Stress, coping, and hope

Effect of Language Barriers and Use of Interpreters on Hope Among Patients With Central Nervous System Malignancies and Bone Metastases

PURPOSE

Hope is important in serious illnesses, as it has been linked to patient quality of life. We aimed to determine factors associated with lower hope scores among patients with central nervous system disease or bone metastases.

METHODS AND MATERIALS

The Adult Dispositional Hope Scale (AHS) is a 12-item questionnaire that measures hope through 2 qualities: agency (goal-directed energy) and pathways (plan to meet goals). Total scores range from 8 to 64, with higher scores reflecting higher agency and pathways thinking. We prospectively collected scores from patients seen in 2 radiation oncology clinics at our institution from October 2022 to April 2023. The method of least squares to fit general linear models and Pearson's correlation coefficients was used to determine relationships between AHS score and socioeconomic and disease factors.

RESULTS

Of the 197 patients who responded, the median age was 60.5 years (range, 16.9-92.5 years) and most patients were male (60.9%), were White (59.4%), and had malignant disease (59.4%). The median overall AHS score was 54 (range, 8-64), and median pathway and agency thinking scores were 27 (range, 4-32) and 27 (range, 4-32), respectively. Patients who needed an interpreter compared with those who did not had significantly lower overall AHS scores (mean score, 45.4 vs 51.2, respectively; P = .0493) and pathway thinking scores (mean score, 21.5 vs 25.7, respectively; P = .0085), and patients with poorer performance status had significantly worse overall AHS scores (Pearson's correlation coefficient = -0.2703, P = .0003).

CONCLUSIONS

Patients with central nervous system disease or bone metastases requiring the use of an interpreter had lower AHS scores, highlighting the possible association of language barriers to hope. Addressing patient language barriers and further studies on the possible association of language barriers to hope may improve hope, quality of life, and outcomes among these patients.

A narrative inquiry into the communication experiences of mothers caring for children with cancer in Jordan

BACKGROUND

This study aims to investigate the parenting experiences of mothers who care for children with cancer in Jordan and specifically focuses on the communication experiences of mothers who care for children with cancer.

METHODOLOGY

A qualitative research design employing a narrative inquiry methodology was adopted; it employed the implementation of twenty semi-structured interviews with the mothers of children with cancer recruited from one pediatric hospital located in Amman, Jordan.

FINDINGS

The findings of this study reveal that the majority of mothers attempted to conceal or delay any discussion regarding the diagnosis with their child, particularly during the immediate post-diagnosis period. Additionally, the mothers expressed that their relationships with the parents of children diagnosed with the same illness contain positive and negative aspects. Finally, most mothers participating in this study praised the role of hope in helping them cope with the challenging health condition of their children.

CONCLUSIONS

The findings of this study reveal that mothers would withhold diagnostic information from their children for several reasons: firstly, they wished to safeguard their children from feelings of distress; secondly, they perceived that their children were too immature to fully comprehend the seriousness of their diagnosis; and, finally, they desired to protect their children from unnecessary fear and negative emotions.

PRACTICAL IMPLICATIONS

Pediatric cancer care requires effective communication between physicians, pediatric nurses, caregivers, and children; clear and accurate communication between healthcare providers and parents of children with cancer ensures that they fully understand the diagnosis and can make values-based decisions.

Exploration of Hope Among Young Adults with Cancer in Malaysia

Purpose: Hope is vital for cancer patients to cope with their illnesses. It is positively associated with better health outcomes, quality of life, and daily functioning. However, restoring hope after a cancer diagnosis can be challenging, especially for young adult cancer patients. This research aimed to investigate hope among young adults with cancer throughout their cancer experience and the exploration of hope preservation in these individuals. Methods: This qualitative study involved 14 young adults recruited from a closed Facebook group. The median age of the participants was 30.5 years (range 20-39 years), and their median survival year was 3 years (range 1-18 years from the date of diagnosis). Semistructured interviews and a thematic analysis were performed to identify the major themes that emerged from these interviews. Results: The findings identified that young adults expressed hopes for cancer advocacy, good physical and mental health, ease in the afterlife, and uncertain hopes due to thoughts of death. Three areas that influenced their hope are: (1) active hope with cancer peers; (2) cancer prognosis and hope; and (3) hope comes from prayer. Their cultural and religious beliefs influenced the various forms of hope and affected their experiences with cancer. In addition, this study discovered that not all positive communication with their physician resulted in hope. Conclusion: These findings provide important insight to health care professionals (HCPs) by encouraging young adults to discuss hope and improving the existing oncology social work-based intervention. This study suggests that hope is essential for chronic illness patients and should be supported continuously during and after treatments.

Reclaiming hope: Subjective nearness to death as a moderator between posttraumatic stress symptoms and hope among older adults

Perceiving one's remaining time until death, can serve as a source of resilience when faced with adversity in the second half of life. The current work is based on a prospective study and examines whether subjective nearness-to-death (SNtD) moderates the association between posttraumatic-stress symptoms (PTSS) and hope among adults in the second half of life. The first wave was conducted after the end of a military conflict in the south of Israel, and included 170 participants (M = 66.61, SD = 9.16; age range 51-91), 115 of whom also participated in Wave 2. Participants filled out self-reported questionnaires regarding background information, PTSS, SNtD and hope. A moderation effect was found, revealing that high levels of PTSS predicted lower levels of hope among those who felt close to their death, but not among those who felt far from their death. We suggest that one's evaluation of little time remaining to live, especially in old age, may be a significant factor exacerbating the negative consequences of PTSS on hope. The importance of the results to the research field is discussed.

The impact of psychological distress, socio-demographic and work-related factors on coping strategies used by nurses during the COVID-19 pandemic: A cross-sectional study

AIM

This study aimed to determine factors associated with coping strategies used by nursing staff during the COVID-19 pandemic in Iran.

DESIGN

Cross-sectional study.

METHODS

A convenience sample of 365 nurses were selected from referral hospitals for COVID-19 patients in Tabriz, Iran between February 2022 and July 2022. An online self-administered questionnaire was distributed through social media platforms, including WhatsApp and Instagram. The survey package included a modified Brief COPE scale, socio-demographic and work-related questions, and a measure of psychological distress. Multiple regression analysis examined associated factors with coping strategies in SPSS. The study adhered to the STROBE guidelines for reporting.

RESULTS

The mean age of participants was 31.2 (7.3) years old. Of the 365 participants, 209 (58.9%) used maladaptive coping strategies, and 214 (57.6%) reported experiencing psychological distress. Psychological distress was the strongest predictor of maladaptive coping strategies (β = 4.473, p < 0.001). Female nurses (β = 3.259, p < 0.05), nurses who were under 35 years of age (β = 3.214, p < 0.05), nurses with fewer than ten years of experience (β = 2.416, p < 0.001), those who worked in COVID-19 ICUs (β = 4.321, p < 0.001), floor nurses (β = 2.344, p < 0.001), and those who worked two or more years in COVID-19 settings (β = 3.293, p < 0.001) had higher mean scores in maladaptive coping strategies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contributions.

Hope, quality of life, and psychological distress in patients on peritoneal dialysis: A cross-sectional study

Hope is a goal-directed thought that reflects the sense of control over uncertainties and can promote adjustment to chronic illness. This study aimed to assess the level of hope among patients on peritoneal dialysis and evaluate the association of hope with health-related quality of life and psychological distress. This cross-sectional study included 134 Chinese patients receiving peritoneal dialysis in Hong Kong. Patients' level of hope was assessed using the Adult Trait Hope Scale. Participants who were employed, had a higher income, and received automated peritoneal dialysis reported a higher hope score. Hope was found to have significant correlations with age and social support. A higher hope score was associated with better mental well-being and less severe depressive symptoms. Specific relationships between agency/pathway thinking and these outcomes were identified. The patient subgroups at risk for losing hope need to be identified and received early interventions to prevent adverse outcomes.

