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Brea Larios D. Navigating wellness through integration: coping strategies for depression among Syrian refugees in Norway. BMC Psychol 2024; 12:485. [PMID: 39277763 PMCID: PMC11401405 DOI: 10.1186/s40359-024-01987-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 09/05/2024] [Indexed: 09/17/2024] Open
Abstract
BACKGROUND Refugees frequently face the challenges of adapting to unfamiliar environments and new cultural contexts. Such adaptations emphasize the importance of coping strategies during resettlement and for individuals to successfully integrate in the new communities. Particularly for Syrian refugees in Norway, many of whom have escaped war and conflict, understanding their ways of coping with mental health problems, such as depression, is pivotal. METHOD This study used a cross-sectional study design to explore the relationship between integration aspects and coping strategies for depression from the Syrian population living in Norway. Syrian participants (N = 96) answered questions from the Brief COPE, the Hopkins symptom checklist (HSCL-13), and the Immigration Policy Lab index (IPL-12/24). RESULTS Hierarchical multiple regression analysis indicated that employing a problem-focused coping strategy was significantly associated with better psychological and social integration outcomes among Syrian refugees in Norwegian society. CONCLUSION The study suggests that certain aspects of integration, such as feeling a sense of belonging and actively seeking help, significantly improve mental health outcomes for Syrian refugees. Emphasizing problem-focused coping strategies could be vital in facilitating the successful integration of refugees into Norwegian society.
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Affiliation(s)
- Dixie Brea Larios
- Department of Psychosocial Science, University of Bergen, Christies gate 12, Postboks 7807, Bergen, 5015, Norway.
- Research Department at the Oral Health Centre for Expertise in Western Norway, Postbox 2354 Møllendal, Bergen, 5867, Norway.
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Anchors ZG, Moore LJ, Burnard SD, Bressington CA, Moreton AE, Arnold R. A mixed-methods stress audit with midwives in the United Kingdom. Women Birth 2024; 37:101639. [PMID: 38968701 DOI: 10.1016/j.wombi.2024.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/16/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024]
Abstract
PROBLEM UK midwives report high work-related stress, which can negatively impact their health and wellbeing, with many considering leaving the profession. BACKGROUND An occupational stress audit guides the implementation of stress management intervention, by identifying which stressors have the most negative impact and why, and highlighting "at risk" groups. AIM To conduct a concurrent mixed-methods stress audit with UK midwives in an NHS Trust. METHODS Seventy-one midwives (Mage= 39 years, SD = 11) completed a survey assessing stressors (e.g., relationships), stress appraisals (i.e., challenge vs. threat), coping strategies (e.g., avoidance-focused), and outcomes (i.e., mental health, performance, and intention to leave). Ten midwives (Mage = 42 years, SD = 10) participated in semi-structured interviews. FINDINGS Quantitative data revealed that more work-related demands, poorer peer support and relationships, and threat appraisals predicted worse mental health. Moreover, less control and more work-related demands predicted poorer performance, while less control, poorer manager support, more change-related demands, and threat appraisals predicted greater intention to leave. Qualitative data generated three themes: organisational pressures exacerbated by unexpected changes; individualised responses but largely debilitative emotions; and personal coping and power of social support. DISCUSSION AND CONCLUSION This study offered a comprehensive and novel insight into the stress experiences of UK midwives, highlighting targets for future stress management interventions, including key stressors (e.g., manager support), underlying mechanisms (e.g., stress appraisals), and "at-risk" groups (e.g., night shift workers). Practical recommendations are provided for stakeholders operating at multiple levels (e.g., midwife, trust, policy) to better support midwives with work-related stress.
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Affiliation(s)
- Zoe G Anchors
- School of Health and Social Wellbeing, University of the West of England, BS16 1DD, UK.
| | - Lee J Moore
- Department for Health, Claverton Down, University of Bath, Bath, England BA2 7PB, UK
| | - Sara D Burnard
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park Bath, England BA1 3NG, UK
| | | | - Annette E Moreton
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park Bath, England BA1 3NG, UK
| | - Rachel Arnold
- Department for Health, Claverton Down, University of Bath, Bath, England BA2 7PB, UK
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Salihu D, Chutiyami M, Bello UM, Wong EML, Pich J, Alsharari AF, Ali MU, Sulaiman SK, Kwan RYC. Coping strategies of internally displaced persons and the host community in a region of armed conflict: A cross-sectional study. Psychiatry Res 2024; 339:116035. [PMID: 38885568 DOI: 10.1016/j.psychres.2024.116035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Conflict leads to the displacement of people, making it more difficult for them to cope with increasing stress. In war-affected regions, people use different strategies to cope with their stress. This study examines the coping strategies of internally displaced persons (IDPs) and those in host communities in war zones. METHODS People living in the IDP camp and host communities in Maiduguri, Nigeria were recruited using a convenient sampling strategy. A 28-item Hausa version of the Brief COPE Scale wasused for data collection. Data were analyzed using linear regression and presented as unstandardized beta (B) and standard error (SE). RESULTS A total of 562 participants were recruited (IDPs, n = 281; and the host communities, n = 281). Problem- and emotion-focused coping strategies were identified as the most common approaches used in host communities; however, dysfunctional strategies were morecommon among the IDPs. Age (younger or older adulthood) was identified as a predictor forthe use of emotion-, problem-, and dysfunctional-focused coping strategies. CONCLUSION Host communities were more likely to use a problem-and emotion-focused approach to coping, while IDPs were more likely to use dysfunctional strategies. Location and demographic factors (being single, aged 18-29years, >50 years and older) also influenced coping.
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Affiliation(s)
- Dauda Salihu
- Jouf University, College of Nursing, Sakaka, Saudi Arabia.
| | - Muhammad Chutiyami
- University of Technology Sydney, Faculty of Health, School of Nursing and Midwifery, Sydney, Australia
| | - Umar Muhammad Bello
- Glasgow Caledonian University, School of Health and Life Sciences, Department of Physiotherapy and Paramedicine, Glasgow, United Kingdom
| | | | - Jacqueline Pich
- University of Technology Sydney, Faculty of Health, School of Nursing and Midwifery, Sydney, Australia
| | | | - Mohammed Usman Ali
- The Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Kowloon City, Hong Kong SAR, China
| | | | - Rick Yiu Cho Kwan
- Tung Wah College, School of Nursing, Kowloon City, Hong Kong SAR, China
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Zhang Q. Coping styles and the developmental trajectories of anxiety symptoms in children during transition into early adolescence. Br J Psychol 2024; 115:475-496. [PMID: 38502134 DOI: 10.1111/bjop.12699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/20/2024]
Abstract
The study investigated how active and avoidant coping styles predicted the trajectory membership of anxiety symptoms during the transition into early adolescence. A total of 321 Chinese children aged 9 to 10 years were recruited from a primary school in mainland China. Self-reported trait anxiety, coping styles and anxiety symptoms were assessed at baseline. After 6 months, self-reported anxiety symptoms were measured at three follow-up assessments with an interval of 6 months. Latent class growth modelling revealed high (18.7%) and low (81.3%) trajectories of anxiety symptoms in children during the transition into early adolescence. After controlling for trait anxiety, depression and sex, high active coping style predicted the trajectory of high anxiety symptoms, which was not moderated by trait anxiety. Before controlling for these covariates, the relation between active coping style and anxiety symptoms was in the opposite direction. A high avoidant coping style showed a trend to predict the trajectory of high anxiety symptoms only for children with low trait anxiety. These findings add a developmental context to the relationships of active and avoidant coping styles to anxiety symptoms and suggest that trait anxiety may moderate these relationships.
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Affiliation(s)
- Qiaochu Zhang
- Department of Social and Behavioural Sciences, College of Humanities and Social Sciences, City University of Hong Kong, Kowloon, Hong Kong
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Papadopoulos A, Tsapara A, Gryparis A, Tafiadis D, Trimmis N, Plotas P, Skapinakis P, Tzoufi M, Siafaka V. A Prospective Study of the Family Quality of Life, Illness Perceptions, and Coping in Mothers of Children Newly Diagnosed with Autism Spectrum Disorder and Communication Difficulties. Eur J Investig Health Psychol Educ 2024; 14:2187-2204. [PMID: 39194940 DOI: 10.3390/ejihpe14080146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/12/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
(1) Background: This study assesses the impact of mothers' illness perceptions about autism spectrum disorder and their coping strategies on the family's quality of life during the initial period following diagnosis and one year afterward. (2) Method: The sample consisted of 53 mothers of children newly diagnosed with autism spectrum disorder and having communication difficulties who completed the following: the Beach Center Family Quality of Life Scale, the Brief Illness Perception Questionnaire, and the Brief-COPE. (3) Results: The findings revealed a moderate family quality of life in the initial assessment and a lack of a statistically significant change one year later. Notably, statistically significant changes were observed in coping strategies, as in the second assessment, and the score in denial and self-blame decreased. Pearson and Eta analyses indicated several correlations between socio-demographic characteristics, illness perceptions, coping strategies, and family quality of life. Multiple regression analysis showed that positive reframing was positively associated with total family quality of life in the initial period following diagnosis and one year afterward, while self-blame was associated with poorer quality of life in the time after diagnosis. Furthermore, the belief about the controllability of the disorder was correlated with better family quality of life one year after the diagnosis. (4) Conclusions: Illness perceptions and coping can be considered as predictors of family quality of life outcomes one year after the diagnosis of autism spectrum disorder. The focus of interventions, apart from controlling the disorder's symptoms, should aim to strengthen specific strategies and weaken others.
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Affiliation(s)
- Angelos Papadopoulos
- School of Humanities and Social Sciences, University of Patras, 26504 Patras, Greece
- General Children's Hospital of Patras "Karamandaneio", 26331 Patras, Greece
| | - Angeliki Tsapara
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Alexandros Gryparis
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 4th Km National Road Ioannina-Athens, 45500 Ioannina, Greece
| | - Dionysios Tafiadis
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 4th Km National Road Ioannina-Athens, 45500 Ioannina, Greece
| | - Nikolaos Trimmis
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Laboratory of Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Panagiotis Plotas
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Laboratory of Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Petros Skapinakis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Meropi Tzoufi
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 4th Km National Road Ioannina-Athens, 45500 Ioannina, Greece
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Yildizel S, Arayici ME, Umay C, Sahin S. Hope, coping strategies, and their predictors in older patients with prostate and breast cancer undergoing radiotherapy: A cross-sectional study. J Med Imaging Radiat Oncol 2024; 68:481-488. [PMID: 38576403 DOI: 10.1111/1754-9485.13645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION The aim of this paper was to evaluate the level of hope, coping methods, and the factors affecting them in patients aged 60 years and over who were diagnosed with breast and prostate cancer and who were receiving radiotherapy (RT) as part of their treatment. METHODS A total of 66 patients (37 breast cancer and 29 prostate cancer patients) were included in this cross-sectional study. The RT and treatment information of the patients were collected by using the records in the hospital database. The scale responses, baseline characteristics, and demographic information of the participants were collected through the questionnaire form and scales [HHI (Heart Hope Index), COPE (Coping Attitudes Assessment Scale), and VAS (Visual Analogue Scale)]. Two surveys were administered to the participants before and after radiotherapy treatment. A first survey was administered to the participants 10-15 days before radiotherapy treatment, and the second survey was administered within 2-3 weeks after radiotherapy treatment. The weight and waist circumference of the patients were also measured before and after radiotherapy. RESULTS The median age of the participants was 65 (interquartile range (IQR): 62.0-70.2) years. There was a decrease in the weight (mean change (MC): -1.5, 95% CI: -2.9 to -0.2, P = 0.029) and waist circumference (MC: -1.8, 95% CI: -3.2 to -0.4, P = 0.014) of the participants after RT. There was no significant change in the HHI (MC: 0.4, 95% CI: -0.7 to 1.5) and COPE (MC: -0.6, 95% CI: -3.2 to 2.0) total scores of the patients before and after RT (P = 0.459 and P = 0.650, respectively). When only patients with prostate cancer were studied, the self-help sub-dimension of COPE (MC: -1.5, 95% CI: -2.7 to -0.3, P = 0.013) was found to be lower. CONCLUSION Multidimensional evaluations and interventions may be required in terms of hope levels and coping attitudes of cancer patients receiving radiotherapy. There is an increasing need for further studies in larger populations and cohorts related to this topic in the literature.
