Latent classes of resilience and psychological response among only-child loss parents in China

A Latent Class Analysis on Indicators of Early Prolonged Grief Disorder and Well-Being Among Dutch Adults Bereaved During the First Year of the COVID-19 Pandemic

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well-being. This is the first study examining symptom profiles of early PGD and subjective mental well-being in 266 Dutch adults recently bereaved during the pandemic. Early PGD and well-being indicators were assessed with the Traumatic Grief Inventory-Self Report Plus and the World Health Organization-Five Well-Being Index, respectively. Latent class analysis identified four classes: low PGD/high well-being (32%), low PGD/moderate well-being (24%), moderate PGD/high well-being (23%) and high PGD/low well-being class (21%). People in the poorer mental health classes were more likely to be female, lower educated, suffering from a mental disorder, have a poor health status, closer kinship to the deceased, and higher risk of severe COVID-19. Classifying adults according to symptom profiles of negative and positive outcomes provides a more complete picture of mental health in bereaved people and offers potential intervention targets.

A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

A latent profile analysis of resilience and their relation to differences in sleep quality in patients with lung cancer

PURPOSE

Sleep problems are a significant issue in patients with lung cancer, and resilience is a closely related factor. However, few studies have identified subgroups of resilience and their relationship with sleep quality. This study aimed to investigate whether there are different profiles of resilience in patients with lung cancer, to determine the sociodemographic characteristics of each subgroup, and to determine the relationship between resilience and sleep quality in different subgroups.

METHODS

A total of 303 patients with lung cancer from four tertiary hospitals in China completed the General Sociodemographic sheet, the Connor-Davidson Resilience Scale, and the Pittsburgh Sleep Quality Index. Latent profile analysis was applied to explore the latent profiles of resilience. Multivariate logistic regression was used to analyze the sociodemographic variables in each profile, and ANOVA was used to explore the relationships between resilience profiles and sleep quality.

RESULTS

The following three latent profiles were identified: the "high-resilience group" (30.2%), the "moderate-resilience group" (46.0%), and the "low-resilience group" (23.8%). Gender, place of residence, and average monthly household income significantly influenced the distribution of resilience in patients with lung cancer.

CONCLUSION

The resilience patterns of patients with lung cancer varied. It is suggested that health care providers screen out various types of patients with multiple levels of resilience and pay more attention to female, rural, and poor patients. Additionally, individual differences in resilience may provide an actionable means for addressing sleep problems.

'Nobody comes to help us': lived experiences and needs of older adults who lost their only child in China

PURPOSE

This qualitative study aimed to gather insights into the experiences of older adults after losing their only child and explore meaningful life needs as a basis for social interventions.

METHODS

We conducted individual face-to-face interviews with 29 participants from 10 communities in Changsha, Hunan Province, China. Interviews were transcribed verbatim and then analysed using the inductive category development of conventional content analysis.

RESULTS

The experience of losing an only child was devastating and linked with a helpless life in old age. The analysis generated the following three themes encompassing their lived experiences and needs: afraid of getting sick, lying on the edge of misery and surrounded by loneliness.

CONCLUSIONS

Losing an only child triggered older adults' feelings of being misunderstood, disconnected and hopeless. They had an increased likelihood of lacking more on love and belonging, esteem and self-actualization needs than their physiologic and safety needs. Findings from our study will raise awareness on this vulnerable group and help design intervention programmes targeting the specific needs of this neglected segment of the population.

Heterogeneity of resilience and the curvilinear relationship between childhood trauma and resilience among people with schizophrenia

Background

As a group with a high incidence of childhood trauma, the differential characteristics of resilience in schizophrenia and its relationship with childhood trauma are still unclear.

Methods

A total of 626 individuals diagnosed with schizophrenia were selected from four psychiatric hospitals in northern China. Childhood trauma and resilience were measured using the Childhood Trauma Questionnaire-short form (CTQ-SF) and Connor-Davidson Resilience Scale (CD-RISC), respectively. Latent profile analysis (LPA) was used to identify the potential classes of resilience. A generalized additive mixed model (GAMM) and restricted cubic spline (RCS) was used to explore and determine the shape of the relationship between childhood trauma and resilience.

