84,5
Psychological advice on family rela 琀椀
onships
Yes
No
102
207
33,0
67,0
Psychological advice on appearance and
physical
Yes
No
117
192
37,9
62,1
Psychological Counseling on Reproduc 琀椀 ve
Health and Sexual Friendship
Yes
97
31,4
No
212
68,8
Psychological counseling on living skills
and future orienta 琀椀 on
Yes
No
168
141
54,4
45,6
The areas in which the subjects in need of psychological counseling accounted for the majority were life
skills and future orienta 琀椀 on accoun 琀椀 ng for 54.4%, appearance and physical accoun 琀椀 ng for
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37.9%, family rela 琀椀 onships accoun 琀椀 ng for 33.0%, and reproduc 琀椀 ve health issues and friendship
of other sexes account for 31.4%.
3.2. Some factors related to the need for psychological consulta 琀椀 on in the study subject
Table 3. Mul 琀椀 variable regression model logis 琀椀 c factors related to the need for psychological
consulta 琀椀 on
Independence variables
OR
KTC (95%)
p
Gender
Male
1
-
0.83
Female
1.05
0.62 - 1.79
Age group
≤ 15
1
-
0.07
> 15
1.65
0.94 - 2.89
Family economy
Not poor
1
-
0.06
Poor/near poor
4.16
0.97 - 17.79
Time of parents’
separa 琀椀
on/divorce
≥ 5 year
< 5 year
1
2.80
-
1.32 - 5.95
0.01
Status of Internet Use
Use more than expected
1
-
0.25
Not used or used very li 琀琀 le
1.58
0.72 - 3.46
Best friend rela 琀椀
onship
Yes
1
-
0.02
No
3.11
1.16 - 8.32
Friend’s problems
No
1
-
0.01
Yes
2.76
1.24 - 6.16
Problem with behavior
No
1
-
0.01
Yes
6.36
2.68 - 15.06
Harassed experience
No
1
-
0.81
Yes
1.21
0.24 - 5.91
Violence experience
No
1
-
0.02
Yes
4.61
1.18 - 18.02
Quality of school
Good
1
-
0.03
Not good
2.01
1.06 - 3.78
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Family quality
Good
1
-
0.01
Not good
2.38
1.39 - 4.07
Results from the mul 琀椀 variable logis 琀椀 c regression model suggest that the factor associated with
the need for psychological consulta 琀椀 on is the 琀椀 me of parents’ separated/divorced (< 5 years with
OR = 2.80; 95%CI:1.32 - 5.95); close friendship (no close friends with OR = 3.11; 95%CI: 1.16 - 8.32); having
friendship problems (with OR = 2.76; 95%CI: 1.24 - 6.16); having behavioral problems (with OR = 6.36; 95%CI:
2.68 - 15.06); violence (with OR = 4.61; 95%CI:11.18 - 18.02); school quality (not achieve with or = 2.01;
95%CI: 1.06 - 3.78) and family quality (no achieve OR = 2.38; 95% CI: 1.39 - 4.07) with p < 0.05.
4. DISCUSSION
4.1. The need for psychological counseling of
high school students whose parents are separated/
divorced
The research results on 309 high school students
with separated/divorced parents showed that 40.5%
of the students required psychological counseling.
The general rate of high school students with the
need for psychological counseling is in line with a
previous study in Quang Ninh, showing that 15.8% of
the students had an increased need for counseling;
69.4% had a moderate need; 14.8% had a low need
and 52.6% of the students rated that it was
necessary or indispensable to have psychological
counseling room [11]. Among the counseling 昀椀
elds men 琀椀 oned above, the three 昀椀 elds that
the students had the most need for psychological
counseling were the need for living skills and future
orienta 琀椀 on (54.4%), the need for physical and
mental (37.9%), and the need for family rela 琀椀
onships (33.0%). Next is the demand for
psychological consulta 琀椀 on on the emo 琀椀
onal, behavioral, school rela 琀椀 onship and
gender, and other friendship aspects. The demand
for life skills and future direc 琀椀 on accounts for
the highest propor 琀椀 on, rela 琀椀 vely in line
with some previous studies, par 琀椀 ally re
ec 琀椀 ng the current situa 琀椀 on when students’
life skills are limited and need early guidance for
future youth [11,12]. However, in our research, the
demand for rela 琀椀 onships in the family was
chosen by the students, showing that parents’
divorce/separa 琀椀 on had a signi 昀椀 cant impact
on the psychology of the research subjects, and the
need for consulta 琀椀 on on family rela 琀椀
onships was priori 琀椀 zed by the subjects and
more desired than some other 昀椀 elds of
psychological consulta 琀椀 on.
4.2 Several factors related to the need for
psychological consulta 琀椀 on in the subject of
study
Results from the mul 琀椀 variable logis 琀椀 c
regression model suggest that the factors involved
in the need for psychological counseling are the
me of parents’ divorce (< 5 years with OR= 2.80;
95%CI: 1.32 - 5.95); The best friend rela 琀椀 onship
(No close friends. OR = 3.11; 95%CI: 1.16 - 8.32);
Problems with friends (with OR = 2.76; 95%CI: 1.24
- 6.16); There is behavior problem (OR= 6.36;
95%CI: 2.68 - 15.06); by violent (with OR= 4.61;
95%CI: 1.18 - 18.02); Quality of school (not
achieved with OR= 2.01; 95%CI: 1.06 - 3.78) and
family quality (not achieved with OR = 2.38; 95%CI:
1.39 - 4.07) with p < 0.05.
In our study, the group of students whose
parents separated/divorced less than 5 years is
likely to have needs for psychological counseling
2.80 (OR= 2.80; 95%CI: 1.32 - 5.95) 琀椀 mes higher
than those with parents separated/divorced from
昀椀 ve years or longer. Parental post-divorce
problems in children vary depending on the judge,
which may depend on the 琀椀 me passed since
the divorce; physical and psychological su 昀昀
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ering increases in the early stages of divorce and
will decrease over 琀椀 me [13,14].
Lansford’s research and its collaborators
showed that parental divorce/separa 琀椀 on
earlier is more nega 琀椀 vely related to the
morality of internal and external orienta 琀椀 on
issues than late divorce/ separa 琀椀 on [15].
