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Lotzin A, Morozova-Larina O, Paetow A, Schratz L, Keller V, Zarubin I, Krupelnytska L. Resilient coping during the Russian-Ukrainian war: Does it buffer the effects of cumulative trauma on ICD-11 posttraumatic stress disorder symptoms? Compr Psychiatry 2025; 140:152592. [PMID: 40209478 DOI: 10.1016/j.comppsych.2025.152592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 01/21/2025] [Accepted: 03/27/2025] [Indexed: 04/12/2025] Open
Abstract
BACKGROUND Individuals with higher resilient coping may manage war-related trauma better than individuals with lower resilient coping. If so, resilient coping may weaken the relationship between war trauma and posttraumatic stress disorders. OBJECTIVE This study aimed to investigate the role of resilient coping in moderating the associations between cumulative war trauma exposure and ICD-11 posttraumatic stress disorders during war. METHODS This cross-sectional study included N = 851 Ukrainian students living in the Ukraine between December 2022 and January 2023 during the Russian-Ukrainian war. We tested a model in which resilient coping was specified as a moderator of the effect of war-related cumulative trauma exposure (Harvard Trauma Questionnaire-R) on ICD-11 posttraumatic stress disorder (PTSD), and disturbances in self-organization (DSO) symptom levels (International Trauma Questionnaire-R), respectively. We used Structural Equation Modeling and controlled our analysis for previous trauma exposure, gender, years of study, and level of income. RESULTS In contrast to our hypothesis, the level of resilient coping did not moderate the effect of cumulative war trauma exposure on PTSD and DSO symptom levels. Instead, we found a strong direct effect of the level of resilient coping on PTSD and DSO symptom levels. CONCLUSIONS Resilient coping may directly affect the level of PTSD and DSO symptoms but may not weaken the association between trauma exposure and posttraumatic stress disorders during war.
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Affiliation(s)
- Annett Lotzin
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Olha Morozova-Larina
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
| | - Antje Paetow
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Lisa Schratz
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Vladyslava Keller
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
| | - Illia Zarubin
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
| | - Liudmyla Krupelnytska
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
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Weedage D, Kool-Goudzwaard N, Meijnckens D, Vermeiren RRJM, Boonmann C. Resilience revisited: a systematic review and synthesis of Non-Suicidal Self-Injury (NSSI) and its relation with resilience. BMC Psychiatry 2025; 25:463. [PMID: 40335940 PMCID: PMC12060524 DOI: 10.1186/s12888-025-06868-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Accepted: 04/15/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND The aim of the current study is to examine the relationship between nonsuicidal self-injury (NSSI) and resilience. Resilience has been identified as a critical area for further investigation in the context of NSSI. Resilience has been conceptualized in different ways over the years, from psychological resilience, with a focus on the individual's problem/deficiency, into a dynamic, cultural, interactive process in which people's biological, psychological, social, and ecological systems work together to help them cope with challenges and maintain or improve their mental well-being. METHOD For this systematic review was searched within PubMed, PsycINFO, the Cochrane Library, and Web of Science for currently published studies on the relationship between NSSI and resilience to provide a summary, following the Preferred Reporting Items for Meta-analysis and Meta-Analysis. Second, it determines the magnitude of this relationship by calculating a random effects size, using the meta-package of R. RESULTS Included were 17 studies with a total sample size of 12,273 participants (Mage = 17.56, range: 12.93-27.50, SD = 3.95; female: 59.5%) and a NSSI sample size of 4,767 (38.8%). The pooled results indicate a small to moderate relationship between resilience and NSSI, with a random effects model effect size of 0.28 (95% CI: 0.10; 0.47), with higher levels or the presence of NSSI associated with lower levels of resilience. Most studies measured psychological resilience. Several reporting the moderator and mediator function of resilience, whereby higher resilience reduces the odds of developing NSSI in the case of stressful or traumatic events. A minority of studies reported effect sizes per resilience factor. Of which problem solving/coping and emotional reactivity were predominantly reported. CONCLUSIONS Resilience is related to NSSI. However, it also shows that resilience is mostly measured as a psychological and individual concept. This is contrary to the multimodal perspective of resilience as well as the multimodal and non-linear nature of the recovery process of NSSI. Therefor this review highlights the need for a holistic approach with a shift in focus to a multimodal perspective. More research is needed to understand the role of resilience within the nonlinear recovery process. This research should include the voices of people with lived experience.
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Affiliation(s)
- Daphne Weedage
- Department of Child and Adolescent Psychiatry (LUMC Curium), Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK Oegstgeest, Postbus 15 - 2300 AA, Leiden, The Netherlands.
| | - Nienke Kool-Goudzwaard
- Intensive Treatment Centre and Parnassia Academy, Parnassia Groep, The Hague, The Netherlands
| | - Dwayne Meijnckens
- Stichting Zelfbeschadiging (National Self-harm Foundation), Utrecht, the Netherlands
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry (LUMC Curium), Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK Oegstgeest, Postbus 15 - 2300 AA, Leiden, The Netherlands
| | - Cyril Boonmann
- Department of Child and Adolescent Psychiatry (LUMC Curium), Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK Oegstgeest, Postbus 15 - 2300 AA, Leiden, The Netherlands
- Department of Psychology, University of Basel, Basel, Switzerland
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Gunasekaran S, Tay EH, Shafie S, Shahwan S, Wang P, Zhang Y, Satghare P, Tan SC, Ni MY, Lun P, Chong SA, Subramaniam M. A nationwide study exploring the factors associated with psychological resilience during the COVID-19 pandemic in Singapore. Front Public Health 2025; 13:1516829. [PMID: 40342507 PMCID: PMC12058489 DOI: 10.3389/fpubh.2025.1516829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Accepted: 03/21/2025] [Indexed: 05/11/2025] Open
Abstract
Background The COVID-19 pandemic is a global adverse event that affected many individuals' well-being. Resilience is an essential component that allows one to cope during stressful events such as the pandemic. Not many studies have longitudinally explored changes in resilience across time during the pandemic in the Southeast Asia region. The current article investigates resilience and the sociodemographic and psychological factors associated with resilience across two waves of survey of a Singapore adult population. Methods The study was conducted across two timepoints from May 2020 to June 2021 (T1) and October 2021 to September 2022 (T2). 1129 participants partook during T1 (response rate = 54.8%) and 858 participants partook during T2 (response rate = 76.0%). The questionnaire included sociodemographic information and measures such as the Brief Resilience Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, the stress component of the Depression, Anxiety and Stress Scale, and four COVID-19-related stressors. Generalized estimating equations (GEE) were utilized to investigate the relationships adjusting for timepoints. Results Most participants had normal levels of resilience (M = 3.61, SD = 0.62), and resilience scores did not differ much over time (p = 0.852). Males, younger adults, university-educated, employed individuals, and individuals living in private housing had higher levels of resilience. Higher levels of anxiety symptoms, depressive symptoms, stress, and one specific COVID-19-related stressor (i.e., employment concerns) were associated with lower levels of resilience. Individuals who reported having moderate to severe depression and anxiety symptoms were more likely to have low resilience. Discussion The findings suggest that resilience levels remained within the normal range and unchanged over time, reflective of the population's ability to cope with the pandemic. However, there is still a need for more targeted interventions for individuals who are more vulnerable to lower resilience. Continued research is also needed to understand the long-term psychological effects of the pandemic.
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Affiliation(s)
| | - Eng Hong Tay
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - YunJue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Sing Chik Tan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Michael Y. Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Phyllis Lun
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Qin XJ, Kang MM, Zhong F, Liu JJ, Zhu ZC, Zhang D, Han K. Correlations of resilience with coping styles and quality of life in patients with malignancies. World J Psychiatry 2025; 15:100573. [PMID: 40309588 PMCID: PMC12038679 DOI: 10.5498/wjp.v15.i4.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 01/23/2025] [Accepted: 02/13/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND Resilience is an individual's ability and psychological rebound capacity to adapt well after experiencing adversity, trauma, etc. Patients with strong resilience can face illnesses actively. AIM To determine the association of resilience with coping styles and quality of life in patients with malignancies. METHODS This study included patients with malignant tumors who were hospitalized at Fuyang Hospital Affiliated to Anhui Medical University from March 2022 to March 2024. The Connor-Davidson Resilience Scale, Medical Coping Modes Questionnaire, Social Support Rating Scale, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were utilized to assess patients' resilience, coping styles, social support, and quality of life, respectively. Pearson correlation analysis was conducted to assess the correlations. RESULTS A total of 175 patients with malignant tumors demonstrated no marked difference in terms of age, education level, employment status, monthly household income, and disease staging (P < 0.05). Further, patients with malignancies demonstrated scores of 17.49 ± 1.20, 17.27 ± 1.46, and 11.19 ± 1.29 points in terms of coping styles in confrontation, avoidance, and resignation dimensions, respectively. Subjective support, objective support, and support utilization scores in terms of social support were 10.67 ± 1.80, 11.26 ± 2.08, and 9.24 ± 1.14 points, respectively. The total resilience score and tenacity, self-improvement, and optimism dimension scores were positively correlated with the confrontation coping style score, whereas the total resilience score and tenacity and self-improvement scores were negatively associated with avoidance and resignation coping style scores (P < 0.05). The total resilience score and the tenacity dimension score were positively associated with physical, role, cognitive, emotional, and social functions, as well as global health status (P < 0.05), and were inversely related to fatigue, insomnia, and economic difficulties (P < 0.05). CONCLUSION The resilience of patients with malignancies is positively associated with the confrontation dimension in the coping style, the total and various social support domain scores, and the overall quality of life. Clinical medical staff need to pay attention to the effect of medical coping styles and social support on the resilience level of patients with malignancies to further improve their quality of life.
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Affiliation(s)
- Xue-Jin Qin
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
| | - Man-Man Kang
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
| | - Fei Zhong
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
| | - Jing-Jing Liu
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
| | - Zheng-Chun Zhu
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
| | - Di Zhang
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
| | - Ke Han
- Department of Oncology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang 236000, Anhui Province, China
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Parlikar N, Strand LB, Kvaløy K, Espnes GA, Moksnes UK. The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study. Soc Psychiatry Psychiatr Epidemiol 2025:10.1007/s00127-025-02888-2. [PMID: 40195157 DOI: 10.1007/s00127-025-02888-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 03/21/2025] [Indexed: 04/09/2025]
Abstract
BACKGROUND Loneliness is a recognized risk factor for anxiety and depression, yet research on its interaction with low resilience remains sparse, particularly across the adolescent-to-adult transition. This study investigates how adolescent loneliness, both independently and in interaction with low resilience, influences anxiety and depression in young adulthood. METHODS This study utilized longitudinal data from The Trøndelag Health Study (HUNT) to track adolescents (13-19 years) from Young-HUNT3 (2006-08) through to HUNT4 (2017-19). Loneliness was assessed via a single-item measure, while resilience was estimated using the Resilience Scale for Adolescents. Anxiety and depression outcomes at the 11-year follow-up were measured using the Hospital Anxiety and Depression Scale. Multivariable logistic regression analyses were done to analyze the associations. Moreover, interaction effects were evaluated using relative excess risk due to interaction (RERI). RESULTS Loneliness during adolescence independently predicted anxiety and depression in young adulthood. Adolescents experiencing both loneliness and low resilience showed notably higher risks compared to other groups (highly resilient adolescents without loneliness [reference], highly resilient adolescents with loneliness, and adolescents with low resilience and low loneliness). The combined effect of loneliness and low resilience exhibited a synergistic interaction on the additive scale, although it was not statistically significant (RERI 0.13, 95% CI -2.39-2.65). CONCLUSION Adolescent loneliness and low resilience independently predict anxiety and depression in young adulthood. The interaction between loneliness and low resilience further heightens these risks. This underscores the importance of early interventions that focus on resilience-building during adolescence and reducing the impacts of loneliness on mental health.
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Affiliation(s)
- Nayan Parlikar
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Linn Beate Strand
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kirsti Kvaløy
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Geir Arild Espnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Unni Karin Moksnes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Farchi MU, Peled-Avram M. The ART of resilience: a theoretical bridge across resilience perspectives. Front Psychol 2025; 16:1556047. [PMID: 40230999 PMCID: PMC11995016 DOI: 10.3389/fpsyg.2025.1556047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Accepted: 03/19/2025] [Indexed: 04/16/2025] Open
Abstract
The theoretical understanding of psychological resilience has evolved significantly over recent decades, leading to diverse conceptual frameworks that emphasize different aspects of resilient adaptation. Some frameworks focus on resilience as a personal trait, others view it as a dynamic process, while still others emphasize the role of environmental and systemic factors. This theoretical paper introduces the ART framework (Acknowledgment, Reframe, and Tailoring), which provides an integrative perspective that bridges these seemingly disparate approaches. The ART framework offers a comprehensive understanding of how various resilience mechanisms work together in real-world contexts by focusing on the dynamic interplay between resource identification, reframing threats as challenges, and adaptive tailoring between resources and challenges. The ART framework incorporates and extends existing theoretical perspectives while providing a practical structure for understanding resilience development and intervention.