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Affiliation(s)
- Sema Yildizel
- Division of Geriatrics, Department of Internal Medicine, Institute of Health Sciences, Ege University, Bornova, Izmir, Turkey
| | - Mehmet Emin Arayici
- Department of Public Health, Faculty of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey
| | - Cenk Umay
- Department of Radiation Oncology, Faculty of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey
| | - Sevnaz Sahin
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey
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Galanis P, Moisoglou I, Katsiroumpa A, Malliarou M, Vraka I, Gallos P, Kalogeropoulou M, Papathanasiou IV. Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies. Healthcare (Basel) 2024; 12:797. [PMID: 38610219 PMCID: PMC11011316 DOI: 10.3390/healthcare12070797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (P.G.); (M.K.)
| | - Ioannis Moisoglou
- Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece; (I.M.); (M.M.); (I.V.P.)
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (P.G.); (M.K.)
| | - Maria Malliarou
- Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece; (I.M.); (M.M.); (I.V.P.)
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece;
| | - Parisis Gallos
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (P.G.); (M.K.)
| | - Maria Kalogeropoulou
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.K.); (P.G.); (M.K.)
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Varela P, Zervas I, Vivilaki V, Lykeridou A, Deltsidou A. Validity and reliability of the Greek version of Wijma delivery expectancy/experience questionnaire (Version A) among low-risk pregnant women. BMC Psychol 2024; 12:165. [PMID: 38504313 PMCID: PMC10953171 DOI: 10.1186/s40359-024-01662-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Fear of childbirth is a frequent health issue for pregnant women. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is a widely used instrument to measure the fear of childbirth during the antenatal period. The aim of the study was to assess the psychometric properties of the W-DEQ (version A) in a sample of Greek pregnant women. METHODS Low-risk pregnant women in the second or third trimester of pregnancy (N = 201) were invited to participate in the study and to complete a booklet of questionnaires including the Greek versions of W-DEQ-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Exploratory (EFA) and confirmatory factor analysis (CFA) was performed. RESULTS The mean age of participants was 34.2 years (SD = 4.3 years). EFA yielded six factors ("Lack of self-efficacy", "Lack of positive anticipation", "Lack of feeling lonely", "Concerns about delivery and losing control", "Calmness", and "Concern for the child") of 33 items of W-DEQ-A. CFA confirmed the multidimensionality of the instrument. All Cronbach's alpha were over 0.7, indicating acceptable reliability of the factors. All factors were significantly correlated with each other, and convergent validity was demonstrated by a significant association with stress, anxiety, and depression among low-risk pregnant women. CONCLUSION The Greek version of W-DEQ-A proved to be a valid and reliable instrument of fear of childbirth among Greek low-risk pregnant women.
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Affiliation(s)
- Pinelopi Varela
- Department of Midwifery, University of West Attica, Athens, Greece.
| | - Ioannis Zervas
- National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, MD, Greece
| | | | | | - Anna Deltsidou
- Department of Midwifery, University of West Attica, Athens, Greece
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Koutra K, Mavroeides G, Basta M, Vgontzas AN. Family Functioning, Illness-Related Self-Regulation Processes, and Clinical Outcomes in Major Depression: A Prospective Study in Greece. Healthcare (Basel) 2023; 11:2938. [PMID: 37998430 PMCID: PMC10671578 DOI: 10.3390/healthcare11222938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Major depressive disorder (MDD) is a common, seriously impairing, and often recurrent mental disorder. Based on the predictions of the Circumplex Model of Marital and Family Systems and the Common-Sense Self-Regulation Model, the aim of the present prospective study is to examine the predictive value of clinical outcomes of a process model in which associations between perceived family functioning and patient's clinical outcomes (i.e., symptom severity and suicide risk) are mediated by illness representations and coping strategies. A total of 113 patients with a clinical diagnosis of MDD (16.8% males and 83.2% females) aged 47.25 ± 13.98 years and recruited from the outpatient department and the mobile mental health unit of the Psychiatric Clinic of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group participated in the study. Family functioning was assessed in terms of cohesion and flexibility (Family Adaptability and Cohesion Evaluation Scales IV) at baseline. Illness representations (Illness Perception Questionnaire-Mental Health) and coping strategies (Brief Cope Orientation to Problems Experienced) were measured about five months later (5.04 ± 1.16 months). Symptom severity (Beck Depression Inventory) and suicidality (Risk Assessment Suicidality Scale) were measured about 10 months after the baseline assessment (9.56 ± 2.52 months). The results indicated that representations about MDD impact and symptom severity serially mediated the association between family cohesion and suicide risk in MDD. Furthermore, family cohesion was found to be linked with maladaptive coping through MDD impact representations. Family-based psychotherapeutic interventions specifically designed to target unhealthy family functioning, along with negative illness perceptions and dysfunctional coping, could be further developed and explored as adjunctive therapy to standard treatment in MDD.
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Affiliation(s)
- Katerina Koutra
- Department of Psychology, School of Social Sciences, University of Crete, 74100 Rethymnon, Crete, Greece;
| | - Georgios Mavroeides
- Department of Psychology, School of Social Sciences, University of Crete, 74100 Rethymnon, Crete, Greece;
| | - Maria Basta
- Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, 71003 Heraklion, Crete, Greece;
| | - Alexandros N. Vgontzas
- Mobile Mental Health Unit, University Hospital of Heraklion, University of Crete, 71003 Heraklion, Crete, Greece;
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, USA
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Ramachandran S, Soheilipour S, Ford NL, Brondani MA. Exploring stressors and coping strategies among dental students during COVID-19 pandemic in British Columbia. J Dent Educ 2023; 87:1427-1436. [PMID: 37429731 DOI: 10.1002/jdd.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/25/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has caused stress among undergraduate dental students; coping mechanisms might be employed to deal with such stress. A cross-sectional study was conducted to explore the coping strategies employed by dental students at the University of British Columbia (UBC) in response to their self-perceived stressors during the pandemic. METHODS An anonymous 35-item survey was distributed to all four cohorts of UBC undergraduate dental students enrolled in the 2021-2022 academic year, 229 students in total. The survey gathered sociodemographic information, self-perceived COVID-19-related stressor, and coping strategies via the Brief Cope Inventory. Adaptive and maladaptive coping were compared among the years of study, self-perceived stressors, sex, ethnicity, and living situations. RESULTS Of the 229 eligible students, 182 (79.5%) responded to the survey. Of the 171 students that reported a major self-perceived stressor, 99 (57.9%) of them were stressed about clinical skill deficit due to the pandemic; fear of contraction was reported by 27 (15.8%). Acceptance, self-distraction, and positive reframing were the most used coping strategies among all students. The one-way ANOVA test revealed a significant difference in the adaptive coping scores among the four student cohorts (p = 0.001). Living alone was found to be a significant predictor for maladaptive coping (p < 0.001). CONCLUSION The main cause of stress related to the COVID-19 pandemic for dental students at UBC is their clinical skills being negatively affected. Coping strategies including acceptance and self-distraction were identified. Continued mitigation efforts should be made to address students' mental health concerns and create a supportive learning environment.
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Affiliation(s)
- Swathi Ramachandran
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Shimae Soheilipour
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
- Dental Research Institute and Department of Dental Public Health, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nancy L Ford
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Mario A Brondani
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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Sikioti T, Zartaloudi A, Pappa D, Mangoulia P, Fradelos EC, Kourti FE, Koutelekos I, Dousis E, Margari N, Stavropoulou A, Evangelou E, Dafogianni C. Stress and burnout among Greek critical care nurses during the COVID-19 pandemic. AIMS Public Health 2023; 10:755-774. [PMID: 38187893 PMCID: PMC10764964 DOI: 10.3934/publichealth.2023051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/04/2023] [Accepted: 08/22/2023] [Indexed: 01/09/2024] Open
Abstract
Occupational stress and burnout of health personnel during the COVID-19 pandemic, especially of the nursing population in intensive care units (ICUs), were quite frequent along with negative effects and a direct correlation with the manifestation of many physical, behavioral and psychological symptoms. For the purposes of this research, a quantitative survey was carried out, in which 153 ICU nurses of secondary and tertiary public hospitals in Greece participated. Nurses completed anonymously and voluntarily a special electronic questionnaire about stress, burnout, personal concerns about the pandemic, the consequences of the outbreak and their resilience toward COVID-19 patients' care. Specific validated scales were used in this study. Female nurses felt, to a greater extent than males, work-related burnout, especially patient-related burnout and total burnout. There was a statistically significant negative relationship between the existence of a psychological support group within a hospital and personal burnout. Participants who had experience in caring for SARS-CoV-2 patients had higher mental resilience than those without experience. As the consequences experienced by the health professionals of the reference COVID-19 hospitals were increased, so did mental resilience and stress coping strategies during the pandemic. The COVID-19 outbreak and the conditions configurated in the health system had negative effects on the psycho-emotional state of ICU nurses. The manifestation of anxiety, stress and burnout had a direct correlation with both the work and personal functionality of the nurses and the whole of the healthcare services provided. The early recognition of symptoms and their individualized management are imperative for the protection of the psycho-emotional well-being of nurses.
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Affiliation(s)
| | | | - Despoina Pappa
- Faculty of Nursing, University of West Attica, Athens, Greece
| | - Polyxeni Mangoulia
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | | | | | - Eleni Evangelou
- Faculty of Nursing, University of West Attica, Athens, Greece
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Gurung RAR, Byers S, Grapentine J, Stone A. I Believe I Can Try: Self-Efficacy, Pandemic Behaviors, Coping, and Learning. PSYCHOLOGY LEARNING AND TEACHING-PLAT 2023; 22:124-136. [PMID: 38603456 PMCID: PMC9922645 DOI: 10.1177/14757257231155250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
While colleges and universities grapple with delivering instruction face-to-face during the pandemic, there is still a lot to learn from remote teaching experiences. The present study aimed to predict self-reported learning during the first year of the pandemic. Building on previous scholarship on the topic, we focus on the moderating effects of self-efficacy, and the mediating effects of coping styles on the relationship between stress and self-reported learning experiences. We also included self-perceptions of class effort, the instructor, and changes in class, personal, professor, and health behaviors. Students (N = 272) in Introductory Psychology classes participated in an online survey as part of a class research requirement. Analyses demonstrated that self-efficacy predicted differences in many measures associated with learning and predicted learning over and above all other variables entered in a hierarchical regression. The relationship between stress and learning was mediated by coping, but not moderated by self-efficacy. These results suggest student beliefs about their ability to perform online are important to learning outcomes, but coping mechanisms mediate the relationship of stress and learning. Especially while teaching during pandemic times using different modalities, instructors will do well to directly address students' perceptions of their own ability and build self-efficacy.
