Twelve tips for creating a multicultural mindfulness-based intervention in diverse healthcare settings

High levels of stress and burnout, low help-seeking behaviour and unhealthy coping in healthcare professionals (HCPs), are a critical concern globally. Mindfulness-based interventions (MBIs) reduce stress, are a healthy coping mechanism and have become increasingly popular among HCPs, especially during the Covid-19 pandemic. Nevertheless, HCPs' busy schedules require the intervention to be accessible, pragmatic, and context specific. Key to this goal is approaching mindfulness from a multicultural perspective, especially in diverse settings such as Africa. This paper aims to provide practical tips to ensure that the MBI offered is effective with multicultural HCPs during intense stress. Four tips each discuss the curriculum, implementation, and sustainability, respectively. The tips are elucidated by practical examples of regulating stress in healthcare settings and to offer a guideline to help structure future MBIs to be culturally and context appropriate.

Chronomobility of international students under COVID-19 Australia

This article investigates the chronomobility of international students in Australia going through COVID-19. Existing literature on international students approaches them largely in two manners: a market or victims. Using Shanti Robertson's chronomobility, the study focuses on international students' coping mechanisms and strategies for their next moves. Drawing from 15 in-depth interviews with international students formally enrolled in Australian institutions in Melbourne, the longest lockdown city during the pandemic, the authors find various ways of short-term coping mechanisms through meditation, physical exercises, virtual escapism and counselling. Furthermore, despite pandemic immobility, students presented a high level of resilience in making future decisions for post-pandemic mobilities. We conclude that family support and social networks are key to realise full potentials of international students as skilled migrants and valued members of society. Our manuscript contributes to the field of migration and mobility by enriching Robertson's concept of chrono-mobility and adding the empirical case study from international students in Australia during the latest pandemic in 2020-2021.

Effects of Education and Guided Imagery Program on Stress Level and Coping Behaviors Among Pregnant Women at Risk of Preterm Birth

Purpose

The rate of preterm birth continues to increase worldwide. Pregnant women at risk of preterm birth experience more stress during pregnancy, which directly impacts their mental well-being and preterm birth situation. Stress management can significantly reduce stress and promote appropriate coping behaviors in pregnant women at risk of preterm birth. The purpose of this study was to determine the effects of education and guided imagery program on stress level and coping behaviors among pregnant women at risk of preterm birth.

Patients and Methods

Forty-eight pregnant women who visited the antenatal care unit at Ramathibodi Hospital and were at risk of preterm birth with moderate stress score were included. They were divided into two groups, each comprising 24 participants. The control group received standard nursing care, whereas the experimental group received an education and guided imagery program in addition to standard nursing care. The Perceived Stress Scale-10 and Coping Behavior Questionnaire were used to collect data.

Results

The results revealed that the mean stress score in the experimental group after receiving the program was lower than before with statistical significance (t = 7.14, p < 0.001). Moreover, the experimental group had lower stress score (F1,45 = 16.92, p < 0.001) and greater coping behavior score (F1,45 = 7.85, p < 0.01) compared with the control group after receiving the program, and the differences were statistically significant.

Conclusion

This research highlights the importance of preventing mental health problems in pregnant women at risk of preterm birth by using an education and guided imagery program to decrease stress and promote appropriate coping behaviors.

Potential impacts of Russo-Ukraine conflict and its psychological consequences among Ukrainian adults: the post-COVID-19 era

Background

Since February 2022, the nation of Ukraine has become entangled in an escalating conflict that erupted after coronavirus outbreak fostering a situation of indeterminacy and precariousness, which adversely affected several facets, especially psychological well-being. However, there is a lack of empirical evidence on the psychological well-being of Ukrainians during the Russo-Ukraine war, as well as their coping strategies in response to the war's repercussions. Consequently, this investigation endeavors to explore the prevalence of symptoms associated with depression, anxiety, stress, and insomnia and to correlate these symptoms with Ukrainians' effective coping mechanisms during the ongoing war.

Methods

An online survey was administered in Ukraine from June to August 2022 due to the ongoing Russo-Ukraine conflict. The survey employed a quota sampling technique, targeting 2,664 individuals (≥18 years). Out of the total sample, 1,833 valid responses were obtained, yielding a response rate of 68. 81%. Depression, anxiety, and stress were measured using the depression, anxiety, and stress scale-21 (DASS-21), while the Pittsburgh sleep quality index (PSQI) was utilized to evaluate insomnia symptoms. In addition, Brief-COPE was adopted to evaluate the coping mechanisms of the selected study participants.

