'Turbulence even in a bubble': a reflexive thematic analysis with family caregivers of people with dementia in the United Kingdom during and beyond the COVID-19 pandemic

OBJECTIVE

This study aimed to understand how family caregivers of people with dementia managed changes caused by COVID-19 restrictions and how they adjusted to the lifting of restrictions. A particular focus of the study was on understanding the impact of social isolation, a reduction of social interactions, and reduced access to healthcare services.

METHODS AND MEASURES

Fourteen voluntary caregivers (nine women) were interviewed using a semi-structured interview schedule.

RESULTS

Five themes were identified based on reflexive thematic analysis: (i) Outlets to cope with lockdown; (ii) 'Not all doom and gloom': A silver lining amid COVID-19; (iii) Optimism helps provide resilience; (iv) The challenges and joys of reopening; and (v) Caregiving toward a new normality.

CONCLUSION

The research highlighted difficulties reported by family caregivers and people with dementia during COVID-19, while also showing how such carers coped. Interviews also identified ways that family caregivers often used optimism to help navigate through lockdown and to tackle the reopening stage. Family caregivers in this study reported coping well overall, but welcomed the lifting of restrictions.

Always Look on the Bright Side: Associations of Optimism With Functional Outcomes After Stroke

Background Psychological health is as an important contributor to recovery after cardiovascular disease, but the roles of both optimism and depression in stroke recovery are not well characterized. Methods and Results A total of 879 participants in the SRUP (Stroke Recovery in Underserved Populations) 2005 to 2006 Study, aged ≥50 years, with incident stroke admitted to a rehabilitation facility were included. Optimism was assessed by the question: "Are you optimistic about the future?" Depression was defined by Center for Epidemiologic Studies Depression scale score >16. Participants were categorized into 4 groups: optimistic/without depression (n=581), optimistic/with depression (n=197), nonoptimistic/without depression (n=36), and nonoptimistic/with depression (n=65). Functional Independence Measure scores were used to assess stroke outcomes at discharge, 3 months after discharge, and 1 year after discharge with adjusted linear mixed models to estimate score trajectories. Participants were a mean age of 68 years (SD, 13 years), 52% were women, and 74% were White race. The optimistic/without depression group experienced the most recovery of total Functional Independence Measure scores in the first 3 months, 24.0 (95% CI, 22.5-25.4), followed by no change in the following 9 months, -0.3 (95% CI, -2.3 to 1.7), similar to the optimistic/with depression group with rapid recovery in 0 to 3 months, 21.1 (95% CI, 18.6-23.6) followed by minimal change in 3 to 12 months, 0.7 (95% CI, -2.8 to 4.1). The nonoptimistic groups demonstrated slow but continued recovery throughout the 12-month period, with overall change, 25.4 (95% CI, 17.6-33.2) in the nonoptimistic/without depression group and 17.6 (95% CI, 12.0-23.1) in the nonoptimistic/with depression group. There was robust effect modification between optimism and depression (P_interaction<0.001). Conclusions In this longitudinal cohort, optimism and depression are synergistically associated with functional recovery after stroke. Measuring optimism status may help identify individuals at risk for worse poststroke recovery.

Related factors to the coping style of patients with sudden sensorineural hearing loss

BACKGROUND

Coping style can affect the patient's physical and mental health management. Therefore this study aimed to identify factors related to the coping style of young and middle-aged sudden sensorineural hearing loss (SSNHL) patients to provide reference for clinical nursing practice.

METHODS

A cross-sectional study was conducted on young and middle-aged SSNHL patients hospitalized in the otolaryngology departments of four hospitals in Suzhou City, China. A paper-based self-administered questionnaire investigated the patient's coping style and related factors. Multiple linear stepwise regression analysed the effective related factors in patients' coping styles.