Various psychological, physical, and transi 琀椀 on
disorders can be seen in the children of divorced
parents, causing emo琀椀 onal damage, high levels
of depression, di culty concentra 琀椀 ng,
suicidal thoughts, sadness, anger, confusion in
learning, interpersonal rela 琀椀 onships, and a
higher risk of many other mental illnesses; this has
been noted in some domes 琀椀 c and foreign
studies [13,16,17]. Therefore, the period of living
with parents has a signi 昀椀 cant in uence on
the psychology of children as well as the issues
related to psychology.
Students who did not have close friends are likely
to have needs for psychological counseling 3.11 (OR
= 3.11; 95%CI: 1.16 - 8.32) 琀椀 mes higher than
those who had close friends, and the group with
problems with friends likely to have needs for
psychological counseling 2.76 (OR = 2.76; 95%CI:
1.24 - 6.16) 琀椀 mes more than the other group.
This is quite consistent with many studies on the
psychology and mental health of adolescents with
the factor of friendship as well as the quality of
friendship [18,19,20]. The 昀椀 ndings indicate that
peer-to-peer friends are the primary source of
support for young people with mental health
problems, with both men and women choosing
friends and family members who are most likely to
help when in trouble [21,22]. Research on teenagers
in the UK shows a signi 昀椀 cant posi 琀椀 ve link
between the quality of perceived friendship and
psychological resilience [23]. Therefore, students
who do not have close friends or have problems in
friendship o 昀琀 en have more problems to face, di
culty sharing, and the need for support when
they have psychological di cul 琀椀 es, which
leads to higher needs for support in psychological
counseling than those with good friends or close
friends.
Our research showed that the group of students
in the unful 昀椀 lled school quality factor is likely to
have needs for psychological counseling 2.01 (OR =
2.01; 95%CI: 1.06 - 3.78) 琀椀 mes higher than the
rest of the group. This is rela 琀椀 vely consistent
with a study “Psychological Health Services in the
United States”, which notes that schools are
currently mee 琀椀 ng students’ mental health needs
and they also show an increasing demand for mental
health services and the many challenges that schools
face in addressing those needs [24]. A report by
UNICEF in Vietnam found that mental health issues
are also related to factors of learning circumstances,
such as awareness of safety, student engagement,
and the learning environment. Adolescents who feel
a 琀琀 ached to school have fewer psychological
symptoms, while children who feel less connected to
school - o 昀琀 en girls - or have more mental health
problems [25]. From the above results can be seen
that the school is the environment where children
are more exposed and the problems in school have a
major impact on the child’s psychology, including the
services that the school provides including
psychological counseling services for students, the
need for psychological counseling that may be a
ected by the learning environment and the desire
for psychologic counseling in uenced by factors
from the school.
Family is an extremely important factor for each
person, studies at home and abroad that can show
that family cohesion, living circumstances, and the
quality of family rela 琀椀 onships are related to
mental and psychological health problems in
adolescents [26, 27, 28]. Younger people can seek
help for mental health issues by talking to their
family and friends, with families more important to
younger teens [29]. Our study noted that students
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10
with unful 昀椀 lled family quality are likely to have
needs for psychological counseling 2.38 (OR = 2.38;
95%CI: 1.39 - 4.07) 琀椀 mes higher than those with
achieved family quality. This result suggests that the
family’s quality greatly a 昀昀 ects the child’s need
for psychological counseling, which is consistent with
some foreign studies. A study in Arab-Israeli minority
adolescents showed a higher rate of consulta 琀椀
on found in adolescents who felt uncomfortable at
home; a study by Myla E. Harrison, Mary M. McKay,
and William M. Bannon Jr. suggests that the most
signi 昀椀 cant factors associated with the use of
mental health care services are social support and
parental skills e 昀昀 ec 琀椀 veness. In addi 琀椀
on, another study surveying public school teachers in
Southern California noted that families iden 琀椀昀
ed as being not fully intact had a par 琀椀 cularly
strong impact on the issues of psychological
counseling [30, 31, 32].
Our results showed that the group of students
experiencing violence had a much higher need for
psychological counseling than the nonviolent group,
which was likely to have needs for psychological
counseling 4.61 (OR = 4.61; 95%CI: 1.18 - 18.02)
mes (p < 0.05). Our research results are consistent
with both domes 琀椀 c and overseas studies. The
survey in Nghe An recorded the factors related to
depression and anxiety in students due to bullying by
friends [33]. Marleen Wong’s research and
associates showed that children exposed to violence
had higher mental health needs than those who
were not exposed to violence [34]. The survey by
Drotar D, Flannery D, Day E, and associates
highlighted the feasibility of developing mental
health services to meet the needs of children
exposed to violence, par 琀椀 cularly family violence,
at a cri 琀椀 cal 琀椀 me a 昀琀 er exposure to
violence [35].
In our study, the need for psychological consulta
琀椀 on was related to the presence of problem
behavior among high school students. The group of
students with problem behavior is likely to have
needs for psychological counseling 6.36 (OR = 6.36;
95%CI: 2.68 - 15.06) 琀椀 mes higher than the group
without problem behavior. Children from
divorced/separated families had a higher rate of
depression than those from intact families, with di
erent behaviors such as agita 琀椀 on, di culty
concentra 琀椀 ng, suicidal intent, sadness, and
pessimism [17]. Children from divorced/separated
families had a signi 昀椀 cantly higher prevalence of
mental health disorders, especially substance use
disorders, compared to normal individuals [36].
Another study in Canada showed that psychological
needs and factors were strongly associated with the
use of health care services [37]. This showed that the
mental health issues faced by children from
divorced/separated families are higher than those
from intact families, and the need for and use of
mental health services may be higher. This aligns
with many other studies worldwide, where children
with behavioral disorders require more mental
health services. Family counseling, individual work
with the children (especially for younger children),
and social support during the post-separa 琀椀 on
period were suggested to prevent long-term, some
琀椀 mes lifelong consequences [38]. However,
more research is needed on mental health consulta
琀椀 on among adolescents, especially those in
divorced/separated families.
Some limita 琀椀 ons of the study: We use a
crosssec 琀椀 onal study, making it di cult to
determine the cause-and-e 昀昀 ect rela 琀椀
onship between the variables. Therefore, more
studies with safety design are needed to
understand be 琀琀 er the situa 琀椀 on, needs,
and approaches to providing emo 琀椀 onal
support.
4. CONCLUSION
Secondary school and high school students with
separated/divorced parents have an increased need
for psychological counseling, so it is necessary to
lOMoARcPSD|39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
10
combine family and school to create a healthy
environment for children.