Results

Of 1,833 Ukrainian adults, 60.5% had symptoms of stress; 62.4% of them reported symptoms of anxiety; and 58.2% reported symptoms of depression. Symptom criteria for insomnia were found in about 21.8% of the study sample. The factors of sex, living area, area occupied by Russian forces, and having older adults and children in the house were statistically significant with symptoms of depression, anxiety, stress, and insomnia. The productive coping strategies of self-distraction, using instrumental support, planning, and behavioral disengagement, were observed as statistically significant with four psychological constructs.

Conclusion

The study outcomes highlight a substantial prevalence of symptoms related to depression, anxiety, stress, and insomnia attributed to the accumulated consequences of ongoing conflict and the COVID-19 outbreak. The aforementioned findings emphasize the imperative of providing healthcare services and facilitating effective coping strategies among Ukrainians amid the ongoing war.

Coping Mechanisms of Psychiatric Nurses in Child Mental Health Environments in North West Province, South Africa: A Qualitative Call for Urgency

There is currently a growing understanding of child mental health. However, with little attention and investment from decision-makers, the prevalence of child mental health challenges shows no signs of diminishing. Psychiatric nursing is a process in which the major knowledge and skills dealing with the interpersonal and intrapersonal dynamics of human beings are practised. These nurses have to cope with this demand in a scant clinical child psychiatric environment. An exploratory, descriptive, and contextual research design was used to postulate the coping mechanism of these nurses in a clinical child psychiatric environment. This study comprised psychiatric nurses, and data were collected through focused group interviews. The findings emphasised the importance of clinical support to enhance quality nursing care and adjustment related to the demands on psychiatric nurses to participate fully in the service. Conclusion: Child and mental health services ought to enable nurses to better deal with the service demands and quality of psychiatric health care. An increased understanding of child mental health challenges is needed so that nurses' roles and functions in child psychiatric practice can be defined. Effective management and support ought to enable psychiatric nurses and health care teams to make decisions that support international development targets.

Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan

Background

Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan.

Methods

Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke.

Results

The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance.

Conclusion

Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.

The experiences and coping mechanisms of mothers caring for a child with cerebral palsy

Mothers caring for a child with cerebral palsy suffer from many physical and psychosocial problems. Their quality of life is significantly lower than mothers with healthy children. The first step in improving these women's quality of life is to improve the understanding of their experiences and coping mechanisms in specific cultural contexts. Therefore, this study aimed to explore the experiences and coping mechanisms of mothers caring for a child with cerebral palsy through a qualitative study conducted in Turkey. The study took place in 2021. Ten mothers were selected to participate through purposeful sampling. Inclusion criteria were mothers who had cared for a child with cerebral palsy for over three years, had no chronic diseases, could speak Turkish fluently, and wanted to participate in the study. The data were collected through semi-structured interviews. Qualitative content analysis was used to analyze the data. Two main themes and three categories emerged from the data analysis. The themes were "dedication" and "seeking." The analysis showed that mothers were dedicated as they engaged in all aspects of care. Their coping mechanisms involved self-focused and problem-focused seeking. These mothers must be acknowledged and supported while considering cultural and religious beliefs.

Evaluation of Psychological Resources of Young Adults With Type 1 Diabetes Mellitus During the Transition From Pediatric to Adult Diabetes Clinics: Multicenter Cross-sectional Study

BACKGROUND

The transition period of patients with type 1 diabetes from pediatric to adult-oriented health care is associated with poorer glycemic control and less frequent clinic attendance. Fears and anxiety about the unknown, care approach differences in adult settings, and sadness about leaving the pediatric provider all contribute to a patient's reluctance to transition.

OBJECTIVE

This study aimed to evaluate the psychological parameters of young patients with type 1 diabetes transitioning to an adult outpatient clinic during the first visit.

METHODS

We examined 50 consecutive patients (n=28, 56% female) transitioning from March 2, 2021, to November 21, 2022, into adult care (3 diabetes centers from 3 regions in southern Poland: A, n=16; B, n=21; and C, n=13) and their basic demographic information. They completed the following psychological questionnaires: State-Trait Anxiety Inventory (STAI), Generalized Self-Efficacy Scale, Perceived Stress Scale, Satisfaction with Life Scale, Acceptance of Illness Scale, Multidimensional Health Locus of Control Scale Form C, Courtauld Emotional Control Scale, and Quality of Life Questionnaire Diabetes. We compared their data with those for the general healthy population and patients with diabetes from Polish Test Laboratory validation studies.