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Affiliation(s)
- Moshe U. Farchi
- Department of Social Work, Research Center for Innovation in Social Work, Tel-Hai Academic College, Tel Hai, Israel
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Çalışkan E, Gökkaya F. Reviewing Psychological Practices to Enhance the Psychological Resilience Process for Individuals with Chronic Pain: Clinical Implications and Neurocognitive Findings. Curr Pain Headache Rep 2025; 29:68. [PMID: 40119957 PMCID: PMC11929684 DOI: 10.1007/s11916-025-01373-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2025] [Indexed: 03/25/2025]
Abstract
PURPOSE OF REVIEW Psychological practices have emerged as promising treatments for coping with chronic pain (CP) as a psychological resilience (PR) enhancer mechanism. These practices contain cognitive, behavioral and emotional modulation of pain. In this regard, classical cognitive-behavioral therapy (CBT) and current trends in CBT, including acceptance and commitment therapy and mindfulness-based practices may demonstrate significant improvements in pain perception, physical functioning, catastrophic beliefs and fear-avoidance behaviors among patients with CP. However, understanding the neurocognitive mechanisms of these practices includes challenges, such as the need to identify associated brain regions with PR to CP. Our review explored psychological practices to enhance PR as a dynamic neurocognitive process (e.g., changing affect) rather than only being a static trait. RECENT FINDINGS Psychological practices have promising results in improving positive outcomes for CP sufferers. To illustrate, along with superior PR scores, higher positive affect, adaptive pain beliefs, and physical functioning were reported after these practices. Conversely, lower pain catastrophizing, pain-related fear-avoidance, and self-reported pain ratings were seen as PR factors. Moreover, enhanced PR process may be associated with increased activity of the brain regions, including prefrontal cortex and orbitofrontal cortex, whereas diminished activity, reactivity, and functional connectivity in the anterior cingulate cortex, amygdala and insula. This review discusses the neurocognitive modulation of CP through psychological practices and highlights the role of enhancing the PR process for individuals with CP. As the field continues to evolve, understanding the importance of psychological practices to develop PR-related factors is crucial for increasing pain management outcomes.
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Affiliation(s)
- Elif Çalışkan
- Department of Psychology, Institute of Postgraduate Education, İzmir Tınaztepe University, İzmir, Türkiye.
| | - Füsun Gökkaya
- Department of Psychology, Institute of Postgraduate Education, İzmir Tınaztepe University, İzmir, Türkiye
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Hohashi N, Kijima N. Japanese Family Conditions Demonstrating Family Resilience: Directed Content Analysis Based on Literature and Family Interviews. NURSING REPORTS 2025; 15:96. [PMID: 40137669 PMCID: PMC11945855 DOI: 10.3390/nursrep15030096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 02/28/2025] [Accepted: 03/12/2025] [Indexed: 03/29/2025] Open
Abstract
Background/Objectives: When experiencing a variety of negative family events, families that, as a whole, have high family resilience maintain and improve family functioning. It is important, therefore, for nursing professionals to be able to assess families lacking in family resilience in order to prevent, reduce, or ameliorate family symptoms (such as family-perceived problems, issues, difficulties, or suffering). The purpose of this study was to clarify how family resilience works. Methods: Family resilience is defined based on the Concentric Sphere Family Environment Theory (CSFET) as when a family becomes aware of family symptoms on its own, and its power to autonomously and actively improve its own family functions. The contents of 22 family nursing cases from 16 qualitative studies on family resilience and the results of 28 semi-structured interviews with 28 parenting-age families in Japan were qualitatively categorized using the triangulation method, and then directed content analysis was conducted based on the CSFET. Results: A total of 157 labels, with a total of 23 categories and 47 subcategories, were found to relate to family resilience, such as "can utilize relatives", "family members can communicate with members of other families", "family members can share information", "all family members can communicate with one another", "all family members can cooperate with one another", and "can share time with family". Conclusions: From these, a variety of diverse aspects contributing to a family's resilience, including family member interactions, entire family interactions, use of social resources, and religious and spiritual support, were indicated.
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Affiliation(s)
- Naohiro Hohashi
- Division of Family Health Care Nursing, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan;
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Puia AM, Mihalcea A, Rotărescu VȘ. Well-being factors. An item-level analysis of the positive cognitive triad role, in the relationship between resilience and well-being. Acta Psychol (Amst) 2025; 253:104692. [PMID: 39787890 DOI: 10.1016/j.actpsy.2025.104692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 12/20/2024] [Accepted: 01/02/2025] [Indexed: 01/12/2025] Open
Abstract
This study examines the impact of resilience and the positive cognitive triad (consisting of three components: view of the self, view of the world, and view of the future) on well-being, a subject that is presently understudied. The present study investigated well-being models that take into consideration the role of the positive cognitive triad, in the relationship between resilience and several concepts of well-being: subjective (general) happiness, subjective (hedonic) well-being, and psychological (eudaimonic) well-being (N = 742). Eudaimonic and hedonic well-being contribute to overall happiness through different mechanisms, while subjective happiness is people's assessment of their happiness. These distinctions bring forth a complete approach to well-being that integrates affects, life satisfaction, self-esteem, and long-term psychological health. Data was analyzed using Structural Equation Modeling (SEM) in R. Results showed that resilience and the positive cognitive triad are predictors of well-being and there was a positive association between resilience and well-being, mediated by the positive cognitive triad factors. The fit indices in SEM indicated that the best fitting model is resilience ⇒ positive cognitive triad ⇒ subjective well-being. People who experience subjective (hedonic) well-being have an optimistic perspective on the world, while this perspective does not impact psychological (eudaimonic) well-being. Individuals experiencing psychological well-being have high self-esteem because well-being implies autonomy, self-acceptance, personal growth, and environmental mastery. Improved self-view also translates into increased subjective well-being. An optimistic view of the future fosters hope, and motivation, and it is associated with higher levels of well-being.
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Affiliation(s)
- Anca-Monica Puia
- Faculty of Psychology and Educational Sciences, University of Bucharest, Romania.
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Flinn C, McInerney A, Nearchou F. The prevalence of comorbid mental health difficulties in young people with chronic skin conditions: A systematic review and meta-analysis. J Health Psychol 2025; 30:652-679. [PMID: 38812260 PMCID: PMC11927027 DOI: 10.1177/13591053241252216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
Chronic skin conditions can have psychosocial and somatic implications, influencing well-being and quality of life. This systematic review and meta-analysis aimed to synthesise evidence on the prevalence of comorbid mental health difficulties in 0-25-year-olds with chronic skin conditions. A secondary aim included identifying factors associated with resilience. The narrative synthesis included 45 studies. Four meta-analyses were performed with moderate-high quality studies, one for each outcome: diagnosed mental disorders; mental health symptoms; suicidal behaviour; socio-emotional and behavioural difficulties. The pooled prevalence of diagnosed mental disorders was 1.2% (95% CI = 0.2-6.1); of mental health symptoms was 22.6% (95% CI = 18.9-26.7); of suicidal behaviour was 7.8% (95% CI = 1.4-3.1); of socio-emotional and behavioural difficulties was 20.9% (95% CI = 14.7-28.8). Findings demonstrate the pooled prevalence of comorbid mental health difficulties in youth with chronic skin conditions.
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Sun Z, Tang N, Gan X, Chen J, Su Q, Song J, Gao Y. The association between resilience and fatigue among mariners during ocean voyages: a chain mediating effect of coping style and psychological stress. BMC Public Health 2025; 25:490. [PMID: 39915785 PMCID: PMC11800580 DOI: 10.1186/s12889-025-21481-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 01/15/2025] [Indexed: 02/11/2025] Open
Abstract
BACKGROUND Fatigue seriously reduces the sensory sensitivity and operational efficiency ofmariners, which is a major safety threat to ship navigation. This study aimed to investigate the relationship between resilience and fatigue and to explore the chain-mediated role of coping style and psychological stress among mariners during ocean voyages. METHODS Using Connor-Davidson resilience scale, simplified coping style questionnaire, psychological stress self-evaluation test and multidimensional fatigue inventory, a questionnaire survey was conducted on 510 mariners from a Shandong fleet who finished a 32-day ocean voyage on September 12, 2023. SPSS 26.0 was employed to perform correlation analysis, while Amos 21.0 was applied to establish structural equation model and demonstrate the mediator effects. RESULTS Daily working hours, negative coping style and psychological stress were positively correlated with fatigue, while resilience was negatively related to fatigue (all P < 0.01). The structural equation indicated that the 4 paths of "resilience → fatigue", "resilience → psychological stress → fatigue", "resilience → positive coping → psychological stress → fatigue" and "resilience → negative coping → psychological stress → fatigue" occupied 68.72%, 11.45%, 9.99% and 9.84% of the total effect, respectively (all P < 0.05), suggesting the validity of hypothesis. CONCLUSION Resilience exerts significant direct and indirect effects on fatigue of mariners during ocean voyages. In addition, coping style and psychological stress partially and serially mediate the relation between resilience and fatigue. The results have significant implications for the intervention and prevention of fatigue, providing additional evidence for the relationship between resilience and fatigue among mariners during ocean voyages.
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Affiliation(s)
- Zhanying Sun
- Graduate School of Chinese PLA Medical School, Beijing, 100853, China
- Department of Nursing, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Nan Tang
- Graduate School of Chinese PLA Medical School, Beijing, 100853, China
| | - Xueyang Gan
- Graduate School of Chinese PLA Medical School, Beijing, 100853, China
| | - Jingru Chen
- Department of Nursing, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Qingqing Su
- Department of Nursing, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jie Song
- Department of Nursing, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yuan Gao
- Department of Nursing, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Gil-Hernández E, Carrillo I, Martin-Delgado J, García-Torres D, Mira JJ. Development of a Web-Based Intervention for Middle Managers to Enhance Resilience at the Individual, Team, and Organizational Levels in Health Care Systems: Multiphase Study. JMIR Hum Factors 2025; 12:e67263. [PMID: 39908547 PMCID: PMC11840388 DOI: 10.2196/67263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Revised: 12/30/2024] [Accepted: 12/31/2024] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND Health care institutions face high systemic risk due to the inherent uncertainty and complexity of their operations. This often leads to stressful incidents impacting the well-being of health care professionals, which can compromise the effectiveness of health care systems. Enhancing resilience among health care professionals is essential for maintaining high-quality care and ensuring patient safety. The role of middle managers is essential to ensure the response capacity of individuals and teams. OBJECTIVE This study aims to develop a web-based intervention aimed at middle management to enhance individual, team, and organizational resilience. METHODS An observational study was conducted in 3 phases: design, validation, and pilot study. The study was initiated in February 2022 and concluded in June 2023. Phase 1 involved designing the content for the web-based tool based on a comprehensive review of critical elements around resilience. Phase 2 included validation by an international panel of experts who reviewed the tool and rated it according to a structured grid. They were also encouraged to highlight strengths and areas for improvement. Phase 3 involved piloting the tool with health care professionals in Ecuador to refine the platform and assess its effectiveness. A total of 458 people were invited to participate through the Institutional Course on Continuous Improvement in Health Care Quality and Safety offered by the Ministry of Public Health of Ecuador. RESULTS The tool, eResiliencia, was structured into 2 main blocks: individual and team resilience and organizational resilience. It included videos, images, PDFs, and links to dynamic graphics and additional texts. Furthermore, 13 (65%) of the 20 experts validated the tool, rating content clarity at an average of 4.5 (SD 0.7) and utility at an average of 4.7 (SD 0.5) out of 5. The average overall satisfaction was 9.3 (SD 0.6) out of 10 points, and feedback on improvements was implemented. A total of 362 health care professionals began the intervention, of which 218 (60.2%) completed preintervention and postintervention questionnaires, with significant knowledge increases (P<.001). Of the 362 health care professionals, 146 (40.3%) completed the satisfaction questionnaire, where overall satisfaction was rated at an average of 9.4 (SD 1.1) out of 10 points. CONCLUSIONS The eResiliencia web-based platform provides middle managers with resources to enhance resilience among their teams and their components, promoting better well-being and performance, even under highly stressful events. Future research should focus on long-term impacts and practical applications in diverse clinical settings.
