Factors influencing the thriving of emergency department nurses in China

INTRODUCTION

Thriving is a positive feeling arising from nurses' work and is increasingly valued by managers. Given their demanding workloads and various duties, it is necessary to research the determinants of ED nurses' thriving. This study aimed to investigate the factors influencing thriving and the mechanisms of interaction between the factors among ED nurses.

METHODS

380 ED nurses from six tertiary hospitals in Shandong Province, China, participated in this cross-sectional study. The instruments used were the General Information Questionnaire, Challenge-Hindrance Stressors Scale, Psychological Detachment Scale, and Thriving at Work Scale. Data analysis methods included univariate analysis, Pearson correlation, PROCESS 4.0, and hierarchical multiple regression.

RESULTS

Weekly working hours affected nurses' thriving. Challenge stressors and psychological detachment were positively related to thriving. Hindrance stressors had a negative link with thriving. Psychological detachment suppressed the relationship between challenge stressors and thriving; however, it mediated the relationship between hindrance stressors and thriving.

CONCLUSION

Challenge-hindrance stressors and psychological detachment are significant elements influencing ED nurses' thriving. Nursing administrators should help ED nurses properly address stressors with different attributes and adopt appropriate strategies to improve nurses' thriving by enhancing psychological detachment.

Interrogating multisystem intended pathways to youth thriving and resilience: Benefits of inclusive human development theoretical framing

Moving more deeply into the 21st century and acknowledging the ongoing patterned needs of children, there continues to be broadly voiced sentiments about the importance of all children's thriving, adaptive coping, and resiliency. This paper notes that social science more broadly and developmental science specifically is a major resource determinative of the nature of remedies conceptualized, designed, and implemented. Evident is that the harms experienced by children and the solutions implemented by delivery systems are frequently unaligned. Efficacy and impact do not appear to be improved by multisystem integration delivery. This paper explores the benefits of incorporating inclusive and shared human development theory. As well, it examines the need to question the character virtue of the multisystem integration efforts intended to afford supportive solutions required for youths' thriving and resiliency. Specifically, it addresses whether democratic and equity relevant character values are integrated into public and privately funded intended supportive systems. The position taken is that whether considered under conditions of trauma illustrated by the global COVID pandemic or the efficacy of systems intended to aid the most vulnerable youngsters, the character of the content of support and its delivery matter and can benefit from inclusive human development interrogation and theorizing.

'Being Actively Confident in All Contexts': A Qualitative Exploration of Thriving as an Emerging Adult of Diverse Sexual Orientation

When one thrives, they grow, develop and succeed. For people of diverse sexual orientations (DSO) thriving within one's sexuality is often restricted by heteronormativity, minority stress and poor mental health outcomes. Particularly at risk, are DSO "emerging adults" aged between 18-29 years who seek stability before transitioning to adulthood. Therefore, this qualitative study interviewed 12 participants between the ages of 18-29 years to investigate perceptions of thriving within one's sexuality and factors that may foster or hinder its occurrence. The results indicated participants perceived thriving as a spectrum of states and processes involving a sense of personal safety with high levels of self-acceptance to believe one could exist freely as a person of DSO. The findings suggested thriving within one's sexuality during emerging adulthood is fostered through the factors of seeking personal growth, social representation/visibility, affirming social support and opportunities to support other DSO people. In contrast, identity denial, unsupportive social environments, erasure/tokenism, and experiences of discrimination eroded one's ability to thrive. Psychological interventions focusing on establishing a strong sense of identity, building a social support network and encouragement to seek thriving opportunities, may foster thriving experiences for Australian DSO emerging adults.

Development of a Chinese version of the Stress Adaption Scale and the assessment of its reliability and validity among Chinese patients with multimorbidity

OBJECTIVES

To develop a Chinese version of the Stress Adaption Scale (SAS) and to assess its reliability and validity among Chinese patients with multimorbidity.

METHODS

The Brislin model was used to translate, synthesize, back-translate, and cross culturally adapt the SAS. A total of 323 multimorbidity patients selected by convenience sampling method from four hospitals in Zhejiang province. The critical ratio method, total question correlation method, and graded response model (item characteristic curve and item discrimination) were used for item analysis. Cronbach's alpha coefficient and split-half reliability were used for the reliability analysis. Content validity analysis, structural validity analysis, and criterion association validity analysis were performed by expert scoring method, confirmatory factor analysis, and Pearson correlation coefficient method, respectively.

