Family Resilience Research Articles

Nurturing family business resilience through strategic supply chain management

PurposeThe study aspires to enhance comprehension of the intricate interplay between supply chain management (SCM) and resilience in family businesses, thereby offering valuable insights to managers and policymakers endeavouring to foster resilience in uncertain environments.Design/methodology/approachCommencing from the premise that family businesses (FBs) prioritize the preservation of socio-emotional wealth (SEW) when formulating strategic decisions, this study endeavours to advance understanding of supply chain practices adopted by FBs and their direct impact on resilience during crisis situations or economically challenging periods. Through an exploratory case study of nine FBs, the present research reveals four pivotal strategies in SCM that contribute to their resilience: (i) reorganization of inventory management; (ii) cultivating close relationships with suppliers; (iii) emphasizing product quality and customer retention; and (iv) implementing cost reduction measures to bolster resilience. The aim of the study is to provide an in-depth understanding of the intricate interplay between SCM and resilience in FBs, thereby offering valuable insights to managers and policymakers endeavouring to foster resilience in uncertain environments.FindingsOur approach offers a theoretical framework for SCM aligned with prior research on the interplay between characteristics of family businesses and resilience strategies. Furthermore, this paper illustrates how factors such as the emphasis on high-quality products and services by family businesses contribute to achieving non-economic objectives that owners adopt to reconcile family and business needs, creating intrinsic added value for the company. It reveals various challenges in SCM, including inventory organization changes, supplier closures and the significance of customer retention. Family businesses are implementing product and technology enhancements and leveraging digitization to enhance supply chain processes.Originality/valueThis paper contributes significantly to the field of FBs by highlighting the crucial role of SCM in enhancing business resilience during crises. It empirically examines how the SEW characteristics of FBs influence the reconfiguration of their supply chains to enhance resilience, presenting a theoretical model for this context. Our theoretical framework employs an SEW perspective to elucidate how FBs respond to the challenges posed by the COVID-19 pandemic by adapting their SCM processes to safeguard their social and emotional legitimacy, organizational visibility and reputation. These adaptations gain particular relevance during crises or turbulent conditions, potentially leading to alterations in how FBs formulate their supply chain strategies and manage supply chain-related processes.

A 6-Item Family Resilience Scale (FRS6) for Measuring Longitudinal Trajectory of Family Adjustment.

Two studies were conducted in Hong Kong to validate a brief measure of family resilience based on the three-factor CPR model. The CPR model stipulates that family resilience comprises three major factors: Communication and Connectedness (C), Positive Framing (P), and External Resources (R). Study 1 abbreviated the 16-item Family Resilience Scale (FRS16) into six items (FRS6) with a parent sample in the community (N = 1270). Study 2 tested the validity of the FRS6 with a single parent sample (N = 336). The result of Study 1 suggests a dominant general family resilience factor structure with three distinct subfactors. The highest factor loading items from each of the three subfactors were retained in the six-item FRS6. The resultant FRS6 was internally consistent and related to various correlates in similar or better strengths as compared to the FRS16. The results of a separate sample in Study 2 indicated that the FRS6 demonstrated satisfactory internal reliability and correlated significantly with individual resilience, quality of life, anxiety, and depression in the expected directions. Both studies supported that the FRS6 is a psychometrically sound measure of family resilience and can be used in longitudinal studies that aim to chart the trajectory of family adjustment following life adversities.

The experience of growing up with a sibling who has depression from emerging adults' perspectives

AbstractObjectiveThe aim was to explore the experiences of growing up with a sibling with depression from the perspective of emerging adult siblings.BackgroundGrowing up with a sibling who experiences depression profoundly impacts the personal lives of emerging adults. This study addresses a research gap by delving into the unique experiences of these emerging adult siblings.MethodsUtilizing a qualitative‐phenomenological approach, we examined the experiences of 25 emerging adults (aged 18–29) who had lived with a depressed sibling during adolescence. In‐depth, semistructured interviews were conducted. Data collection continued until concept saturation. Thematic analysis was employed.ResultsWe identified two central themes in the participants' experiences. In the first theme, significant challenges were illuminated within the parent–child relationship, marked by frustration, the assumption of parental roles, emotional disconnect, and hindrances to personal growth. The second theme pertained to the implications of their sibling's depression on the emerging adults' personal lives, resulting in sacrifices, emotional turmoil, and a sense of responsibility. Participants also exhibited resilience, empathy, and personal growth.ConclusionsThis research illuminates the nuanced dynamics among emerging adults with depressed siblings, underscoring the need for tailored interventions that support both caregiving responsibilities and personal development. Incorporating sibling perspectives into clinical practice can enhance intervention strategies and promote well‐being.ImplicationsThese findings underscore the need for personalized support that enables emerging adults to balance caregiving for their depressed siblings with their own personal growth, with a focus on fostering family communication and resilience.