RESULTS

During the first adult outpatient visit, patients' mean age was 19.2 (SD 1.4) years, with a diabetes duration of 9.8 (SD 4.3) years and BMI of 23.5 (SD 3.1) kg/m². Patients came from diverse socioeconomic backgrounds: 36% (n=18) live in villages, 26% (n=13) live in towns with ≤100,000 inhabitants, and 38% (n=19) live in bigger cities. Regarding therapy type, 68% (n=34) were treated with insulin pump therapy, whereas 32% (n=16) were treated with multiple daily injections. Patients from center A had a mean glycated hemoglobin level of 7.5% (SD 1.2%). There was no difference regarding the level of life satisfaction, perceived level of stress, and state anxiety between the patients and reference populations. Patients had similar health locus of control and negative emotions control to the general population of patients with diabetes. Most patients (n=31, 62%) believe that control over their health depends on themselves, whereas 52% (n=26) believe that it depends mostly on others. Patients had higher levels of suppression of negative emotions-anger, depression, and anxiety-than the age-matched general population. Additionally, the patients were characterized by a higher acceptance of illness and higher level of self-efficacy compared to the reference populations: 64% (n=32) had a high level of self-efficacy and 26% (n=13) had a high level of life satisfaction.

CONCLUSIONS

This study indicated that young patients transitioning to adult outpatient clinics have good psychological resources and coping mechanisms, which might result in adequate adaptation and adult life satisfaction including future metabolic control. These result also disprove the stereotypes that young people with chronic disease have worse life perspectives when entering adulthood.

Women experiencing homelessness in Dire Dawa city: Coping mechanisms and suggestions to stakeholder, 2021

BACKGROUND

In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people.

OBJECTIVES

To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021.

DESIGN

A community-based phenomenological qualitative study was conducted at Dire Dawa city.

METHODS

Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up.

RESULTS

Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation).

CONCLUSION

Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society's mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.

Prevalence of Anxiety and Burnout, and Coping Mechanisms among Clinical Year Medical Undergraduate Students in Universiti Kebangsaan Malaysia Amidst the COVID-19 Pandemic

This study aimed to determine the prevalence of anxiety and burnout, and the coping mechanisms among clinical year undergraduate medical students in Universiti Kebangsaan Malaysia (UKM) during the coronavirus disease 2019 (COVID-19) pandemic. In total, 378 clinical year undergraduate medical students in UKM participated in this cross-sectional study from May to July 2021. A self-administered questionnaire consisting of questions on the participant's sociodemographic data and items from the DASS-21, CBI, and Brief-COPE was distributed. Chi-square and Spearman's correlation tests were used to calculate the correlation coefficient between both anxiety and burnout, and coping mechanisms. The prevalence of anxiety and burnout were 44.2% and 22.2%, respectively. There was a significant difference in the percentage of students with extremely severe anxiety in the presence and absence of burnout, 23.8% vs. 4.8% (p < 0.001). Among the three coping mechanisms, avoidant coping had a significant positive moderate correlation with both the presence of anxiety (r = 0.3966, p < 0.001) and the presence of burnout (r = 0.341, p < 0.001). Meanwhile, coping that was neither approach nor avoidant had a positive weak correlation with the presence of burnout (r = 0.176, p = 0.001). The prevalence of anxiety and burnout was concerning. Increased anxiety and burnout among students may negatively impact aspects of their personal, professional, and academic lives. Early recognition and preventive measures should be emphasised to prevent negative ramifications.

Coastal Erosion and Flood Coping Mechanisms in Southern Thailand: A Qualitative Study

Communities in coastal regions are affected by the impacts of extreme climatic events causing flooding and erosion. Reducing the impacts of flood and erosion in these areas by adopting coping strategies that fortify the resilience of individuals and their localities is desirable. This study used summative content analysis to explore the coping mechanisms of coastal communities before, during, and after various dangers relating to flooding and erosion. The findings from the study show that effective surveillance systems, disaster preparedness, risk mapping, early warning systems, availability of databases and functional command systems, as well as reliable funding are essential to efficiently cope with hazards of coastal flooding and erosion. As flooding and erosion have been predicted to be more severe due to climate change in the coming years, the adoption of effective natural and artificial mechanisms with modern technologies could help coastal regions to be more resilient in coping with the dangers associated with flooding and erosion. Pragmatic policies and programs to this end by actors are critical to averting crises induced by flooding and erosion in coastal areas.

