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Clinical Scenario: Athletic identity (AI) can be defined as, "the degree to which an individual identifies with an athlete role, and the values, and social networks associated with that identity," and can pose a problem when athletes do not explore themselves outside of sport. This lack of identity development beyond athletics has the potential to lead to the development of a high AI. High AI in athletes can have positive effects in areas such as performance, however, high AI may also pose negative consequences. The development of such an identity can limit the adaptive responses to substantial life changes such as retirement from sport. This inability to adapt may thereby contribute to mental health problems during the transition. Therefore, the purpose of this study is to better understand the relationship between athletic identity and mental health symptoms so clinicians may provide support to enable positive outcomes after retirement from sport. Clinical Question: What is the influence of athletic identity on mental health symptoms in athletes retiring from sports? Summary of Key Findings: (1) High athletic identity contributes to increased mental health symptoms following retirement. (2) Athletic identity had no relationship to mental health symptoms during the preretirement phase of an athlete's career Clinical Bottom Line: The findings suggest that there is high-quality evidence to support that AI has no relationship with mental health symptoms during the preretirement phase and that athletes with high AI are more likely to experience mental health symptoms during their transition out of or retirement from sport. Strength of Recommendation: The grade of B is recommended by the Strength of Recommendation taxonomy for consistent, limited-quality, patient-oriented evidence that high AI has a strong relationship to mental health symptoms following retirement in athletes. [ABSTRACT FROM AUTHOR]

The current study explored coach and athlete reactions and challenges leading up to the Tokyo 2020 Paralympic Games, with a specific focus on the impacts of the COVID-19 pandemic and the Games' postponement. Nine Australian Paralympic coaches (n = 3) and athletes (n = 6) shared their experiences in semistructured interviews. The thematic analysis highlighted how participants experienced the emergence of the pandemic in different ways, but all were relieved when the late but eventual decision to postpone the Games was made. Regarding lockdown periods (i.e., social-distancing restrictions), some coaches and athletes thrived under the new reality (i.e., training from home, online coaching) while others had more difficulty adjusting. Furthermore, results highlight the many uncertainties still remaining, which continue to influence participants' sport and personal lives. The experiences of coaches and athletes during the COVID-19 pandemic sheds light on strategies and resources that could support Paralympic coaches and athletes during current and future crises. [ABSTRACT FROM AUTHOR]

Qualitative meta-ethnography. Pre-registered with OSF:10.17605/OSF.IO/UTZE6. To understand the patient experience pre- and/or post-lumbar spine surgery. Literature search: A literature search was conducted in MEDLINE, EMBASE, EmCare and CINAHL from inception to October 17, 2022. Study selection criteria: Peer-reviewed qualitative or mixed-method studies of English text investigating the beliefs, perceptions, or experiences of adults (≥18 years old) pre- and/or post-lumbar spine surgery for degenerative, non-traumatic or non-infectious concerns. Data synthesis: The eMERGE meta-ethnography reporting guidelines were followed to create themes and subthemes from the original themes of the included studies. A quality appraisal was performed using the McMaster Quality Appraisal tool. We included 18 studies and identified five themes that were separated into pre- and post-operative categories. The two pre-operative themes included [1]: the influence of physiotherapy interventions on patients' experiences, and [2] the importance of education/the power of communication, and the three post-operative themes included [1]: psychosocial coping [2], redefining oneself post-operatively, and [3] experience with the healthcare system. These findings emphasize the complexity of the peri-operative experience for individuals undergoing lumbar spine surgery. Future research should focus on addressing psychosocial factors that may optimize patient experiences and recovery following LSS. The results of this study identified potential pre-operative and post-operative factors that may influence whether patients' have positive or negative perioperative experiences with lumbar spine surgery. Health care providers should be encouraged to focus on psychosocial factors that can be implemented in the health care system to improve the perioperative experience of patients undergoing lumbar spine surgery. [ABSTRACT FROM AUTHOR]

This Perspectives paper advances understanding of coaching in pediatric rehabilitation. We compare three coaching approaches designed for pediatric rehabilitation: Coping with and Caring for Infants with Special Needs (COPCA), Occupational Performance Coaching (OPC), and Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds). Our objectives are to contrast the theory underpinning the approaches, discuss the evidence for outcomes and hypothesized mechanisms of change, consider the necessary mindsets of effective coaches, and propose directions for research and practice. The coaching approaches have different theoretical bases and are designed for specific contexts, yet are similar in their mechanisms of change and intended outcomes. There is growing evidence of important effects of coaching on coachees' goal achievement, empowerment, and capacity building. Studies indicate that stakeholders value coaching, and provide a preliminary understanding of the mechanisms, including engagement and self-efficacy, by which coaching approaches support clients' self-directed and sustained change. Open, curious, and client-centered practitioner mindsets are fundamental to effective coaching. Coaching is a distinctive group of relational, goal-oriented, and evidence-based approaches that support goal achievement and empowerment. These approaches reflect and advance an ongoing paradigm shift in pediatric rehabilitation—a movement from therapist-as-expert approaches to those that build empowerment and capacity. Coaching is a distinctive group of theory-based approaches that support clients' goal achievement and empowerment, and build capacity Coaching practitioners are collaborative facilitators who assist clients and families with their own discovery of solutions that fit their everyday contexts The evidence suggests that coaching triggers engagement and self-efficacy, which are the mechanisms by which changes in longer-term outcomes occur Open, curious, and client/family-centered practitioner mindsets are fundamental to effective coaching [ABSTRACT FROM AUTHOR]

Because people living with environmental sensitivities are poorly acknowledged in our society, we still know very little about their experiences navigating in the health care system, especially with respect to dental services. Our objective, therefore, was to describe their dental care pathway and better understand their experiences accessing oral health services. A qualitative descriptive study was conducted in partnership with organizations supporting people with environmental sensitivities. Through a criterion sampling technique, 12 people living with environmental sensitivities in Quebec (Canada) were invited to participate in individual semi-structured interviews. These interviews lasted around 90 min and were transcribed to be thematically analysed. Participants faced major barriers accessing dental services and thus lived for long periods of time with unmet dental needs. Their dental care pathways were often delayed or even interrupted for several reasons. First because they were exposed to pollutants upon leaving their house, which rendered their trip to the dentist perilous. Second because dentists lacked knowledge about environmental sensitivities and seemed reluctant to accommodate them. We invite governments, dental professionals, and researchers to develop policies and clinical approaches for improving people living with environmental sensitivities' quality of life and access to dental services. Although environmental sensitivities are recognized as disability in several countries such as Sweden and Germany, people with these conditions face major barriers to access healthcare services. Dental professionals, for instance, are reluctant to acknowledge environmental sensitivities as a disability and seldom accommodate sufferers' special needs. We invite dentists to foster holistic and person-centered approaches and be receptive to the health conditions and needs of people with environmental sensitivities. Dentists could address oral health needs of people with environmental sensitivities by doing home-visits with portable dental equipment as this removes barriers related to their exposure to pollutants. [ABSTRACT FROM AUTHOR]

Background: Nursing students encounter various stressors during their clinical practicum; however, the stressors are not the same during different periods. At present, studies on the stressors and coping styles of nursing students in the middle period of their clinical practicum are rare. Aims: The current study aimed to explore the stressors and coping styles of nursing students in the middle period of their clinical practicum. Methods: A qualitative study with a descriptive phenomenological method was conducted to collect data from 10 nursing students undergoing the middle period of their clinical practicum from December 2020 to February 2021. The data were collected by semistructured interviews using interview outlines prepared in advance. The data were analyzed by Colaizzi's analysis method. Results: The stressors experienced by nursing students in the middle period of their clinical practicum mainly included personal reasons, teaching arrangements, interpersonal relationships, occupational particularity and career planning. Additionally, nursing students coped with the stressors that they face in the clinical practicum by eliminating stressors and regulating emotions. Conclusions: Nursing students experienced various stressors and used a variety of coping styles in the middle period of their clinical practicum, which was different from what occurred in the early and late periods. Targeted interventions should be formulated and implemented to relieve nursing students' stress and guide them to adopt effective coping styles. [ABSTRACT FROM AUTHOR]

