Nursing students' perceptions regarding well-being and healthy use of digital technology: A qualitative thematic analysis

BACKGROUND

The health and well-being of nursing students are of the utmost importance. Well-being is affected by many factors, ranging from day-to-day hassles to severe stressors in students' college lives. In addition to many other challenges, one new component is added with the advancement of technology, that is, the use of digital technology. The objectives of the study were to explore the perceptions of nursing students regarding well-being, its associated factors, digital technology usage and association between well-being and digital technology use.

MATERIALS AND METHODS

A qualitative descriptive design using focus group discussion (FGD) was adopted in this study. A purposive sampling technique was followed for selecting the participants. Five nursing colleges in the city of Bengaluru from Karnataka state (Central Government-1, State Government-2, and Private-2) were selected based on their willingness to allow their students to be a part of the study. Around 12-15 students from each college who might provide potentially rich data were invited to participate in the study. Six FGDs were conducted during June-August 2018 with a total of 80 participants. All the participants were informed about the study. Written informed consent was obtained. All FGDs were audio recorded, and audiotapes were transcribed. Thematic analysis was done using Atlas.ti software.

RESULTS

The emerging themes were clustered under the following broad categories: understanding the concept of well-being and associated factors; understanding digital technology; ways to healthy use of digital technology; strategies to maintain well-being; and a felt need for professional help.

CONCLUSION

This study provides an insight into the experiences of well-being, stress, and use of digital technology among undergraduate nursing students. The findings have led to elicit the components required to develop an intervention program that may help the undergraduate nursing students to enhance well-being as well as promote healthy use of digital technology.

Mixed-Method Investigations Uncovering Tension, PTSD Symptoms, and Trauma-Related Difficulties Among Indian Women from Slums Reporting Gender-Based Violence

Indian women exposed to gender-based violence (GBV) report experiencing cultural concepts of distress, such as tension, and trauma-related difficulties. However, tension and trauma-related sequalae have not been explicitly explored. The present study examined the symptoms, causes, and coping strategies associated with tension among slum-residing Indian women reporting GBV (N = 100). This study also explored linkages between tension and posttraumatic stress disorder (PTSD) symptom severity. Qualitative results among a subsample of women (n = 38) indicated tension was commonly reported. Tension was characterized by varied affective, behavioral, cognitive, and somatic components and was most commonly caused by interpersonal stressors. Participants described various coping strategies to manage tension, including avoiding, cognitively reframing, considering consequences, distracting themselves, seeking medical, religious and/or spiritual assistance, finding social support, and tolerating tension. Barriers to coping were stigma, hopelessness about present circumstances, and negative reactions from others. One-way analysis of covariance with Bonferroni-adjusted post hoc results (N = 100) indicated that participants with higher tension exhibited significantly higher PTSD symptom severity as compared to participants reporting no tension. Altogether, the polyvalence of tension suggested that it requires idiographic assessment. Tension appears responsive to skills consistent with evidence-based psychological treatments for Indian women from slums reporting GBV.

Perceived Wellbeing, Happiness, and Related Challenges among Indian College Students

The present study aimed to examine the conceptualisation and determinants of happiness among Indian college students and identify areas in which they require help. The sample consisted of 362 students in the age group of 18 to 30 years (M_age = 20.9, SD_age = 2.25) from two locations in North and South India. Online forms, including the Satisfaction with Life Scale (Diener et al., 1985), Positive and Negative Affect Schedule (Watson et al. in J Pers Soc Psychol 54:1063-1070, 1998) and a qualitative survey, were used to collect the data. Results indicated that participants from institutions that offered mental health initiatives reported higher well-being than those who did not. Findings from the qualitative survey suggest that most participants conceptualised happiness in terms of need for satisfaction and well-being. The responses also indicated that leisure activities and time spent with the family determined the participants' happiness. Concerns related to interpersonal relationships made the participants unhappy, and most of them were willing to seek help in this regard. Factors beyond immediate self and interpersonal networks had a limited role in participants' perceived happiness and unhappiness. Study findings could guide the development of customised mental health and well-being promotion initiatives to meet the needs of Indian college students.

Conceptualizing mental health among diverse Americans

Purpose

A single conceptualization of mental health based on empirical research has yet to be adopted by researchers and practitioners. This paper aims to explore how diverse Americans define mental health. The aim of the study was to build a conceptualization of the term “mental health”, using qualitative and quantitative methods, on the basis of definitions provided by an ethnically diverse sample of lay-people and professionals.

