Resilience to emotional distress in response to failure, error or mistakes: A systematic review

Static and Temporal Dynamic in Functional Connectivity of Large-scale Brain Networks During Acute Stress Regulate Stress Resilience Differently: The Promotion Role of Trait Resilience

Stress resilience has been largely regarded as a process in which individuals actively cope with and recover from stress. Over the past decade, the emergence of large-scale brain networks has provided a new perspective for the study of the neural mechanisms of stress. However, the role of inter-network functional-connectivity (FC) and its temporal fluctuations in stress resilience is still unclear. To bridge this knowledge gap, seventy-seven participants (age, 17-22 years, 37 women) were recruited for a ScanSTRESS brain imaging study. A static perspective was initially adopted, using changes in FC that obtained from stress vs. control condition during the entire stress induction phase as a static indicator. Further, changes in FC between different stress runs were analyzed as an index of temporal dynamics. Stress resilience was gauged using salivary cortisol levels, while trait resilience was measured via behavioral-activation-system (BAS) sensitivity. Results found that, for the static index, enhanced FC between the salience-network (SN), default-mode-network (DMN) and limbic-network (LBN) during acute stress could negatively signal stress resilience. For the temporal dynamics index, FC among the dorsal-attention-network (DAN), central-executive-network (CEN) and visual-network (VN) decreased significantly during repeated stress induction. Moreover, the decline of FC positively signaled stress resilience, and this relationship only exist in people with high BAS. The current research elucidates the intricate neural underpinnings of stress resilience, offering insights into the adaptive mechanisms underlying effective stress responses.

Effects of self-healing training on perfectionism and frustration tolerance in mothers of single-parent students

It is essential to focus on the variables that can empower mothers of single-parent students. The present study aimed to investigate the effects of self-healing training on perfectionism and frustration tolerance in mothers of single-parent students. The statistical population included all divorced mothers of elementary school students within the 2020-21 academic year. Sampling was performed in two stages, the first of which was multistage cluster sampling, whereas the second stage was purposive sampling based on inclusion and exclusion criteria. The study sample (n = 40) was divided into two groups of 20 (control and experimental). This quasi-experimental research adopted a pretest-posttest control group design with follow-up. The experimental group was trained in the self-healing protocol for fourteen weekly 90-minute sessions. The repeated measures ANOVA in SPSS-26 was then used for data analysis. The mean ± SD of perfectionism in the self-healing and control groups in the posttest was 67.75 ± 11.84 and 106.05 ± 22.01. Moreover, in the posttest stage, the mean ± SD of frustration tolerance in the intervention and control groups was 78.60 ± 7.93 and 99.45 ± 9.36, respectively. According to findings, self-healing training significantly affected the components of perfectionism including personal standards, concern over mistakes, and parental criticism. It also had significant effects on the components of frustration tolerance including discomfort intolerance, emotional intolerance, and achievement made by single mothers of students. The results were stable over time. However, self-healing training had no significant effects on perfectionism entitlement and subscales of frustration tolerance including discipline and organization, doubt about actions, and parental expectations.

Association between non-restorative sleep and psychotic-like experiences among Chinese college students: A latent profile and moderated mediation analysis

BACKGROUND

Non-restorative sleep (NRS) is a core symptom of insomnia that has considerable consequences for daily life. However, the association between NRS and psychotic-like experiences (PLEs) remains unclear. The current study was designed to explore the relationship between NRS and PLEs as well as the mediation/moderation role of rumination and resilience among college students in China.

METHODS

3060 college students were recruited from two universities in South China from September 21st to October 26th, 2022. Non-restorative Sleep Scale, 8-item Positive Subscale of the Community Assessment of Psychic Experiences, Ruminative Response Scale, and 10-item Connor-Davidson Resilience Scale were administered. Latent profile analysis and moderated mediation analysis were performed.

RESULTS

11.3 % participants reported frequent PLEs in the past one month. Three profiles of rumination were identified and named as "low rumination" group (27.7 %), "medium rumination" group (55.3 %), and "high rumination" group (16.9 %). NRS directly predicted PLEs, and rumination played a significant mediation role between NRS and PLEs. Resilience significantly moderated the association between NRS and rumination as well as the association between NRS and PLEs.

CONCLUSIONS

NRS, rumination and resilience are important predictors to PLEs. Strategies on increasing restorative sleep, decreasing rumination, and enhancing resilience are of great significance in the prevention of PLEs.

Can the Reboot coaching programme support critical care nurses in coping with stressful clinical events? A mixed-methods evaluation assessing resilience, burnout, depression and turnover intentions

BACKGROUND

Critical care nurses (CCNs) are routinely exposed to highly stressful situations, and at high-risk of suffering from work-related stress and developing burnout. Thus, supporting CCN wellbeing is crucial. One approach for delivering this support is by preparing CCNs for situations they may encounter, drawing on evidence-based techniques to strengthen psychological coping strategies. The current study tailored a Resilience-boosting psychological coaching programme [Reboot] to CCNs. Other healthcare staff receiving Reboot have reported improvements in confidence in coping with stressful clinical events and increased psychological resilience. The current study tailored Reboot for online, remote delivery to CCNs (as it had not previously been delivered to nurses, or in remote format), to (1) assess the feasibility of delivering Reboot remotely, and to (2) provide a preliminary assessment of whether Reboot could increase resilience, confidence in coping with adverse events and burnout.

METHODS

A single-arm mixed-methods (questionnaires, interviews) before-after feasibility study design was used. Feasibility was measured via demand, recruitment, and retention (recruitment goal: 80 CCNs, retention goal: 70% of recruited CCNs). Potential efficacy was measured via questionnaires at five timepoints; measures included confidence in coping with adverse events (Confidence scale), Resilience (Brief Resilience Scale), depression (PHQ-9) and burnout (Oldenburg-Burnout-Inventory). Intention to leave (current role, nursing more generally) was measured post-intervention. Interviews were analysed using Reflexive Thematic Analysis.

RESULTS

Results suggest that delivering Reboot remotely is feasible and acceptable. Seventy-seven nurses were recruited, 81% of whom completed the 8-week intervention. Thus, the retention rate was over 10% higher than the target. Regarding preliminary efficacy, follow-up measures showed significant increases in resilience, confidence in coping with adverse events and reductions in depression, burnout, and intention to leave. Qualitative analysis suggested that CCNs found the psychological techniques helpful and particularly valued practical exercises that could be translated into everyday practice.

CONCLUSION

This study demonstrates the feasibility of remote delivery of Reboot and potential efficacy for CCNs. Results are limited due to the single-arm feasibility design; thus, a larger trial with a control group is needed.

Cognitive Reappraisal Moderates the Longitudinal Relationship between Adolescents' Peer Victimization and Self-Esteem. A Latent Interaction Model

Poor self-esteem relates closely to youth maladjustment and appears to be predicted by peer victimization experiences. However, not all peer victimized adolescents face the same risk for self-esteem erosion over time. Drawing upon the Bi-Dimensional Framework for resilience and extant research, the present study examined the potential moderating role of cognitive reappraisal in the prospective relationship from peer victimization to self-esteem. To increase precision of findings the long-term impact of self-esteem on peer victimization was also tested. Self-reported data were collected from 285 early adolescents (Mage = 10.53 years, SD = 0.16; 54.0% girls) at two waves, spaced 1-year. Latent moderated structural equation analysis showed that peer victimization was negatively related to later self-esteem, but only for youth displaying low levels of cognitive reappraisal. For adolescents with high levels of cognitive reappraising, peer victimization was not found to predict any changes in self-esteem over time. The long-term impact of self-esteem on peer victimization was not supported. Overall the present study suggests that enhancing cognitive reappraisal could be a promising avenue for lowering risk for poor self-esteem in young individuals experiencing peer victimization.

