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Wu CY, Lee MB, Huong PTT, Chen IM, Chen HC, Hsieh MH. Longitudinal Outcomes of Resilience, Quality of Life, and Community Integration in Treatment-Resistant Depression: A Two-Group Matched Controlled Trial. J Am Psychiatr Nurses Assoc 2024; 30:765-777. [PMID: 37904528 DOI: 10.1177/10783903231204881] [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] [Indexed: 11/01/2023]
Abstract
BACKGROUND Current evidence of nonpharmacological intervention for patients with treatment-resistant depression (TRD) is lacking. AIMS: To examine whether an 8-week nurse-led cognitive-behavioral based group intervention would enhance resilient coping and life quality among community-based patients with TRD. METHOD The participants were randomly sampled from a cohort of TRD recruited from two general teaching hospitals. The two groups were assessed with multiple outcome measures at baseline (T0); 8-week post-baseline (T1); and at 3, 6, and 9 months after T1 (T2-4). Psychoeducation was nested in the cognitive behavioral group intervention to facilitate discussion. RESULTS Of the 23 participants (mean age 56 years, 69.6% female) in the experimental group, higher resilient coping and lower mental distress levels at T1 as well as later improved quality of life and community integration at T2-4 were observed compared to the controls across COVID-19 (T3). Overall, the scores of resilience and community integration were higher throughout the four follow-up points of observations for the experimental group. CONCLUSION The findings indicated that an 8-week nurse-led cognitive-behavioral based group intervention may enhance the TRD patients' resilient coping and mental distress levels while providing the potentials for community reintegration after mental health psychoeducation engagement. It is imperative for the nurses caring for patients with TRD to extend from clinical-based intervention to community-based self-care approach, with the importance of short-term stress management and healthy lifestyle development highlighted during the community reintegration trajectory.
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Affiliation(s)
- Chia-Yi Wu
- Chia-Yi Wu, RN, PhD, School of Nursing, National Taiwan University College of Medicine, Taipei; Department of Nursing, National Taiwan University Hospital, Taipei
| | - Ming-Been Lee
- Ming-Been Lee, MD, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; National Taiwan University College of Medicine, Taipei
| | | | - I-Ming Chen
- I-Ming Chen, MD, PhD, National Taiwan University Hospital, Taipei
| | - Hsi-Chung Chen
- Hsi-Chung Chen, MD, PhD, National Taiwan University Hospital, Taipei
| | - Min-Hsien Hsieh
- Min-Hsien Hsieh, MD, PhD, National Taiwan University Hospital, Taipei
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Sánchez J, Estrada-Hernández N, Booth J, Pan D. Factor structure, internal reliability, and construct validity of the Brief Resilience Scale (BRS): A study on persons with serious mental illness living in the community. Psychol Psychother 2021; 94:620-645. [PMID: 33749967 DOI: 10.1111/papt.12336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 02/22/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Resilience, the ability to bounce back from a stressful situation, is a valuable asset for aiding adults with serious mental illness (SMI) in navigating the recovery process. People with SMI experience stress, including traumatic experiences at disproportionate rates. The purposes of this study were to examine the factor structure, internal reliability, and construct validity of the Brief Resilience Scale (BRS) among adults with SMI living in the community. DESIGN A cross-sectional survey design was used. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and correlational analyses were employed. METHODS Three hundred fifteen adults with SMI were recruited for two studies (Sample 1, n = 122; Sample 2, n = 193) from three states. All participants completed the BRS along with nearly identical positive psychology- and psychopathology-related measures. RESULTS EFA revealed the BRS was unidimensional and explained 61.20% of the variance. Results from seven CFA models suggested a bifactor structure for the BRS, which fit the data best. Internal reliability of the BRS was computed to be within acceptable ranges (α = .87, ω = .90). The BRS was positively correlated with measures of positive coping and life satisfaction, providing convergent validity. Divergent validity was supported by negative correlations between the BRS and measures of psychiatric symptoms, succumbing, and self-stigma. CONCLUSIONS The BRS is a valid measure that can be used by clinical and research professionals to assess levels of resilience in adults with SMI at baseline and across time. PRACTITIONER POINTS The Brief Resilience Scale (BRS) was developed to measure a person's ability to bounce back from stressful situations. The BRS was examined in adults with serious mental illness living in the community. The BRS presented a bifactor structure measuring resilience (an outcome) and correlated with positive psychology- and psychopathology-related measures. The BRS can be used by practitioners to assess levels of resilience in their clients at baseline and over time to evaluate the effectiveness of therapeutic interventions.