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Papadopoulos A, Siafaka V, Tsapara A, Tafiadis D, Kotsis K, Skapinakis P, Tzoufi M. Measuring parental stress, illness perceptions, coping and quality of life in families of children newly diagnosed with autism spectrum disorder. BJPsych Open 2023; 9:e84. [PMID: 37198138 DOI: 10.1192/bjo.2023.55] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND A variety of psychosocial factors have been shown to affect the quality of life of families (FQoL). AIM This study aimed to assess the impact of mother's demographic characteristics, parental stress, illness perceptions about autism spectrum disorder (ASD), coping strategies, ASD severity and time since diagnosis on FQoL during the initial period following diagnosis (≤6 months). METHOD Fifty-three mothers of children newly diagnosed with ASD completed the Beach Center Family Quality of Life Scale, the Autism Parenting Stress Index, the Brief Illness Perception Questionnaire and the Brief Coping Orientation to Problems Experienced Inventory. A descriptive analysis was conducted on the demographic characteristics of the family. Eta coefficients and Pearson's analysis were used to determine the associations between the variables and the FQoL dimensions. Hierarchical regression was used to determine whether variables explained a statistically significant family quality of life variance. RESULTS Pearson's analysis and eta coefficients indicated several correlations. Hierarchical regression analysis showed that higher parental stress related to core autism symptoms was associated with poorer FQoL (95% CI -0.08 to -0.02, P = 0.001), and higher perceived treatment control was associated with better FQoL (95% CI 0.04-0.16, P = 0.001). In addition, stronger perceived personal control was associated with higher physical/material well-being (95% CI 0.01-0.16, P = 0.022) and higher disability-related support (95% CI 0.30-0.61, P = 0.001). Higher family monthly income was associated with better FQoL (95% CI 0.08-0.027, P = 0.000), whereas marital status (divorced mother) was correlated with poorer FQoL (95% CI -0.68 to -0.16, P = 0.002). CONCLUSIONS Interventions should emphasise managing the disorder's characteristics and implementing psychoeducational and supportive programmes for parents, immediately after the diagnosis, to enhance FQoL.
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Affiliation(s)
- Angelos Papadopoulos
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Angeliki Tsapara
- Faculty of Medicine of Patras, School of Health Sciences, University of Patras, Patras, Greece
| | - Dionysios Tafiadis
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Konstantinos Kotsis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Petros Skapinakis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Meropi Tzoufi
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Liozidou A, Varela V, Vlastos DD, Giogkaraki E, Alzueta E, Perrin PB, Ramos-Usuga D, Arango-Lasprilla JC. Forced social isolation and lockdown during the COVID-19 pandemic: depression, anxiety, trauma-distress and coping mechanisms of a Greek sample. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-10. [PMID: 37361299 PMCID: PMC10097449 DOI: 10.1007/s10389-023-01907-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/28/2023] [Indexed: 06/28/2023]
Abstract
Aim The COVID-19 outbreak escalated into a global pandemic, pushing many governments around the world to impose measures affecting all aspects of life. Similar to other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the association between social restriction measures, an mental health and coping strategies employed by a Greek adult sample. Subject and methods An online questionnaire was used to collect data during the second national lockdown (February to May 2021). A total of 650 participants (M age 33.13, 71.5% female) comprised the final sample. Results The results show 21.3% of respondents reported moderate-to-extremely severe anxiety, 33% moderate-to-extremely severe depression, 31.8% moderate-to-severe stress, and 38% clinically significant trauma-related distress. Hierarchical linear regression analyses revealed that the strongest contributors to adverse mental health outcomes were being female, of younger age, experiencing increases in verbal arguments at home, being separated from family and close friends, and being unable to afford enough or healthy food. Lastly, participants reported moving away from social support and into more individual strength and resilience-based coping strategies to cope with challenges. Conclusion These findings suggest that in addition to the detrimental effects on physical health, social restriction measures related to COVID-19 also imposed a heavy psychological burden on the population via forced social isolation, which, by design, increased not only physical distancing but also psychological distancing between people. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01907-3.
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Affiliation(s)
- Athanasia Liozidou
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, SCG - Scientific College of Greece, Athens, Greece
- Neuropsychology Department, 1st & 2nd Neurology Clinic, Henry Dunant Hospital Center, Athens, Greece
- Department of Psychology, SCG – Scientific College of Greece in Collaboration with the University of Strasbourg, Athens, Greece
| | - Vasiliki Varela
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, SCG - Scientific College of Greece, Athens, Greece
- Department of Psychology, SCG – Scientific College of Greece in Collaboration with the University of Strasbourg, Athens, Greece
- 1st Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - Dimitris D. Vlastos
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, SCG - Scientific College of Greece, Athens, Greece
- Department of Psychology, SCG – Scientific College of Greece in Collaboration with the University of Strasbourg, Athens, Greece
- Laboratory of Experimental and Applied Psychology, SCG - Scientific College of Greece, Athens, Greece
| | - Erasmia Giogkaraki
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, SCG - Scientific College of Greece, Athens, Greece
- Department of Psychology, SCG – Scientific College of Greece in Collaboration with the University of Strasbourg, Athens, Greece
| | - Elisabet Alzueta
- Center for Health Sciences, SRI International, Menlo Park, CA USA
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA USA
| | - Daniela Ramos-Usuga
- Biomedical Research Doctorate Program, University of the Basque Country, Leioa, Spain
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Varela P, Lykeridou A, Zervas I, Deltsidou A. Psychometric properties of the Greek Version of the Traumatic Event Scale (TES) (Version A) among low-risk pregnant women. BMC Psychol 2023; 11:105. [PMID: 37029446 PMCID: PMC10082481 DOI: 10.1186/s40359-023-01152-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The Traumatic Event Scale (TES) is one of the most often used instruments for the assessment of the Posttraumatic Stress Disorder (PTSD) symptomatology during pregnancy which is linked with adverse effects. The aim of the study was to assess the psychometric properties of the TES (version A) in a sample of Greek pregnant women. METHODS Two hundred one low risk pregnant women in their second or third trimester were invited to participate in the study. Participants completed a number of questionnaires including the Greek versions of TES-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Confirmatory factor analysis (CFA) was conducted in order to test how well the already TES-A five-factor model fits the data from Greece. RESULTS Participants' average age was 34.2 years (SD = 4.3 years). Through CFA the already five-factor structure of the TES-A (Anticipation of trauma, Intrusion, Avoidance, Resignation, Hyperstimulation) was applied to our sample. All five factors were significantly and positively correlated with each other. All Cronbach's alpha were over 0.7, indicating acceptable reliability of the factors. Relatively convergent validity, all factors of the Greek version of the TES-A were significantly associated with stress, anxiety, depression and coping strategies. CONCLUSION The Greek version of TES-A is detected to be a valid and reliable instrument of prenatal Posttraumatic Stress Disorder (PTSD) symptomatology among low-risk Greek pregnant women.
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Affiliation(s)
- Pinelopi Varela
- General Hospital of Athens "Alexandra", Department of Midwifery, University of West Attica, Athens, Greece.
| | | | - Ioannis Zervas
- Professor of Psychiatry and Psychosomatic Medicine, Head of the Women's mental health and reproductive psychiatric clinic, National and Kapodistrian University of Athens Medical School, Eginition University Hospital, Athens, Greece
| | - Anna Deltsidou
- Department of Midwifery, University of West Attica, Athens, Greece
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Hanfstingl B, Gnambs T, Fazekas C, Gölly KI, Matzer F, Tikvić M. The Dimensionality of the Brief COPE Before and During the COVID-19 Pandemic. Assessment 2023; 30:287-301. [PMID: 34654329 PMCID: PMC9902999 DOI: 10.1177/10731911211052483] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Brief COPE (Coping Orientation to Problems Experienced) is a frequently used questionnaire assessing 14 theoretically derived coping mechanisms, but psychometric research has suggested inconsistent results concerning its factor structure. The aim of this study was to investigate primary and secondary order factor structures of the Brief COPE during the COVID-19 pandemic by testing 11 different models by confirmatory factor analyses and to assess differences between sex, age groups, and relationship status. Altogether, 529 respondents from Austria and Germany participated in a web-based survey. Results supported the originally hypothesized 14-factor structure but did not support previously described higher-order structures. However, bass-ackwards analyses suggested systematic overlap between different factors, which might have contributed to different factor solutions in previous research. Measurement invariance across sex, age groups, and relationship status could be confirmed. Findings suggest that cultural and situational aspects as well as the functional level should be considered in research on theoretical framing of coping behavior.
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Affiliation(s)
- Barbara Hanfstingl
- University of Klagenfurt, Klagenfurt am Wörthersee, Austria,Barbara Hanfstingl, Associate Professor, Institute of Instructional and School Development, University of Klagenfurt, Sterneckstrasse 15, Klagenfurt am Wörthersee 9020, Austria.
| | - Timo Gnambs
- Leibniz Institute for Educational Trajectories, Bamberg, Germany
| | | | | | | | - Matias Tikvić
- University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Maria GC, Christos AP, Theodoros DK, Ioannis AN, Charalambos IK. Adjustment Mechanisms in the Acute Phase of Myocardial Infarction in Men. Psychol Rep 2023; 126:133-149. [PMID: 34455859 DOI: 10.1177/00332941211040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AIM Stress and Coping Model and Post-Traumatic Growth Theory indicate adjustment procedures concepts after a crisis. The objective of this study was to assess the relationships between causal attributions, coping strategies and post-traumatic growth in male patients with acute myocardial infarction and variable cardiac function severity. METHODS Seventy-eight male patients surviving a myocardial infarction, were divided into two sub-groups based on left ventricular ejection fraction measurements [Group A (left ventricular ejection fraction: <45%, n = 34), Group B (left ventricular ejection fraction: ≥45%, n = 44)] and were interviewed after the acute phase of myocardial infarction, on the last day of their coronary unit stay. Medical data was obtained from their medical records. Causal Attributions' List, Coping Orientation to Problems Experienced and Post-Traumatic Growth Inventory were used. RESULTS Causal attributions were found to be related to active coping, emotional support, religious coping and self-blame in both groups. Planning, positive reinterpretation and active coping were the strategies associated positively with most of the post-traumatic inventory subscales in total data analyses. CONCLUSIONS Diverse coping strategies were associated with posttraumatic growth factors. It is important to assess adjustment mechanisms in the acute phase of myocardial infarction. A tailored scheme therapy, considering patient's needs, has to be planned.
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Affiliation(s)
| | | | - D Karamitsos Theodoros
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - A Nimatoudis Ioannis
- Department of Psychiatry, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - I Karvounis Charalambos
- 1st Department of Cardiology, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Marakshina J, Vasin G, Ismatullina V, Malykh A, Adamovich T, Lobaskova M, Malykh S. The brief COPE-A inventory in Russian for adolescents: Validation and evaluation of psychometric properties. Heliyon 2023; 9:e13242. [PMID: 36747558 PMCID: PMC9898444 DOI: 10.1016/j.heliyon.2023.e13242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 01/09/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
In this paper, the results of a psychometric analysis of a Brief Russian-language version of the COPE-A inventory for adolescents are presented. The inventory was designed for identifying coping strategies used in stressful situations and is comprised of 31 items. The study involved 3530 adolescents aged 13 to 17 years old. Using exploratory factor analysis and confirmatory factor analysis, it was shown that the data correspond to the expected six-factor configuration, but the distribution of items by factors differs from the theoretical structure. To improve the factor structure, two questions were excluded; the final version included 29 items. The resulting inventory's scales turned out to be highly reliable (Cronbach's alpha values range from 0.72 to 0.89). Additionally, the construct validity of the method was assessed. In conclusion, the adapted version of the Brief COPE-A is suitable for use in the adolescent population.