Learning What Works: A Mixed-Methods Study of American Self-identified Food Conservers

OBJECTIVE

Identify psychosocial factors influencing food waste mitigation and explore motivations and strategies for successful conservation among self-identified food conservers.

METHODS

Mixed-methods study consisting of an online survey estimating food waste production and psychosocial factors and a focus group to explore waste mitigation strategies and motivations.

RESULTS

Sampled 27 self-identified conservers (female, aged 18-30 years, White/Asian). Mean household food waste was 6.6 cups/wk (range, 0.0-97.9 cups/wk; median 1.3 cups). Reported waste mitigation strategies include proactive mitigation and adaptive recovery measures in each phase of the food management continuum. Conservers reported various intrinsic and extrinsic motivations to reduce food waste and viewed barriers as manageable.

CONCLUSIONS AND IMPLICATIONS

Food conservers act on high intentions to reduce waste by consistently employing both proactive waste mitigation and adaptive food recovery measures. Future research is needed to determine if these findings hold in larger, more diverse samples and link specific behaviors to waste volume.

Framing doctor-managers' resilience during Covid-19 pandemic: A descriptive analysis from the Italian NHS

With the aim of providing evidence about doctor-managers' resilience during the Covid-19 pandemic, this study analyzes the characteristics of 114 doctor-managers operating within the Italian National Health Service (NHS). During the emergency, doctor-managers had to show adaptive capacities to deal with unexpected situations and develop new paradigms, procedures, and quick responses to patients' needs. This is in line with resilience, and in this perspective, it is crucial to investigate resilience determinants. The paper, therefore, provides an identikit of the resilient doctor-manager. The research was conducted between November and December 2020. Primary data were collected through an online questionnaire consisting of six sections. Participation was voluntary and anonymous. Data were analyzed using quantitative techniques and employing Stata 16. Confirmatory Factor Analysis was employed to test construct validity and scale reliability. Results show that increasing levels of individual resilience are related to increasing levels of managerial identity. Moreover, physicians' individual resilience has a positive association with commitment, knowledge diffusion, and Evidence-Based Medicine adoption. Finally, physicians' individual resilience has a negative association with their role in the university, their specialty, and their gender. The study suggests some practical implications for healtcare organizations. In general, career paths are decided primarily on competency assessment, while an important role should be devoted to behavioral characteristics. Furthermore, organizations should take care of the levels of individual commitment and encourage professional networking because both help doctor-managers cope with uncertainty. The originality of the study relies on a fresh look at all previous work. There are currently few contributions in the literature to explore and investigate resilience elements in doctor-managers during the pandemic era.

The Role of Resilience in the Impact of Family Economic Adversity on Youth Emotional Distress over Time

Previous research has highlighted the enduring negative impact of family economic adversity on youth emotional well-being. However, the longitudinal mechanism underlying the link between economic adversity and emotional distress is less explored. The present study examined the longitudinal pathway of parent economic adversity, and parent and adolescent emotional distress at age 16, parental support at age 21, youth self-esteem and mastery at age 23, and adult emotional distress at age 27. Data came from the Family Transitions Project (N = 441, 57% female), a 30-year study of families from the rural Midwest. Structural equation models revealed that economic adversity exerted a long-term negative influence on adult emotional well-being through parent and adolescent emotional distress and youth self-esteem and mastery. Additionally, parental support was associated with adult emotional distress through youth self-esteem and mastery. The current study advances our understanding of youth emotional well-being by suggesting a longitudinal family process and resilience pathways from adolescence to early adulthood.

Mental health of general practitioners in Chongqing, China during COVID-19: a cross-sectional study

OBJECTIVES

In the context of the COVID-19 pandemic, general practitioners (GPs) continue to face unprecedented challenges that affect their mental health. However, few studies have assessed the mental health status of GPs. This study aimed to provide preliminary understanding of stress, job burn-out and well-being levels among GPs to train and manage them during public health emergencies.

DESIGN

We conducted a cross-sectional online self-report survey.

SETTING

The survey was conducted in Chongqing, China from July to August 2022.

PARTICIPANTS

Data were collected from 2145 GPs, with an effective response rate of 91.0%.

PRIMARY AND SECONDARY OUTCOME MEASURES

The main evaluation indicators were stress (Cohen's Perceived Stress Scale), job burn-out (Maslach Burnout Inventory-Human Services Survey Scale) and well-being (WHO-5 Well-Being Index). Multiple linear regression analysis was used to compare the effect of different demographic characteristics on the impact of stress, job burn-out and decreased well-being.

RESULTS

Stress, job burn-out and decreased well-being were common among GPs. In this study, 59.7% experienced job burn-out, 76.1% experienced high levels of stress and 52.0% may have experienced depression. The main factors that influenced stress, burn-out and well-being were differences in age, working hours per week, title, part-time management work, work-life balance, sleep disorders, whether GPs received adequate recognition by patients and the work team and mental toughness (p<0.05).

CONCLUSION

This survey is the first to investigate stress, job burn-out and well-being levels among local GPs in China during the COVID-19 pandemic. Curbing stress and job burn-out levels and ensuring well-being among GPs could be achieved by reducing paperwork, management work and working hours; promoting life and work balance; and increasing resilience among GPs. The findings provide a basis for policy-makers to formulate strategies for developing general practice.

Evaluation of the reboot coaching workshops among urology trainees: A mixed method approach

Background

Urology trainees experience high burnout, and there is an urgent need for acceptable and effective interventions. The current study evaluated Reboot coaching workshops (Reboot-C), a tailored intervention based on cognitive-behavioural principles, with urology trainees.

Objective

Our primary objective was to evaluate the acceptability of Reboot-C among urology trainees. In addition, this study aimed to investigate whether there were changes in confidence, resilience, depression and burnout levels.

Materials and method

A single-arm design was used, including pre- and post-online questionnaires and semi-structured interviews.

Result

Twenty-one urology trainees replied to the survey, attended both Reboot-C workshops and responded to the post-intervention questionnaire. Thirteen of 21 (61%) urology trainees participated in the interview. Participating in Reboot-C was associated with significant improvements in resilience and confidence and a significant reduction in burnout. However, there was no significant reduction in depression. Qualitative data indicated that Reboot was acceptable and helped participants develop useful skills.

Conclusion

These findings pave the way for more conclusive studies on the efficacy of Reboot-C for surgeons.

