Validation of the Polish version of the Brief Resilience Scale (BRS)

Short-term effectiveness of music therapy songwriting for mental health outcomes of at-risk parents in the NICU: a study protocol of an international multicenter mixed-methods trial

BACKGROUND

Preterm birth contributes to adverse mental health outcomes of parents dealing with a premature neonate. The main objective of this study is to determine whether music therapy (MT) songwriting during the infants' stay in the neonatal intensive care unit (NICU) is superior to standard care in reducing the risk of postpartum depression in high-risk parents of preterm children throughout the hospital treatment. The secondary objectives include assessment of effectiveness of MT in other aspects of mental health (anxiety level, perceived stress, mental wellbeing, coping, resilience). Furthermore, this trial will evaluate the medical and social factors that may be associated with the effects of MT songwriting.

PARTICIPANTS AND PROCEDURE

The study design is a sequential mixed method study with a dominant status QUAN to qual. The quantitative trial was designed as a parallel, multicenter, pragmatic, randomized controlled trial. The qualitative study is a descriptive phenomenological study that seeks to understand the lived experiences of participants exposed to songwriting. Participants are parents of premature infants hospitalized in NICU (106 families) in 5 hospitals, in Colombia and Poland. Intervention: 3 MT songwriting sessions per week across 3 weeks. Primary outcome: the risk of postnatal depression; secondary outcomes: anxiety level, mental wellbeing, resilience, stress, coping.

RESULTS

The results will be analyzed quantitatively and qualitatively.

CONCLUSIONS

This study will provide a report on the effectiveness of MT songwriting on mental health in at-risk parents of preterm infants.

Reliability and Validity of the Korean Version of the Brief Resilience Scale

Objective

: To translate the Brief Resilience Scale into Korean and evaluate its reliability and validity.

Methods

: To investigate the factor structure of the Brief Resilience Scale, we examined a two-factor model comprising positively and negatively worded items. Congruent and divergent validity of the Brief Resilience Scale were investigated using correlation analysis between the Brief Resilience Scale and resilience, depression, and perceived stress. By conducting an analysis of variance among groups classified by suicidality (no suicidality, only suicidal ideation, and suicidal ideation or suicidal plan groups), we evaluated how well the Brief Resilience Scale could detect people with a high risk of suicide.

Results

: Confirmatory factor analysis results supported the construct validity of the Brief Resilience Scale using a two-factor model. Cronbach's alpha (0.91) and McDonald's omega (0.91) scores indicated high internal consistency. Correlation analysis showed that the Brief Resilience Scale scores were strongly associated with a questionnaire evaluating resilience, depression, and perceived stress. Analysis of variance and post-hoc tests showed that he Brief Resilience Scale scores were highest in the no suicidality group (p ＜ 0.001).

Conclusion

: The Korean version of the Brief Resilience Scale is a valid and reliable instrument for evaluating resilience as the capacity to recover from adversity and endure obstacles or stress. This study also provides important evidence regarding the sensitivity of the Brief Resilience Scale to suicidal risk.

Effectivity of Palliative Care Bundle on Advanced Gallbladder Cancer: A Randomised Controlled Trial

Objectives

The main aim of this study was to develop, test, and compare palliative care bundles to improve functional recovery, resilience, and quality of life among advanced gallbladder cancer patient with their routine palliative care.

Material and Methods

This study was to test a palliative care bundle, a single-center, and two-arm randomised controlled trial done on a total of 116 participants (58 in each arm) from July 2019 to December 2021 at All India Institute of Medical Sciences, Rishikesh.

Results

By the end of 4th month, the recruitment rate was 96.7%, retention rate acceptance rate was 95%, and adherence rate was 85%. The palliative care bundle showed that a significant difference in trial outcome index score (P = 0.014*) indicates the effectiveness of the palliative care bundle related to improvement in physical mobility, resilience, and quality of life of patients and reduced caregiver burden. Reported barriers faced by participants were physical exhaustion (65%), psychological factors (25%), social factors (15%) and unfamiliar surroundings (5%). Caregivers reported barriers that their job (40%), physical fatigue related to the care of their patient (40%), their education (10%), and lack of support for their other family members (10%) were some reasons forcing them not to practice palliative care bundle.

