[How can resilience be described in a process-oriented view and does this have significance for psychotherapy? A qualitative study]

Objectives: Despite its high appeal, the concept of resilience remains unclear. Current definitions include a process approach, but most resilience scales remain trait-based. This study assessed implicit concepts of researchers in an interdisciplinary research group in order to develop a process-based model of resilience. Methods: Expert interviews were conducted with nine experienced researchers from the fields of theology, medicine, and philosophy and analyzed using qualitative content analysis. Results: Categories are classified as predictive, process-related or outcome-related. Central elements in the process are the articulation and acceptance of negative experiences as well as a narrativization and meaningful integration of experiences. Conclusions: Based on the categories, a working definition for a process-oriented resilience model is created.The categories show proximity to known elements and goals of psychotherapy. The reinterpretation of resilience as a process of conscious "moving forward" (Yahuda) instead of an unattainable "hero ideal" can be helpful for psychotherapy patients.

[Resilient Children: Evaluation of a Programme to Promote Resilience in Kindergarten and Elementary School]

In the project "Resilient Children", a resilience promotion program for kindergartens and elementary schools was directly applied and evaluated during the COVID-19-crisis.The aim of the study was to strengthen the three sources of resilience according to Grotberg (1995) I HAVE, I AM and I CAN through targeted exercises and resilience-promoting communication (transfer to everyday life). Additionally, gender differences with regard to the effect of the programme were addressed. "Resilient Children" was evaluated at the impact level (pre-post design) and process level. Eight kindergartens and three elementary schools with 125 children participated. A total of 122 teachers and 70 parents provided information about the children. The results at the impact level showed that from the parent and teacher perspective, and from the self-perspective (children), the three sources of resilience were significantly strengthened. With regard to gender differences, the results from the perspective of teachers and parents showed that girls were characterised by greater changes than boys. Compared to the girls, the physical andmental well-being of the boys improved fromthe parents' point of view. The results of the process evaluation revealed a high level of motivation and enthusiasm for participation in the programme on the part of participating children and teachers. The success of "Resilient Children" depends on the identification of the teachers with the program.

Resources and resilience factors: How advanced practice nurses can promote resilience in hearing and visually impaired people - A grounded theory perspective from Switzerland

BACKGROUND

There is an increase in hearing and visual impairments worldwide. Those affected have a reduced ability to participate in social contacts, mobility, and access to information. Until now, there have been no recommendations for Advanced Practice Nurses (APNs) in Switzerland to support this group of people in the autonomous organization of everyday life in their own homes.

OBJECTIVE

The aim of the study was to understand how people integrate their dual hearing and visual impairments into everyday life to derive recommendations for APNs to support individuals to manage their daily lives.

METHODS

Following the constructivist approach of grounded theory, guided interviews and a questionnaire survey with hearing and visually impaired persons (n = 46) over 70 years of age on independent daily living were conducted (concurrent embedded strategy). In addition, demographic data on age, gender, living situation, and use of assistive devices were analyzed.

FINDINGS

Based on the results, a communication-based dynamic resilience model (CoRes) was developed. This article represents the third phase of the three-stage-model. Integration of altered hearing depends on resources and risk factors.

CONCLUSIONS

Advanced practice nurses can use recommendations from this research to actively help individuals and their families build resilience.

The Anima as an Archetype of Human Resilience in the Face of Calamity

This paper will provide a theoretical basis for looking at a dream in the analysis of a client during a calamity. Finding the archetype of the anima is a way of responding to a crisis, in this case to the COVID-19 pandemic period. With all the basic instincts disrupted by a catastrophe, the emergence of the anima, as archetype of life, is there to remind us how to survive and recover. The anima archetype, often representing psychological resilience in ancient myths, shows up in dreams to guide human transformation from the struggle to survive trauma to the art of living a full life.

Financing health promotion, prevention and innovation despite the rising healthcare costs: How can the new German government square the circle?