Results

Model fits of LPA showed three heterogeneous classes of resilience: moderate resilience levels (n = 312; 49.06%); high resilience levels (n = 171; 26.89%) and low resilience levels (n = 153; 24.06%). Resilience scores fluctuated depending on amount of exposure to childhood trauma. The GAMM results verified the non-linear relationship between resilience and childhood trauma, with an estimated degree of freedom higher than 1 (4.573) and p = 0.003. RCS fitted for ordinary least square (OLS) regression models determined a smooth continuous cubic curve of resilience across childhood trauma levels, and the two turning points of the curve line were 41.04 and 54.74 for childhood trauma.

Discussion

Our findings confirm the people-specific differences in the level of resilience in schizophrenia and describe the cubic curvilinear relationship between childhood trauma and resilience, which provides data support for mechanistic research and intervention in related fields.

Subgroups of self-directed learning ability and their differences in professional identity among nursing undergraduates during the COVID-19 pandemic: a latent profile analysis

BACKGROUND

Promoting self-directed learning (SDL) among nursing undergraduates is crucial to meet the new requirements of the healthcare system and to adapt to online learning contexts during the COVID-19 pandemic. Therefore, identifying the classification features of SDL ability and developing targeted interventions are both critical. Professional identity (PI) may contribute to the cultivation of SDL ability, but their relationship remains relatively unknown. This study aimed to explore the subgroups of SDL ability and their differences in PI among nursing undergraduates during the COVID-19 pandemic.

METHODS

A total of 2438 nursing undergraduates at four universities in China were enrolled in this cross-sectional study from November 2021 to February 2022. The Self-Directed Learning Scale of Nursing Undergraduates (SLSNU) and the Professional Identity Scale for Nursing Students (PISNS) were administered. A latent profile analysis was performed to explore SDL ability latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the PI scores in each latent profile.

RESULTS

Three latent profiles were identified and labeled 'low SDL ability' (n = 749, 30.7%), 'low initiative of help-seeking' (n = 1325, 54.4%) and 'high SDL ability' (n = 364, 14.9%). Multinomial logistic regression analysis suggested that nursing undergraduates who voluntarily chose a nursing major, had served as a student cadre, and had participated in clinical practicum were less likely to be included in the "low SDL ability" group. The average PI score was statistically different across the three profiles (F = 884.40, p < 0.001).

CONCLUSION

The SDL ability among nursing undergraduates was divided into three profiles, and results show that promoting PI may effectively foster SDL ability. This study highlights the importance of targeted interventions by considering their distinct SDL ability patterns, especially during the COVID-19 pandemic.

A Latent Class Analysis of Intergenerational Relationships Among the Elderly Migrants in Nanjing, China

Objective

This study aimed to identify (1) different types of intergenerational relationships among the elderly migrants, (2) factors influencing each type of relationship, and (3) the types significantly associated with psychological well-being of the elderly migrants.

Methods

Data were collected from 654 elderly migrants in Nanjing, China. Incorporating ten solidarity conflict indicators, the latent class analysis (LCA) was performed to classify intergenerational relationships. Logistic regression were used to analyze influencing factors, and ordinary least squares (OLS) regression was used to analyze the relationship of each type of intergenerational relationship with depression and life satisfaction.

Results

Three types of intergenerational relationships were classified: tight-knit (65%), conflicting (25%), distant intimate (10%). Gender, marital status, education level, annual income, subjective health, number of children and parentage were influencing factors for the three types. The tight-knit type predicted a healthy mental status.

Discussion

Three intergenerational relationships exist between elderly migrants and their children in Nanjing, China. A closer relationship predicts a better mental health in the elderly migrants.

Psychological Resilience among Left-Behind Children in a Rural Area of Eastern China

Childhood is an important period for individuals’ psychological development. Due to long-term separation from the parents, left-behind children (LBC) more easily develop deviation in cognition and abnormal personality. In this study, we aimed to explore the status of psychological resilience among LBC in a rural area of eastern China. We carried out a cross-sectional survey including middle and high school students from Qingyuan County of Zhejiang Province. Psychological resilience was measured using a modified scale developed for Chinese children. Data from a total of 1086 participants were collected, and the mean ± standard deviation score of psychological resilience was 4.11 ± 0.42. Multivariable linear regression analyses revealed that being a class leader (p = 0.010) and having high self-evaluation of academic performance (p < 0.001) were related with psychological resilience. Moreover, high contact frequency between parents and children (p = 0.019) was associated with better psychological resilience among LBC. In conclusion, we found that being a class leader and having high self-evaluation of academic performance were associated with better psychological resilience among the children in this rural area and contact between parent and child was an essential factor associated with psychological resilience among LBC.