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Affiliation(s)
- Julia Marakshina
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Russia,Developmental Behavioral Genetics Lab, Psychological Institute of Russian Academy of Education, Russia
| | - Georgy Vasin
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Russia
| | - Victoria Ismatullina
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Russia,Developmental Behavioral Genetics Lab, Psychological Institute of Russian Academy of Education, Russia
| | - Artem Malykh
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Russia
| | - Timofey Adamovich
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Russia,Developmental Behavioral Genetics Lab, Psychological Institute of Russian Academy of Education, Russia
| | - Marina Lobaskova
- Center of Population Research, Ural Institute of Humanities, Ural Federal University Named After the First President of Russia B.N. Yeltsin, Russia,Developmental Behavioral Genetics Lab, Psychological Institute of Russian Academy of Education, Russia
| | - Sergey Malykh
- Department of Psychology, Lomonosov Moscow State University, Russia,Developmental Behavioral Genetics Lab, Psychological Institute of Russian Academy of Education, Russia,Corresponding author. Department of Psychology, Lomonosov Moscow State University, Russia.
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Neophytou K, Theodorou M, Artemi TF, Theodorou C, Panayiotou G. Gambling to escape: A systematic review of the relationship between avoidant emotion regulation/coping strategies and gambling severity. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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20
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Dafogianni C, Pappa D, Mangoulia P, Kourti FE, Koutelekos I, Dousis E, Margari N, Ferentinou E, Stavropoulou A, Gerogianni G, Fradelos E, Zartaloudi A. Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10122573. [PMID: 36554097 PMCID: PMC9778423 DOI: 10.3390/healthcare10122573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators.
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Affiliation(s)
| | - Despoina Pappa
- Department of Nursing, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | - Polyxeni Mangoulia
- Department of Nursing, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | | | | | - Evangelos Dousis
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Nikoletta Margari
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | | | | | | | - Evangelos Fradelos
- Faculty of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
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Bongelli R, Fermani A, Canestrari C, Riccioni I, Muzi M, Bertolazzi A, Burro R. Italian validation of the situational Brief Cope Scale (I-Brief Cope). PLoS One 2022; 17:e0278486. [PMID: 36454789 PMCID: PMC9714734 DOI: 10.1371/journal.pone.0278486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022] Open
Abstract
The Brief COPE (Coping Orientation to Problems Experienced) inventory is 14 faced scales used to assess coping strategies. It has been administered on different population samples and translated into several languages. Nonetheless, the Italian validation of its situational format is missing, and the present study aimed to fill this gap. To this end, the original English version of the scale was translated into Italian and administered to a sample of 682 Italian healthcare workers (HCWs), during the first wave of COVID-19. The Exploratory and Confirmatory Factor Analysis (EFA and CFA) were performed and led to the validation of the Italian Brief COPE (I-Brief COPE) scale, consisting of 21 items, loading properly on 6 factors, which range from activation (F1) to deactivation (F2), via social support (F3), humorous reframing (F4), religious/spiritual reliance (F5), substances use (F6). The six factors identified represent, according to our analyses, the relevant dimensions of coping in a stressful situation such as COVID-19. The results of this study reveal that the I-Brief Cope can be considered as a valid tool for measuring coping strategies in facing stressful, unpredictable, and damaging events.
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Affiliation(s)
- Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Macerata, Italy
- * E-mail:
| | - Alessandra Fermani
- Department of Education, Cultural Heritage and Tourism, University of Macerata, Macerata, Italy
| | - Carla Canestrari
- Department of Education, Cultural Heritage and Tourism, University of Macerata, Macerata, Italy
| | - Ilaria Riccioni
- Department of Education, Cultural Heritage and Tourism, University of Macerata, Macerata, Italy
| | - Morena Muzi
- Department of Education, Cultural Heritage and Tourism, University of Macerata, Macerata, Italy
| | - Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Macerata, Italy
| | - Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
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Tsouvelas G, Kalaitzaki A, Tamiolaki A, Rovithis M, Konstantakopoulos G. Secondary traumatic stress and dissociative coping strategies in nurses during the COVID-19 pandemic: The protective role of resilience. Arch Psychiatr Nurs 2022; 41:264-270. [PMID: 36428058 PMCID: PMC9428110 DOI: 10.1016/j.apnu.2022.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/07/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
During the COVID-19 pandemic, nurses are repeatedly exposed to acute stress at their workplace, and therefore, they are at high risk for developing mental health symptoms. The prolonged exposure of healthcare professionals may lead to Secondary Traumatic Stress (STS). STS is an aspect of "cost of care", the natural consequence of providing care to people who suffer physically or psychologically. The purpose of this study was to investigate the levels of STS in nurses during the first phase of the COVID-19 pandemic in Greece and to detect aggravating and protective factors. Participants were 222 nurses (87.4 % women; mean age 42.3 years) who completed an online survey. The questionnaire comprised of the Secondary Traumatic Stress Scale, the Brief Resilience Scale, and the Brief Coping Orientation to Problems Experienced Inventory. Nurses had high levels of STS. The hierarchical regression analyses showed that STS and its dimensions Avoidance and Arousal were positively predicted mainly by denial and self-distraction coping strategies and inversely by resilience. Resilience exhibited a protective (partial mediation) effect on the strong relationship between the dissociative coping strategies (denial, self-distraction, venting and behavioral disengagement) and STS. Trauma-informed care psychosocial interventions are needed to support the already overburdened nursing staff during the coronavirus pandemic.
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Affiliation(s)
- George Tsouvelas
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece.
| | - Argyroula Kalaitzaki
- Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Hellenic Mediterranean University, CP: 71004 Heraklion, Greece.
| | - Alexandra Tamiolaki
- Department of Social Work, Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, CP: 71004 Heraklion, Greece
| | - Michael Rovithis
- Department of Nursing, Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life, Affiliated Researcher of the Research Centre 'Institute of Agri-Food and Life Sciences', Health Sciences Faculty, Hellenic Mediterranean University, CP: 71004 Heraklion, Crete, Greece.
| | - George Konstantakopoulos
- Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece; Department of Clinical, Education and Health Psychology, University College London, London, UK.
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Huda N, Lin YK, Shaw MK, Hsu YY, Chang HJ. Psychometric properties and cross-cultural adaptation of the Indonesian version of the Brief COPE in a sample of advanced cancer patients. PLoS One 2022; 17:e0275083. [PMID: 36441773 PMCID: PMC9704551 DOI: 10.1371/journal.pone.0275083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/09/2022] [Indexed: 11/29/2022] Open
Abstract
The Brief COPE Inventory has been proven as acceptable psychometric properties to examine coping strategies among cancer patients. However, most psychometric testing studies have been carried out in Western countries, raising concerns about the properties' relevance and applicability in other cultural contexts. This study aimed to present psychometric properties of the Brief COPE in a sample of patients with advanced cancer in Indonesia. Specifically, we intended to examine the factorial structure and the measure's validity and reliability. This study included 440 patients from the original study who completed the Indonesian version of Brief COPE. We used exploratory factor analysis and confirmatory factor analysis to assess factor structure and evaluate the structural model fit, respectively. Reliability was demonstrated by internal consistency represented by Cronbach's alpha coefficient. The factor analysis identified a 21-items scale with 5-factors (avoidance, religion and acceptance, social support coping, problem solving and distraction). Confirmatory factor analysis demonstrated a good model fit. For the whole scale and its subscales Cronbach's alpha coefficients were acceptable signifying good reliability. Convergent, divergent validity and contrast group comparison were evidenced by significant correlations among subscales and the other instruments used. This study shows that the Indonesian version of Brief COPE is a reliable and valid instrument to measure coping in advanced cancer patients and is ready for use amongst this population in the Indonesian cultural context.
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Affiliation(s)
- Nurul Huda
- Nursing Faculty, Universitas Riau, Pekanbaru, Indonesia
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Malissa Kay Shaw
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ying Hsu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Ju Chang
- College of Nursing, Department of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- College of Nursing, Efficient Smart Care Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- * E-mail:
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Rodrigues F, Figueiredo N, Rodrigues J, Ferreira R, Hernández-Mendo A, Monteiro D. A Comprehensive Review and Bifactor Modeling Analysis of the Brief COPE. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221108127. [PMID: 36305610 PMCID: PMC9619253 DOI: 10.1177/00469580221108127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Brief COPE is a measure of coping strategies that contains 14 factors. The purpose of this research was twofold: (a) examine the psychometric proprieties of the Brief Cope in previous studies; and (b) perform Confirmatory Factor Analyses (CFA) with second-order model and bifactor model specifications that could be used to assess the best model that represents the 14 coping strategies inherent to the instrument. In order to meet the first objective, a bibliographic review of published peer-reviewed studies between 1997 and 2021 was conducted. Results from the review identified 50 studies, of which 21 used exploratory factor analysis, 28 CFA and one study test-retest analysis. Seventeen studies used the entire correlated 14-factor structure. However, only 11 studies conducted a CFA. For the second objective, a sample of 472 working class individuals (female = 278) with a mean work experience of 19.06 years (SD = 11,92) were recruited. We tested several model specifications, convergent and discriminant validity analysis. We found the correlated 14-factor structure of the Brief COPE to have good psychometric properties. The second-order and bifactor model specifications displayed poor fit or did not converge, respectively. The measure showed good convergent and discriminant validity, and the subscales showed adequate internal consistency. We provide further validity and reliability of the correlated 14-factor structure, evidencing that this measure can assess coping mechanisms. Second-order model specifications need further testing and empirical evidence to support such hierarchical categorization.
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Affiliation(s)
- Filipe Rodrigues
- ESECS – Polytechnique of Leiria, Leiria, Portugal,Life Quality Research Centre, Rio Maior, Portugal
| | - Nuno Figueiredo
- ESECS – Polytechnique of Leiria, Leiria, Portugal,Nuno Figueiredo, Instituto Politécnico de Leiria Escola Superior de Educação e Ciências Sociais, Rua Dr. João Soares, Apartado 4045, Leiria 2411-901, Portugal.
| | - José Rodrigues
- Life Quality Research Centre, Rio Maior, Portugal,Sport Science School of Rio Maior – Polytechnique Institute of Santarém (ESDRM-IPSantarém), Rio Maior, Portugal
| | - Regina Ferreira
- Life Quality Research Centre, Rio Maior, Portugal,Health Science School – Polytechnique Institute of Santarém, Santarém, Portugal
| | | | - Diogo Monteiro
- ESECS – Polytechnique of Leiria, Leiria, Portugal,Life Quality Research Centre, Rio Maior, Portugal,Research Center in Sport, Health and Human Development, Vila Real, Portugal
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Avraam G, Samakouri M, Tzikos A, Arvaniti A. High Expressed Emotion and Warmth among Families of Patients with Schizophrenia in Greece. Healthcare (Basel) 2022; 10:healthcare10101957. [PMID: 36292404 PMCID: PMC9602413 DOI: 10.3390/healthcare10101957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2022] Open
Abstract
Expressed emotion (EE) is an established prognostic factor for relapse in schizophrenia. Through critical comments (CC), hostility (H) and emotional overinvolvement (EOI), a relative can be rated as high or low EE, but the role of warmth should also be evaluated in order to consider the influence of a positive affect within the family context. In this study, EE was assessed in a sample of 48 relatives of patients with schizophrenia using the Camberwell Family Interview (CFI). Questionnaires assessing coping (brief-COPE), their wellbeing (World Health Organization Well-Being Index WHO-5) and the socio-demographic variables were also administered. Relatives who expressed a higher level of warmth were found to make fewer CC (5.2 ± 4.6 vs. 8.4 ± 4.6, p = 0.009) and have, on average, higher EOI scores (3.2 ± 1.0 vs. 1.9 ± 1.1, p = 0.002) than those who expressed no or very little warmth. High EE was found to be associated with having fewer family members (p = 0.035), while relatives with a higher level of education expressed less warmth (p = 0.007). Relatives with a low level of warmth had higher maladaptive coping scores and tended to score worse for their overall wellbeing in comparison to relatives who showed a higher level of warmth (28.4 ± 5.0 vs. 24.1 ± 5.2, p = 0.006 and 39.1 ± 20.4 vs. 51.3 ± 22.0, p = 0.073, respectively). Since the role of warmth is important, it should be taken into account when designing family interventions, independently from lowering EE. Customized interventions to promote warmth and the routine screening of relatives are recommended.