Anxiety, Depression, and Coping Strategies during Chemotherapy Treatment: A Comparison of Older and Younger Adults with Advanced Cancer in Brazil

We sought to examine differences in anxiety, depression and coping strategies among younger (<64-year old) and older (≥65-year old) patients. Patients were assessed at baseline (T1), mid-point (T2) and on the last day of treatment (T3) using the Hospital Anxiety and Depression Scale and the Ways of Coping. A linear mixed modeling approach was used. The study included 200 patients (gender: 70% women; diagnosis: 30% breast, 22% hematological, 18% gastrointestinal; disease stage: 60% advanced). Older patients who used an emotion-focused coping strategy had a greater decrease in anxiety at T3 compared to those that used problem-focused coping (p = .002).

Moderating Effect of Self-Esteem on the Relationship between Depression and Family Conflict Coping Strategies in the Elderly with Chronic Diseases in Korea

(1) Background: The elderly with chronic diseases often experience high levels of depression, which can negatively affect their family conflict coping strategies. Additionally, as the level of depression increases, self-esteem tends to decrease. This study aims to investigate whether self-esteem plays a moderating role in the relationship between depression and family conflict coping strategies among the elderly with chronic diseases. (2) Method: The subjects were 2501 older adults with chronic diseases included in the 16th Korean Welfare Panel Study. The CES-D scale, Rosenberg Self-Esteem Scale, and the tool of Family Conflict Coping Strategies were used. (3) Results: Depression was negatively correlated with self-esteem and coping strategies for family conflict, while self-esteem was positively correlated with coping strategies for family conflict. In the multiple regression model, self-esteem had a moderating effect (F = 43.20, p < 0.001). This result indicated that as self-esteem increases, the negative influence of depression on family conflict coping strategies becomes weaker (β = -0.08, t = -3.04, p = 0.002). (4) Conclusions: When addressing family conflict coping strategies in the elderly with chronic diseases, it is crucial to focus on enhancing self-esteem. Additionally, it may be beneficial to classify the elderly into groups based on their level of self-esteem.

Hope, optimism, and self-efficacy predicting mental health and illness in a community sample exposed to Hurricane Harvey

In 2017, Hurricane Harvey flooded more than 300,000 buildings causing an estimated $125 billion in damages and resulting in 68 deaths (National Hurricane Center). This actual or threatened loss of life and physical harm led many to report negative effects on mental well-being and greater mental illness. However, many individuals have been able to experience similar adverse events without a significant negative impact on their mental health and well-being. Positive thinking factors such as hope, optimism, and self-efficacy have been proposed as protective factors in the face of difficult life events. Hope, optimism, and self-efficacy are related but distinct constructs that have often been studied separately, but whose unique impact on well-being and mental illness is less clear, especially in the context of a natural hazard. The current study uses structural equation modeling to measure the unique contribution of hope, optimism, and hurricane-coping self-efficacy on mental well-being and mental illness in a community sample of 300 subjects who experienced Hurricane Harvey, recruited from Mechanical Turk.

The Role of Mass Media in Influencing the Lifestyle of the Elderly during the COVID-19 Pandemic

The elderly represent one of the categories that was most affected by the pandemic period. The purpose of this research was to analyze the ways in which mass media and very often contradictory information flows influenced the lives and personal communications of the Romanian elderly population during the COVID-19 pandemic. In order to conduct the research, we used a mixed-methods approach. For the quantitative research, we gave a questionnaire to the elderly population of Romania, and for the qualitative research, we conducted interviews. Our quantitative sample included 881 retired persons with an age between 55 and 94 years old; the mean age was 71.48 years old with 6.6 years standard deviation. The elderly described the pandemic period using negative words: fear, loneliness, anxiety, disaster; the channel they mostly watched and trusted was the TV; they were aware of the measures they had to take to protect themselves; they missed most of the meetings with the family and the main problems they had were represented by loneliness, the inability to be with their families or the lack of access to medical services. The elderly's mass media consumption during the pandemic was mostly represented by TV consumption; the information spread by mass media was sometimes contradictory; it influenced their behavior and may have generated feelings of anxiety among them.

Front-line hotel employees mental health and quality of life post COVID-19 pandemic: The role of coping strategies

The tourism business has been severely impacted by the COVID-19 pandemic, resulting in economic and job losses due to travel restrictions and lockdown measures. Among those most impacted are tourism employees, who have experienced job insecurity, financial difficulties, and increased work-related stress. The pandemic has also produced a significant negative effect on both mental health and quality of life (QOL) of these employees, leading to high levels of anxiety, stress, and depression. This study aims to assess the impacts of three coping strategies (problem-focused, social support, and avoidance) on the mental health and quality of life of front-line hotel employees. Data were collected from 700 participants and analyzed using SPSS version 25 and structural equation modeling (SEM) and AMOS program version 24. Our study found that social support and problem-solving coping strategies were effective in mitigating the negative impacts of stress, depression, and anxiety, while avoidance coping strategy did not have a significant impact. The mental health consequences of stress, depression, and anxiety were found to reduce the quality of life of hotel employees. The study highlights the significance of developing and implementing effective coping strategies to support the mental health and well-being of tourism employees. The findings suggest that organizations should provide resources and support to address the mental health needs of their employees.

Coping strategies predict daily emotional reactivity to stress: An ecological momentary assessment study

BACKGROUND

Emotional reactivity predicts poor health and psychopathology. Despite its theoretical importance, little research has tested whether coping predicts emotional reactivity to stressors. We analyse three studies to test this hypothesis for negative (NA) and positive affect (PA) reactivity to daily stressors.

METHODS

422 Participants (72.5 % females, M_age = 22.79 ± 5.36) came from three longitudinal, ecological momentary assessment (EMA) studies across 7-15 days (ACES N = 190; DESTRESS N = 134; SHS N = 98). Coping was measured at baseline. NA, PA, and daily stressors were assessed via EMA. Mixed effects linear models tested whether coping predicted NA and PA reactivity, defined as their slope on within- and between-person daily stressors.

RESULTS

Behavioural disengagement and mental disengagement coping predicted greater within-person NA reactivity across all studies (all p < .01, all f² = 0.01). Denial coping predicted greater within-person NA reactivity in ACES and DESTRESS (both p < .01, f² from 0.02 to 0.03) and between-person in ACES and SHS (both p < .01, f² from 0.02 to 0.03). For approach-oriented coping, only active planning coping predicted lower within-person NA reactivity and only in DESTRESS (p < .01, f² = 0.02). Coping did not predict PA reactivity (all p > .05).

LIMITATIONS

Our findings cannot be generalised to children or older adults. Emotional reactivity to daily stressors may differ from severe or traumatic stressors. Although data were longitudinal, the observational design precludes establishing causality.

CONCLUSIONS

Avoidance-oriented coping strategies predicted greater NA reactivity to daily stressors with small effect sizes. Few and inconsistent results emerged for approach-oriented coping and PA reactivity. Clinically, our results suggest that reducing reliance on avoidance-oriented coping may reduce NA reactivity to daily stressors.

The mediating role of specific coping styles in the relationship between perceived social support and depressive symptoms in adolescents

BACKGROUND

Depressive symptoms are one of the most common mental health problems in adolescence, and the relationship between perceived social support and depressive symptoms has been well-studied. However, little research has been conducted on the mediating role of specific coping styles in the relationship. Therefore, the primary purpose of this study was to examine the mediating role of specific coping styles in perceived social support and depressive symptoms in adolescents.

METHODS

A questionnaire was administered to 3887 Chinese junior and senior high school adolescents (mean age = 15.72 years, SD = 1.43) using a multistage stratified and cluster sampling method. The PROCESS model 4 was used to conduct a multiple mediation analysis.

