Does Gratitude Promote Resilience During a Pandemic? An Examination of Mental Health and Positivity at the Onset of COVID-19

Associations between depression, psychological resilience, and gratitude levels of patients with chronic diseases: Implications for medical social work practice

This cross-sectional study aims to examine the relationships between psychological resilience, gratitude, and depression levels of patients with chronic diseases (cancer, cardiovascular, and kidney diseases) in the context of medical social work practice. A survey model, one of the quantitative research methods, was used in the study. The sample consisted of 160 patients with chronic diseases who were regularly followed up for treatment in the polyclinics of Oltu State Hospital and Erzurum City Hospital operating in Türkiye. The hierarchical logistic regression model was used in the analysis of the data. According to the results, psychological resilience was the strongest predictor of depression in chronic patients, even when some sociodemographic and disease-related variables were controlled. While gratitude was found to have depression risk-reducing effects, some of this may be related to age. Also, high dependence levels and previous depression diagnosis were determined as important risk factors against depression. Medical social workers may benefit from interventions aimed at increasing psychological resilience and gratitude in the prevention and treatment of depression in patients with chronic diseases.

The role of positive leadership in influencing recreational and extracurricular (R&E) programs to address mental wellbeing of prisoners

PURPOSE

Mental health issues such as stress, anxiety and depression are prevalent among the prisoners, highlighting the urgent need to address mental health challenges in prison facilities. Existing research highlights the crucial role of recreational and extracurricular (R&E) programs in promoting the mental well-being of prisoners. Another stream of literature identifies the importance of effective leadership within the prison system to the success of these programs and services aimed at improving the mental health of incarcerated individuals. The purpose of this study is to provide a thorough examination of the breadth, scope and characteristics of the published literature, focusing on how positive leadership in prison settings can foster the success of R&E programs in addressing mental health challenges among prisoners.

DESIGN/METHODOLOGY/APPROACH

In this scoping review, a systematic literature review (SLR), using the guidelines of preferred reporting items for systematic reviews and meta-analysis (PRISMA, 2020) by Page et al. (2021), was followed which provides guidelines for study selection and research question, identification of relevant studies via databases and registers, multi-step screening to exclude literatures that are not directly relevant and finalizing body of literature for theory development, summarizing and reporting. The included studies for theory development were appraised for quality using methodology-specific tools. A critical narrative synthesis was adopted to present a theoretical framework for positive leadership influence on R&E programs to promote prisoner engagement and their mental well-being.

FINDINGS

The SLR procedure resulted in a total of 122 studies that met the inclusion criteria for the topics of the current paper. The finalized list of studies that were used for theory development included 21studies in the area of prison and prison system (including organizations), 33 in the area of individual and team behavior (including inmates and correctional officers), 26 in the area of leadership (both organizational and correctional facilities), 12 in the area of R&E (including training and education), 31 in the area of mental health and behavior and 2 studies on research methods. Of these 122 studies, 83 studies were peer-reviewed scientific publications, selected chapters from 7 books, while the remaining 32 included nonscientific and anecdotal reports.

ORIGINALITY/VALUE

Despite the plethora of literature on the significance of effective leadership within organizational strategies and operations, there remains a notable gap in literature regarding the role of leadership and other enabling factors in the implementation and management of effective programs within correctional facilities aimed at improving the mental well-being of prisoners. This paper explores the role and relationship of leadership and R&E programs and activities in prisons to improve the mental well-being of prisoners. Specifically, a program's resource sufficiency, positive reinforcement of prisoner behavior during the engagement and psychological conditions of the program are critical for successful prisoner engagement in such programs. Based on organizational theories of positive leadership and engagement (i.e. prisoner participation and engagement in R&E programs), this study offers four propositions to develop a theoretical framework of positive leadership in influencing such programs, which in turn can be a catalyst to reduce mental health issues among prisoners in correction facilities.

Effect of Positive Mental Health on Elderly Patients with Chronic Diseases: The Chain-Mediated Effects of Gratitude and Forgiveness Tendencies at a Tertiary Hospital in Guangzhou