Acknowledgments: The study team sincerely
thanks the students who par 琀椀 cipated in the
research and the 昀椀 nancial support received
from Hue University project code DHH 2021-04-
155.
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96
Risk screening, nutri 琀椀 on assessment and associated factors of
malnutri 琀椀 on among elderly inpa 琀椀 ents in Hue University of
Medicine and Pharmacy Hospital
Che Thi Len Len
1
, Hoang Thi Bach Yen
2
, Nguyen Minh Tam
1
(1) Family Medicine Center, University of Medicine and Pharmacy, Hue University
(2) Faculty of Public Health, University of Medicine and Pharmacy, Hue University
Abstract
Background: Undernutri 琀椀 on is a signi 昀椀 cant risk factor for mortality, complica 琀椀 ons, hospital
infec 琀椀 ons, length of hospital stay, quality of life, and prognosis. Pa 琀椀 ents with proper nutri 琀椀 on
will help prevent undernutri 琀椀 on, prevent the development of the disease, and improve the e 昀昀 ec
琀椀 veness of treatment. Nutri 琀椀 on is an integral part of the comprehensive treatment process. Nutri
琀椀 onal risk screening is one criterion that shows the hospital’s nutri 琀椀 onal care capacity. Assessing
nutri 琀椀 onal status plays an essen 琀椀 al role in trea 琀椀 ng and recovering health. This study aims (1)
to screen and assess the nutri 琀椀 onal status of inpa 琀椀 ents aged from 60 years old in Hue University
Medicine and Pharmacy Hospital and (2) to iden 琀椀 fy some factors related to malnutri 琀椀 on. Methods:
A cross-sec 琀椀 onal study was carried out on 389 inpa 琀椀 ents at two departments of internal medicine,
Hue University of Medicine and Pharmacy Hospital, from 11/2020 - 03/2021. We used the mini nutri 琀椀
onal assessment tool for screening nutri 琀椀 on risks. The subjec 琀椀 ve global assessment tool was used
to assess nutri 琀椀 onal status and ques 琀椀 onnaires to understand some related factors. Results: There
were 68.9% of pa 琀椀 ents at risk of malnutri 琀椀 on and 38.8% of pa 琀椀 ents had malnutri 琀椀 on.
There were signi 昀椀 cant rela 琀椀 onships between the nutri 琀椀 on status of pa 琀椀 ents with re-admi
琀琀 ed status (p < 0.05), including diseases (p < 0.05), oral pathology (p < 0.05), decreased taste (p < 0.05)
Conclusion: The prevalence of inpa 琀椀 ents with nutri 琀椀 onal risk in two departments of internal
medicine was rela 琀椀 vely high. It is necessary to conduct nutri 琀椀 on screening in all inpa 琀椀 ents to
improve the e 昀昀 ec 琀椀 veness of treatment and comprehensive care.
Keywords: malnutri
琀椀
on, inpa
琀椀
ents, nutri
琀椀
on treatment, subjec
琀椀
ve global
assessment tool, mini nutri
琀椀
onal assessment tool.
lOMoARcPSD|39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
97
1. INTRODUCTION
Ea 琀椀 ng, nutri 琀椀 onal status, health, and
disease in an individual or popula 琀椀 on are all
recognized to be related. Addi 琀椀 onally, insu
cient nutri 琀椀 on or a de 昀椀 ciency impacts a
pa 琀椀 ent’s capacity to recuperate from an illness
or surgery. If the pa 琀椀 ent has a diet full of
nutrients suitable for the disease, the e 昀昀 ec
veness of treatment will increase. A healthy diet
can stop the progression of the disease when it is s
琀椀 ll in the latent stage of development. Malnutri
琀椀 on in pa 琀椀 ents is a factor that signi 昀椀
cantly a 昀昀 ects complica 琀椀 ons,
hospitalacquired infec 琀椀 ons, length of hospital
stay, quality of life, and disease prognosis. Older
people will be more severely a 昀昀 ected by
healing, higher mortality, and expensive costs for
individuals, families, and society. A popular nutri
onal screening technique, the primary nutri 琀椀
onal assessment, is endorsed and advised by na
onal and interna 琀椀 onal scien 琀椀昀椀 c and
clinical organiza 琀椀 ons to support older people.
The most frequently accepted and validated [1,
2]. The subjec 琀椀 ve global assessment is a
measure to evaluate pa 琀椀 ents’ nutri 琀椀 onal
status, commonly u 琀椀 lized in interna 琀椀 onal
and Vietnamese clinical nutri 琀椀 on research
studies [3].
According to research by Kang M.C. et al. (2018),
hospitalized pa 琀椀 ents have a malnutri 琀椀 on
rate of 22.0% [4]. Pa 琀椀 ents at Quang Nam
Central General Hospital have a malnutri 琀椀 on
rate of 26.1%, according to research done by Dang
Thi Hoang Khue in 2019 [5]. In 2017, a study by
Hoang Thi Bach Yen at Hue University of Medicine
and Pharmacy Hospital revealed that 28.1% of pa
ents were malnourished and 37.4% were at risk
for malnutri 琀椀 on [6]. In these inves 琀椀 ga
ons, malnutri 琀椀 on was quite common among
hospitalized pa 琀椀 ents. Each pa 琀椀 ent needs
a pathologically appropriate diet and exercise
program to maintain excellent health and prevent
malnutri 琀椀 on. In an integrated treatment plan,
nutri 琀椀 on is crucial because it keeps the condi
琀椀 on stable, reduces complica 琀椀 ons, and
shortens hospital stays and overall care. To avoid
the disease’s
Corresponding author: Che Thi Len Len, email: ctllen@huemed-univ.edu.vn
Recieved: 2/2/2023; Accepted: 15/5/2023; Published: 10/6/2023
| 1/14

Preview text:

lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
Psychological counseling needs among middle and high school
students with separated/divorced parents in Hue city

Tran Binh Thang1, Ho Uyen Phuong1, Dinh Thi Lieu1, Pham Thi Thu Ha1, Chau Nguyen Dan1,
Nguyen Ngo Bao Khuyen1, Luong Thi Thu Tham1, Tran Thi Tra My1, Vo Nu Hong Duc1, Nguyen Thanh Gia1,
Nguyen Van Thong1, Nguyen Minh Tam1, Nguyen Minh Tu1*
(1) University of Medicine and Pharmacy, Hue University Abstract
Background: Adolescents who live in incomplete families may be vulnerable to various psychological e
昀昀 ects, ranging from mild to complex. This study aims to examine the need for psychological counseling
among high school students whose parents are separated/divorced, and to iden 琀椀 fy factors associated
with this need. Methods: A cross-sec 琀椀 onal descrip 琀椀 ve study was conducted on 309 high school
students with separated/separated/divorced parents in Hue City. Results: The percentage of high school
students with separated/divorced parents who need psychological counseling accounted for 40.5%. The
need for psychological consulta 琀椀 on about life skills and future orienta 琀椀 on accounted for 54.4%,
appearance and physicality accounted for 37.9%, family rela 琀椀 onships accounted for 33.0% and problems
with reproduc 琀椀 ve health and heterosexual friendship accounted for 31.4%. Factors related to the need
for psychological counseling include the 琀椀 me of parents’ divorce, close friendship rela 琀椀 onship,
problems with friends, behavioral problems, violence, family quality and school quality, with a signi 昀椀
cance level of p < 0.05. Conclusion: High school students with separated/divorced parents need
psychological counseling, so it is necessary to combine family and school to create a healthy environment for children.
