Resilience and Coping as Predictors of Well-Being in Adults

Spiritual Well-Being and Mental Health During the COVID-19 Pandemic in Italy

During the COVID-19 pandemic in Italy, people and families experienced a new and sudden situation that forced them to stay in their homes for a long period (February 25- May 26). In this context, many people found themselves in great difficulty, not only because of the fear of contagion or the economic problems deriving from the closure of production activities but also because the virus profoundly changed the way of life in society. The "Social distancing" concept became central in all personal relationships, including close family relationships. In this situation, our paper seeks to understand the role of spirituality and religiosity in reacting to this difficult situation and in particular on the physical and psychological health of the people involved. The data we present here are part of a multidisciplinary research with a quantitative theoretical framework. As the data was collected during the first Italian lockdown, a total of 1,250 adults from all over Italy participated in the on-line questionnaire. Among the main results it emerged that the participants perceived lower levels of spiritual well-being and mental health than the pre-pandemic situation with a significant gender difference; in fact, women perceived lower mental health than men. At the same time, it is evident that spirituality and religious practices are a protective factor connected not only with psychological and mental but also physical health. Finally, it appears evident that the family is a protective factor with respect to mental health, even in a period so full of stress factors, those who did not live alone and especially those who had to take care of small children reported higher perceived mental health and a greater ability to activate coping resources.

Flourishing as a Measure of Global Well-being in First Year Residents: A Pilot Longitudinal Cohort Study

BACKGROUND

Physician well-being is critical to optimal learning and performance, yet we remain without validated measures to gauge the efficacy of well-being curricula for trainees. This study evaluates initial evidence of flourishing as a valid measure of global well-being in postgraduate-year-1 residents (PGY-1s), providing a means of assessing well-being intervention efficacy.

STUDY DESIGN

In this single-site study of PGY-1s participating in Enhanced Stress Resilience Training (ESRT), an online questionnaire of published measures was administered at baseline (T1, just before PGY-1), post-ESRT (T2, 7 weeks later), and at PGY-1 end (T3, 11 months later). The Mental Health Continuum (MHC) was used to assess our primary outcome variable, flourishing, a well-established metric of psychosocial thriving in non-physicians that can be treated continuously or categorically. Correlation between flourishing and both resilience (mindfulness and workplace support) and risk (emotional exhaustion, depersonalization, stress, depressive symptoms, anxiety, and workplace demand) factors was assessed at each time-point and longitudinally.

RESULTS

Forty-five interns completed the survey at T1, 37 at T2, and 21 at T3; 21 responded at all time points. MHC score was significantly positively correlated with mindfulness (β = 1.47, SE = 0.35, P < .001) and workplace support (β = 2.02, SE = 1.01, P = .05) longitudinally, and at all time points. Flourishing was significantly negatively correlated with depressive symptoms (β = -7.48, SE = 1.68, P < .001), stress (β = -1.28, SE = 0.29, P < .001), and anxiety (β = -1.74, SE = 0.38, P < .001) longitudinally and at all time points, and significantly negatively correlated with emotional exhaustion (β = -2.65, SE = 0.89, P = .003) longitudinally and at T1 (β = -3.36, SE = 1.06, P = .003).

CONCLUSION

Flourishing showed appropriate correlation with established resilience and risk factors, thus supporting its concurrent validity as a measure of global well-being in this population. As such, the MHC may provide a simple, meaningful assay of well-being and an effective tool for evaluating the efficacy of well-being interventions. Further validation requires a larger, multi-center study.

Appraisal and social support as moderators between stress and physical and psychological quality of life

One proposed mechanism of social support is the facilitation of primary and secondary reappraisal of stressful situations. The current study examined the expansion of the original stress-buffering hypothesis to include primary or secondary appraisal in an emerging adult population (N = 854) on physical and psychological health outcomes. The additional moderating effects of gender also were examined. Perceived social support (by the Multidimensional Survey of Perceived Social Support) significantly buffered the effects of stress from negative events (by the Risky Behaviour and Stressful Events Scale) on physical and psychological health (by the World Health Organizations Quality of Life Instrument) for females only. Neither primary nor secondary appraisal (by the Stress Appraisal Measure) acted as additional buffers for male or females. Social support may be a more salient buffer for females. Reappraisal mechanisms may have another role in the buffering pathways. Further implications and limitations were discussed.