Aim: To explore the views and experiences of formal caregivers caring for older inpatients with physical disabilities. Methods: It was a qualitative phenomenological study. Using purposive sampling, twelve formal caregivers were chosen in a tertiary comprehensive hospital in Hangzhou, China. Semi-structured, face-to-face interviews were conducted, guided by open-ended questions that focused on gaining rich insights into participants' views and experiences. Coding reliability thematic analysis was used to guide data analysis and categorize, based on Lazarus and Folkman's theory of transactional coping. Results: Four themes emerged from the data analysis: (1) Caregiving Threats. (2) motivations. (3) Responsibility Management. (4) Fear. Conclusion: Despite facing significant pressure at work, formal caregivers of elderly inpatients with physical disabilities possess the drive and various coping strategies to excel in their role. Identifying caregivers' experiences of care can be helpful in improving resilience to stress and maintaining stability in formal caregivers. [ABSTRACT FROM AUTHOR]

De nombreuses personnes ont été infectées par le COVID-19 et pour une minorité d'entre elles, des symptômes multi-systémiques, fluctuants et impactant la qualité de vie, ont persisté au-delà de 20 jours. Le COVID long a été d'abord défini par les patients eux-mêmes au printemps 2020 pour décrire leurs parcours de non-récupération. Plus précisément, le COVID long est défini comme « une constellation de symptômes physiques et mentaux qui peut persister ou émerger par la suite, façonnant un syndrome multi-systémique et invalidant, qui varie d'un patient à l'autre et qui fluctue dans le temps ». La persistance des symptômes du COVID, la diminution de la qualité de vie, l'incertitude quant à l'avenir, assorties parfois d'un faible soutien social perçu dans l'entourage médical et personnel, ont pu favoriser la survenue d'un trouble dépressif chez les patients atteints de COVID-long. L'objectif de cette recherche a été d'étudier l'effet des symptômes du COVID-long, des incertitudes et de l'altération de la qualité de vie sur les symptômes anxiodépressifs, tout en identifiant l'impact de variables modératrices comme les stratégies de coping et le soutien social. Deux cent quatorze participants atteints de COVID long (âgés de 18 à 68 ans, M = 44 ans, ET = 11), dont 93 % de femmes (n = 200) et 7 % d'hommes (n = 14), ont participé à cette étude quantitative transversale entre les mois d'avril et de juin 2022. Ils ont décrit leurs symptômes et répondu à cinq échelles : l'échelle d'intolérance à l'incertitude (EII), l'échelle des stratégies de coping (WCC), l'échelle de mesure de la qualité de vie (MOS SF-36), l'échelle de soutien social perçu (QSSP), et l'échelle de mesure d'anxiété et de dépression (HADS). Les participants ont déclaré des symptômes de fatigue 91 % (n = 171), de perte de concentration 52 % (n = 111), de douleurs 51 % (n = 110), de troubles du sommeil 49 % (n = 104) et des difficultés de mémorisation 41 % (n = 88). En comparaison avec la population générale, ils présentaient une qualité de vie dégradée, ainsi que des scores d'anxiété, de dépression et d'intolérance à l'incertitude élevés. Les scores aux stratégies de coping étaient également supérieurs aux normes relatives à la population générale, et ceux de la satisfaction du soutien social étaient généralement bons. Il est également apparu que les variables de l'intolérance à l'incertitude, de la qualité de vie et de la dépression étaient toutes corrélées entre elles. Par ailleurs, l'analyse de régression a permis de mettre en évidence les prédicteurs de la dépression. Ainsi les domaines de la qualité de vie Bien être émotionnel (β = –0,41, t (199) = –6,23, p < 0,01) et Fatigue/énergie (β = –0,16, t (199) = –2,83, p < 0,01) étaient des prédicteurs négatifs de la dépression, tout comme le score de coping centré sur le problème (β = –0,14, t (199) = –2,84, p < 0,05). Les symptômes de la maladie en lien avec les difficultés de concentration (β = 0,27, t (199) = 5,16, p < 0,01) et ceux impactant les projets (β = 0,18, t (199) = 3,31, p < 0,01) étaient quant à eux des prédicteurs positifs de la dépression. Le deuxième constat de cette étude est que les personnes prises en charge spécifiquement pour leur COVID long présentaient des scores significativement moins élevés d'anxiété et d'intolérance à l'incertitude malgré des scores à certaines dimensions de la qualité de vie plus faibles. Également, les personnes prises en charge dans notre étude développaient davantage de stratégies de coping basées sur le problème et déclaraient davantage de disponibilité et de satisfaction liées au soutien social. Enfin, sur le plan de la qualité de vie, la population prise en charge a exprimé une meilleure santé psychique. L'étude a montré, outre l'influence des symptômes du COVID long, de la qualité de vie, et des stratégies de coping sur les symptômes dépressifs, que la prise en charge spécifique des patients atteints de COVID long semble constituer en elle-même un facteur de protection de la dépression et de l'anxiété. Il apparaît donc essentiel que tout patient présentant un COVID long puisse bénéficier d'une prise en charge pluridisciplinaire spécifique à cette pathologie. Many people were infected by COVID-19 and for a minority of them, symptoms persisted beyond twenty days. These symptoms are multi-systemic, fluctuating, and impact the quality of life. Long COVID was first defined by patients themselves in the spring of 2020 to describe their recovery problems. Specifically, long COVID is defined as "a constellation of physical and mental symptoms which can persist or emerge afterwards, generating a multi-systemic and disabling syndrome, which varies from patient to patient and fluctuates over time". The persistence of COVID symptoms, the decrease in the quality of life, the uncertainly about the future sometimes accompanied by a low level of social support perceived in the medical and personal entourage may have triggered the occurrence of a depressive disorder in patients with long COVID. The objective of this research was to study the effect of long COVID symptoms, of uncertainty and the impairment of quality of life on the development of depressive symptoms, while identifying the impact of moderating variables such as coping strategies and social support. Two hundred and fourteen participants with long COVID (aged 18–68, M = 44, SD = 11), including 93 % females (n = 200) and 7% males (n = 14), participated in this cross-sectional quantitative study between the months of April and June 2022. They described their symptoms and responded to five scales: the Evaluation of Intolerance of Uncertainty Scale (EII), the Coping Strategies Checklist (WCC), the Medical Outcome Study Short Form 36-item health survey (MOS SF-36), the Perceived Social Support Questionnaire (QSSP), and the Hospital Anxiety and Depression Scale (HADS). 91% of the participants reported symptoms of fatigue (n = 171), 52% a loss of concentration (n = 111), 51% pain (n = 110), 49 % trouble sleeping (n = 104), and 41% memory problems (n = 88). Compared with the general population, they presented a poorer quality of life, as well as high scores for anxiety, depression, and intolerance of uncertainty. Scores on coping strategies were also higher than the norms for the general population, and scores on satisfaction with social support were generally good. It was also found that the variables of intolerance of uncertainty, quality of life, and depression all correlated with each other. Furthermore, the regression analysis revealed predictors of depression. The areas of quality of life and emotional well-being (β = –0.41, t(199) = –6.23, P < 0.01) and fatigue/energy (β = –0.16, t(199) = –2.83, P < 0.01) were negative predictors of depression, as was the problem-focused coping score (β = –0.14, t(199) = –2.84, P < 0.05). Symptoms of the disorder related to concentration difficulties (β = 0.27, t(199) = 5.16, P < 0.01) and those impacting projects (β = 0.18, t(199) = 3.31, P < 0.01) were positive predictors of depression. The second finding of this study is that people treated specifically for their long COVID had significantly lower scores for anxiety and intolerance of uncertainty despite lower scores for certain dimensions of quality of life. The individuals who took part in our study also developed more problem-based coping strategies and reported more availability of and satisfaction with social support. Lastly, in terms of quality of life, the treated population expressed better mental health. The study showed that, in addition to the effects of long COVID symptoms, quality of life, and coping strategies on the onset of symptoms of depression, the specific treatment of patients with long COVID seemed to constitute in itself a protective factor against depression and anxiety. It therefore would seem essential that any patient suffering from long COVID should receive multidisciplinary care specific to this pathology. [ABSTRACT FROM AUTHOR]

Greek health care workers (HCWs) working with refugee and asylum‐seeker populations may be at risk of trauma exposure and related distress. The current study sought to further understand the factors that may promote or hinder psychological adaptation among HCWs working with trauma‐exposed refugee populations in Greece. Participants were HCWs (N = 20) who completed semistructured interviews. Thematic analysis procedures identified three main themes: vicarious traumatization, (b) mismatch of expectations, and (c) difficulty coping. Our study findings highlight the need to provide adequate training, supervision, and mental health support for HCWs to prevent mental health issues in this population. Additional studies are necessary to understand the long‐term consequences of working with refugee populations and explore ways to assist HCWs with self‐care. [ABSTRACT FROM AUTHOR]