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Affiliation(s)
- Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA
| | - Noel Estrada-Hernández
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA
| | - Jamar Booth
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA.,Department of Clinical Counseling and Mental Health, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Deyu Pan
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA
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Resilience in severe mental disorders: correlations to clinical measures and quality of life in hospitalized patients with major depression, bipolar disorder, and schizophrenia. Qual Life Res 2021; 31:507-516. [PMID: 34173172 DOI: 10.1007/s11136-021-02920-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate resilience in severe mental disorders and correlate it with clinical measures and quality of life. METHODS Resilience (Resilience Scale, RS) and quality of life (WHOQOL-BREF questionnaire) were prospectively evaluated in a sample of 384 hospitalized patients diagnosed with severe mental disorders (depression, bipolar disorder and schizophrenia). Clinical outcomes were measured using the Global Assessment of Functioning Scale (GAF), Clinical Global Impression (CGI), Cumulative Illness Rating Scale (CIRS), Hamilton Scale-Depression (HAM-D), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS). RESULTS Resilience measure showed a difference between the three clinical groups analyzed in the study, with lower scores in depressed patients than in bipolar disorder or schizophrenia patients. There was a trend toward a correlation between resilience and depressive symptoms (Hamilton Scale-Depression; P = 0.052; rs = - 0.163). The scores in the resilience scale's personal competence domain presented a tendency of association with general psychiatric symptoms (Brief Psychiatric Rating Scale; P = 0.058; r = - 0.138). There was a significantly positive association between resilience and all domains of quality of life (r = 0.306-0.545; P < 0.05). Sociodemographic data like age, education, intelligence quotient, sex, and marital status were associated with resilience. CONCLUSION Depressive patients had low scores on the resilience scale compared to patients with other disorders. Resilience was positively associated with quality of life. Therefore, it deserves special attention, as it promotes more positive outcomes and improves patients' quality of life with severe mental disorders.
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Echezarraga A, Las Hayas C, López de Arroyabe E, Jones SH. Resilience and Recovery in the Context of Psychological Disorders. JOURNAL OF HUMANISTIC PSYCHOLOGY 2019. [DOI: 10.1177/0022167819851623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Echezarraga A, Calvete E, González-Pinto AM, Las Hayas C. Resilience dimensions and mental health outcomes in bipolar disorder in a follow-up study. Stress Health 2018. [PMID: 28639427 DOI: 10.1002/smi.2767] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The individual process of resilience has been related to positive outcomes in mental disorders. We aimed (a) to identify the resilience domains from the Resilience Questionnaire for Bipolar Disorder that are associated cross sectionally and longitudinally with mental health outcomes in bipolar disorder (BD) and (b) to explore cross-lagged associations among resilience factors. A clinical adult sample of 125 patients diagnosed with BD (62.10% female, mean age = 46.13, SD = 10.89) gave their informed consent and completed a battery of disease-specific tools on resilience, personal recovery, symptomatology, psychosocial functioning, and quality of life, at baseline and at follow-up (n = 63, 58.10% female, mean age = 45.13, SD = 11.06, participation rate = 50.40%). Resilience domains of self-management of BD, turning point, self-care, and self-confidence were significantly associated with mental health indicators at baseline. In addition, self-confidence at baseline directly predicted an increase in personal recovery at follow-up, and self-confidence improvement mediated the relationship between interpersonal support and self-care at baseline and personal recovery at follow-up. These findings highlight that resilience domains are significantly associated with positive mental health outcomes in BD and that some predict personal recovery at follow-up. Moreover, some resilience factors improve other resilience factors over time.
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Affiliation(s)
- A Echezarraga
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - E Calvete
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - A M González-Pinto
- Psychiatry Department, University Hospital Santiago Apostol, Vitoria-Gasteiz, Spain.,CIBERSAM
| | - C Las Hayas
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
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Böell JEW, Silva DMGVD, Hegadoren KM. Sociodemographic factors and health conditions associated with the resilience of people with chronic diseases: a cross sectional study. Rev Lat Am Enfermagem 2016; 24:e2786. [PMID: 27598377 PMCID: PMC5016006 DOI: 10.1590/1518-8345.1205.2786] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 03/15/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE to investigate the association between resilience and sociodemographic variables and the health of people with chronic kidney disease and / or type 2 diabetes mellitus. METHOD a cross-sectional observational study performed with 603 people with chronic kidney disease and / or type 2 diabetes mellitus. A tool to collect socio-demographic and health data and the Resilience Scale developed by Connor and Davidson were applied. A descriptive and multivariate analysis was performed. RESULTS the study participants had on average 61 years old (SD= 13.2), with a stable union (52.24%), religion (96.7%), retired (49.09%), with primary education (65%) and income up to three minimum wages. Participants with kidney disease showed less resilience than people with diabetes. CONCLUSION the type of chronic illness, disease duration, body mass index and religious beliefs influenced the resilience of the study participants.