RESULTS

The Chinese version of the SAS contained 2 dimensions of resilience and thriving, with a total of 10 items. In the item analysis, the critical ratio method showed that the critical ratio of all items was greater than 3.0 (P<0.001); the correlation coefficient method showed that the Pearson correlation coefficients for all items exceeded 0.4 (P<0.01). The graded response model showed that items of the revised scale exhibited distinct item characteristic curves and all items had discrimination parameters exceeding 1.0. In the reliability analysis, Cronbach's alpha coefficient of the revised Chinese version of the SAS scale was 0.849, and the split-half reliability was 0.873. In the validity analysis, the item-level content validity index and scale-level content validity index both exceeded 0.80. In the confirmatory factor analysis, the revised two-factor model showed satisfactory fit indices (χ2/df=3.115, RMSEA=0.081, RMR=0.046, GFI=0.937, AGFI=0.898, CFI=0.936, TLI=0.915). In the criterion-related validity analysis, the Chinese version of the SAS score was negatively correlated with the Perceived Stress Scale and the Treatment Burden Questionnaire, with correlation coefficients of －0.592 and －0.482, respectively (both P<0.01).

CONCLUSIONS

The Chinese version of the SAS has good reliability and validity, which can be used to evaluate the stress adaption capacity among multimorbidity patients in China, and provides a reference for developing individualized health management measures.

Association Between Head Impact Exposure, Psychological Needs, and Indicators of Mental Health Among U.S. High School Tackle Football Players

PURPOSE

Age of first exposure to tackle football and head impact kinematics have been used to examine the effect of head impacts on mental health outcomes. These measures coupled with retrospective and cross-sectional designs have contributed to conflicting results. The purpose of this study was to identify the effect of one season of head impact exposure, age of first exposure to football, and psychological need satisfaction on acute mental health outcomes in adolescent football players.

METHODS

This prospective single-season cohort study used sensor-installed mouthguards to collect head impact exposure along with surveys to assess age of first exposure to football, psychological satisfaction, depressive symptoms, anxiety symptoms, and thriving from football players at four high schools (n = 91). Linear regression was used to test the association of head impact exposure, age of first exposure, and psychological satisfaction with acute mental health outcomes.

RESULTS

A total of 9,428 impacts were recorded with a mean of 102 ± 113 impacts/player. Cumulative head impact exposure and age of first exposure were not associated with acute mental health outcomes at postseason or change scores from preseason to postseason. Greater psychological satisfaction was associated with fewer depressive symptoms (β = -0.035, SE = 0.008, p = < .001), fewer anxiety symptoms (β = -0.021, SE = 0.008, p = .010), and greater thriving scores (β = 0.278, SE = 0.040, p = < .001) at postseason.

DISCUSSION

This study does not support the premise that greater single-season head impact exposure or earlier age of first exposure to tackle football is associated with worse acute mental health indicators over the course of a single season in adolescent football players.

Resilience is more than Nature: An Exploration of the Conditions that Nurture Resilience Among Rural Women who have Experienced IPV

Purpose

Intimate partner violence (IPV) is a significant public health concern exacerbated by the pandemic. Experiences of violence vary based on geographic location and living in rural communities has been found, in some contexts, to amplify consequences of IPV. Resilience, the ability to survive and thrive despite facing adversity, has long been a dominant narrative within IPV literature, yet little is known about how resilience is cultivated among rural women experiencing violence. The purpose of this study was to explore how rural women experiencing IPV cultivate resilience.

Methods

Using Interpretive Description, in-depth qualitative interviews were conducted with 14 women who experienced IPV and 12 staff from women's shelters across rural communities in Ontario, Canada to elicit perspectives about women's resilience and environmental conditions that may shape resilience in the context of IPV.

Results

Women's resilience was cultivated by personal changes aimed at surviving or thriving, and aspects of their environment that enabled or created barriers for resilience. Women adopted a positive, hopeful mindset and bolstered their inner strength through living from a place of integrity, being resolute in decisions, and using mental resistance when faced with doubt. Women faced barriers to resilience in the form of unhelpful help and COVID-19 public health guidelines. Paradoxically, living in a rural community both cultivated and undermined resilience.

Conclusions

Supporting women to cultivate resilience through modifying environmental factors to enable personal strengths to flourish is paramount in supporting women who have experienced IPV, particularly in rural contexts.