Academic stress is a problem that affects students due to a number of factors that are considered stressors. These include academic overload and completion of assignments and exams, exacerbated by such external conditions as family, social and economic problems. Together, these can affect emotional and physical health, which may lead in the long term to developing a number of pathologies, given the alteration of immunological homoeostasis with which they are related. Objective: To evaluate the effect of academic stress on the production of cytokines IL‐6, TNF‐α, IL‐1β and IL‐10 in Morphology students in the Faculty of Health Sciences of the Universidad del Cauca during an academic period. Methodology: A descriptive longitudinal study was carried out with a population of 78 students studying Morphology, among the subjects with the highest academic load in the Physiotherapy, Medicine, Nursing and Phonoaudiology programs in the Faculty. Academic stress was assessed in the students by applying the Academic Stress Questionnaire (ASQ), and through quantification of the IL‐6, TNF‐α, IL‐1β and IL‐10 cytokines using the ELISA (Enzyme‐linked immunosorbent assay) technique in three "moments" of the academic semester: Moment 1: beginning of the academic semester; Moment 2: week of evaluations of 70% of the semester; Moment 3: week of final exams. Results: The students perceived stress as "normal" at Moment 1, while at Moments 2 and 3 it was perceived as "quite a lot", with percentages of 48.7% and 50%, respectively. The predominant stressors were: "methodological deficiencies", "academic overload", and "exams", for the three moments of the study. "Physical exhaustion" was the most prevalent stress response at all three moments, followed by "irascible behaviour" (Moment 2 and 3), and "sleep disturbances" (Moment 3). To cope with the stress, the students resorted mainly to "planning and management of personal resources" in the three moments of the study. A progressive increase in the pro‐inflammatory cytokines IL‐6 and TNF‐α and a decrease in IL‐10 were observed at all three moments. A correlation was found between some questions belonging to the "methodological deficiencies", "beliefs about performance", "sleep disturbances", "physical exhaustion" and "irascible behaviour" dimensions with IL‐6, IL‐1β, TNF‐α and IL. −10. Conclusion: The morphology students suffer increased stress indicators (perceived stress and pro‐inflammatory cytokines) throughout the academic period. The "methodological deficiencies", "academic overload" and "exams" stressors, together with "physical exhaustion", "sleep disturbances" and "irascible behaviour", possibly influence the production of the IL‐6, TNF‐α and IL‐10 cytokines. [ABSTRACT FROM AUTHOR]

Listening to people talk about their trauma experiences involves indirect exposure to trauma (IET) and can trigger emotional distress. Existing studies about the risk factors for post‐IET distress have methodological limitations and reported inconsistent results, making their findings difficult to meaningfully synthesise. Also, most of them did not focus explicitly on trauma narratives and did not explore qualitatively the opinions and experiences of professionals who work closely with trauma survivors. The present study involved 36 professionals who worked with trauma survivors and used a qualitative design to investigate: (a) the perceived impact of the survivors' accounts, (b) the factors they deemed as important to be psychologically prepared for trauma accounts, and (c) their strategies for coping with IET. The semi‐structured interviews conducted yielded rich data that was analysed thematically and organised in 13 subordinate themes, and 4 master themes. Listening to trauma narratives was thought to lead to emotional distress when it challenges the listener's 'basic assumptions' of safety and justice, when the listener has reduced sense of control and operates outside their 'window of tolerance', when empathic responses are too strong, and psychological preparedness for trauma‐narratives is perceived as insufficient. Recommendations for future research and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Disasters can lead to decreased functionality in medical practice. This study aimed to quantitatively measure presenteeism and to determine the role of coping strategies among disaster‐victim doctors living in a city affected by the 2023‐Turkey earthquakes. This cross‐sectional study included 220 doctors reached through social media groups using the convenience sampling method. A weak negative relationship was found between presenteeism and positive re‐evaluation, one of the coping strategies with earthquake stress. A weak negative correlation was found between the Positive Reappraisal sub‐dimension score of the Coping with Earthquake Stress Scale (CESS) and presenteeism (r = −0.299, p < 0.001). In the linear regression analysis, the sub‐dimensions that contributed significantly to the model were found to be the Positive Reappraisal sub‐dimensions of CESS, whose increase resulted in a decrease in presenteeism and Seeking Social Support sub‐dimension, whose increase caused an increase in presenteeism. Presenteeism was higher in those who lost their loved ones, had damage in their workplace/home, and thought they were helpless or in danger. Both material and emotional factors decreased functionality at work after an earthquake. We recommend developing material and psychological support strategies to reduce presenteeism in post‐disaster periods. [ABSTRACT FROM AUTHOR]

Individuals who have been exposed to trauma experience high levels of sleep impairment. Given the well‐established negative effects of stress on sleep, the ways in which trauma‐exposed individuals cope with stress is likely to be associated with their sleep. This study examined how the use of health behaviours (i.e., exercise, comfort eating, and maintaining a self‐care routine) to cope relate to sleep impairment in a community sample of trauma‐exposed adults (N = 84, mean age = 35.1, 83% female). We also tested whether use of health behaviours to cope moderates the relationship between psychological distress and sleep impairment. Results demonstrate that exercise and maintaining a self‐care routine to cope are associated with less sleep impairment, while comfort eating to cope is associated with greater sleep impairment. Further, comfort eating to cope moderated the relationship between distress and sleep impairment. Findings suggest that the use of health behaviours to cope is differentially associated with sleep impairment, which has important clinical and research implications for the health of trauma‐exposed adults. [ABSTRACT FROM AUTHOR]

There is an empirical association between stress and symptoms of food addiction (FA), but it is still not clear which domains of stress are the most relevant when it comes to FA, limiting the ability of researchers and practitioners to address problematic eating‐related health outcomes. In order to address this gap in the literature, we analysed how different domains of chronic stress are related to FA. We used data from a subsample of the LIFE‐Adult‐Study (N = 1172), a German cohort study. We conducted a linear regression analysis with stress domains (Trier Inventory for Chronic Stress, TICS) as predictors of FA (Yale Food Addiction Scale, YFAS). In the second regression analysis we included sociodemographic variables, personality, and smoking as control variables. There was a significant and positive association between Social Overload, Work Discontent, Excessive Demands from Work, and Chronic Worrying and FA. After adding control variables, only Social Overload, Excessive Demands from Work, and Chronic Worrying remained significant predictors. Connections between stress domains and FA can serve as starting points for the development of meaningful interventions that support individuals self‐care strategies (Social Overload), complexity management (Excessive Demands from Work), and coping with negative emotions (Chronic Worrying). [ABSTRACT FROM AUTHOR]

Stress forecasting is the cognitive process of anticipating and preparing to respond to future stress experiences based on one's own perceived future stress. Though it may seem intuitive that stress forecasting predicts stress, competing theories exist that indicate the relationship is not so inherent. In this paper we conducted two studies which both examine the relationships between stress forecasting and day stress, examining two different stress domains (appraisal and coping). Participants in Study 1 (n = 143 working adults) and Study 2 (n = 60 undergraduate students) completed 4 and 14 days, respectively, of ecological momentary assessment reports of stress appraisal forecasting, stress coping forecasting, stress appraisal reports, and stress coping reports, for a combined total of 5280 completed assessments. Exploratory analysis in Study 2 examined the importance of morning forecast discrepancy in relation to evening recalls of day stress. Results indicate that within domain (e.g., stress appraisal to appraisal reports), or domain specific, stress forecasting is predictive of day stress, and that across domains (e.g., stress appraisal to coping reports), or domain crossover, was consistent between stress appraisal forecasting and stress coping reports. Results suggest that magnitude of bias and day outlook (i.e., being either optimistic or pessimistic) about one's coping ability matters for day stress outcomes. Findings have implications for developing challenge‐based thinking interventions and further understanding cognitive processes for building stress management strategies. [ABSTRACT FROM AUTHOR]