Expression of resilience, coping and quality of life in people with cancer

Considering the importance of coping strategies and resilience in adapting to the stress caused by cancer, the objective of this research is to explore which coping strategies are the most used, in order to know whether different groups of levels of resilience and an appropriate coping style are related to a higher quality of life and better adaptation to the disease. There were 74 participants with cancer in this study (79.7% of them were women) ranging in age from 29 to 85 years (M = 50.9). Different instruments were used to measure the resilience construct (ER-20 items Resilience Scale), coping strategies (Cognitive Emotion Regulation Questionnaire-Short) and quality of life (General Health Questionnaire). People with higher resilience showed higher scores in the use of adaptive strategies, being acceptance and positive revaluation the most frequent ones. Regarding perception of quality of life, people with lower resilience showed statistically significant differences in the dimensions of pain and general health, which were likewise the most common ones for people with lower resilience. A significant association has been demonstrated between resilience and an adaptive coping, which at the same time are positively linked to quality of life of people with cancer. This study provides information about how different groups of resilience levels are related with coping and quality of life in people with cancer. It could be useful information for psychologists in the oncological area who have to take decisions in the clinical context. A practical consequence would involve trying to modify the type of coping, as well as increasing the level of resilience in people with cancer, in order to achieve a better adjustment to the disease.

Psychometric properties of the Assessment Tool for Perceived Agency (ATPA-22) - utility for the rehabilitation of young adults not in education, employment or training (NEETs)

BACKGROUND

Promoting and supporting agency have been at the heart of the debate multidisciplinary. To promote self-awareness of young people's agency and identify persons in need of support the Assessment Tool for Perceived Agency (ATPA-22) was developed.

AIM

This study aims to evaluate the psychometric properties of the ATPA-22. Participants were young adults not in education, employment or training (NEETs) and students in higher education (HEI).

MATERIALS AND METHODS

The main data analysis was implemented by Many Faceted Rasch (MFR) analysis.

RESULTS

The ATPA-22 items defined a unidimensional construct with reasonable internal consistency and separation ability. The ATPA-22 was capable of detecting differences between HEI students and young adult NEETs. Nine differential functioning items emerged between the groups.

CONCLUSIONS

ATPA-22 shows promise as a tool to assess young adults' perceived agency. Anyhow, as the individual life situation affects strongly to perceived agency, research on the stability of the ATPA-22 among different populations is needed.

SIGNIFICANCE

The purpose of the ATPA-22 is to measure perceived agency of individuals, and to identify aspects of agency in need for support. ATPA-22 can be used as a tool for promoting self-awareness of occupational challenges.

Well-Being and Satisfaction of Nurses in Slovenian Hospitals: A Cross-Sectional Study

Introduction

Well-being is one of the most important factors in whether nurses decide to remain in the nursing profession. This study aims to examine well-being and satisfaction among nurses working in Slovenian hospitals and to identify the related demographic factors.

Methods

This descriptive cross-sectional study uses standardised instruments. The sample included 640 nurses working in Slovenian hospitals. The difference between individual variables were analysed using the Mann-Whitney and Kruskal-Wallis tests.

Results

Nurses self-assessed their satisfaction and well-being as moderate. Forty-seven per cent of nurses were satisfied with their job, 49% assessed their psychological well-being as good, 52% were often exposed to stress at the workplace and 30% were always exposed to stress at the workplace. Levels of job satisfaction (p=0.031), psychological well-being (p=0.029) and subjective well-being (p=0.014) were found to differ significantly according to level of education, while levels of job satisfaction (p=0.005), life satisfaction (p<0.001), psychological well-being (p<0.001) and subjective well-being (p<0.001) were also found to differ according to years of nursing service and from hospital to hospital (p<0.001).

Conclusions

The key finding of the study is that nurses are moderately satisfied with their work and life and that they display moderate levels of psychological and subjective well-being. Hospitals can be successful and achieve the goals of the organisation if their employees are satisfied with work and enjoy good levels of well-being. Hospital management have to recognise the importance of ensuring that nurses and other employees are satisfied and healthy.

Resiliency and Allostatic Load among Veterans at Risk for Adverse Prostate Cancer Outcomes

Objective

To examine the relationships between resiliency, sociodemographic factors, and allostatic load among male Veterans.

Design/Study Participants

Cross-sectional study with minority (African American or Hispanic) and non-minority (White) male Veterans undergoing prostate biopsy.

Setting

Veterans Affairs Medical Center located in Charleston, SC.

Main Outcome Measures

Self-reported resilience measured using the two item sub-scale from the Connor-Davidson Resiliency Scale and allostatic load determined from biomarkers measured in blood.

Results

In this small sample, bounce-back resilience and allostatic load level had a significant negative correlation, while adaptation resilience and allostatic load were slightly correlated, but the association was not statistically significant. Sixty-six percent of participants reported that they were able to adapt and 40% reported they were able to bounce back. Higher income and lower PSA level were significantly correlated with greater adaptation resilience. Minority men were significantly more likely than non-minority men to report that they are able to bounce back. Married men were also significantly more likely than unmarried men to report that they were able to bounce back.