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Affiliation(s)
- Georgios Avraam
- Department of Psychiatry, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-69-4252-0100
| | - Maria Samakouri
- Department of Psychiatry, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece
- Department of Psychiatry, University General Hospital of Alexandroupolis, 681 00 Alexandroupolis, Greece
| | - Anthimos Tzikos
- Department of Psychiatry, University General Hospital of Alexandroupolis, 681 00 Alexandroupolis, Greece
| | - Aikaterini Arvaniti
- Department of Psychiatry, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece
- Department of Psychiatry, University General Hospital of Alexandroupolis, 681 00 Alexandroupolis, Greece
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Rawlings GH, Thompson AR, Armstrong I, Novakova B, Beail N. Coping styles associated with depression, health anxiety and health-related quality of life in pulmonary hypertension: cross-sectional analysis. BMJ Open 2022; 12:e062564. [PMID: 35948373 PMCID: PMC9379501 DOI: 10.1136/bmjopen-2022-062564] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pulmonary hypertension (PH) is a life-shortening disease associated with early mortality and high morbidity. With advancements in medical treatment, people are living longer with the disease, and research is now needed to explore variables that help to enhance patient-reported outcomes. This study investigated the coping strategies of individuals with PH and examined the relationship between coping, depression, health anxiety and health-related quality of life (HRQoL). DESIGN A cross-sectional survey design was used. PARTICIPANTS Participants (n=121) were recruited from membership of Pulmonary Hypertension Association (PHA) UK. OUTCOME MEASURES Participants completed a series of questionnaires assessing depression (Patient Health Questionnaire-9), health anxiety (Short Health Anxiety Inventory), HRQoL (emPHasis-10) and coping (Brief COPE). A principal component analysis was used to identify participants' coping profile. A series of correlational, linear and moderated multiple regression analyses were performed to examine the relationship between coping and health-related outcomes. RESULTS Overall, 43% participants met criteria for potential clinical depression. Depression and health anxiety were strongly associated with HRQoL, explaining 37% and 30% of variance respectively (p<0.001). A principal component analysis identified a four-component model of coping. Dimensions were named based on construct items: 'cognitive and affirmation coping' (seven items), 'passive coping' (four items), 'external coping' (seven items) and 'substance use coping' (two items). Cognitive and affirmation and external coping moderated the relationship between depression and HRQoL, with high use of these coping strategies reducing the impact of depression on HRQoL. External coping also moderated the effect of health anxiety on HRQoL. CONCLUSIONS The results uniquely highlight the importance of coping styles and psychological distress in predicting HRQoL in PH. Our findings indicate the importance to assess for psychological distress in this population and suggest the need to offer psychological interventions that take into account coping resources and strategies.
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Affiliation(s)
| | - Andrew R Thompson
- South Wales Clinical Psychology Training Programme, Cardiff University, Cardiff, UK
- Clinical Psychology Unit, The University of Sheffield, Sheffield, UK
| | - Iain Armstrong
- Sheffield Pulmonary Vascular Disease Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Barbora Novakova
- Health and Wellbeing Service, Sheffield IAPT, Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
| | - Nigel Beail
- Clinical Psychology Unit, The University of Sheffield, Sheffield, UK
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Zhang Q, Zhou Y, Ho SMY. Active and avoidant coping profiles in children and their relationship with anxiety and depression during the COVID-19 pandemic. Sci Rep 2022; 12:13430. [PMID: 35927558 PMCID: PMC9352659 DOI: 10.1038/s41598-022-15793-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/29/2022] [Indexed: 01/01/2023] Open
Abstract
Active and avoidant coping styles are important dispositional factors in the development of anxiety and depression symptoms. Children use both active and avoidant coping strategies together in daily life. No studies have investigated the relationship between active–avoidant coping profiles and internalizing symptoms in children. The present study aimed to investigate children’s active–avoidant coping profiles and assess the relationship that active–avoidant coping profiles have with anxiety and depression symptoms. A two-wave longitudinal study was conducted among 322 Chinese children in the People’s Republic of China during the COVID-19 pandemic. Participants completed the Children’s Coping Strategies Checklist-Revised 1 at Time 1 and the Revised Child Anxiety and Depression Scale at Time 1 and 6 months later (Time 2). Four active–avoidant coping profiles were revealed: low active copers, high active copers, balanced copers, and avoidant copers. Low and high active copers had lower levels of anxiety and depression symptoms than balanced copers and avoidant copers. Avoidant copers showed a larger decrease in depression symptoms than balanced copers and high active copers during the COVID-19 pandemic. It is important to improve children’s active–avoidant coping profiles to relieve anxiety and depression symptoms.
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Affiliation(s)
- Qiaochu Zhang
- Department of Social and Behavioural Sciences, College of Humanities and Social Sciences, Floor 7, AC1, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong.
| | - Yanlin Zhou
- Department of Social and Behavioural Sciences, College of Humanities and Social Sciences, Floor 7, AC1, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong.,Department of Psychology and Behavioral Sciences, Zhejiang University, 148 Tianmushan Rd, Xixi Campus, Hangzhou, China
| | - Samuel M Y Ho
- Department of Social and Behavioural Sciences, College of Humanities and Social Sciences, Floor 7, AC1, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong
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Weeratunga E, Senadheera C, Hettiarachchi M, Perera B. Validation of the Sinhalese Version of Brief COPE Scale for patients with cancer in Sri Lanka. BMC Psychol 2022; 10:157. [PMID: 35725504 PMCID: PMC9210691 DOI: 10.1186/s40359-022-00863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background Coping strategies play a vital role in cancer management and has been an integral part in the recovery process of cancer patients worldwide. Coping refers to specific efforts; both behavioral and psychological, that diminishes stresses emerged in cancer patients. This study evaluated the psychometric properties of the Sinhalese version of the Coping Orientation to Problems Experienced Inventory (S-BC) which was developed based on the Brief COPE scale for cancer patients in Sri Lanka. Methods The original Brief COPE is a self-administered tool with 28 items designed to measure coping methods used by people in stressful life events. It consisted of statements related to adaptive and maladaptive coping strategies. Forty patients with cancer who were registered at the Oncology ward, Teaching Hospital, Galle, Sri Lanka were included in the study. A cross-cultural adaptation of the Brief COPE was done using WHO guidelines. Reliability of the S-BC was assessed using test–retest and internal consistency procedures. The construct validity of the tool was assessed by performing exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent and discriminant validity of the S-BC was tested using World Health Organization-Quality of Life-Brief scale (WHOQOL-BREF) and Centre for Epidemiological Studies-Depression scale (CES-D). Results The mean (± SD) age of the sample was 61(± 12) years, and 52.5% (n = 21) of the participants were men. Eighty percent (n = 32) of the participants were more than one year of treatment from diagnosing as a cancer patient. The test–retest reliability of the S-BC was 0.66, and the internal consistency of the S-BC was good (Cronbach’s alpha - 0.819). Both EFA and CFA revealed a structure comprised of seven factors. Such factors were Avoidance/Behavioral disengagement, Religious faith/Acceptance, Seeking support, Planning, Substance use/Venting, Self-blame and Active/positive coping. The scores of the adaptive coping of the S-BC was negatively and the scores of the maladaptive coping of the S-BC was positively correlated with the CES-D score. The scores of the adaptive coping of the S-BC was positively correlated with the total score of the WHOQOL-BREF questionnaire indicating the S-BC’s convergent and discriminant validity properties. Conclusion The Sinhalese version of the Brief COPE is found to be a valid and a reliable measure to assess coping strategies used by patients with cancer in Sri Lanka. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00863-z.
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Affiliation(s)
- Eranthi Weeratunga
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka.
| | - Chandanie Senadheera
- Department of Psychiatry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | | - Bilesha Perera
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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Lim LTS, Regencia ZJG, Dela Cruz JRC, Ho FDV, Rodolfo MS, Ly-Uson J, Baja ES. Assessing the effect of the COVID-19 pandemic, shift to online learning, and social media use on the mental health of college students in the Philippines: A mixed-method study protocol. PLoS One 2022; 17:e0267555. [PMID: 35503779 PMCID: PMC9064082 DOI: 10.1371/journal.pone.0267555] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/11/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and teachers. Our study aims to assess Filipino college students' mental health status and to estimate the effect of the COVID-19 pandemic, the shift to online learning, and social media use on mental health. In addition, facilitators or stressors that modified the mental health status of the college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning will be investigated. METHODS AND ANALYSIS Mixed-method study design will be used, which will involve: (1) an online survey to 2,100 college students across the Philippines; and (2) randomly selected 20-40 key informant interviews (KIIs). Online self-administered questionnaire (SAQ) including Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE will be used. Moreover, socio-demographic factors, social media usage, shift to online learning factors, family history of mental health and COVID-19, and other factors that could affect mental health will also be included in the SAQ. KIIs will explore factors affecting the student's mental health, behaviors, coping mechanism, current stressors, and other emotional reactions to these stressors. Associations between mental health outcomes and possible risk factors will be estimated using generalized linear models, while a thematic approach will be made for the findings from the KIIs. Results of the study will then be triangulated and summarized. ETHICS AND DISSEMINATION Our study has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01). The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.
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Affiliation(s)
| | - Zypher Jude G. Regencia
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines
| | | | | | | | - Josefina Ly-Uson
- Department of Psychiatry, College of Medicine, University of the Philippines, Manila, Philippines
| | - Emmanuel S. Baja
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines
- * E-mail:
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30
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Efthymiou A, Middleton N, Charalambous A, Papastavrou E. Health literacy and eHealth literacy and their association with other caring concepts among carers of people with dementia: A descriptive correlational study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1109-1119. [PMID: 33956368 DOI: 10.1111/hsc.13341] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 02/01/2021] [Accepted: 02/12/2021] [Indexed: 06/12/2023]
Abstract
Health literacy (HL) and eHealth literacy (eHL) can facilitate carers of people with dementia (PwD) to search, find, assess and apply information related to dementia-specific issues from different resources. There is a lack of research with regard to HL and eHL among carers of PwD. The aim of this study is to identify the levels of HL and eHL among carers of PwD in Greece and Cyprus and to search for the associations with other caring concepts. This study followed a descriptive correlational design. In total, 174 primary informal carers of PwD, mostly women, over 45 years old and with more than 12 years of education and 67 secondary carers (family, friends or neighbours) participated in the study. Primary informal carers completed a face-to-face survey on the level of HL and eHL, internet use, dementia-specific internet use, care-giving self-efficacy, coping strategies, care-giving perceptions and social support. Primary informal carers reported a high level of eHL and HL. Carers with higher HL were more likely to report higher score of eHL, care-giving self-efficacy and lower score of problematic/dysfunctional coping. Higher score of eHeals-Carer "information seeking" was related with higher use of emotion-focused strategies. From this study, a positive message was received with regard to the role of HL and eHL in the everyday caring life. Non-for-profit organisations and healthcare professionals could integrate in their practice assessment tools and develop tailored training courses for carers enhancing low level of HL and eHL.