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Affiliation(s)
- Eva Gil-Hernández
- ATENEA Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Alicante, Spain
| | - Irene Carrillo
- Health Psychology Department, Universidad Miguel Hernández, Elche, Spain
| | - Jimmy Martin-Delgado
- Junta de Beneficencia de Guayaquil, Hospital de Especialidades Alfredo Paulson, Portoviejo, Ecuador
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias de la Salud, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Daniel García-Torres
- ATENEA Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Alicante, Spain
| | - José Joaquín Mira
- ATENEA Research Group, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Alicante, Spain
- Health Psychology Department, Universidad Miguel Hernández, Elche, Spain
- Conselleria de Sanidad, Health Centre Hospital Provincial-Pla, Alicante-Sant Joan Health District, Alicante, Spain
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Hollaar MHL, Kemmere B, Kocken PL, Denktaş S. Resilience-based interventions in the public sector workplace: a systematic review. BMC Public Health 2025; 25:350. [PMID: 39875936 PMCID: PMC11773882 DOI: 10.1186/s12889-024-21177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 12/20/2024] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND Previous studies have advocated the benefits of resilience-based interventions for creating a healthy and sustainable workforce. However, resilience is defined and measured in diverse ways. Therefore, the aim of this systematic review is (1) to identify how resilience is defined within different workplace interventions, translated into intervention content, and measured in these interventions; and (2) to synthesize the effectiveness of these interventions. METHODS A systematic literature search was conducted and included articles from 2013 - 2023. Twenty-four studies met the inclusion criteria, covering a total of 26 unique interventions. Definitions were categorized as: resilience as a trait, process, or outcome. Cohen's D was calculated to depict the effect sizes within the intervention groups from pre-test to post-test and, when possible, from pre-test to 3-month follow-up. RESULTS Included studies applied a wide range of definitions; most definitions fitted within the trait-orientation, conceptualizing resilience as an individual characteristic or ability, or the process-orientation, conceptualizing resilience as a dynamic process. No studies solely used the outcome-orientation, but some did combine elements of all three orientations. Various definitions, measures and intervention strategies were applied, however, almost half of the studies (46%) showed inconsistencies within these choices. Furthermore, findings show that most resilience-based interventions in the workplace have a positive impact. While educational workshops with a higher frequency and duration had medium to large effects, solely digital interventions had small effects, changing to small to medium when combined with non-digital elements. CONCLUSIONS Findings suggest that resilience-based can benefit employees by enhancing their psychological well-being. This, in turn, can lead to improved work-related outcomes such as productivity, thereby offering advantages to employers as well. This underscores the growing recognition that resilience should be viewed as a shared responsibility between the individual and the organization. Further advancement in the field of resilience-based interventions in the workplace calls for future research to focus on maintaining consistency when choosing a definition of resilience, developing intervention content, and choosing an outcome measure. PREREGISTRATION The search protocol was preregistered in the Open Science Framework, see Hollaar et al. (2023). https://doi.org/10.17605/OSF.IO/UKYF7 .
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Affiliation(s)
- Malin H L Hollaar
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
| | - Bram Kemmere
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Paul L Kocken
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
| | - Semiha Denktaş
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands
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See CRZ, Si S, Hedges E, Tognin S, Modinos G, van der Gaag M, de Haan L, Velthorst E, McGorry P, Nelson B, Riecher-Rössler A, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Ruhrmann S, Sachs G, Rutten BP, van Os J, McGuire P, Valmaggia LR, Kempton MJ. The effects of recent stressful life events on outcomes in individuals at clinical high risk for psychosis: results from the longitudinal EU-GEI high-risk study. Psychol Med 2025:1-11. [PMID: 39773326 DOI: 10.1017/s0033291724003039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2025]
Abstract
BACKGROUND Recent stressful life events (SLE) are a risk factor for psychosis, but limited research has explored how SLEs affect individuals at clinical high risk (CHR) for psychosis. The current study investigated the longitudinal effects of SLEs on functioning and symptom severity in CHR individuals, where we hypothesized CHR would report more SLEs than healthy controls (HC), and SLEs would be associated with poorer outcomes. METHODS The study used longitudinal data from the EU-GEI High Risk study. Data from 331 CHR participants were analyzed to examine the effects of SLEs on changes in functioning, positive and negative symptoms over a 2-year follow-up. We compared the prevalence of SLEs between CHR and HCs, and between CHR who did (CHR-T) and did not (CHR-NT) transition to psychosis. RESULTS CHR reported 1.44 more SLEs than HC (p < 0.001), but there was no difference in SLEs between CHR-T and CHR-NT at baseline. Recent SLEs were associated with poorer functioning and more severe positive and negative symptoms in CHR individuals (all p < 0.01) but did not reveal a significant interaction with time. CONCLUSIONS CHR individuals who had experienced recent SLEs exhibited poorer functioning and more severe symptoms. However, as the interaction between SLEs and time was not significant, this suggests SLEs did not contribute to a worsening of symptoms and functioning over the study period. SLEs could be a key risk factor to becoming CHR for psychosis, however further work is required to inform when early intervention strategies mitigating against the effects of stress are most effective.
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Affiliation(s)
- Cheryl R Z See
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Shuqing Si
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emily Hedges
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gemma Modinos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mark van der Gaag
- Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, Amsterdam UMC, Amsterdam, The Netherlands
- Arkin Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Research, GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | | | - Rodrigo Bressan
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Marie-Odile Krebs
- University Paris Descartes, Hôpital Sainte-Anne, C'JAAD, Service Hospitalo-Universitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Lucia R Valmaggia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
- Department of Psychiatry, KU Leuven, Leuven, Belgium
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Notebaert L, Clarke PJF, Meeten F, Todd J, Van Bockstaele B. Cognitive flexibility and resilience measured through a residual approach. ANXIETY, STRESS, AND COPING 2025; 38:125-139. [PMID: 38767336 DOI: 10.1080/10615806.2024.2353654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/05/2024] [Indexed: 05/22/2024]
Abstract
Background and Objectives: Resilience refers to the process through which individuals show better outcomes than what would be expected based on the adversity they experienced. Several theories have proposed that variation in resilience is underpinned by cognitive flexibility, however, no study has investigated this using an outcome-based measure of resilience.Design: We used a residual-based approach to index resilience, which regresses a measure of mental health difficulties onto a measure of adversity experienced. The residuals obtained from this regression constitute how much better or worse someone is functioning relative to what is predicted by the adversity they have experienced.Methods: A total of 463 undergraduate participants completed questionnaires of mental health difficulties and adversity, as well as a number-letter task-switching task to assess cognitive flexibility.Results: Multiple regression analyses showed that better cognitive flexibility was not associated with greater resilience.Conclusions: Our findings do not support theoretical models that propose the existence of a relationship between cognitive flexibility and resilience. Future research may serve to refine the residual-based approach to measure resilience, as well as investigate the contribution of "hot" rather than "cold" cognitive flexibility to individual differences in resilience.
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Affiliation(s)
- Lies Notebaert
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Patrick J F Clarke
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
- Cognition and Emotion Research Group, Curtin University, Perth, Australia
| | - Frances Meeten
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jemma Todd
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
- Clinical Psychology Unit, School of Psychology, University of Sydney, Sydney, Australia
| | - Bram Van Bockstaele
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
- Developmental Psychopathology, University of Amsterdam, Amsterdam, Netherlands
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16
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Qiao T, Wang X, Ye P. Maternal Psychological Aggression, Problem Behaviors, and the Mediating Roles of Psychological Resilience and Self-Control in Preschoolers. Psychol Res Behav Manag 2024; 17:4383-4398. [PMID: 39735857 PMCID: PMC11673682 DOI: 10.2147/prbm.s497806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 12/16/2024] [Indexed: 12/31/2024] Open
Abstract
Objective This study examines the relationship between maternal psychological aggression (PA) and preschoolers' problem behaviors (PB), focusing on the mediating roles of psychological resilience (PR) and self-control (SC), and gender differences. Methods Mothers of 1141 preschoolers (52.9% boys, 47.1% girls; Mage = 4.26, SD = 0.85) participated in three waves of a longitudinal survey, each two months apart. Mothers participating in this study reported basic demographic information and PA at T1. PR and SC were reported at T2. PB of preschoolers was reported at T3. Path analysis models were employed to ascertain the relationship between PA and PB, as well as the mediating roles of PR and SC. Multiple group analyses were employed to ascertain the moderating role of gender. Results Maternal PA (T1) was positively associated with preschoolers' PB (T3) (β=0.220, p<0.001). PR (T2) and SC (T2) independently and sequentially mediated the relationship between maternal PA (T1) and preschoolers' PB (T3). Maternal PA (T1) was negatively associated with preschoolers' PR (T2) only in boys (β =-0.155, p<0.001), not in girls (β =-0.030, p>0.05). Conclusion This study reveals the impact and underlying mechanisms of maternal PA on preschoolers' PB and highlights gender differences. These findings underscore the importance of protective factors in fostering positive adaptive behaviors in children subjected to maternal PA. Interventions should focus on preventing maternal PA and enhancing children's PR and SC, particularly in boys, to promote healthy and positive behaviors.
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Affiliation(s)
- Tianqi Qiao
- College of Education, Guangzhou University, Guangzhou, People’s Republic of China
| | - Xinxin Wang
- College of Education, Guangzhou University, Guangzhou, People’s Republic of China
| | - Pingzhi Ye
- College of Education, Guangzhou University, Guangzhou, People’s Republic of China
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David MK, Ali A. Spousal Loss- Older Adults' Gender-specific Experiences With Resilience in Pakistan's Sindh Province. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241305487. [PMID: 39602491 DOI: 10.1177/00302228241305487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
Spousal loss among older persons is an emerging public health concern. Older adults from Pakistan's Sindh province may be particularly vulnerable when encountering the tragedy of spousal loss due to their age. Although resilience in older persons who live in social isolation has been researched extensively, less is known about older Sindhi adults' experience of how they achieve resilience after late-life spousal loss, and what different ways of achieving resilience are used by male and female older persons. This study aims to explore how older persons achieve resilience and how ways of achieving resilience differ across gender lines. The criterion-based selection of participants was undertaken before doing interviews. Data were collected via in-depth, semi-structured interviews conducted with twenty six bereaved older adults, ranging in age from sixty two to seventy four, all living in Pakistan's Sindh province. Follow-up discussions with the participants improved the credibility of findings and contributed to the depth and breadth of the study. Employing the concept of resilience as our analytical lens, we identified social engagement, cultural activities and leisurely activities that contributed to the post spousal loss resilience in older persons.
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Affiliation(s)
| | - Ameer Ali
- Government Arts and Commerce College Larkano, Sindh, Pakistan
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18
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Bączyńska E, Zaręba-Kozioł M, Ruszczycki B, Krzystyniak A, Wójtowicz T, Bijata K, Pochwat B, Magnowska M, Roszkowska M, Figiel I, Masternak J, Pytyś A, Dzwonek J, Worch R, Olszyński K, Wardak A, Szymczak P, Labus J, Radwańska K, Jahołkowski P, Hogendorf A, Ponimaskin E, Filipkowski R, Szewczyk B, Bijata M, Włodarczyk J. Stress resilience is an active and multifactorial process manifested by structural, functional, and molecular changes in synapses. Neurobiol Stress 2024; 33:100683. [PMID: 39524934 PMCID: PMC11543545 DOI: 10.1016/j.ynstr.2024.100683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 10/16/2024] [Accepted: 10/18/2024] [Indexed: 11/16/2024] Open
Abstract
Stress resilience is the ability of neuronal networks to maintain their function despite the stress exposure. Using a mouse model we investigate stress resilience phenomenon. To assess the resilient and anhedonic behavioral phenotypes developed after the induction of chronic unpredictable stress, we quantitatively characterized the structural and functional plasticity of excitatory synapses in the hippocampus using a combination of proteomic, electrophysiological, and imaging methods. Our results indicate that stress resilience is an active and multifactorial process manifested by structural, functional, and molecular changes in synapses. We reveal that chronic stress influences palmitoylation of synaptic proteins, whose profiles differ between resilient and anhedonic animals. The changes in palmitoylation are predominantly related with the glutamate receptor signaling thus affects synaptic transmission and associated structures of dendritic spines. We show that stress resilience is associated with structural compensatory plasticity of the postsynaptic parts of synapses in CA1 subregion of the hippocampus.
