Coping strategies as a mediator of posttraumatic growth among adult survivors of the Wenchuan earthquake

Physical Symptoms and Coping Strategies With Earthquake Stress Among Adults Living in Tent Cities: A Cross-Sectional Study

AIM

This study aimed to examine the physical symptoms, coping strategies for earthquake stress and factors predicting coping strategies among adults staying in tent cities after an earthquake.

DESIGN

A cross-sectional design was conducted.

METHODS

The study sample consisted of 706 adults residing in tent cities in three cities of earthquake-affected regions. Data were collected through face-to-face surveys and the Earthquake Coping Strategies Scale, starting from the 16th day after the earthquake in February-March 2023. Independent samples t-test, one-way analysis of variance, McNemar test and multiple linear regression analysis used for data analysis.

RESULTS

The first three physical symptoms with the highest frequency after the earthquake were insomnia, frequent waking and difficulty falling asleep, respectively. Individuals with chronic illnesses, lower education levels, no previous experience with earthquakes and having undamaged homes more frequently used religious coping strategies. Individuals with higher incomes, employed individuals, non-smokers and those with having undamaged homes more frequently used positive reappraisal strategies.

CONCLUSION

The present study concluded that physical symptoms were common among individuals in the post-earthquake period and that many individuals adopted religious coping strategies.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nurses can develop effective interventions for preventing physical and mental health problems in the post-earthquake period. They can contribute significantly as caregivers, leaders, researchers and advisors in health monitoring and improvement practices for individuals after earthquakes.

IMPACT

The results of the study are instructive for designing prevention and improvement practices to minimise future destructive effects of earthquakes. Individuals mostly experienced sleep problems and preferred different coping styles in the early post-earthquake period. The physical and mental health of individuals can be improved by early intervention and encouraging effective coping methods after an earthquake.

REPORTING METHOD

STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

Improving post-traumatic growth of disaster survivors: An integrative literature review

BACKGROUND

The psychological aspect is one of the important aspects of the affected disaster survivors. The change in the disaster management paradigm is one reason for the need to change interventions that previously only focused on handling posttraumatic distress syndrome into interventions to increase post-traumatic growth to prevent post-disaster psychological disorders. This review aims to synthesise recent research to develop further explanations regarding potential strategies to improve the post-traumatic growth of disaster survivors.

METHOD

This is an integrative review of previous studies. Articles were identified via SCOPUS, EMBASE, JSTOR, PROQUEST, MEDLINE and grey literature (Google Scholar). All subject-relevant literature from 2000 to 2022 was identified. This review included quantitative and qualitative studies and literature reviews, with criteria: all types of interventions used to improve the post-traumatic growth of disaster survivors and potential influencing factors that may affect the implementation as well as other relevant outcomes.

RESULT

From 400 initial search studies, 27 studies (24 quantitative. one qualitative, and two mixed methods) were eligible to be included in the review. Some factors promoting post-traumatic growth included religious coping, culture, social support, the severity of the trauma, coping strategies, education level and work satisfaction.

CONCLUSION

By systematically exploring the factors that foster post-traumatic growth of disaster survival, this integrative review will give fundamental information to develop an intervention that prevents or minimises the psychological impacts of a disaster towards survivors.

Working With a Psychopath: Is There Light at the End of the Tunnel?

Having a supervisor with psychopathic characteristics is related to being bullied, poorer job satisfaction, work/family life conflict, financial instability, and distress. To date, all research on corporate psychopathy victims considers how they are negatively impacted rather than potential positive outcomes. In response, this study examined how working with a psychopath impacts posttraumatic growth (PTG). Utilizing a mixed-methods approach, this study draws upon the experiences of 285 individuals who have worked with a colleague or supervisor with alleged psychopathic characteristics. Results indicated that approach coping and psychopathic characteristics predicted PTG. Qualitative analyses revealed that the majority of participants used various coping strategies (e.g., emotion-focused), received support (e.g., emotional), and underwent post-experiential growth or learning (e.g., positive personal growth); not all growth/learning was positive, however (e.g., less trusting). Results suggest that cultivating approach-focused coping strategies may enhance PTG following a traumatic event.

