Strengthening resilience in over 50’s: a nested clustered-randomized controlled trial of adaptive systematic self-reflection

Stepping back or stepping in: A qualitative investigation of self-distanced versus self-immersed stressor reflections with competitive swimmers

High performance sport consists of stressor events which can disrupt an athletes' functioning and negatively influence performance. The way in which one reflects upon stressor events and develops insights regarding how they coped is essential to overcoming similar experiences in the future. We conducted a pilot randomised controlled trial with a qualitative analysis to explore the coping insights among 48 highly trained/national level swimmers in the lead up to major swimming competitions, who reflected on stressor events from self-distanced or self-immersed perspectives over a 3-week period. Using the self-reflection and coping insight framework as a guideline, we captured divers coping insights across both groups. Irrespective of the group to which they were assigned, athletes showed positive signs towards re-interpreting their stressor experience and embracing the stressor event, whereas consideration of individual values and adoption of a future-focus viewpoint were areas lacking. The emotionality described by athletes in their written reflections varied across both groups and influenced the development of coping insights. Our findings indicate a necessity to examine the emotionality associated with unique stressor events and consider integrating reflection strategies, while also enhancing the operational definitions within conceptual models of stress reflection protocols.

A randomized controlled trial comparing the effects of self-reflective writing focused on successful and unsuccessful coping experiences on resilience

Evidence supports the effectiveness of self-reflective training approaches for the development of resilience. Building this work, the objective of this study was to investigate the impact of the focus of coping self-reflective activities on resilience by applying a self-reflection approach to a sample of 254 Australian ministry workers. This randomized controlled trial included three attention-matched conditions: (1) self-reflective writing focused on successful coping, (2) self-reflective writing focused on unsuccessful coping or (3) written descriptions of stressor events alone. Participants were assessed across four time points: prior to, immediately post, 3-months, and 6-months after the intervention. Results demonstrated that self-reflective writing was more effective in enhancing perceived resilience than descriptive writing. Analyses also showed greater maintenance of beneficial effects in the successful self-reflection condition, compared to the unsuccessful condition. These findings support the use of self-reflection training to strengthen individuals' psychological resilience, particularly when focused on successful coping situations for those who initially experience more ruminative thought.

The effect of personalized mobile health (mHealth) in cardiac rehabilitation for discharged elderly patients after acute myocardial infarction on their inner strength and resilience

INTRODUCTION

Given the importance of promoting self-care and quality of life for discharged elderly patients after acute Myocardial Infarction(MI), It is necessitated we conduct interventions to promote these items. This study was conducted to determine the effect of mHealth-Cardiac rehabilitation (CR) on the inner Strength and resilience of elderly patients with MI after discharge from the hospital.

METHODS

The present study was a randomized controlled trial that was conducted on 56 Elderly patients with myocardial infarction were discharged from the heart departments. In the intervention group after the patient's discharge, the patients were contacted twice a week for one month and the necessary training and support were given online. To gather data, the Mini-Mental State Examination (MMSE), the demographic and clinical characteristics questionnaire, the inner strength scale (ISS), and the Connor-Davidson Resilience Scale (CD-RISC) were completed pre- and post-intervention. The data analysis was done by SPSS16.

RESULTS

This study showed the mean resilience and inner strength scores before and after the intervention in the control group had no statistically significant difference(P˃0.05). There was a significant increase in the mean resilience and inner strength scores in the intervention group after the intervention (P ≤ 0.001).

CONCLUSION

The results of this study showed that mHealth as a kind of telenursing nursing has a significant effect on both variables of inner strength and resilience of post-discharge elderly patients after acute myocardial infarction. This means that using mHealth for these patients could increase the inner strength and resilience of the elderly discharged after myocardial infarction. Therefore, through using this method, elderly patients' self-care ability and quality of life could be increased.

Web-Based Mind-Body Tactical Resilience Training Program for First Responders: Pre-Post Study Assessing Feasibility, Acceptability, and Usability

BACKGROUND

First responders report elevated rates of mental disorders, including posttraumatic stress disorder (PTSD), yet many are reluctant to seek care. Preventative resilience training programs attempt to proactively address this issue, and there is evidence showing promise for programs targeting cognitive processes. However, these programs rarely address the physical health conditions associated with PTSD. There is emerging evidence of mind-body exercise training improving PTSD symptoms as well as its associated physical health symptoms. However, the feasibility and acceptability of delivering a web-based mind-body resilience training among first responders are not yet known.

OBJECTIVE

This study aimed to evaluate the feasibility, usability, and acceptability of a web-based mind-body tactical resilience training program designed for first responders. In addition, we explored the preliminary effectiveness of the training program on mental health outcomes, adaptive cognitive strategies, and work productivity.

METHODS

A total of 42 first responders based in the United States enrolled in the web-based training program. Participants were administered web-based surveys before enrolling in the 6-week web-based program and at the end of the program. The primary outcomes of feasibility were measured using the number of training hours, program adherence rates, and self-reported data on frequency of practice. Acceptability and usability were measured using self-reported data. Secondary outcomes were symptoms of PTSD, psychological distress, emotion regulation, stress mindset, psychological preparedness, and work performance.