RESULTS

Problem solving, seeking help, venting, fantasy and endurance mediated the relationship between internal family support or external family support and depressive symptoms. The problem solving coping style mediated the largest amount of effect, accounting for 22.32 % and 19.05 %, respectively.

LIMITATIONS

This study used a cross-sectional survey and self-reported information, which may be the main research limitation.

CONCLUSIONS

The findings suggest that higher social support not only directly reduces the likelihood of adolescent depression, but also influences depressive symptoms through specific coping styles. This may help further develop targeted prevention and interventions for at-risk adolescents for specific coping styles.

A Qualitative Approach to Understanding Canadian Healthcare Workers' Use of Coping Strategies during the COVID-19 Pandemic

Throughout the COVID-19 pandemic, healthcare workers (HCWs) have been exposed to highly stressful situations, including increased workloads and exposure to mortality, thus posing a risk for adverse psychological outcomes, including acute stress, moral injury, and depression or anxiety symptoms. Although several reports have sought to identify the types of coping strategies used by HCWs over the course of the pandemic (e.g., physical activity, religion/spirituality, meditation, and alcohol), it remains unclear which factors may influence HCWs' choice of these coping strategies. Accordingly, using a qualitative approach, the purpose of the present study was to gain a deeper understanding of the factors influencing HCWs' choice of coping strategies during the COVID-19 pandemic in Canada. Fifty-one HCWs participated in virtual, semi-structured interviews between February and June 2021. Interview transcripts were analysed through an inductive thematic approach, yielding two primary themes. First, HCWs described an ongoing shift in their approach to coping depending on their mental "bandwidth", ranging from "quick fix" to more "intentional effort" strategies to engage in proactive strategies to improve mental health. Second, many HCWs identified various barriers to desired coping strategies during the pandemic, including the preponderance of pandemic- and other circumstantial-related barriers. The findings from this study offer a unique understanding of the factors influencing HCWs' choice of coping strategies under novel and increased stress. This knowledge will be central to developing appropriate forms of support and resources to equip HCWs throughout and after the pandemic period, and in mitigating the potential adverse mental health impacts of this period of prolonged stress and potential trauma.

The Relationship of Artificial Intelligence Opportunity Perception and Employee Workplace Well-Being: A Moderated Mediation Model

Several previous studies have revealed a positive relationship between artificial intelligence (AI) technology development and employees' employment, income, and job performance. If individuals can seize the opportunity to master the knowledge and skills relevant to the implementation of AI, they could make career progress and improve their workplace well-being (WWB). Based on the transactional theory of stress and resource conservation theory, we constructed a moderated mediation model to explore the relationship between AI opportunity perception and employees' WWB and examine the mediating factor of informal learning in the workplace (ILW), as well as the moderating factor of unemployment risk perception (URP). Through a survey of 268 employees, our results showed the following: (1) AI opportunity perception was significantly positively correlated with employees' WWB; (2) ILW played a mediating role in the positive relationship between AI opportunity perception and employees' WWB; and (3) URP negatively moderated the mediating relationship of ILW between AI opportunity perception and employees' WWB. Our research results have a guiding significance for enterprises seeking to promote WWB during AI application.

The Relationships of Creative Coping and College Students' Achievement Emotions and Academic Stress: The Mediating Role of Psychological Capital

Creative coping is the use of creativity as a positive strategy when facing stress. The existing empirical investigation of creative coping is scarce, particularly in the field of educational psychology. The present study aims to explore the relationships of college students' creative coping and their achievement emotions and academic stress as well as the underlying mechanism. The sample included 780 Chinese college students. The Creative Coping Scale, Positive Psychological Capital Questionnaire, Learning Stress Inventory for College Students, and the short version of the Achievement Emotions Questionnaire were used. Statistical results showed that creative coping was positively related with students' positive achievement emotions and negatively related with negative achievement emotions, but insignificantly with academic stress. Moreover, psychological capital played a mediating role in the relationship between creative coping and achievement emotions and in the relationship between creative coping and academic stress with a suppression effect.

Psychological distress, understanding of cancer and illness uncertainty in patients with Cancer of Unknown Primary

OBJECTIVE

Patients diagnosed with Cancer of Unknown Primary (CUP) experience high levels of psychological distress and report poor understanding of their cancer. We aimed to investigate: (1) if CUP patients with poorer understanding of their cancer diagnosis and testing experience more symptoms of psychological distress than those with better understanding; (2) if the relationship between patients' understanding of their cancer and psychological distress is mediated by illness uncertainty; and (3) explore whether patients' degree of understanding of their cancer can be predicted by clinical and socio-demographic factors.

METHODS

209 CUP patients completed a questionnaire measuring anxiety, depression, illness uncertainty, fatigue, pain, sleep and understanding of their cancer. Using an apriori theoretical framework, we employed structural equation modelling to investigate predictors of patient's understanding of their cancer and psychological distress and the relationships between understanding, illness uncertainty and distress.

RESULTS

The structural equation model displayed good fit indices and supported the hypothesised relationship of patient's understanding of their cancer and the extent of psychological distress, which was mediated via illness uncertainty. Physical symptoms were positively associated with psychological distress and illness uncertainty. Younger age was predictive of lower patient's understanding of their cancer and higher levels of psychological distress.

CONCLUSIONS

Patients with CUP, particularly those who are younger and experiencing more physical symptoms, report higher levels of psychological distress and may require additional mental health support. Our findings highlight a need to improve CUP patient's understanding about their illness, which could help reduce their illness uncertainty and alleviate psychological distress.

The possibility of impossibility: The hope for a cure among terminally ill cancer patients in China

OBJECTIVE

Although the medical potential of the hope for a cure has been fiercely debated within academia, few researchers have approached this topic from the perspective of terminally ill cancer patients themselves. As such, this article aims to help bridge the gap by exploring how terminally ill cancer patients in China construct the hope for a cure.

METHODS

Seventeen terminally ill cancer patients were recruited from the department of oncology at a tertiary hospital, where data were collected through individual interviews and participatory observation from April to December 2020 and analysed via thematic analysis.

RESULTS

The respondents experienced a dynamic swing between construction and denial of the hope for a cure. Furthermore, the patients negotiated between three forms of hope, including the hope for a cure, the hope for prolonged life expectancy and the hope of living in the moment. Meanwhile, family-oriented hope was centred on intergenerational relationships, which further shaped the construction of the hope for a cure.

CONCLUSION

Medical staff needs to be sensitive to terminally ill cancer patients' dynamic swing, negotiation and motivation during the process of constructing the hope for a cure.

Sub-groups (profiles) of individuals experiencing post-traumatic growth during the COVID-19 pandemic

Objective

Some people experience post-traumatic growth (PTG), entailing positive changes such as a greater appreciation of life following traumatic events. We examined PTG in the context of the negative consequences of the COVID-19 pandemic, notably working from home and social distancing. We aimed to assess whether distinct sub-groups (profiles) of individuals experiencing PTG could be identified by how they appraised and coped with the COVID-19 pandemic.

Method

For this cross-sectional study, we used convenience sampling. In total, 951 participants from the general population completed an online questionnaire with items focusing on primary and secondary appraisal, positive reappraisal, rumination, and coping flexibility. For the latent profile analysis, we selected a sample of 392 individuals who had experienced moderate degrees of pandemic-related PTG, reporting at least two of the 10 positive changes in the PTG Inventory-Short Form.

Results

We identified two distinct profiles among people experiencing PTG. The first was characterised by low levels of primary appraisal and stressfulness and higher levels of secondary appraisal (e.g., resilient group), increased coping flexibility and greater use of positive reappraisal. The second was characterised by higher levels of stressfulness and primary appraisal (e.g., stressed group) and greater use of rumination.

Conclusion

The two sub-groups evidently appraised and coped with the COVID-19 pandemic differently. Therefore, future research should account for these different profiles of people experiencing PTG.