Design/methodology/approach

Concept mapping methods, including multidimensional scaling and hierarchical cluster analysis, were applied to 146 statements generated by 125 participants of diverse American racial and ethnic groups. The resulting concept map was inspected visually, quantitatively and qualitatively.

Findings

Out of the 146 statements, 8 overarching themes emerged from multidimensional scaling and hierarchical cluster analysis. Themes include Well-being, balance, coping, adaptability, relational, self, lack of mental illness and physical. T-tests revealed statistically significant differences on ratings of importance for statements within the theme “Lack of Mental Illness” from those included in “Well-Being”, “Balance” and “Coping.” Statements included in the theme “Lack of Mental Illness” were rated least essential to the construct of mental health. The “Self” cluster appeared at the center of the data visualization, suggesting that Americans believe that self is essential to the construct in question.

Practical implications

This mixed-method study is consistent with prior evidence that mental health and mental illness might best be considered separate constructs (Westerhof and Keyes, 2010). A logical follow-up might examine why the concept of “Self” emerges centrally as it would help mental health practitioners and policymakers to focus their understanding of mental health to improve mental health interventions.

Originality/value

Understanding that the concept of “Self” is central to Americans’ conceptualizing of mental health may help mental health practitioners and policymakers to focus their efforts in delivering targeted mental health interventions.

Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations

BACKGROUND

Globally, 20% of young people experience mental disorders. In India, only 7.3% of its 365 million youth report such problems. Although public stigma associated with mental health problems particularly affects help-seeking among young people, the extent of stigma among young people in India is unknown. Describing and characterizing public stigma among young people will inform targeted interventions to address such stigma in India, and globally. Thus, we examined the magnitude and manifestations of public stigma, and synthesised evidence of recommendations to reduce mental-health-related stigma among young people in India.

METHOD

A systematic review and meta-analysis of observational studies was conducted. Nine electronic databases were searched and 30 studies (n = 6767) met inclusion criteria.

RESULTS

Most studies (66%) focused on youth training to become health professionals. One-third of young people display poor knowledge of mental health problems and negative attitudes towards people with mental health problems and one in five had actual/intended stigmatizing behavior (I2>=95%). Young people are unable to recognize causes and symptoms of mental health problems and believe that recovery is unlikely. People with mental health problems are perceived as dangerous and irresponsible, likely due to misinformation and misunderstanding of mental health problems as being solely comprised of severe mental disorders (e.g. schizophrenia). However, psychiatric labels are not commonly used/understood.

CONCLUSION

Public education may use symptomatic vignettes (through relatable language and visuals) instead of psychiatric labels to improve young people's understanding of the range of mental health problems. Recommended strategies to reduce public stigma include awareness campaigns integrated with educational institutions and content relevant to culture and age-appropriate social roles.

Contested meanings of mental health and well-being among university students

Emerging adults are an important group not only because their opinions and knowledge will determine future attitudes but also because of the emergence of mental health problems during young adulthood. In order to provide relevant support, academics, health care providers as well as policy makers need to be more cognisant of how emerging adults make meaning of their psycho-social developmental context. The objective of the study was to explore how a cohort of 150 university students made meaning of emotional well-being and mental illness, the causes of mental health problems, the negative connotations associated with mental ill health, help-seeking behaviours, and how culture was used as a lens through which mental well-being was understood. The main findings indicate that students struggle to fully understand these concepts mainly because it is shrouded in mystery and complexity and not engaged with freely because of stigma and stereotypical attitudes, and while culture provides a lens to understand the causes and interventions, emerging adults often adopt a level of scepticism and are beginning to vacillate between tradition and modernity. Emerging adults face many barriers to accessing health care services including limited knowledge and stigma related to services, lack of confidentiality, fear of mistreatment, location of facilities, and the high cost of services. Universities and government should actively engage with research evidence to inform policies and programmes to improve the health and well-being of emerging adults.

Lay Worker Health Literacy: A Concept Analysis and Operational Definition

The concept of lay worker health literacy is created by concurrently analyzing and synthesizing two intersecting concepts, lay workers and health literacy. Articulation of this unique intersection is the result of implementing a simplified Wilson's Concept Analysis Procedure. This process incorporates the following components: a) selecting a concept, b) determining the aims/purposes of analysis, c) identifying all uses of the concept, d) determining defining attributes, e) identifying a model case, f) identifying borderline, related, contrary, and illegitimate cases, g) identifying antecedents and consequences, and h) defining empirical referents. Furthermore, as current literature provides no operational definition for lay worker health literacy, one is created to contribute cohesion to the concept.