COVID‐19 pandemic‐related stressors and posttraumatic stress: The main, moderating, indirect, and mediating effects of social support

The COVID-19 pandemic has created a variety of stressors, some of which have been linked to intense stress reactions, such as posttraumatic stress (PTS)-like symptoms. However, we have limited knowledge on cumulative effects of pandemic-related stressors on PTS or on variables that may mitigate the effects of these stressors. We aimed to address some of these knowledge gaps by testing three models to examine the interrelationships among pandemic-related stressors, perceived social support, coping flexibility, and pandemic-related PTS. The sample of this cross-sectional correlational study is comprised of 2291 adults from the United States who completed an online survey between 22 May 2020 and 15 July 2020. Results indicated that greater exposure to secondary stressors, but not COVID-19-related stressors, was associated with increased PTS. After controlling for COVID-19-related and secondary stressors, social support had negative direct and indirect (via coping flexibility) effects on PTS. In addition, social support mediated the effects of COVID-19-related and secondary stressors on PTS. Our findings highlight the complexity of the role of social support in relation to pandemic-related stressors and PTS, and suggest that early interventions that target social support and coping flexibility may help reduce pandemic-related PTS.

Living beyond placenta accreta spectrum: parent's experience of the postnatal journey and recommendations for an integrated care pathway

BACKGROUND

Placenta Accreta Spectrum is associated with significant clinical maternal morbidity and mortality, which has been extensively described in the literature. However, there is a dearth of research on the lived experiences of pregnant people and their support partners. The aim of this study is to describe living beyond a pregnancy and birth complicated by PAS for up to four years postpartum. Participants experiences inform the development of an integrated care pathway of family centered support interventions.

METHODS

An Interpretative Phenomenological Analysis approach was applied to collect data through virtual interviews over a 3-month period from February to April 2021. Twenty-nine participants shared their stories; six people with a history of PAS and their support partners were interviewed together (n = 12 participants), six were interviewed separately (n = 12 participants), and five were interviewed without their partner. Pregnant people were eligible for inclusion if they had a diagnosis of PAS within the previous 5 years. This paper focuses on the postnatal period, with data from the antenatal and intrapartum periods described separately.

RESULTS

One superordinate theme "Living beyond PAS" emerged from interviews, with 6 subordinate themes as follows; "Living with a different body", "The impact on relationships", "Coping strategies", "Post-traumatic growth", "Challenges with normal care" and recommendations for "What needs to change". These themes informed the development of an integrated care pathway for pregnant people and their support partners to support them from diagnosis up to one year following the birth.

CONCLUSION

Parents described the challenges of the postnatal period in terms of the physical and emotional impact, and how some were able to make positive life changes in the aftermath of a traumatic event. An integrated care pathway of simple supportive interventions, based on participant recommendations, delivered as part of specialist multidisciplinary team care may assist pregnant people and their support partners in alleviating some of these challenges.

Post-Traumatic Growth during COVID-19: The Role of Perceived Social Support, Personality, and Coping Strategies

Although many studies on mental health have been conducted among various populations during the COVID-19 pandemic, few studies have focused on post-traumatic growth (PTG) in the general population. The current study aimed to explore whether perceived social support, personality, and coping strategies are associated with PTG in the COVID-19 pandemic period. The study also investigated whether coping strategies mediate the relations between perceived social support, personality, and PTG. A total of 181 participants (Mage = 24) completed the self-report questionnaire online, which was distributed via various online channels, mainly in China and Sweden. The relations between the study variables were examined with correlation analyses and a multiple mediation analysis. Results showed that more than half of the participants (60.8%) reported experiences of PTG during the pandemic. Additionally, perceived social support, personality traits (extraversion, emotional stability, agreeableness, and conscientiousness) and coping strategies (problem-focused coping, emotion-focused coping, and social support coping) were positively correlated with PTG. In addition, coping strategies (problem-focused coping, emotion-focused coping, and avoidance coping) mediated the relations between perceived social support, personality traits and PTG. Theoretical and practical implications of this study are discussed, concluding that the findings of this study have the potential to guide intervention efforts to promote positive change during the pandemic.