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Affiliation(s)
- E. Bączyńska
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
- Department of Regenerative Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw, 02-781, Poland
| | - M. Zaręba-Kozioł
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - B. Ruszczycki
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
- AGH University of Krakow, Faculty of Physics and Applied Computer Science, Department of Medical Physics and Biophysics, al. A. Mickiewicza 30, 30-059, Krakow, Poland
| | - A. Krzystyniak
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - T. Wójtowicz
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - K. Bijata
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - B. Pochwat
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
- Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343, Cracow, Poland
| | - M. Magnowska
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - M. Roszkowska
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - I. Figiel
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - J. Masternak
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - A. Pytyś
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - J. Dzwonek
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - R. Worch
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - K.H. Olszyński
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Pawinskiego 5, 02-106, Warsaw, Poland
| | - A.D. Wardak
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Pawinskiego 5, 02-106, Warsaw, Poland
| | - P. Szymczak
- Institute of Theoretical Physics, Faculty of Physics, University of Warsaw, Pasteura 5, 02-093, Warsaw, Poland
| | - J. Labus
- Cellular Neurophysiology, Center of Physiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - K. Radwańska
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - P. Jahołkowski
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0424, Oslo, Norway
| | - A. Hogendorf
- Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343, Cracow, Poland
| | - E. Ponimaskin
- Cellular Neurophysiology, Center of Physiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - R.K. Filipkowski
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Pawinskiego 5, 02-106, Warsaw, Poland
| | - B. Szewczyk
- Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343, Cracow, Poland
| | - M. Bijata
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
| | - J. Włodarczyk
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteur 3, Warsaw, 02-093, Poland
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Li S, Hao C, Ren J. Cross-cultural adaptation and validation of the Chinese version of the Trauma Resiliency Scale (tRS-18). BMC Psychiatry 2024; 24:743. [PMID: 39468545 PMCID: PMC11520583 DOI: 10.1186/s12888-024-06166-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 10/10/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Trauma is a prevalent issue in public health, where individuals who experience physical injuries are also at risk of compromised mental health. Psychological resilience is considered a positive indicator that can predict the prognosis of trauma patients throughout their traumatic experiences. Currently, there is a lack of tools in China for measuring the psychological resilience of trauma patients. The aim of this study was to translate and cross-culturally adapt the Trauma Resiliency Scale (tRS-18) into Chinese and to test its reliability and validity in China. METHODS The Trauma Resiliency Scale (tRS-18) was translated into a Chinese version suitable for the Chinese language environment using the Brislin translation model. A convenience sampling method was used to select 588 trauma patients as study subjects. Reliability was assessed using Cronbach's alpha coefficient, 14-day test-retest reliability, and split-half reliability. Validity was examined through the content validity index, structural validity, and convergent validity. Structural validity was specifically evaluated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS The total variance explained by the single-factor model in the exploratory factor analysis (EFA) of the Chinese version of the tRS-18 was 62.048%, and the factor loading of each item exceeded 0.4. The results of the CFA indicated that the model demonstrated a favorable fit index (X2/df = 1.620; RMSEA = 0.046; SRMR = 0.026; NFI = 0.945; CFI = 0.978; GFI = 0.927; TLI = 0.975; IFI = 0.978). The Cronbach's alpha coefficient of the reliability index was 0.963, the test-retest reliability was 0.970, and the split-half reliability was 0.964, which were all within the reference value range. CONCLUSION The Chinese version of the tRS-18 has good validity and reliability and can be used as an assessment tool for trauma resilience in trauma patients.
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Affiliation(s)
- Shihan Li
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
| | - Chunyan Hao
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China.
- Department of Nursing, Huludao Second People's Hospital, Huludao, P.R. China.
| | - Jiaxin Ren
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
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Chye SM, Kok YY, Chen YS, Er HM. Building resilience among undergraduate health professions students: identifying influencing factors. BMC MEDICAL EDUCATION 2024; 24:1168. [PMID: 39425181 PMCID: PMC11490005 DOI: 10.1186/s12909-024-06127-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 10/03/2024] [Indexed: 10/21/2024]
Abstract
BACKGROUND Resilience contributes to mental well-being, hence expediting recovery from stressful events. Health professions students, in particular, often experience heightened levels of stress and anxiety due to academic demands and other stressors. This study aimed to explore the factors contributing to resilience and identify support systems that universities can implement to help undergraduate health professions students build resilience and manage their mental well-being. METHODS A total of 28 students from the fields of Medicine, Dentistry, Pharmacy, and Dietetics and Nutrition participated in semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The interviews were stopped when data saturation was achieved. The data were analysed using thematic analysis. RESULTS Thematic analysis of the interviews identified five key themes contributing to resilience: life experience, socioeconomic factors, personal attributes, support resources, and role modelling. Universities play a crucial role in fostering resilience among health professions students through soft skills training, workplace-oriented training, mentoring, and extracurricular activities. These opportunities enable students to develop and strengthen resilience in both formal and informal settings. Such initiatives not only equip students to manage future career challenges but also support their overall personal and professional development. CONCLUSIONS This study provided a comprehensive understanding of the contributing factors to health professions students' resilience. The availability of support resources together with a nurturing environment provided by university are crucial. By fostering resilience, students are better prepared to navigate the challenges of the demanding professions and develop the emotional fortitude necessary for long-term success in healthcare.
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Affiliation(s)
- Soi Moi Chye
- IMU Centre for Education & Department of Applied Biomedical Science and Biotechnology, School of Health Science, IMU University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
| | - Yih Yih Kok
- IMU Centre for Education & Department of Applied Biomedical Science and Biotechnology, School of Health Science, IMU University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
| | - Yu Sui Chen
- IMU Centre for Education & Department of Human Biology, School of Medicine, IMU University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
| | - Hui Meng Er
- IMU Centre for Education & School of Pharmacy, Faculty of Medicine and Health Sciences, IMU University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia.
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21
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Li Q, Chen X, Zhu Y, Shi X. Developmental pathways from insomnia to suicidality: A resilience perspective. J Affect Disord 2024; 362:45-53. [PMID: 38942204 DOI: 10.1016/j.jad.2024.06.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Insomnia has been identified as a potential risk factor for suicidality. However, to date, few studies using the longitudinal-design have examined the underlying mechanism of this relationship. Based on a resilience perspective, this study aimed to investigate the dynamic longitudinal relationships between insomnia, resilience, and suicidality. METHODS A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students. This study spanned six waves, covering the period from 2020 to 2022. Data from T1 to T4 were used because resilience was not measured at baseline (T0) and T5. The cross-lagged panel models and the latent growth curve mediation model were used to examine the longitudinal dynamic relationships between insomnia, resilience, and suicidality. RESULTS The results showed that insomnia symptoms and suicidality mutually predicted each other, and resilience played a longitudinal mediating role in linking insomnia symptoms and suicidality. CONCLUSIONS Given that resilience served as a mediator in the relation between insomnia symptoms and suicidality, some resilience-oriented prevention and intervention programs will be helpful in reducing the risk of suicide among university students.
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Affiliation(s)
- Qi Li
- College of Education, Hebei University, Baoding, China
| | - Xiaoyan Chen
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ya Zhu
- Center for Mental Health Education and Counseling, Guangdong University of Science and Technology, Dongguan, China
| | - Xuliang Shi
- College of Education, Hebei University, Baoding, China.
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22
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Bijata M, Wirth A, Wlodarczyk J, Ponimaskin E. The interplay of serotonin 5-HT1A and 5-HT7 receptors in chronic stress. J Cell Sci 2024; 137:jcs262219. [PMID: 39279505 PMCID: PMC11491811 DOI: 10.1242/jcs.262219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 09/11/2024] [Indexed: 09/18/2024] Open
Abstract
Serotonin regulates multiple physiological and pathological processes in the brain, including mood and cognition. The serotonin receptors 5-HT1AR (also known as HTR1A) and 5-HT7R (also known as HTR7) have emerged as key players in stress-related disorders, particularly depression. These receptors can form heterodimers, which influence their functions. Here, we explored the developmental dynamics of 5-HT1AR and 5-HT7R expression and validated heterodimerization levels in the brain of control and stressed mice. In control animals, we found that there was an increase in 5-HT1AR expression over 5-HT7R in the prefrontal cortex (PFC) and hippocampus during development. Using a chronic unpredictable stress as a depression model, we found an increase in 5-HT7R expression exclusively in the PFC of resilient animals, whereas no changes in 5-HT1AR expression between control and anhedonic mice were obtained. Quantitative in situ analysis of heterodimerization revealed the PFC as the region exhibiting the highest abundance of 5-HT1AR-5-HT7R heterodimers. More importantly, upon chronic stress, the amount of heterodimers was significantly reduced only in PFC of anhedonic mice, whereas it was not affected in resilient animals. These results suggest an important role of brain-region-specific 5-HT1AR-5-HT7R heterodimerization for establishing depressive-like behaviour and for development of resiliency.
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Affiliation(s)
- Monika Bijata
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteura 3, 02-093 Warsaw, Poland
| | - Alexander Wirth
- Cellular Neurophysiology, Center of Physiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jakub Wlodarczyk
- Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteura 3, 02-093 Warsaw, Poland
| | - Evgeni Ponimaskin
- Cellular Neurophysiology, Center of Physiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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23
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Padaigaitė‐Gulbinienė E, Hammerton G, Powell V, Rice F, Collishaw S. Modifiable protective factors for mental health resilience in the offspring of depressed parents: A high-risk longitudinal cohort spanning adolescence and adulthood. JCPP ADVANCES 2024; 4:e12240. [PMID: 39411477 PMCID: PMC11472801 DOI: 10.1002/jcv2.12240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/26/2024] [Indexed: 10/19/2024] Open
Abstract
Background Several protective factors have been identified for mental health (MH) resilience in adolescent offspring of depressed parents. However, it is unclear if these effects persist into adulthood. Methods Depressed parents and their offspring (N = 188) from the Early Prediction of Adolescent Depression study were assessed four times (mean offspring ages 12.39, 13.77, 14.82, and 23.41). Mental health resilience was examined using residual scores (better-than-expected mood-, behaviour-, or anxiety-related MH at mean age 23 given risk exposure), and categorically as sustained good MH across adolescence and young adulthood. Results Only 9.2% of young adults demonstrated sustained good MH. Parents of resilient individuals showed lower comorbidity (anxiety, antisocial behaviour and harmful drinking) and higher depression remission. Considering adolescent protective factors, weak evidence was observed of associations of mood-resilience with adolescent peer-relationship quality (β = -0.20, 95%CI:-0.36, -0.04); friendship quality (β = -0.14, 95%CI:-0.31, 0.02); risk adjustment (β = -0.16, 95%CI:-0.34, 0.03) and dysfunctional attitudes (β = 0.18, 95%CI:0.01, 0.35). There was weak evidence of behavioural-resilience association with parent positive expressed emotion (β = -0.15, 95%CI:-0.31, 0.02) and offspring exercise (β = -0.37, 95%CI:-0.77, 0.03). No adolescent protective factors showed an association with anxiety-resilience. For sustained good MH, there was weak evidence of an association with inhibitory control (OR = 0.39, 95%CI:0.14, 1.07). Strong evidence was observed for associations between young adult-reported peer relationship quality and mood-resilience (β = -0.35, 95%CI:-0.53, -0.17), behavioural-resilience (β = -0.33, 95%CI:-0.51, -0.14) and anxiety-resilience (β = -0.34, 95%CI:-0.53, -0.14), while weak evidence was observed of an association of social activities with anxiety-resilience (β = -0.51, 95%CI:-0.97, -0.06). Conclusions We found limited evidence for the long-lasting effects of adolescent protective factors on adult MH resilience. Social factors remained protective into young adulthood, while family factors did not. Early preventative intervention might not be sufficient to maintain good long-term MH, and young people will likely require more prolonged support.
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Affiliation(s)
- Eglė Padaigaitė‐Gulbinienė
- Wolfson Centre for Young People's Mental HealthSection of Child and Adolescent PsychiatryDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
| | - Gemma Hammerton
- Centre for Academic Mental HealthPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
- Medical Research Council Integrative Epidemiology Unit at the University of BristolPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Victoria Powell
- Wolfson Centre for Young People's Mental HealthSection of Child and Adolescent PsychiatryDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
| | - Frances Rice
- Wolfson Centre for Young People's Mental HealthSection of Child and Adolescent PsychiatryDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
| | - Stephan Collishaw
- Wolfson Centre for Young People's Mental HealthSection of Child and Adolescent PsychiatryDivision of Psychological Medicine and Clinical NeurosciencesCardiff UniversityCardiffUK
- Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
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24
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Chrétien A, Hayotte M, Vuillemin A, d'Arripe Longueville F. Resilience profiles of elite athletes and their associations with health-related behaviors, well-being, and performance: A latent profile analysis. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 74:102689. [PMID: 38901549 DOI: 10.1016/j.psychsport.2024.102689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 06/14/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
Resilience is an important factor in the performances of elite athletes as it helps them overcome the adversity they face on a daily basis. It is a dynamic process with resilience qualities evolving throughout athletes' sporting careers. Recent research has established links between resilience, sports performance, lifestyle, and health-related factors. However, no study has yet focused on the resilience profiles of athletes (i.e., sub-groups of individuals with similar levels of different resilience qualities). The aims of this study were to: (a) explore the resilience profiles of elite athletes, (b) determine the characteristics of these resilience profiles (i.e., health-related behaviors, well-being, perceived social support), and (c) determine the correlates of these profiles at intrapersonal and interpersonal levels. Latent profile analysis was performed on 307 French elite athletes. Results revealed "high resilience" and "moderate resilience" profiles. Athletes with "high resilience" profiles were more likely to be men, exhibit better health-related behaviors, and have higher levels of psychological well-being and perceived performance. High levels of conscientiousness, extraversion, the dimensions of the coach-athlete relationship and the motivational climate were also related to the "high resilience" profile. This study is the first to explore the resilience profiles of elite athletes. The results suggest that a high level of resilience is related to the adoption of health-related behaviors favorable to elite sport. Based on these findings, health promotion programs targeting the concept of resilience should be developed in elite sport centers for athletes, coaches, and parents.