Healthcare Workers' Emotions, Perceived Stressors, and Coping Strategies at Workplace during the COVID-19 Pandemic in Palestine

Evidence about the impact of the COVID-19 pandemic on the mental health of Palestinian healthcare professionals is lacking and has been disregarded during the COVID-19 pandemic. This study aims to describe Palestinian healthcare workers (HCWs) emotions and factors causing stress, and factors used to reduce the stress experienced at the workplace and to examine the relationships between HCWs level of stress and their coping strategies and motivational factors during the COVID-19 pandemic. A self-reported online survey was completed by 506 doctors and nurses working in healthcare facilities that provide COVID-19 care. Descriptive statistics, bivariate, and multivariate regression models were developed to adjust for the association between HCWs coping and motivation factors with HCWs' perceived stressors. The findings showed that 24.1% of the participants had a high-stress level, and 25.7% had a low level of stress. The participant's main coping strategy was avoidance and the key emotional factor was the ethical and professional obligation to continue working. Additionally, a major cause of their stress was their personal safety and having the COVID-19 infection. Findings showed a positive association between stress and the younger age of participants, with physicians being less stressed than nurses. In addition, receiving no training on the treatment of COVID-19 was strongly associated with stress levels. Furthermore, there was a significant positive correlation between stress scoring and coping strategies scoring but not with motivation score. In conclusion, this study shows that Palestinian healthcare workers experienced emotional turmoil during the COVID-19 pandemic. These results indicate the necessity of providing supervision, psychological counseling and intervention to professional healthcare workers who work directly with COVID-19 patients in health settings during the current pandemic or in the event of future outbreaks. Policymakers and managers must also conduct training and provide interventions on how to cope with stress in pandemics, in order to assist HCWs in developing their adaptive coping strategies and increase their motivation.

Wellbeing and coping of UK nurses, midwives and allied health professionals during COVID-19-a cross-sectional study

Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7^th May 2020-3^rd July 2020); Phase 2 (17^th November 2020-1^st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p<0.001). The COVID-19 pandemic had a significant effect on psychological wellbeing and quality of working life which decreased while the use of negative coping and burnout of these healthcare professionals increased. Health services are now trying to respond to the needs of patients with COVID-19 variants while rebuilding services and tackling the backlog of normal care provision. This workforce would benefit from additional support/services to prevent further deterioration in mental health and wellbeing and optimise workforce retention.

The Post-Traumatic Growth of Primary Caregivers of Patients after Liver Transplantation

Liver transplantation is a very important surgery. In many cases, it involves two loved ones (receiver and donor in the same family) and causes stress and feelings of burden in family caregivers. The purpose of this study was to investigate post-traumatic growth in primary caregivers of liver transplant patients. A cross-sectional research design was adopted to recruit 84 participants. The Perceived Stress Scale, Short-Form Coping Strategies Scale, and Post-traumatic Growth Scale were used. The results revealed that the total score of perceived stress of the main caregivers of liver transplantation was 27.27 ± 6.63; problem-oriented coping and emotion-oriented coping were used as the main coping strategies, and the traumatic growth score was 42.01 ± 13.84. All three variables were significant predictors of post-traumatic growth (F = 13.71, p < 0.05), explaining 38% of the total variance. This study can help nurses understand the post-traumatic growth status and related factors of the main caregivers of liver transplant patients. It can also help caregivers understand their own perceived pressure and then take relevant care measures to reduce the degree of physical and mental load and achieve a balanced state.

Hope and life satisfaction among Chinese shadow education tutors: The mediating roles of positive coping and perceived social support

Previous studies of the relationship between hope and life satisfaction left the underlying mechanism of how hope predicts life satisfaction unexplored to scholars. This study thus investigates the two potential mediators in the relationship between hope and life satisfaction among a sample of Chinese shadow education institution (SEI) tutors who may be under immense professional development pressure from a cross-sectional approach. The main body of the study consists of an online survey in which 221 SEI tutors reported their hope, positive coping, perceived social support, and life satisfaction. The survey results were analyzed using mediation and moderation analysis via SPSS 23.0. The results indicated that positive coping improved the relationship between hope and life satisfaction, supporting the hypothesis regarding the serial mediating effect of positive coping and perceived social support. In other words, tutors with a high level of hope tend to adopt positive coping strategies, thus will receive more social support and improve life satisfaction. Our findings revealed the independent and accumulative mediating effects of positive coping and perceived social support on the relationship between hope and life satisfaction, and had implications for the psychological intervention of SEI tutors who are currently facing enormous industry pressure.

Trajectories of mental health status during the early phase pandemic in China: A longitudinal study on adolescents living in the community with confirmed cases

Sufficient research reports that individuals living in the community with confirmed COVID-19 cases are more likely to exhibit poor mental health condition. However, little is known about the longitudinal trajectories of mental health status among these people who are exposed to increased risk of contracting COVID-19. Using a 3-wave longitudinal survey between February and June 2020, data has been collected from 2,352 adolescents living in the community with confirmed cases. Depressive/anxiety symptoms, soc-demographic, and other psychological factors of interest (e.g., social support) were measured. Using latent growth mixture modeling, we identified two subgroups (Resistance vs. Dysfunction) of adolescents based on their depressive and anxiety symptoms. More social support and positive coping are identified as protective factors for mental health, whereas higher level of negative coping predicts unfavorable outcomes. These findings suggested that adolescents living in the community with confirmed cases of COVID-19 are a group to which researchers should pay more attention when studying the impacts of quarantine on mental health. It is also crucial to emphasize the role of social support and positive coping in planning psychological interventions for adolescents.

Coping strategies at the frontline of care: Comparisons between Covid-19 and non-Covid-19 units' nurses and the role of moderator variables

INTRODUCTION

Relatively few studies focused on the coping strategies adopted by the healthcare workers during the second phase of the pandemic. The present study compared the coping strategies between Italian nurses working in Covid-19 and in other units and it explored whether socio-demographic and work-related variables moderate the relation between the type of unit and coping strategies.

METHODS

A web-based questionnaire that included sociodemographic and work-related questions and the Coping Orientation to Problem Experienced-New Italian Version-25 item was administered. Moderation effects between variables and coping strategies were analyzed using generalized linear models.

RESULTS

253 nurses participated. Nurses who worked in a Covid-19 unit had significantly lower scores on Avoidance Strategies subscale and higher scores on Positive Attitude and Social Support subscales than nurses working in other units.

DISCUSSION

Gender differences emerged only on the social support coping dimension, with women being more likely to adopt social support than men. No association between the type of unit and the other coping strategies was found.

CONCLUSION

Nurses working in Covid-19 units showed better coping strategies than their colleagues: this suggests that support interventions aimed to promote coping strategies should be offered also to Covid-19-free units' nurses.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

The Moderated Mediating Effect of Hope, Self-Efficacy and Resilience in the Relationship between Post-Traumatic Growth and Mental Health during the COVID-19 Pandemic

As a major life trauma, COVID-19 had negative impacts on psychological well-being. The aim of this study was to test and verify the mediation of resilience, hope and self-efficacy and to analyze the moderating effect of gender and COVID-19 contagion on the association between symptoms of anxiety, stress and depression, and post-traumatic growth among adults during COVID-19. A cross-sectional study was conducted via an online survey with self-administered questionnaires. The Depression, Anxiety, and Stress Scale, the Post-traumatic Growth Inventory, the Resilience Scale, the General Self-Efficacy Scale, and the Comprehensive State Hope Scale were used. A total of 493 (n = 262 female and n = 231 male) participated in the survey (M_age = 33.40 years, SD = 13.41, range = 20 to 60). A multiple mediation model was used to verify the mediating effect of resilience, hope and self-efficacy on the relationship between symptoms of anxiety, stress and depression, and PTG. A moderated mediation model was examined to find and test the moderated effects of gender and COVID-19 contagion on the mediation model. Results showed the indirect effects of anxiety (β = 0.340 (0.120); 95% CI [from 0.128 to 0.587]) and depression (β = 0.222 (0.095); 95% CI [0.048, 0.429]) on PTG trough resilience and hope. Symptoms of anxiety, stress and depression, and self-efficacy were significantly highest in females. Moreover, males and participants with COVID-19 contagion had significantly higher levels of resilience and post-traumatic growth. These findings suggest that hope and resilience, as protective factors, could be an important key to developing an intervention strategy to enhance and improve psychological health during a crisis.