Keywords: psychological counseling, needs, students, parents separated/divorced. 1. INTRODUCTION
suicidal idea 琀椀 on, suicide a 琀琀 empt, distress,
Nowadays, issues related to mental health
smoking, and substance abuse [4].
among adolescents are increasing, especially for
children in separated or separated/divorced families
The fact shows that parents’ divorce has signi 昀
[1]. According to a study by Nguyen Thi Nhu Thuy and
椀 cantly impacted teenagers’ percep 琀椀 on of the
colleagues (2019) on the psychological injury of
value of family and life. Teenagers tend to develop
teenagers in disintegrated families in Ho Chi Minh
Corresponding author: Nguyen Minh Tu, email: nmtu@huemed-univ.edu.vn
Recieved: 2/2/2023; Accepted: 15/5/2023; Published: 10/6/2023
City, 16.1% of minors have psychological manifesta
more emo 琀 椀 ons and behavior during the
琀椀 ons [2]. Another study by Phillip A. Radetzki and
postdivorce period rather than before [5]. Di 昀昀
colleagues (2020) also found that children whose
parents were separated/divorced were more likely
erent psychosocial, physical, and transi 琀椀 onal
to be a 昀 昀 ected by adverse mental health
disorders can occur in children a 昀昀 ected by
separated/divorced parents [4]. Notably, at an older
outcomes than other children [3]. Children a 昀昀
ected by separated/divorced parents are at high risk
age, children tend to seek emo 琀椀 onal compensa
for a variety of mental health condi 琀 椀 ons
琀椀 on and sharing with a tendency to look outside
of society, which can lead to many other
including emo 琀椀 onal and behavioral disorders,
psychosocial problems [6]. The behavior of children
poor school performance, depression, anxiety,
caused by divorce and con 昀氀 ict between parents 96 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
depends on the child’s age and stage of development − n Z= 12 p(1 2 p)
of the child, and it is important to recognize them to − d
intervene appropriately [7]. A study of psychology in In which:
the UK on adolescents with psychological distress
n: is the smallest reasonable sample size.
showed that those who were advised had signi 昀椀
z: is the value depending on the desired level of
cantly reduced levels of psychological su 昀昀 ering
reliability of the es 琀椀 mate; desired con 昀椀
than those in the control group [8]. Psychological
dence level is 95% when z = 1.96. p: the es 琀椀
counseling is an interac 琀椀 ve process between a
mated ra 琀椀 o of the popula 琀椀 on p = 0.273,
professional with counseling skills and ethics of the
counseling profession and a person with mental
the percentage of students who want to set up a
health di 昀케 cul 琀椀 es in need of assistance.
school psychology consul 琀椀 ng room according
to research by Bui Thi Hoa [10].
Through the exchange, in 琀 椀 mate sharing,
d: is the desired tolerable devia 琀椀 on or the
empathy, and acceptance of reality, self-discovery of
one’s poten 琀 椀 al to solve one’s problems is
di 昀昀 erence between the p ra 琀椀 o obtained
achieved [9]. In Vietnam, there has been no research
on the sample and the actual p ra 琀椀 o in the
on the mental health counseling needs of popula 琀椀 on; d = 0.05.
adolescents with separated/divorced parents. That is
From the formula and the facts above we
why we conducted research “Psychological calculate n = 305.
counseling needs among middle and high school
In fact, in this study, we collected 309 students
students with separated/divorced parents in Hue
who agreed to par 琀椀 cipate. Method of selec
city” with two objec 琀椀 ves: (1) To examine the
need for psychological counseling among high school

ng the sample Selec 琀椀 on of mul 琀椀 ple
students whose parents are separated/divorced in stages.
Hue city; (2) iden 琀椀 fy factors associated with this
Stage 1: Randomly selected two secondary
schools out of 26 schools and two high schools out need.
of 11 schools in the city of Hue.
2. MATERIALS AND METHODS
Stage 2: Take the sample of all students living in
a family whose parents are separated/divorced.
2.1. Par 琀椀 cipants
Stage 3: Conduct interviews with all students -
The criteria of choice: High school students
selected to collect research informa 琀椀 on.
with separated/divorced parents are studying in
Hue city and are approved by their guardians.
2.5. Data collec 琀椀 on -
Exclusion criteria: Subjects experiencing -
Data collec 琀椀 on tools: The toolkit is
health problems, are unlikely to par 琀椀 cipate in
designed based on built-in variables. the survey. -
Inves 琀椀 gators are trained and instructed 2.2. Time and place
on the toolkit and approach, interviewing research
The study was conducted at three schools (2 subjects.