The German health system is under pressure due to increasing costs of healthcare provision and rising demand for health services. With the new coalition government, Germany has increased efforts to build a modern, innovative infrastructure for prevention and high-quality health services. The coalition agreement has a strong climate, innovation, and sustainability focus, reflecting at the same time the ambition of the new government to implement a preventive, inter-connected, and modern healthcare system in Germany. However, the agreement lacks detailed information on the achievement of the plans, especially concerning the question of how those measures should be funded in light of increasing expenditures for healthcare. Thus, the objectives of this study are to interpret the new government's plans and answer the question of how Germany can ensure and fund in the new legislative period population-based prevention programmes, health-promoting measures and innovative solutions despite the rising healthcare costs. By analysing the relevant content of the coalition agreement and drawing on an expert workshop, this paper suggests the establishment of a prevention fund and flexible remuneration model for digitalised and innovative forms of care in the new legislative period. Our findings may help identify feasible approaches to sustainable financing of health promotion, prevention and innovation in the German healthcare system.

WER HILFT DEN HELFERINNEN: GESUNDHEITS - UND PFLEGEPERSONAL IN DER PANDEMIEWHO HELPS THE HELPERS: HEALTH AND CARE PERSONNEL IN THE PANDEMIC

In diesem Beitrag wird aufgezeigt, dass das Gesundheitspersonal während der COVID-19-Pandemie nicht nur physisch, sondern auch psychisch stark belastet war. Unterschiedliche Risikofaktoren wie ein junges Alter, das weibliche Geschlecht, ein niedriger sozioökonomischer Status und bereits bestehende psychische Erkrankungen spielten eine Rolle. Das Gesundheitspersonal zeigte erhöhten Stress, Symptome von Posttraumatischen Belastungsstörungen, Depressionen, Ängsten und Schlafstörungen. Eigene Studien zeigen auch, dass moralische Konflikte und eine unzureichende Unterstützung durch die Organisation und die Gesellschaft zu weiteren Belastungen führten. Die Bedeutung von Resilienz, die auf individueller, team- und organisationsbezogener Ebene gefördert werden sollte, spielt eine entscheidende Rolle. Hierfür sind Maßnahmen wie Stressmanagement-Trainings, Unterstützungssysteme, Kommunikation, Weiterbildung, emotionale Unterstützung und Partizipationsmöglichkeiten erforderlich. Auch politische Maßnahmen sind erforderlich, um das Wohlergehen des Gesundheitspersonals zu fördern, das sie die Gesetzgebung sowie die Verfügbarkeit von Akutunterstützung und die Förderung von Forschung und Innovationen beeinflussen.

[Resilience, a Buzzword?]

Resilience, a Buzzword? Abstract. There is a growing awareness of the importance of resilience in many areas of our society. Current research largely assumes that resilience can be trained and used to avoid suffering or to better overcome crises. This article deals with the question of what is meant by resilience and how t can be trained.

Developmental patterns of emotion regulation in toddlerhood: Examining predictors of change and long-term resilience

Emotion regulation is critical for optimal functioning across a wide range of domains and may be even more important for individuals in high-risk environments. While evidence suggests that childhood is generally a period of emotion regulation growth and development, research is needed to examine factors that may contribute to deviations from a typical trajectory. In a prospective study of 1,905 children, latent class growth analysis (LCGA) was used to identify trajectory groups of emotion regulation across toddlerhood (age 14-36 months), examine predictors of those trajectory groups from child temperament, parenting behaviors, and environmental risk, and explore predictions of resilience in 5th grade from the identified groups. LGCA supported a three-class model, with a Stable Incline group, a Decline group, and a Catch-Up group. Child negative emotionality, positive and negative parenting, and environmental risk predicted group membership. These trajectory groups in toddlerhood were predictive of child resilient functioning in the 5th grade. Our findings highlight the importance of utilizing developmental models of emotion regulation and provide implications for prevention and early intervention services to enhance emotion regulation development in early childhood.