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Affiliation(s)
- Areti Efthymiou
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Andreas Charalambous
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
- Department of Nursing, University of Turku, Turku, Finland
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31
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Muniandy M, Richdale AL, Arnold SRC, Trollor JN, Lawson LP. Associations between coping strategies and mental health outcomes in autistic adults. Autism Res 2022; 15:929-944. [PMID: 35218321 DOI: 10.1002/aur.2694] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/31/2022] [Accepted: 02/14/2022] [Indexed: 12/28/2022]
Abstract
Compared to the general population, mental health difficulties are commonly reported in autistic adults. However, the ways in which coping strategies are associated with mental health and well-being in this population remain unknown. Further, we do not know if, and if so, how these associations might differ to that of non-autistic adults. In this study, we hypothesized that in both our autistic (N = 255) and non-autistic (N = 165) adult samples, disengagement coping strategies (e.g., denial) would relate to poorer mental health and well-being, while engagement coping strategies (e.g., problem solving) would relate to better mental health and well-being. Regression analyses revealed that higher use of disengagement coping strategies was significantly associated with higher levels of anxiety and depression, and lower levels of well-being in both samples. In contrast, increased use of engagement coping strategies was associated with better well-being, but only in the autistic sample. Our results contribute to the characterization of negative and positive mental health outcomes in autistic adults from a coping perspective, with potential to offer novel information regarding coping strategies to consider when addressing support options for mental health difficulties in the autistic adult population.
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Affiliation(s)
- Melanie Muniandy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Australia
| | - Amanda L Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Australia
| | - Samuel R C Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Australia.,Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Australia.,Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, New South Wales, Australia
| | - Lauren P Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Brisbane, Australia
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Stress Levels and Coping Strategies Among Undergraduate Nursing Students in Greece During Economic Recession. Nurse Educ Pract 2022; 60:103299. [DOI: 10.1016/j.nepr.2022.103299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/18/2022]
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E. Kalaitzaki A, Tsouvelas G, Tamiolaki A, Konstantakopoulos G. Post-traumatic stress symptoms during the first and second COVID-19 lockdown in Greece: Rates, risk, and protective factors. Int J Ment Health Nurs 2022; 31:153-166. [PMID: 34658113 PMCID: PMC8652774 DOI: 10.1111/inm.12945] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/24/2021] [Accepted: 10/05/2021] [Indexed: 01/25/2023]
Abstract
The aim was to (i) compare the rates of perceived stress, post-traumatic stress symptoms (PTSS) and other potential correlates (i.e., resilience, social support, coping strategies, and loneliness) in the general population between the two COVID-19 lockdowns in Greece and (ii) explore risk and protective factors of PTSS. Online data were collected amid the first (timepoint 1-T1) and second lockdown (timepoint 2-T2) by 1009 and 352 participants, respectively. The PTSD Checklist for DSM-5 and the Perceived Stress Scale measured levels of PTSS and perceived stress. The Brief Resilience Scale, the COPE, the revised UCLA Loneliness Scale, and the ENRICHD Social Support Instrument measured resilience, coping strategies, loneliness, and social support, respectively. Higher levels of PTSS and perceived stress were reported during T2, compared to T1. Clinically significant levels of PTSS were presented by 26.1% and 35.5% of the participants during T1 and T2, respectively. Higher levels of loneliness and use of maladaptive coping strategies and lower levels of social support, resilience and use of adaptive coping strategies were also found. During both lockdowns, PTSS were predicted by perceived stress, loneliness, reduced resilience and the coping strategies of denial and self-blame. PTSS were associated with younger age, female gender, being single, not having children, and the evaluation of the pandemic as a crisis. The findings highlight the significant public mental health concerns during the COVID-19 lockdowns. Understanding the risk and protective factors against PTSS and focusing on vulnerable populations should be prioritized by the governments worldwide in the development of evidence-based interventions.
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Affiliation(s)
- Argyroula E. Kalaitzaki
- Department of Social WorkLaboratory of Interdisciplinary Approaches to the Enhancement of Quality of LifeHealth Sciences FacultyUniversity Research Centre ‘Institute of AgriFood and Life Sciences’Hellenic Mediterranean UniversityHeraklionGreece
| | - George Tsouvelas
- Department of NursingUniversity of West AtticaAigaleoGreece
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of LifeHellenic Mediterranean UniversityHeraklionGreece
| | - Alexandra Tamiolaki
- Department of Social WorkLaboratory of Interdisciplinary Approaches to the Enhancement of Quality of LifeHealth Sciences FacultyHellenic Mediterranean UniversityHeraklionGreece
| | - George Konstantakopoulos
- Department of PsychiatryNational and Kapodistrian University of AthensEginition HospitalAthensGreece
- Department of Clinical, Education and Health PsychologyUniversity College LondonLondonUK
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Coelho GLDH, Hanel PH, Byrne A, Hourihane J, DunnGalvin A. The food allergy COPE inventory: Adaptation and psychometric properties. World Allergy Organ J 2022; 15:100626. [PMID: 35145606 PMCID: PMC8819115 DOI: 10.1016/j.waojou.2022.100626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/22/2021] [Accepted: 01/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background Food allergy (FA) has been shown to have an adverse impact on food allergy quality of life (FAQL). To more fully understand this impact, correlates and predictors of FAQL must be reliably measured. Coping is one such factor. In the present study (n = 200), we sought to adapt the widely used Coping Orientation to Problems Experienced (COPE) Inventory and its 15 distinct strategies to food allergy, named FA-COPE Inventory. More specifically, we propose a long (60-item) and short (30-item) version of the measure. Methods To examine the robustness of the newly adapted FA-COPE Inventory, we tested whether the 15-factor structure of the adapted version would present good psychometrical properties, using gold standard psychometric techniques. We used Confirmatory Factor Analysis to assess model fit, McDonald's omega, and inter-item correlations to assess reliability, and Pearson's correlation to assess convergent validity with a generic coping measure and satisfaction with FA life. Results Our results showed a good model fit (eg, CFI and TLI ≥ .94) for the 15-factor structure of the measure's long and short version. These factors also presented reliability levels aligned with the coping literature. Finally, the majority of the FA-COPE Inventory factors (eg, acceptance) were significantly associated with the generic coping measure and satisfaction with FA life. Conclusion Both the long and short adapted FA-COPE Inventory showed a good fit to food allergy issues. These measures can help facilitate the identification of the most commonly used strategies to deal with FA. Their use can lead to a more in-depth understanding of the impact of the coping strategies and how they can help improve the quality of life of those impacted by the disease.
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Desie Y, Habtamu K, Asnake M, Gina E, Mequanint T. Coping strategies among Ethiopian migrant returnees who were in quarantine in the time of COVID-19: a center-based cross-sectional study. BMC Psychol 2021; 9:192. [PMID: 34879855 PMCID: PMC8653623 DOI: 10.1186/s40359-021-00699-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/29/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Following the coronavirus disease 2019 (COVID-19) outbreak, many numbers of Ethiopian migrant workers from the Middle East repatriated to their home country. Returnees who came back to Ethiopia during the early stages of COVID-19 went through difficult experiences of unplanned return and unfamiliar quarantine. Despite burgeoning studies on the coping strategies of the general population on stresses associated with the pandemic, there is lack of research on how returnees cope with challenges related to migration and quarantine experiences. The aim of this study was to examine the coping strategies used by returnees who were in mandatory quarantine in Addis Ababa, Ethiopia in the context of the COVID-19 pandemic. METHODS A center-based cross-sectional study was conducted with 405 migrant returnees who were in mandatory quarantine in Addis Ababa, Ethiopia. We developed a structured questionnaire to collect data about the socio-demographic, migration related, quarantine related and COVID-19 related characteristics of participants. We used the Brief COPE (Coping Orientation to Problems Experienced) scale to measure returnees coping strategies. Descriptive statistics and multiple regression analyses were used to determine extent of use of coping strategies and identify factors associated with them. RESULTS Emotion-focused coping mainly religious coping was the most frequently used coping strategy in the study group. Dysfunctional coping, however, was the least frequently employed coping strategy. Higher scores on emotion-focused and problem-focused coping strategies were associated with absence of perceived support from family and relatives after the quarantine and with no history of contact with COVID-19 suspected or infected person. CONCLUSIONS The study shows that emotion-focused coping, particularly religious coping, was the most commonly used coping strategy among returnees who were in quarantine centers in the context of COVID-19. Returnees who perceived that they will not have support from family and relatives and those who were not exposed to the virus were more likely to use either emotion- or problem-focused coping strategies. Psychosocial reintegration efforts need to focus on enhancing returnees' capacity to use adaptive coping strategies. We suggest in-depth qualitative studies for better understanding of returnees' coping strategies and to facilitate reintegration activities.
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Affiliation(s)
- Yekoyealem Desie
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O. Box: 150299, Addis Ababa, Ethiopia
| | - Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O. Box: 150299, Addis Ababa, Ethiopia
| | - Mulat Asnake
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O. Box: 150299, Addis Ababa, Ethiopia
| | - Endirias Gina
- Research, Consultancy and Community Service Department, Ethiopian Police University, Sendafa, Ethiopia
| | - Temesgen Mequanint
- Research, Consultancy and Community Service Department, Ethiopian Police University, Sendafa, Ethiopia
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Kalaitzaki A. Posttraumatic symptoms, posttraumatic growth, and internal resources among the general population in Greece: A nation-wide survey amid the first COVID-19 lockdown. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 56:766-771. [PMID: 33656173 PMCID: PMC8014530 DOI: 10.1002/ijop.12750] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/12/2021] [Indexed: 01/07/2023]
Abstract
Scarce and inconclusive evidence exists on the mental health consequences of the COVID-19 lockdown. This study examined the psychological impact of the lockdown in Greece, resilience levels, use of coping strategies, and identified high-risk groups. A sample of 1661 participants (mean age = 39.5, SD = 12.2; 75.5% females) completed a web-based survey, which was distributed through social networking sites, webpages, and personal contacts. Posttraumatic symptoms, posttraumatic growth, resilience, and coping strategies were assessed. Different population subgroups suffered the impact of lockdown disproportionately. Healthcare workers, females, younger, less educated, and those living alone reported higher rates of posttraumatic stress symptoms. Females achieved more posttraumatic growth and were using coping strategies more frequently than men. Men, older, healthcare workers, and those with a partner were more resilient. Interventions need to be developed to target personal resources, protect vulnerable populations, facilitate posttraumatic growth, and ameliorate wellbeing and quality of life.
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Affiliation(s)
- Argyroula Kalaitzaki
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life, Social Work Department, Affiliated Researcher of the Research Centre ‘Institute of Agri‐Food and Life Sciences’, Health Sciences FacultyHellenic Mediterranean UniversityCreteGreece
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Testa A, Fahmy C. Family member incarceration and coping strategies during the COVID-19 pandemic. HEALTH & JUSTICE 2021; 9:16. [PMID: 34244863 PMCID: PMC8270238 DOI: 10.1186/s40352-021-00142-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/21/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND The disproportionately high rate of incarceration and COVID-19 cases during the summer of 2020 in the United States contributed to a set of circumstances that has produced considerable public health concerns as correctional facilities have emerged as significant COVID-19 hot spots. During the COVID-19 pandemic, having a family member incarcerated can be an especially stressful experience. This study assesses how concern about an incarcerated family member contracting COVID-19 impacts diverse coping strategies. RESULTS Data are from a survey of individuals who have a family member incarcerated in Texas (N = 365). Ordinary least squares regression is used to examine the association between concern about an incarcerated family member contracting COVID-19 and coping strategies. Findings demonstrate that higher levels of concern for an incarcerated person's wellbeing during the COVID-19 pandemic is associated with dysfunctional coping mechanisms, but not adaptive or functional coping strategies. CONCLUSIONS Results suggest appropriate systemic responses by correctional administrations and public health practices can help mitigate dysfunctional coping mechanisms by family members during infectious disease outbreaks in correctional facilities.