Longitudinal trajectories of insomnia symptoms among college students during the COVID-19 lockdown in China

PURPOSE

This study aimed to examine the patterns and predictors of the trajectories of college students' insomnia symptoms across different stages of the COVID-19 pandemic.

METHODS

A total of 35,516 college students completed three online surveys during the COVID-19 outbreak period (3-10 February 2020), initial remission period (24 March-3 April 2020), and effective control period (1-15 June 2020), respectively. These surveys measured the participants' socio-demographic and pandemic related factors, insomnia symptoms, mental health status, and psychosocial factors. Multivariate logistic regressions were used to examine predictors for trajectory membership.

RESULTS

The prevalence of insomnia symptoms increases during home quarantine. Five insomnia symptoms trajectories were observed: resistance (82.8% of the sample), recovery (5.0%), delayed-dysfunction (5.8%), chronic-dysfunction (1.8%), and relapsing/remitting (4.6%). Female gender, residence location in urban, has history of sleep problems, smoking, alcohol use, community or village has confirmed COVID-19 cases, current poor mental health, higher negative coping were related to higher risk of developing insomnia symptoms in at least one time point, whereas better family function increased the possibility of recovery relative to chronic dysfunction. Lower social support and positive coping could also cause insomnia chronicity.

CONCLUSION

Adolescents have different trajectories of insomnia symptoms during pandemic lockdown. Although most adolescents did not experience insomnia or recovered over time, some adolescents, especially those with the risk factors noted above, exhibit delayed or chronic symptoms. These findings could inform mental health professionals regarding how to provide individualized and appropriate intervention for college students after their return to school.

Demoralization in suicide: A systematic review

OBJECTIVE

In psychiatric literature, few original studies exist on the topic of demoralization in suicide. In this review, we aim to identify original studies on suicidal ideation (SI)/suicidal behavior (SB) and demoralization in populations of community-dwellers and patients with somatic or psychiatric disorders.

METHODS

We employed a systematic approach that followed PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, Science Direct, and PsychINFO) for relevant titles/abstracts published from January 1980-June 2021. We included original studies that explicitly mentioned the investigation of a potential association between SI/SB and demoralization.

RESULTS

A total of 18 studies met our inclusion criteria. Their synthesis revealed that demoralization can be associated with SI/SB in a wide range of populations (community dwellers, patients with somatic or psychiatric disorders) and lead to significantly higher suicide risk (odds ratios of >6 were encountered in community dwellers experiencing financial hardship or isolation). Moreover, demoralization alone (about half the patients who were demoralized did not meet the criteria for an affective disorder nor were they clinically depressed) or together with depression has been identified as a major risk factor for SI/SB. Regarding the crucial issue of progression from SI to SA, in the context of the "ideation-to-action" frame, some authors found that the interaction of demoralization and over-arousal could be a useful predictor for this progression, while others found that depression alone was sufficient to differentiate attempters from non-attempters or the interaction with shutdown (helplessness and low positive emotions).

CONCLUSION

These results emphasize the possibility to identify demoralization as an independent risk factor for suicide. In patients with psychiatric disorders, the association between demoralization and SI/SB may be transnosographic. Overall, from the clinical implications perspective, our findings highlight that: i. Assessment of demoralization may contribute to a more comprehensive suicide risk detection. This appears particularly relevant in Emergency Departments (EDs) where heterogeneous population typologies are usually admitted and a clinical diagnosis of depression is often difficult to be defined. ii. Additionally, since meaninglessness is considered one of the demoralization subcomponents, meaning-centered psychotherapeutic approaches prove to be indicated and they can be initiated already at the EDs upon first contact with the patient. Further studies are necessary to confirm these findings.

“I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study

Cachexia is a prevalent muscle wasting syndrome among people with advanced cancer that profoundly impacts patient quality of life (QoL) and physical function. Exercise can improve QoL, physical function, and overall health in people with cancer and may be an important addition to treatment approaches for cancer cachexia. Greater understanding of patients’ perception of exercise can help elucidate the feasibility of implementing exercise interventions for cancer cachexia and facilitate the design of patient-centered interventions. We aimed to describe the perception of exercise in patients with advanced cancer and cachexia, and capture exercise motivators, barriers, and preferences, to inform the feasibility of exercise interventions. Individual interviews (n = 20) with patients with locally advanced or metastatic cancer with cachexia were conducted and analyzed using reflexive thematic analysis. Main themes from interviews were: 1) Life is disrupted by cancer and cachexia; 2) Exercise offers hope; 3) Exercise barriers are multifaceted; and 4) Exercise access and support are important. Participants reported that their cancer and cachexia had intensely altered their lives, including ability to exercise. Exercise was perceived as important and participants described a hope for exercise to improve their health and wellbeing. Yet, several complex exercise barriers, such as burdensome cancer symptoms and the overwhelming impact of the COVID-19 pandemic, hindered exercise participation and prevented participants from fully realizing the perceived benefits of exercise. Factors believed to improve exercise engagement and overcome exercise barriers included increased exercise support (e.g., professional supervision) and accessibility (e.g., convenient locations). Patient-reported exercise barriers and preferences can inform the design of exercise interventions, particularly within future research studies aiming to establish exercise feasibility and efficacy in people with advanced cancer and cachexia.

Hope and meaning-making in phase 1 oncology trials: a systematic review and thematic synthesis of qualitative evidence on patient-participant experiences

Background

Phase 1 drug trials are popular treatment options for patients with advanced disease, despite the greater levels of uncertainty associated with them. However, their meaning and consequences for patient-participants remains under-explored. This review synthesises the qualitative evidence of patients’ experiences of participating in phase 1 oncology trials, exploring their decisions to take part and the impacts of these trials on patient wellbeing.

Methods

A comprehensive literature search involving medical subject headings (MeSH) and keywords was undertaken in the following databases: MEDLINE, EMBASE, PsycINFO, Scopus, CINAHL, and Cochrane CENTRAL, with supplementary searches also conducted. Studies were independently screened for inclusion by two researchers. Included studies were critically appraised and data extracted using standardised forms. Qualitative results were analysed using thematic synthesis.

Results

Three main themes were identified across 13 studies: decision-making and joining the trial; experiences of taking part in the trial and hope and coping. Patients primarily joined trials hoping for therapeutic benefits, sentiments which prevailed and shaped their experiences across their trial journey. Rather than indicate therapeutic misconception based on poor understanding, patient perspectives more commonly pointed to differences between hope and expectation and cultural narratives of staying positive, trying everything and trusting in experts.

Conclusions

These findings challenge information-based models of consent, favouring coping frameworks which account for the role of hope and meaning-making during serious illness. Personalised consideration of existential and quality-of-life matters before and during trials is recommended, including palliative and supportive care alternatives to active treatment.

Review Registration

The review was registered with PROSPERO international prospective register of systematic reviews (CRD 42020163250).

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06306-9.

Goals of care communication and higher-value care for patients with advanced-stage cancer: A systematic review of the evidence

CONTEXT

Goals-of-care communication (GOCC) is recommended to increase the value of cancer care near the end of life (EOL).

OBJECTIVES

Conduct a systematic review of the evidence that GOCC is associated with higher-value care.

METHODS

We searched PubMed, Scopus, Ovid MEDLINE, EMBASE, EMB Reviews, CINAHL, and PsycInfo from inception to July 2019. We analyzed the population,design, and results and the authors' definitions of GOCC. Risk of bias was assessed.