Three paths to a Swedish nursing license: Two for internationally educated nurses and one for regular nursing students - A cross-sectional study of self-rated professional competence, self-efficacy, and thriving

BACKGROUND

Bridging programs are offered to support migrated nurses, but in some countries, nurses can also choose to validate their nursing competence. Thus far, little is known about how migrated nurses estimate their competence when they are about to enter working life in a new country and how this differs from regular nursing students.

OBJECTIVE

To compare two groups of internationally educated nurses' - those from bridging programs and those who chose validation - and one group of regular nursing students' self-rated professional competence when they are about to start working as registered nurses. The hypotheses were: 1) internationally educated nurses rate their competence higher than regular nursing students and 2) those from bridging programs rate their competence higher than those who chose validation. In addition, the aim was to compare the groups' self-efficacy and thriving.

DESIGN

A cross-sectional, comparative design.

SETTINGS

Five universities in Sweden.

PARTICIPANTS

Nurses educated in non-European countries from a bridging program (n = 128, response rate 79.0 %) or validation process (n = 61, response rate 59.2 %) and students graduating from the regular nursing program (n = 213, response rate 68.3 %).

METHODS

Data were collected with coded questionnaires (paper or online) between 2019 and 2021 and analyzed using non-parametric tests, e.g., Kruskal-Wallis.

RESULTS

Both groups of internationally educated nurses had higher median scores on total nursing competence (both groups p < 0.001), general self-efficacy (bridging programs p < 0.001, validation p = 0.020), and total thriving (bridging programs p < 0.001, validation p = 0.012) than regular nursing students did. However, comparing the groups of internationally educated nurses showed no significant differences.

CONCLUSION

Internationally educated nurses rated their competence high but with differences within the groups for different competence areas. More research is needed to investigate whether the different paths are important for nurses' competence later in working life, and some of the competence areas might need extra attention when nurses start working.

Thriving in Residency: a Qualitative Study

BACKGROUND

While a great deal of research has brought attention to the issue of physician burnout in recent years, and resident physician burnout in particular, the topics of physician well-being, and by extension physician thriving, have been relatively understudied. Consequently, we propose a model of resident physician thriving. Objective To understand what factors contribute to a subjective sense of thriving among resident physicians.

DESIGN

In this study, we conducted in-depth interviews from May 2020 through February 2021 with resident physicians to determine what factors have contributed to their sense of thriving in their careers as well as in their lives more generally. We used a snowball sampling technique to recruit participants. Validated instruments were used to quantify the participant's subjective level of job and life satisfaction as well as their level of career burnout. To derive our conclusions, we employed thematic content analysis using a grounded theory-based approach.

PARTICIPANTS

Resident physicians in the internal medicine, pediatrics, and combined internal medicine-pediatrics residency programs at a single university-affiliated institution.

APPROACH

We interviewed those residents with high life, career, and residency satisfaction who did not meet criteria for burnout to explore those factors that contribute to their sense of thriving.

KEY RESULTS

Thirty-seven screening interviews were conducted. Twenty-four participants met criteria for life, career, and residency satisfaction while also not meeting criteria for burnout. The six key themes contributing to resident thriving that we identified during the course of our analysis included program leadership, learning climate, connectedness, joy in medicine, life balance, and intrinsic factors.

CONCLUSIONS

This project proposes a model of resident thriving that can potentially inform program structure, culture, and values.

The effect of anxiety on thriving levels of university students during the COVID-19 pandemic

Background

During the COVID-19 pandemic, university students struggle with unexpected changes in their lives, which have adverse effects on their levels of anxiety and thriving. Thriving with its two subdimensions, namely vitality and learning, is a prominent concept for university students due to contributing the academic achievement and wellbeing.

Aim

This study aimed to examine the effect of anxiety on thriving levels of university students during the COVID-19 pandemic.

Methods

An analytical and cross-sectional study was conducted between December 1, 2020 and January 6, 2021. Data were collected using online surveys with convenience sampling method. The sample consisted of 322 university students from a health sciences school of a public university in Turkey.

Findings

The students' anxiety and thriving levels were found to be moderate with 10.38 ± 5.24 and 3.41 ± 0.85, respectively. The results also indicated that anxiety had negative and significant effect on thriving and its subdimensions of vitality and learning. In addition, anxiety level differed significantly according to gender, worried about getting COVID-19 virus and following the COVID-19 cases on a daily basis while thriving level only differed significantly according to the gender.