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Li S, Wu L, He J, Ge Y, Li S. Early postoperative core symptoms and their relationship with resilience in oesophageal cancer patients-A multicentre cross-sectional study. J Adv Nurs 2024. [PMID: 39176978 DOI: 10.1111/jan.16388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/30/2024] [Accepted: 07/31/2024] [Indexed: 08/24/2024]
Abstract
AIM To assess early postoperative core symptoms in oesophageal cancer patients and their relationship with resilience. BACKGROUND Patients with oesophageal cancer face a high number of severe symptoms in the early post-operative period and require the development of an effective symptom management programme. Identifying core symptoms through network analysis helps in accurate patient care. DESIGN A multicentre cross-sectional study. METHODS A cross-sectional survey was conducted from August 2022 to August 2023 at three hospitals in Anhui Province, China. A total of 469 patients were recruited for this study and 418 (89.1%) patients completed this investigation. Using network analysis to find early post-operative core symptoms in oesophageal cancer patients. Multiple linear regression was used to analyse resilience factors affecting core symptoms. RESULTS Sadness was the most core symptom in oesophageal cancer patients in the early post-operative period (rs = 1.41), followed by incision pain and difficulty breathing while resting (rs = 1.20, rs = 1.08). Resilience was significantly associated with patients' feelings of sadness, with optimism having the greatest impact on sadness (p < .01). CONCLUSION Sadness is the most core symptom in patients in the early post-operative period and special attention should be paid to improving their level of resilience. Local symptoms and dysfunction in the early post-operative period should be treated in a synergistic manner. IMPACT This study identifies core symptoms and their relationship to resilience in patients with oesophageal cancer in the early post-operative period. Symptoms as the main core symptom in patients in the early post-operative period, which was sadness and was significantly associated with resilience. Precise interventions can be made to target patients' core post-operative symptoms, which can help improve the effectiveness of symptom management. REPORTING METHOD We have complied with the relevant EQUATOR research reporting checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution in the study.
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Affiliation(s)
- Shaoxue Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Lijun Wu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jie He
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yaping Ge
- School of Nursing, Anhui Medical University, Hefei, China
| | - Shuwen Li
- School of Nursing, Anhui Medical University, Hefei, China
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26
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Tan WY, Chen JN, Lu SH, Liu CQ, Luo Q, Ma Y, Zhou Y, Wong TKS, Chen HF, Song LQ, Miao CY, Chen JW, Smith GD. Psychometric evaluation of the Chinese version of the Academic Resilience Scale-30 (C-ARS-30) in college students. Front Psychol 2024; 15:1276618. [PMID: 39171240 PMCID: PMC11335623 DOI: 10.3389/fpsyg.2024.1276618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 07/17/2024] [Indexed: 08/23/2024] Open
Abstract
Background Amidst the expansion of student enrollment in higher education, the well-being and retention rates of students have emerged as important concerns. Resilience, especially academic resilience, a multidimensional construct that can lead to academic success in adversity, is pivotal in enabling students to successfully cope with academic challenges. While the Academic Resilience Scale-30 (ARS-30) has been validated as an effective instrument in various languages, its applicability for Chinese students in higher education remains unexplored. Objective This study aims to translate and validate the ARS-30 in Chinese, assessing its reliability and validity among Chinese college students in higher education. Methods A convenience sample of 1,542 students participated in this study. The inventory included the demographic form, Chinese version of ARS-30 (C-ARS-30), 10-item Connor Davidson Resilience Scale (CD-RISC-10), and General Self-Efficacy Scale (GSES). The assessment of validity was conducted by analyzing content validity, construct validity, convergent and discriminant validity, as well as criterion-related validity. Construct validity was evaluated through Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA) and Exploratory Structural Equation Modeling (ESEM). Reliability analysis was performed using Cronbach's alpha and test-retest reliability. Results The C-ARS-30 demonstrated commendable content validity, with the CVI value of items ranging from 0.833 to 1.000, and a total scale CVI of 0.986. ESEM analysis revealed a solid four-factor structure, maintaining the scale's 30 items with excellent fit indices (χ2/df = 2.647, CFI = 0.937, TLI = 0.915, RMSEA = 0.057, SRMR = 0.027). The total score of C-ARS-30 exhibited positive correlations with the CD-RISC-10 (r = 0.542) and the GSES (r = 0.488). The scale demonstrated high internal consistency (Cronbach's α = 0.930) and test-retest reliability (0.794, p < 0.01). Conclusion The C-ARS-30 is a reliable and valid instrument for assessing academic resilience among Chinese college students, offering a valuable tool for educational and psychological evaluations.
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Affiliation(s)
- Wen-ying Tan
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jia-ni Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sui-hua Lu
- School of Guangzhou Health Science College, Guangzhou, Guangdong, China
| | - Chun-qin Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qing Luo
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu Ma
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Thomas K. S. Wong
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hui-fang Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Li-qin Song
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chu-yuan Miao
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jing-wen Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Graeme D. Smith
- School of Health Sciences, Caritas Institute of Higher Education, Tseung Kwan O, Hong Kong SAR, China
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27
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Thorvaldsen S, Hansen KT, Forsberg JT. Children and adolescents weathering the storm: Resilience in the presence of bullying victimization, harassment, and pandemic lockdown in northern Norway. Scand J Psychol 2024; 65:735-746. [PMID: 38574243 DOI: 10.1111/sjop.13012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 04/06/2024]
Abstract
Resilience is a concept of growing interest because it can systematically inform prevention measures and psychosocial interventions for children and adolescents. The aim of this study was to explore resilience factors among young people who are victims of bullying and harassment (age 9 to 16 years old). In 2021 the burden of the pandemic lockdown became an additional adversity. The study used a repeated cross-sectional design. Two datasets with a total of 2,211 participants from 2017 (N = 972) and 2021 (N = 1,239) were included. The strengths and difficulties questionnaire (SDQ) was applied to define the resilient and non-resilient groups, and the quality-of-life questionnaire (KINDL) was used to map resilience factors. A total of 227 participants reported that they were being bullied, and 604 participants reported harassments from their peers. We used correlation and regression analyses to identify which factors predicted the highest resistance to the negative effects of bullying and harassment. The results were that 77.2% of the participants stayed resilient when facing these maladjustments, but this dropped to 61.7% during the pandemic. The most important resilience factors before the pandemic were the school environment, emotional well-being, and good relations with their friends. The impact of these predictors changed during the pandemic. Emotional well-being increased in strength, school environment was reduced, and friends did not predict resilience anymore. The effect sizes were generally large to medium. As it is common to experience adversity at some stage in life, it is vital for families, schools, social and healthcare workers to be aware of the factors associated with resilience. The results of this study may contribute towards an evidence base for developing plans to increase the capacity of resilience among young people.
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Affiliation(s)
| | - Karl T Hansen
- Pedagogical and Psychological Service Troms (PPT), Tromsø, Norway
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28
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Sun H, Wacharasin C, Hengudomsub P. Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China. J Psychosom Res 2024; 183:111538. [PMID: 38823371 DOI: 10.1016/j.jpsychores.2023.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 06/03/2024]
Abstract
OBJECTIVE A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.
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Affiliation(s)
- Haiyan Sun
- Faculty of Nursing, Burapha University, Chon Buri 20131, Thailand; School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu 224005, PR China
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Semkovska M, Joyce C, Keyes J, Reilly S, Delaney A, Harrold A, McManus H. Modelling the Relationship Between Resilience to Depression and Recent Stressful Life Events in University Students. Psychol Rep 2024; 127:1561-1587. [PMID: 36377829 DOI: 10.1177/00332941221139713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Resilience, or successful coping with the experience of stressful life events (SLEs), protects against depression, but its operational mechanisms are unclear. Views diverge whether resilience intervenes as a trait or as a process of dynamic interactions of protective factors, such as self-esteem, social support and family cohesion. We evaluated five theoretically-based models of how resilience, defined as either a trait or a process, interacts with recent SLEs, to explain depressive symptomatology in 2434 university students. The moderating effect of problematic, age-inappropriate parenting (i.e., helicopter parenting) was also assessed. SLEs moderated both the effects of trait and process resilience on depression, but models conceptualising resilience as a dynamic process of interacting components showed better explanatory power than models conceptualising resilience solely as a trait. Trait resilience was protective through self-esteem at all levels of SLEs exposure (low, mild, moderate or high), and significantly, but less so through hope or social support. Experiencing helicopter parenting weakened the protective influence of process resilience, through decreasing family cohesion in the presence of SLEs. The overall assessment of the five models supports a process conceptualisation of resilience to depression in the face of adversity. However, the results also suggest that not all protective factors are equally important, with self-esteem appearing a significant and strong mediator of resilience to depression in all models including it as a variable. Building process resilience is proposed as a key intervention target for depressive symptoms. Clinical assessments and interventions following SLEs should routinely consider both trait resilience and self-esteem, as the interaction of these two factors protects against depression even at the highest levels of adversity exposure. Depression prevention approaches should address the individual's experience of overparenting, given the deleterious influence of helicopter parenting on resilience.
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Affiliation(s)
- Maria Semkovska
- Department of Psychology, University of Southern Denmark, Denmark; Department of Psychology, University of Limerick, Ireland
| | - Ciara Joyce
- Department of Psychology, University of Limerick, Ireland
| | - Jessica Keyes
- Department of Psychology, University of Limerick, Ireland
| | - Sinead Reilly
- Department of Psychology, University of Limerick, Ireland
| | - Aoife Delaney
- Department of Psychology, University of Limerick, Ireland
| | - Aine Harrold
- Department of Psychology, University of Limerick, Ireland
| | - Hannah McManus
- Department of Psychology, University of Limerick, Ireland
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30
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Seidel L, Cawley EI, Blanchard C. Enduring education and employment: Examining motivation and mechanisms of psychological resilience. Scand J Psychol 2024; 65:617-627. [PMID: 38361344 DOI: 10.1111/sjop.13007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
Resilience, the ability to bounce back from difficult events, is critical for an individual to negotiate stressors and adversity. Despite being widely studied, little is known about the processes involved in the development of resilience. The goal of the studies are to investigate the relationship between motivation orientation, emotional intelligence, cognitive appraisals, and psychological resilience. Two studies, using self-report questionnaires were conducted with employed young adults also enrolled in post-secondary studies (pre- and during the pandemic) to test the tenability of our proposed models. Study 1 and Study 2 showed that emotional intelligence and challenge appraisals were mediators of autonomous motivation and resilience. Study 2 revealed statistically significant differences in mean scores of autonomous motivation and emotional intelligence between non-pandemic students and pandemic students. Based on the findings, it is suggested that autonomous motivation, emotional intelligence, and challenge appraisals are important aptitudes for the development of resilience. Furthermore, findings suggest that social isolation caused by the pandemic may have affected levels of emotional intelligence. Ultimately, the research expands the literature on both self-determination theory and resilience by offering a unique multiple mediation model for predicting the development of resilience within the employed undergraduate population.
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Turliuc MN, Balcan AD. Psychological intervention programme for developing resilience in the military personnel. A randomized controlled trial. Stress Health 2024; 40:e3399. [PMID: 38619082 DOI: 10.1002/smi.3399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
Military gendarmes are frequently exposed to events with traumatic impact, with negative effects on emotional and physical health. The present research aims to analyse the effectiveness of Military Resilience Training (MRTR), a psychological intervention programme developed to reduce perceived stress, increase the perception of adaptive resources and strengthen resilience. Ninety-eight participants who met the inclusion criteria were enroled in a single-blind randomized controlled trial. The psychological training programme was implemented in the intervention group (n = 48) for a duration of 5 months. The participants in the control group (n = 50) were scheduled to start the training later. The levels of perceived stress, adaptive resources and resilience were measured in all participants, from the intervention and the control group, before and after the intervention, and at a 3-month follow-up. The effects of the intervention (Cohen's d) were very high for adaptive resources (d = 0.99), self-schemes (d = 1.33), family support (d = 0.70), and partner support (d = 0.66), average for resilience (d = 0.53) and stress (d = 0.49), with very high effects on military task demands (d = 1.19) and averages for friction with authority (d = 0.51). The effects were obtained only in the intervention group, and all gains were maintained at follow-up. This study provides evidence of the effectiveness of MRTR, a psychological intervention implemented in the military gendarmerie population. In the short and long term, MRTR has significant effects in reducing perceived stress, increasing the perception of adaptive resources and strengthening the resilience of military gendarmes.