secondary schools and 2 high schools) in Hue from 2.6. Measurements
June 2022 to December 2022. 2.3. Study design - Dependent variable: the need for
Cross-sec 琀椀 onal study 2.4
psychological counseling of secondary school and
Sample size and sampling method high school students. Sample size according to the
We assessed based on seven ques 琀椀 ons about formula:
the need for psychological counseling support in 97 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
seven areas: emo 琀椀 onal, behavioral, school rela
Therefore, the behavioral problems were divided
into two groups in the analysis process: having
琀椀 ons, family rela 琀椀 ons, appearance and
behavior problems (from 5-10 points) and no
physical, reproduc 琀椀 ve health and friendship, life
behavioral problems (from 0-4 points); friend’s
skills and future orienta 琀椀 on. The ques 琀椀 ons
problems were classi 昀椀 ed into two categories in
are scored, 0 = no need and 1 = need, so the highest
the process of analysis including having friend’s
total score is 7, the lowest is 0 and from 3 points
problems: (from 6-10 points), and no friend’s issues
above is the need for psychological support [11]. (from 0-5 points). - Independence variables: Demographic -
Quality of school: We assessed based on
factors: age, gender; family factors: family economy,
nine ques 琀椀 ons how o 昀琀 en behaviors have
琀 椀 me of divorce of parents; psychosocial-
occurred over the past six months, which revolved
behavioral factors: internet usage status, bullying
around ques 琀椀 ons about students’ feelings about
status, state of violence, behavioral problems,
school (pleasure at school; score pressure; safety in
having problems with friends, close friends rela 琀椀
school; being encouraged by the teacher; being
listened to by the professor; being treated fairly;
onships; school quality; family quality.
being able to get acquainted with new friends; being -
Assessment of school violence and school
cri 琀 椀 cized by the master; being helped by
bullying based on the GSHS 2019 ques 琀椀 onnaire
friends). Each sentence scores a minimum of 1 and a [39].
maximum of 5 depending on the speci 昀 椀 c
+ Harassed experience: Divided into two groups
answer: 1 - never, 2 - rarely, 3 - occasionally, 4 -
and measured over the last 30 days (no bullying and harassment).
frequently, 5 - always; the cri 琀椀 cal factor itself
+ Violence experience: Divided into two groups
scores the opposite. The score is calculated by
and measured over the past 12 months (no violence
adding the total score of the answers, ranging from and violence).
9 to 45. And they were assessed based on cut points -
with ≥30 points and not <30 points.
There are behavioral problems and - Family Quality: On family quality
problems with friends: Assessment of student
assessment, we assessed based on 7 ques 琀椀 ons
mental health based on the SDQ-25 ques 琀 椀
about the frequency of behavior over the past 6
onnaire: Ques 琀椀 onnaire assessing strengths and
months, the ques 琀 椀 ons revolving around
di 昀케cul 琀椀 es (Strength and Di 昀케cul 琀椀 es
problems of student feelings towards parents and
Ques 琀椀 onnaire) 25 ques 琀椀 ons were evaluated
adults in the family (crying, insul 琀椀 ng, pressure
over 5 aspects of emo 琀 椀 onal problems,
and expecta 琀椀 ons of learning; bea 琀椀 ng; not
behavioral problems, problems of increased a 琀琀
feeling loved; not listening, caring, sharing;
comparing with friends; interest, encouragement,
en 琀椀 on, friend’s problems, posi 琀椀 ve social
praise, sharing). Each sentence scores a minimum of
problems and scored as follows: 0 - wrong, 1 - par 琀
1 and a maximum of 5 depending on the speci 昀椀
椀 ally right, 2 - right. Excluding sentences 7, 11, 14, c answer
21, 25 each corresponding answer: 2 - not correct, 1
- par 琀椀 ally correct, 0 - surely correct. In our study, 3. RESULTS
children were assessed as having mental health
3.1. Common characteris 琀椀 cs of par 琀椀
problems (MHP) when the total score was abnormal cipants
and children were not assessed with MHP when
as follows: 1 - always, 2 - frequently, 3 - occasionally,
there was a normal and boundary total score.
4 - rarely, 5 - never; individual factors of interest, 98 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
encouragement, sharing, and praise are scored the
琀椀 fy factors related to the need for psychological
opposite. The score is calculated based on the sum
of the total score of the answers, the score ranges
consulta 琀椀 on on the subject.
from 7 to 35 and is evaluated as follows. And they 2.8. Ethics statement
were assessed based on cut points with ≥ 25 points
The research was approved by the Ethics Council and not < 25 points.
in Biomedical Research of the University of
2.7. Sta 琀椀 s 琀椀 cal Analysis
Medicine-Pharmacy, University of Hue and the
funding support of Hue University with code
The data collected was imported using the DHH2021-04-155.
Epidata 3.1 so 昀琀 ware. Data processing with SPSS
The study is carried out only with the approval
20.0 so 昀琀 ware. Use descrip 琀椀 ve sta 琀椀 s
of the study subject and guardian. Research is 琀椀
conducted in a spirit of respect for the privacy of the
cs (frequency and percentage %); use a logis subject of study.
琀椀 cal mul 琀椀-variable regression model to iden
Table 1. Common characteris 琀椀 cs of par 琀椀 cipants (n = 309) Characteris 琀椀 Frequency (n) Percentage (%) Gender Male 175 56.6 Female 134 43.4 Age group ≤ 15 172 55.7 > 15 137 44.3 Family economy Poor/near poor 11 3.6 Not poor 298 96.4
Time of parents’ separa 琀椀 on/ ≥ 5 year 70 22.7 divorce < 5 y ear 239 77.3 Status of Internet Use Use more than expected 267 86.4
Not used or used very li 琀琀 le 42 13.6
Best friend rela 琀椀 onship Yes 284 91.9 No 25 8.1 Friend’s problems Yes 47 15.2 No 262 84.8 Problem with behavior Yes 53 17.2 No 256 82.8 Harassed experience Yes 17 5.5 No 292 94.5 Yes 26 8.4 Violence experience No 283 91.6 Good 104 33.7 Quality of school Not good 205 66.3 X 29.23 ± 5.13 Good 148 47.9 Family quality Not good 161 52.1 X 24.79 ± 3.94
The results show 56.6% of students are male; 44.3% of students are over 15 years old. 3.6% of students
reported their family economics are poor/near poor. 77.3% of students have parents divorced/separated 99 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
less than 5 years. 86.4% of students reported using the internet more than expected. 8.1% of students have
no friends; 15.2% of students have problems with friends; 17.2% of students have problems with behavior.
5.5% of students reported being bullied; 8.4% of students reported being violent. 66.3% of students rated
the school quality inadequate; 52.1% of students rated family quality inadequate. 3.2. The need for
psychological consulta 琀椀 on in the subject of study
Chart 1. The need for psychological consulta 琀椀 on of the study subject
In the study sample, the percentage of high school students with separated/divorced parents who
needed psychological counseling was 40.5%.