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Affiliation(s)
- Alexander Testa
- Department of Criminology & Criminal Justice, The University of Texas at San Antonio, 501 W. Cesar Chavez Blvd., San Antonio, TX, 78207, USA.
| | - Chantal Fahmy
- Department of Criminology & Criminal Justice, The University of Texas at San Antonio, 501 W. Cesar Chavez Blvd., San Antonio, TX, 78207, USA
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Factor Structure of the Brief Coping Orientation to Problems Experienced Inventory in Chinese (Brief-COPE-C) in Caregivers of Children with Chronic Illnesses. J Pediatr Nurs 2021; 59:63-69. [PMID: 33476915 DOI: 10.1016/j.pedn.2021.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/02/2021] [Accepted: 01/02/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE This study aimed to translate and evaluate the factor structure of the Chinese version of the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE-C) among the caregivers of children with chronic illnesses. DESIGN AND METHODS In this cross-sectional study, we recruited 217 caregivers, aged 18 years and older and cared for children with chronic illnesses. All participants were recruited from two local hospitals in Hong Kong using convenience sampling. We excluded caregivers diagnosed with major psychiatric diseases, such as major depression or schizophrenia. RESULTS The Brief-COPE-C had good validity and three factors were identified: active coping, distraction, and dysfunctional coping. The content validity index was 0.97, and the item content validity index ranged from 0.83-1 for all 28 items. The Brief-COPE-C had adequate internal consistency. The Cronbach's alpha for the overall scale was 0.89, while the Intraclass Correlation Coefficient (ICC) was 0.876. CONCLUSIONS The Brief-COPE-C is a valid, reliable, and culturally appropriate tool for measuring coping in caregivers of children with chronic illnesses. PRACTICE IMPLICATIONS Use of the Brief-COPE-C to assess coping responses of caregivers can facilitate clinicians' and researchers' understanding of how these individuals cope. Hence, appropriate interventions can be implemented to improve caregivers' physical and psychological outcomes.
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Cheng C, Yang CY, Inder K, Chan SWC. Psychometric properties of Brief Coping Orientation to Problems Experienced in patients with multiple chronic conditions: A preliminary study. Int J Nurs Pract 2021; 28:e12955. [PMID: 34062623 DOI: 10.1111/ijn.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/25/2021] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Multiple chronic conditions (MCCs) are highly prevalent in primary care. Coping is an important psychological factor that influences patients' ability to adapt physically and mentally to MCCs. Testing a reliable and valid psychometric inventory is necessary to identify coping strategies before developing coping-oriented interventions. PURPOSE The purpose of this study is to examine the psychometric properties of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE-CN) inventory in patients with MCCs. METHOD This study adopted a cross-sectional design. A convenience sample of 290 Chinese patients with MCCs was recruited from a tertiary hospital in East China. The Brief COPE-CN, sociodemographic characteristics and clinical data were collected using a self-reported questionnaire from November 2017 to May 2018. Factor analysis and reliability analysis were performed. RESULTS The mean age of the participants was 58.5 years (range from 23 to 95 years), and approximately half of the participants were female (49.3%). Most participants had two chronic conditions (82.1%) and reported having had MCCs for more than 2 years. The explanatory factor analysis (EFA) identified five factors in the Brief COPE-CN that explained 58.4% of the total variance. The Cronbach's α coefficients ranged from .65 to .85 for the five subscales. CONCLUSIONS The psychometric properties of the Brief COPE-CN were acceptable for use with Chinese patients with MCCs. With further evaluation, this instrument may help health-care professionals understand patients' coping and develop coping-based interventions to promote coping in this population.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Shanghai Medical College, Fudan University, Shanghai, China
| | - Cong-Yan Yang
- Department of Nursing, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Kerry Inder
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sally Wai-Chi Chan
- UON Singapore Department, The University of Newcastle Singapore, Singapore
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Solberg MA, Gridley MK, Peters RM. The Factor Structure of the Brief Cope: A Systematic Review. West J Nurs Res 2021; 44:612-627. [PMID: 33942676 DOI: 10.1177/01939459211012044] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Brief COPE is a widely used measure of coping that contains 28 items on 14 factors. Researchers have shortened the inventory, but the factor structure remains debated. A systematic review of peer-reviewed studies published in English between 1997 and 2021 was conducted to determine if a more parsimonious number of factors could be identified. Cumulative Index for Nursing and Allied Health, PsycINFO, PsycARTICLES, Medline, PubMed, and Scopus databases were searched using keywords "Brief COPE" and "factor, valid*, or psychometric.*" Searching yielded 573 articles; cited references added 38; 85 articles met inclusion criteria. Principal components analysis and confirmatory factor analysis were major analytic strategies used (28% and 27%, respectively). Only eight studies analyzed the original 14-factor structure. Factors identified ranged from 2 to 15, with dichotomous factors most frequently identified (25%; n = 21). A smaller number of factors may be able to represent the Brief COPE. Research is needed to test a condensed instrument.
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Arifin SRBM, Cheyne H, Maxwell M, Yousuf A. The Malaysian Women's Experience of Care and Management of Postnatal Depression. Clin Pract Epidemiol Ment Health 2021; 17:10-18. [PMID: 34040649 PMCID: PMC8097402 DOI: 10.2174/1745017902117010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 11/22/2022]
Abstract
Objectives Early detection and intervention for Maternal Postnatal Depression (PND) are imperative to prevent devastating consequences for mothers, babies, and families. However, there are no guidelines that explicitly focus on the management of PND in Malaysia. Consequently, it is unclear whether women with PND are receiving proper care and treatment. Therefore, this study aimed to explore Malaysian Women's experience in managing PND symptoms. Methods A qualitative study was conducted among 33 women attending Maternal and Child Health (MCH) clinics in Kuala Lumpur. Data were obtained through a face-to-face semi-structured interview and analysed using framework analysis. Results The women considered PND as a personal and temporary issue. Therefore, professional care was deemed unnecessary for them. Additionally, all Malay women considered religious approach as their primary coping strategy for PND. However, this was not the case for most Indian and Chinese women. Conclusion The findings of this study indicated that women did not acknowledge the roles of Healthcare Practitioners (HCPs) in alleviating their emotional distress.Also, they perceived PND as a personal problem and less serious emotional condition. It is due to this perception that the women adopted self-help care as their primary coping strategy for PND. However, the coping strategy varied between different cultures. These findings underscore the importance of HCPs' proactive action to detect and alleviate PND symptoms as their attitude towards PND may influence Women's help-seeking behaviour.
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Affiliation(s)
- Siti R B M Arifin
- Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling, Stirling FK9 4LA, United Kingdom
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional (NMAHP) Research Unit, University of Stirling, Stirling FK9 4LA, United Kingdom
| | - Abdilahi Yousuf
- College of Medicine and Health Sciences, Jijiga University, Jijiga, Ethiopia
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Nunes C, Pérez-Padilla J, Martins C, Pechorro P, Ayala-Nunes L, Ferreira LI. The Brief COPE: Measurement Invariance and Psychometric Properties among Community and At-Risk Portuguese Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062806. [PMID: 33801958 PMCID: PMC7998814 DOI: 10.3390/ijerph18062806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 12/11/2022]
Abstract
Parenting generally brings about high internal and external demands, which can be perceived as stressful when they exceed families’ resources. When faced with such stressors, parents need to deploy several adaptive strategies to successfully overcome these challenges. One of such strategies is coping, an important cognitive and behavioural skill. In this study, we intended to examine the psychometric properties of Carver’s (1997) Brief COPE (Coping Orientation to Problems Experienced), extending its cross-cultural validity among a Portuguese sample of community and at-risk parents. The sample comprised community (n = 153) and at-risk (n = 116) parents who completed the brief COPE, the Family Adaptability and Cohesion Scales and the Parenting Stress Index—Short Form. Confirmatory factor analysis, internal consistency, cross sample invariance, convergent and discriminant validity were analysed. Data from the confirmatory factor analysis revealed that the 14-factor model obtained the best fit. The results provided evidence that the Brief COPE is a psychometrically sound instrument that shows measurement invariance across samples and good reliability. Our findings demonstrated that the Portuguese version of brief COPE is a useful, time-efficient tool for both practitioners and researchers who need to assess coping strategies, a relevant construct in family context.
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Affiliation(s)
- Cristina Nunes
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
- Correspondence: ; Tel.: +351-289-800-100
| | - Javier Pérez-Padilla
- Faculty of Humanities and Education Sciences, University of Jaen & Research Group (HUM604) Development of Lifestyles in the Life Cycle and Health Promotion of University of Huelva, Campus de las Lagunillas, 23071 Jaén, Spain;
| | - Cátia Martins
- Psychology Research Centre (CIP) & Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal;
| | - Pedro Pechorro
- School of Psychology, Universidade do Minho, 4710-057 Braga, Portugal;
| | - Lara Ayala-Nunes
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK;
| | - Laura I. Ferreira
- Department of Psychology and Educational Sciences, Campus de Gambelas, Universidade do Algarve, 8005-139 Faro, Portugal;
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Cheng PX, Park HRP, Gatt JM. Approach Coping Mitigates Distress of COVID-19 Isolation for Young Men With Low Well-Being in a Sample of 1,749 Youth From Australia and the USA. Front Psychiatry 2021; 12:634925. [PMID: 34054598 PMCID: PMC8153185 DOI: 10.3389/fpsyt.2021.634925] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/24/2021] [Indexed: 12/24/2022] Open
Abstract
The unprecedented COVID-19 pandemic has led to lockdowns across the world with people being separated from their loved ones including partners, family, and friends. Here, using a large sample of 1,749 Australians and Americans, we investigated the impact of COVID-19 isolation on younger populations (13-25 years), and the influence of coping strategies and mental well-being on this impact. Overall, COVID-19 isolation had a more negative impact on adolescence (13-17 years) than young adulthood (18-25 years), but with no difference apparent between men and women, or between Australian and American residents. However, a deeper analysis revealed a gender-specific effect: the type of coping strategies differentially influenced the negative impact of COVID-19 isolation on men with various levels of well-being, an interaction effect not apparent in women. For men with lower levels of mental well-being, COVID-19 isolation appeared to have a less negative impact on them if they used more approach-oriented coping strategies (e.g., actively focusing on the problem). Our results provide cross-sectional evidence for a differential impact on young men at low levels of wellbeing by pandemic isolation. In sum, young men and adolescent boys with lower well-being coped better with COVID-19 isolation when they used more approach coping strategies.