Discussion

Consistent with previous literature, university students experienced high level of anxiety during the COVID-19 pandemic according to the current study. The students with high level of anxiety had lower vitality and learning scores comparing to their peers with low level of anxiety. This result is crucial, because students with high levels of thriving can cope with stress and feel themselves better psychologically than others.

Conclusion

This study showed that the students exhibited higher anxiety symptoms and had lower levels of thriving. Therefore, interventions, psychological support, and instrumental support are recommended to improve psychological health of university students.

Beyond Mere Surviving: The role of host country support and gratitude in thriving during the pandemic

While the ensuing COVID-19 pandemic has significantly altered individuals' lives worldwide, it has been perhaps especially disruptive to the lives of sojourners as many have been unable to return home and are absent from their families, a familiar culture, and normal social support systems. While it is important to ask how such individuals can successfully survive in such a crisis, we were interested in extending our knowledge and understanding by asking "how can such individuals move beyond mere surviving to a state of thriving?" In answering this question, we utilized a positive psychology framework to develop a theoretical model wherein we expected higher/lower levels of perceived social support from host country people (i.e., host country support) to result in higher/lower levels of perceived gratitude, which would then result in higher/lower levels of thriving, and ethnocentrism moderated this indirect effect. To test our model, we utilized a sample of sojourners who responded to a survey measuring ethnocentrism (February 2020). We then administered daily surveys measuring perceived host country support, gratitude, and thriving over a nine-day period during the COVID-19 crisis (March 26-April 3, 2020). Results supported the indirect effect of host country support on thriving via gratitude. Further, we found that sojourners with lower levels of ethnocentrism exhibited stronger host country support- gratitude link, hence stronger indirect effect of host country support on thriving via gratitude. We close by offering implications for the existing literature, future research, and organizational practices.

"I love the job…" Thriving in nursing: A qualitative interview study with framework analysis

BACKGROUND

Burnout is a well-known issue among nurses in critical care settings, including emergency nurses. There are decades of research indicating that emergency nurses experience burnout in their work. However, many nurses have long careers in emergency settings, which suggests that burnout is not the only outcome for nurses. Thriving may also be part of nurses' experiences. The Model of Thriving at Work includes external factors (autonomy, climate of trust and respect, and information sharing) and internal factors (knowledge, personal outlook, and relationships). Thriving is characterized by the concepts of vitality and ongoing learning. Previous researchers suggest that thriving fits with some nurses' experiences, based on validated questionnaires. However, thriving has not been investigated among nurses using interview approaches.

AIMS

This article explores nurses' experiences of thriving and assesses the fit of Spreitzer et al.'s Model of Thriving at Work with nurses' experiences.

STUDY DESIGN

Qualitative interview study, using framework analysis.

METHODS

Eleven nurses, from a single site, completed semi-structured interviews. These interviews explored nurses' workplace experiences, both positive and negative.

RESULTS

Participants reported experiences that fit with the Model of Thriving at Work, consisting of vitality, ongoing learning, and external and internal factors. Nurses hesitated to describe themselves in positive ways, referring instead to being 'not burnt out'. Nurses could, however, readily identify qualities of thriving in others, and viewed those nurses as aspirational. In addition to the Model, participants highlighted their emotional burden, workload, and ethical issues as important contributors to thriving. The Model could potentially be expanded to include these factors.

CONCLUSIONS

Thriving at work could be part of a range of emergency nurses' workplace outcomes. External and internal factors contribute to thriving. Healthcare leaders could support thriving among emergency nurses by fostering a positive work environment.

How do family supportive supervisors affect nurses' thriving: A research before and during COVID-19 pandemic

