The mediating effect of family resilience between coping styles and caregiver burden in maintenance hemodialysis patients: a cross-sectional study

BACKGROUND

Primary caregivers of hemodialysis patients suffer from varying degrees of stress from their patients. Caring for hemodialysis patients can expose caregivers to many problems, leading to an increased burden of care and even impacting the quality of care. The purpose of our study was to examine whether family resilience could be a mediating variable moderating the relationship between patient coping styles and caregiver burden.

METHODS

The study was a cross-sectional and descriptive-analytical study that interviewed 173 pairs of hemodialysis patients and their caregivers at a blood purification center in a public hospital in China. The Brief Coping Styles Scale (Chinese version) was used to assess individuals' coping styles for disease and treatment. From the caregiver's perspective, the Family Resilience Assessment Scale (Chinese version) was used to understand the resilience of families, and the Zarit Caregiver Burden Scale was used to capture the caregiver's subjective experience of burden. Statistical analyses were conducted using SPSS version 23 and Amos version 26 to analyze the relationships between variables to examine for correlation and construct mediated effects models.

RESULTS

Coping styles showed a significant positive correlation with family resilience (r = 0.347, P < 0.01) and a negative correlation with caregiver burden (r = -0.379, P < 0.01). A significant negative correlation was found between family resilience and caregiver burden (r = -0.503, P < 0.01). In the mediation model, patient coping styles directly impacted caregiver burden significantly (95% CI [-0.372, -0.058]), and coping styles indirectly impacted caregiver burden by family resilience in a significant way (95% CI [-0.275, -0.098]).

CONCLUSIONS

Patient coping styles directly affect caregiver burden. Family resilience is a mediating variable between patients' coping styles and the burden on caregivers.

Purpose in life as an asset for well-being and a protective factor against depression in adolescents

Purpose in life, which is a central component of the eudaimonic paradigm of well-being, has been sparsely examined in adolescence. This is unfortunate as adolescence is characterised by identity development and is a key period for the onset of mental disorders. To inform future research on well-being and purpose in life in adolescents, we drew factors from several fields of research, including mental health and psychological factors, and explored which factors were most strongly associated with purpose in life. Data were collected in a sample of 444 Italian adolescents (Mage = 16.30 [SD = 1.50], range: 14 to 20 years; 58% girls) and associations with mental health (stress, anxiety, depression, anger), psychological traits (mindfulness, self-hate, self-inadequacy, self-reassurance, isolation), and sociodemographic variables (age, sex, place of birth) were examined. Regression, dominance, and network analyses indicated that a stronger sense of purpose in life was associated with lower depressive symptoms, higher levels of self-reassurance, and being born in Italy. Our findings suggest that purpose in life is an important asset for well-being in adolescents and may protect against depression. Future longitudinal and/or experimental research should examine the potential protective role of purpose in life in relation to adolescent depression and how self-reassurance and sociodemographic factors (e.g., immigrant background) are involved.

Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis

During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ²  = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ²  = 82.21, p <0.001) or primarily dysfunctional (χ²  = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.

Resilience and mental health among juveniles: role of strategies for coping with stress

BACKGROUND

Mental health is an important aspect of the process of individual adaptation and development. The present study analysed the role played by resilience in mental health while taking into account both positive and negative indicators among juveniles. The aim of the first study (Study 1) is to analyse the relationship between resilience and the broadly understood mental health of juveniles admitted to youth education centres. Study 2 aimed to understand the direct and indirect role of resilience in shaping the mental health of juveniles. In the model we tested, we looked at the relationship among resilience, coping strategies, and mental well-being.

METHODS

The first study involved 201 juveniles, and the second involved 253 juveniles. Resilience was measured by the Resilience Scale-14. Coping strategies were measured with the Brief-COPE Questionnaire, and information on mental health was obtained using the Kutcher Adolescent Depression Scale, the Satisfaction with Life Scale and the Warwick-Edinburgh Mental Well-being Scale.

RESULTS

The results of both studies have shown that resilience is an important predictor of the mental health of juveniles, primarily with respect to its positive indicator. The stronger the severity of resilience, the greater the satisfaction with life and mental well-being of the juveniles surveyed. In addition, two coping strategies (seeking support from others and coping through emotions) mediated the relationship between resilience and mental well-being.