The Impact of Coping Skills in Post-traumatic Growth of Healthcare Providers: When Mental Health Is Deteriorating Due to COVID-19 Pandemic

Background: Frontline healthcare providers are consistently exposed to potentially traumatic events while assisting patients with COVID-19. Post-traumatic growth (PTG) happens when a person can transform trauma and use adversity in one’s advantage. In response to limited studies on positive outcomes that may occur from the pandemic; this study aimed to elucidate the positive impact of coping with COVID-19 outbreak on mental health, such as PTG.

Methodology: The study comprised a sample of 691 healthcare providers 59% female, including physicians (n = 138) and nurses (n = 550), working in public health facilities in Kosovo, with an average age of 41.6 years (SD = 10.79). They were asked to complete a questionnaire with four parts: Socio-demographic, GHQ-28, COPE and PTGI. A deterioration of mental health with somatic symptoms leading to the escalation due to COVID-19 outbreak was found.

Results: Female healthcare providers reported more clinical symptoms as well as higher coping skills scores than men. The domains in which positive changes were most frequently observed were Relating to Others, New Possibilities and Personal Strength. There was no significant direct effect of mental health on PTG in the mediation model, though a significant indirect effect was observed for coping skills.

Conclusion: The results suggest that levels of mental health exacerbation do not play a conclusive role in determining levels of PTG, as long coping mechanisms are in place. The development and implementation of interventions to minimize COVID-19-related mental health consequences, by fostering PTG among healthcare providers could be highly beneficial in pandemic response work.

Perceived organizational support and PTSD symptoms of frontline healthcare workers in the outbreak of COVID-19 in Wuhan: The mediating effects of self-efficacy and coping strategies

The present study aimed to examine the effect of perceived organizational support on the PTSD symptoms of frontline healthcare workers, and to examine the mediating effects of coping self-efficacy and coping strategies in this relationship. A short-term longitudinal study design was used to conduct two waves of online surveys in March and April 2020. Participants comprised 107 medical staff in both waves of investigation. Self-efficacy, coping strategies, and perceived organizational support were reported at Wave 1, and PTSD symptoms were reported at Wave 2. Results indicated that (1) The prevalence of probable PTSD was 9.3% and 4.7% on the Chinese version of the Impact of Events Scale-Revised of 33 and 35, respectively. Local healthcare workers had greater risks of PTSD than the members of medical rescue teams. Doctors reported higher PTSD symptoms than nurses. (2) Perceived organizational support had a significant indirect effect on PTSD symptoms through the mediation of problem-focused coping strategies and the sequential mediating effect of coping self-efficacy and problem-focused coping strategies. The findings highlight the importance of providing adequate organizational support to reduce PTSD symptoms in frontline medical staff during the COVID-19 pandemic.

Coping strategies mediate the association between family functioning and posttraumatic growth in family caregivers of people with dementia

OBJECTIVES

This study aimed to examine the mediating effect of coping strategies on the relationship between family functioning and posttraumatic growth in family caregivers of people with dementia (PwD).

METHODS

A total of 124 family caregivers of PwD from a memory clinic were investigated from July to October 2017. Family functioning, coping strategies, and posttraumatic growth of family caregivers of PwD were measured. Data were processed using descriptive statistics, correlation analysis, regression analysis, and structural equation modelling.

RESULTS

Posttraumatic growth was observed in family caregivers of PwD. The caregiver's gender, relationship with the patient, and difficulty balancing financial income and expenditures in the past month, as well as disease severity of PwD, are significant predictors of posttraumatic growth. There were significantly positive correlations among posttraumatic growth, family functioning and positive coping strategies (P＜0.01). Positive coping strategies exert a complete mediating effect between family functioning and posttraumatic growth (β = 0.49, P < 0.05).