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Affiliation(s)
| | - Ana-Diana Balcan
- Department of Psychology, Alexandru Ioan Cuza University of Iaşi, Iaşi, Romania
- The Group of Mobile Gendarmes of "Matei Basarab" Ploiești, Ploieşti, Prahova
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Hettwer MD, Dorfschmidt L, Puhlmann LMC, Jacob LM, Paquola C, Bethlehem RAI, Bullmore ET, Eickhoff SB, Valk SL. Longitudinal variation in resilient psychosocial functioning is associated with ongoing cortical myelination and functional reorganization during adolescence. Nat Commun 2024; 15:6283. [PMID: 39075054 PMCID: PMC11286871 DOI: 10.1038/s41467-024-50292-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/03/2024] [Indexed: 07/31/2024] Open
Abstract
Adolescence is a period of dynamic brain remodeling and susceptibility to psychiatric risk factors, mediated by the protracted consolidation of association cortices. Here, we investigated whether longitudinal variation in adolescents' resilience to psychosocial stressors during this vulnerable period is associated with ongoing myeloarchitectural maturation and consolidation of functional networks. We used repeated myelin-sensitive Magnetic Transfer (MT) and resting-state functional neuroimaging (n = 141), and captured adversity exposure by adverse life events, dysfunctional family settings, and socio-economic status at two timepoints, one to two years apart. Development toward more resilient psychosocial functioning was associated with increasing myelination in the anterolateral prefrontal cortex, which showed stabilized functional connectivity. Studying depth-specific intracortical MT profiles and the cortex-wide synchronization of myeloarchitectural maturation, we further observed wide-spread myeloarchitectural reconfiguration of association cortices paralleled by attenuated functional reorganization with increasingly resilient outcomes. Together, resilient/susceptible psychosocial functioning showed considerable intra-individual change associated with multi-modal cortical refinement processes at the local and system-level.
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Affiliation(s)
- Meike D Hettwer
- Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Centre Jülich, Jülich, Germany.
- Max Planck School of Cognition, Leipzig, Germany.
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Lena Dorfschmidt
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lara M C Puhlmann
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Linda M Jacob
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Casey Paquola
- Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Centre Jülich, Jülich, Germany
| | | | | | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Centre Jülich, Jülich, Germany
- Max Planck School of Cognition, Leipzig, Germany
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Sofie L Valk
- Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Centre Jülich, Jülich, Germany.
- Max Planck School of Cognition, Leipzig, Germany.
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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Schellekens MPJ, Zwanenburg LC, van der Lee ML. Resilience in the Face of Cancer: On the Importance of Defining and Studying Resilience as a Dynamic Process of Adaptation. Curr Oncol 2024; 31:4003-4014. [PMID: 39057169 PMCID: PMC11276221 DOI: 10.3390/curroncol31070297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Resilience is defined as the maintenance or relatively quick recovery of mental health during and after adversity. Rather than focusing on psychopathology and its causes, resilience research aims to understand what protective mechanisms shield individuals against developing such disorders and translate these insights to improve psychosocial care. This resilience approach seems especially promising for the field of oncology because patients face stressor after stressor from diagnosis to survivorship. Helping patients to learn how they can best use the resources and abilities available to them can empower patients to handle subsequent stressors. In the past few decades, resilience has increasingly been considered as a dynamic process of adaptation. While researchers use this definition, resilience has not yet been studied as a dynamic process in the field of oncology. As a result, the potential of resilience research to gain insight into what helps protect cancer patients from developing psychopathology is limited. We discuss conceptual and methodological proposals to advance resilience research in oncology. Most importantly, we propose applying prospective longitudinal designs to capture the dynamic resilience process. By gaining insight in how cancer patients engage in protective factors, resilience research can come to its full potential and help prevent psychopathology.
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Affiliation(s)
- Melanie P. J. Schellekens
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| | - Laura C. Zwanenburg
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
| | - Marije L. van der Lee
- Scientific Research Department, Helen Dowling Institute, Expert Centre for Psycho-Oncology, 3720 AB Bilthoven, The Netherlands; (L.C.Z.); (M.L.v.d.L.)
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, 5037 AB Tilburg, The Netherlands
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Song P, Cai X, Qin D, Wang Q, Liu X, Zhong M, Li L, Yang Y. Analyzing psychological resilience in college students: A decision tree model. Heliyon 2024; 10:e32583. [PMID: 38961892 PMCID: PMC11219503 DOI: 10.1016/j.heliyon.2024.e32583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 05/27/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
In the evolving landscape of higher education, particularly in the post-pandemic era, it is crucial for college students to face societal challenges and achieve success by understanding and predicting psychological resilience. To deepen our understanding of psychological resilience, this study used a decision tree model to explore influencing factors. We surveyed 776 college students and collected data on demographic information, self-esteem, sense of school belonging, pro-environmental behavior, subjective well-being, internet game addiction, life autonomy, and academic procrastination using several scales. The decision tree model identified eight key predictors of psychological resilience, which are as follows in order of importance: self-esteem, sense of school belonging, pro-environmental behavior, subjective well-being, academic procrastination, life autonomy, internet game addiction, and academic achievement. This model's accuracy reached 73.985 %, emphasizing its potential utility in educational settings. The findings not only provide a novel and data-driven perspective to understand psychological resilience in college students compared to existing research but also provide practical guidance for educational practitioners and policymakers on how to develop psychological resilience in college students.
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Affiliation(s)
- Pu Song
- Department of Preschool and Early Education, Guiyang Preschool Education College, Guizhou, China
| | - Xuan Cai
- Wenzhou Business College, Zhejiang, China
| | - Dan Qin
- Faculty of Educational Studies, University Putra Malaysia, Kuala Selangor, Malaysia
| | - Qingqing Wang
- Guizhou Aerospace Vocational and Technical College, Guizhou, China
| | - Xiangwei Liu
- School of Distance Education, Universiti Sains Malaysia, Penang, Malaysia
| | - Mengmeng Zhong
- Trade and Tourism Management School, Liuzhou Vocational & Technical College, Liuzhou, Guangxi Province, China
| | - Linying Li
- Division of Multi/Interdisciplinary Studies, Graduate School, Srinakharinwirot University, Thailand
| | - Yan Yang
- Research Institute of Higher Education, Yunnan University, China
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Carlisle K, Kamstra P, Carlisle E, McCosker A, De Cotta T, Kilpatrick S, Steiner A, Kahl B, Farmer J. A qualitative exploration of online forums to support resilience of rural young people in Australia. Front Public Health 2024; 12:1335476. [PMID: 38841668 PMCID: PMC11150697 DOI: 10.3389/fpubh.2024.1335476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Prevention and early intervention are crucial strategies for improving young people's mental health and well-being. Building resilience is a key component of these strategies, especially among young individuals in rural areas who face well-documented mental health disparities. This study aimed to investigate how online mental health forums can contribute to enhancing individual resilience in young rural users. Methods A sample of forum posts (n = 1,000) made by Australian rural users (18-25 years) on an online peer support mental health forum were qualitatively analyzed. The analysis was guided by themes derived from the literature on indicators of rural resilience. Results Analysis of forum posts showed evidence of rural resilience in forum users. Online peer support forums offered a virtual space for individuals to establish social connections, experience a sense of belonging, share information, acquire knowledge, and offer mutual support. There were indications of increased self-efficacy among forum users, as they demonstrated their ability to implement strategies for better managing their mental health. Discussion These findings significantly contribute to our understanding of how online forums can enhance resilience factors that are beneficial for young people living in rural communities. In the context of prevention and early intervention, this study illustrates the intricate connections between forum design and user activity with resilience outcomes, providing valuable insights into the underlying causal mechanisms. Consequently, it emphasizes the importance of incorporating such digital interventions as integral components of mental health service ecosystems.
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Affiliation(s)
- Karen Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | | | - Emily Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | - Anthony McCosker
- Department of Media and Communications, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Tracy De Cotta
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
| | | | - Artur Steiner
- Glasgow Caledonian University, Yunus Centre, Glasgow, United Kingdom
| | | | - Jane Farmer
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
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Ghasempour S, Abbasi A, Basirinezhad MH, Dadgari A, Ebrahimi H. Relationship between resilience and self-efficacy among Iranian nurses: a cross-sectional study during the post-Corona era. BMC Nurs 2024; 23:243. [PMID: 38622581 PMCID: PMC11020472 DOI: 10.1186/s12912-024-01894-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Resilience and self-efficacy play an influential role in nurses' clinical performance, which are considered resources for improving adaptability and promoting work engagement. This study aimed to determine the relationship between resilience and self-efficacy among nurses at Shahroud University of Medical Sciences hospitals during the post-Corona era. METHODS This cross-sectional study was conducted on 280 nurses in all clinical departments. Nurses with a bachelor of science in nursing or higher degree and at least one year of full-time work experience were included in the study using a convenience sampling method. Participants completed a three-part tool, which included the demographic information form, the Connor-Davidson Resilience Scale, and the General Self-Efficacy Scale. The data were analyzed using descriptive statistics and inferential tests (multivariate linear regression using the backward method). RESULTS In this study, nurses reported low levels of resilience (63.64 ± 15.66) and high levels of self-efficacy (63.01 ± 9.57). Among the five resilience subscales, the highest mean item score was associated with "spiritual influences" (2.80 out of 4), while the lowest mean item score was associated with "trust in one's instincts and tolerance of negative affect" (2.36 out of 4). Furthermore, the multivariate linear regression model results indicated that self-efficacy accounted for 33.6% of the variance in resilience (P < 0.001 and β = 0.952). CONCLUSION According to the results of the present study, it is suggested that nurses' psychological capabilities, such as self-efficacy, should be increased to improve resilience and address the stressful conditions of the work environment.
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Affiliation(s)
- Saeed Ghasempour
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Abbasi
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Dadgari
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
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van der Heide A, Dommershuijsen LJ, Puhlmann LMC, Kalisch R, Bloem BR, Speckens AEM, Helmich RC. Predictors of stress resilience in Parkinson's disease and associations with symptom progression. NPJ Parkinsons Dis 2024; 10:81. [PMID: 38605033 PMCID: PMC11009258 DOI: 10.1038/s41531-024-00692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
People with Parkinson's disease (PD) are sensitive to effects of long-term stress, but might differ in stress resilience, i.e. the ability to maintain mental health despite adversity. It is unclear whether stress resilience in PD is predominantly determined by dopamine deficiency, psychosocial factors, or both. In PD animal models, chronic stressors accelerate disease progression, but evidence in humans is lacking. Our objectives were to (1) distinguish stressor-reactive from resilient PD patients, (2) identify resilience factors, and (3) compare symptom progression between stressor-reactive and resilient patients. We conducted a longitudinal survey in Personalized Parkinson Project participants (N = 350 PD). We used the COVID-19 pandemic as a model of a stressor, aligned in time for the entire cohort. COVID-19-related stressors, perceived stress, and PD symptoms were assessed at 11 timepoints (April-October 2020). Both pre-COVID and in-COVID clinical assessments were available. We quantified stressor-reactivity as the residual between actual and predicted perceived stress relative to COVID-19-related stressors, and modeled trajectories of stressor-reactivity across timepoints. We explored pre-COVID predictors of 6-month average stressor-reactivity, and tested whether stressor-reactivity was prospectively associated with one-year clinical progression rates. Latent class trajectory models distinguished patients with high (N = 123) or low (N = 227) stressor-reactivity. Pre-existing anxiety, rumination and non-motor symptom severity predicted high stressor-reactivity (risk factors), whereas quality of life, social support, positive appraisal style and cognitive abilities predicted low stressor-reactivity (resilience factors). PD-specific factors, e.g. disease duration, motor severity, and levodopa use, did not predict stressor-reactivity. The COVID-19 pandemic did not accelerate disease progression, but worsened depressive symptoms in stressor-reactive PD patients.
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Affiliation(s)
- Anouk van der Heide
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands.