Table 2. Some areas of study require psychological consulta 琀椀 on Characteris 琀椀 c Frequency (n) Percentage (%)
Psychological Counseling on Emo 琀椀 ons Yes 83 26,9 No 226 73,1
Psychological counseling on behavior Yes 43 13,9 No 266 86,1
Psychological Advice on Rela 琀椀 onships at Yes 48 15,5 School No 261 84,5
Psychological advice on family rela 琀椀 Yes 102 33,0 onships No 207 67,0
Psychological advice on appearance and Yes 117 37,9 physical No 192 62,1
Psychological Counseling on Reproduc 琀椀 ve Yes 97 31,4 Health and Sexual Friendship No 212 68,8
Psychological counseling on living skills Yes 168 54,4 and future orienta 琀椀 on No 141 45,6
The areas in which the subjects in need of psychological counseling accounted for the majority were life
skills and future orienta 琀椀 on accoun 琀椀 ng for 54.4%, appearance and physical accoun 琀椀 ng for 10 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
37.9%, family rela 琀椀 onships accoun 琀椀 ng for 33.0%, and reproduc 琀椀 ve health issues and friendship
of other sexes account for 31.4%.
3.2. Some factors related to the need for psychological consulta 琀椀 on in the study subject
Table 3. Mul 琀椀 variable regression model logis 琀椀 c factors related to the need for psychological consulta 琀椀 on Independence variables OR KTC (95%) p Gender Male 1 - 0.83 Female 1.05 0.62 - 1.79 Age group ≤ 15 1 - 0.07 > 15 1.65 0.94 - 2.89 Family economy Not poor 1 - 0.06 Poor/near poor 4.16 0.97 - 17.79 Time of parents’ ≥ 5 year 1 - separa 琀椀 < 5 year 2.80 1.32 - 5.95 0.01 on/divorce
Status of Internet Use Use more than expected 1 - 0.25
Not used or used very li 琀琀 le 1.58 0.72 - 3.46 Best friend rela 琀椀 Yes 1 - onship 0.02 No 3.11 1.16 - 8.32 Friend’s problems No 1 - 0.01 Yes 2.76 1.24 - 6.16 Problem with behavior No 1 - 0.01 Yes 6.36 2.68 - 15.06 Harassed experience No 1 - 0.81 Yes 1.21 0.24 - 5.91 Violence experience No 1 - 0.02 Yes 4.61 1.18 - 18.02 Quality of school Good 1 - 0.03 Not good 2.01 1.06 - 3.78 10 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023 Family quality Good 1 - 0.01 Not good 2.38 1.39 - 4.07
Results from the mul 琀椀 variable logis 琀椀 c regression model suggest that the factor associated with
the need for psychological consulta 琀椀 on is the 琀椀 me of parents’ separated/divorced (< 5 years with
OR = 2.80; 95%CI:1.32 - 5.95); close friendship (no close friends with OR = 3.11; 95%CI: 1.16 - 8.32); having
friendship problems (with OR = 2.76; 95%CI: 1.24 - 6.16); having behavioral problems (with OR = 6.36; 95%CI:
2.68 - 15.06); violence (with OR = 4.61; 95%CI:11.18 - 18.02); school quality (not achieve with or = 2.01;
95%CI: 1.06 - 3.78) and family quality (no achieve OR = 2.38; 95% CI: 1.39 - 4.07) with p < 0.05. 4. DISCUSSION
divorce/separa 琀椀 on had a signi 昀椀 cant impact
4.1. The need for psychological counseling of
on the psychology of the research subjects, and the
high school students whose parents are separated/ divorced
need for consulta 琀椀 on on family rela 琀椀
The research results on 309 high school students
onships was priori 琀椀 zed by the subjects and
with separated/divorced parents showed that 40.5%
more desired than some other 昀 椀 elds of
of the students required psychological counseling.
The general rate of high school students with the
psychological consulta 琀椀 on.
need for psychological counseling is in line with a
4.2 Several factors related to the need for
previous study in Quang Ninh, showing that 15.8% of
psychological consulta 琀椀 on in the subject of
the students had an increased need for counseling;
69.4% had a moderate need; 14.8% had a low need study
and 52.6% of the students rated that it was
Results from the mul 琀椀 variable logis 琀椀 c
necessary or indispensable to have psychological
regression model suggest that the factors involved
counseling room [11]. Among the counseling 昀椀
in the need for psychological counseling are the 琀
elds men 琀椀 oned above, the three 昀椀 elds that
椀 me of parents’ divorce (< 5 years with OR= 2.80;
the students had the most need for psychological
95%CI: 1.32 - 5.95); The best friend rela 琀椀 onship
counseling were the need for living skills and future
(No close friends. OR = 3.11; 95%CI: 1.16 - 8.32);
orienta 琀椀 on (54.4%), the need for physical and
Problems with friends (with OR = 2.76; 95%CI: 1.24
mental (37.9%), and the need for family rela 琀椀
- 6.16); There is behavior problem (OR= 6.36;
onships (33.0%). Next is the demand for
95%CI: 2.68 - 15.06); by violent (with OR= 4.61;
95%CI: 1.18 - 18.02); Quality of school (not
psychological consulta 琀椀 on on the emo 琀椀
achieved with OR= 2.01; 95%CI: 1.06 - 3.78) and
onal, behavioral, school rela 琀 椀 onship and
family quality (not achieved with OR = 2.38; 95%CI:
gender, and other friendship aspects. The demand
1.39 - 4.07) with p < 0.05.
for life skills and future direc 琀椀 on accounts for
In our study, the group of students whose
parents separated/divorced less than 5 years is
the highest propor 琀椀 on, rela 琀椀 vely in line
likely to have needs for psychological counseling
with some previous studies, par 琀椀 ally re 昀氀
2.80 (OR= 2.80; 95%CI: 1.32 - 5.95) 琀椀 mes higher
ec 琀椀 ng the current situa 琀椀 on when students’
than those with parents separated/divorced from
life skills are limited and need early guidance for
昀 椀 ve years or longer. Parental post-divorce
future youth [11,12]. However, in our research, the
problems in children vary depending on the judge,
demand for rela 琀椀 onships in the family was
which may depend on the 琀椀 me passed since
chosen by the students, showing that parents’
the divorce; physical and psychological su 昀昀 10 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
ering increases in the early stages of divorce and
昀케 culty sharing, and the need for support when
will decrease over 琀椀 me [13,14].
they have psychological di 昀케 cul 琀椀 es, which
Lansford’s research and its collaborators
leads to higher needs for support in psychological
showed that parental divorce/separa 琀 椀 on
counseling than those with good friends or close
earlier is more nega 琀 椀 vely related to the friends.