COVID-19 meets control-value theory: Emotional reactions to canceled high-stakes examinations

In many countries, examinations scheduled for summer 2020 were canceled as part of measures designed to curb the spread of the COVID-19 pandemic. To examine how four retrospective emotions about canceled examinations (relief, gratitude, disappointment, and anger) and one prospective emotion (test anxiety) were related to control-value appraisals, a sample of 474 participants in the UK aged 15-19 years, who would have taken high-stakes examinations if they had not been canceled, self-reported measures of control, value, retrospective emotions and test anxiety. Data were analysed using the confirmatory factor analysis within exploratory structural equation modeling (EwC) approach. Relief, gratitude, and anger were predicted from expectancy × value interactions. Disappointment was related to expectancy only. Test anxiety was predicted independently by expectancy and positive/negative value. Findings offer broad support for Control-Value Theory and show how the appraisals underpinning achievement emotions can differ when focused on canceled examinations rather than success or failure.

Relationship between sleep disturbance and burnout among Chinese urban teachers: Moderating roles of resilience

BACKGROUND

Sleep disturbance and burnout are prevalent among primary and secondary school teachers. Nevertheless, little is known about the relationship between sleep disturbance and burnout, and the mechanisms connecting this link. Our study aimed to explore the relationship between sleep disturbance and burnout among urban teachers, as well as to investigate this influencing mechanism further with resilience as a moderator.

METHODS

14,218 primary and secondary school teachers provided valid data. We assessed demographic information, sleep disturbance, burnout, and resilience. Multivariable logistic regression, Spearman correlation, and moderation analyses were used to evaluate the relationship between sleep disturbance and burnout and the moderating role of resilience.

RESULTS

Of the participants, the prevalence of sleep disturbance and sleep deprivation among teachers was 20.0% and 31.7%, respectively. Additionally, 58.4% of teachers reported moderate or severe burnout, and 15.3% had both sleep disturbance and burnout. Sleep disturbance was significant and positively related to burnout. Resilience was found to moderate the association between sleep disturbance and burnout.

CONCLUSIONS

These findings suggested strong associations between sleep disturbance and burnout. Interventions in improving resilience may protect teachers with sleep disturbance from burnout.

Surviving Burnout as an Oncologist

PURPOSE OF REVIEW

The aim of this review is defining burnout in medical oncologists, analyzing the causes, and evaluating both individual and institutional approaches to overcome burnout.

RECENT FINDINGS

Burnout is defined as a reaction to long-term work-related stress, which is a serious condition and has negative consequences at both personal and professional levels. In recent years, there has been a greater emphasis on burnout in medicine in general and specifically in oncology given the complexity of care provided to oncology patients. More research is being done in this field and more coping strategies are evolving to help oncologists reduce the amount of stress and burnout they are experiencing. Oncologists need to recognize and acknowledge burnout and use different strategies to find joy in their work while maintaining their work-life balance. Strategies like individual-directed interventions and organizational-directed interventions, such as providing support and resources to oncologists to relieve their work-related stress may have a positive impact on oncologists' well-being, their patients' care, and satisfaction.

The influence of resilience on stress reaction of college students during COVID-19: the mediating role of coping style and positive adaptive response

The COVID-19 pandemic was a stressful event for all. It threatened people's physical and mental health. Previous studies have found that resilience can help people deal with stress and difficulties more effectively and prevent them from mental health problems. Coping style mediates the relationship between resilience and psychological well-being. Given the novelty and recency of the COVID-19, it is unknown whether resilience can also protect individuals in new difficulties, and whether the previous effective coping styles can be applied to new situations. The current study aimed to explore the influence mechanism of college students' resilience on negative stress response during the pandemic, and the chain mediation of coping style and positive adaptive response. A questionnaire survey was conducted among 910 college students (Mage = 20.58 years; 41.1% men, 58.9% women) studying in Shanghai by stratified random cluster sampling. At that time, they were in 27 different provinces and cities because of the COVID-19 pandemic lockdown. The research tools included Connor-Davidson Resilience Scale (CD-RISC), Simplified Coping Style Questionnaire (SCSQ), Positive Adaptive Response Questionnaire (PARQ), and Negative Stress Reaction Questionnaire (NSRQ). The results showed that: (1) College students' resilience, coping style, positive adaptive response and negative stress reaction were significantly correlated with each other; (2) Resilience could not directly affect negative stress reaction, but it could affect negative stress reaction through the chain mediation of coping style and positive adaptive response. These findings suggest that resilience enhancement intervention programs need to focus on the cultivation of individual positive coping style; In response to major emergencies such as the COVID-19 pandemic, officials can help people reduce negative stress reaction by disseminating positive coping strategies through the media.

A Survey of the Relationship Between Trait Anxiety and Mental Resilience of Marathoners in China

This study aims to investigate the relationship between trait anxiety and mental resilience in marathoners and the general population. The study recruited 135 marathoners and 140 members of the general population. Trait anxiety and mental resilience were measured by the State-Trait Anxiety Scale and the Chinese version of the Connor-Davidson Resilience Scale. The amount of weekly exercise resulted in significant differences in the trait anxiety ( F = 6.358, p < 0.01) and mental resilience ( F = 5.996, p < 0.05) levels of the general population and marathoners. Age led to a significant difference in the trait anxiety of marathoners ( F = 10.890, p < 0.01). The half marathoners' daily exercise program is most suitable for the general population for reducing trait anxiety level and increasing mental resilience. Furthermore, marathoners showed lower trait anxiety and higher mental resilience. Therefore, long-term marathon adherence can help improve mental health.

Impact of social support on college students' anxiety due to COVID-19 isolation: Mediating roles of perceived risk and resilience in the postpandemic period

Introduction

Because of the outbreak of COVID-19, several colleges and universities in Xi'an, China, implemented quarantine measures and closed their gates, which increased anxiety among the students.

Methods

The Perceived Social Support Scale, Perceived Risk of COVID-19 Pandemic Scale, Connor-Davidson Resilience Scale, and Self-Rating Anxiety Scale were used for measurements. SPSS26 and AMOS26 (IBM SPSS AMOS Statistics, New York, United States) were used for data analysis. Structural equation modeling (SEM) was used to test the data from the 2,251 respondents and the hypothetical model.

Results

The students' perceived social support was discovered to have had a significant negative effect on anxiety. The students' perceived COVID-19 risk and resilience played significant mediating roles in the relationship between social support and anxiety.

Discussion

When college students feel social support and have resilience, they can reduce anxiety during the epidemic stage. Therefore, education administrators and parents should help college students to identify the current situation of the epidemic environment, enrich relevant knowledge.

Interactions between attributions and beliefs at trial-by-trial level: Evidence from a novel computer game task

Inferring causes of the good and bad events that we experience is part of the process of building models of our own capabilities and of the world around us. Making such inferences can be difficult because of complex reciprocal relationships between attributions of the causes of particular events, and beliefs about the capabilities and skills that influence our role in bringing them about. Abnormal causal attributions have long been studied in connection with psychiatric disorders, notably depression and paranoia; however, the mechanisms behind attributional inferences and the way they can go awry are not fully understood. We administered a novel, challenging, game of skill to a substantial population of healthy online participants, and collected trial-by-trial time series of both their beliefs about skill and attributions about the causes of the success and failure of real experienced outcomes. We found reciprocal relationships that provide empirical confirmation of the attribution-self representation cycle theory. This highlights the dynamic nature of the processes involved in attribution, and validates a framework for developing and testing computational accounts of attribution-belief interactions.