Stress among Parents of Children with Hearing Loss and How They Deal with It: A Systematic Review

Introduction  Parenting a child with hearing loss may be accompanied by high stress levels and several challenges. Objectives  The present systematic review was performed to compile the existing literature pertaining to parental stress in parents of children with hearing loss and coping strategies. Data synthesis  The databases searched include PubMed/Medline, Scopus, Cochrane Library and Cumulative Index to Nursing, and Allied Health Literature. The systematic review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. The screening for studies was performed independently by two researchers. Methodological quality appraisal was done using the Mixed methods appraisal tool. Twenty-eight studies were identified and included in the present review, which discussed the stress factors and coping mechanism associated with having child with hearing loss reported by parents. The factors leading to stress were thematically classified into parent/family-related factors, child-related factors, and professionals/service-related factors. The coping strategies were thematically classified into improved support systems and better professional resources. Conclusion  The present systematic review was an attempt at exploring the various stress causing factors among parents of children with hearing loss. The various coping strategies would help in better planning services for these parents and helping to lessen the stress.

The Pattern of Substance Use among People Who Use Drugs (PWUD) Receiving Treatment at University Malaya Medical Centre (UMMC) during the COVID-19 Pandemic and the Associated Factors

There was a change in the pattern of substance usage among people who use substances during the COVID-19 pandemic period. This study aims to determine the effects of the COVID-19 pandemic on the pattern of substance usage among people who use drugs (PWUD) receiving treatment at the University Malaya Medical Centre (UMMC) as well as levels of anxiety and depression together with coping mechanisms and the factors affecting the pattern of substance use during COVID-19 pandemic period. A cross-sectional study was applied. The questionnaire used was the Mini-European Web Survey on Drugs (EWSD): COVID-19, Hospital Anxiety and Depression Scale (HADS), and Brief COPE Scale. In total, 130 PWUD were recruited. Of the participants, 36.2% of PWUD had not used/stopped the usage of illicit drugs/alcohol, 26.2% increased their usage, 20% decreased, and 14.6% used the same amount of illicit substances/alcohol during the COVID-19 pandemic period/restrictions. In addition, 28.5% of PWUD had an increased intention to seek professional support for drug counseling/treatment during the COVID-19 pandemic period. The prevalence anxiety and depression symptoms in PWUD according to HADS was 33% and 41.5%, respectively, with depression (p = 0.05) and isolation status (adjusted OR = 2.63, p < 0.05) being associated with an increase in alcohol/illicit substance use during the COVID-19 pandemic. PWUD who had increased their intention to seek professional support had significantly higher odds (adjusted OR = 4.42, p < 0.01) of reducing their alcohol/illicit substance use during the COVID-19 pandemic period. There were increased odds of maintaining alcohol/illicit substance usage among PWUD who practiced dysfunctional coping (adjusted OR = 3.87, p < 0.025) during the COVID-19 pandemic period. In conclusion, depression, isolation status, dysfunctional coping, and intention to seek professional support affected the pattern of alcohol/illicit substance use during the COVID-19 pandemic period. Strategies, substance rehabilitation/counseling, and proper mental health screening and the associated risk factors must be emphasized to prevent a further epidemic of substance use during the pandemic.

Exploring the Impact and Lived Experiences of Hospice Staff Working in End-of-Life Care: An Interpretative Phenomenological Analysis (IPA)

Current research surrounding the experiences of hospice staff is significantly underdeveloped. Additionally, the stigmatisation of death in Western society has formed delusions of hospice care amongst the general public. These findings gained an insight of the lived experiences of six hospice staff across England and Wales, through an interpretative phenomenological analysis. Eight superordinate themes were identified; 'COVID-19 as a barrier to care delivery', 'Discomfort is key for personal growth', 'Self-preservation is paramount', 'Psychological impact of hospice environment', 'Internal conflict surrounding life and death', 'Complexities of a firm belief system', 'Utopian view of hospices' and 'Colleagues are a pillar of support'. All narratives shared overarching themes on growth, acceptance, and morality. These findings have future implications at the organisational level, identifying areas for adjustment for employee wellbeing. Furthermore, this may also educate aspiring end-of-life care staff in preparation for the reality of hospice environments.