RESULTS

Thirty-two articles were selected. Ten articles reported results from 8 interventions; 17 characterized participants' perspectives; and 5 were retrospective The topics, behaviors, timing, and anticipated outcomes of GOCC varied significantly and were indistinguishable from practices such as advance care planning. GOCC typically focused on treatment outcomes rather than patients' goals. Four of 5 interventions increased evidence of GOCC after clinician training. Only one reported improved patient outcomes.

CONCLUSION

No consensus exists about what GOCC entails. There is limited evidence that GOCC increases the value of EOL care.

PRACTICE IMPLICATIONS

Future studies should focus on how to engage patients in conversations about their personal goals and integrate their goals into care planning. Clinicians can encourage GOCC by explaining how patients' goals influence decisions especially as treatment options become limited.

Interaction between self-perceived disease control and self-management behaviours among Chinese middle-aged and older hypertensive patients: the role of subjective life expectancy

Background

One of the effective ways to control hypertension is long-term self-management, which is difficult to maintain. Therefore, understanding how people engage in the process of self-management behaviour change is necessary. In this study, we aimed to examine the dynamic relationship between self-perceived disease control and self-management behaviours in Chinese middle-aged and older hypertensive patients, namely, medication use, self-monitoring, physical activity, tobacco and alcohol avoidance, and to explore the mediating role of subjective life expectancy (SLE) on this relationship.

Methods

Data were obtained from a nationally representative sample of 508 middle-aged and older hypertensive patients (aged 45+) from the 2013, 2015, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged panel model combined with mediation analysis was used to determine the dynamic relationship between self-perceived disease control and self-management behaviours and to clarify the mediating effect of SLE on this ascertained relationship.

Results

Good self-perceived disease control subsequently predicted good medication use, self-monitoring and physical activity, and vice versa. Subjective life expectancy (SLE) partially mediated the prospective reciprocal relationships between self-perceived disease control and these self-management behaviours, which accounted for 37.11, 25.88, and 19.39% of the total effect of self-perceived disease control on medication use, self-monitoring and physical activity, respectively. These self-management behaviours had a significant and positive feedback effect on self-perceived disease control. However, neither the direct and indirect effects (via SLE) of self-perceived disease control on tobacco and alcohol avoidance were revealed.

Conclusions

Positive feedback loops of present self-perceived disease control, future SLE and self-management behaviours (medication use, self-monitoring, and physical activity) help middle-aged and older hypertensive patients adhere to these behaviours but are useless for the avoidance of addictive behaviours. Interventions aimed at enhancing the effect perception of general self-management behaviours (e.g., medication use, self-monitoring and physical activity) on the present disease control perspective, and future lifespan perspective would be beneficial for the consistent self-management behaviours of middle-aged and older hypertensive patients. The utility of present disease control perception to these self-management behaviours was much higher than the utility of future expectations. Alternative stress relief strategies may be conducive to long-term changes in addictive behaviours.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12990-8.

Epistemic Beliefs: Relationship to Future Expectancies and Quality of Life in Cancer Patients

CONTEXT

Expectations about the future (future expectancies) are important determinants of psychological well-being among cancer patients, but the strategies patients use to maintain positive and cope with negative expectancies are incompletely understood.

OBJECTIVES

To obtain preliminary evidence on the potential role of one strategy for managing future expectancies: the adoption of "epistemic beliefs" in fundamental limits to medical knowledge.

METHODS

A sample of 1307 primarily advanced-stage cancer patients participating in a genomic tumor testing study in community oncology practices completed measures of epistemic beliefs, positive future expectancies, and mental and physical health-related quality of life (HRQOL). Descriptive and linear regression analyses were conducted to assess the relationships between these factors and test two hypotheses: 1) epistemic beliefs affirming fundamental limits to medical knowledge ("fallibilistic epistemic beliefs") are associated with positive future expectancies and mental HRQOL, and 2) positive future expectancies mediate this association.

RESULTS

Participants reported relatively high beliefs in limits to medical knowledge (M = 2.94, s.d.=.67) and positive future expectancies (M = 3.01, s.d.=.62) (range 0-4), and relatively low mental and physical HRQOL. Consistent with hypotheses, fallibilistic epistemic beliefs were associated with positive future expectancies (b = 0.11, SE=.03, P< 0.001) and greater mental HRQOL (b = 0.99, SE=.34, P = 0.004); positive expectancies also mediated the association between epistemic beliefs and mental HRQOL (Sobel Z=4.27, P<0.001).

CONCLUSIONS

Epistemic beliefs in limits to medical knowledge are associated with positive future expectancies and greater mental HRQOL; positive expectancies mediate the association between epistemic beliefs and HRQOL. More research is needed to confirm these relationships and elucidate their causal mechanisms.

Spiritual aspects of the family caregivers' experiences when caring for a community-dwelling adult with severe mental illness: A systematic review of qualitative evidence

WHAT IS KNOWN ON THE SUBJECT?: Being a caregiver of a relative with severe mental illness often impacts the quality of life, physical and mental health. The use of coping strategies related to spirituality can enhance physical and mental well-being. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review found 26 primary studies that refer to spiritual aspects of the experience of caring for a relative with mental health problems. Caregivers express spiritual needs, such as hope and finding meaning in life, and spiritual or religious practices that help to cope with stressful situations. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Spiritual needs and spiritual coping strategies of family caregivers of a relative with severe mental illness should be included in mental health nursing care. A spiritually sensitive approach should be used when promoting coping strategies of the family caregivers of a relative with severe mental illness. ABSTRACT: Introduction Deinstitutionalization of individuals with severe mental illness transferred the responsibility of care to the relatives who need to adapt their personal life. Caregivers often develop coping strategies which involve the relationship with oneself, others, or the transcendent/God or nature and may include religious/spiritual practices. Question/Aim This review aims to identify the spiritual aspects of the family caregivers' experiences when caring for a community-dwelling adult with severe mental illness. Method The review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. Search was conducted in March 2019, updated in August 2020, limited to English, Spanish and Portuguese. Results A total of 26 studies were included. Two synthesized findings emerged: spiritual coping strategies are used by family caregivers; spiritual needs are expressed by family caregivers. The findings are based on the experiences of 467 caregivers, from 14 countries. Discussion In stressful times, family caregivers question the meaning in life and acknowledge hopelessness. To cope, caregivers mention a turn to the sacred and the use of spiritual/religious practices. Implications for practice Spirituality should be considered according to caregivers' individual beliefs and needs, as may represent important resources for the sense of meaning and overall well-being.

Coping Strategies of Women With Long-Term Spinal Cord Injury: The Role of Beliefs About the World, Self-Efficacy, and Disability

The present study aimed to investigate the indirect effect of appraisal of disability on the relationship between basic hope and coping strategies in women with long-term spinal cord injury (SCI), taking into account the moderating role of general self-efficacy. A cross-sectional study with 187 women with paraplegia was conducted. Main outcome measures, the Coping Orientations to Problems Experienced (COPE), the Basic Hope Inventory (BHI), Appraisals of Disability Primary and Secondary Scale (ADAPSS), and General Self-Efficacy Scale (GSES), were used. Our study showed that the strategies most commonly used by participants are seeking emotional support, religion, and acceptance. More than 45% of the respondents reveal average levels of basic hope, 58.82% reveal high levels of general self-efficacy, and most of them assessed their disability as determined resilience while noticing its negative aspects. The indirect effect of disability appraisal on the relationship between basic hope and coping strategies (denial, focus on emotions, seeking emotional support, religion, and acceptance) was confirmed. The moderating role of general self-efficacy in this analysis of mediating was also confirmed. General self-efficacy plays a significant role in explaining the relationship between basic hope and coping strategies mediated by appraisals of disability in women with long-term SCI.