CONCLUSIONS

A model of the posttraumatic growth of family caregivers of PwD can be established, and the relevant mechanisms can be explored. Healthcare providers should pay attention to the family functioning of caregivers and take effective measures to provide them with positive coping strategies to promote their posttraumatic growth.

A COVID-19 descriptive study of life after lockdown in Wuhan, China

On 8 April 2020, the Chinese government lifted the lockdown and opened up public transportation in Wuhan, China, the epicentre of the COVID-19 pandemic. After 76 days in lockdown, Wuhan residents were allowed to travel outside of the city and go back to work. Yet, given that there is still no vaccine for the virus, this leaves many doubting whether life will indeed go back to normal. The aim of this research was to track longitudinal changes in motivation for self-isolating, life-structured, indicators of well-being and mental health after lockdown was lifted. We have recruited 462 participants in Wuhan, China, prior to lockdown lift between 3 and 7 April 2020 (Time 1), and have followed up with 292 returning participants between 18 and 22 April 2020 (Time 2), 284 between 6 and 10 May 2020 (Time 3), and 279 between 25 and 29 May 2020 (Time 4). This four-wave study used latent growth models to examine how Wuhan residents' psychological experiences change (if at all) within the first two months after lockdown was lifted. The Stage 1 manuscript associated with this submission received in-principle acceptance (IPA) on 2 June 2020. Following IPA, the accepted Stage 1 version of the manuscript was preregistered on the OSF at https://osf.io/g2t3b. This preregistration was performed prior to data analysis. Generally, our study found that: (i) a majority of people still continue to value self-isolation after lockdown was lifted; (ii) by the end of lockdown, people perceived gradual return to normality and restored structure of everyday life; (iii) the psychological well-being slightly improved after lockdown was lifted; (iv) people who used problem solving and help-seeking as coping strategies during lockdown had better well-being and mental health by the end of the lockdown; (v) those who experienced more disruptions in daily life during lockdown would display more indicators of psychological ill-being by the end of the lockdown.

The prevalence of posttraumatic stress in adolescents eight years after the Wenchuan earthquake

In 2008, an 8.0 Richter scale earthquake devastated Wenchuan in China, which resulted in heavy casualties, and had wide-reaching psychological effects on survivors. To examine its impact on the survivors, this study aims to investigate the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adolescents eight years after the earthquake. The cross-section survey was conducted in two different earthquake-affected areas, and data were collected from 4118 respondents. Instruments included the questionnaire on demographic information, the questionnaire on seismic exposure, PTSD Checklist-Civilian Version (PCL-C) questionnaire, Posttraumatic Growth Inventory (PTGI), Perceived Social Support Scale (PSSS) and Simple Coping Style Questionnaire (SCSQ). During the survey, there were 1998 valid questionnaires from the generally affected area and 2120 questionnaires from the severely affected area. The rate of PTSD is 1.9% in the generally affected area and 2.7% in the severely affected disaster area; there is no significant difference between the two differently affected areas. Occurrences of PTSD and PTG are significantly positively correlated in the generally affected area, nevertheless, there is a significant negative correlation between PTSD and PTG in most systems of the severely affected area. The results of this study help to expand our knowledge regarding posttraumatic stress in adolescents 8 years after the Wenchuan earthquake, and it provides suggestions for specific long-term health interventions in such populations. To prevent earthquake-related psychological issues among adolescent survivors, social support, psychological aid, and improvement of the living environment are necessary to buffer negative posttraumatic stress.