The present study harnessed job demands‐resources theory to identify key predictors of psychological strain (feeling overwhelmed by one's problems) and life satisfaction among a sample of 1060 adults randomly selected from the Australian electoral roll. The investigation sought to ascertain: (a) the relative contribution of health demands (e.g., inadequate health treatment) and health resources (e.g., access to helpful health‐related information) in predicting psychological strain and life satisfaction, (b) the extent to which a recently proposed personal resource—adaptability—explained variance in wellbeing beyond individuals' health demands and resources, and (c) the role of psychological strain in predicting life satisfaction in the context of these demands and resources. Applying structural equation modelling we found that contextual health demands predicted greater psychological strain, individual health resources and adaptability both predicted lower psychological strain and greater life satisfaction, and psychological strain predicted lower life satisfaction. Notably, the adverse effects of health demands reduced significantly when health resources and adaptability were entered into the modelling. Taken together, the findings offer support for a health demands‐resources framework that may be applied to better support individuals to respond to the stressors in their lives and in turn boost their sense of subjective wellbeing. [ABSTRACT FROM AUTHOR]

Numerous studies have pointed to the strong impact of stressful life events on subjective stress and indirectly on the adolescents' mental health. However, the results of many such studies contain bias caused by the choice of measurement method or an incomplete theoretical framework. To estimate the extent of possible bias when using self‐reports, we conducted research on a representative sample of 2201 Croatian adolescents aged 14–18 years. Using manipulation we examined the influence of measurement method and the number of constructs included in the model on the variance of subjective stress explained by stressful events. Structural equation modelling indicated that different measurement methods, occurrence‐based and severity‐based, provide a marked discrepancy in the impact size estimation. The occurrence‐based method provided estimates of a much smaller proportion of the explained variance (6%–25%) compared to the severity‐based approach, which estimated the explained variance in the range of 25%–55% depending on the model. The complexity of the tested models additionally contributed to the variation in the estimates. It is recommended that when using self‐reports to measure stressful life events, occurrence‐based and severity‐based methods are used simultaneously and that impact estimates are expressed within intervals. [ABSTRACT FROM AUTHOR]

To successfully complete a Polar expedition individuals and teams must respond resiliently to the environmental, psychological, and social demands they face. In this study we examined profiles of resilient function in seven people from three expeditions in the High Arctic. Using a structured daily diary, participants reported on experiences of physical health (morning and evening), affect, team cohesion, performance, and potential explanatory factors including sleep, demand appraisals, events, and coping strategies. Notable intra‐ and inter‐individual variability was observed in daily reports and all profiles could be interpreted as representing resilient function. A number of significant relationships were found between markers of resilient physical and psychosocial function and potential explanatory variables. For example, there was much more daily variability in an individual's reporting of positive affect than prior research might imply, and what prior research designs could capture. Further, while negative affect tended to remain low and stable, our findings reveal that even minor and infrequent increases in negative emotions were significantly associated with other variables in the network. Finally, across the expedition period individual coping resources consistently exceeded demands, suggesting that individuals viewed the expedition as a challenge and not a threat. More broadly, these findings inform efforts to monitor, and maintain resilience when operating in Polar and other extreme settings. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic constituted tremendous traumatic stress among the frontline healthcare workers. In the present study, we investigated relationships of two types of rumination, namely brooding and reflection, with traumatic stress and post‐traumatic growth and the mediating role of recollective experience in these relationships. A total of 88 healthcare workers (75% female, Mage = 54.91) actively providing service to COVID‐19 patients reported two memories of events that impacted them the most at the first peak of the pandemic and rated their recollective experience (i.e., phenomenological characteristics of memories). We used structural equation modelling to test whether recollective experience mediated the link of brooding and reflection with post‐trauma reactions of stress and growth. The findings showed that brooding and reflection were associated with higher levels of traumatic stress and post‐traumatic growth. Importantly, recollective experience mediated the relationship of rumination with traumatic stress but this differed for the type of rumination. Higher brooding was associated with greater traumatic stress and that relationship was independent of how well the memories were recollected, while for reflection, high reflection was associated with stronger recollective experience, which predicted higher traumatic stress and post‐traumatic growth. The present study shows the functional dimensions of reflective rumination and presents novel findings that demonstrates the discrete mnemonic mechanisms underlying the association between brooding, reflection, and post‐trauma reactions. [ABSTRACT FROM AUTHOR]

University students consistently report high levels of stress, which has been associated with a range of adverse outcomes. Promoting adaptive coping behaviours, such as problem‐focused coping for managing university stress, is therefore a timely area of investigation. Current coping intervention approaches target reasoned cognitive processes; however, recent research has suggested that automatic processes are more strongly associated with problem‐focused coping behaviour. The current study examined the effect of an implementation intentions intervention, a technique that can support behaviour to be performed automatically by facilitating continued repetition of a plan, on problem‐focused coping behaviour under stress and stress‐related outcomes. Following a pilot study (N = 21), a preregistered randomized controlled trial was conducted with university students (N = 154) using an online survey. Participants completed baseline measures of problem‐focused coping behaviour, behavioural automaticity, behavioural intentions, action planning, perceived stress, procrastination, and psychological wellbeing; before receiving the intervention or control condition stimuli, and then at a 2‐week follow‐up. Behavioural intention and action planning were also measured immediately post‐intervention. The intervention had a significant medium‐sized effect on action planning for problem‐focused coping, but no other significant effects were detected. Exploratory assessment of plan quality revealed medium‐sized correlations between plan quality and changes in problem‐focused coping behaviour. Findings indicate that implementation intentions may be a promising approach for increasing planning for the use of problem‐focused coping. Indicators of plan quality found to be associated with changes in problem‐focused coping provide valuable avenues for intervention optimisation in future research. [ABSTRACT FROM AUTHOR]

Existing literature indicates that academic staff experience increasing levels of work stress. This study investigated associations between day‐to‐day threat and challenge appraisal and day‐to‐day problem‐focused coping, emotion‐focused coping, and seeking social support among academic office workers. This study is based on an Ecological Momentary Assessment (EMA) design with a 15‐working day data collection period utilising our self‐developed STRAW smartphone application. A total of 55 office workers from academic institutions in Belgium (n = 29) and Slovenia (n = 26) were included and 3665 item measurements were analysed. Participants were asked approximately every 90 min about their appraisal of stressful events (experienced during the working day) and their coping styles. For data analysis, we used an unstructured covariance matrix in our linear mixed models. Challenge appraisal predicted problem‐focused coping and threat appraisal predicted emotion‐focused coping. Our findings suggest an association between threat appraisal as well as challenge appraisal and seeking social support. Younger and female workers chose social support more often as a coping style. While working from home, participants were less likely to seek social support. The findings of our EMA study confirm previous research on the relationship between stress appraisal and coping with stress. Participants reported seeking social support less while working from home compared to working at the office, making the work location an aspect that deserves further research. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To read about contemporary UK-based literature on fathers’ experiences of having a child with a learning disability • To recognise that having a child with a learning disability can affect all aspects of a father’s life • To appreciate the need for tailored support for fathers of a child with a learning disability. Children with learning disabilities often require greater levels of support from their parents than other children. However, there can be differences in the caring experiences of mothers and fathers. This literature review aimed to develop an understanding of fathers’ experiences of caring for children with learning disabilities in the UK. Analysis of seven UK studies identified two overarching themes – gender stereotypes in parenthood and loss of imagined future. Findings suggest that parenting a child with a learning disability can be a positive experience for fathers but can involve a journey through loss and grief before eventual acceptance of their child’s condition. Tailored interventions, such as male-only support groups, might help fathers as they move through this journey. [ABSTRACT FROM AUTHOR]

Background Adaptation, to reduce the health impacts of climate change, is driven by political action, public support and events (extreme weather). National adaptation policies or strategies are limited in addressing human health risks and implementation of adaptation in the public health community is not well understood. Aim To identify key issues in climate change adaptation implementation for public health in Europe. Methods Key informant interviews with decision-makers in international, national and local city governments in 19 European countries. Participants were recruited if a senior decision-maker working in public health, environmental health or climate adaptation. Interviews addressed Barriers and levers for adaptation, policy alignment, networks and evidence needs. Results Thirty-two interviews were completed between June and October 2021 with 4 international, 5 national and 23 city/local government stakeholders. Respondents reported inadequate resources (funding, training and personnel) for health-adaptation implementation and the marginal role of health in adaptation policy. A clear mandate to act was key for implementation and resource allocation. Limited cross-departmental collaboration and poor understanding of the role of public health in climate policy were barriers to implementation. Conclusions Across Europe, progress is varied in implementation of climate adaptation in public health planning. Providing appropriate resources, training, knowledge mobilization and supporting cross-departmental collaboration and multi-level governance will facilitate adaptation to protect human health. [ABSTRACT FROM AUTHOR]