Coping Mechanism among Parents of Children with Autism Spectrum Disorder: A Review

This review presented the current literature on coping mechanisms among parents of children with autism spectrum disorder (ASD), focusing on types of coping mechanisms among parents and different coping mechanisms between mothers and fathers of children with ASD. A search of published literature in English was conducted using Google Scholar, PsycINFO, Medline, Scopus, CINAHL, EBSCO, Springer, Ovid, PubMed, and Cochrane Library up to February 2020. Overall, 18 articles were relevant to the review. The review included thirteen studies for types of coping mechanisms among parents of children with ASD and five studies for different coping mechanisms between mothers and fathers. Coping mechanisms demonstrated by parents when caring for their child include problem-focused and emotion-focused coping. A comparison between fathers and mothers in our review showed that mothers used emotion-focused coping more than fathers, while fathers used problem-focused coping more frequently than mothers. The review provides an exciting opportunity to advance our knowledge on types of coping mechanisms and gender difference in using coping mechanisms among parents of children with ASD. The review also sheds new light on developing supportive interventions by healthcare providers to improve coping mechanisms among parents of children with ASD.

Doctors Dealing With COVID-19 in Pakistan: Experiences, Perceptions, Fear, and Responsibility

This study aimed to describe the dealings of 20 biomedical doctors with coronavirus disease-19 (COVID-19) in the Sindh province of Pakistan. Focusing on physicians from three different hospitals, we describe their challenges, emotions, and views concerning the pandemic. Many regarded the virus from a biomedical standpoint. Yet some also perceived it as a “tool of a proxy war” and a “plot,” without giving agency to anyone for that “plot.” Furthermore, these care providers faced a great fear of infection and an even greater fear of transmitting the virus to their families and friends. A few also feared stigmatization as viral carriers. Whether they experienced fear or not, all of our physician interlocutors emphasized their sense of responsibility to “serve humanity,” yet some also expressed a strong belief in the inevitability of the will of Allah. Some were satisfied with the role of the government in containing the virus, while others expressed concerns and felt that the government should be doing much more. All expressed confidence in the use of personal protective equipment (PPE), viewing it as an effective buffer against viral contagion. We conclude with a call for further research especially ethnographic studies on dealings of physicians with COVID-19 across Pakistan as frontline care providers.

Understanding social resilience in honeybee colonies

Honeybee colonies experience high losses, induced by several stressors that can result in the collapse of colonies. Experiments show what effects stressors, such as parasites, pathogens and pesticides, can have on individual honeybees as well as colonies. Although individuals may die, colonies do not always collapse from such disturbances. As a superorganism, the colony can maintain or return back to homeostasis through colony mechanisms. This capacity is defined as social resilience. When the colony faces a high stress load, this may lead to breakdown in mechanisms, loss in resilience and eventually colony collapse. Before social resilience can be measured in honeybees, we need to examine the mechanisms in colonies that allow recovery and maintenance after stressor exposure. Here, we discuss some of these mechanisms and how they affect the social resilience of honeybee colonies. Understanding social resilience in honeybees is essential to managing colony health and loss prevention.

Predictors of Mental Health Status among Quarantined COVID-19 Patients in Saudi Arabia

BACKGROUND

The negative psychological impact of COVID-19 in the general population has been well documented. Similar studies among those who were infected and who underwent quarantine remain scarce, particularly in the Arab region. The present study aims to fill this gap.

METHODS

In this cross-sectional study, suspected/confirmed COVID-19 individuals who were quarantined in the Ministry of Health (MOH) facilities were invited to participate in an online survey. All consenting participants answered a generalized questionnaire that included demographic characteristics, as well as a five-part questionnaire that assessed the symptoms of depression, anxiety, insomnia, and distress.

RESULTS

A total of 335 suspected/confirmed COVID-19 individuals (198 males and 137 females) participated. Being female is associated with increased risk of depression (odds ratio OR 1.8 (confidence interval, CI 1.1-3.1; p = 0.03)) as well as being employed by the government (OR 2.8 (CI 1.1-7.0; p = 0.03)). Level of education (OR 2.3 (CI 1.0-5.4; p = 0.049)) and employment in government (OR 3.0 (CI 1.2-7.8; p = 0.02)) were significantly associated with distress. Increasing age (45 years and above) appeared to be protective against distress (OR 0.2 (CI 0.02-0.69; p = 0.008)), as well anxiety and sleep pattern (OR 0.3 p < 0.05).

CONCLUSION

Findings of the present study highlight that infected COVID-19 populations are at higher risk for acute and detrimental psychological well-being during quarantine and/or self-isolation. Identification of the coping mechanisms of older adults during periods of distress may prove beneficial in the pandemic preparedness of younger generations.