[Resilience: A Longitudinal Study of Children with Risk Factors]

Resilience: A Longitudinal Study of Children with Risk Factors This study examines the development of children who have grown up with severe early childhood stress. A distinction was made between resilient and maladapted child developments. On the one hand, the aim was to identify longitudinal protective factors that can contribute to the development of resilience. On the other hand, we cross-sectionally examined in which psychological areas resilience manifests itself. The sample consists of 343 children who were examined first in early childhood (M = 4 years) and then ten years later in adolescence. 24 % of the children belonged to the risk group of which 14 % showed a resilient and 9 % a maladapted development. An active temperament, higher intelligence, and more self-control in early childhood proved to be protective factors with medium effect sizes. The proportion of resilience was increased among migrants. Cross-sectionally we found differences with small and medium effect sizes in addictive behavior (alcohol, tobacco and drug use), internet dependency, overweight, and school grades.

[Evaluation of a Manualized Group Program for Siblings of Children with Diseases or Disabilities]

Evaluation of a Manualized Group Program for Siblings of Children with Diseases or Disabilities This study evaluates a manualized group program for siblings of children with life-threatening/life-limiting diseases or disabilities. The program aims to activate resources and to reduce emotional and behavioral problems, using cognitive-behavioral methods and experience-based interventions. In this multi-center study, 13 GeschwisterTREFFs were conducted by 11 study sites in Germany. Prior to and after the intervention 97 siblings aged 7 to 14 years and their parents were examined with standardized questionnaires. At baseline, the siblings of children with diseases or disabilities showed significant more emotional and behavioral problems compared to the respective norm samples. After the intervention, the siblings reported declined problem behavior scores that were mostly in the range of the particular norm values. Furthermore, the children indicated a significant improvement of self-esteem, self-efficacy, school competences and relations to their siblings. However, parents reported more problem behavior and less health-related quality of life of their children at both assessments. The present multi-center study showed the interventions' feasibility in different settings and confirmed expected improvements of target variables during the intervention period. Randomized-controlled trails are warranted to verify our results.

Trauma, resilience and healthy and unhealthy forms of dissociation

This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.

Language, politics and dreams: the challenges of building resilience in refugees

This paper describes a case study of a 60-year-old Peruvian refugee in some detail, focusing on the importance of building emotional resilience in a patient in Spanish in order to create a space for learning the English language - the patient did not speak English after 20 years of living in Britain. The work was carried out with an interpreter and some of the literature on working with interpreters is referred to. The paper also briefly outlines the refugee journey in broad terms, which is a journey from the culturally known to the culturally unknown. The question of how well the literature on resilience, which sits firmly within a Western developmental perspective, can be applied to refugees, most of whom come from group and family-based cultures dominated by ideas of honour and shame, is discussed. The paper also touches on the importance of the receiving country enabling or not, as the case may be, a transitional space for refugees who have lost their home and are seeking to find a safe haven in a strange culture.

[In the Same Boat: How to Support Relatives of Patients with Dementia Using Diverse Interventions]

In the Same Boat: How to Support Relatives of Patients with Dementia Using Diverse Interventions Abstract. Caring for people with dementia has great psychological, physical, social, financial and spiritual effects on relatives. Support and counseling can contribute to an improved health of the relative, to the relationship with the dementia patient, as well as to better treatment (through shared decision-making/care planning) of the patient. This article reviews data from Switzerland and international studies.

[German Military Families: A Qualitative Inquiry of Strategies of Coping with the Fathers' Absence]

German Military Families: A Qualitative Inquiry of Strategies of Coping with the Fathers' Absence Military families with experiences of deployment are subject to multiple stressors. In this research an explorative qualitative design was used to identify specific challenges, resources and strategies of coping within the families, focusing on the children's perspective. Results show that the fathers' absence causes vital changes in the family system, which demand specific strategies to deal with the abrupt emotional and social challenges. Four of these coping strategies will be presented in this article. Furthermore, resources embedded in the social environment as well as supportive structures provided by the German military will be discussed. Two hypotheses were formulated to outline the findings that the preparation for a deployment as well as patterns of communication about the father's absence are the most crucial factors for the children's resilience in the case of military families.