Conclusion

The palliative care bundle did not interfere with the palliative treatment plan of any patients and significantly improved physical mobility, resilience, quality of life of patients, and reduced caregiver burden. Hence, a palliative care bundle can be considered in the palliative care of advanced cancer patients during their palliative treatment to provide holistic care.

Psychometric evaluation of PHQ-9 and GAD-7 among community health volunteers and nurses/midwives in Kenya following a nation-wide telephonic survey

Background

Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya.

Methods

Between June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach's alpha and MacDonalds' omega were used to evaluate the scale's internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools' divergent and convergent validity.

Results

The internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were significantly negatively correlated with resilience and work engagement, supporting divergent validity. The PHQ-9 and GAD-7 were also significantly positively correlated with resilience and work engagement, supporting divergent validity.

Conclusion

The PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.

The development and validation of a new resilience inventory based on inner strength

There are a number of resilience scales with good psychometric properties. However, the various scales differ in their item content in accordance with the model of resilience the developer had in mind. Culture is one of the reasons for the difference. Thailand, one of the Buddhist cultures, has a different view on resilience compared with Western culture. This study aimed to develop and validate a resilience inventory created based on the inner strength concept using a confirmatory factor analysis (CFA) and Rasch measurement model. The resilience inventory (RI) was developed by creating new items representing inner strengths attributed to resilience. The inner strength was adopted to form the resilience construct, including perseverance, wisdom, patience, mindfulness, loving-kindness and equanimity. In addition, face and content validity were examined by experts in both mental health and Buddhism. The final RI comprised nine items with a 5-point Likert-type scale. The RI-9 was completed by 243 medical students who participated in the study, along with other measurements, i.e., Inner Strength-Based Inventory (iSBI), measuring the ten characteristics of perfection or inner strength, and the Core Symptom Index, measuring anxiety, depression and somatization symptoms. CFA, internal consistency and the Polytomous Rasch rating model were used to investigate the RI-9 construct validity. The mean age of the participants was 22.7 years (SD, 0.8); one-half were male (50%). The RI-9 construct demonstrated item hierarchy as follows: perseverance, patience (tolerance), mindfulness and equanimity, wisdom and loving-kindness. CFA showed that the unidimensional model fitted the data well. Rasch analysis showed no misfitting items and local dependence. The reliability of the person and item was good, and no disordered threshold was observed. Two items were found to exhibit differential item functioning due to sex. RI-9 scores were significantly related to all ten strengths from the iSBI, whereas they were negatively related to depression, anxiety, somatization and interpersonal difficulties. The RI-9 demonstrated validity and reliability. It constitutes a promising tool for outcome assessment in nonclinical populations. Further investigation on external validity as well as psychometric validation in other different cultures, should be encouraged.

Posttraumatic growth and posttraumatic depreciation among people living with HIV: the role of resilience and HIV/AIDS stigma in the person-centered approach

Posttraumatic growth (PTG) among people living with HIV (PLWH) remains an understudied and controversial topic, and several research gaps need to be filled. In our study, we focused on one such gap by implementing parallel assessment of positive (PTG) and negative changes (posttraumatic depreciation [PTD]) following trauma related to HIV diagnosis, along with measurement of resilience and HIV/AIDS stigma and socio-medical data. The study sample comprised 509 PLWH, which completed the standardized psychometric inventories measuring the study variables. The results showed an unexpected positive relationship between PTG and PTD among participants. In addition, following the person-centered approach, we observed specific PTG/PTD clusters in the study sample with different resilience and HIV/AIDS stigma levels. Our study may shed some light on understanding PTG/PTD processes among PLWH and inspire planning for effective psychological help adjusted to patients' specific needs.