As part of interpreting our experiences, we spontaneously make causal attributions and use them to update our beliefs about the world, ourselves and others. This has long been a topic of interest, particularly within psychiatry. Some theories assume that people have stable “attributional styles”, others focus on the changing nature of attribution-making and on the relationships between attributions and one’s beliefs about the self, suggesting that the two are mutually connected. In this area of research, people have traditionally been asked to imagine themselves experiencing various significant life events and report on how they would interpret those, or have been exposed to artificial and highly simplified situations in the lab. In this work, we introduce a new task to study relationships between causal attributions and beliefs: repeatedly playing an engaging and relatively complex game of skill. We show that we can detect mutual influences between attributions and beliefs at the level of individual wins and losses. This has implications for how everyday successes and failures impact our beliefs about ourselves and our well-being. It also could help understand how our interpretations of negative experiences can spiral out of control, affecting our mental health.

Toward Constructive Change After Making a Medical Error: Recovery From Situations of Error Theory as a Psychosocial Model for Clinician Recovery

BACKGROUND

Making a medical error is a uniquely challenging psychosocial experience for clinicians. Feelings of personal responsibility, coupled with distress regarding potential or actual patient harm resulting from a mistake, create a dual burden. Over the past 20 years, experiential accounts of making an error have provided evidence of the associated distress and impacts. However, theory-based psychosocial support interventions to improve both individual outcomes for the involved clinicians and system-level outcomes, such as patient safety and workforce retention, are lacking. There is a need for evidence-based ways to both structure and evaluate interventions to decrease the distress of making a medical error and its impacts. Such interventions play a role within wider programs of health professional support. We sought to address this by developing a testable, psychosocial model of clinician recovery after error based on recent evidence.

METHODS

Systematic review methodology was used to identify studies published between January 2010 and June 2021 reporting experiences of direct involvement in medical errors and/or subsequent recovery. A narrative synthesis was produced from the resulting articles and used as the basis for a team-based qualitative approach to model building.

RESULTS

We identified 25 studies eligible for inclusion, reporting evidence primarily from experiences of doctors and nurses. The identified evidence indicates that coping approach, conversations (whether they occur and whether they are perceived to be helpful or unhelpful), and learning or development activities (helpful, unhelpful or absent) may influence the relationship between making an error and both individual clinician outcomes of emotional impact and resultant practice change. Our findings led to the development of the Recovery from Situations of Error Theory model, which provides a preliminary theoretical basis for intervention development and testing.

CONCLUSIONS

The Recovery from Situations of Error Theory model is the first testable psychosocial model of clinician recovery after making a medical error. Applying this model provides a basis to both structure and evaluate interventions to decrease the distress of making a medical error and its impacts and to support the replication of interventions that work across services and health systems toward constructive change. Such interventions may be embedded into the growing body of peer support and employee support programs internationally that address a diverse range of stressful workplace experiences.

Just listen to your mind: Consequences of theory of mind development for deaf or hard-of-hearing children

BACKGROUND

Previous research reveals relations between theory of mind (ToM) and cognitive outcomes, but mostly among typically developing children.

AIM

To study these relations in children with developmental difficulties, this longitudinal study investigated the cognitive consequences of ToM in deaf or hard-of-hearing (DHH) children.

METHODS AND PROCEDURES

One hundred and thirty-four (X = 9.2 years) participants were assessed in three waves, i.e., one wave every ten months. The participants completed the ToM scale, language and literacy skills (LLS) tests, the academic self-concept in language (ASC-L) questionnaire, and the sensitivity to criticism measure.

OUTCOMES AND RESULTS

The results revealed that high levels of children's ToM ability predicted higher levels of LLS 20 months later. Mediators of this association were sensitivity to criticism and ASC-L. Controlling for LLS at T1, ASC-L at T2 mediated the relations between ToM and LLS at T3. Moreover, sensitivity to criticism predicted ASC-L, and sensitivity to criticism and ASC-L mediated the relation between ToM and LLS at T3. That is, children who were sensitive to criticism and held positive views of their academic self were also better skilled in ToM and in LLS.

CONCLUSIONS AND IMPLICATIONS

Our results can help improve the education of DHH students.

Multiple meanings of resilience: Health professionals' experiences of a dual element training intervention designed to help them prepare for coping with error

RATIONALE, AIMS AND OBJECTIVES

Consistent data demonstrates negative psychological effects of caregiving on front-line health professionals. Evidence that psychological resilience factors can help minimize distress and the potential for low-cost interventions have created interest in resilience-based development programmes; yet evidence of perceived value amongst health professionals is lacking. This study explored health professionals' experiences and perceptions of a novel, resilience-based intervention designed to pro-actively prepare staff for coping with error; to investigate their perceptions of what resilience meant to them, the relevance of the intervention, and impact of participation on ability to cope with error.

METHODS

Semi-structured interviews 4-6 weeks post intervention with 23 randomly selected participants from seven cohorts (midwives, paediatricians, obstetricians/gynaecologists, paramedics) and trainees (physician associates, mammographers, sonographers). Thematic analysis of interview data.

FINDINGS

Participants reported various interpretations of, and a shift in perception regarding what the concept of psychological resilience meant to them and their practice. These included for example, resilience as a positive or negative concept and their awareness and response to a range of personal, organizational and system factors influencing personal resilience. They valued the prophylactic, clinically relevant, interactive and applied nature of the intervention; having developed and applied valuable skills beyond the context of involvement in error, noting that individuals needed to be willing to explore their own coping mechanisms and human fallibility to gain maximum benefit. There was also consensus that whilst proactively developing individual level psychological resilience is important, so too is addressing the organizational and system factors that affect staff resilience which are outside individual staff control.

CONCLUSION

Enhancing resilience appears to be considered useful in supporting staff to prepare for coping with error and the wider emotional burden of clinical work, but such interventions require integration into wider system approaches to reduce the burden of clinical work for health professionals.

Study protocol for the online adaptation and evaluation of the 'Reboot' (Recovery-boosting) coaching programme, to prepare critical care nurses for, and aid recovery after, stressful clinical events

Background

Critical care nurses (CCNs) are routinely exposed to highly stressful events, exacerbated during the COVID-19 pandemic. Supporting resilience and wellbeing of CCNs is therefore crucial to prevent burnout. One approach for delivering this support is by preparing critical care nurses for situations they may encounter, drawing on evidence-based techniques to strengthen relevant psychological coping strategies. As such, the current study seeks to tailor a Resilience-boosting psychological coaching programme [Reboot] for CCNs, based on cognitive behavioural therapy (CBT) principles and the Bi-Dimensional Resilience Framework (BDF), and (1) to assess the feasibility of delivering Reboot via online, remote delivery to CCNs, and (2) to provide a preliminary assessment of whether Reboot could increase resilience and confidence in coping with adverse events.

Methods

Eighty CCNs (n=80) will be recruited to the 8-week Reboot programme, comprised of two group workshops and two individual coaching calls. The study uses a single-arm before-after feasibility study design and will be evaluated with a mixed-methods approach, using online questionnaires (all participants) and telephone interviews (25% of participants). Primary outcomes will be confidence in coping with adverse events (the Confidence scale) and resilience (the Brief Resilience Scale) measured at four time points.