Subtypes of work engagement in frontline supporting nurses during COVID-19 pandemic: A latent profile analysis

AIM

The aim was to examine the subgroups of work engagement in frontline nurses during the COVID-19 pandemic.

BACKGROUND

The pandemic may affect the work engagement of nurses who have direct contact with infected patients and lead to a poor quality of care. Identifying classification features of work engagement and tailoring interventions to support frontline nurses is imperative.

DESIGN

This study utilized a cross-sectional study design.

METHODS

Three hundred fifty-five nurses were enrolled in this cross-sectional study from 14 February to 15 April 2020. A latent profile analysis was performed to identify classification features of work engagement. Multiple logistic regression analyses were used to examine predictors of profile membership.

RESULTS

A four-profile model provided the best fit. The four profiles were titled 'low work engagement' (n = 99), 'high vigour-low dedication and absorption' (n = 58), 'moderate work engagement' (n = 63) and 'high work engagement' (n = 135). A regression analysis suggested that young nurses and nurses who were the only children of their family were more likely to be in the 'low work engagement' and 'high vigour-low dedication and absorption' groups.

CONCLUSION

This study highlights the importance of tailoring interventions for frontline supporting nurses by considering their distinct work engagement patterns, especially during the COVID-19 pandemic, to improve the promotion of work satisfaction and quality of care.

IMPACT

This was the first study to explore the latent profiles of work engagement in frontline nurses during the COVID-19 pandemic. Over 40% of nurses were in the 'low work engagement' and 'high vigour-low dedication and absorption' groups and reported low levels of work engagement. Understanding different patterns of work engagement in frontline nurses can help nursing managers provide emotional, material and organizational support based on the features of each latent profile, which may improve the quality of care and patient safety.

A latent class analysis of resilience and its relationship with depressive symptoms in the parents of children with cancer

PURPOSE

Depressive symptoms are among the most common afflictions that plague the parents of children with cancer. Given that resilience is an important factor that inhibits the development and progression of depressive symptoms, it can be harnessed as a potential solution for this psychological issue. This study aimed to identify the latent classes of resilience in the parents of children with cancer and explore the relationships of these classes with depressive symptoms.

METHODS

The study was conducted in three tertiary hospitals in mainland China. The parents of children (0-19 years old) with cancer were invited to participate in the study. We used standardised self-report questionnaires to collect data. A latent class analysis was performed to identify the classes of resilience in the parents of children with cancer.

RESULTS

The study recruited 258 participants. Four classes of resilience were identified, namely, good adaptation and optimism (24.9%), high strength and low control (12.1%), moderate resilience (37.3%), and maladaptation and low tenacity (25.6%). The mothers (OR = 3.48, P = 0.003) and parents with more than one child (OR = 2.73, P = 0.023) were more likely to belong to the maladaptation and low tenacity class. The depressive symptoms experienced by the participants differed significantly between the four classes of resilience (F = 30.80, P < 0.001).

CONCLUSION

Targeted interventions should be developed and implemented based on the characteristics of each class of resilience to maximise the effectiveness of interventions and thereby promote parental well-being.

Resilience Predicts the Trajectories of College Students' Daily Emotions During COVID-19: A Latent Growth Mixture Model

The objective of this study was to examine the association between resilience and trajectories of college students’ negative and positive affect during the COVID-19 pandemic. A total of 391 college students recruited from China completed a daily online negative and positive affect scale for 1 week, and their resilience was also measured. Profiles of brief trajectories of negative and positive affect over time were identified using the latent growth mixture model, and the effect of resilience on these trajectories was further explored. Two latent profiles of negative affect were found: a constant high negative affect profile and a slowly decreasing low negative affect profile, while three latent profiles of positive affect were identified: a slowly increasing high positive affect profile, a rapidly decreasing medium positive affect profile, and a constant medium positive affect profile. The optimism dimension of resilience predicted the membership in the various profiles significantly, whereas the prediction of tenacity and strength dimensions of resilience was not significant. Activities that promote resilience, especially optimism, should be included to improve the daily emotions of college students during COVID-19.