Professional Identity Formation, Professionalism, Leadership and Resilience (PILLAR) in Medical Students: Methodology and Early Results

Objectives

The fundamental role of medical education is the transformation of students to doctors, through a process of education and professional identity formation (PIF), which can be informed by several educational, behavioural and emotional factors. PIF has been deemed to be of equal importance to the acquisition of clinical knowledge and skills and includes constructs such as professionalism, leadership and resilience. We aimed to assess professional identity formation, professionalism, leadership and resilience (PILLAR) in the junior years of medical school in the 2020/2021 academic year and illustrate the potential role of quantitative assessment to demonstrate progression in these areas. In this research, we provide the methods and baseline results for the PILLAR study.

Methods

We implemented a compulsory assessment in pre-clinical years of graduate entry and direct entry medicine at the Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland. Validated scales were used to assess students' PILLAR. Descriptive and univariable statistical techniques were used to compare student scores between respective years.

Results

A total of 1311 students (92% response rate) provided their consent for research. For the psychometric scales, there were no evident trends among the years on these assessment measures. Results indicated significant differences in all measures, however, these did not correspond to ascending years of seniority.

Conclusion

The PILLAR methodology provides important information on the challenges of quantitatively assessing medical students in the four key areas of PIF, professionalism, leadership, and resilience. Our cross-sectional results point to cohort effects, without the expected progression per year in the cross-sectional data, or suggest that the chosen quantitative measures may be problematic for these constructs in pre-clinical students. Therefore, while we believe that PILLAR has potential as a progress test for these constructs, this will only truly be elucidated by repeated measures of each cohort over time.

Exploring the mediating effects of negative and positive religious coping between resilience and mental well-being

Background:

The purpose of the study was to examine more thoroughly the relationship between trait resilience and mental well-being. Although research demonstrates that this relationship is partially mediated by stress-related variables, no study has taken into account the mediating role of religious coping. We examined the mediating role of both variants of religious coping, positive and negative, along with specific strategies within the scope of religious coping strategies in a group of practicing Catholics.

Method:

Participants were 317 people aged 19–60 years (M = 24.34; SD = 6.30). The respondents indicated their gender and age, and then completed the RS-14 (trait resilience), RCOPE (religious coping), and WEMWBS (mental well-being) scales.

Results:

The results displayed a significant relationship between resilience and mental well-being (r = 0.67; p < 0.001). The relationship between resilience and positive religious coping was negligible (r = 0.09; p = 0.74), contrary to the relationship between resilience and negative coping that was significant but weak (r = −0.29; p < 0.001). Although the relationships between overall negative and positive religious coping with mental well-being were irrelevant, we found significant relationships between some strategies and mental well-being. The mediation analysis has demonstrated that the general negative religious coping and the strategies of demonic reappraisal, passive religious deferral, and spiritual discontent have enhanced the positive relationship between resilience and mental well-being. Contrary to expectation, positive strategies did not mediate the relationship between resilience and mental well-being, except religious practices (c′path totaled β = 0.66; t = 15.74, p < 0.001). The insignificant mediation effect can stem from the fact that the relationship between positive religious coping and stress is noticeable only in the long term. We controlled age and sex as statistically significant covariates so that the mediation effects obtained were devoid of the influence of those critical variables on the models.

Conclusion:

This is the first study to investigate the role of religious coping as a mediator in the relationship between resilience and mental well-being.

Trajectories of posttraumatic growth and posttraumatic depreciation: A one-year prospective study among people living with HIV

Objective

Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) are considered two sides of growth after trauma. Nevertheless, previous studies pointed out that in trauma living with a life-threatening illness, they may be experienced as two independently and share distinct predictors. In our study we aimed to find the different trajectories of PTG and PTD among a sample of people living with HIV (PLWH) and to investigate its predictors out of psychological resilience, and gain and loss of resources from the conservation of resources theory (COR).