Importance of Digital Literacy in the Process of Confronting the Stress During COVID-19 Pandemic

COVID-19 pandemic is a global problem that raised the perception of stress to a completely new level, unseen so far in peace conditions. To reduce the level of stress and deal with its accumulated consequences, people enforce different strategies and coping mechanisms. In the vast amount of information available, imposed by the media, and often filled with falsehoods and catastrophizing related topics, it can be very challenging to distinguish the truth from falsehoods. The existence of an adequate level of digital literacy and e-Health literacy can help society to deal with that problem. Digital and e-Health literacy enables society to search for information efficiently, while remaining critical and open-minded, and use the newly adopted knowledge to improve our mental health. The aim of the paper was to present the frequency of news searches and trusting the COVID-19 related information in the group of medical professionals in Croatia. The survey was conducted using an online questionnaire, containing psychological questionnaires and relevant questions about everyday functioning. Based on the results that show a significant correlation between the frequency of information search and the lack of trust in the search results, we discuss the importance of digital and e-Health literacy, primarily within medical professionals.

"This Is the Result of Something Else": Experiences of Men That Abused Drugs and Had Experienced Childhood Trauma

Drug abuse is a serious public health issue that may have irreversible consequences. Research has revealed that childhood psychological trauma can promote addictive behaviors in adulthood and that drugs are often used as a coping mechanism. Men are less likely to report trauma and seek help than women. The purpose of this qualitative study was to explore the experience of men in Iceland who have abused drugs and experienced childhood psychological trauma, to increase knowledge and deepen the understanding of trauma and addiction. Participants were seven men who had both experienced childhood trauma and had a history of drug abuse. Two interviews were conducted with each participant. The main findings suggest that participants abused drugs as a coping mechanism due to the trauma experienced in childhood. For some participants, seeking companionship was a key component of their drug use. Participants were mostly dissatisfied with treatment resources in Iceland; waiting lists were long and too much focus was on religion. Five main themes were identified: emotional impact, self-medication for pain, gender expectations, impermanence of thoughts, and loss of a sense of wholeness. Increased societal and professional awareness of the linkage between trauma and drug abuse is needed, as are additional resources specific to men who have experienced childhood trauma and drug abuse. It is important to integrate trauma focused services into health-care settings to educate health-care professionals on trauma and the consequences thereof, in addition to utilizing screening tools such as the Adverse Childhood Experience Questionnaire for those seeking assistance.

Impacts of Coping Mechanisms on Nursing Students' Mental Health during COVID-19 Lockdown: A Cross-Sectional Survey

The COVID-19 pandemic and consequent lockdown have precipitated significant disruption in the educational system. Nursing students are known to have higher levels of stress and anxiety than other non-nursing students, but there is a dearth of evidence regarding the impacts of the COVID-19 lockdown on their mental health and coping mechanisms.

PURPOSE

The aim of this study was to explore the influence of coping mechanisms as predictors of stress, anxiety, and depression among nursing students during the COVID-19 lockdown.

METHODS

A cross-sectional online survey was conducted from 20 April to 10 May 2020 among 173 nursing students at a private university in Southern California, USA.

RESULTS

Self-reported stress, anxiety, and depression were significantly higher during the lockdown compared to the pre-lockdown period (p < 0.001). Almost a quarter of participants reported high stress, while more than half reported moderate-to-severe symptoms of anxiety and depression. High resilience was negatively associated with high stress (Odds Ratio (OR) = 0.46; 95% Confidence Interval (CI) = 0.22-0.98; p = 0.045), moderate-to-severe anxiety (OR = 0.47; 95%CI = 0.25-0.90; p = 0.022), and moderate-to-severe depression (OR = 0.50; 95%CI = 0.26-0.95; p = 0.036). Similarly, high family functioning was negatively associated with high stress (OR = 0.41; 95%CI = 0.20-0.86; p = 0.018), moderate-to-severe anxiety (OR = 0.41; 95%CI = 0.21-0.80; p = 0.009), and moderate-to-severe depression (OR = 0.41; 95%CI = 0.20-0.81; p = 0.011). High spiritual support was negatively associated with moderate-to-severe depression (OR = 0.48; 95%CI = 0.24-0.95; p = 0.035).

CONCLUSIONS

During the COVID-19 lockdown, nursing students experienced remarkable levels of poor mental health. High levels of resilience and family functioning were associated with 2- to 2.4-fold lower risk of stress, anxiety, and depression, whereas high spiritual support was associated with 2-fold lower risk of depression. As the pandemic evolves, fostering these coping mechanisms may help students to maintain their psychological wellbeing.