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Affiliation(s)
- Julia Estela Willrich Böell
- Doctoral Student, Departamento de Enfermagem, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil. Substitute Professor, Departamento de Enfermagem, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Desarrollo del Inventario de factores de resiliencia ante la adversidad. ANSIEDAD Y ESTRES-ANXIETY AND STRESS 2016. [DOI: 10.1016/j.anyes.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hoorelbeke K, Marchetti I, De Schryver M, Koster EHW. The interplay between cognitive risk and resilience factors in remitted depression: A network analysis. J Affect Disord 2016; 195:96-104. [PMID: 26878206 DOI: 10.1016/j.jad.2016.02.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/17/2016] [Accepted: 02/03/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Individuals in remission from depression are at increased risk for developing future depressive episodes. Several cognitive risk- and resilience factors have been suggested to account for this vulnerability. In the current study we explored how risk- and protective factors such as cognitive control, adaptive and maladaptive emotion regulation, residual symptomatology, and resilience relate to one another in a remitted depressed (RMD) sample. METHODS We examined the relationships between these constructs in a cross-sectional dataset of 69 RMD patients using network analyses in order to obtain a comprehensive, data-driven view on the interplay between these constructs. We subsequently present an association network, a concentration network, and a relative importance network. RESULTS In all three networks resilience formed the central hub, connecting perceived cognitive control (i.e., working memory complaints), emotion regulation, and residual symptomatology. The contribution of the behavioral measure for cognitive control in the network was negligible. Moreover, the directed relative importance network indicates bidirectional influences between these constructs, with all indicators of centrality suggesting a key role of resilience in remission from depression. LIMITATIONS The presented findings are cross-sectional and networks are limited to a fixed set of key constructs in the literature pertaining cognitive vulnerability for depression. CONCLUSIONS These findings indicate the importance of resilience to successfully cope with stressors following remission from depression. Further in-depth studies will be essential to identify the specific underlying resilience mechanisms that may be key to successful remission from depression.
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Affiliation(s)
- Kristof Hoorelbeke
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
| | - Igor Marchetti
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - Maarten De Schryver
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - Ernst H W Koster
- Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
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Woolhouse H, Small R, Miller K, Brown SJ. Frequency of "Time for Self" Is a Significant Predictor of Postnatal Depressive Symptoms: Results from a Prospective Pregnancy Cohort Study. Birth 2016; 43:58-67. [PMID: 26678360 DOI: 10.1111/birt.12210] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND We aimed to explore the relationship between frequency of time for self and maternal depressive symptoms at 6 months postpartum. METHODS A prospective cohort study of 1,507 first-time mothers in Australia, recruited in early pregnancy with follow-up at 6 months postpartum, was conducted. Scores of more than or equal to 13 on the Edinburgh Postnatal Depression Scale were used to identify depressive symptoms. RESULTS Of 1,507 women recruited to the study, 92.6 percent completed follow-up at 6 months postpartum. Almost half (48.5%) reported having time for themselves when someone else looked after their baby (time for self) once a week or more. Compared with women who reported less frequent time for self, women who had time for themselves once a week or more were less likely to report depressive symptoms (unadjusted OR 0.44 [95% CI 0.30-0.66]). Women who had more frequent time for themselves were more likely to have more practical and emotional support. However, this only partially explained the relationship between time for self and depressive symptoms, which remained significant in regression models after adjusting for other recognized risk factors for maternal depression, including social support (adjusted OR 0.60 [95% CI 0.39-0.94]). CONCLUSIONS Our findings suggest that having time for self at least once a week in the first 6 months after childbirth may have a beneficial influence on maternal mental health. Ensuring women get regular respite from the challenges of caring for a young baby may be a relatively simple and effective way of promoting maternal mental health in the year after childbirth.
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Affiliation(s)
- Hannah Woolhouse
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Rhonda Small
- Judith Lumley Centre, Latrobe University, Melbourne, Vic., Australia
| | - Kirsty Miller
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Vic., Australia
| | - Stephanie J Brown
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,General Practice and Primary Health Care Academic Centre, The University of Melbourne, Melbourne, Vic., Australia
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Abstract
SummaryThis article updates previous evidence on the role of primary care in the management of depression and related disorders, unexplained physical symptoms, and severe and enduring mental illness. Regarding depression and related disorders, there is now evidence for the benefits of non-medical interventions and collaborative care, providing alternatives to the simplistic over prescription of antidepressant medication. For severe and enduring illness, the emphasis in primary care is now on the effective management of comorbid physical health problems. The article also summarises best practice for the primary care assessment and management of dementia, including the need for holistic review of care quality and the potential benefits of collaborative care. Finally, it notes the growing emphasis on primary mental healthcare in low- and middle-income countries (LMIC).
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