- Radboud University, Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands.
| | - Lisanne J Dommershuijsen
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Lara M C Puhlmann
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center, Focus Program Translational Neuroscience, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Bastiaan R Bloem
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Anne E M Speckens
- Radboud University Medical Centre, Department of Psychiatry, Nijmegen, the Netherlands
| | - Rick C Helmich
- Radboud University Medical Centre, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
- Radboud University, Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands
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Thielmann B, Meyer F, Böckelmann I. [Against the mental stress-Resilient work in surgery]. CHIRURGIE (HEIDELBERG, GERMANY) 2024; 95:135-147. [PMID: 37987763 PMCID: PMC10834595 DOI: 10.1007/s00104-023-01977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Surgery represents a challenging medical discipline. AIM This article focuses on psychological stress in surgery and explains resilience as a protective factor against the consequences of psychological stress, based on selected literature references and own relevant clinical experiences. In this context, the sense of coherence, social support and self-efficacy expectation are discussed in more detail as resilience factors. METHOD Narrative review. RESULTS (CORNER POINTS) Surgery is classified as a challenging medical subspecialty with a high reputation but associated with diverse and varied physical and psychological stress factors. Stress factors differ individually in terms of requirements (can be overdemanding or underdemanding but also stimulating, relevant to learning and meaningful, thus positively or negatively stressful) and resources (potentially beneficial working conditions, experience, or behavior, e.g., social support, scope for action). Fluctuations within surgical specialties and a high dropout rate during residency training are well known and the causes include high psychological stress. In the case of persistent and at the same time insufficient compensation of work stress caused by a lack of or insufficient resources, these can be associated with mental illnesses. Nonetheless, many physicians spend their entire lives working in hospital or private surgical settings and remain healthy, a strong sense of resilience to mental illness may be fundamental to this. Resilience can be present as a personal characteristic or it can be learnt through a process or adapted through positive or negative influences, thus strengthening the personal characteristics. Overall, data on surgeon resilience or interventional studies in resilience research in the surgical setting are limited and provide another research gap. Resilience training (directed at a sense of coherence, social support, strengthening knowledge of coping skills, positive emotions, optimism, hope, self-efficacy expectations, control beliefs or robustness), also clearly indicated in the "robust" medical specialty of surgery, is always individual and should not be generalized. If the surgeon cannot retrieve sufficient resources due to the stressful situation, stress management with its methods is helpful to reduce the psychological stress and to be able to maintain the performance and health of this person. CONCLUSION The consolidation of resilience as a notable aspect of employee management. In collegial interactions, resilience must be based on workplace-based approaches to strengthen coping mechanisms in the face of work stress. Workplace-related stress should also be perceived, addressed and counteracted within the organization, certainly also as an elementary management task.
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Affiliation(s)
- Beatrice Thielmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Frank Meyer
- Universitätsklinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität Magdeburg mit Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland.
| | - Irina Böckelmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
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Karska J, Rejek M, Misiak B. Resilience buffers the association between psychotic-like experiences and suicide risk: a prospective study from a non-clinical sample. BMC Psychiatry 2024; 24:32. [PMID: 38191366 PMCID: PMC10775531 DOI: 10.1186/s12888-024-05491-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/01/2024] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Several studies have reported that psychotic-like experiences are associated with low levels of resilience and increased suicide risk. However, it remains unknown as to whether resilience mediates or moderates the association between psychotic-like experiences and suicide risk. Therefore, in this study, we aimed to explore the moderating and mediating effect of resilience in the association between psychotic-like experiences and suicide risk. METHODS A total of 1100 non-clinical, young adults (aged 18 - 35 years) with a negative history of psychiatric treatment were enrolled. Participants were recruited by the snowball sampling methodology through advertisements posted in the online platform. They were followed-up for about 7 months. Variables of interest were recorded using self-reports. Psychopathological assessment was conducted using the Prodromal Questionnaire-16, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Traumatic Experience Checklist, the Childhood Experience of Care and Abuse Questionnaire, the Cannabis Problems Questionnaire, the Connor-Davidson Resilience Scale-10, and the Mini-International Neuropsychiatric Interview. The STROBE statement guidelines were followed. RESULTS The moderation analysis revealed that higher levels of psychotic-like experiences and related distress at baseline were associated with significantly higher suicide risk at the follow-up after adjustment for baseline sociodemographic characteristics, depressive and anxiety symptoms, a history of childhood trauma, and problematic cannabis use. The interaction between follow-up resilience and distress related to baseline psychotic-like experiences was significantly and negatively associated with suicide risk at the follow-up. Specifically, the correlation between the level of distress related to psychotic-like experiences and suicide risk was significant and positive only in participants with lower levels of resilience. This interaction did not reach statistical significance for the baseline level of psychotic-like experiences. No significant mediating effect of the follow-up resilience level in the association between baseline psychotic-like experiences and the follow-up suicide risk was found. CONCLUSIONS Findings from the present study indicate that resilience might protect against suicide risk in people with psychotic-like experiences. These findings could be applied in the formulation of early intervention strategies aimed at mitigating the risk of suicide. Future studies need to explore the effects of interventions targeting resilience for individuals with psychotic-like experiences.
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Affiliation(s)
- Julia Karska
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, Wroclaw, 50-367, Poland
| | - Maksymilian Rejek
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, Wroclaw, 50-367, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, Wroclaw, 50-367, Poland.
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Hassan A, Brooks BL, McArthur BA, Beauchamp MH, Craig W, Doan Q, Zemek R, Yeates KO. Dynamic Relations Between Psychological Resilience and Post-Concussion Symptoms in Children With Mild Traumatic Brain Injury Versus Orthopedic Injury: An A-CAP Study. J Neurotrauma 2024; 41:135-146. [PMID: 37485612 DOI: 10.1089/neu.2023.0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Higher psychological resilience is correlated with less severe post-concussion symptoms (PCS) after mild traumatic brain injury (mTBI) in children, but the directional nature of this relationship remains uncertain. Although traditionally regarded as a stable, trait-like construct, resilience may be malleable and potentially influenced by mTBI and post-concussive symptoms. The current study sought to examine the stability of resilience, elucidate the dynamic nature of the resilience-PCS relation, and determine whether resilience-symptom associations are specific to mTBI or applicable to traumatic injury in general. Participants were children aged 8-16.99 years with either mTBI (n = 633) or orthopedic injury (OI; n = 334) recruited to participate in a prospective cohort study after presenting acutely to five Canadian pediatric emergency departments (EDs). Symptoms and psychological resilience were assessed at 1 week, 3 months, and 6 months post-injury. Group differences in resilience over time were examined using a mixed linear model, and associations between resilience and symptoms over time were examined using random intercepts cross-lagged panel modeling (RI-CLPM). The mTBI group reported significantly lower resilience than the OI group, but the difference was significantly larger 1 week post-injury (d = 0.50) than at 3 months (d = 0.08) and 6 months (d = 0.10). Cross-lagged panel models indicated that resilience had both stable and dynamic aspects, and both affected and was affected by PCS, although their association varied by time post-injury, symptom measure, and reporter (parent vs. child). Higher parent-reported cognitive symptom severity at 1 week was significantly associated with higher resilience at 3 months (β = 0.23, p = 0.001). Higher resilience at 3 months was associated with lower levels of parent-reported somatic symptom severity (β = -0.14, p = 0.004) and fewer total symptoms (β = -0.135, p = 0.029) at 6 months. Higher resilience at 3 months was associated with fewer child-reported symptoms at 6 months (β = -0.11, p = 0.030) and, reciprocally, fewer child-reported symptoms at 3 months were associated with higher resilience at 6 months (β = -0.22, p = 0.001). Notably, injury group was not a significant moderator in cross-lagged models, suggesting that resilience-symptom associations are not specific to mTBI. Psychological resilience and symptoms have bidirectional relationships after injury. Interventions designed to foster resilience have the potential to promote recovery after mTBI specifically and injury more generally.
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Affiliation(s)
- Ali Hassan
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Brian L Brooks
- Departments of Pediatrics, Clinical Neurosciences, and Psychology, and Alberta Children's Hospital Research Institute, University of Calgary, Alberta Children's Hospital, Neurosciences Program, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Departments of Psychology and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal and Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - William Craig
- Department of Pediatrics, University of Alberta, and Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Quynh Doan
- Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Roger Zemek
- Department of Pediatrics and Emergency Medicine, Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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Yashadhana A, Zwi AB, Brady B, De Leeuw E, Kingsley J, O'Leary M, Raven M, Serova N, Topp SM, Fields T, Foster W, Jopson W, Biles B. Gaawaadhi Gadudha: understanding how cultural camps impact health, well-being and resilience among Aboriginal adults in New South Wales, Australia-a collaborative study protocol. BMJ Open 2023; 13:e073551. [PMID: 38135326 DOI: 10.1136/bmjopen-2023-073551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in 'cultural camps' held on sites of cultural significance promotes health and well-being. METHODS AND ANALYSIS The study will be undertaken in close collaboration and under the governance of traditional cultural knowledge holders from Yuwaalaraay, Gamilaraay and Yuin nation groups in New South Wales, Australia. Three cultural camps will be facilitated, where participants (n=105) will engage in activities that foster a connection to culture and cultural landscapes. A survey assessing connection to culture, access to cultural resources, resilience, self-rated health and quality of life will be administered to participants pre-camp and post-camp participation, and to a comparative group of Aboriginal adults who do not attend the camp (n=105). Twenty participants at each camp (n=60) will be invited to participate in a yarning circle to explore cultural health, well-being and resilience. Quantitative analysis will use independent samples' t-tests or χ2 analyses to compare camp and non-camp groups, and linear regression models to determine the impact of camp attendance. Qualitative analysis will apply inductive coding to data, which will be used to identify connections between coded concepts across the whole data set, and explore phenomenological aspects. Results will be used to collaboratively develop a 'Model of Cultural Health' that will be refined through a Delphi process with experts, stakeholders and policymakers. ETHICS AND DISSEMINATION The study has ethics approval from the Aboriginal Health and Medical Research Council (#1851/21). Findings will be disseminated through a combination of peer-reviewed articles, media communication, policy briefs, presentations and summary documents to stakeholders.
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Affiliation(s)
- Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony B Zwi
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Brooke Brady
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Evelyne De Leeuw
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- École de Santé Publique, l'Université de Montréal, Montréal, Quebec, Canada
| | - Jonathan Kingsley
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Michelle O'Leary
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Miri Raven
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Nina Serova
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephanie M Topp
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ted Fields
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Warren Foster
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Wendy Jopson
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Brett Biles
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Zelčāne E, Pipere A. Finding a path in a methodological jungle: a qualitative research of resilience. Int J Qual Stud Health Well-being 2023; 18:2164948. [PMID: 36606329 PMCID: PMC9828684 DOI: 10.1080/17482631.2023.2164948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023] Open
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
| | - Anita Pipere
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia
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Krause-Sorio B, Siddarth P, Milillo MM, Kilpatrick LA, Narr KL, Lavretsky H. Regional gray matter volume correlates with anxiety, apathy, and resilience in geriatric depression. Int Psychogeriatr 2023; 35:698-706. [PMID: 37381880 DOI: 10.1017/s1041610223000510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES Geriatric depression (GD) is associated with significant medical comorbidity, cognitive impairment, brain atrophy, premature mortality, and suboptimal treatment response. While apathy and anxiety are common comorbidities, resilience is a protective factor. Understanding the relationships between brain morphometry, depression, and resilience in GD could inform clinical treatment. Only few studies have addressed gray matter volume (GMV) associations with mood and resilience. PARTICIPANTS Forty-nine adults aged >60 years (38 women) with major depressive disorder undergoing concurrent antidepressant treatment participated in the study. MEASUREMENTS Anatomical T1-weighted scans, apathy, anxiety, and resilience data were collected. Freesurfer 6.0 was used to preprocess T1-weighted images and qdec to perform voxel-wise whole-brain analyses. Partial Spearman correlations controlling for age and sex tested the associations between clinical scores, and general linear models identified clusters of associations between GMV and clinical scores, with age and sex as covariates. Cluster correction and Monte-Carlo simulations were applied (corrected alpha = 0.05). RESULTS Greater depression severity was associated with greater anxiety (r = 0.53, p = 0.0001), lower resilience (r = -0.33, p = 0.03), and greater apathy (r = 0.39, p = 0.01). Greater GMV in widespread, partially overlapping clusters across the brain was associated with reduced anxiety and apathy, as well as increased resilience. CONCLUSION Our results suggest that greater GMV in extended brain regions is a potential marker for resilience in GD, while GMV in more focal and overlapping regions may be markers for depression and anxiety. Interventions focused on improving symptoms in GD may seek to examine their effects on these brain regions.
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Affiliation(s)
- Beatrix Krause-Sorio
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Prabha Siddarth
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Michaela M Milillo
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Lisa A Kilpatrick
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Li Y, Zhang Z, Ma X, Zhang X, Li S. A latent class analysis of resilience and its association with patient-reported symptoms in patients with esophageal cancer after esophagectomy. Front Psychol 2023; 14:1241129. [PMID: 37881212 PMCID: PMC10595953 DOI: 10.3389/fpsyg.2023.1241129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose To identify the latent classes of resilience in patients with esophageal cancer after esophagectomy and develop a deeper understanding of the association between these classes and patient-reported symptoms. Background China accounts for more than half of the global burden of esophageal cancer, and patients with esophageal cancer experience numerous symptoms that affect their quality of life and prognosis. Given that resilience is a key element that alleviates the progression of symptoms, it may represent a potential means of to enhancing cancer patients' physical and psychological well-being. Methods The study was implemented in the thoracic surgery departments of three tertiary hospitals in eastern China. The participants were patients who were still hospitalized after esophagectomy. Data were gathered by self-report questionnaires, and a latent class analysis was utilized to identify different categories of resilience among the patients. Results A total of 226 patients were recruited. The three classes of resilience identified included high strength and striving (53.5%), medium resilience but weak self-recovery (35.9%), and minimal tenacity and external support (10.6%). Patients with low income (OR = 12.540, p = 0.004) were more likely to be in the minimal tenacity and external support class. Patients without comorbidities (OR = 2.413, p = 0.013) and aged 66-70 years (OR = 4.272, p < 0.001) were more likely to be in the high strength and striving class. The patient-reported symptoms and symptom-related interference of patients after esophagectomy varied considerably among the three categories of resilience. Conclusion Accurate interventions should be devised and executed according to the features of each type of resilience in patients after esophagectomy to maximize intervention efficacy. These findings highlight the important role of precision nursing.