Background: This study aims to elucidate the mediating roles of gratitude and forgiveness tendency between mature happiness and positive mental health, seeking to reveal the significance of enhancing these psychological traits to enhance the well-being of this population, so as to provide a theoretical foundation for strategies aimed at promoting healthy aging and enhancing the happiness of elderly patients with chronic illness. Methods: From April to October 2024, elderly patients with chronic diseases in the geriatric department of a tertiary hospital in Guangzhou China were selected as subjects through convenience sampling. The study utilized the general information questionnaire, the Chinese Version of Mature Happiness Scale-Revised, the Positive Mental Health Scale, the Gratitude Questionnaire-6, and the Tendency to Forgive Scale for data collection. Results: A total of 319 valid questionnaires were obtained. The mature happiness, positive mental health, gratitude, and forgiveness tendency of elderly patients with chronic diseases were at a medium level. Correlation analysis indicated that mature happiness was positively associated with positive mental health, gratitude, and forgiveness tendency. Mediation analysis illuminated that positive mental health robustly predicted the extent of gratitude, which served as a pivotal predictor of mature happiness. Moreover, gratitude and forgiveness tendency together played a significant chain mediating role between mature happiness and positive mental health, accounting for 26.31% of the total effect (p = 0.246). Conclusions: Positive mental health has a significant positive impact on mature happiness amongst elderly patients with chronic diseases, mediated through the chain mediating effects of gratitude and forgiveness tendency. Consequently, fostering traits of gratitude and forgiveness in this population may enhance their mental health and mature happiness.

Urban green space visitation and mental health wellbeing during COVID-19 in Bangkok, Thailand

Urban green spaces offer numerous benefits, and their role in supporting mental health, particularly during global crises such as the COVID-19 pandemic, is of growing interest to researchers and policymakers. This study explored the relationship between urban green space visitation and mental health well-being during the COVID-19 pandemic in Bangkok, Thailand. This cross-sectional study, conducted in Bangkok during the COVID-19 lockdown, used a telephone survey of 579 respondents. A logistic regression model was employed to examine the association between urban green space visitation and the WHO-5 mental health well-being score, considering various factors such as socioeconomic variables, healthy behaviors, and COVID-19-related experiences. The findings revealed a significant association between urban green space visitation during the lockdown and higher mental health well-being. Socioeconomic variables and healthy behaviors of respondents were also notably linked to higher WHO-5 mental health well-being scores. These findings collectively indicate that urban greenspace visitation serves as a crucial determinant of mental health and well-being, especially during the COVID-19 pandemic.

Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data

BACKGROUND

The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces.

METHODS

The COVID-19's Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked "What was the worst thing about the pandemic that you experienced?" and "Was there anything positive in your life that resulted from the pandemic?" Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes.

RESULTS

Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18-64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8-18.6%, p = 0.03).

DISCUSSION

Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.

How Trait Gratitude Influences Adolescent Subjective Well-Being? Parallel-Serial Mediating Effects of Meaning in Life and Self-Control

The relationship between trait gratitude and subjective well-being is well documented in the literature. Recently, growing attention has been given to examining which factors are determinants in the relationship. However, there are no studies to present a comprehensive model of how meaning in life and self-control jointly play a role in this relationship. This study investigated parallel and serial mediation of the presence of meaning, the search for meaning, and self-control in the relationship between trait gratitude and subjective well-being. A total of 764 adolescents (Mage = 14.10, SD = 1.43, 48.43% males) from three middle schools in China completed a six-item measures of gratitude questionnaire form, a meaning in life questionnaire, a middle school students' self-control ability questionnaire, and a satisfaction with life scale. The study revealed that trait gratitude affected the presence of meaning and subsequently affected subjective well-being. In addition, trait gratitude affected self-control through the presence of meaning and the search for meaning, and it subsequently affected subjective well-being. Therefore, the presence of meaning, the search for meaning, and self-control played an important role in the positive effects of trait gratitude on adolescent subjective well-being. The findings were in line with the intrinsic and extrinsic goal theory of gratitude and provided new insight to inform the improvement of adolescent subjective well-being in the future.

Fear of COVID-19, Perceived Stress, and PTSD: The Serial Mediating Role of Sense of Coherence

The literature has identified that a sense of coherence plays a protective role in the relationship between adverse events and mental health. The current study examines the role of a sense of coherence (SOC) in the relationship between fear of COVID-19, perceived stress, and dimensions of post-traumatic stress disorder (PTSD). Participants (n = 322) were students at a metropolitan university in South Africa who completed the Fear of COVID-19 Scale, the Perceived Stress Scale, the 13-item Sense of Coherence Scale, and the PTSD Checklist. Path analysis was used to conduct a serial mediation analysis. The results show that SOC mediates the relationship between perceived stress and the dimensions of PTSD but does not mediate the relationship between fear of COVID-19 and PTSD. Furthermore, the relationship between fear of COVID-19 and dimensions of PTSD was mediated by serial perceived stress and sense of coherence, supporting the hypothesis that higher levels of fear of COVID-19 leads to higher levels of perceived stress. However, while high levels of fear of COVID-19 increase perceived stress, SOC significantly mediates the subsequent impact on PTSD symptoms.