Methods

We designed a longitudinal study that consisted of three measurements at 6-month intervals, and we recruited, respectively, 87, 85 and 71 PLWH. Each time participants filled out the following questionnaires: the expanded version of the PTG and PTD Inventory (PTGDI-X), the Brief Resilience Scale (BRS), the Conservation of Resources Evaluation (COR-E), and a survey on sociodemographic and medical data.

Results

We observed two separate trajectories of PTG and PTD within participants and found that each of the trajectories were related to different predictors from the studied variables. More specifically, we found a positive relationship between resilience and a descending PTD trajectory that stabilized over time. Gain of resources generally predicted a PTG trajectory, while loss of resources predicted the dynamics of PTD.

Conclusions

Including two parallel constructs, i.e., PTG and PTD, confirmed the independence of their mechanisms in growth processes among PLWH. The initial insight concerning the role of resilience and resources in PTG/PTD processes may inspire more effective planning for psychological help for PLWH, and it may stimulate studies on growth after trauma to further examine the two sides of this phenomenon.

Exhausted due to the pandemic: Validation of Coronavirus Stress Measure and COVID-19 Burnout Scale in a Polish sample

This study validated Polish versions of the Coronavirus Stress Measure (CSM) and the COVID-19 Burnout Scale (COVID-19-BS) to measure stress and burnout associated with COVID-19. Participants were 431 Polish young adults (72.6% female; Meanage = 26.61 ± 12.63). Confirmatory factor analysis verified a one-factor solution for both the CSM and the COVID-19-BS. Both scales had high internal consistency reliability. Coronavirus stress and COVID-19 burnout were positively related to depression, anxiety, and stress and negatively related to resilience. The coronavirus stress and COVID-19 burnout were correlated with elevated levels of depression, anxiety, and stress over and beyond resilience, age, and gender. Findings suggest that the Polish versions of the CSM and the COVID-19-BS are valid scales to measure stress and burnout related to COVID-19. Findings also demonstrated that the coronavirus stress and COVID-19 burnout experienced during the later stages of the pandemic might be a permanent risk factor for mental health problems.

Resilience and Mental Health in the Polish Population during the COVID-19 Lockdown: A Mediation Analysis

The aim of this paper was to assess the state of resilience and well-being in the Polish population during the COVID-19 pandemic. We also assessed the relationship between resilience and mental health. Finally, we tested the mediating role of COVID-19 anxiety, persistent thinking, and the stress burden in the relationship between mental health and resilience. This research perspective can provide important insights into how individuals can become mentally stronger during the COVID-19 pandemic.

METHODS

This study included 1758 people (73% women) aged 18-80 years. The procedure consisted of completing a questionnaire measuring well-being, COVID-19 anxiety, obsession with COVID-19, stress over COVID-19, and resilience.

RESULTS

Bootstrap sampling analysis showed significant partial mediators for the relationship between resilience and well-being. Important mediators were coronavirus anxiety, persistent thinking, and perceived stress.

CONCLUSIONS

The results of the present study clearly indicate that resilience as a protective factor is associated with reduced anxiety about COVID-19, perceived stress burden, obsessive thoughts about the pandemic, and increased well-being of individuals. Resilience plays an important role in minimizing negative and enhancing positive health indicators in the face of challenging life events.

How Czecho-Slovakia Bounces Back: Population-Based Validation of the Brief Resilience Scale in Two Central European Countries

OBJECTIVE

In recent years, resilience has become a focus of research in the medical and behavioral sciences. The Brief Resilience Scale (BRS) was developed to assess the individual ability to recover from stress ("to bounce back") after experiencing adversities. The aim of the study was to validate the Czech and Slovak versions of the BRS.

METHODS

A representative sample of the Czech and Slovak populations (N_CZ = 1800, mean age M_CZ = 46.6, SD_CZ = 17.4, 48.7% of men; N_SK = 1018, mean age M_SK = 46.2, SD_SK = 16.6, 48.7% men) completed a survey assessing their health and well-being. Several confirmatory factor analysis (CFA) models of the BRS were compared to find the best fit. Cronbach's alpha and McDonald's omega coefficients of reliability were evaluated. Convergent validity was assessed by correlating resilience (BRS), physical and mental well-being (SF-8) and psychopathology symptoms (BSI-53). Differences in gender and age groups were appraised.

