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Radbruch L. [On the difficulty of dealing with words and concepts]. Schmerz 2024:10.1007/s00482-024-00801-5. [PMID: 38381188 DOI: 10.1007/s00482-024-00801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Lukas Radbruch
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
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Petri-Romão P, Engen H, Rupanova A, Puhlmann L, Zerban M, Neumann RJ, Malyshau A, Ahrens KF, Schick A, Kollmann B, Wessa M, Walker H, Plichta MM, Reif A, Chmitorz A, Tuescher O, Basten U, Kalisch R. Self-report assessment of Positive Appraisal Style (PAS): Development of a process-focused and a content-focused questionnaire for use in mental health and resilience research. PLoS One 2024; 19:e0295562. [PMID: 38306328 PMCID: PMC10836662 DOI: 10.1371/journal.pone.0295562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/23/2023] [Indexed: 02/04/2024] Open
Abstract
Positive Appraisal Style Theory of Resilience posits that a person's general style of evaluating stressors plays a central role in mental health and resilience. Specifically, a tendency to appraise stressors positively (positive appraisal style; PAS) is theorized to be protective of mental health and thus a key resilience factor. To this date no measures of PAS exist. Here, we present two scales that measure perceived positive appraisal style, one focusing on cognitive processes that lead to positive appraisals in stressful situations (PASS-process), and the other focusing on the appraisal contents (PASS-content). For PASS-process, the items of the existing questionnaires Brief COPE and CERQ-short were analyzed in exploratory and confirmatory factor analyses (EFA, CFA) in independent samples (N = 1157 and N = 1704). The resulting 10-item questionnaire was internally consistent (α = .78, 95% CI [.86, .87]) and showed good convergent and discriminant validity in comparisons with self-report measures of trait optimism, neuroticism, urgency, and spontaneity. For PASS-content, a newly generated item pool of 29 items across stressor appraisal content dimensions (probability, magnitude, and coping potential) were subjected to EFA and CFA in two independent samples (N = 1174 and N = 1611). The resulting 14-item scale showed good internal consistency (α = .87, 95% CI [.86, .87]), as well as good convergent and discriminant validity within the nomological network. The two scales are a new and reliable way to assess self-perceived positive appraisal style in large-scale studies, which could offer key insights into mechanisms of resilience.
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Affiliation(s)
| | - Haakon Engen
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Anna Rupanova
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Rebecca J Neumann
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Kira F Ahrens
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Medical Faculty Mannheim, Department of Public Mental Health, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Henrik Walker
- Department of Psychiatry & Psychotherapy, Division of Mind and Brain Research, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael M Plichta
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Oliver Tuescher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Ulrike Basten
- Department of Psychology, University of Kaiserslautern-Landau, Landau, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
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Heuser C, Schneider JN, Heier L, Ernstmann N, Nakata H, Petermann-Meyer A, Bremen R, Karger A, Icks A, Brümmendorf TH, Geiser F. Family resilience of families with parental cancer and minor children: a qualitative analysis. Front Psychol 2024; 14:1251049. [PMID: 38314254 PMCID: PMC10836593 DOI: 10.3389/fpsyg.2023.1251049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Estimated 50,000 minor children in Germany experience a newly diagnosed cancer in one of their parents every year. Family resilience has proven to be an important concept against life crises. However, little research exists regarding family resilience in the context of parental cancer with minor children. Based on the "Family Resilience Framework," the aim of the study is to investigate the processes of family resilience of affected families. In addition, we explore which combinations of promoting family resilience processes can be characterized. Methods As part of the mixed-method quasi-experimental interventional study "F-SCOUT," a qualitative content analysis was used to analyze the documentation of the "Family-Scouts" (a fixed contact person who advises, accompanies, and supports the families). Documentation was performed by families' study inclusion (T0), after 3 months (T1) and 9 months (T2) concerning current family situation, organization of everyday life, emotional coping, open communication within the family, and planned tasks. Results The N = 73 families had between one and six children. In 58 (79%) families, the mother had cancer. In the course of the analysis, a category system with 10 main categories and 36 subcategories emerged. Family resilience processes were described to different extents. Combinations of categories promoting family resilience were characterized by the use of social resources, flexibility, economic resources, and open communication. Discussion The findings are consistent with existing assumptions about family resilience in terms of the importance of social resources, family cohesion, mutual support, flexibility, open communication, and psychological well-being. In contrast to the findings of previous research, spirituality, and collaborative problem-solving indicate less centrality here. In turn, the findings on economic resources and information-seeking provide a valuable addition to the family resilience literature in the context of parental cancer with minor children. Clinical trial registration ClinicalTrials.gov, identifier NCT04186923.