Background: The role of family caregivers in the management of cerebrovascular accident survivors is invaluable. So far, there is a strong evidence affirming the effectiveness of family support for cerebrovascular accident survivors. Meanwhile, caring for cerebrovascular survivors can be labour and time intensive and pretty stressful for caregivers. The purpose of the study was to examine the lived experiences of family caregivers of cerebrovascular accident survivors in the Ho Municipality in the Volta Region of Ghana. This aims are to establish their caregivers' knowledge, preparedness, and impact of caregiving on the caregiver, and coping strategies caregivers adopted. Methods: Using a four-item (with 14 prompts) interview guide and descriptive phenomenological approach, we gathered and analysed data from 37 family caregivers in the Ho Municipality of Ghana. Results: We found that caregivers had limited knowledge about cerebrovascular disease-risk factors and were ill-prepared for their caregiving roles. Additionally, we found limited knowledge about coping strategies among the caregivers. We further report that some caregivers lost close relationships, and their jobs because of the caregiving, they also used fasting and prayer as coping strategies. Conclusions: Caregivers suffered broken relationship, loss their jobs and incomes due to their caregiving roles. Moreover, some engaged in fasting and prayers, and alcohol use to cope with the stress associated with caring for the cerebrovascular accident survivors. We discussed the potential implications of our findings on the realisation of the Sustainable Development Goal 3.4. The aim of this goal is to reduce by 75% premature deaths due to cerebrovascular and other non-communicable diseases by 2030. [ABSTRACT FROM AUTHOR]

Purpose: This report provides the experimental, clinical, theoretical, and historical background that motivated a patented transitional intervention and its implementation and evaluation in a field trial for mitigation of debilitating loudness based hyperacusis (LH). Background and Rationale: Barriers for ameliorating LH, which is differentiated here from other forms of hyperacusis, are delineated, including counterproductive management and treatment strategies that may exacerbate the condition. Evidence for hyper-gain central auditory processes as the bases for LH and the associated LH-induced distress and stress responses are presented. This presentation is followed by an overview of prior efforts to use counseling and therapeutic sound as interventional tools for recalibrating the hyper-gain LH response. We also consider previous efforts to use output-limiting sound protection devices in the management of LH. This historical background lays the foundation for our transitional intervention protocol and its implementation and evaluation in a field trial. Conclusions: The successful implementation and evaluation of a transitional intervention, which we document in the outcomes of a companion proof-of concept field trial in this issue, build on our prior efforts and those of others to understand, manage, and treat hyperacusis. These efforts to overcome significant barriers and vexing long-standing challenges in the management and treatment of LH, as reviewed here, are the pillars of the transitional intervention and its primary components, namely, counseling combined with protective sound management and therapeutic sound, which we detail in separate reports in this issue. [ABSTRACT FROM AUTHOR]

Introduction: This clinical focus article describes a structured counseling protocol for use with protected sound management and therapeutic sound in a transitional intervention for debilitating hyperacusis. The counseling protocol and its associated visual aids are crafted as a teaching tool to educate affected individuals about hyperacusis and encourage their acceptance of a transitional intervention. Description of Counseling Components: The counseling protocol includes five components. First, the patient’s audiometric results are reviewed with the patient, and the transitional intervention is introduced. An overview of peripheral auditory structures and central neural pathways and the concept of central gain are covered in the second and third components. Maladaptive hyper-gain processes within the auditory neural pathways, which underlie the hyperacusis condition, and associated connections with nonauditory processes responsible for negative reactions to hyperacusis are covered in the fourth component. Detrimental effects from misused hearing protection devices (HPDs) and the necessity to wean the patient from overuse of HPDs are also discussed. In the fifth component, the importance of therapeutic sound is introduced as a tool to downregulate hyper-gain activity within the auditory pathways; its implementation in uncontrolled and controlled sound environments is described. It is explained that, over the course of the transitional intervention, recalibration of the hyper-gain processes will be ongoing, leading to restoration of normal homeostasis within the auditory pathways. In turn, associated activation of reactive nonauditory processes, which contribute to hyperacusis-related distress, will be reduced or eliminated. As recalibration progresses, there will be less need for protected sound management and sound therapy. Sound tolerance will improve, hyperacusis will subside, and daily activities in typical healthy sound environments will again become routine. Results and Conclusion: The combination of counseling with protected sound management and therapeutic sound is highlighted in companion reports, including a summary of the outcomes of a successful trial of the transitional intervention. [ABSTRACT FROM AUTHOR]

Purpose: This report describes a hearing device and corresponding fitting protocol designed for use in a transitional intervention for debilitating loudnessbased hyperacusis. Method: The intervention goal is to transition patients with hyperacusis from their typical counterproductive sound avoidance behaviors (i.e., sound attenuation and limited exposure to healthy low-level sounds) into beneficial sound therapy treatment that can expand their dynamic range to the point where they can tolerate everyday sounds and experience an improved quality of life. This requires a combination of counseling and sound therapy, the latter of which is provided via the hearing device technology, signal processing, and precision fitting approach described in this report. The device combines a miniature behind-the-ear sound processor and a custom earpiece designed to maximize the attenuation of external sounds. Output-limiting loudness suppression is used to restrict exposure to offending high-level sounds while unity gain amplification maximizes exposure to healthy and tolerable lower level sounds. The fitting process includes measurement of the real-ear unaided response, the realear measurement (REM) system noise floor, the real-ear occluded response, real-ear insertion gain, and the output limit. With these measurements, the device can achieve the prescribed unity gain needed to provide transparent access to comfortable sound levels. It also supports individualized configuration of the therapeutic noise from an on-board sound generator and adaptive output limiting based on treatment-induced increases in dynamic range. Results and Conclusion: The utility of this device and fitting protocol, in combination with structured counseling, is highlighted in the outcomes of a successful 6-month trial of the transitional intervention described in a companion report in this issue. [ABSTRACT FROM AUTHOR]

Background and Objectives Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020–December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. Research Design and Methods This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. Results The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. Discussion and Implications HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations. [ABSTRACT FROM AUTHOR]

Background and Objectives Behavioral expressions of dementia are often stressful for family caregivers to manage as they strive to ensure their relative's needs are met. Guided by Lazarus and Folkman's Transactional Model of Stress and Coping, we identified specific behaviors that disrupt daily routines and challenge the achievement of caregiving goals, and the approaches and strategies caregivers employ to address them. Research Design and Methods We conducted semistructured interviews with 30 family caregivers in rural Appalachia caring for a relative living with dementia. Analysis involved use of open and focused coding processes to identify the ways caregivers managed behaviors and bar graphs to examine management approaches relative to categories of behaviors and caregiver demographic and emotional well-being variables. Results Analyses revealed 10 types of behavioral expressions of dementia associated with confusion, irritability, and resistance to engaging in necessary activities of daily living. Caregiver approaches to managing behaviors included gentle persuasion, being harsh by yelling or threatening, being persistent in expecting the person with dementia to complete the tasks at hand, disengaging by postponing the activity, and employing a combination of strategies. Approaches differed across types of behavior and caregiver demographics and had varying effects on caregiver well-being. Discussion and Implications Uncovering specific behaviors family caregivers of persons living with dementia found bothersome, caregivers' adaptive strategies for managing behaviors, and the impact of those approaches provides new information to inform training on effective dementia caregiving practices and development of targeted intervention programs for dementia care. [ABSTRACT FROM AUTHOR]

Phenomenon: The Coping Reservoir Model is a useful theoretical and analytical framework through which to examine student resilience and burnout. This model conceptualizes wellbeing as a reservoir which is filled or drained through students' adaptive and maladaptive coping mechanisms. This dynamic process has the capacity to foster resilience and reduce burnout or the inverse. This study aimed to explore health profession students' coping mechanisms and their experiences of resilience and burnout during the unprecedented COVID-19 pandemic. Approach: Employing the Coping Reservoir Model, qualitative focus groups involving health profession students enrolled at Qatar University were conducted, in October 2020, to solicit their lived experiences of stress and burnout during the pandemic. The Coping Reservoir Model was used to structure the topic guide for the focus group discussion and the Framework Analysis Approach was used in the data analysis. Findings: A total of 43 participants comprised eight focus groups. Health profession students encountered myriad personal, social, and academic challenges during the pandemic which adversely impacted their wellbeing and their capacity for coping. In particular, students reported high levels of stress, internal conflict, and heavy demands on their time and energy. The shift to online learning and uncertainty associated with adapting to online learning and new modes of assessment were exacerbating factors. Students sought to replenish their coping reservoir through engagement in a range of intellectual, social, and health-promoting activities and seeking psychosocial support in their efforts to mitigate these stressors. Insights: Students in this region have traditionally been left to their own devices to deal with stress and burnout during their academic training, wherein the institutions focus exclusively on the delivery of information. This study underscores student needs and potential avenues that health profession educators might implement to better support their students, for instance the development and inclusion of longitudinal wellbeing and mentorship curricula geared to build resilience and reduce burnout. The invaluable contributions of health professionals during the pandemic warrant emphasis, as does an examination of the stress associated with these roles to normalize and justify inclusion of wellbeing and resilience modules within the curriculum. Actively engaging health profession students in university-led volunteer activities during public health crises and campaigns would provide opportunities to replenish their coping reservoirs through social engagement, intellectual stimulation, and consolidating their future professional identities. [ABSTRACT FROM AUTHOR]