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Affiliation(s)
| | | | | | | | - Shuwen Li
- Department of Nursing, Anhui Medical University, Hefei, China
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Rivas S, Albertos A. Potential connection between positive frustration in family leisure time and the promotion of adolescent autonomy. Front Psychol 2023; 14:1258748. [PMID: 37799524 PMCID: PMC10547906 DOI: 10.3389/fpsyg.2023.1258748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Family relationships during leisure time in adolescence have the potential to promote positive development, particularly in terms of autonomy. However, the scientific literature that links specifically positive family leisure to the development of adolescent autonomy is scarce, and lower when analyzing the role of frustration in leisure time. Grounded in Self-Determination Theory (SDT) this article examines the potential relationship between positive frustration in family leisure time and the promotion of adolescent autonomy. For that purpose, the manuscript addresses four objectives to be discussed consecutively: (1) to delimit the concept of adolescent autonomy and point out the difficulty of parental support; (2) to explore positive frustration, a concept aligned with Csikszentmihalyi's theory of flow, as a construct that can promote socio-emotional development in adolescence; (3) to describe the components of family leisure; and (4) to understand how the experience of optimal frustration may be linked to the development of adolescent autonomy during family leisure time. From this central question, several additional inquiries emerge: the interplay of frustration and failure in adolescence, the importance of parents and adolescents spending quality time together, the enjoyment in structured family leisure time, the autonomy-supportive parenting in leisure time activities in relation to daily activities, the need to strengthen adolescent bonds developed in infancy, and the complexity of paternal and maternal autonomy granting.
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Affiliation(s)
- Sonia Rivas
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
- Institute for Culture and Society, Universidad de Navarra, Pamplona, Spain
| | - Aranzazu Albertos
- School of Education and Psychology, Universidad de Navarra, Pamplona, Spain
- Institute for Culture and Society, Universidad de Navarra, Pamplona, Spain
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Bagereka P, Ameli R, Sinaii N, Vocci MC, Berger A. Psychosocial-spiritual well-being is related to resilience and mindfulness in patients with severe and/or life-limiting medical illness. BMC Palliat Care 2023; 22:133. [PMID: 37697251 PMCID: PMC10494355 DOI: 10.1186/s12904-023-01258-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Improvement of psychosocial-spiritual well-being in patients with life-threatening or life-limiting illness is desirable. Resilience and mindfulness are considered to be helpful for enhancing psychosocial-spiritual well-being. Mindfulness-based interventions have been shown to promote resilience to stress and enhance well-being. However, in medical patients, evidence for the associations between mindfulness and resilience is lacking. We hypothesize patients with higher levels of psychosocial-spiritual well-being demonstrate greater resilience and mindfulness. METHODS 200 patients (mean age = 50.2, SD = 15.5) with serious and or life-limiting illnesses were recruited from the NIH Clinical Center. Patients completed a demographic questionnaire, the NIH-HEALS measure of psychosocial-spiritual well-being, the Connor-Davidson Resilience Scale (CD-RISC-10), and the Mindful Attention Awareness Scale (MAAS). The demographic questionnaire also included a question on current stress level. RESULTS The NIH-HEALS was positively correlated to CD-RISC-10 (rs=0.44, p < 0.001) and MAAS (rs=0.32, p < 0.001). These findings were consistent across all three NIH-HEALS factors. Additionally, CD-RISC-10 and MAAS demonstrated a meaningful relationship to each other (rs=0.46, p < 0.001). All three constructs were inversely related to current stress level. CONCLUSIONS Findings suggest that there is a meaningful relationship between psychosocial-spiritual well-being, mindfulness, and resilience. Mindfulness and resilience are positively correlated in a medical population. Clinical interventions aimed at enhancing psychosocial-spiritual well-being through mindfulness and resilience can be highly promising for patients with severe and or life limiting illness.
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Affiliation(s)
- Polycarpe Bagereka
- Pain and Palliative Care Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Rezvan Ameli
- Pain and Palliative Care Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Ninet Sinaii
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Marcelli Cristine Vocci
- Pain and Palliative Care Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Ann Berger
- Pain and Palliative Care Service, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
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Nesbitt AE, Sabiston CM, deJonge ML, Barbic SP, Kozloff N, Nalder EJ. A scoping review of resilience among transition-age youth with serious mental illness: tensions, knowledge gaps, and future directions. BMC Psychiatry 2023; 23:660. [PMID: 37679708 PMCID: PMC10483804 DOI: 10.1186/s12888-023-05158-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION The study of resilience among transition-age youth (aged 16-29 years) living with serious mental illness (SMI) has provided a promising new direction for research with the capacity to explore individuals' strengths and resources. However, variability in how resilience is defined and measured has led to a lack of conceptual clarity. A comprehensive synthesis is needed to understand current trends and gaps in resilience research among this population. The purpose of the current study was to map how resilience has been conceptualized and operationalized among transition-age youth with SMI, explore resilience factors and outcomes that have been studied, and recommend areas for future research. METHODS A six-stage scoping review methodology was used to systematically identify relevant empirical literature across multiple databases (MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Scopus), addressing transition-age youth diagnosed with SMI and resilience. Topic consultation and reaction meetings were conducted to gather feedback from transition-age youth with SMI, researchers, and clinicians during the review process to enhance the applicability of the review findings. A meta-narrative approach was used to organize included studies into research traditions (i.e., paradigms of inquiry with similar storylines, theoretical and methodological orientations). Resilience factors and outcomes, and the consultative meetings, were analyzed using content analysis. RESULTS Twenty-four studies met inclusion criteria (14 quantitative, 9 qualitative, 1 mixed-method). Four research traditions were identified, each contributing a unique storyline which conceptualized and operationalized resilience in slightly different ways: Stress Adaptation, Person-Environment Interactions, Recovery-Focused, and Critical and Cultural Perspectives. Resilience factors and outcomes were most commonly evaluated at the individual-level or within the immediate environment (e.g., personal characteristics, social support networks). Limited research has explored the influence of macro-level systems and health inequalities on resilience processes. Results from the consultative meetings further demonstrated the importance of health services and sociocultural factors in shaping processes of resilience among youth. CONCLUSION The present results may be used to inform future work, as well as the development of age-appropriate, strengths-based, and resilience-oriented approaches to service delivery. Interdisciplinary and intersectional research that prioritizes community and youth engagement is needed to advance current understandings of resilience among transition-age youth with SMI.
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Affiliation(s)
- Amy E Nesbitt
- Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada.
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Melissa L deJonge
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Skye P Barbic
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Foundry, Vancouver, BC, Canada
- Providence Research, Vancouver, BC, Canada
| | - Nicole Kozloff
- Child, Youth and Emerging Adult Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Emily J Nalder
- Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Nahum M, Sinvani RT, Afek A, Ben Avraham R, Jordan JT, Ben Shachar MS, Ben Yehuda A, Berezin Cohen N, Davidov A, Gilboa Y. Inhibitory control and mood in relation to psychological resilience: an ecological momentary assessment study. Sci Rep 2023; 13:13151. [PMID: 37573400 PMCID: PMC10423230 DOI: 10.1038/s41598-023-40242-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 08/07/2023] [Indexed: 08/14/2023] Open
Abstract
Psychological resilience, the ability to adapt to adversity, is theorized to rely on intact inhibitory control (IC) mechanisms, which underlie one's ability to maintain goal-directed behavior by inhibiting prepotent responses. However, no study to date has explored daily fluctuations of IC performance in relation to resilience. Here, we examined the association between IC and mood measured daily in relation to psychological resilience in young adults in a stressful situation. Baseline resilience was obtained from 144 female and male soldiers during their basic combat training. Then, participants completed an ecological momentary assessment protocol, in which they reported their momentary mood and completed a short IC assessment twice/day for 2 weeks. A hierarchical linear modeling analysis revealed that psychological resilience moderated the relationship between momentary IC and momentary mood, such that better IC was associated with better mood only for those with higher, but not lower, self-reported psychological resilience at baseline. These results show that psychological resilience is manifested in the everyday association between IC and mood. Furthermore, they lend important support to cognitive models of resilience and may have significant contribution to our understanding of resilient behavior in real life.Trial Registration: MOH_2018-0-13_002451.
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Affiliation(s)
- Mor Nahum
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel.
| | - Rachel-Tzofia Sinvani
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Anat Afek
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Rina Ben Avraham
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, USA
| | | | - Ariel Ben Yehuda
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Ramat Gan, Israel
- "Shalvata" Mental Health Center, "Clalit" Health Services, Hod-Hasharon, Israel
| | - Noa Berezin Cohen
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Ramat Gan, Israel
| | - Alex Davidov
- Mental Health Section, Medical Services Center, Israel Defense Forces (IDF), Ramat Gan, Israel
| | - Yafit Gilboa
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
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Tai APL, Leung MK, Geng X, Lau WKW. Conceptualizing psychological resilience through resting-state functional MRI in a mentally healthy population: a systematic review. Front Behav Neurosci 2023; 17:1175064. [PMID: 37538200 PMCID: PMC10394620 DOI: 10.3389/fnbeh.2023.1175064] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Conceptualizations and operational definitions of psychological resilience vary across resilience neuroimaging studies. Data on the neural features of resilience among healthy individuals has been scarce. Furthermore, findings from resting-state functional magnetic resonance imaging (fMRI) studies were inconsistent across studies. This systematic review summarized resting-state fMRI findings in different modalities from various operationally defined resilience in a mentally healthy population. The PubMed and MEDLINE databases were searched. Articles that focused on resting-state fMRI in relation to resilience, and published before 2022, were targeted. Orbitofrontal cortex, anterior cingulate cortex, insula and amygdala, were reported the most from the 19 included studies. Regions in emotional network was reported the most from the included studies. The involvement of regions like amygdala and orbitofrontal cortex indicated the relationships between emotional processing and resilience. No common brain regions or neural pathways were identified across studies. The emotional network appears to be studied the most in association with resilience. Matching fMRI modalities and operational definitions of resilience across studies are essential for meta-analysis.
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Affiliation(s)
- Alan P. L. Tai
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Integrated Centre for Wellbeing, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Bioanalytical Laboratory for Educational Sciences, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mei-Kei Leung
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Xiujuan Geng
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Way K. W. Lau
- Department of Health Sciences, The Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
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50
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Fernandes JB, Domingos J, Almeida AS, Castro C, Simões A, Fernandes S, Vareta D, Bernardes C, Fonseca J, Vaz C, Dias AR, Fernandes T, Godinho C. Enablers, barriers and strategies to build resilience among cancer survivors: a qualitative study protocol. Front Psychol 2023; 14:1049403. [PMID: 37533724 PMCID: PMC10392835 DOI: 10.3389/fpsyg.2023.1049403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 06/27/2023] [Indexed: 08/04/2023] Open
Abstract
Cancer is a life-threatening illness affecting all dimensions of a person's health. Cancer survivors must build resilience to face this adversity and continue their life projects. The present study explores the enablers, barriers, and strategies to build resilience among cancer survivors. This qualitative, descriptive exploratory study will use purposive sampling to recruit cancer survivors and healthcare professionals from two hospital centers in Lisbon and Tagus Valley. Interviews will be conducted until data saturation occurs. Data analysis will be performed using an inductive content analysis process with the help of the QDA Miner Lite database. The findings from this study will generate knowledge that may help stakeholders to identify effective strategies to build resilience among cancer survivors. By implementing strategies to foster resilience, healthcare professionals can potentially promote positive adaptations to cancer by strengthening resilience enablers and reducing the impact of barriers.
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Affiliation(s)
- Júlio Belo Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Josefa Domingos
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
| | - Ana Silva Almeida
- Department of Nursing, Centro Hospitalar de Setúbal EPE, Setúbal, Portugal
| | - Cidália Castro
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Aida Simões
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Sónia Fernandes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Diana Vareta
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Catarina Bernardes
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
| | - Jorge Fonseca
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Department of Gastroenterology, Hospital Garcia de Orta EPE (HGO), Almada, Portugal
| | - Célia Vaz
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Department of Nursing, Centro Hospitalar Barreiro Montijo EPE, Barreiro, Portugal
| | - Ana Rita Dias
- Department of Nursing, Centro Hospitalar Universitário de Lisboa Central, Hospital Santo António dos Capuchos, Lisboa, Portugal
| | - Tatiana Fernandes
- Department of Nursing, Centro Hospitalar Universitário de Lisboa Central, Hospital Santo António dos Capuchos, Lisboa, Portugal
| | - Catarina Godinho
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal
- Nurs* Lab, Almada, Portugal
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