Resilience anchors for children in an out-of-home care institution during and after COVID-19

Growing numbers of children of all ages grow up in out-of-home care institutions due to personal and socioecological risk variables that destabilized their families of origin. In the aftermath of the COVID-19 pandemic which disrupted lives and development, there is particular interest in how children who grow up in out-of-home care institutions cope and develop. This paper reports the findings of a study that sought to document anchors of resilience in children who resided in a care institution run by a non-governmental, church-based welfare organization in one of the central provinces of South Africa. In line with recent developments in childcare, the organization mainly functions via smaller child and youth group homes across the province (compared to bigger children's homes in the past). In our qualitative, phenomenological study, we used the participatory, child-friendly, and less intrusive draw-and-write technique to generate data. We asked the 20 participating children of one of these group homes to make drawings that mirror their lives, and to write paragraphs in which they described their drawings. All were school-going children in care, aged from 12 to 19. There were 11 girls and 9 boys in the study, and one of these identified as "other." The grades ranged from 7 to 12 and they spoke African languages, namely Afrikaans, Sesotho, Setswana and IsiXhosa. We used inductive content analysis to process the data, and the findings indicate that, notwithstanding personal and socioecological risks during and after the COVID-19 pandemic, the resilience of the participants was anchored by a number of universal personal strengths as well as socioecological resources.

Validation of the Transpersonal Gratitude Scale (TGS) and the Relationship between Transpersonal Gratitude, Spiritual Well-Being and Distress in India

This study explores the psychometric properties of the transpersonal gratitude scale (TGS) in the Indian context. It also examines the relationship between transpersonal gratitude, spiritual well-being, and distress. The psychometric properties (reliability and validity) of the TGS were evaluated with the help of two studies. In the first study, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) reported a four-factor solution. These four factors- expression of gratitude, value of gratitude, transcendent gratitude, and spiritual connection- explained 74.1% of the total variance. Further, CFA results indicated an excellent model fit of four-factor structure derived from EFA. These findings recommended appropriate factorial validity of TGS in the Indian context. In the second study, Cronbach's alpha and composite reliability values recommended reliability of TGS among Indians. Also, the average variance explained (AVE) values and the Fornell-Larcker test concluded convergent and discriminant validity of the scale. In addition, positive correlations were reported between TGS, GRAT-16 (gratitude resentment and appreciation scale), and spiritual well-being scale scores. Also, a negative linkage was reported between TGS and distress score. These associations established criterion validity of the scale. Overall, the scale reported acceptable psychometric properties in the Indian context.

Psychological and Personality Characteristics Associated With COVID-19 Vaccination Behavior in Korean General Population

BACKGROUND

This study characterized coronavirus disease 2019 (COVID-19) vaccination behavior in the Korean general population using cluster analysis and explored related psychological factors.

METHODS

We categorized 1,500 individuals based on their attitudes toward COVID-19 vaccination using hierarchical clustering and identified their level of vaccine acceptance. We examined the associations between vaccine acceptance and behavioral and psychological characteristics.

RESULTS

Clustering revealed three groups according to vaccine acceptance: 'totally accepting' (n = 354, 23.6%), 'somewhat accepting' (n = 523, 34.9%), and 'reluctant' (n = 623, 41.5%). Approximately 60% of all participants who belonged to the 'totally accepting' and 'somewhat accepting' groups were willing to receive a COVID-19 vaccine despite concerns about its side effects. High vaccine acceptance was associated with older age, regular influenza vaccination, and trust in formal sources of information. Participants with high vaccine acceptance had higher levels of gratitude, extraversion, agreeableness, and conscientiousness, and lower levels of depression, anxiety, and neuroticism.

CONCLUSIONS

People weighed the benefits of COVID-19 vaccination against the risk of side effects when deciding to receive the COVID-19 vaccine. Our findings also indicate that this vaccination behavior may be affected by coping mechanisms and psychological factors.

Effect of Sleep Duration on Blood Pressure in Patients with SARS-CoV-2 Infection and Hypertensive Urgencies in Shanghai Fangcang Shelter Hospital

Objective

To evaluate the effect of sleep duration on blood pressure in patients with hypertension urgencies combined with SARS-CoV-2 infection in a Fangcang shelter hospital.

Methods

From April 10, 2020 to May 20, 2022, we statistically analyzed the blood pressure and sleep conditions of 52 patients with combined hypertension urgencies and SARS-CoV-2 infection admitted in Shanghai National Convention and Exhibition Center Fangcang shelter hospital. They were divided into the short-term (daily sleep duration: <7 h) and normal sleep group (7-9 h). We performed a comparison of the control effects of basic antihypertensive drugs. Additionally, patients in the short-term sleep group underwent drug therapy for sleep regulation and continuous monitoring of blood pressure.

Results

Among these patients, the blood pressure was higher in the short-term sleep group than that of the normal sleep group, and also more difficult to control (p <0.05). Furthermore, the blood pressure of the patients in the short-term sleep group was more easily controlled after treatment with drugs for sleep regulation and basic antihypertensive drugs (p <0.05).