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Affiliation(s)
- Phillip Xin Cheng
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia.,School of Psychology, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Haeme R P Park
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia.,School of Psychology, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Justine M Gatt
- Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia.,School of Psychology, University of New South Wales (UNSW), Sydney, NSW, Australia
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Matsumoto S, Yamaoka K, Nguyen HDT, Nguyen DT, Nagai M, Tanuma J, Mizushima D, Nguyen KV, Pham TN, Oka S. Validation of the Brief Coping Orientation to Problem Experienced (Brief COPE) inventory in people living with HIV/AIDS in Vietnam. Glob Health Med 2020; 2:374-383. [PMID: 33409417 DOI: 10.35772/ghm.2020.01064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/24/2020] [Accepted: 10/07/2020] [Indexed: 11/08/2022]
Abstract
The Brief Coping Orientation to Problem Experienced (Brief COPE) inventory is one of the most widely used instruments in coping research; however, no study has evaluated the psychometric properties of the Brief COPE in the Vietnamese population. This study aimed to validate a culturally appropriate Vietnamese version of the Brief COPE for the evaluation of coping strategies in people living with HIV/AIDS in Vietnam. We translated the Brief COPE into Vietnamese, and it was self-administered among 1,164 HIV-infected patients receiving antiretroviral therapy at a large HIV outpatient clinic in Hanoi between January 2019 and March 2020. Data on demographics and HIV-related information, depression and social support were also collected. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to assess construct validity. Content validity, internal consistency, and convergent validity were also assessed. The CFA of a 14-factor structure of the original Brief COPE revealed acceptable model fitness, but poor internal consistency for some subscales. In the subsequent EFA, we found a revised 26-item version which had a six-factor structure consisting of problem-solving, avoidance, humor, social support, religion, and substance use. The final CFA found that the model fitness of the revised scale with fewer factor structures was comparable to that of the original Brief COPE; the internal consistency of the revised scale was even better than that of the original scale. Furthermore, six factors of the revised scale showed anticipated associations with depression and social support.
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Affiliation(s)
- Shoko Matsumoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazue Yamaoka
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | | | | | - Moeko Nagai
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Tanuma
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daisuke Mizushima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kinh Van Nguyen
- National Hospital for Tropical Diseases, Hanoi, Vietnam.,Hanoi Medical University, Hanoi, Vietnam
| | | | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
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Depression and Its Relationship with Coping Strategies and Illness Perceptions during the COVID-19 Lockdown in Greece: A Cross-Sectional Survey of the Population. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:3158954. [PMID: 32908697 PMCID: PMC7450302 DOI: 10.1155/2020/3158954] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The COVID-19 epidemic has shown a more benign course in Greece possibly due to the early lockdown measures. Mental health consequences of the lockdown however are unknown. In addition, illness perceptions and relevant strategies to cope with the stress of the epidemic may have played a role in complying with the restrictions. We conducted a survey of the Greek population with the aim to investigate the prevalence of anxiety and depression during the lockdown, the emotional impact of the epidemic, and the effect of coping strategies and illness perceptions in mental health. METHODS Adult persons were invited during the peak of the lockdown period through social media. Depressive and anxiety symptoms were assessed with the PHQ-9 and GAD-2 scales, respectively. Coping strategies were assessed with selected items of the Brief COPE questionnaire, while illness beliefs were assessed with items from the revised Illness Perception Questionnaire (IPQ-R). RESULTS A total of 3379 individuals took part. A strong emotional impact of the epidemic was more often in women and in those with severe financial difficulties. Levels of depressive and anxiety symptoms were high but similar to past assessments. Participants showed high levels of personal control and used more often positive strategies to cope with the stress of the epidemic. Depressive symptoms were higher in the younger, in students, in those with a stronger emotional impact, in those isolated due to symptoms, and those overexposed to media for COVID-19-related news. Lower levels of depression were seen in those using positive coping strategies and showing high levels of personal and treatment control. CONCLUSIONS The study shows that certain psychological and social determinants were associated with increased depressive symptoms during the lockdown warranting the development of public health guidelines to mitigate the effects of the epidemic to the mental health of the population.
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Gebhart V, Buchberger W, Klotz I, Neururer S, Rungg C, Tucek G, Zenzmaier C, Perkhofer S. Distraction-focused interventions on examination stress in nursing students: Effects on psychological stress and biomarker levels. A randomized controlled trial. Int J Nurs Pract 2019; 26:e12788. [PMID: 31724291 DOI: 10.1111/ijn.12788] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 08/14/2019] [Accepted: 08/20/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nursing students all over the world experience high levels of stress with negative impacts on their health, emotional state and performance. AIM This study aimed to investigate the effects of distraction-focused interventions on examination stress and anxiety in nursing students. METHODS A randomized controlled, parallel trial design was conducted from January to June 2016. After baseline measurement, 72 participants were randomized to one of the following groups (n = 18 each): (i) animal-assisted therapy; (ii) music therapy; (iii) mandala painting; (iv) control group. Outcomes of all groups in terms of stress-reduction were compared by measuring self-reported perceived stress (STAI-State and visual analogue stress scale) and salivary biomarker levels (Cortisol and Immunoglobulin A). RESULTS Fifty-seven complete data sets (n = 12-16 for each group) were analysed. All distraction-focused interventions showed stress and anxiety reduction in everyday school situations. By contrast, on days with examinations, stress reductions did not reach statistical significance in regard to self-reported psychological stress. At the same time, interventions resulted in significantly decreased levels of stress biomarkers (P < .001). CONCLUSIONS Our preliminary findings suggest positive but situation-dependent effects of distraction-focused interventions in academic settings. Further research should investigate the complex relationship between physiological and psychological stress parameters.
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Affiliation(s)
- Verena Gebhart
- FHG - Zentrum für Gesundheitsberufe Tirol GmbH, Innsbruck, Austria
| | - Waltraud Buchberger
- FHG - Zentrum für Gesundheitsberufe Tirol GmbH, Innsbruck, Austria.,Ausbildungszentrum West für Gesundheitsberufe der Tirol Kliniken GmbH, Innsbruck, Austria
| | - Isabella Klotz
- Ausbildungszentrum West für Gesundheitsberufe der Tirol Kliniken GmbH, Innsbruck, Austria
| | | | - Christine Rungg
- FHG - Zentrum für Gesundheitsberufe Tirol GmbH, Innsbruck, Austria
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Ștefan CA. Self-compassion as mediator between coping and social anxiety in late adolescence: A longitudinal analysis. J Adolesc 2019; 76:120-128. [PMID: 31479892 DOI: 10.1016/j.adolescence.2019.08.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/16/2019] [Accepted: 08/26/2019] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Previous research uncovered that self-compassion is related to coping strategies elicited during stressful situations, and might also contribute to less biased perceptions of social situations. Hence, the current study's objective was to investigate longitudinally the mediator role of self-compassion in the relation between coping and social anxiety in late adolescence, with emphasis on the first months of adjustment to college life. METHODS The sample included 63 first-year students (75% women) from Romania with a mean age of 18.76 years. They filled out the Coping Orientation to Problems Experienced Inventory at Time 1 (beginning of the first semester), as well as the Self-Compassion Scale-Short Form and the Leibowitz Social Anxiety Scale-Short Form at both T1 and Time 2 (3 months after the baseline assessment). RESULTS The results of the mediation analyses showed that both approach and avoidant coping at T1 exhibited a significant indirect effect on social anxiety levels at T2 through self-compassion measured at T2 controlling for the effects of gender, self-compassion and social anxiety at T1. These findings suggested that approach coping increases the likelihood of more compassionate views of oneself, which are likely to contribute to less social anxiety; conversely, avoidant coping decreases self-compassionate attitudes, which in turn increase social anxiety symptoms. CONCLUSIONS These results provided added evidence to the fact that during the transition from adolescence to adulthood, teaching college students a more self-accepting and kind perspective on one's imperfections could play a significant role in preventing and treating social anxiety.
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Affiliation(s)
- Catrinel A Ștefan
- Department of Psychology, Babeş-Bolyai University, 37 Republicii Street, Cluj-Napoca, 400015, Romania.
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Papadopoulos D, Kiagia M, Charpidou A, Gkiozos I, Syrigos K. Psychological correlates of sleep quality in lung cancer patients under chemotherapy: A single‐center cross‐sectional study. Psychooncology 2019; 28:1879-1886. [DOI: 10.1002/pon.5167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Dimitrios Papadopoulos
- Oncology Unit, 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens“Sotiria” Regional Chest Diseases Hospital of Athens Athens Greece
| | - Maria Kiagia
- Oncology Unit, 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens“Sotiria” Regional Chest Diseases Hospital of Athens Athens Greece
| | - Andriani Charpidou
- Oncology Unit, 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens“Sotiria” Regional Chest Diseases Hospital of Athens Athens Greece
| | - Ioannis Gkiozos
- Oncology Unit, 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens“Sotiria” Regional Chest Diseases Hospital of Athens Athens Greece
| | - Konstantinos Syrigos
- Oncology Unit, 3rd Department of Medicine, Medical School, National and Kapodistrian University of Athens“Sotiria” Regional Chest Diseases Hospital of Athens Athens Greece
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Jenzer T, Read JP, Naragon-Gainey K, Prince MA. Coping trajectories in emerging adulthood: The influence of temperament and gender. J Pers 2019; 87:607-619. [PMID: 29999532 PMCID: PMC6330139 DOI: 10.1111/jopy.12419] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 06/01/2018] [Accepted: 07/03/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The study of coping has far-reaching implications for understanding psychopathology and resilience, as well as for the treatment of psychological disorders. Developmental work has examined how the ability to cope changes across time in children and adolescents; however, work in emerging adulthood is still lacking. Coping is thought to emerge from basic biological and psychological processes, such as temperament and gender, which may influence the trajectory of coping use over time. METHOD Using a sample of college students (N = 1,000), our 4-year longitudinal study with yearly assessments sought to (a) examine the trajectory of coping styles in emerging adulthood and to (b) examine the influence of temperament and gender on these coping trajectories. RESULTS Our findings suggest that young adults' use of avoidance strategies decreased slightly over college, whereas the use of approach strategies and social support seeking remained stable. Temperament (BIS/BAS) and gender were related to certain coping styles at baseline and appeared to have an influence on some of these trajectories over time, though these associations were complex. CONCLUSIONS This work may inform intervention research attempting to promote adaptive coping because it may help identify young adults most in need of such interventions.
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Affiliation(s)
- Tiffany Jenzer
- Department of Psychology, State University of New York - University at Buffalo, Buffalo, NY 14260
| | - Jennifer P. Read
- Department of Psychology, State University of New York - University at Buffalo, Buffalo, NY 14260
| | - Kristin Naragon-Gainey
- Department of Psychology, State University of New York - University at Buffalo, Buffalo, NY 14260
| | - Mark A. Prince
- Department of Psychology, Colorado State University, Fort Collins, CO
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Subedi A, Edge DS, Goldie CL, Sawhney M. Resettled Bhutanese Refugees in Ottawa: What Coping Strategies Promote Psychological Well-Being? Can J Nurs Res 2019; 51:168-178. [DOI: 10.1177/0844562119828905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Since 2008, Bhutanese refugees have been resettled in Canada, including Ottawa. This relocation and resettling process is associated with significant physical and psychological stress, as individuals acclimatize to a new country. Purpose To assess the relationship between coping strategies and psychological well-being of Bhutanese refugees resettled in Ottawa. Methods A cross-sectional survey utilizing a convenience sample of adults (n = 110) was conducted in the fall of 2015 in Ottawa. Two tools, Brief COPE and general well-being schedule were used. Results Bhutanese refugees were in moderate distress. Using multiple linear regression, age, education, and three coping strategies (positive reframing, self-blame, and venting) were identified as predictors of general well-being ( F (11, 96) = 3.61, p < .001, R2 = 21.2%). Higher levels of education and positive reframing were associated with greater general well-being scores, while self-blame and well-being between ages 41 and 50 years were inversely associated with general well-being. Conclusions Findings suggest that a broad intersectorial approach between nurses and partner agencies is needed to enhance the mental health of this population for better adjustment in the host country. Nurses could provide support and counseling to minimize the use of self-blame and venting and promote positive coping strategies.
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Affiliation(s)
- Anita Subedi
- School of Nursing, Queen’s University, Kingston, ON, Canada
| | - Dana S. Edge
- School of Nursing, Queen’s University, Kingston, ON, Canada
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