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Affiliation(s)
- Christian Heuser
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Juliane Nora Schneider
- Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Lina Heier
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands
| | - Nicole Ernstmann
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Hannah Nakata
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Andrea Petermann-Meyer
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Rebecca Bremen
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - André Karger
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Clinical Institute for Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Düsseldorf, Germany
| | - Tim H. Brümmendorf
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Franziska Geiser
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany
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Abstract
Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.
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Affiliation(s)
- Elīna Zelčāne
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia,CONTACT Elīna Zelčāne Department of Health Psychology and Paedagogy, Riga Stradiņš University, Jāņa Asara street 5, RigaLV-1009, Latvia
| | - Anita Pipere
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia
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Sun H, Qian Q, Qin Y, Guo L, Hengudomsub P. Dynamic changes in resilience among family caregivers in the face of healthcare challenges: A scoping review. Arch Psychiatr Nurs 2023; 45:113-123. [PMID: 37544685 DOI: 10.1016/j.apnu.2023.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/14/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Resilience as a dynamic concept has already been described through various longitudinal studies. To better understand the changes in the resilience of caregivers over the course of care-providing, however, a scoping review can provide a clearer picture of their resilience process which, in turn, can be used to improve caregivers' well-being. OBJECTIVES To provide a comprehensive overview of dynamic change in the resilience of caregivers while caring for the family to enhance understanding and potential for future research. METHODS Following the methodological framework of Arksey and O'Malley, this scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and the Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Five electronic databases were searched for research published in English between January 2012 and May 2022, after which a manual search was performed. Key terms related to resilience and caregivers in longitudinal studies were included and screened for. Identified trajectories of patterns in resilience and factors associated with resilience process were categorized using content analysis. RESULTS In total, 24 longitudinal studies met the eligibility criteria. Conceptually, our findings demonstrate three modes of change following healthcare challenges, each of which varies substantially. Methodologically, the results reveal three subcategories of assessment tools that can be used to impact caregivers' resilience when confronted with significant healthcare challenges. Consequentially, personal traits and environmental resources interacting with the resilience process will then lead to various outcomes in their resilience, including stability, growth, or decline. CONCLUSION This review describes the change patterns of the resilience process, assessment instruments, and associated factors to offer a dynamic perspective for the investigation and intervention of psychological resilience. Major gaps nonetheless remain for future research regarding an operationalizing dynamic change in resilience.
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Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China; Faculty of Nursing, Burapha University, 20131, Chon Buri, Thailand
| | - Qian Qian
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China
| | - Yang Qin
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China; Faculty of Nursing, Burapha University, 20131, Chon Buri, Thailand
| | - Lingling Guo
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China
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Peusquens F, Maus K, Geiser F, Jaspers B, Radbruch L. [Who is afraid of Ockham's razor? : A discourse analysis on resilience in palliative care (2000-2021)]. Schmerz 2023; 37:107-115. [PMID: 36943476 DOI: 10.1007/s00482-023-00703-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/07/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND The concept of resilience is becoming increasingly disseminated from material science into various fields of science. It is infiltrating medical fields predominantly via psychology and is also recommended for coping with the special burdens in pain management and palliative care. A precise definition of the term and its operationalization pose problems. AIM A critical stocktaking of the use of this term in the discourse of palliative care research. METHOD Analytical discourse analysis of a text corpus from palliative medical care publications in the time period from 2000 to 2021, obtained by means of a systematic literature search. RESULTS In the research discourse of palliative care, resilience is a topic primarily as a strategy for self-optimization of employees (e.g., burnout prophylaxis with the aim of preserving the workforce). Only rarely does the question of whether it offers potential for patients and their families take center stage, and then more as a catchword than as a concrete concept. The reason is that there is so far no adequate operationalization of the concept of resilience. Furthermore, there is a lack of sufficient justification for the relevance of the concept in patient care of palliative medicine. CONCLUSION There is a lack of qualified contributions of palliative research to the metadiscourse about resilience, especially in the context of affected patients. A successful operationalization of the term requires a highly complex multidimensionality of the palliative path of an interdisciplinary approach. There is a lack of ethical standards that prevent an affirmative instrumentalizing application of the term.