Impact of trimethylaminuria on daily psychosocial functioning

BACKGROUND

Trimethylaminuria (TMAU) (OMIM #602079) is a rare inherited metabolic condition. TMAU is associated with decreased hepatic trimethylamine N-oxidation, which leads to an excess of the volatile trimethylamine (TMA) instead of substrate conversion to trimethylamine N-oxide (TMAO). TMA is a tertiary amine derived from the enterobacterial metabolism of precursors such as choline and phosphatidylcholine present in the diet, and is also a bacterial metabolite of TMAO, a normal constituent of saltwater fish. When the involved enzyme flavin mono-oxygenase 3 is deficient, TMA builds up and is released in the person's sweat, urine, and breath, giving off a strong body odor. We have recently reported the biochemical and genetic characteristics of 13 Irish adult patients with TMAU attending the main Irish Reference Center. Research on the behavioral and psychosocial aspects of this condition is limited. This study explores the patients' perspectives of living with TMAU in Ireland.

METHODS

A qualitative descriptive phenomenological approach was used. Six adults participated in this study. Data were gathered through semi-structured interviews, which were transcribed and analyzed.

RESULTS

The results suggest that the participants experienced a negative journey to diagnosis. Fear, anxiety, paranoia, and dysfunctional thinking are a constant struggle. Participants reported using avoidant coping mechanisms and strategic planning to navigate daily life.

CONCLUSION

It is considered that the results from this study will inform future interventions with this unique patient cohort.

The relationship between Internet addiction, psychological distress, and coping strategies in a sample of Saudi undergraduate students

PURPOSE

This study aimed to investigate the relationship between Internet addiction (IA), psychological distress, and coping strategies.

METHODS

Data were collected using a convenience sample of 163 student nurses.

FINDINGS

The results showed that there was high prevalence rate of IA among students. In addition, the use of avoidance and problem-solving coping mechanism was statistically significant among the IA group compared with the non-IA group (P < .05). This was associated with a more negative impact on psychological distress and self-efficacy (P < .05).

CONCLUSIONS

IA is an increasing problem in the general population and among university students. It can affect many aspects of a student life.

PRACTICAL IMPLICATIONS

The results will raise awareness of the deleterious effects of IA on a wide range of student life.

Vulnerability and Adaptation to Extreme Heat in Odisha, India: A Community Based Comparative Study

Background: Extreme heat and heat illness are becoming very frequent in India. We aimed to identify the factors associated with heat illness and the coping practices among city dwellers of Odisha, India during the summer. Methods: A cross-sectional study included 766 households (HHs) in twin cities of Odisha covering a population of 1099 (slum: 404 and non-slum: 695) in the year 2017. We collected information on sociodemographic, household characteristics, coping practices to heat and the heat illness history reported during the summer. Multivariate logistic regression accounting for clustering effects at the household and slum levels was used to identify the associated factors of heat illness after adjustment of other variables. Result: Nearly, 49% of the study participants were female and the mean age was 38.36 years (95% confidence interval (CI): 37.33–39.39 years). A significant difference of living environment was seen across the groups. More than two-thirds of the study participants at least once had heat illness. In the non-slum population, males (adjusted odds ratio (aOR): 3.56; 95% CI: 2.39–5.29), persons under medication (aOR: 3.09; 95% CI: 1.15–8.29), and chronic conditions had higher association with heat illness. Whereas, in the slum population, having a kitchen outside the home (aOR: 1.63; 95% CI: 1.02–3.96) and persons with chronic conditions were positively associated with heat illness. Use of cooling practices in slum areas reduced the risk of heat illness by 60%. Conclusion: Heat illness is associated with the living environment and physical health of the individuals. Identifying the vulnerable population and scaling up adaptive practices can strengthen the public health preparedness.

Humor Associated With Positive Outcomes in Individual Psychotherapy

Considerable anecdotal evidence points to the usefulness of humor in the therapeutic process, but empirical evidence is lacking. The purpose of this study, conducted in Belgium, was to search for an association between humor and therapy outcomes in a population of 110 adult psychotherapy clients who attended at least 10 therapy sessions. Clients and their therapist evaluated the frequency and intensity of humorous events, as well as therapy effectiveness, therapeutic alliance, perceived hope, and pleasure in participating in therapy sessions. A strong positive correlation was observed between humor and therapy effectiveness, from both client (r_s=0.40; p<0.001) and therapist perspectives (r_s=0.37; p<0.001). The link between humor and therapy effectiveness remained significant in subgroups of clients with more severe illness, although these clients reported less humor in their therapy sessions. Further research is needed to determine whether humor enhances outcomes or whether positive outcomes trigger occurrence of humor.