Nurses need psychological resources (supervisor support), as well as formal support from their organizations, which help them combat the demands from work and home and be more thrive at work. Family supportive supervisor behaviors have been demonstrated above and beyond general levels of supervisor support in reducing work-family conflict and improving well-being. In line with this, first aim is to examine the effects of Covid-19 pandemic on nurses' perceived family supportive supervisor behaviors, work-to-family conflict, psychological well-being, and thriving. Second aim is to test the effects of nurses' perceived family supportive supervisor behaviors on their thriving through work-to-family conflict and psychological well-being. This study was designed as cross-sectional and analytical. A total of 511 nurses from Nigeria and Turkey participated in the study. Parametric tests and Structural Equation Analysis were employed to analyze the data. During Covid-19 pandemic, the scores of nurses' perceived family supportive supervisor behaviors and thriving decreased while the scores of their work-to-family conflict increased significantly. Results confirmed the negative effects of Covid-19 pandemic on nurses. Furthermore, results showed that family supportive supervisor behaviors had positive effect on thriving by decreasing work-to-family conflict and increasing psychological well-being. This study is one of the very first study examining the effects of family supportive supervisor behaviors on nurses' work-to-family conflict, psychological well-being and thriving. Results of this study indicate that nurses need family supportive supervisors to be more thrive at work. Therefore, formal family friendly policies and implications improving family supportive supervisor behaviors are recommended in organizations.

Recognizing expressions of thriving among persons living in nursing homes: a qualitative study

Background

Thriving has emerged as a contemporary and health-promoting concept for older people living in nursing homes; however, there has been limited research to explore how nursing home staff identify thriving in their everyday practice. The aim of this study was to explore how staff recognize expressions of thriving among persons living in nursing homes.

Methods

Semi-structured interviews were conducted with 14 nurses working at a nursing home in Victoria, Australia. The interviews were audio-recorded, transcribed and analyzed using qualitative content analysis.

Results

The analysis resulted in six sub-categories and three main categories. Expressions of thriving were recognized in relation to how staff understood thriving, observed thriving and sensed thriving. Staff described comparing and contrasting clinical assessment indicators with their own personal and professional understandings of thriving, as well as their overall sense of the individual person within the wider situational and environmental context.

Conclusions

Our results illuminate how staff recognize everyday expressions of thriving for people living in nursing homes and emphasizes the importance of utilizing person-centred care principles in clinical assessments. These findings have practical implications with regards to how thriving is identified and assessed in long-term care, and could be used to inform and guide staff education, person-centred care strategies, and organizational policies to better support and promote thriving in nursing homes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-020-00526-7.

Illuminating Meanings of Thriving for Persons Living in Nursing Homes

Background and Objectives

Thriving has been described as a multidimensional concept that can be used to explore place-related well-being; however, there has been limited research into the meaning of thriving in aged care. This study aimed to illuminate meanings of thriving as narrated by persons living in nursing homes.

Research Design and Methods

Narrative interviews were conducted with 21 persons residing in a rural Australian nursing home. The interviews were audio-recorded, transcribed, and interpreted using a phenomenological hermeneutic approach.

Results

Meanings of thriving could be understood as: Striving toward acceptance of being in a nursing home while maintaining a positive outlook; Feeling supported and cared for while maintaining a sense of independence; Balancing opportunities for solitude and company while living with others; and, Feeling a sense of home while residing in an institutional environment. The meanings of thriving, as presented through the interpretive lens of Gaston Bachelard’s “Poetics of Space,” encompassed having access to literal, metaphorical, and symbolic doors, as well as having the freedom to open, close, and use these doors however the person wishes.

Discussion

Exploring meanings of thriving in nursing homes could contribute towards understanding and implementing positive life-world constructs in research and practice. These findings could be used to inform and enhance person-centered care practices by maximizing opportunities for persons residing in nursing homes to have options and choices, and the agency to make decisions where possible, in relation to their everyday care and living environment.

A cross-sectional study]

INTRODUCTION

The aging of the population has led to the introduction of qualitative and quantitative changes in healthcare resources, among which are the introduction of models of person-centred care (PCC), although there is a lack of information on their impact. The objective of this study is to assess the impact of a PCC model on the quality of life, well-being and thriving, in people living in nursing homes METHODS: Cross-sectional study.

POPULATION

all persons who lived indefinitely in the two participating centres that gave their consent. Impact of PCC vs. traditional model was assessed in terms of quality of life, well-being and thriving. Effect size was estimated with Cohen d adjusted for health problems, Charlson index, and presence of depression.

RESULTS

Overall participation was 78% (59/77 persons from the conventional centre and 66/88 from the PCC). The people of the PCC centre had better well-being (d = 0.378) and thriving (d = 0.566). No differences were found in quality of life.

CONCLUSION

The PCC model can have a positive impact on well-being and thriving in persons living in nursing homes.