Our research showed that the group of students
morality of internal and external orienta 琀椀 on
in the unful 昀椀 lled school quality factor is likely to
issues than late divorce/ separa 琀 椀 on [15].
have needs for psychological counseling 2.01 (OR =
Various psychological, physical, and transi 琀椀 on
2.01; 95%CI: 1.06 - 3.78) 琀椀 mes higher than the
disorders can be seen in the children of divorced
rest of the group. This is rela 琀椀 vely consistent
parents, causing emo 琀椀 onal damage, high levels
with a study “Psychological Health Services in the
of depression, di 昀케 culty concentra 琀椀 ng,
United States”, which notes that schools are
suicidal thoughts, sadness, anger, confusion in
currently mee 琀椀 ng students’ mental health needs
learning, interpersonal rela 琀椀 onships, and a
and they also show an increasing demand for mental
higher risk of many other mental illnesses; this has
health services and the many challenges that schools
face in addressing those needs [24]. A report by
been noted in some domes 琀椀 c and foreign
UNICEF in Vietnam found that mental health issues
studies [13,16,17]. Therefore, the period of living
are also related to factors of learning circumstances,
with parents has a signi 昀椀 cant in 昀氀 uence on
such as awareness of safety, student engagement,
the psychology of children as well as the issues
and the learning environment. Adolescents who feel related to psychology.
a 琀琀 ached to school have fewer psychological
Students who did not have close friends are likely
symptoms, while children who feel less connected to
to have needs for psychological counseling 3.11 (OR
school - o 昀琀 en girls - or have more mental health
= 3.11; 95%CI: 1.16 - 8.32) 琀椀 mes higher than
problems [25]. From the above results can be seen
those who had close friends, and the group with
that the school is the environment where children
problems with friends likely to have needs for
are more exposed and the problems in school have a
psychological counseling 2.76 (OR = 2.76; 95%CI:
major impact on the child’s psychology, including the
1.24 - 6.16) 琀椀 mes more than the other group.
services that the school provides including
This is quite consistent with many studies on the
psychological counseling services for students, the
psychology and mental health of adolescents with
need for psychological counseling that may be a 昀
the factor of friendship as well as the quality of
昀 ected by the learning environment and the desire
friendship [18,19,20]. The 昀椀 ndings indicate that
for psychologic counseling in 昀氀 uenced by factors
peer-to-peer friends are the primary source of
support for young people with mental health from the school.
problems, with both men and women choosing
Family is an extremely important factor for each
friends and family members who are most likely to
person, studies at home and abroad that can show
help when in trouble [21,22]. Research on teenagers
that family cohesion, living circumstances, and the
in the UK shows a signi 昀椀 cant posi 琀椀 ve link
quality of family rela 琀椀 onships are related to
between the quality of perceived friendship and
mental and psychological health problems in
psychological resilience [23]. Therefore, students
adolescents [26, 27, 28]. Younger people can seek
who do not have close friends or have problems in
help for mental health issues by talking to their
family and friends, with families more important to
friendship o 昀琀 en have more problems to face, di
younger teens [29]. Our study noted that students 10 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
with unful 昀椀 lled family quality are likely to have
students with problem behavior is likely to have
needs for psychological counseling 6.36 (OR = 6.36;
needs for psychological counseling 2.38 (OR = 2.38;
95%CI: 2.68 - 15.06) 琀椀 mes higher than the group
95%CI: 1.39 - 4.07) 琀椀 mes higher than those with without problem behavior. Children from
achieved family quality. This result suggests that the
divorced/separated families had a higher rate of
family’s quality greatly a 昀昀 ects the child’s need
depression than those from intact families, with di 昀
for psychological counseling, which is consistent with
some foreign studies. A study in Arab-Israeli minority
昀 erent behaviors such as agita 琀椀 on, di 昀케culty
adolescents showed a higher rate of consulta 琀椀
concentra 琀 椀 ng, suicidal intent, sadness, and
on found in adolescents who felt uncomfortable at
pessimism [17]. Children from divorced/separated
home; a study by Myla E. Harrison, Mary M. McKay,
families had a signi 昀椀 cantly higher prevalence of
and William M. Bannon Jr. suggests that the most
mental health disorders, especially substance use
signi 昀椀 cant factors associated with the use of
disorders, compared to normal individuals [36].
mental health care services are social support and
Another study in Canada showed that psychological
parental skills e 昀昀 ec 琀椀 veness. In addi 琀椀
needs and factors were strongly associated with the
use of health care services [37]. This showed that the
on, another study surveying public school teachers in
mental health issues faced by children from
Southern California noted that families iden 琀椀昀
divorced/separated families are higher than those
椀 ed as being not fully intact had a par 琀椀 cularly
from intact families, and the need for and use of
strong impact on the issues of psychological
mental health services may be higher. This aligns counseling [30, 31, 32].
with many other studies worldwide, where children
Our results showed that the group of students
with behavioral disorders require more mental
experiencing violence had a much higher need for
health services. Family counseling, individual work
psychological counseling than the nonviolent group,
with the children (especially for younger children),
which was likely to have needs for psychological
and social support during the post-separa 琀椀 on
counseling 4.61 (OR = 4.61; 95%CI: 1.18 - 18.02) 琀
period were suggested to prevent long-term, some 椀 琀 椀
mes (p < 0.05). Our research results are consistent
mes lifelong consequences [38]. However,
more research is needed on mental health consulta
with both domes 琀椀 c and overseas studies. The
琀 椀 on among adolescents, especially those in
survey in Nghe An recorded the factors related to
depression and anxiety in students due to bullying by divorced/separated families.
friends [33]. Marleen Wong’s research and
Some limita 琀椀 ons of the study: We use a
associates showed that children exposed to violence
crosssec 琀椀 onal study, making it di 昀케cult to
had higher mental health needs than those who
were not exposed to violence [34]. The survey by
determine the cause-and-e 昀 昀 ect rela 琀 椀
Drotar D, Flannery D, Day E, and associates
onship between the variables. Therefore, more
highlighted the feasibility of developing mental
studies with safety design are needed to
health services to meet the needs of children
understand be 琀琀 er the situa 琀椀 on, needs,
exposed to violence, par 琀椀 cularly family violence,
and approaches to providing emo 琀 椀 onal
at a cri 琀椀 cal 琀椀 me a 昀琀 er exposure to support. violence [35].