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Affiliation(s)
- Frank Peusquens
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Gebäude 66, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Katja Maus
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Gebäude 66, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Franziska Geiser
- Klinik für Psychosomatik, Universitätsklinikum Bonn, Gebäude 80, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Birgit Jaspers
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Gebäude 66, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - Lukas Radbruch
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Gebäude 66, Venusberg-Campus 1, 53127, Bonn, Deutschland
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Taherkhani Z, Kaveh MH, Mani A, Ghahremani L, Khademi K. The effect of positive thinking on resilience and life satisfaction of older adults: a randomized controlled trial. Sci Rep 2023; 13:3478. [PMID: 36859479 DOI: 10.1038/s41598-023-30684-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/28/2023] [Indexed: 03/03/2023] Open
Abstract
The cumulative effects of adversity and unhappiness affect life satisfaction and quality of life in the growing older adult population. Most of the interventions aimed at improving the health and quality of life of older adults have adopted a problem-oriented or weakness-focused approach. However, a positive or strengths-focused approach can also have a virtuous but more effective capacity to contribute to the well-being and life satisfaction of older adults. Therefore, the present study was conducted to investigate the effect of positive thinking training on improving resilience and life satisfaction among older adults. A randomized controlled trial was conducted on 100 older adults with simple random sampling. The intervention group received 90-min weekly sessions for eight weeks on positive thinking training through written homework for reflection, group discussion, and media. The data were collected using Ingram and Wisnicki Positive Thinking Questionnaire, Connor-Davidson Resilience Scale, and Tobin Life Satisfaction Questionnaire at baseline and one week and two months after the training. The collected data were analyzed using descriptive and inferential statistics in SPSS software 26. P values below 0.05 were considered statistically significant. Positive thinking training led to better thinking (p < 0.001), higher resilience (p < 0.001), and greater life satisfaction (p < 0.001). The study's findings showed the effectiveness of the positive thinking training approach in improving resilience and life satisfaction in older adults. It is recommended to evaluate the long-term outcome in populations with different social, economic, and cultural statuses in future studies.
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Abstract
Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles,we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research.
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Affiliation(s)
- Allison S Troy
- Popular Comms Institute, Lancaster, Pennsylvania, USA; .,Department of Psychology, Franklin & Marshall College, Lancaster, Pennsylvania, USA
| | - Emily C Willroth
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA;
| | - Amanda J Shallcross
- Department of Population Health, New York University School of Medicine, New York, NY, USA;
| | | | - James J Gross
- Department of Psychology, Stanford University, Stanford, California, USA;
| | - Iris B Mauss
- Department of Psychology, University of California, Berkeley, California, USA;
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Kriegsmann-Rabe LM, Hiebel N, Maus K, Geiser F. “Flying over the crisis”: A study on interdisciplinary metaphors of resilience. Culture & Psychology 2022. [DOI: 10.1177/1354067x221111438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background/Aim: Metaphors on theoretical concepts may be congruent or divergent from their explicit definitions. We carried out a secondary qualitative analysis on metaphors of members of an interdisciplinary research group on resilience and investigated: (A) Which metaphors do experts in different disciplines use to describe people showing resilience? (B) Do these (implicit) metaphors support the (explicit) theses of the research group on resilience? (C) Do we find differences between experts from different disciplines in the use of metaphors on resilience? Method: Nine guideline-based interviews with experts from medicine, psychology, philosophy, and theology were studied using a systematic metaphor analysis, basing on inductive and deductive categorizations. Results: Eight metaphor sources were identified, for example, battle, path. Experts used similar metaphors to describe resilience that often overarched the concepts of resilience as a trait, process, and outcome. Moments of vulnerability within the resilience trajectory were found. Conclusions: The analysis revealed high concordance of metaphors across different disciplines, reflecting both the ideas of the group as well as the mainstream view of resilience. This supports that implicit concepts may be more difficult to reframe than explicit theories. Few differences between disciplines may point to the impact of an overarching Western concept of individual resilience.