Hope and Fear of Threats as Predictors of Coping with Two Major Adversities, the COVID-19 Pandemic and an Armed Conflict

Coping with adversities has been explained by two major theories: the fear appeal theory and the hope theory. The predictability of hope with that of fear of threats as variables explaining coping with two major adversities, the COVID-19 pandemic and an armed conflict, was compared. Participants were approached via an internet panel company in two different times: (1) January 2021 (N = 699; age range: 18–82; 330 women), during the third wave of the COVID-19 pandemic in Israel and (2) May 2021 (N = 647; age range: 19–83; 297 women), during an armed conflict between Israel and Hamas. Participants self-reported on hope, four perceived threats (health, economics, security, and political), well-being, individual resilience, societal resilience, and distress symptoms (anxiety and depression symptoms) were collected. Hope was found as a more consistent and stronger predictor of the following expressions of coping: well-being, individual and societal resilience, depression, and anxiety. It can be concluded that hope is a better and more consistent predictor of coping, as well as coping suppressing expressions, compared with fear of threats, in the face of the current adversities. The innovative nature of these findings, the importance of hope as a coping supporter, and the need for replicating these innovative results are discussed and elaborated.

Profiling resilience: A latent profile analysis of German nurses' coping and resilience

Introduction

Because of the shortage of nurses, it becomes crucial for organizations and health systems to keep nurses in their workforce. As individual resilience is positively associated with organizational commitment and negatively with mental disorders, it may reduce nurses' intention to leave the profession. Thus, individual resilience gained attention in research. Nevertheless, there is no common conceptualization of individual resilience in the literature. Rather, three prevalent understandings exist. Due to these multiple understandings, the role of coping in the context of resilience remains unclear. Against this background, the aim of this study is to analyze the relationship between nurses' resilience and coping based on a person-centered approach.

Methods

This study presents a latent profile analysis based on a survey of 210 German nurses. The profiles were generated based on the Brief Resilience Scale and Brief COPE. The Perceived Workload of Nurses' Scale and sociodemographic data were considered as explanatory factors using nominal logistic regression. Further, the relation with possible consequences was tested by χ²-test using the Irritation Scale and KUT Commitment Measure.

Results

The study identifies four different profiles of coping and resilience. The profiles "resistant" and "social-active" show rather low irritations and high organizational commitment. The "passive" profile has lower irritation scores than the "solitary" profile does, but the "passive" profile is associated with more irritation than the "resistant" or the "social-active" profile. Whereas the other profiles include characteristics of resilience, the "solitary" profile has a vulnerable nature. The analysis shows that more coordination and information problems, higher age, and not being in a leadership role are associated with a higher probability of belonging to the "solitary" profile. The chance of belonging to the "solitary" profile is significantly higher for women than for men, whereas women have a significantly lower chance of belonging to the "resistant" profile, compared to men.

Conclusion

The analysis shows that the three prevalent understandings of resilience are appropriate but it also indicates that future scientific debate requires more precision in defining individual resilience. The study contributes to sharpening the definition of resilience as well as to understanding the link between coping and resilience.

Mental Health and Psychological Impact during COVID-19 Pandemic: An Online Survey of Portuguese Higher Education Students

The COVID-19 pandemic has had significant psychological impact on vulnerable groups, particularly students. The present study aims to investigate the mental and psychological impact of the COVID-19 pandemic and associated factors in a sample of Portuguese higher education students. An online cross-sectional study was conducted among 1522 higher education students selected by convenience sampling. The survey assessed mental health symptoms as well as sociodemographic variables, health-related perceptions, and psychological factors. Results were fitted to binary and multivariable logistic regression models. The overall prevalences of stress, anxiety, and depression were 35.7%, 36.2%, and 28.5%, respectively. Poor mental health outcomes were related with being female, having no children, living with someone with chronic disease, facing hopelessness, and lacking resilient coping. Future studies focusing on better ways to promote mental health and wellbeing among students are warranted. It is necessary to gather more evidence on the post-pandemic mental health using robust study designs and standardized assessment tools.

Distress and Spiritual Well-Being in Brazilian Patients Initiating Chemotherapy during the COVID-19 Pandemic-A Cross-Sectional Study

Social distancing and the priority given to COVID-19 patients in health services, which caused postponement of appointments and cancer treatment, may have triggered unprecedented levels of distress in cancer patients. The aim of this study was to analyze the prevalence of distress and the levels of spiritual well-being of people initiating chemotherapy during the COVID-19 pandemic, identifying the factors associated with distress, and determining if there is a relationship between distress and spiritual well-being. A cross-sectional study was conducted with 91 Brazilians. Data were collected by applying the Spiritual Well-Being Scale (SWBS) and the Distress Thermometer and Problem List for Patients. The prevalence of distress was 59.5%, and the average score of spiritual well-being was 106.54 (±9.06). Emotional issues were the most reported by patients with distress. The Poisson regression showed that male sex (PR = 0.588; 95% CI 0.392–0.881), age (PR = 0.985; 95% CI 0.973–0.996), and spiritual well-being score were predictors of distress (PR = 0.971; 95% CI 0.946–0.996). These findings indicate that distress relief involves implementation of public health programs capable of integrating spiritual interventions into cancer care.

The relationship between active coping and hope during the COVID-19 pandemic: The mediating role of meaning in life

This study aims to examine the relationship between active coping and hope during the COVID-19 pandemic and investigate the underlying mechanism based on meaning making theory. We conducted a two-wave survey and recruited 521 Chinese adults (aged 18-65). Results show that all three active coping strategies (personal hygiene practice, support seeking, and positive reappraisal) at T1 was positively associated with T2 hope. Importantly, T2 meaning in life serves as a mediator between T1 active coping and T2 hope. Our findings suggest that active coping could be an effective approach to maintain mental health by making meaning and promoting hope.

Shades of hope: Marcel's notion of hope in end-of-life care

This article examines the compatibility and relevance of Gabriel Marcel's phenomenology of hope in interdisciplinary research on the role of hope in end-of-life (EOL) care. Our analysis is divided into three thematic topics which examine the various shades of hope observed in Marcel's phenomenology of hope and in the collection of 20 EOL studies on hope as experienced by adult palliative care (PC) patients, health care professionals (HCP) and parents of terminally ill children. The three topics defining the shades of hope are: the meaning of hope in its dynamic aspects, the dialectics of hope and despair, and the transcendent facets of hope. We analyse how Marcel's understanding of hope is reflected in EOL studies, and how this perception can enrich the philosophy of PC and significantly deepen and broaden HCPs' understanding of hope. Our findings prove that despite terminological differences between Marcelian phenomenology and the concepts of hope in the 20 EOL studies, hope emerges as a resourceful movement towards being. Implementing Marcelian hope within communication in EOL care could help in HCPs' interpersonal approach to patients as his concept harbors a holistic perception of the existential situation of a person. Equally, introducing Marcel's phenomenology of hope into the clinical encounter could play a beneficial role in improving the ability of patients to adapt to the difficult conditions of their disease and PC treatment.

Estimating the training effect through the levels of trait anger, anger expression, and coping with the stress of private security guards

BACKGROUND

Professionally, private security guards are expected to manage their anger and stress successfully.

OBJECTIVE

The primary purpose of this study is to determine stress and anger levels of private security guards working in the Ankara Electricity, Gas and Bus Operations Organization. The secondary aim of this research is to determine the effectiveness of the training program given to private security guards within the scope of anger and stress control. The effects of training on 690 private security guards who participated in the training program were investigated.

METHODS

In the first part of the study, the validity and reliability of the Trait Anger, Anger Expression Scale and Coping with Stress Scale were investigated, and in the second part, the effectiveness of training given to 690 private security guards was examined. Also, as a comparison group, 201 private security guards who did not participate in the training were reached and the scales were applied.

RESULTS

The results showed that private security guards had an inability to cope with stress and anger was triggered easily. The average treatment effect was E[Y(1)   Y(0)| X] = -0.111 and statistically significant. It shows that training had a significant effect on anger. Anger decreased when stress-coping behaviours increased and the training was effective.