RESULTS

Among 872 patients, 866 completed the survey, with an average age of 37.27 y. Factors related to the coping style of these patients included gender, chronic diseases, history of trauma, social support and type D personality (p<0.05). Female patients adopt more negative coping styles than male patients. Patients with chronic diseases or a history of trauma had more positive coping styles. Higher social support scores were related to improvements in coping style. Patients with type D personality were more likely to adopt negative coping styles.

CONCLUSIONS

This study suggests that psychological assessment of patients, chronic diseases, history of trauma, social support and type D personality may benefit the understanding of these patients' coping styles and, as a consequence, may improve their stress management.

Influencing Factors of Hope Among Chinese Patients With Hematological Malignancies From the Perspective of Positive Psychology: A Cross-sectional Study

BACKGROUND

Hope is an important resource and reserve for patients with hematological malignancies to cope with stress. Through analyzing hope levels and its influencing factors, this study provides evidence for developing psychological interventions for this population.

OBJECTIVE

The aim of this study was to explore the influencing factors of hope in patients with hematological malignancies.

METHODS

A cross-sectional study including 165 participants with hematological malignancies was performed from November 2019 through June 2020 in a tertiary hospital in Beijing, China. The Adult Dispositional Hope Scale, UCLA Loneliness Scale, Simplified Coping Style Questionnaire, Self-esteem Scale, and Big Five Short-Form Scale were used to evaluate each variable. Regression analysis was conducted to explore the influencing factors of hope.

RESULTS

The total mean hope level (40.39 ± 4.32) was significantly lower than the national norm. Multiple stepwise regression analysis indicated that openness ( β = .38, P < .001), neuroticism ( β = -0.25, P < .001), rigor ( β = -0.15, P = .043), self-esteem ( β = .33, P < .001), positive response ( β = .22, P < .001), negative response ( β = .12, P = .039), and residential region ( β = .17, P = .002) were significantly associated with the total hope level among patients with hematological malignancies. Self-esteem and openness were positively correlated with the total mean hope score and its 3 subdimensions.

CONCLUSION

The hope level was relatively low in patients with hematological malignancies. Hope level was affected by individual personality traits, coping styles, self-esteem, and loneliness.

IMPLICATION FOR PRACTICE

Attention should be drawn to the relationship between the hope level and positive psychological characteristics among patients with hematological malignancies. Our study supports the need to develop tailored and effective interventions to improve the level of hope among this patient population.

Examining Intra- and Inter-Personal Health Effects of Optimism and Pessimism: The Role of Subjective Well-Being in Romantic Couples

Recent meta-analytic research suggests that the absence of pessimism could be a stronger predictor of physical health than the presence of optimism (Scheier et al., 2021a). The present study examined the role of subjective well-being in the effects of optimism and pessimism on physical health in romantic couples. It was hypothesized that pessimism would be more strongly associated with both well-being and health than optimism, intra- and inter-personally. Subjective well-being was also expected to explain variance in the associations between optimism, pessimism, and health. A baseline sample of 153 opposite-sex couples completed various measures of subjective well-being (e.g., life satisfaction, positive and negative affect, and depressive symptoms) and physical health (e.g., subjective health, sleep efficiency, physical symptoms, cold symptoms, and chronic illness). Results of actor-partner interdependence models showed that the absence of pessimism, but not the presence of optimism, was associated with better physical health at baseline and over time. Pessimism was also a stronger predictor than optimism of baseline levels in some indicators of subjective well-being. These effects were obtained intra- and inter-personally. Finally, subjective well-being explained variance in some of the effects of pessimism on levels of physical health. Implications for theory, research, and practice are discussed.

Implementation of an Ask Me 3 ® education video to improve outcomes in post-myocardial infarction patients

Objective: The Advanced Practice Providers (APPs) in an adult cardiology practice in a large metropolitan city, provide hospital follow-up care to post-myocardial infarction (MI) patients. The APPs identified a problem: patients retained very little of the information they receive during their hospitalization. The purpose of this pilot project was to evaluate the impact of an Ask Me 3 ® post-MI education video on patients’ knowledge of self-care activities. The video was designed to promote secondary prevention of cardiovascular disease and support optimal cardiovascular health.