RESULTS

Overall, the training program was feasible based on the median number of training hours spent on the web-based program (7.57 hours out of an expected total of 6 to 9 hours), and 55% (23/42) of the enrolled participants completed more than half of the program. Although acceptability, usability, and frequency of practice were rated as high, this was based on only 29% (12/42) of the respondents who provided follow-up data. Secondary outcomes showed a significant improvement in the adaptive cognitive strategy of the stress mindset, with a mean difference of -5.42 (SD 4.81; 95% CI -8.475 to -2.358; t₁₁=-3.898; P=.002). All other secondary outcomes were not significant. However, the secondary outcomes were exploratory only, and this study was neither designed nor powered to adequately assess efficacy.

CONCLUSIONS

These findings suggest that a mind-body tactical resilience training program delivered in a web-based format is feasible and acceptable among first responders; however, further refinements may be required to improve adherence rates. Further research using a larger, more rigorous trial design is warranted to examine the effectiveness of this type of training as a possible prevention or treatment strategy for this population.

Association of Self-reflection With Cognition and Brain Health in Cognitively Unimpaired Older Adults

BACKGROUND AND OBJECTIVES

Self-reflection (the active evaluation of ones thoughts, feelings, and behaviors) can confer protection against adverse health outcomes. Its effect on markers sensitive to Alzheimer disease (AD), however, is unknown. The primary objective of this cross-sectional study was to examine the association between self-reflection and AD-sensitive markers.

METHODS

This study used baseline data from cognitively unimpaired older adults enrolled in the Age-Well clinical trial and older adults with subjective cognitive decline from the SCD-Well clinical trial. In both cohorts, self-reflection was measured via the reflective pondering subscale of the Rumination Response Scale, global cognition assessed via the Preclinical Alzheimer's Cognitive Composite 5, and a modified late-life Lifestyle-for-Brain-Health (LIBRA) index computed to assess health and lifestyle factors. In Age-Well, glucose metabolism and amyloid deposition were quantified in AD-sensitive gray matter regions via fluorodeoxyglucose- and AV45-PET scans, respectively. Associations between self-reflection and AD-sensitive markers (global cognition, glucose metabolism, and amyloid deposition) were assessed via unadjusted and adjusted regressions. Furthermore, we explored whether associations were independent of health and lifestyle factors. To control for multiple comparisons in Age-Well, false discovery rate-corrected p values (p _FDR) are reported.

RESULTS

A total of 134 (mean age 69.3 ± 3.8 years, 61.9% women) Age-Well and 125 (mean age 72.6 ± 6.9 years, 65.6% women) SCD-Well participants were included. Across unadjusted and adjusted analyses, self-reflection was associated with better global cognition in both cohorts (Age-Well: adjusted-β = 0.22, 95% CI 0.05-0.40, p _FDR = 0.041; SCD-Well: adjusted-β = 0.18, 95% CI 0.03-0.33, p = 0.023) and with higher glucose metabolism in Age-Well after adjustment for all covariates (adjusted-β = 0.29, 95% CI 0.03-0.55, p _FDR = 0.041). Associations remained following additional adjustment for LIBRA but did not survive false discovery rate (FDR) correction. Self-reflection was not associated with amyloid deposition (adjusted-β = 0.13, 95% CI -0.07 to 0.34, p _FDR = 0.189).

DISCUSSION

Self-reflection was associated with better global cognition in 2 independent cohorts and with higher glucose metabolism after adjustment for covariates. There was weak evidence that relationships were independent from health and lifestyle behaviors. Longitudinal and experimental studies are warranted to elucidate whether self-reflection helps preserve cognition and glucose metabolism or whether reduced capacity to self-reflect is a harbinger of cognitive decline and glucose hypometabolism.

TRIAL REGISTRATION INFORMATION

Age-Well: NCT02977819; SCD-Well: NCT03005652.

Challenge Demands and Resilience

Abstract. This study investigates the relationship of challenge demands (i. e., time pressure, job complexity) on employee resilience. We provide insights into potential pathways (i. e., learning, cognitive irritation) for how challenge stressors influence employee resilience. We employed a two-wave, time-lagged design to examine the influences of challenge stressors and explanatory pathways on employee resilience 2 months later. The data from 359 participants (52.1 % male) were analyzed using a Bayesian time-lagged path model. Results indicate that time pressure and job complexity are negatively related to employee resilience via cognitive irritation. In contrast, we found a positive, indirect effect of job complexity and resilience via learning. This paper contributes to existing employee resilience and stress research by highlighting the roles of learning and cognitive irritation to explain the relationships of challenge stressors on employee resilience. Moreover, the results provide us with a deeper understanding of which factors foster or drain employee resilience.

The coping insights involved in strengthening resilience: The Self-Reflection and Coping Insight Framework

BACKGROUND

Recent theoretical work suggests that self-reflection on daily stressors and the efficacy of coping strategies and resources is beneficial for the enhancement of resilient capacities. However, coping insights emerging from self-reflection, and their relationship to resilient capacities, is an existing gap in our understanding.

OBJECTIVES

Given that insights come in many forms, the objective of this paper is to delineate exemplar coping insights that strengthen the capacity for resilience.

METHODS

After providing an overview of self-reflection and insight, we extend the Systematic Self-Reflection model of resilience strengthening by introducing the Self-Reflection and Coping Insight Framework to articulate how the emergence of coping insights may mediate the relationship between five self-reflective practices and the enhancement of resilient capacities.

RESULTS

We explore the potential for coping insights to convey complex ideas about the self in the context of stressor exposure, an awareness of response patterns to stressors, and principles about the nature of stress and coping across time and contexts.

CONCLUSIONS

This framework adds to existing scholarship by providing a characterization of how coping insight may strengthen resilient capacities, allowing for a guided exploration of coping insight during future research.