Family and community resilience: a Photovoice study

BackgroundAdverse childhood experiences (ACEs), in combination with adverse community environments, can result in traumatic stress reactions, increasing a person’s risk for chronic physical and mental health conditions. Family resilience refers to the ability of families to withstand and rebound from adversity; it involves coping with disruptions as well as positive growth in the face of sudden or challenging life events, trauma, or adversities. This study aimed to identify factors contributing to family and community resilience from the perspective of families who self-identified as having a history of adversity and being resilient during the COVID-19 pandemic.MethodsThis study used Photovoice, a visual participatory research method which asks participants to take photographs to illustrate their responses to a research question. Participants consisted of a maximum variation sample of families who demonstrated family level resilience in the context of the pair of ACEs during the COVID-19 pandemic. Family members were asked to collect approximately five images or videos that illustrated the facilitators and barriers to well-being for their family in their community. Semi-structured in-depth interviews were conducted using the SHOWeD framework to allow participants to share and elucidate the meaning of their photos. Using thematic analysis, two researchers then independently completed line-by-line coding of interview transcripts before collaborating to develop consensus regarding key themes and interpretations.ResultsNine families were enrolled in the study. We identified five main themes that enhanced family resilience: (1) social support networks; (2) factors fostering children's development; (3) access and connection to nature; (4) having a space of one’s own; and (5) access to social services and community resources.ConclusionsIn the context of additional stresses related to the COVID-19 pandemic, resilient behaviours and strategies for families were identified. The creation or development of networks of intra- and inter-community bonds; the promotion of accessible parenting, housing, and other social services; and the conservation and expansion of natural environments may support resilience and health.

Finding Center in the Heart (of the Pandemic): Practical Tools from the Islamic Tradition for Building Resilient Families in Times of Disruption and Trauma

When the COVID-19 pandemic drastically altered how people lived their lives, many called it a “wake up call.” Within the global Muslim community, many shared the sentiment that the coinciding of the lockdown with Ramadan presented an opportunity for khalwa (spiritual retreat and reflection). Although Muslim religious leaders sought to frame the Islamic tradition’s wisdom in light of the pandemic, much of this remained theoretical and abstract. The pandemic’s extended impact revealed that Muslim families lack guidance on how to employ the resources found in the Qur’ān and Sunnah practically for their own well-being and resilience.
 This paper outlines how one Muslim mental health professional and his network of colleagues responded to this crisis by tending to the well-being needs and collective trauma of Muslim families in the U.S. using online webinar platforms to address increased anxiety, family conflict, depression, and existential grief. A detailed framework of an Islamic psychology used as a psycho-educational tool to orient families to indigenous Islamic tools for building resiliency and decreased anxiety is also presented.
 From this user-friendly theoretical framework, a daily routine of psychological, physical, and contemplative exercises is mapped out and was amended to comply with the particular resources and restrictions imposed by the pandemic. The tools offered, while grounded in the Islamic tradition, provide contemporary and pragmatic solutions that many Muslims have used to build resiliency and engage with the dīn (Islamic religion) in a transformational, rather than a simply transactional, way during these trying times.

Short-term gains versus long-term strains: productivist policies and family resilience in China

This article studies the intricate dynamics of family resilience within the Chinese productivist regime over the course of seven decades, emphasizing the instrumental role of public policy in shaping this resilience. Drawing on a dynamic approach, the research demonstrates how, across distinct periods of central planning and economic reform, policies have persistently harnessed families to advance economic objectives. Showing that the productivist regime’s double-edged role on family resilience emerged while public policies bolstered short-term family resilience in times of sustained economic growth and favorable demographics, and signs of family sector downturn—declining fertility rates, family dysfunctions—became evident, the current article underscores the challenges of a model that primarily perceives families as economic instruments. Advocating for a policy paradigm shift that harmonizes economic ambitions with family well-being, this study offers valuable insights for policy-makers and lays the groundwork for future research in comparative welfare systems.