Objectives "SuperAgers" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. Methods We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]). SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55–64, and (3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. Results Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p  < .001; HRS: OR = 1.14, p  = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p  = .019; HRS: OR = 0.58, p  = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p  = .031; HRS: OR = 0.67, p  = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p  = .015; HRS: OR = 0.69, p  = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g. chronic conditions and self-rated health) did not relate to SuperAging. Discussion Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults. [ABSTRACT FROM AUTHOR]

Objectives This research explores how the representations and meanings of living with dementia are constructed by older adults. Methods Focus groups (N = 19) and in-depth interviews (N = 29) were conducted with older adults aged 65+ living in the Czech Republic, representing different levels of personal familiarity with care for an individual experiencing dementia. Results We identified 2 different discourses: (1) Tragedy discourse with two distinctive repertoires "dementia as a thief of personality" and "dementia as a thief of humanity." Within such discourse, dementia transcends mere medical terminology, serving as a symbolic representation of existential anxieties linked to aging and the perceived loss of control. (2) The discourse of Dementia as a specific way in which people approach the world was articulated mainly by caregivers, providing them with a coping mechanism and a means to reconstruct the agency of the person experiencing dementia. In older adults' representations, references to suffering among family members emerged as a primary association with dementia. Dementia was portrayed as "contagious" in its effect on the family members who were, in a sense, depicted as the primary sufferers of the disease. Discussion Dementia often serves as a symbolic tool for older adults to articulate concerns about advanced old age, extending beyond its clinical definition to convey deep-seated fears associated with aging. The experience of people surrounding those diagnosed with dementia and the permeability of the impacts of this disease between bodies represented crucial frameworks for conceptualizing dementia in the narratives of older adults. [ABSTRACT FROM AUTHOR]

Objectives To characterize the effect of the actual and potential ability to get rides from others on older adults' driving reduction at 3-year follow-up in the United States. Methods We analyzed National Health and Aging Trends Study data from community-dwelling drivers in 2015 (unweighted n  = 5,102). We used weighted logistic regression models to estimate whether getting rides from others in 2015 was associated with older adults increasing the number of driving behaviors they avoided, decreasing the frequency with which they drove, or not driving at 3-year follow-up after adjusting for biopsychosocial variables. We also measured presence of social network members living nearby including household and non-household members and estimated associated odds of driving reduction at 3-year follow-up. Results Older adults who got rides from others in 2015 had greater odds of reporting no longer driving at 3-year follow-up compared to those who did not get rides (adjusted odds ratio [aOR] = 1.53, 95% confidence interval [CI]: 1.11–2.11). We found no statistically significant association between older adults living with others or having more nearby confidantes outside their household and their odds of reducing driving at 3-year follow-up. Discussion These findings suggest that getting rides from others plays an important role in the transition to non-driving for older adults. Future research should examine whether other aspects of social networks (e.g. type, quality, and closer proximity) might also be key modifiable coping factors for older adults transitioning to non-driving. [ABSTRACT FROM AUTHOR]

Background and purpose Minority stressors have been linked with alcohol use among transgender and gender diverse (TGD); however, no ecological momentary assessment studies have examined daily links between minority stress and alcohol use specifically among TGD. This study examined gender minority stressors and resilience as predictors of same-day or momentary alcohol-related outcomes. Feasibility and acceptability of procedures were evaluated. Methods Twenty-five TGD adults (mean age = 32.60, SD = 10.82; 88% White) were recruited Canada-wide and participated remotely. They completed 21 days of ecological momentary assessment with daily morning and random surveys (assessing alcohol outcomes, risk processes, gender minority stressors, resilience), and an exit interview eliciting feedback. Results Gender minority stress had significant and positive within-person relationships with same-day alcohol use (incidence risk ratio (IRR) = 1.12, 95% confidence interval [CI] [1.02, 1.23]), alcohol-related harms (IRR = 1.14, 95% CI [1.02, 1.28]), and coping motives (IRR = 1.06, 95% CI [1.03, 1.08]), as well as momentary (past 30-min) alcohol craving (IRR = 1.32, 95% CI [1.18, 1.47]), coping motives (IRR = 1.35, 95% CI [1.21, 1.51]), and negative affect (IRR = 1.28, 95% CI [1.20, 1.36]). Gender minority stress indirectly predicted same-day drinking via coping motives (ab = 0.04, 95% CI [0.02, 0.08]). Resilience was positively associated with same-day alcohol use (IRR = 1.25, 95% CI [1.03, 1.51]) but not harms. Conclusions TGD adults may use alcohol to cope with gender minority stress, which can increase the risk for alcohol-related harms. Interventions are needed to eliminate gender minority stressors and support adaptive coping strategies. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the impact of web-based marriage preparation education provided to engaged couples before marriage on their knowledge of sexual and reproductive health, marital adjustment, sexual satisfaction, and sexual self-efficacy. The randomized controlled experimental study took place between September 2021 and November 2022 at a municipal marriage registry office in Ankara. The study enrolled 60 engaged couples embarking on their first marriage (30 couples assigned to the intervention group and 30 to the control group). The intervention group received web-based marriage preparation education, while the control group received standardized follow-up. Data collection involved the use of the "Data Collection Form," the "Sexual and Reproductive Health Knowledge Test for Premarital Couples (SRH)," the "Marital Adjustment Scale (MAS)," the "New Sexual Satisfaction Scale (NSSS)," and the "Sexual Self-Efficacy Scale (SSES)." Data analysis employed descriptive statistics (percentage, frequency, mean, and standard deviation), split-plot ANOVA for pre-test and post-test comparisons, two-way ANOVA for intergroup scale score comparisons, and the Pearson correlation test for correlational analysis. The post-test knowledge scores on sexual and reproductive health for the group that received marriage preparation education were found to be significantly higher (p < 0.01). Additionally, the intervention group exhibited significantly higher scores on the MAS, NSSS, and SSES than the non-education group (p < 0.05). The study concludes that pre-marriage education played a crucial role in enhancing couples' understanding of sexual and reproductive health, marital adjustment, sexual satisfaction, and sexual self-efficacy. Moreover, the education administered by a women's health nurse highlighted the importance of web-based technologies in counseling. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to investigate the validity and reliability of the Turkish version of the Premenstrual Change Coping Inventory (PMS‐Cope). Methods: A total of 170 women who met the inclusion criteria were included in the methodological study. Data were collected between the dates of November 5, 2018 and May 5, 2019 with personal information form, PMS‐Cope Turkish version, and Premenstrual Syndrome Scale. Results: The PMS‐Cope was obtained through the translation‐back translation method and the content validity was obtained according to expert opinions. After the factor analysis, the Turkish version of the PMS‐Cope consisted of three sub‐dimensions as in the original scale. The factor loadings of the three‐dimensional scale ranged from 0.46 to 0.84, and the explained variance (60.329%) was at the desired level. As a result of structural equation modeling; ×2/SD values of the scale were found to be 4.19, GFI 0.93, AGFI 0.91, CFI 0.95, RMSEA 0.079, and SRMR 0.082, and this scale was acceptable. The Cronbach alpha coefficient of the PMS‐Cope was 0.86. It was determined that item‐total score correlations were higher than 0.30 in all items of PMS‐Cope and there was no need to remove items from the scale. When the mean scores of the lower 27% and upper 27% of the scale were compared, a statistically significant difference was found between the groups (p < 0.05). The PMS‐Cope score was 41.04 ± 8.99. Conclusion: It was determined that the Turkish version of the PMS‐Cope was a valid and reliable measurement tool. [ABSTRACT FROM AUTHOR]