Discussion

Results will determine whether it is feasible to deliver and evaluate a remote version of the Reboot coaching programme to CCNs, and will indicate whether participating in the programme is associated with increases in confidence in coping with adverse events, resilience and wellbeing (as indicated by levels of depression).

Shadow of Your Former Self: Exploring Project Leaders’ Post-Failure Behaviors (Resilience, Self-Esteem and Self-Efficacy) in High-Tech Startup Projects

Globally, demands for sustainable strategies in the ICT industry have attracted greater momentum as high-tech projects continue to fail in large numbers. Recent studies have underpinned project resilience as a major factor for overcoming these increasing project failures, delays, or termination. However, the complex behaviors of resilient project leaders, especially in post-failure conditions, have been largely overlooked. To address this critical research gap, the present study identifies the direct relationships between three potential behavioral traits of project leaders (i.e., resilience, self-esteem, and self-efficacy) and examines how they move forward beyond project failures. The present study also explored whether self-esteem mediates project leaders’ resilience and self-efficacy. Drawing on data from 232 project leaders in Pakistan’s high-tech start-ups, the new findings suggest that there are significant positive effects of project leaders’ resilience and self-esteem on their self-efficacy, and that project leaders’ resilience and self-efficacy is significantly mediated by their self-esteem. As the project resilience theory gains traction, the present study findings have pinpointed major steps for meeting project challenges ahead of time, allowing leaders and teams to learn from failures, and also for improving organisations’ ability to implement successful and sustainable high-tech projects especially in emerging economies.

Stressors and vulnerability during upper secondary school: subjective experiences of classroom climate and coping beliefs as predicting factors of school stress in Norway

The present longitudinal study was designed to scrutinize how adolescents perceive their life in upper secondary schools in general, and how central aspects of their perceived classroom climate predicted their coping beliefs and experience of school stress in particular. The participants were 1215 students in upper secondary schools (grades 2 and 3) from one county in Norway. The data were analysed by means of structural equation modelling, and the findings reveal gender differences that need further investigation in future research. Our study indicates that a performance-oriented goal structure and social support from peers and teachers seem to be a potential risk factor and/or protective factor when it comes to adolescents’ development of coping beliefs and experiences of school stress, especially among girls.

Psychological Resilience in Young Female Athletes

Psychological resilience is an important construct that can enhance athletic performance and foster valuable life skills. Through positive adaptation to adversity and stressors in the athletic arena, athletes are able to cultivate their ability to effectively respond to negative stimuli, ultimately evolving to personal growth. For young female athletes, development of resilience may be particularly important. Young female athletes face distinct challenges in sport including sport inequity, body image issues, eating disorders, increased mental distress, and internalization of emotions. The aim of this review is to define and describe the construct of resilience and discuss the implications and applications relevant to young female athletes. By understanding how to foster resilience strategies in this population, we can enhance sport performance and enjoyment, as well as bolster valuable life skills that facilitate personal growth.

Support for Healthcare Professionals After Surgical Patient Safety Incidents: A Qualitative Descriptive Study in 5 Teaching Hospitals

OBJECTIVE

Patient safety incidents can have a profound effect on healthcare professionals, with some experiencing emotional and psychological distress. This study explored the support medical and nonmedical operating room staff received after being involved in a surgical patient safety incident(s) in 5 UK teaching hospitals.

METHODS

An invitation letter and information sheet were e-mailed to all medical and nonmedical operating room staff (N = 927) across the 5 sites. Semistructured interviews were arranged with a range of different healthcare professionals working in operating rooms across a wide variety of surgical specialities. Interviews were audio recorded, transcribed verbatim, and analyzed using an inductive thematic approach.

RESULTS

We conducted 45 interviews with medical and nonmedical operating room staff, who emphasized the importance of receiving personalized support soon after the incident. Operating room staff described how the first "go to" people were their peers and reported feeling comforted when their peers empathized with their own experience(s). Other participants found it very difficult to seek support, perceiving it as a sign of weakness. Although family members played an important role in supporting second victims, some participants felt unable to discuss the incident with them, fearing that they might not understand.

CONCLUSIONS

There should be clear support structures in place for operating room staff who have been involved in surgical incidents. Health organizations need to offer timely support to frontline staff after these incidents. Senior clinicians should be proactive in offering support to junior colleagues and empathize with their own experiences, thus shifting the competitive culture to one of openness and support.

An Ontology-Based Framework for Psychological Monitoring in Education During the COVID-19 Pandemic

BACKGROUND

Especially in the current crisis of the COVID-19 pandemic and the lockdown it entailed, technology became crucial. Machines need to be able to interpret and represent human behavior, to improve human interaction with technology. This holds for all domains but even more so for the domain of student behavior in relation to education and psychological well-being.

METHODS

This work presents the theoretical framework of a psychologically driven computing ontology, CCOnto, describing situation-based human behavior in relation to psychological states and traits. In this manuscript, we use and apply CCOnto as a theoretical and formal description system to categorize psychological factors that influence student behavior during the COVID-19 situation. By doing so, we show the added value of ontologies, i.e., their ability to automatically organize information from unstructured human data by identifying and categorizing relevant psychological concepts.

RESULTS

The already existing CCOnto was modified to automatically categorize university students' state and trait markers related to different aspects of student behavior, including learning, worrying, health, and socially based on psychological theorizing and psychological data conceptualization.

DISCUSSION

The paper discusses the potential advantages of using ontologies for describing and modeling psychological research questions. The handling of dataset completion, unification, and its explanation by means of Artificial Intelligence and Machine Learning models is also discussed.

Resilience and Subjectively Experienced Stress Among Paramedics Prior to and During the COVID-19 Pandemic

INTRODUCTION

Paramedics play a vital role in the healthcare system by providing professional support in situations of direct threat to patient health and life. They experience numerous difficulties during their work, which result in occupational stress. During the COVID-19 pandemic, their work has become even more demanding. The aim of the current study was to examine the role of resilience in the subjective experience of stress among paramedics during the COVID-19 pandemic.

MATERIALS AND METHODS

The study was carried out in two phases, in October-November 2019 (N = 75) and in May-June 2020 (N = 84), using the Sense of Stress Questionnaire (Skala Poczucia Stresu) and the Resilience Scale (Skala Pomiaru Prężności).

RESULTS

Paramedics exhibited higher intrapsychic stress before the COVID-19 pandemic. Tolerance of failure and treating life as a challenge were higher during the pandemic, in contrast to optimism and the ability to mobilize in difficult situations. Paramedics who were in contact with patients with COVID-19 experienced higher stress. Perseverance and determination, openness to new experiences and sense of humor, as well as competences and tolerance of negative emotions were revealed to play a key part in mitigating subjectively experienced stress.

CONCLUSION

Paramedics' subjectively experienced stress was lower during the COVID-19 pandemic. Paramedics who were in direct contact with patients with COVID-19 experienced higher stress. They had sufficient psychological resources, in the form of resilience (perseverance and determination, openness to new experiences, sense of humor, and competences and tolerance of negative emotions), which allowed them to cope with the situation of the COVID-19 pandemic.