The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience

BackgroundThe caregiver burden frequently experienced by family members tending to advanced cancer patients significantly impacts their psychological well-being and quality of life (QoL). Although family resilience might function as a mitigating factor in this relationship, its specific role remains to be elucidated. This study aims to probe the mediating effect of psychological distress on the relationship between caregiver burden and QoL, as well as the moderating effect of family resilience.MethodsA cross-sectional study was conducted between June 2020 and March 2021 in five tertiary hospitals in China. Data were collected on caregiver burden, family resilience, psychological distress (including anxiety and depression), and QoL. Moderated mediation analysis was performed.ResultsData analysis included 290 caregivers. It confirmed the mediating role of psychological distress in the caregiver burden-QoL relationship (P < 0.001). Both overall family resilience and the specific dimension of family communication and problem-solving (FCPS) demonstrated significant moderating effects on the “psychological distress/anxiety—QoL” paths (P < 0.05). The utilization of social and economic resources (USER) significantly moderated the association between depression and QoL (P < 0.05).ConclusionsThe study corroborates psychological distress's mediation between caregiver burden and QoL and family resilience's moderation between psychological distress and QoL. It underscores the need for minimizing psychological distress and bolstering family resilience among caregivers of advanced cancer patients. Accordingly, interventions should be tailored, inclusive of psychological assistance and promotion of family resilience, particularly focusing on FCPS and USER, to augment the caregivers' well-being and QoL.

A psychometric study of the revised Chinese version of the family resilience assessment scale among children disadvantaged due to family migration

ObjectiveThe family system is important for children's development. Previous research has demonstrated that some families are able to maintain good adaptability or resilience in the face of stressors. This study aimed to develop the revised Chinese version of the Family Resilience Assessment Scale and examine the psychometric properties of the scale among children disadvantaged in adversity due to family migration. MethodsA total of 1487 children (47.6 % girls) from disadvantaged families participated in this study, whom completed the revised Chinese version of the Family Resilience Assessment Scale, the Chinese version of the Connor-Davidson Resilience Scale, and the Center for Epidemiologic Studies Depression Scale for Children. Results(1) Good language equivalency was found (Intraclass Correlation Coefficient = 0.96); (2) Item analysis indicated that the critical ratio values of all 45 items were above 0.30 (p < 0.001), except for 7 items that were dropped from further analysis; (3) The exploratory factor analysis indicated that the best model was four-factor model; (4) The confirmatory factor analysis showed that the four-factor model had good model fit; (5) Family resilience was significantly correlated with personal resilience and depression; (6) The internal consistency reliability of the scale was 0.95. ConclusionsThis study confirmed that the revised Chinese version of the Family Resilience Assessment Scale was a reliable and valid instrument to assess family resilience of Chinese children who are disadvantaged.

Resilience of families with the elderly amid the COVID-19 pandemic: lesson learned from two tourism villages in Yogyakarta, Indonesia

Resilience of families with the elderly amid the COVID-19 pandemic: lesson learned from two tourism villages in Yogyakarta, Indonesia

THE USE OF MEDICINAL PREPARATION GINKGO BILOBA IN THE PROCESS OF PROVIDING COMPLEX PSYCHOCORRECTIVE ASSISTANCE TO FAMILIES WITH THE CONSEQUENCES OF WAR PSYCHOTRAUMA

Introduction. The prolonged extreme crisis situation of the full-scale war in Ukraine has a negative impact on the institution of the family, the structure and functions of the modern Ukrainian family. Therefore, the development of effective approaches to the psychocorrection of family relations in wartime is an urgent topic of research.&#x0D; The aim. The purpose of the work is to develop and test a model of complex psychocorrection of family relations using the drug Ginkgo biloba in wartime conditions.&#x0D; Materials and methods. Analytical, psychodiagnostic, statistical research methods and the method of conceptual modeling are used in the work. The methodological basis of the study was the understanding of a person as a whole multi-level biopsychosocial living system and an empirical approach. The research sample consisted of 44 young couples (88 people), temporarily displaced from the zone of active hostilities. The subjects were randomly divided into two groups: experimental (21 couples, 42 people) and control (23 couples, 46 people). Psychodiagnostic methods were used in the work: Questionnaire "Diagnosis of personality behavior in a conflict situation" (O.S. Kocharyan); Methodology "Settings in a married couple" (Y.Ye. Alyoshina); Communication in the family (Y.Ye. Alyoshina, L.Ya. Gozman, O.M. Dubovska); Marriage satisfaction test questionnaire (V. V. Stolin, T.L. Romanova, G.P. Butenko); Connor-Davidson resilience scale-10. Complex psychocorrective intervention was carried out in both groups for three weeks based on the author's model, which contained four groups of factors: individual, family, group, social, and consisted of seven content blocks: 1) correction of individual mental states of each spouse and development of resilience; 2) correction of communication skills and internal and external communication styles of spouses; 3) correction of family attitudes and values; 4) correction of the educational function of the family; 5) correction of the protective function of the family; 6) increasing the vitality of the family and forming its psychotherapeutic function; 7) formation of satisfaction with marriage and determination of constructive prospective directions for the development of family relations. In addition, the respondents of the experimental group received the Ginkgo biloba drug in the form of a standardized leaf extract (Ginkgo biloba-F capsules 400 mg No. 60 of the domestic manufacturer PTF LLC Pharmacom) for three weeks.&#x0D; Results. A complex model of psychocorrection of family relationships using the drug gingko biloba was theoretically substantiated, developed and tested, and its effectiveness in providing medical and psychological assistance to families with the consequences of war psychotrauma was demonstrated.&#x0D; Conclusions. It has been proven that the developed and tested comprehensive psychocorrective technique is effective in increasing the resilience of families with the consequences of war psychotrauma. A statistically reliable and significant positive effect of the Ginkgo biloba drug on the adaptive resources and vitality of the individual has been demonstrated, which contributes to the increase of stress resistance and the normalization of family relationships and allows to recommend the Ginkgo biloba drug in a complex of psychocorrective and psychoprophylactic measures to overcome the consequences of war psychotrauma.&#x0D; Prospective research is planned to be directed to the study of the impact of the war psychotraumatic situation on children and the elderly and the development of appropriate psychocorrective and psychoprophylactic methods.