Conclusion

It may be important to target resiliency training programs to Veterans based on their social determinants and to examine the effects of these programs on allostatic load.

“One does not forget, it all comes back”: elderly people with intellectual disability review adversities and stress-protection in their lives

Purpose

People with intellectual disability are reported to encounter many negative life events during their increasingly long lives. In the absence of protective elements, these may cause toxic stress and trauma. Given the reported negative effects of such adverse events on their quality of life (QoL), the perspective of older people with intellectual disability themselves may be of relevance. The paper aims to discuss these issues.

Design/methodology/approach

The authors questioned nine participants with mild intellectual disability, aged 61–88 years old, in four 90-min focus group sessions and thematically analysed the data.

Findings

Many recent and bygone negative life events still weighed heavily on the participants. Negative interactions, experiences of loss, lack of control and awareness of one’s disability caused stress. Their emotional response contrasted with their contentment, compliance and resilience. Having (had) good relationships, having learnt coping skills, remaining active, talking about past experiences and feeling free of pain, safe, well supported, capable, respected and involved seemed to heighten resilience and protect participants from toxic stress.

Research limitations/implications

Monitoring and preventing adverse (childhood) experiences, supporting active/emotional coping strategies, psychotherapy and life story work may facilitate coping with negative events and enhance QoL of elderly people with intellectual disability.

Originality/value

Elderly people with mild intellectual disability run a higher risk of experiencing (early) adverse events in life. They are very capable of talking about their experiences, QoL, and the support they need. Focus groups were a reliable method to capture their insights.

Is higher resilience predictive of lower stress and better mental health among corporate executives?

Objective

To assess the impact of resilience, the ability to withstand and bounce back from adversity, on measures of well-being, self-reported stress, and mental health diagnoses.

Methods

This study was a cross-sectional survey of participants seen at an executive health practice at Mayo Clinic, Rochester, Minnesota, from January 2012 through September 2016. Participants completed an anonymous survey that included demographic information and 3 validated survey instruments—the 10-item Connor-Davidson Resilience Scale (CD-RISC), the 12-item Linear Analogue Self-Assessment Scale (LASA), and the 14-item Perceived Stress Scale (PSS). Self-reported history of mental health diagnoses was also collected. CD-RISC scores were used to stratify participants into lower (<30), medium (30–34), or higher (≥35) resilience categories. Participants’ LASA scores, PSS scores, and self-reported mental health diagnoses were compared among resilience categories.

Results

Of the 2,027 eligible participants, 1,954 met the study inclusion criteria as currently employed corporate-sponsored executive or business professionals (self-designated) who completed the CD-RISC survey. Most participants (62.5%) were aged 40 to 59 years. The majority were male (78.3%), white (95.3%), educated (86.2%), and in a committed relationship (89.7%). Among participants, 41.7% reported higher resilience, 34.3% had medium resilience, and 24.0% had lower resilience. The quality of life and overall LASA scores were positively associated with higher resilience (P < .001). PSS scores and self-reported mental health diagnoses were negatively associated with higher resilience (P < .001). These associations remained significant after adjusting for patient characteristics.

Conclusions

In this cross-sectional survey of a large cohort of corporative executives, the lower-resilience cohort had a 4-fold higher prevalence of depression and an almost 3-fold higher prevalence of anxiety compared with the higher-resilience cohort. High resilience was positively associated with well-being and negatively associated with perceived stress. Our findings suggest that higher resilience in the executive workplace environment is associated with better mental health, reduced stress, and greater well-being.

Regulatory Focus and Subjective Well-Being: The Mediating Role of Coping Styles and the Moderating Role of Gender

Although previous research has suggested that regulatory focus may exert considerable impacts on individuals' subjective well-being (SWB), little research has explored the mechanism for this relation and the potential gender difference. The current study investigated the potential mediating effects of coping styles on the relationship between regulatory focus and three aspects of SWB (indicated by life satisfaction, positive affect, and negative affect) among Chinese adolescents. Total of 2943 Chinese adolescents participated in this cross-sectional survey and completed self-reported questionnaires (M_age = 14.47, SD = 1.59, 44.50% boys). Hypothesized pathways were tested by structural equation models. Results showed that regulatory foci were significantly associated with SWB. Promotion focus predicted SWB mainly through problem-focused coping, and the mediating effects of emotion-focused coping were also observed; Prevention focus predicted SWB mainly through emotion-focused coping, and the mediating effects of problem-focused coping were observed. Furthermore, relative to boys, the prediction of problem-focused coping on life satisfaction was stronger and the prediction of promotion focus on life satisfaction was weaker for girls. These findings provide a new approach to understand the mechanism for the relationship between regulatory foci and SWB, and indicate the gender differences of this process.