Resilience Assessment Scale for the Prediction of Suicide Reattempt in Clinical Population

The objective of this work was to construct and validate an instrument for assessing resilience to suicide attempts in a Spanish clinical population that has made a previous attempt, and to verify its efficacy for predicting future suicide reattempts at 6 months. For the construction of a Scale of Resilience to Suicide Attempts (SRSA) the theoretical-rational strategy was used. The constructed SRSA-18 consisted of 18 items and 3 subdimensions (internal and external protection and emotional stability), had high internal consistency (α = 0.88; ω = 0.89) and a high positive correlation with the Suicide Resilience Inventory-25, SRI-25 (r = 0.91; p < 0.01), and to a lesser extent with general resilience scales such as the Connor-Davidson Resilience Scale, CD-RISC (r = 0.79; p < 0.01) and the Resilience Scale of 14 items, RS-14 (r = 0.76; p < 0.01). Additionally, a specific SRSA-18 score predicted future suicide reattempts 6 months after the first attempt. This new scale (SRSA-18) assesses in a brief and rapid way, through protective factors rather than risk factors, the level of resilience to the suicide attempt in specific clinical subpopulations in hospital emergency services, being able to prevent suicide reattempts with higher lethality.

Early predictors of mental health in mid-adulthood

AIM

Substantial research has focused on the examination of factors that contribute to the development of psychiatric problems. However, much less is known about factors early in life that may protect from poor mental health outcomes in midlife. This study aimed to identify the extent to which a set of key perinatal demographic variables and adolescent academic performance were associated with good mental health in mid-adulthood.

METHODS

In a sample of 525 individuals (aged 34-44, 55.4% male) born and raised in Jerusalem, Israel (STREAM study) we attempted to differentiate those who did and did not report psychiatric symptoms in mid-adulthood. Using χ² and regression analysis, we explored birth factors (year of birth, sex, birth weight, and number of older siblings, data on parental immigration and socioeconomic status), academic achievement in eighth grade and contemporaneous measures of lifestyle factors, personality traits, and perceived resilience.

RESULTS

Participants with good mental health were more often male (P = .005) and had better academic performance already at adolescence than participants who reported psychiatric symptoms in midlife (P < .001). They reported fewer physical complaints (P = .008), were less likely to smoke (P = .001) and considered themselves to be more "resilient" (P < .001).

CONCLUSIONS

The results showed that better academic performance in adolescence may be associated with better stress-coping strategies, resulting in fewer psychiatric complaints, more perceived resilience, and less stress-related behaviours in mid-adulthood. Future studies confirming this hypothesis could inform public mental health interventions.

Can we prepare healthcare professionals and students for involvement in stressful healthcare events? A mixed-methods evaluation of a resilience training intervention

Background

Healthcare professionals are experiencing unprecedented levels of occupational stress and burnout. Higher stress and burnout in health professionals is linked with the delivery of poorer quality, less safe patient care across healthcare settings. In order to understand how we can better support healthcare professionals in the workplace, this study evaluated a tailored resilience coaching intervention comprising a workshop and one-to-one coaching session addressing the intrinsic challenges of healthcare work in health professionals and students.

Methods

The evaluation used an uncontrolled before-and-after design with four data-collection time points: baseline (T1); after the workshop (T2); after the coaching session (T3) and four-to-six weeks post-baseline (T4). Quantitative outcome measures were Confidence in Coping with Adverse Events (‘Confidence’), a Knowledge assessment (‘Knowledge’) and Resilience. At T4, qualitative interviews were also conducted with a subset of participants exploring participant experiences and perceptions of the intervention.

Results

We recruited 66 participants, retaining 62 (93.9%) at T2, 47 (71.2%) at T3, and 33 (50%) at T4. Compared with baseline, Confidence was significantly higher post-intervention: T2 (unadj. β = 2.43, 95% CI 2.08–2.79, d = 1.55, p < .001), T3 (unadj. β = 2.81, 95% CI 2.42–3.21, d = 1.71, p < .001) and T4 (unadj. β = 2.75, 95% CI 2.31–3.19, d = 1.52, p < .001). Knowledge increased significantly post-intervention (T2 unadj. β = 1.14, 95% CI 0.82–1.46, d = 0.86, p < .001). Compared with baseline, resilience was also higher post-intervention (T3 unadj. β = 2.77, 95% CI 1.82–3.73, d = 0.90, p < .001 and T4 unadj. β = 2.54, 95% CI 1.45–3.62, d = 0.65, p < .001). The qualitative findings identified four themes. The first addressed the ‘tension between mandatory and voluntary delivery’, suggesting that resilience is a mandatory skillset but it may not be effective to make the training a mandatory requirement. The second, the ‘importance of experience and reference points for learning’, suggested the intervention was more appropriate for qualified staff than students. The third suggested participants valued the ‘peer learning and engagement’ they gained in the interactive group workshop. The fourth, ‘opportunities to tailor learning’, suggested the coaching session was an opportunity to personalise the workshop material.

Conclusions

We found preliminary evidence that the intervention was well received and effective, but further research using a randomised controlled design will be necessary to confirm this.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-020-05948-2.

Emotional Impairments and Neuroinflammation are Induced in Male Mice Invulnerable to Repeated Social Defeat Stress

Prolonged stress triggers neuroinflammation, which plays a significant role in the development of depression; however, stressed people do not always suffer from depression because of individual differences in stress vulnerability. Negative cognitive bias (NCB) toward pessimistic judgment often underlies depressive episodes. However, a relationship between stress vulnerability, neuroinflammation, and NCB remains elusive. In addition, an animal model with all the traits would be a powerful tool for studying the etiology of depression and its therapeutic approaches. Accordingly, this study evaluated the effect of stress vulnerability on neuroinflammation and depression-related behaviors, including NCB in males, using a modified version of repeated social defeat stress (mRSDS) paradigm, a validated animal model of psychosocial stress. Exposure to mRSDS, consisting of 5 min of social defeat by unfamiliar CD-1 aggressor mice for five consecutive days, caused NCB, which co-occurred with depressive- and anxiety-like behaviors, and neuroinflammation in male BALB/c mice. Treatment with minocycline, an antibiotic with anti-inflammatory property, blocked mRSDS-induced depressive-like behaviors and neuroinflammation, but not NCB, indicating the limited effect of an anti-inflammatory intervention. In addition, marked differences were found in neuroinflammatory profiles and hippocampal gene expression patterns between resilient and unstressed mice, as well as between susceptible and resilient mice. Therefore, mice resilient to mRSDS are indeed not intact. Our findings provide insights into the unique features of the mRSDS model in male BALB/c mice, which could be used to investigate the etiological mechanisms underlying depression as well as bridge the gap in the relationship between stress vulnerability, neuroinflammation, and NCB in males.

Occupational stress and cognitive failure of nurses and associations with self-reported adverse events: A national cross-sectional survey

AIM

To determine correlations for nurse self-reported occupational stress, prevalence of cognitive failure (CF), and adverse events.

DESIGN

Cross-sectional nationwide survey.

METHODS

Tertiary-level public hospitals (N = 115) from 13 provinces in Iran were recruited and 2,895 nurses surveyed (August 2016-December 2017). Participants' self-reported demographic information, occupational stress, CF, and frequency of adverse events were analysed using chi-square, t tests, and binary logistic regression.