Psychosocial correlates of flourishing in the late lifespan

BackgroundFlourishing is a primary dimension of psychological well-being that contributes massively to the development of an active, purposeful, and respectful life, full of meaning, values, and personal interests that nurture social ties.AimsThis study primarily intended to examine the contribution of satisfaction with family relations, resilience, metacognitive efficiency, and crystallized intelligence in predicting a flourishing measure in cognitively healthy older adults. Moreover, the impact of gender was investigated on flourishing, satisfaction with family ties, resilience, and metacognitive efficiency.MethodsOne hundred and eighty 65–94-year-old community dwellers were recruited in Sardinia (Italy). Participants self-rated their flourishing, satisfaction with their family connections, psychological hardness (i.e., a dimension of resilience), and cognitive function, whereas global cognitive efficiency and vocabulary were assessed through two internationally validated objective tests.ResultsA hierarchical regression analysis revealed that 30% of the variance in the flourishing condition was explained by satisfaction with family ties, resilience, and metacognitive efficiency. In addition, males exhibited higher flourishing and satisfaction with family ties than females, and the former group also reported being more autonomous and acting proactively to influence its destiny.ConclusionEmotional support and rewarding relations with family members, the ability to face stressful events, and a good perception of one’s cognitive efficiency play a crucial role in promoting flourishing in late adulthood.

Unpacking the Relationship Between COVID‐19‐Related Stress and Quality of Life Among High School Students: A Socio‐Ecological Resilience Perspective

ABSTRACTThe COVID‐19 pandemic is a serious public health challenge that causes negative effects on adolescents. This study aims to investigate the mediating roles of individual, family and community resilience in the association between COVID‐19‐related stress and quality of life according to the socio‐ecological theory. The sample consists of 814 adolescents from high schools in Zhejiang province, China (mean age = 16.79 years; 51.11% girls), collected by a multi‐stage cluster random sampling. The multiple mediation model is performed by SPSS macro PROCESS. The results show that individual resilience (β = −0.017, 95% CI [−0.044, −0.003]), family resilience (β = −0.028, 95% CI [−0.058, −0.008]) and community resilience (β = −0.031, 95% CI [−0.062, −0.007]) partially mediate the relationship between COVID‐19‐related stress and life satisfaction. Moreover, individual resilience (β = −0.028, 95% CI [−0.056, −0.008]), family resilience (β = −0.017, 95% CI [−0.042, −0.002]) and community resilience (β = −0.033, 95% CI [−0.065, −0.007]) also partially mediate the relationship between COVID‐19‐related stress and subjective well‐being. This study not only elucidates the mediating roles of multidimensional resilience but also provides valuable insights into improving adolescent resilience across different systems.

Current status and influencing factors of family resilience in families of children with epilepsy: a cross-sectional study.