The present study attempts to understand what happens to conventional values like obedience in a changing socio-cultural milieu. There are two possible courses. Either the society tends to move towards the values of autonomy, independence, and individuality from the conventional values of obedience and interdependence (Lerner in The passing of traditional society: modernizing the middle east, Press Identifier Glencoe, 1958 and Schramm in Mass media and national development. The role of information in developing countries, Stanford University, California, 1964), or old values are aptly modified by interacting with new values (Trommsdorff, in: Noack (Ed) Psychological responses to social change: Human development in changing environments, de Gruyter, Berlin, 1995). Indian studies demonstrate that co-existence is a preferred strategy of Indians to accommodate cultural changes (Mishra, In: Sharan and Suar (Eds) Psychology matters: development, health, and organization, Allied Publishers, New Delhi, 2007, Mishra, Sinha and Berry in Ecology, acculturation, and psychological adaptation: a study of Adivasis in Bihar, Sage Publication, New Delhi, 1996, Chaubey in Psychol Dev Soc 14:201–220, 2002, Mishra and Sinha in Soc Sci Int 28:159–175, 2012). Testing these ideas regarding obedience, a study was conducted in Varanasi, with 30 participants (15 boys, 15 girls) aged 18–19 years randomly selected for the sample. They were given a questionnaire with ten open-ended questions assessing obedience's meaning, significance, flexibility, and context. Thematic analysis showed that the value of obedience is very significant in the lives of young people. It serves four functions, viz., knowledge function, self-enhancement function, harmonising function, and other miscellaneous functions for them. However, signs of acculturation are also evident in increased demands for autonomy and independence. This makes obedience more flexible and context-bound than before. In an attempt to balance autonomy with relatedness, a guided autonomy model has emerged in India which helps Indian youth accommodate cultural change without getting uprooted. [ABSTRACT FROM AUTHOR]

Background: Studies examining the effects of incorporating patients' preferences into treatment outcomes highlight their impact on crucial aspects such as reduced dropout rates and enhanced effectiveness. Recognizing individuals' rights to participate in decisions about their treatments underscores the importance of studying treatment preferences and the factors influencing these choices. Aim: This study aims to identify treatment preferences (psychological, pharmacological, or combined) among a sample of patients and to discern the psychosocial and clinical factors influencing these preferences. Methods: A total of 2,133 individuals receiving care at a community mental health unit completed assessments on anxious-depressive symptoms, social and occupational adjustment, and their treatment preference. Data analysis was conducted using SPSS, with descriptive statistics, Chi-square tests, and one-way ANOVA applied. Results: Preferences for treatments were distributed as follows: Combined (49.8%), psychological (33%), and pharmacological (10.6%). Factors such as diagnosis, severity of depressive and anxious symptoms, and functional impact were related to treatment preference with a moderate effect size. Meanwhile, various sociodemographic factors correlated with the selected treatment, though with a weak effect size. Conclusions: There is a pronounced preference for combined treatments. The significance of psychological treatments is evident, as four out of five participants favored them in their choices. Addressing these preferences calls for an exploration within the broader context of prescription freedom in mental health. [ABSTRACT FROM AUTHOR]

Background: Soldiers in military service are at risk of exposure to traumatic and stressful experiences, which can lead to symptoms of posttraumatic stress disorder (PTSD) and symptoms of depression. In the context of veterans' PTSD and depression, social support has been shown to be a very significant resource. However, while general depression has been examined among veterans and although combat soldiers are often men, male depression has been rarely examined. Therefore, the present study aimed to examine the relationships between social support, PTSD symptoms, and male depression among veterans. Methods: Five hundred and ninety-five male combat veterans completed a demographic questionnaire and measures of social support, PTSD, and male depression, including the specific symptoms of anger, substance use, social withdrawal, and restricted emotions. Results: Structural-equation-model analyses showed that social support was negatively associated with both PTSD symptoms and depression symptoms. Specifically, social support showed lower trends of associations with substance use and anger; whereas there were higher associations with social withdrawal and restricted emotions. PTSD showed the strongest association with anger. Thus, we can see that social support is a key resource for coping with PTSD and different symptoms of male depression. Conclusion: Greater attention to social support, PTSD, and aspects of male depression could assist the development of intervention and therapeutic programs and also help to prevent the misdiagnosis of depression among military veterans. [ABSTRACT FROM AUTHOR]

Background: Depression is a mental health disorder. The prevalence of mental health disorders in the elderly is high. Aims: This study was to determine the mental status depression and emotional of the elderly based on their characteristics. Methods: This study was a further analysis of Basic Health Research 2018 data. The population was all households from all districts/cities in 33 provinces in Indonesia with a cross-sectional design. The sample was all elderly, with a total sample of 82,304,000 people. The respondents included young elderly (60–69 years), middle elderly (70–79 years), and old elderly (>80 years). Result: Depression is experienced by most of elderly aged 60 to 69 years as many as 3,756,384 respondents (59.72%), females as many as 3,885,191 respondents (61.77%), living in urban areas, as many as 3,147,131 respondents (50.03%), graduated from elementary school as many as 2,052,22 respondents (32.63%), not working as many as 3,535,241 respondents (56.21%), and quintile one expenditure level as many as 1,532,358 respondents (24.36%). Conclusions: Emotional disorders of depression in elderly are due to the adaptation process to physical and psychosocial changes. Family support is a must to improve elderly's quality of life on mental health aspects, especially depression. Furthermore, better treatment by medical personnel is required. [ABSTRACT FROM AUTHOR]

Background: Older adults have been found to internalize stigma from society and this has been linked to several variables including social support, coping, psychological distress, and mental well-being. However, there is a dearth of research on how these variables interact with each other to impact the life of older adults. Aims: This study employed path analysis to explore social support and coping as boundary conditions and underlying mechanisms in the link between internalized stigma, psychological distress, and mental well-being, among older adults in Ghana. Method: Using a cross-sectional design, the study recruited 167 older adults who responded to standardized questionnaires including The Internalized Stigma of Mental Illness scale, Multidimensional Perceived Social Support Scale, The Brief Coping Inventory, Kessler Distress Scale, and the Warwick-Edinburgh Mental Well-being Scale, to determine levels of internalized stigma, social support, coping strategies, psychological distress, and mental well-being, respectively. Results: The findings revealed that at low levels of social support, there is a significant and positive correlation between internalized stigma and mental well-being (β = −.36, SE = 0.17, p <.001). Path analysis showed that the relationship between internalized stigma and mental well-being was fully mediated by problem-focused coping (β =.11, p =. 001, 95% CI [0.04, 0.21]), but not psychological distress. Problem-focused coping was also found to have a significant positive correlation with mental well-being but no significant correlation with psychological distress. Conversely, avoidant-focused coping was found to have a significant positive correlation with psychological distress and a significant negative correlation with mental well-being. Conclusions: This study revealed the importance of social support and coping to attaining mental well-being among older adults. This study provides insights into the development of tailored interventions aimed at improving social support and problem-focused coping among older Ghanaian adults facing internalized stigma, and it also establishes a base for future research. [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine‐related information and have a primary role in building confidence regarding vaccines. Aim: The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID‐19) and their attitudes towards the COVID‐19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated. Methods: A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling. Results: Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID‐19. Age and fear were also positively associated with anxiety related to COVID‐19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine. Conclusion: Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination. Summary statement: What is already known about this topic? The COVID‐19 pandemic significantly affected the psychological health of nurses.Nurses have a fundamental function in the general acceptance of vaccines. What this paper adds? Relationships were found between COVID‐19‐related fear, anxiety and attitudes towards the COVID‐19 vaccine.Anxiety and a positive attitude towards the vaccine were found to be predictors of fear related to COVID‐19.Fear related to COVID‐19 and being vaccinated against COVID‐19 were predictors of attitudes towards vaccination. The implications of this paper: Nursing managers could organize programmes to improve the coping skills of nurses in responding to situations that cause psychological burden.Nursing managers could support nurses through education to develop positive attitudes towards vaccines. [ABSTRACT FROM AUTHOR]

During cancer treatment, oncology nurses emphasize patient and family education about coping strategies to manage adverse events such as gastrointestinal effects and fatigue. However, information about how to return to healthy eating and physical activity behaviors may not be systematically implemented early in the post-treatment survivorship period. This article reviews and compares clinical practice guideline recommendations for nutrition and physical activity during and after cancer treatment. [ABSTRACT FROM AUTHOR]