CONCLUSIONS

The results obtained indicate that work at the level of juvenile resilience leads to the strengthening of positive mental health indicators and buffering of negative indicators.

Burning out? Watch your own incivility and the emotions you spread

BACKGROUND

The present study focuses on perpetrators of workplace incivility.

OBJECTIVE

We set to answer two questions: 1) why the perpetrator instigates uncivil behaviors in the workplace, and 2) what are the consequences of workplace incivility on the perpetrator him/herself.

METHODS

We examined the perpetrator burnout outcome of instigated incivility and infected emotional contagion as predictor of one's uncivil behaviors towards others and tested the cross-country structural invariance of the hypothesized nomological network on data from the U.S. and Italy.

RESULTS

Data from employees in the U.S. (N = 350) and Italy (N = 273) suggest that contagion of joy infected into others and anger infected into others were related to instigated incivility, which, in turn, was positively related to emotional exhaustion and cynicism. Our results were structurally invariant across the two countries.

CONCLUSIONS

Similar to the victims of incivility, the perpetrator of workplace incivility also suffers from heightened burnout. As such, an employee experiencing and infecting into other employees his/her own negative/positive emotions increases/decreases his/her own tendency to initiate rude behaviors toward others. Overall, our findings shed light on predictors and consequences of workplace instigated incivility. We hope our research can serve as a springboard to the understanding and prevention of incivility initiated by employees.

Coping strategies and distress reduction in psychological well-being? A structural equation modelling analysis using a national population sample

BACKGROUND

Little is understood about of the role of coping strategies in psychological well-being (PWB) and distress for the general population and different physical and psychiatric disease groups. A thorough examination of these relationships may provide evidence for the implementation of public mental health promotion and psychiatric disease prevention strategies aimed at improving the use of positive coping approaches or addressing the causes and maintainers of distress. The present study using a structural equation modelling (SEM) approach and nationally representative data on the Canadian population investigates the relationships among PWB, distress and coping strategies and identifies major factors related to PWB for both the general population and diverse-specific disease groups.

METHODS

Data examined were from the Canadian Community Health Survey of Mental Health and Well-being (CCHS 1.2), a large national survey (n = 36 984). We applied exploratory factor analysis (EFA), confirmatory factor analysis and SEM to build structural relationships among PWB, distress and coping strategies in the general population.

RESULTS

Both SEM measurement and structure models provided a good fit. Distress was positively related to negative coping and negatively related to positive coping. Positive coping indicated a higher level of PWB, whereas negative coping was associated with a lower level of PWB. PWB was negatively related to distress. These same relationships were also found in the population subgroups. For the population with diseases (both physical and psychiatric diseases, except agoraphobia), distress was the more important factor determining subjective PWB than the person's coping strategies, whereas, negative coping had a major impact on distress in the general population. Strengths and limitations were also discussed.

CONCLUSIONS

Our findings have practical implications for public psychiatric disease intervention and mental health promotion. As previously noted positive/adaptive coping increased the level of PWB, whereas negative/maladaptive coping was positively related to distress and negatively related to PWB. Distress decreased the level of PWB. Our findings identified major correlates of PWB in both the general population and population subgroups. Our results provide evidence for the differential use of intervention tactics among different target audiences. In order to improve the mental health of the general population public mental health promotion should focus on strategies that reduce negative coping at a population level, whereas clinicians treating individual clients should make the reduction of distress their primary target to maintain or improve patients' PWB.

Caregiver Burden, Spirituality, and Psychological Well-Being of Parents Having Children with Thalassemia