The meaning of working in a person-centred way in nursing homes: a phenomenological-hermeneutical study

Background

The present study aims to illuminate the meaning of working in a person-centred way as experienced by staff in nursing homes. Insights into what working in a person-centred way mean for nursing home staff may contribute to a more comprehensive understanding of what gives staff satisfaction in their work and support further development of person-centred care approach in nursing homes.

Methods

Interviews with 29 health care personnel who had participated in a one-year intervention focusing on person-centred care and thriving in three nursing homes in Australia, Norway and Sweden were performed, and a phenomenological-hermeneutical method was used to explore staffs’ lived experiences of working in a person-centred way in nursing homes.

Results

For nursing home staff, working in a person-centred way meant that they were able to meet individual resident’s needs and expressed preferences in close family-like relationships, understanding the residents’ rhythms and preferences as the basis of the daily work plans and being able to do ‘the little extra’ for residents. Also, working in a person-centred way meant meeting shared goals by working towards a collective practice in collaborative teams. As a whole, the staffs’ lived experiences of working in a person-centred way in nursing homes was interpreted to mean thriving at work as a psychological state in which individuals experience both a sense of vitality and learning.

Conclusions

Working in a person-centred way means staff thriving at work in nursing homes. The results further indicate that delivering care by only focusing on routines and practical tasks and not on residents’ preferences and well-being would inhibit thriving among nursing staff, leading to the potential for dissatisfaction with work.

Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care

Background

Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.

Method

A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units responded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of Lean maturity reflect participants’ judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and job demands and resources reflect participants’ judgements regarding their own situation.

Results

First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving and increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated with decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job demands and job resources had a moderated mediation effect.

Conclusion

The results indicate that primary care staff may benefit from working in organizations characterized by high levels of Lean maturity and that caregiving may also be improved as perceived by staff.

Electronic supplementary material

The online version of this article (10.1186/s12913-019-4502-6) contains supplementary material, which is available to authorized users.

DigitalMe: a journey towards personalized health and thriving

The use of information and communication technologies for health (eHealth) delivered via mobile-based or digitally enhanced solutions (mHealth) have rapidly evolved. When used together across various mobile applications and devices eHealth and mHealth technologies have the ability to passively monitor behavior as an indicator of socialization and mood; accumulate a range of biomedical data such as weight and heart rate; and track metrics associated with activities including steps taken and hours slept. Yet, these technologies are insufficient for measuring the full array of data about an individual and the impact of that data on a person's current and future health. Digital health converges eHealth and mHealth with patient data about their health, healthcare, living, and environment with genomics. An innovative opportunity to unravel the complexities of disease and aging is increasingly possible with an integrative multi-omics approach informed by multidisciplinary sciences including medicine, design, biomedical informatics and engineering. The digitization of individual level data from all available sources makes possible the development of DigitalMe™, a personalized virtual avatar of a real person. The combination of longitudinally collected person generated data and molecular data derived from biospecimens offers researchers unique opportunities to better understand the mechanisms of disease while advancing person-centric hypotheses generation related to treatments, diagnostics, and prognostics.

Life Goals Over Time Among Homeless Adults in Permanent Supportive Housing

Permanent supportive housing (PSH) is a widely-accepted solution to the challenge of chronic homelessness. While housing support and retention, physical health, and healthcare continue to be important for formerly homeless persons in PSH, "higher-order" and humanistic needs such as thriving have received less attention and as a result are less well understood in this population. One important indicator of thriving is the ability to establish and articulate life goals. This study utilizes longitudinal data from 421 formerly homeless adults prior to their move into PSH, and at 3-, 6- and 12-months after move-in (369 respondents completed all four interviews), to examine what life goals are articulated by this population and how those goals change over time. Prior to housing, most respondents articulated housing attainment as their primary life goal, whereas at follow-up interviews health goals, housing relocation, and financial goals became more prevalent. Aspirational goals (e.g., independence, self-improvement, artistic pursuits) were also common, but demonstrated a decrease over time in housing. Relationship goals remained common and consistent over time. Findings indicate that housing is a necessary, but perhaps not sufficient, step for improving thriving among formerly homeless adults. Implications for practice and future research are discussed.