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Affiliation(s)
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Katja Maus
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
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Wittlinger T, Bekić S, Guljaš S, Periša V, Volarić M, Trtica Majnarić L. Patterns of the physical, cognitive, and mental health status of older individuals in a real-life primary care setting and differences in coping styles. Front Med (Lausanne) 2022; 9:989814. [PMID: 36388902 PMCID: PMC9650321 DOI: 10.3389/fmed.2022.989814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background Physical frailty and cognitive decline are two major consequences of aging and are often in older individuals, especially in those with multimorbidity. These two disorders are known to usually coexist with each other, increasing the risk of each disorder for poor health outcomes. Mental health disorders, anxiety and depression, are common in older people with multimorbidity, in particular those with functional or sensory deficits, and frailty. Purpose The aim of this study was to show how physical frailty, cognitive impairments and mental disorders, cluster in the real life setting of older primary care (PC) patients, and how these clusters relate to age, comorbidities, stressful events, and coping strategies. Knowing that, could improve risk stratification of older individuals and guide the action plans. Methods Participants were older individuals (≥60, N = 263), attenders of PC, independent of care of others, and not suffering from dementia. For screening participants on physical frailty, cognitive impairment, and mental disorders, we used Fried‘s phenotype model, the Mini-Mental State Examination (MMSE), the Geriatric Anxiety Scale (GAS), and the Geriatric Depression Scale (GDS). For testing participants on coping styles, we used the 14-scale Brief-Coping with Problems Experienced (Brief-COPE) questionnaire. To identify clusters, we used the algorithm fuzzy k-means. To further describe the clusters, we examined differences in age, gender, number of chronic diseases and medications prescribed, some diagnoses of chronic diseases, the number of life events, body mass index, renal function, expressed as the glomerular filtration rate, and coping styles. Results The most appropriate cluster solution was the one with three clusters, that were termed as: functional (FUN; N = 139), with predominant frailty or dysfunctional (DFUN; N = 81), and with predominant cognitive impairments or cognitively impaired (COG-IMP; N = 43). Participants in two pathologic clusters, DFUN and COG-IMP, were in average older and had more somatic diseases, compared to participants in cluster FUN. Significant differences between the clusters were found in diagnoses of osteoporosis, osteoarthritis, anxiety/depression, cerebrovascular disease, and periphery artery disease. Participants in cluster FUN expressed mostly positive reframing coping style. Participants in two pathological clusters were represented with negative coping strategies. Religion and self-blame were coping mechanisms specific only for cluster DFUN; self-distraction only for cluster COG-IMP; and these two latter clusters shared the mechanisms of behavioral disengagement and denial. Conclusion The research approach presented in this study may help PC providers in risk stratification of older individuals and in getting insights into behavioral and coping strategies of patients with similar comorbidity patterns and functional disorders, which may guide them in preparing prevention and care plans. By providing some insights into the common mechanisms and pathways of clustering frailty, cognitive impairments and mental disorders, this research approach is useful for creating new hypotheses and in accelerating geriatric research.
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Affiliation(s)
| | - Sanja Bekić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Silva Guljaš
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Vlatka Periša
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Mile Volarić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ljiljana Trtica Majnarić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- *Correspondence: Ljiljana Trtica Majnarić
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11
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Spendelow J. Improving wellbeing for veterinary professionals in chronically stressful workplaces. Vet Rec 2022; 191:337-339. [PMID: 36269241 DOI: 10.1002/vetr.2365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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12
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Schmuck J, Hiebel N, Kriegsmann-rabe M, Schneider J, Matthias J, Erim Y, Morawa E, Jerg-bretzke L, Beschoner P, Albus C, Weidner K, Radbruch L, Hauschildt E, Geiser F. Individual Stress Burden and Mental Health in Health Care Workers during the COVID-19 Pandemic: Moderating and Mediating Effects of Resilience. IJERPH 2022; 19:6545. [PMID: 35682131 PMCID: PMC9180092 DOI: 10.3390/ijerph19116545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/04/2022]
Abstract
Introduction: The COVID-19 pandemic generated a significant burden on the German health care system, affecting the mental health of health care workers (HCW) in particular. Resilience may serve as an essential protective factor for individuals’ well-being. Objective: Our objective was to identify demographic and work-related correlates of individual resilience and to investigate the association between pandemic-related stress, resilience and mental health using different resilience models. Methods: Our sample comprised 1034 German HCW in different medical professions who completed an online survey from 20 April to 1 July 2020. Resilience was assessed using the Resilience Scale-5 (RS-5). The pandemic-related self-reported stress burden was captured by a single item, while depression and anxiety symptoms were measured with the PHQ-2 and GAD-2, respectively. Additionally, various sociodemographic and work-related factors were assessed. Results: Overall, we found high levels of resilience in the sample compared to a German sample before the pandemic, which were significantly associated only with the older age of participants and having children in both univariate and multivariate analyses. Regarding mechanisms of resilience, moderation analysis revealed that low individual resilience and high pandemic-related stress burden independently contributed to both anxiety and depression symptoms while resilience additionally moderated the relationship between stress burden and anxiety symptoms. The link between self-reported stress burden and mental health symptoms was also partially mediated by individual resilience. Conclusion: Taken together, the findings based on the present sample during the COVID-19 pandemic suggest that resilience plays a central role in the mental health of healthcare workers and that resilience-building interventions should be expanded, especially with a focus on younger employees.