Stress and coping mechanisms among adolescents living in orphanages: An experience from Klang Valley, Malaysia

INTRODUCTION

Health issues often differ from one population to another. Assessing different aspects of the health condition is a vital step toward developing and designing appropriate prevention and treatment programs to reduce health problems in any group or population. This study aimed to assess both the prevalence of stress and the coping mechanisms as well as identify the predictors of stress levels among adolescents in Malaysian orphanages.

METHODS

Overall, 307 male and female adolescents (aged 13-18 y old) living in 9 private orphanages located in Klang Valley, Malaysia, participated in this cross-sectional study. Brief COPE scale and Depression, Anxiety and Stress Scale-21 were used as the main instruments in the current study.

RESULTS

The results of the current study showed female adolescents and participants with a higher level of education were more likely to experience stress. The results also showed significant differences between boys and girls in using of coping mechanisms in self-distraction (t = -2.39, P = .01), substance use (t = 2.12, P = .03), use of emotional support (t = -2.70, P = .001), humor (t = 2.28, P = .02), and religion (t = -2.19, P = .02). Denial, venting, religion, humor, planning, and active coping were identified as predictors of stress among participants.

DISCUSSION

The results showed a high prevalence of stress and a negative coping pattern among participants. The finding of the current study also showed the urgency of taking immediate action to reduce stress and improve coping methods among Malaysian institutional adolescents.

Emergency medicine resident well-being: stress and satisfaction

BACKGROUND

Emergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress.

AIMS

To evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms.

METHODS

An online survey instrument was developed to gauge resident stress, satisfaction with current lifestyle, stress coping mechanisms and demographics. A stratified random sample of EM residents from three postgraduate years (PGY-I, PGY-II and PGY-III) was obtained. Descriptive statistics and one-way analysis of variance were used to compare residents across PGY level.

RESULTS

There were 120 potential participants in each of the three PGYs. The overall response rate was 30% (109) with mean age of 30 and 61% were male. On a 0-4 scale (0 = completely dissatisfied), respondents in PGY-I reported significantly less satisfaction with lifestyle than those in PGY-II and III (mean rating: 1.29, 1.66 and 1.70, respectively; P < 0.001). There were no significant differences in mean ratings between PGYs on each of the other stress categories: work relationships (1.37), work environment (1.10) and response to patients (1.08). Residents reported exercise (94%), hobbies (89%) and use of alcohol (71%) as coping methods.

CONCLUSIONS

Residents reported low satisfaction with current lifestyle. This dissatisfaction was unrelated to perceived work-related stress. Some undesirable coping methods were prevalent, suggesting that training programs could focus on promotion of healthy group activities.

Floods and health in Gambella region, Ethiopia: a qualitative assessment of the strengths and weaknesses of coping mechanisms

Background

Floods are the most frequent and devastating type of natural disaster worldwide, causing unprecedented deaths, diseases, and destruction of property and crops. Flooding has a greater impact in developing countries due to lack of sufficient disaster management structures and a lack of economic resources.

Objective

This study was conducted with the aim of contributing to the knowledge base of development strategies that reduce flood-related health risks in developing countries. The study focused particularly on assessing the flood risks and health-related issues in the Gambella region of Ethiopia; with the intent of producing relevant information to assist with the improvements in the efficacy of the current flood coping strategies in the region.

Methods

Data were gathered through interviews with 14 officers from different government and non-governmental organizations and a questionnaire survey given to 35 flood victims in Itang woreda. A qualitative approach was applied and the data were analyzed using content analysis.

Results

It was found that flooding is a common problem in Gambella region. The findings also indicate that the flood frequency and magnitude has increased rapidly during the last decade. The increase in floods was driven mainly by climate change and changes in land use, specifically deforestation. The reported main impacts of flooding on human health in Gambella region were deaths, injuries, and diseases such as malaria and diarrhea. Another notable consequence of flooding was crop destruction and subsequent malnutrition.

Conclusions

Three weaknesses that were identified in the current coping strategies for flood-related health impacts in Gambella region were a lack of flood-specific policy, absence of risk assessment, and weak institutional capacity. This study recommends new policy approaches that will increase the effectiveness of the current flood coping strategies to sustainably address the impact of flooding on human health.