Methods: The project used a pre-test post-test quasi-experimental design to evaluate the feasibility and efficacy of a post-MI education video compared to the standard teaching methods.

Results: The sample consisted of 25 total participants, 12 in the control group and 13 in the intervention group. The increase in the intervention group's post- test scores was statistically significant (p value = 0.0056), showing a vast improvement in knowledge with the addition of an “Ask Me 3” education video.

Conclusion: An “Ask Me 3” post-MI education video may effectively improve cardiovascular secondary prevention when incorporated with the standard teaching methods. Patients may view the video multiple times, enhancing their knowledge of lifestyle modifications following hospitalization and their overall cardiovascular health.

Optimism as a key to improving mental health in family caregivers of people living with Alzheimer's disease

Objective: The aim of the present work was to study the serial multiple mediating role of optimism, perceived social support and subjective burden in the relationship between objective burden and psychological distress in caregivers of people with Alzheimer´s Disease (AD).Method: One hundred and forty family caregivers of people living with AD were recruited from randomly selected Alzheimer Association Centres. They answered the General Health Questionnaire (GHQ), the Life Orientation Test-Revised (LOT-R), the Functional Social Support Questionnaire (DUKE.UNC), the Zarit Burden Interview (ZBI) and questions relating to gender, age and the amount of time spent on daily caregiving.Results: Results indicated that objective burden and subjective burden were both high in these caregivers. Optimism mediated on psychological distress through social support and through subjective burden with a full mediation role. When comparisons between indirect effects were performed, optimism was the mediator with the greatest effect between objective burden and psychological distress.Conclusion: This study highlights the indirect role of optimism and the advantages that interventions in optimism training in the early stages of the person with AD could produce. Thus, alleviating subjective burden and increasing perceived social support, which would lead to an improvement in the mental health of family caregivers of people with AD.

The Impact of Psychological Functioning on Cardiovascular Disease

PURPOSE OF REVIEW

We report on recent findings pertaining to the relationship of both negative and positive indicators of psychological functioning with cardiovascular disease (CVD) and briefly describe possible mechanistic pathways to account for these relationships.

RECENT FINDINGS

A body of observational literature suggests that (1) depression is predictive of CVD and is a consequence of CVD; (2) anxiety is related to CVD but the precise nature of this relationship remains unclear; and (3) negative affectivity and Type D personality are constructs that combine aspects of negative psychological functioning that have shown relationships with CVD and are worthy of future investigation. Positive psychological constructs of meaning/purpose and optimism predict better cardiovascular outcomes and other positive psychological constructs have received promising, but limited, attention in the literature. Key remaining questions concern the magnitude and directionality of possible causal relationships as well as the mechanisms accounting for them.

What else should we know about experiencing COPD? A narrative review in search of patients' psychological burden alleviation

The present paper is a narrative review focusing on the psychological impact, identification of protective factors, and interventions minimizing the psychological burdens of chronic obstructive pulmonary disease (COPD). The research reviews studies on neurocognitive functions, personality, emotional problems, and health-related quality of life. This is done with regard to resources as well as activities enabling or enhancing a patient's adaptation. PubMed and PsychArticles databases were searched for relevant medical (eg, CODP, emphysema), psychopathology (eg, depression), and psychological (eg, personality) keywords, followed by hand search. After application of the inclusion and exclusion criteria, the search resulted in 82 articles and book chapters. The choice was based on evidence accepted by evidence-based medicine, although at different levels of strength. Psychological experiencing of COPD appears to be very unequally represented with scientific research on emotional problems and functioning decrease significantly outnumbering those addressing resources or effective interventions. As our initial literature search called for an urgent need for further exploration, we have carefully pointed out numerous areas where the knowledge on how to protect or restore psychological well-being among COPD patients should be broadened.