Resilience in inpatient palliative care nursing: a qualitative systematic review

Background

Nurses in inpatient palliative care are frequently exposed to death and dying in addition to common stressors found in other nursing practice. Resilience may mitigate against stress but remains ill-defined and under-researched in the specialist palliative care setting.

Objective

The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses.

Design

A thematic synthesis of qualitative studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

Academic Search Ultimate, Cumulative Index to Nursing and Allied Health Literature, Medline Complete, PsycINFO and Scopus.

Review methods

The review stages were searching for relevant literature, selecting relevant papers, data extraction, critical appraisal and thematic synthesis.

Results

Eight studies revealed 10 subthemes, 3 descriptive themes and 1 analytical theme: resilience occurs when nurses incorporate stressful aspects of their personal or professional lives into a coherent narrative that enhances their ability to cope with the demands of their role.

Conclusion

Palliative care nursing is more stressful if patients or situations remind nurses of personal experiences. Nurses cope better with adequate support; however, coping does not necessarily imply increased resilience. Resilience occurs when nurses cognitively process their experiences, articulate their thoughts and feelings into a coherent narrative, and construct a sense of meaning or purpose. Future research could explore how nurses understand resilience and how it could be enhanced in the palliative care inpatient setting. With resilience, nurses may remain in the profession longer and improve the quality of care when they do.

Predictors of well-being and quality of life in men who underwent radical prostatectomy: longitudinal study1

OBJECTIVE

to identify socio-demographic, clinical and psychological predictors of well-being and quality of life in men who underwent radical prostatectomy, in a 360-day follow-up.

METHOD

longitudinal study with 120 men who underwent radical prostatectomy. Questionnaires were used for characterization and clinical evaluation of the participant, as well as the instruments Visual Analog Scale for Pain, The Ways of Coping Questionnaire, Hospital Depression and Anxiety Scale, Satisfaction with Social Support Scale, Marital Satisfaction Scale, Subjective Well-Being Scale and Expanded Prostate Cancer Index. For data analysis, the linear mixed-effects model was used.

RESULTS

the socio-demographic factors age and race were not predictors of the dependent variables; time of surgery, problem-focused coping, and anxiety were predictors of subjective well-being; pain, anxiety and depression were negative predictors of quality of life; emotion-focused coping was a positive predictor. Marital dissatisfaction was a predictor of both variables.

CONCLUSION

predictor variables found were different from the literature: desire for changes in marital relationship presented a positive association with quality of life and well-being; emotion-focused coping was a predictor of quality of life; and anxiety was a predictor of subjective well-being.

Well-being and associated factors among elementary school teachers in southern Brazil

ABSTRACT Purpose: to verify the prevalence of well-being and its association with sociodemographic features, health and work-related conditions, and vocal behavior in elementary school teachers in the city of Pelotas, RS. Methods: a cross-sectional observational study with 575 teachers from urban and rural areas. The participants answered a structured questionnaire that included items on sociodemographic, health and work-related conditions. The Faces Scale (Andrews) was used to evaluate their psychological well-being. The Vocal Behavior Profile verified occurrences of abuse and vocal misuse. Poisson regression was used for the multivariate analysis. Results: of the total sample, 79.5% of teachers experienced well-being. It was observed that vocal behavior profile was significantly associated with well-being, and the number of students in the classroom showed a trend towards significance. Conclusion: most teachers had a satisfactory well-being perception. Moreover, a lower well-being perception in the teaching population was mainly related to abusive vocal behavior and, less clearly, to the high number of students per classroom.

Distraction coping predicts better cortisol recovery after acute psychosocial stress

The aim of this study was to explore whether different manifestations of state coping predict cortisol response and recovery in an acute stress situation. Fifty-nine healthy adults (59.3% female) were exposed to the Trier Social Stress Test (TSST), and salivary cortisol was measured repeatedly before and after stress. Hierarchical linear modeling was used to test for relationships between factor-analytically derived measures of state coping and cortisol response and recovery. Independent of sex, age, BMI, chronic stress and depression, denial coping was related with higher peak levels of cortisol (β=0.0798, SE=0.0381, p=0.041) while distraction coping predicted steeper recovery after TSST (linear effect: β=-0.0430, SE=0.0184, p=0.023) and less pronounced curvature (quadratic effect: β=0.0043, SE=0.0017, p=0.016). Our results demonstrate the stress-buffering effect of distraction coping on hypothalamic-pituitary-adrenal (HPA) axis activity in situations without sufficient control.