Systematic Review on Post-Traumatic Stress Disorder Among Survivors of the Wenchuan Earthquake

Post-traumatic stress disorder (PTSD) widely occurs among victims or witness of disasters. With flashbacks, hyperarousal, and avoidance being the typical symptoms, PTSD became a focus of psychological research. The earthquake in Wenchuan, China, on May 12, 2008, was without precedent in magnitude and aftermath and caused huge damage, which drew scientists' attention to mental health of the survivors. We conducted a systematic overview by collecting published articles from the PubMed database and classifying them into five points: epidemiology, neuropathology, biochemistry, genetics and epigenetics, and treatment. The large body of research during the past 6 years showed that adolescents and adults were among the most studied populations with high prevalence rates for PTSD. Genomic and transcriptomic studies focusing on gene × environment studies as well as epigenetics are still rare, although a few available data showed great potential to better understand the pathophysiology of PTSD as multifactorial disease. Phytotherapy with Chinese herbs and acupuncture are rarely reported as of yet, although the first published data indicated promising therapy effects. Future studies should focus on the following points: (1) The affected populations under observation should be better defined concerning individual risk factor, time of observation, spatial movement, and individual disease courses of patients. (2) The role of social support for prevalence rates of PTSD should be observed in more detail. (3) Efficacy and safety of Chinese medicine should be studied to find potential interventions and effective treatments of PTSD.

Posttraumatic stress disorder and posttraumatic growth coexistence and the risk factors in Wenchuan earthquake survivors

Various studies have assessed the negative and/or positive changes in the aftermath of traumatic events. Yet few of these have addressed the factors associated with the coexistence of both negative and positive changes after a devastating earthquake. The aim of this study is to assess the relationship between the negative and positive changes and elucidate the risk factors of such changes one year after Wenchuan earthquake. A total of 2080 survivors from 19 counties participated in a self-report questionnaire survey which included the posttraumatic stress disorder (PTSD) Check list-Civilian, the posttraumatic growth PTG Inventory (PTGI). The prevalence of PTSD and moderate PTG was found to be 40.1% (95% CI [37.9% 42.3%]) and 51.1% (95% CI [48.9% 53.3%]). The PTSD and moderate PTG coexistence was 19.6% (95% CI [17.8% 21.4%]). PTSD symptom severity was significantly positively associated with the PTG score. Middle aged groups (31-40 and 41-50 years old, OR=2.323, 95% CI [1.059, 5.095] and OR=2.410, 95% CI [1.090, 5.329] respectively), those with lower income levels (OR=8.019, 95% CI [2.421, 26.558]), those living in temporary house (OR=1.946, 95% CI [1.280, 2.956]), and those who had had less social support (OR=1.109, 95% CI [1.076, 1.143]) had a significantly higher possibility for the presence of PTSD and moderate PTG coexistence. The results indicated the widespread positive changes in earthquake survivors. Better income levels and living conditions and higher social support were suggested to promote PTG in those with PTSD.

Perceptions of distress and positive consequences following exposure to a major disaster amongst a well-studied cohort

OBJECTIVES

Research on the impact of natural disasters on health and well-being faces several methodological challenges, including: sampling issues; exposure assessment; and outcome measurement. The present study used a comprehensive measure of disaster exposure to assess relationships between exposure to the Canterbury (New Zealand) Earthquakes of 2010-2011 and both: (a) self-reported distress and (b) positive outcomes; and also investigated gender differences in reports.

METHODS

Data were gathered from the Christchurch Health and Development Study, a 35-year longitudinal study. The study examined data from 495 individuals exposed to the Canterbury Earthquakes for who complete data on exposure and reactions to the earthquakes at age 35 were available.

RESULTS

Participants with higher levels of exposure to the earthquakes reported significantly (p<0.0001) higher levels of distress due to fear, death and injury, and disruption caused by the earthquakes. Higher levels of exposure to the earthquakes were also associated with significantly (p<0.0001) higher levels of reporting positive consequences following the earthquakes. Women reported significantly (p<0.0001) greater distress than men and significantly (p<0.001) greater positive consequences.

CONCLUSIONS

Higher levels of exposure to disaster were associated with higher levels of distress, but also with higher levels of self-reported positive outcomes, with females reporting higher levels of both positive and negative outcomes. The findings highlight the need for comprehensive assessment of disaster exposure, to consider gender and other group differences in reactions to disaster exposure, and for studies of disasters to examine both positive and negative consequences.