When culture fails: coping with cultural trauma

The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long-term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.

Control versus Complexity: Approaches to the Carbon Dioxide Problem at IIASA

Control versus Complexity: Approaches to the Carbon Dioxide Problem at IIASA. In the 1970s and 1980s the International Institute for Applied Systems Analysis (IIASA) hosted several research projects, workshops and conferences in order to discuss the implications of rising carbon dioxide concentrations in the Earth's atmosphere. A number of distinguished scholars, some of whom later became prominent protagonists within the United Nations' Intergovernmental Panel on Climate Change (IPCC) and sustainability communities more generally, participated in these debates. Since those at IIASA did not engage in obviously related fields such as geophysics or climatology, there is a need to explain how, and via which contexts the issue entered the institute's agenda. This article examines this historical context and contrasts two competing paradigms that emerged at IIASA in order to assess and respond to the carbon dioxide question: The first approach was related to the organisation's research projects on the future of energy systems, which drew on physics, engineering, economics and applied system dynamical modeling; the second approach drew earlier research into ecological management and complex dynamical systems theory, and argued for the use of multiple methods to assess the carbon dioxide question. The first approach invoked ideas of techno-economical control mechanisms, the second resulted in a more embedded framing of climate change as one of a larger complex of issues relating to sustainable development. Based on resources from IIASA's research repositories and institutional archive, this study retraces these competing discourse framings and outlines the specific research and modeling strategies, policies, and cultural and technological imaginaries related to them.

Predictors and determinants for weight reduction in overweight and obese children and adolescents

INTRODUCTION

Worldwide, overweight and obesity are known as posing serious health risks. Successful methods for weight reduction have remained elusive. This multicenter non-randomised trial aimed to identify parameters and determinants of long-term weight reduction.

PATIENTS AND METHODS

A total of 143/159 overweight and obese children and adolescents (90 %) completed the prospective multicenter trial (age 13.9±2.4 years, BMI 31.2±5.4kg/m², BMI-SDS 2.51±0.57). During a 6-week rehabilitation period the patients participated in a structured treatment and teaching program (STTP). Following in-patient treatment the children and adolescents were monitored over a period of 24 months (physical examination, measurements of BMI, BMI-SDS, body composition, carotid intima-media thickness, laboratory parameters, blood pressure, standardized questionnaires to assess socio-demographic and socio-economic parameters, eating behavior, well-being, quality of life, intelligence, intrafamilial conflicts, self-efficacy, resilience, sense of coherence, stress management, social support, actual body shape).

RESULTS

66% of the children and adolescents had abnormal laboratory parameters as well as higher blood pressure and/or an increased carotid intima-media thickness. The mean carotid intima-media thickness was 0.53±0.09mm (range 0.40 to 0.80); 15% of the patients showed normal range values (< 0.45mm), 40% a slightly elevated (≥ 0.45 to ≤ 0.50mm) and 45% an elevated (> 0.50mm) thickness. After the inpatient treatment lasting 40.4±4.1 (range 28 to 49) days, children and adolescents reached a mean weight reduction of 5.52±3.94 (0.4 to 13.3) kg (p<0.01) that was accompanied by a reduction in body fat mass. Using multivariate analyses, the most important psychological factors associated with long-term weight reduction were identified (R-square=0.53): well-being (β=-0.543), resilience (β=0.434), and sense of coherence (β=0.315).

CONCLUSION

The different parameters (i. e., well-being, resilience, sense of coherence) have demonstrated their utility, and strategies should be developed allowing an adaption of these into the STTPs.