The research determined the relationship of caregiving burden, spirituality and psychological well-being of parents of Pakistani thalassemic patients in a crosssectional research design. The sociodemographic form, Montgomery-Borgatta burden measure (Montgomery et al. in Who should care for the elderly? An east-west value divide. World Scientific, River Edge, pp 27-54, 2000), Multidimensional Measure of Islamic Spirituality (Dasti and Sitwat in J Muslim Ment Health 8(2):47-67, 2014. doi: 10.3998/jmmh.10381607.0008.204 ) and Ryff Scale of Psychological Well-being (Ryff in J Pers Soc Psychol 57(6):1069-1081, 1989. doi: 10.1037/0022-3514.57.6.1069 ) were administered on a sample of 80 parents (32 fathers and 48 mothers) recruited from different Thalassemic Centers of Lahore city, Pakistan. Data were analyzed through correlation and mediational analyses. Results indicated that the caregiver burden was negatively correlated with the psychological well-being and the domains of spirituality, while the psychological well-being and spirituality were positively correlated. We identified that the caregiver burden has direct effect on the psychological well-being of the parents and it influences the psychological well-being through the pathway of the two domains of spirituality, i.e., self-discipline and meanness-generosity. These results highlighted the role of spirituality upon the psychological well-being of caregivers, which could be utilized to prevent pathological influences (such as hard feelings, hopelessness, depressed mood, anxiety, and relationship problems) of caregiver burden and enhance psychological well-being through spiritual counseling. Caregivers can work on their well-being and burden by disciplining their lives and forgoing hard feelings toward others.

An Exploration of the Relationship Between Spirituality and State and Trait Anger Among Medical Students

There is a dearth of studies exploring spiritual attitudes of medical students from developing countries and its relationship to anger. This study was conducted to assess spiritual attitudes and their relationship with anger in a set of medical students in southern India. In this cross-sectional observational study, medical students who were undergoing clinical rotations were offered participation. Selected demographic data were obtained. The participants were rated using the Spiritual Attitudes Inventory [SAI, which comprises of Duke Religiosity Index, Existential Well-Being Scale (EWBS), Negative Religious Coping and Multidimensional Health Locus of Control scale] and State and Trait Anger Expression Inventory 2. Out of 98 students approached, 82 participated (response rate 83.6%). The mean age of sample was 20.7 years (±0.9 years) with a slight preponderance of females (54.9%). SAI scores correlated well significantly with subscale scores. Gender had no difference on the SAI or subscale score. Differences were found between self-reported religion and EWBS scores (Kruskal-Wallis χ(2) = 8.891, p = 0.012). Total SAI score had a significant negative correlation with state anger, trait anger and anger expression. High levels of spirituality may be correlated with lower levels of state anger, trait anger and anger expression in medical students.

Emotion recognition in mild cognitive impairment: relationship to psychosocial disability and caregiver burden

BACKGROUND

Impaired emotion recognition in dementia is associated with increased patient agitation, behavior management difficulties, and caregiver burden. Emerging evidence supports the presence of very early emotion recognition difficulties in mild cognitive impairment (MCI); however, the relationship between these impairments and psychosocial measures is not yet explored.

METHODS

Emotion recognition abilities of 27 patients with nonamnestic MCI (naMCI), 29 patients with amnestic MCI (aMCI), and 22 control participants were assessed. Self-report measures assessed patient functional disability, while informants rated the degree of burden they experienced.

RESULTS

Difficulties in recognizing anger was evident in the amnestic subtype. Although both the patient groups reported greater social functioning disability, compared with the controls, a relationship between social dysfunction and anger recognition was evident only for patients with naMCI. A significant association was found between burden and anger recognition in patients with aMCI.

CONCLUSIONS

Impaired emotion recognition abilities impact MCI subtypes differentially. Interventions targeted at patients with MCI, and caregivers are warranted.

The impact of psoriasis on work-related problems: a multicenter cross-sectional survey

BACKGROUND

Psoriasis can have cumulative physical and psychosocial effects preventing sufferers from achieving their full-life potential. Few studies have addressed the impact of psoriasis on work-related characteristics.

OBJECTIVE

To evaluate the impact of psoriasis on education prospects and work limitations in patients with moderate-to-severe psoriasis.

METHODS

This study was conducted in 29 dermatology centres across Italy. Information was collected by questionnaire during office visits.