RESULTS

This study showed that 29.1% of nurses had experienced adverse events in the past six months. Significant predictors for reported adverse events from logistic regression were 'Role stressors', 'Interpersonal relations stressors', and 'Action', while 'Working environment stressors' was protective for reported adverse events. Demographic predictors of adverse events were longer work hours and male gender, while those working in critical care units, general wards, and other wards had higher reported adverse events than for emergency wards.

CONCLUSIONS

Occupational stress and CF are associated with the reporting of adverse events. Further research is needed to assess interventions to address occupational stress and CF to reduce adverse events.

IMPACT

Adverse events compromise patient safety, lead to increased healthcare costs, and impact nursing staff. Higher self-reported adverse events were associated with higher reported stressors and CF. Understanding the factors that influence occupational stress, CF, and adverse events will support quality patient care and safety.

Why Negative or Positive, If It makes Me Win? Dark Personality in Spanish Competitive Athletes

Research on the dark triad traits (narcissism, Machiavellianism and psychopathy) is increasingly focusing on the functional or dysfunctional influences of personality traits on cognitive, behavioural and emotional responses. Thus, studies in sport contexts have shown that athletes who participate in competitive sports have higher scores in the dark triad than those who do not. The objectives of this cross-sectional study were to evaluate the linear and predictive relationships between dark traits and competitiveness (p < 0.01), as well as to identify any differences based on sports orientation (professionals vs. amateurs). Scales SD3 (dark personality) and C-10 (competitiveness) were applied to a sample of Spanish athletes (n = 806). The results show that competitiveness is strongly related to the traits of the dark personality triad. Narcissism is related to both the desire to win and the fear of losing, while Machiavellian tendencies are high when athletes feel like losers. Finally, psychopathic tendencies are related to feelings of inferiority and fear of failure. In conclusion, the results suggest that dark personality traits are related not only to the individuality of the athletes, but also to the self-perception of both their psychological response and the competitiveness of their sporting environment.

Resilience and mental health: how multisystemic processes contribute to positive outcomes

More is known about the factors that predict mental disorder than about the factors and processes that promote positive development among individuals exposed to atypically high levels of stress or adversity. In this brief Review of the science of resilience, we show that the concept is best understood as the process of multiple biological, psychological, social, and ecological systems interacting in ways that help individuals to regain, sustain, or improve their mental wellbeing when challenged by one or more risk factors. Studies in fields as diverse as genetics, psychology, political science, architecture, and human ecology are showing that resilience depends just as much on the culturally relevant resources available to stressed individuals in their social, built, and natural environments as it does on individual thoughts, feelings, and behaviours. With growing interest in resilience among mental health-care providers, there is a need to recognise the complex interactions across systems that predict which individuals will do well and to use this insight to advance mental health interventions.

Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries

OBJECTIVE

The aim of the study was to evaluate psychiatric symptoms among 1022 persons with various disorders of sex development (DSDs).

METHODS

The study was a European multicenter cross-sectional clinical evaluation in six countries. The mean (SD) age of participants was 32.1 (13.4) years. The cohort consisted of 325 individuals with Turner syndrome, 219 individuals with Klinefelter syndrome (KS), female individuals with various XY-DSD conditions (107 with and 67 without androgenization), 87 male individuals with XY-DSD conditions, and 221 female individuals with congenital adrenal hyperplasia. The Hospital Anxiety and Depression Scale, the Short Autism Spectrum Quotient, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, and self-reported mental health history were used to assess psychiatric symptoms.

RESULTS

Across the six DSD diagnostic groups, clinical cutoff symptom scores were reached in 19.5% of participants for anxiety, in 7.1% for depression, in 4.1% for attention-deficit/hyperactivity disorder, and in 9.1% for autism. The mean depression and anxiety scores were higher compared with population norms in men with KS and men with XY-DSD. Compared with participants with other DSD conditions, men with KS reported significantly more mental health symptoms. Self-esteem, satisfaction with care, body dissatisfaction, and experiences of shame were associated with psychiatric symptoms in many DSD conditions.

CONCLUSIONS

A substantial minority of adults with DSD, with KS in particular, experience psychiatric morbidity. Across DSD conditions, adults may share feelings of shame. Developing a positive self-esteem and body image may be challenging. Multidisciplinary DSD care that involves specialized mental health support can be of important value.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00006072.

Coping as a mediator between locus of control, competence beliefs, and mental health: A systematic review and structural equation modelling meta-analysis

OBJECTIVE

This systematic review and two-staged structural equation modelling meta-analysis (TSSEM) aimed to examine whether coping mediates the associations between locus of control, competence beliefs, and mental health in the general population and clinical samples.

METHODS

Eligible studies published until May 2017 were identified through systematic searches of PubMED and EMBASE. The review included 19 studies and the meta-analysis 15 studies.

RESULTS

The review supports the assumption that coping mediates the associations between locus of control and competence beliefs, and mental health. TSSEM using a pooled sample of 3986 respondents and 225 cross-sectional effect sizes indicated that maladaptive coping mediates the association between maladaptive locus of control and mental health problems. On the contrary, adaptive coping did not mediate this association and was only significantly associated with competence beliefs and adaptive locus of control but, unexpectedly, not with mental health. Both maladaptive and adaptive locus of control but not competence beliefs had direct links to mental health problems that were independent of coping.

CONCLUSION

Interventions should not only focus on enhancing adaptive coping as it might be more promising to diminish maladaptive locus of control, which may result in reduced maladaptive coping and, finally, improved mental health.

Shame in Parkinson'S Disease: A Review

Shame is a self-conscious emotion marked by an intensely negative self-evaluation. It is exhibited by an individual upon realizing that she/he has violated an important (usually social) norm. Shame can be a source of emotional distress leading to social withdrawal and depression, with a significant negative impact on quality of life. In Parkinson’s disease (PD), shame is rarely addressed. Based on reports of persons affected with Parkinson’s disease (PwP) as well as a literature review, this article describes PD-related shame. PD-related shame may emerge from motor and non-motor symptoms, from self-perception of inadequacy due to loss of autonomy and need for help, or from perceived deterioration of body image. The neurobiology of shame delineates neuronal networks involved in cognitive and emotions regulation, self-representation and representation of the others mental states. Although this hypothesis remains to be demonstrated, these substrates could be modulated, at least partially, by dopaminergic depletion related to PD, which may open a window for pharmacotherapy. Owing to the negative impact that shame can produce, shame should be actively explored and addressed in the individual PwP. Teaching PwP how to develop resilience to shame may be a useful strategy in preventing the vicious circle of shame. The paucity of existing data on prevalence and management of PD-specific shame contrasts with the manifold reported situations inducing suffering from shame. There is a crucial need for further investigations of shame in PD and the development of interventions to reduce its impact on PwP’s quality of life.

Occupational burnout and lifestyle in Kazakhstan cardiologists

Background

No data exist in the published literature on burnout in physicians from Central Asia. The aim of this analysis was to assess burnout prevalence in doctors and nurses of a cardiological hospital in Almaty, Kazakhstan and ascertain whether smoking, alcohol and physical activity may predict job-associated burnout.

Methods

The staff of the City Cardiological Centre of Almaty (N = 259, 82% females) filled in the questionnaire with the questions on demographics, lifestyle, including smoking, alcohol and physical activity, as well as fatigue (using Fatigue Severity Scale (FSS)) and burnout using Maslach Burnout Inventory (MBI) Human Services Survey for Medical Personnel. We compared the scores of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) between doctors and nurses.