In our study, the need for psychological consulta 4. CONCLUSION
琀椀 on was related to the presence of problem
Secondary school and high school students with
separated/divorced parents have an increased need
behavior among high school students. The group of
for psychological counseling, so it is necessary to 10 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
combine family and school to create a healthy
10. Bui Thi Thoa. (2012). Need for psychological environment for children.
support of students in some high schools in Dan Phuong
Acknowledgments: The study team sincerely
district - Hanoi. (MSc thesis: Clinical psychology of children and adolescents).
thanks the students who par 琀椀 cipated in the
11. Lam TQ, Son ĐN, Phuong LT, Dai H. 2020. School
research and the 昀椀 nancial support received
psychology consulta 琀椀 on needs of students junior high
from Hue University project code DHH 2021-04-
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factors among pupils of a high school in Nghe An province 10 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023
Risk screening, nutri 琀椀 on assessment and associated factors of
malnutri 琀椀 on among elderly inpa 琀椀 ents in Hue University of
Medicine and Pharmacy Hospital

Che Thi Len Len1, Hoang Thi Bach Yen2, Nguyen Minh Tam1
(1) Family Medicine Center, University of Medicine and Pharmacy, Hue University
(2) Faculty of Public Health, University of Medicine and Pharmacy, Hue University Abstract
Background: Undernutri 琀椀 on is a signi 昀椀 cant risk factor for mortality, complica 琀椀 ons, hospital
infec 琀椀 ons, length of hospital stay, quality of life, and prognosis. Pa 琀椀 ents with proper nutri 琀椀 on
will help prevent undernutri 琀椀 on, prevent the development of the disease, and improve the e 昀昀 ec
琀椀 veness of treatment. Nutri 琀椀 on is an integral part of the comprehensive treatment process. Nutri
琀椀 onal risk screening is one criterion that shows the hospital’s nutri 琀椀 onal care capacity. Assessing
nutri 琀椀 onal status plays an essen 琀椀 al role in trea 琀椀 ng and recovering health. This study aims (1)
to screen and assess the nutri 琀椀 onal status of inpa 琀椀 ents aged from 60 years old in Hue University
Medicine and Pharmacy Hospital and (2) to iden 琀椀 fy some factors related to malnutri 琀椀 on. Methods:
A cross-sec 琀椀 onal study was carried out on 389 inpa 琀椀 ents at two departments of internal medicine,
Hue University of Medicine and Pharmacy Hospital, from 11/2020 - 03/2021. We used the mini nutri 琀椀
onal assessment tool for screening nutri 琀椀 on risks. The subjec 琀椀 ve global assessment tool was used
to assess nutri 琀椀 onal status and ques 琀椀 onnaires to understand some related factors. Results: There
were 68.9% of pa 琀椀 ents at risk of malnutri 琀椀 on and 38.8% of pa 琀椀 ents had malnutri 琀椀 on.
There were signi 昀椀 cant rela 琀椀 onships between the nutri 琀椀 on status of pa 琀椀 ents with re-admi
琀琀 ed status (p < 0.05), including diseases (p < 0.05), oral pathology (p < 0.05), decreased taste (p < 0.05)…
Conclusion: The prevalence of inpa 琀椀 ents with nutri 琀椀 onal risk in two departments of internal
medicine was rela 琀椀 vely high. It is necessary to conduct nutri 琀椀 on screening in all inpa 琀椀 ents to
improve the e 昀昀 ec 琀椀 veness of treatment and comprehensive care.
Keywords: malnutri 琀椀 on, inpa 琀椀 ents, nutri 琀椀 on treatment, subjec 琀椀 ve global
assessment tool, mini nutri 琀椀 onal assessment tool. 96 lOMoARcPSD| 39099223
Journal of Medicine and Pharmacy, Volume 13, No.04, June-2023 1. INTRODUCTION
2]. The subjec 琀 椀 ve global assessment is a
Ea 琀椀 ng, nutri 琀椀 onal status, health, and
measure to evaluate pa 琀椀 ents’ nutri 琀椀 onal
disease in an individual or popula 琀椀 on are all
status, commonly u 琀椀 lized in interna 琀椀 onal
recognized to be related. Addi 琀椀 onally, insu 昀
and Vietnamese clinical nutri 琀 椀 on research
케cient nutri 琀椀 on or a de 昀椀 ciency impacts a studies [3].
According to research by Kang M.C. et al. (2018),
pa 琀椀 ent’s capacity to recuperate from an illness
hospitalized pa 琀椀 ents have a malnutri 琀椀 on
or surgery. If the pa 琀椀 ent has a diet full of
rate of 22.0% [4]. Pa 琀 椀 ents at Quang Nam
nutrients suitable for the disease, the e 昀昀 ec 琀
Central General Hospital have a malnutri 琀椀 on
椀 veness of treatment will increase. A healthy diet
rate of 26.1%, according to research done by Dang
can stop the progression of the disease when it is s
Thi Hoang Khue in 2019 [5]. In 2017, a study by
琀椀 ll in the latent stage of development. Malnutri
Hoang Thi Bach Yen at Hue University of Medicine 琀椀
and Pharmacy Hospital revealed that 28.1% of pa 琀
on in pa 琀椀 ents is a factor that signi 昀椀
椀 ents were malnourished and 37.4% were at risk cantly a
昀 昀 ects complica 琀 椀 ons,
for malnutri 琀椀 on [6]. In these inves 琀椀 ga 琀
hospitalacquired infec 琀椀 ons, length of hospital
stay, quality of life, and disease prognosis. Older
椀 ons, malnutri 琀椀 on was quite common among
people will be more severely a 昀 昀 ected by
hospitalized pa 琀椀 ents. Each pa 琀椀 ent needs
healing, higher mortality, and expensive costs for
a pathologically appropriate diet and exercise
individuals, families, and society. A popular nutri 琀
program to maintain excellent health and prevent 椀
malnutri 琀椀 on. In an integrated treatment plan,
onal screening technique, the primary nutri 琀椀
nutri 琀椀 on is crucial because it keeps the condi
onal assessment, is endorsed and advised by na 琀 椀
琀椀 on stable, reduces complica 琀椀 ons, and
onal and interna 琀椀 onal scien 琀椀昀椀 c and
shortens hospital stays and overall care. To avoid
clinical organiza 琀椀 ons to support older people. the disease’s
The most frequently accepted and validated [1,
Corresponding author: Che Thi Len Len, email: ctllen@huemed-univ.edu.vn
Recieved: 2/2/2023; Accepted: 15/5/2023; Published: 10/6/2023 97