Conclusion

The blood pressure level in patients with combined SARS-CoV-2 infection and hypertension urgencies was higher in those with a shorter duration of daily sleep, and also more difficult to control in Fangcang shelter hospital. Drug therapy for sleep regulation should be administered early to obtain sufficient blood pressure control effects.

Art-of-Living Intervention Imparted Through a Blended Learning Approach to Nurture Positivity Among Pakistan's University Students During COVID-19: A Growth Curve Analysis

Art-of-living allows individuals to live a contemplative, mindful, and active life to attain well-being. This study demonstrates the development and implementation of an art-of-living training intervention to nurture positivity among Pakistan's university students during COVID-19. To ensure the efficacy of teaching and learning during the second wave of the pandemic, the intervention was imparted through a blended learning approach comprising two modes: (1) online learning and (2) offline personal and collaborative learning. This approach was based on the emotionalized learning experiences (ELE) format to make learning more engaging, permanent, and gratifying. The study comprised 243 students randomly assigned to an experimental group (n = 122) and a wait-list control group (n = 121). Growth curve analysis indicated that positivity together with the components of art-of-living-self-efficacy, savoring, social contacts, physical care, and meaning-and overall art-of-living increased at a greater rate in the experimental group than in the control group from pretest to posttest and from posttest to follow-up measurement. The analysis provided an all-encompassing view of how positivity developed in the two groups over time. There were significant variations in participants' initial status (intercepts) and growth trajectories (slopes). The influence of participants' initial positivity scores suggested that students with high initial positivity scores had a slower increase in linear growth, whereas those with low initial positivity scores had a faster increase in linear growth over time. The success of the intervention may be attributed to the dimensions of ELE-embodied in the two modes-and fidelity to intervention for effectively implementing the blended learning approach.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10902-023-00664-0.

COVID-19 vaccine acceptance and related behavioral and psychological characteristics in individuals with mental disorders in Korea

Objective

This study aimed to investigate COVID-19 vaccine acceptance and related factors in individuals with mental disorders in Korea.

Methods

We surveyed 572 individuals with mental disorders about their attitudes toward COVID-19 vaccination using a 7-item self-rating questionnaire on vaccine acceptance and hesitancy. We categorized the respondents into groups based on their level of vaccine acceptance using hierarchical clustering. In addition, we evaluated the respondents' vaccination status and trust in sources of information regarding COVID-19 vaccines, and assessed their psychological characteristics using the Patient Health Questionnaire-9, Gratitude Questionnaire-6, and Big Five Inventory-10.

Results

Clustering revealed three groups according to vaccine acceptance: 'totally accepting' (n= 246, 43.0%), 'somewhat accepting' (n= 184, 32.2%), and 'hesitant' (n= 142, 24.8%) groups. Three quarters of all participants, who belonged to the 'totally accepting' or 'somewhat accepting' groups, were willing to receive a COVID-19 vaccine despite concerns about its side effects. Individuals in the high vaccine acceptance group were older (F= 12.52, p< 0.001), more likely to receive the influenza vaccine regularly, and more likely to trust formal information sources. Additionally, they had higher levels of gratitude (F= 21.00, p< 0.001) and agreeableness (F= 4.50, p= 0.011), and lower levels of depression (χ²= 11.81, p= 0.003) and neuroticism (F= 3.71, p= 0.025).

Conclusion

The present study demonstrated that individuals with mental disorders were generally willing to receive COVID-19 vaccination. However, they weighed its need and effectiveness against potential side effects before coming to a decision. It is important to understand the behavioral and psychological characteristics associated with vaccine acceptance, to effectively communicate its importance to individuals with mental disorders.

Shaped by the COVID-19 pandemic: Psychological responses from a subjective perspective-A longitudinal mixed-methods study across five European countries

BACKGROUND

Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors.

METHODS

The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder-New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022.

RESULTS

The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues).

CONCLUSIONS

Our findings indicate that people's reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.

Well-Being amongst College Students during COVID-19 Pandemic: Evidence from a Developing Country

College students face unique challenges that the consequences of COVID-19 might aggravate. To explore the pandemic's consequences on college students' well-being, we conducted an online survey with 634 students from a private university in Cali, Colombia. The study sought to assess students' well-being due to COVID-19, and to explore the mediating effects of optimism, gratitude, and emotional closeness on college students' well-being. Results showed that COVID-19 affected students' mental health and well-being. Being optimistic and grateful mediated with life satisfaction and happiness. Optimism, emotional closeness, and gratitude also mediated the negative effect of fear of infection and the pandemic's impact on students' academic performance. The results of this analysis will promote discussion of the implementation of coping strategies to help students thrive, promote resilience, and contribute to students' well-being and better mental health.