RESULTS

A single-factor model with method effects on the reverse items was evaluated to best fit the data in both the Czech and Slovak samples (χ²_CZ(6) = 39.0, p < 0.001, CFI_CZ = 0.998, TLI_CZ = 0.995, RMSEA_CZ = 0.055, SRMR_CZ = 0.024; χ²_SK(6) = 23.9, p < 0.001, CFI_SK = 0.998, TLI_SK = 0.995, RMSEA_SK = 0.054, SRMR_SK = 0.009). The reliability was high in both samples (α_CZ = 0.80, ω_CZ = 0.85; α_SK = 0.86, ω_SK = 0.91). The BRS was positively associated with physical and mental well-being and negatively associated with somatization, depression and anxiety. In both countries, a lower BRS score was associated with higher age. Czech men reported significantly higher BRS scores than women. No significant difference was found in the mean BRS scores between the two countries.

CONCLUSION

This study provides evidence of good psychometric properties, reliability and validity of the Czech and Slovak adaptations of the BRS.

Development and Psychometric Properties of a Scale to Measure Resilience among Portuguese University Students: Resilience Scale-10

Higher education students lack skills to deal in a positive way with the crises inherent to the developmental phase in which they find themselves. However, the complexity of the current global context adds an urgent need for them to be resilient. For this purpose, it is necessary to evaluate their capacity for resilience, which requires the use of instruments that are easy to access, useful, simple, and fast. In this sense, this study aimed to develop and validate a scale to assess students’ resilience in the face of adversity. The scale was administered to a sample of 2030 Portuguese higher education students. The results obtained pointed towards a factorial structure composed of two factors named “self-determination” and “adaptability”, which showed good internal consistency. Therefore, this scale proved to be a valid measure to assess resilience among the university population. Future studies may consider this variable as an intervention target since it can be a predictor of success in phases of change and crisis.

Meaningful living, resilience, affective balance, and psychological health problems among Turkish young adults during coronavirus pandemic

The present study sought to investigate the mediating effect of the affective balance and resilience on the association between meaningful living and psychological health problems among Turkish young adults in the context of COVID-19. The participants were 359 Turkish young adults, comprising of primarily female (68.2%), and their age ranged between 18 to 43 (age M = 20.67, SD = 3.62). Findings from this study indicated that meaningful living had a positive predictive effect on resilience and positive affect, as well as a negative predicative on psychological health challenges and negative affect. Resilience and affective balance also mediated the effect of meaningful living on psychological health of young adults. These results suggest that resilience and affective balance are important aspects of meaning-focused preventions and interventions designed to build up resilience, positive affectivity, and psychological health.

Resilience and Mental Well-Being During the COVID-19 Pandemic: Serial Mediation by Persistent Thinking and Anxiety About Coronavirus

Reports to date indicate that the COVID-19 pandemic outbreak has negatively impacted mental health in the general population. On the other hand, positive associations of mental resilience and well-being have been widely demonstrated. The objective of this study was to assess the links between resilience (Brief Resilience Scale), persistent thinking about COVID-19 (Obsession with COVID-19 Scale), coronavirus anxiety (Coronavirus Anxiety Scale), and well-being (World Health Organization's 5-item Well-being Index) using serial mediation. The study considered online survey data from 1,547 Poles aged 18-78 (62% of whom were women). Bootstrap sampling analysis revealed that persistent thinking about COVID-19 (M1) and coronavirus anxiety (M2) partially mediate the relationship between resilience and well-being. The results of this study indicate that persistent thinking may be dysfunctional for mental health, as it inflates pandemic anxiety and disrupts well-being. Moreover, practitioners should focus on interventions enhancing resilience in order to reduce negative mental effects during the spread of a pandemic infectious disease.