Results

We found significant differences in the smoking prevalence, alcohol use and regular physical activity, but no mean scores of burnout between men and women. High DP was prevalent in 52% doctors and 45% nurses, whereas high EE was found in 32 and 26% and PA in 16 and 32%, accordingly. In contrast with EE and DP, PA score was greater in nurses (median 38, interquartile range (IQR) 17) compared to doctors (median 41, IQR 9). Age, sex, work duration, smoking or physical activity could not predict higher burnout, whereas FSS score was associated with higher burnout of all dimensions (p < 0.05), and never-alcohol could predict higher PA burnout (p < 0.05).

Conclusions

In Kazakhstan cardiologists, high prevalence of DP burnout should target specific preventive strategies and the association of alcohol use with PA needs further deeper insight.

Resilience in inpatient palliative care nursing: a qualitative systematic review

Background

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

Objective

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

Design

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

Data sources

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

Review methods

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

Results

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

Conclusion

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

Mental healthcare staff well-being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions

Rising levels of burnout and poor well-being in healthcare staff are an international concern for health systems. The need to improve well-being and reduce burnout has long been acknowledged, but few interventions target mental healthcare staff, and minimal improvements have been seen in services. This review aimed to examine the problem of burnout and well-being in mental healthcare staff and to present recommendations for future research and interventions. A discursive review was undertaken examining trends, causes, implications, and interventions in burnout and well-being in healthcare staff working in mental health services. Data were drawn from national surveys, reports, and peer-reviewed journal articles. These show that staff in mental healthcare report poorer well-being than staff in other healthcare sectors. Poorer well-being and higher burnout are associated with poorer quality and safety of patient care, higher absenteeism, and higher turnover rates. Interventions are effective, but effect sizes are small. The review concludes that grounding interventions in the research literature, emphasizing the positive aspects of interventions to staff, building stronger links between healthcare organizations and universities, and designing interventions targeting burnout and improved patient care together may improve the effectiveness and uptake of interventions by staff.

Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout

Oncology clinician burnout has become a noteworthy issue in medical oncology directly affecting the quality of patient care, patient satisfaction, and overall organizational success. Due to the increasing demands on clinical time, productivity, and the evolving medical landscape, the oncology clinician is at significant risk for burnout. Long hours in direct care with seriously ill patients/families, limited control over daily responsibilities, and endless electronic documentation, place considerable professional and personal demands on the oncologist. As a result, the oncology clinician's wellness is adversely impacted. Physical/emotional exhaustion, cynicism, and feelings of ineffectiveness evolve as core signs of burnout. Unaddressed burnout may affect cancer clinician relationships with their patients, the quality of care delivered, and the overall physical and emotional health of the clinician. Oncology clinicians should be encouraged to build upon their strengths, thrive in the face of adversity and stress, and learn to positively adapt to the changing cancer care system. Fostering individual resilience is a key protective factor against the development of and managing burnout. Empowering clinicians at both the individual and organizational level with tailored resilience strategies is crucial to ensuring clinician wellness. Resilience interventions may include: burnout education, work-life balance, adjustment of one's relationship to work, mindful practice, and acceptance of the clinical work environment. Health care organizations must act to provide institutional solutions through the implementation of: team-based oncology care, communication skills training, and effective resiliency training programs in order to mitigate the effects of stress and prevent burnout in oncology.

GPs' perceptions of resilience training: a qualitative study

BACKGROUND

GPs are reporting increasing levels of burnout, stress, and job dissatisfaction, and there is a looming GP shortage. Promoting resilience is a key strategy for enhancing the sustainability of the healthcare workforce and improving patient care.

AIM

To explore GPs' perspectives on the content, context, and acceptability of resilience training programmes in general practice, in order to build more effective GP resilience programmes.

DESIGN AND SETTING

This was a qualitative study of the perspectives of GPs currently practising in England.

METHOD

GPs were recruited through convenience sampling, and data were collected from two focus groups (n = 15) and one-to-one telephone interviews (n = 7). A semi-structured interview approach was used and data were analysed using thematic analysis.

RESULTS

Participants perceived resilience training to be potentially of value in ameliorating workplace stresses. Nevertheless, uncertainty was expressed regarding how best to provide training for stressed GPs who have limited time. Participants suspected that GPs most likely to benefit from resilience training were the least likely to engage, as stress and being busy worked against engagement. Conflicting views were expressed about the most suitable training delivery method for promoting better engagement. Participants also emphasised that training should not only place the focus on the individual, but also focus on organisation issues.

CONCLUSION

A multimodal, flexible approach based on individual needs and learning aims, including resilience workshops within undergraduate training and in individual practices, is likely to be the optimal way to promote resilience.

White matter tract alterations in Parkinson's disease patients with punding

OBJECTIVE

To assess brain white matter tract alterations in patients with Parkinson's disease and punding (PD-punding) compared with controls and PD cases without any impulsive-compulsive behaviour.

METHODS

Forty-nine PD patients (21 PD-punding and 28 PD with no impulsive-compulsive behaviours) and 28 controls were consecutively recruited. Clinical, cognitive and psychopathological evaluations were performed. Diffusion tensor MRI metrics of the main white matter tracts were assessed using a tractography approach.

RESULTS

Compared with controls, both PD groups showed white matter microstructural alterations of the left pedunculopontine tract and splenium of the corpus callosum. PD-punding patients showed a further damage to the right pedunculopontine tract and uncinate fasciculus, genu of the corpus callosum, and left parahippocampal tract relative to controls. When adjusting for depression and/or apathy severity, a greater damage of the genu of the corpus callosum and the left pedunculopontine tract was found in PD-punding compared with patients with no impulsive-compulsive behaviours.

CONCLUSIONS

PD-punding is associated with a disconnection between midbrain, limbic and white matter tracts projecting to the frontal cortices. These alterations are at least partially independent of their psychopathological changes. Diffusion tensor MRI is a powerful tool for understanding the neural substrates underlying punding in PD.

Making Champs and Super-Champs-Current Views, Contradictions, and Future Directions

In our 2016 paper (Collins et al., 2016a), we proposed that superchamps (athletes who have achieved the highest level in their sport) were differentiated from their less successful counterparts by their use of positive proactive coping and a “learn from it” approach to challenge. This skill-based focus to talent development (TD) is supported extensively in the literature (e.g., MacNamara et al., 2010a,b) and suggests that the differences between levels of adult achievement relate more to what performers bring to the challenges than what they experience (Collins et al., 2016a). In this focused review we present and discuss a number of key concepts related to this paper and other parallel research in TD. We begin by presenting our pragmatic objectives and the importance of considering how we evaluate the research with an emphasis on its application to the applied setting. We then consider commonalities and differences in recent psychological approaches to TD, namely the experiential, attitudinal, and skill-based. The paper then provides further exploration of the Psychological Characteristics of Developing Excellence and their role in TD processes. We conclude with a consideration of future research and the application of research in TD. Reflecting our pragmatic stance as researchers, we hope that this focused review provides suggestions for progress and stimulates critical debate amongst practitioners, researchers and policy makers.