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Hannemann J, Abdalrahman A, Erim Y, Morawa E, Jerg-Bretzke L, Beschoner P, Geiser F, Hiebel N, Weidner K, Steudte-Schmiedgen S, Albus C. The impact of the COVID-19 pandemic on the mental health of medical staff considering the interplay of pandemic burden and psychosocial resources-A rapid systematic review. PLoS One 2022; 17:e0264290. [PMID: 35192662 PMCID: PMC8863237 DOI: 10.1371/journal.pone.0264290] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/08/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In times of the global corona pandemic health care workers (HCWs) fight the disease at the frontline of healthcare services and are confronted with an exacerbated load of pandemic burden. Psychosocial resources are thought to buffer adverse effects of pandemic stressors on mental health. This rapid review summarizes evidence on the specific interplay of pandemic burden and psychosocial resources with regard to the mental health of HCWs during the COVID-19 pandemic. The goal was to derive potential starting points for supportive interventions. METHODS We conducted a rapid systematic review following the recommendations of the Cochrane Rapid Reviews Methods Group. We searched 7 databases in February 2021 and included peer-reviewed quantitative studies, that reported related data on pandemic stressors, psychosocial resources, and mental health of HCWs. RESULTS 46 reports were finally included in the review and reported data on all three outcomes at hand. Most studies (n = 41) applied a cross-sectional design. Our results suggest that there are several statistically significant pandemic risk factors for mental health problems in HCWs such as high risk and fear of infection, while resilience, active and emotion-focused coping strategies as well as social support can be considered beneficial when protecting different aspects of mental health in HCWs during the COVID-19 pandemic. Evidence for patterns of interaction between outcomes were found in the context of coping style when facing specific pandemic stressors. CONCLUSIONS Our results indicate that several psychosocial resources may play an important role in buffering adverse effects of pandemic burden on the mental health of HCWs in the context of the COVID-19 pandemic. Nevertheless, causal interpretations of mentioned associations are inadequate due to the overall low study quality and the dominance of cross-sectional study designs. Prospective longitudinal studies are required to elucidate the missing links.
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Affiliation(s)
- Julian Hannemann
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Alan Abdalrahman
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Kerstin Weidner
- Department for Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department for Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University Hospital Cologne, Cologne, Germany
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Majnarić LT, Bosnić Z, Guljaš S, Vučić D, Kurevija T, Volarić M, Martinović I, Wittlinger T. Low Psychological Resilience in Older Individuals: An Association with Increased Inflammation, Oxidative Stress and the Presence of Chronic Medical Conditions. Int J Mol Sci 2021; 22:8970. [PMID: 34445675 DOI: 10.3390/ijms22168970] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/04/2021] [Accepted: 08/17/2021] [Indexed: 01/12/2023] Open
Abstract
The term resilience, which has been present in science for almost half a century, stands for the capacity of some system needed to overcome an amount of disturbance from the environment in order to avoid a change to another stable state. In medicine, the concept of resilience means the ability to deal with daily stress and disturbance to our homeostasis with the intention of protecting it from disturbance. With aging, the organism becomes more sensitive to environmental impacts and more susceptible to changes. Mental disturbances and a decline in psychological resilience in older people are potentiated with many social and environmental factors along with a subjective perception of decreasing health. Distinct from findings in younger age groups, mental and physical medical conditions in older people are closely associated with each other, sharing common mechanisms and potentiating each other’s development. Increased inflammation and oxidative stress have been recognized as the main driving mechanisms in the development of aging diseases. This paper aims to reveal, through a translational approach, physiological and molecular mechanisms of emotional distress and low psychological resilience in older individuals as driving mechanisms for the accelerated development of chronic aging diseases, and to systematize the available information sources on strategies for mitigation of low resilience in order to prevent chronic diseases.
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