RESULTS

A total of 787 patients (64% male, aged 50 years) completed the questionnaire. At the time of the survey, mean Psoriasis Area and Severity Index (PASI) score and disease duration were 10 and 19 years respectively. Current smokers had higher PASI scores compared to non-smokers (10.8 vs. 9.4, P = 0.02). Plaque psoriasis was the most frequently described (91.2%). Fifty-five percent of patients had limited expectations of career progression. Similarly, in 42% of cases, psoriasis reduced the prospects of improvement in employment status and 35% of patients reported having reduced earning potential. Approximately 60% of patients reported that psoriasis localized to their hands or feet caused work limitations, whilst in about 25%, it caused them to quit their job. Approximately 37% of patients reported having lost between 3-10 work days in the past 3 months due to clinical assessment or treatment. Logistic regression revealed that gender, low standard of education, number of localizations, shame, anger and self-esteem were predictors significantly associated with limitations in work.

CONCLUSIONS

Moderate-to-severe psoriasis has a profound negative impact on the employment capacity of patients in Italy. Psoriasis also contributes to days lost from work, affects job opportunity, career prospects and revenue potential.

Assimilation and Individual Differences in Emotion: The Dynamics of Anger and Approach Motivation

Individuals who cross cultural boundaries face many challenges when trying to adapt to a receiving culture. Adaptation challenges such as learning to maneuver across societal domains may become increasingly complex if structural level factors such as discrimination are present. Researchers have conceptualized acculturation as a relatively autonomous decision indicating that four acculturation strategies exist: assimilation, separation, integration, and marginalization. Moreover, researchers have also long debated the link between acculturation strategy, adaptation hassles and negative health outcomes. However, models seeking to explain how individual difference and structural level variables may influence each other and subsequently influence acculturation and adaptation are needed. The purpose of this study is to lay the foundation for the conceptualization of such a model. We propose that temperamental predispositions to negative emotionality, anger, and impulsivity may highlight discrimination which in turn may lead to increases in acculturative stress and negative markers of psychosocial well-being. We used SEM to test our hypothesized model. Results supported a modified model. Implications for the measurement of adaptation and interventions are discussed.

Getting mad but ending up sad: the mental health consequences for African Americans using anger to cope with racism

Anger is a common reaction to stressful life events. However, little is known about anger’s use and efficacy as a coping strategy for racism. Is anger a coping strategy for racism that improves mental health? Or does anger operate in an opposing way, deteriorating mental health? The analyses for this research focused on a probability sample of African Americans who reported experiences of acute (n = 246) or chronic (n = 120) racial discrimination in a survey interview. General linear model results revealed that using anger to cope with racial discrimination negatively affected the general well-being and psychological distress of African Americans. These findings raise concerns about the effectiveness (or lack therefore of) of anger as a common coping mechanism for racism, given the deleterious effects it may have on African Americans’ mental health.

Relations among social support, burnout, and experiences of anger: an investigation among emergency nurses

BACKGROUND

The aim of the present study was to determine whether social support, burnout, and anger expression are related with each other among emergency nurses working in private- or public-sector hospitals.

DESIGN AND SAMPLE

The sample consisted of 100 emergency nurses working in the private or public sector in Ankara, Turkey. The Maslach Burnout Inventory, The Multidimensional Scale of Perceived Social Support, and The Trait-Anger and Anger Expression Scale were used.

RESULTS AND CONCLUSIONS

The results demonstrated that social support did not differentiate among the nurses working in the private sector or in the public sector according to the burnout subscales' scores. However, nurses in the private sector find it more difficult to express their anger. The state-trait anger levels of the nurses differ according to the burnout levels and also according to the sector that they are working in. The congruence between this study's findings and the literature is discussed.

Therapist stress, coping, career sustaining behavior and the working alliance

Relations were examined among therapist stress, coping styles, career sustaining behaviors and therapist working alliance. 160 therapists completed a demographic questionnaire, a rating of stress experienced in work as a psychotherapist, a rating of stress experienced in work with an individual client, the Perceived Stress Scale, the Career Sustaining Behavior Questionnaire, the COPE, and the Working Alliance Inventory. After controlling for demographic and therapists' stress variables, and alternating entry of Career Sustaining Behavior and COPE scores in the regression model, Career Sustaining Behavior contributed significant variance to predicting working alliance, and COPE scores accounted for significant variance in working alliance with active coping a significant predictor. Career Sustaining Behavior and COPE scores entered together accounted for significant unique variance in Working Alliance with career sustaining behavior and avoidant coping identified as significant predictors.