Purpose: Telemedicine approaches to autism (ASD) assessment have become increasingly common, yet few validated tools exist for this purpose. This study presents results from a clinical trial investigating two approaches to tele-assessment for ASD in toddlers. Methods: 144 children (29% female) between 17 and 36 months of age (mean = 2.5 years, SD = 0.33 years) completed tele-assessment using either the TELE-ASD-PEDS (TAP) or an experimental remote administration of the Screening Tool for Autism in Toddlers (STAT). All children then completed traditional in-person assessment with a blinded clinician, using the Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behavior Scales, 3rd Edition (VABS-3), and Autism Diagnostic Observation Schedule (ADOS-2). Both tele-assessment and in-person assessment included a clinical interview with caregivers. Results: Results indicated diagnostic agreement for 92% of participants. Children diagnosed with ASD following in-person assessment who were missed by tele-assessment (n = 8) had lower scores on tele- and in-person ASD assessment tools. Children inaccurately identified as having ASD by tele-assessment (n = 3) were younger than other children and had higher developmental and adaptive behavior scores than children accurately diagnosed with ASD by tele-assessment. Diagnostic certainty was highest for children correctly identified as having ASD via tele-assessment. Clinicians and caregivers reported satisfaction with tele-assessment procedures. Conclusion: This work provides additional support for the use of tele-assessment for identification of ASD in toddlers, with both clinicians and families reporting broad acceptability. Continued development and refinement of tele-assessment procedures is recommended to optimize this approach for the needs of varying clinicians, families, and circumstances. [ABSTRACT FROM AUTHOR]

Few studies have examined differences in autism spectrum disorder (ASD) phenotype between children from multiplex and simplex families at the time of diagnosis. The present study used an age- and gender-matched, community-based sample (n = 105) from the southwestern United States to examine differences in ASD symptom severity, cognitive development, and adaptive functioning. No significant differences between children from multiplex and simplex families were observed. Exploratory analysis revealed that parents underreported receptive and expressive language and fine motor skills compared to professional observation, especially among children from multiplex families. These findings suggest that diagnosticians may need to consider family structure when choosing and interpreting assessments of receptive language, expressive language, and fine motor skills. [ABSTRACT FROM AUTHOR]

This paper aims to provide an overview of the lived experience of a group of individuals who participated in an adventure therapy project, as an adjunct to their routine clinical care with an Early Intervention Service (EIS) for psychosis. We hope it will support the growing literature in this field as well as encourage other services to adopt these approaches within their settings. A group of individuals who had experienced a First Episode of Psychosis (FEP) participated in a programme of outdoor activities, culminating in a six-day residential sailing adventure (N = 5). A semi-structured interview was used to explore their experiences, and an inductive thematic analysis was undertaken to identify themes. Four key themes emerged from the analysis of the transcripts. The themes centred around what people learnt about themselves from taking part in the project: "enhanced self-perception"; "building friendships and being part of a shared experience"; "navigating and overcoming new challenges"; and "working together as a team". Adventure-based approaches offer the opportunity to enhance standard treatment outcomes in EIS, and the unique context in which they occur provides a platform to support social and occupational recovery from psychosis. [ABSTRACT FROM AUTHOR]

Older adults' wellbeing during the transition into an assisted living facility (ALF) is not well understood and may influence their wellbeing. The Mueller Assessment of Transition (MAT) was created to measure the impact of transition on older adults' wellbeing. Early developmental testing of the MAT revealed a hypothesized model with two constructs (adjustment strategies and constraints to wellbeing). Therefore, the purpose of this study was to confirm the factor structure of the MAT with a representative sample of older adults transitioning into ALFs. In a nationwide sample, 108 older adult participants completed the MAT to measure wellbeing when relocating into ALFs. Confirmatory factor analysis (CFA) assessed the structural validity of the MAT. Internal consistency was evaluated, and chi-square tests of association for regional differences in MAT scores were also conducted. The CFA produced strong fit indices to confirm the hypothesized 2-factor (constraints to wellbeing and adjustment strategies) model of the MAT. Cronbach's alpha for the internal consistency was 0.784 and chi-square test indicated no significant regional differences. The MAT was established as a valid and reliable standardized assessment. Implications for using the MAT as a tool to measure older adults' wellbeing and future research are discussed. [ABSTRACT FROM AUTHOR]

Culturally and linguistically Deaf people experience disproportionate suffering and deprivation in prison settings globally (Zidenberg 2021). This article uses the medical and social models of disability to highlight some of the underlying reasons for this. Deaf people view their Deafness through a cultural lens and usually disassociate from views which align with these models (Lane 1995). However, they are prominent across society and in relevant equality legislation, and thus impact the Deaf Community significantly (Obasi 2008). This article explores how the nature of the prison environment – a hostile, disempowering place, designed for similarity, changes and heightens the impact of perspectives which align with the medical and social models. Throughout, findings are presented from qualitative research involving interviews with Deaf prisoners and hearing staff members in England, showing that there is little room for a cultural model of Deafness in prison, and in consequence, prison becomes medically deafening for Deaf prisoners. The Deaf Community is a culturally distinct group comprised of people who value their Deafness and commonly use sign language to communicate. Hearing people generally view deafness as a medical problem and have little understanding of the Deaf Community. This creates difficulties for Deaf people because the Deaf world is part of a wider hearing world. The hearing world is more oppressive in prison because it is hostile, disempowering and designed for people who can easily adjust to the regime. There is a lack of Deaf awareness across the prison system, and appropriate adjustments are rarely made for Deaf prisoners. Relevant equality legislation can create further challenges for Deaf prisoners because it does not recognise the needs of the Deaf Community, and its stipulations are too ambiguous to be effective in prisons. There is little room for cultural Deafness in prison, and Deaf prisoners suffer disproportionately in consequence. [ABSTRACT FROM AUTHOR]

Listeners adapt efficiently to new talkers by using lexical knowledge to resolve perceptual uncertainty. This adaptation has been widely observed, both in first (L1) and in second languages (L2). Here, adaptation was tested in both the L1 and L2 of speakers of Mandarin and English, two very dissimilar languages. A sound midway between /f/ and /s/ replacing either /f/ or /s/ in Mandarin words presented for lexical decision (e.g., bu4fa3 "illegal"; kuan1song1 "loose") prompted the expected adaptation; it induced an expanded /f/ category in phoneme categorization when it had replaced /f/, but an expanded /s/ category when it had replaced /s/. Both L1 listeners and English-native listeners with L2 Mandarin showed this effect. In English, however (with e.g., traffic; insane), we observed adaptation in L1 but not in L2; Mandarin-native listeners, despite scoring highly in the English lexical decision training, did not adapt their category boundaries for /f/ and /s/. Whether the ambiguous sound appeared syllable-initially (as in Mandarin phonology) versus word-finally (providing more word identity information) made no difference. Perceptual learning for talker adaptation is language-specific in that successful lexically guided adaptation in one language does not guarantee adaptation in other known languages; the enabling conditions for adaptation may be multiple and diverse. [ABSTRACT FROM AUTHOR]

Contemporary understanding of combat trauma's psychological effects emphasizes the interpersonal ways survivors process their experiences. Yet cases of incongruence between survivors who want to share their traumatic experience and close others who are not ready to take part in this challenging task are common. Hence, many trauma survivors are compelled to cope with the posttraumatic consequences mostly alone. The present study followed the interpretive phenomenological approach to examine the experience of loneliness, as described by 15 male combat veterans dealing with posttraumatic stress. Participants completed semistructured qualitative interviews in which they shared their knowledge regarding postservice distress, loneliness, coping, and growth. Two main themes emerged: "The Loneliness Complex," highlighting this phenomenon's multifaceted, layered, and cyclical nature; and "Emotional Growth after Loneliness," presenting the positive potential of loneliness. These findings emphasize the importance of interpersonal relations in trauma survivors' recovery process. Participants described how experiences with peers can serve as a pivotal point for coping with postservice distress and how internalization of positive interpersonal interactions seems to be a crucial psychological resource for further rehabilitation and growth. Being a multilayered and cyclical condition, loneliness might serve trauma survivors in their search of safety, while also bearing the potential to motivate them to act upon their condition and promote emotional growth. Clinicians should acknowledge the risks trauma survivors take by leaving their lonely yet safe place, as they are encouraged to process their traumatic experiences and share their inner world with others. [ABSTRACT FROM AUTHOR]