CONCLUSIONS

It is important that training about anger and stress control should be given to security forces at regular intervals.

The impacts of coping style and perceived social support on the mental health of undergraduate students during the early phases of the COVID-19 pandemic in China: a multicenter survey

BACKGROUND

An increasing number of undergraduate students in China have been reported to have psychological problems. In response to the COVID-19 pandemic, a series of preventive and control measures were implemented, which undoubtedly worsened their psychological health. Coping style and social support were probably important factors that affected the psychological well-being of undergraduate students during the pandemic. This study aimed to explore the effects of coping style and perceived social support on the psychological well-being of college students and relevant risk factors.

METHODS

This cross-sectional study was performed in February and March of 2020 by distributing an online questionnaire among undergraduate students from seven geographical regions across China. The questionnaire included sociodemographic information; the 21-item Depression, Anxiety and Stress Scale (DASS-21); the Perceived Social Support Scale (PSSS); and the Simplified Coping Style Questionnaire (SCSQ). For the analyses, t-tests, one-way analysis of variance (ANOVA), the Kruskal-Wallis test and multiple linear regression were utilized. The level of significance was set at P < 0.05.

RESULTS

Among 3113 college students, the rates of anxiety, depression and stress symptoms were 13.3, 15.4 and 6.8%, respectively. Increased rates of current smoking and drinking (5.5 and 25.2%, respectively) among undergraduates were identified. The results indicated that the PSSS subscales and SCSQ subscales were significantly associated with DASS-21 scores (P < 0.001). Multiple linear regression analysis showed that active coping style and family support were protective factors while passive coping style could aggravate psychological problems among participants (P < 0.001).

CONCLUSIONS

A remarkable number of college students adopted passive coping strategies to cope with negative feelings, such as smoking and drinking, which were detrimental to their mental health. In contrast, active coping strategies helped improve their psychological well-being. Moreover, family support was particularly important for maintaining their mental health and ameliorating mental health challenges in this major health crisis. Consequently, suitable psychointervention, routine screening for risk behaviors, and provision of further social support are needed for undergraduate students in the COVID-19 pandemic or other emergency public health events.

Virtual Reality Relaxation for Reducing Perceived Stress of Intensive Care Nurses During the COVID-19 Pandemic

During the COVID-19 pandemic ICU nurses endure high levels of stress. VR relaxation (VRelax, containing 360° immersive environments) provides an easy-to-use and effective means to induce positive affect and reduce perceived stress. We investigated feasibility and immediate effect on perceived stress of VRelax use by ICU nurses during work shifts. ICU nurses working with COVID-19 patients in an academic hospital could use VRelax as a 10-min break during their shift. Primary outcome was the difference between perceived stress immediately before and after VRelax use measured by a single-question VAS-stress scale. Statistically significant difference of the mean VAS-stress before and after use was determined using the paired t student test. A socio-demographic questionnaire, a questionnaire on perceived stress and stress resilience and VRelax user experiences were sent by email. Eighty-six (26%) nurses used VRelax at least once; 77% (N=66) of these filled out the VAS-stress scale before and after use of VRelax. Mean perceived stress lowered with 39.9% after use of VRelax (mean difference=14.0, SD=13.3, p<0.005). Mean score on the perceived stress scale-10 was 11.4 (SD=6.50), mean score on the Connor-Davidson Resilience Scale-10 was 29.0 (SD=5.51). Sixty-two percentage of the ICU nurses thought VRelax was helpful to reduce stress. Main barrier for use was a high workload. It is feasible for nurses to use VRelax in an ICU context. VRelax is an effective intervention to reduce immediate perceived stress and is of added value in stressful situations as during the COVID-19 pandemic, inducing a positive affective state and lowering perceived stress.

The Role of Approach and Avoidance Motivation and Emotion Regulation in Coping Via Health Information Seeking

When dealing with a health threat, health information seeking (HIS) is a prominent way of engagement coping. Yet, there is only limited research as to its motivational and emotion regulatory antecedents. We present a theoretical model integrating approach and avoidance motivation, emotion regulation, HIS self-efficacy, and problem and emotion coping focus as predictors of HIS. We propose that, in the context of HIS, (1) approach and avoidance motivation have a direct effect on emotion regulation ability (positive and negative, respectively), (2) approach and avoidance motivation have indirect effects on intended comprehensiveness of search via emotion regulation, HIS self-efficacy and problem coping focus, (3) avoidance motivation has a direct effect on emotion coping focus. Our model was tested by means of structural equation modeling in a sample of university students (N = 283). Model fit was good, and all three hypotheses were supported. We show that emotion regulation ability is essential to explain the effects of approach and avoidance motivation on HIS as it fosters self-efficacy and a problem coping focus. The direct effect of avoidance motivation on emotion focus may represent an alternative way of coping with a health threat for those individuals who are highly sensitive to threat-related emotions.

Perceived Positive and Negative Life Changes in Testicular Cancer Survivors

Background and objectives: Despite a generally good prognosis, testicular cancer can be a life-altering event. We explored perceived positive and negative life changes after testicular cancer in terms of frequency, demographic and disease-related predictors, and associations with depression and anxiety. Materials and methods: All testicular cancer survivors receiving follow-up care at two specialized outpatient treatment facilities were approached at follow-up visits or via mail. We assessed a total of N = 164 patients (66% participation rate, mean time since diagnosis: 11.6 years, SD = 7.4) by the Posttraumatic Growth Inventory (PTGI, modified version assessing positive and negative changes for each of 21 items), Patient-Health-Questionnaire-9 (PHQ-9), and Generalized-Anxiety-Disorder-Scale-7 (GAD-7). We conducted controlled multivariate regression analyses. Results: Most survivors (87%) reported at least one positive change (mean number: 7.2, SD = 5.0, possible range: 0-21). The most frequent perceived positive changes were greater appreciation of life (62%), changed priorities in life (62%), and ability rely on others (51%). At least one negative change was perceived by 33% (mean number of changes: 1.1, SD = 2.5). Negative changes were most frequent for decreases in self-reliance (14%), personal strength (11%), and ability to express emotions (9%). A higher socioeconomic status was associated with more positive changes (β = 0.25, 95% CI 0.08 to 0.42); no other association with demographic and disease-related predictors emerged. While positive life changes were not associated with depression (β = -0.05, 95% CI -0.17 to 0.07) and anxiety (β = 0.00, 95% CI -0.13 to 0.13), more negative life changes were significantly associated with higher depression (β = 0.15, 95% CI -0.03 to 0.27) and anxiety (β = 0.23, 95% CI 0.11 to 0.36). There was no significant interaction of positive and negative changes on depression or anxiety. Conclusions: Although positive life changes after testicular cancer are common, a significant number of survivors perceive negative changes in life domains that have been primarily investigated in terms of personal growth. Early identification of and psychosocial support for patients who perceive predominantly negative changes may contribute to prevention of prolonged symptoms of anxiety and depression.

Patient and carer experience of nutrition care throughout and beyond treatment for head and neck cancer: a qualitative longitudinal study

Nutrition care plays a critical role in optimising outcomes for patients receiving treatment for head and neck cancer (HNC), with carers playing an important role in supporting patients to maintain nutrition intake. This study explores patient and carer experience of nutrition care from diagnosis of HNC to 1 year post treatment completion to identify areas for improvement of service delivery. A longitudinal qualitative study design was used with a heterogeneous sample of 20 patients and 15 carers of patients undergoing curative intent treatment for HNC. Interviews conducted at four time points provided a total of 117 interview datasets that were analysed using reflexive thematic analysis based on Gadamerian hermeneutic inquiry. Patient and carer experiences were reflected in two primary themes: (1) the battle to maintain control and (2) navigating the road ahead. This research identifies the need to co-design strategies to improve nutrition care that is inclusive of patients and carers.