Does mindfulness prepare adolescents for value-behavior concordance? Examining the role of value content

Great thinkers throughout history advocated living one's values, yet little research has examined factors that contribute to adolescents' value-behavior concordance (VBC). Mindfulness may foster VBC via heightened awareness of values, but VBC for intrinsic values may be more adaptive than VBC for extrinsic values. To situate mindfulness in developmental context, we examined age and attachment security as predictors of mindfulness. We collected self- and parent-report data from 299 families (M_{age-adolescents} = 14.45, SD = 1.68; 51% female) from 42 US states to test these ideas. Results indicated that mindfulness was positively associated with intrinsic VBC but was negatively linked with extrinsic VBC, and both kinds of VBC partially mediated the link from mindfulness to meaning (but not life satisfaction). Attachment security was associated with higher mindfulness. Overall, mindfulness may deliver its benefits by helping young people avoid behaviors that align with extrinsic values.

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial

BACKGROUND

The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this.

METHODS

The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents' thriving, relatives' satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives' experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention.

DISCUSSION

The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care.

TRIAL REGISTRATION

The trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452 .

Are mental toughness and mental health contradictory concepts in elite sport? A narrative review of theory and evidence

OBJECTIVE

Athlete development and management encompass a complex interaction of biological, psychological, and social factors. Within elite sport, multidisciplinary sport science and medicine teams play an important role in achieving an optimal balance between preventing athlete ill-health and optimizing health and performance. The psychological aspects of athlete health and performance have gained increased attention over the past two decades, with much of this research concerned with the mental health of athletes and the concept of mental toughness. Recently, it was proposed that mental health and mental toughness are contradictory concepts in the world of elite sport. Although an interesting proposition, this claim was not substantiated. Thus, the purpose of this narrative review was to evaluate theory and evidence regarding the thesis that mental health and mental toughness are contradictory concepts in the world of elite sport, with the view to advance scholarly knowledge and inform professional practice.

DESIGN

Narrative review.

RESULTS

A critical evaluation of this literature suggests that mental toughness may represent a positive indicator of mental health, or facilitate its attainment, rather than be at odds with it.

CONCLUSION

When implemented alongside multilayered approaches to organizational change (e.g., group structures, policies), mental toughness could be used as a 'hook' to attract athletes into settings that can open dialogue on the importance of mental health and improve knowledge of key issues (e.g., stigma, symptoms).

Thriving Among African-American Adolescents: Religiosity, Religious Support, and Communalism

While research has identified some positive factors in the lives of African-American adolescents, there is limited, yet growing, empirical research examining how positive factors foster thriving for these youth. Using a positive youth development framework, we examined naturally occurring factors that promote thriving among African-American adolescents. This cross-sectional study included 152 youth who were surveyed at five Black churches in a large Midwestern city. Using MPlus, the structural regression model results revealed support for a model that demonstrated religiosity, religious support, and communalism are significantly and directly related to thriving among African-American adolescents. Implications for theory, research and practice are discussed. Moving from a deficit lens to a strengths-based approach can facilitate understanding of developmental processes and provide a foundation for supporting and enhancing positive outcomes among African-American adolescents.

Associations of psychological thriving with coping efficacy, expectations for future growth, and depressive symptoms over time in people with arthritis

OBJECTIVE

Psychological thriving reflects a trajectory of growth over time as opposed to scaling back expectations. Whether thriving is a product, precursor, or process of coping with arthritis-related limitations is unclear. We examined associations between thriving, coping efficacy, and expectations for future growth in individuals with arthritis, and the relations of thriving to depressive symptoms and retrospective perceptions of personal growth over a six-month period.

METHODS

A sample of 423 people with arthritis completed measures of thriving, coping efficacy, depressive symptoms, and expectations for future growth; 168 individuals completed a six-month follow-up survey. Structural equation modeling analyses compared three possible models of psychological thriving, controlling for disease-related variables. Hierarchical regression analyses of the cross-lagged associations of thriving with retrospective perceptions of positive personal change and depressive symptoms were also conducted.

RESULTS

Structural equation analyses suggest that the process model in which thriving and coping efficacy jointly predicted expectations for future growth best fit the data. Baseline thriving was also associated with retrospective perceptions of personal growth at follow-up and fewer depressive symptoms at baseline and follow-up, after controlling for disease-related variables.

CONCLUSION

Overall, these findings suggest that psychological thriving is synergistically related to coping efficacy, and to expectations for future growth and less depression, in people with arthritis. Importantly, our findings support the notion that psychological thriving is more than scaling back expectations, and that thriving may be an important quality to cultivate to address the burden of depression in people with arthritis.