The study was designed to describe the level of family resilience and identify the protective factors and vulnerability factors of family resilience in families of children with epilepsy. So as to provide theoretical guidance for implementing intervention programs to promote family resilience. From November 2020 to July 2021, 258 parents of children with epilepsy were investigated using a convenience sampling method. The questionnaire included demographic data, Chinese-Family Resilience Assessment Scale, Social Support Rating Scale, and the Beck Depression Inventory. SPSS25.0 was used for descriptive statistical analysis, univariate analysis, and multivariate linear regression analysis. In this study, two hundred and fifty-eight primary caregivers completed the paper questionnaires. The total score of family resilience was (134.97 ± 16.57), which was above the medium level. Multiple linear regression analysis revealed that subjective support (β=0.327, P<0.001), comorbidity (β=0.181, P<0.05), objective support (β=0.117, P<0.05), and parental depression (β=-0.158, P<0.05) were significantly related to family resilience. These variables contribute 31.7% of the variance in family resilience (F=18.07, P< 0.001). The families of children with epilepsy presented appropriate resilience after the children were diagnosed with epilepsy. Family resilience was correlated with multiple factors, subjective and objective support could be protective factors, comorbidity and parental depression could be vulnerability factors of family resilience. Therefore, future psychosocial interventions could focus on enhancing subjective support and objective support, reducing parental depression, and screening for epilepsy comorbidity to promote the family resilience of children with epilepsy.

The mediating effect of family resilience between coping styles and caregiver burden in maintenance hemodialysis patients: a cross-sectional study

BackgroundPrimary caregivers of hemodialysis patients suffer from varying degrees of stress from their patients. Caring for hemodialysis patients can expose caregivers to many problems, leading to an increased burden of care and even impacting the quality of care. The purpose of our study was to examine whether family resilience could be a mediating variable moderating the relationship between patient coping styles and caregiver burden.MethodsThe study was a cross-sectional and descriptive-analytical study that interviewed 173 pairs of hemodialysis patients and their caregivers at a blood purification center in a public hospital in China. The Brief Coping Styles Scale (Chinese version) was used to assess individuals’ coping styles for disease and treatment. From the caregiver’s perspective, the Family Resilience Assessment Scale (Chinese version) was used to understand the resilience of families, and the Zarit Caregiver Burden Scale was used to capture the caregiver’s subjective experience of burden. Statistical analyses were conducted using SPSS version 23 and Amos version 26 to analyze the relationships between variables to examine for correlation and construct mediated effects models.ResultsCoping styles showed a significant positive correlation with family resilience (r = 0.347, P < 0.01) and a negative correlation with caregiver burden (r = -0.379, P < 0.01). A significant negative correlation was found between family resilience and caregiver burden (r = -0.503, P < 0.01). In the mediation model, patient coping styles directly impacted caregiver burden significantly (95% CI [-0.372, -0.058]), and coping styles indirectly impacted caregiver burden by family resilience in a significant way (95% CI [-0.275, -0.098]).ConclusionsPatient coping styles directly affect caregiver burden. Family resilience is a mediating variable between patients’ coping styles and the burden on caregivers.

A latent class analysis of family resilience and its relationship with fear of recurrence in lung cancer patients: a cross-sectional study.

Family resilience helps cancer-affected families overcome challenges and may influence an individual's fear of cancer recurrence (FCR). Identifying distinct classes of family resilience among lung cancer patients is crucial for tailored interventions. This study aimed to identify latent classes of family resilience in lung cancer patients and explore their relationships with FCR. Three hundred ten lung cancer patients from three hospitals in Fujian were recruited from June to September 2021. Clinical data were extracted from medical records, while sociodemographic details, family resilience, and FCR were self-reported. A latent class analysis was performed to identify family resilience classes. A 4-class solution showed the best fit. Compared to Class 1, the patients who had no comorbidities (ORs = 3.480-16.005) had an increased likelihood of belonging to Class 2 and 3, while those who were not family breadwinners (ORs = 0.118-0.176) had a decreased likelihood. Further, the patients who (1) did not lack interest/pleasure in doing things during the past 2-week period (OR = 7.057), (2) were never smokers (OR = 6.230), and (3) were urban residents (OR = 8.985) had an increased likelihood of belonging to Class 4, while those who were (1) male (OR = 0.167), (2) not the family breadwinner (OR = 0.152), and (3) had none or only one child (OR = 0.203) had a decreased likelihood of belonging to Class 4. The FCR level differed significantly among these four classes. Our study identified four distinct classes of family resilience among Chinese lung cancer patients. FCR severity decreased with increasing levels of family resilience.

A Mixed-Methods Exploration of Legal Vulnerability, Trauma, and Psychological Wellbeing in Immigrant Caregivers and Youth

(1) Background: Immigrant families in the U.S. face a myriad of migration-related stressors and trauma, and legal vulnerability can further compound such stressors, influencing both immigrant caregiver and child wellbeing. This study explored the relationships between legal vulnerability, trauma, and migration and their effects on caregiving, psychological distress, and resilience in immigrant families. (2) Methods: In total, 37 Latinx immigrant caregiver–child dyads from a community sample were interviewed and completed self-report measures on their experiences of migration, trauma, psychological functioning, and parent–child relationships. (3) Results: Using a community-based, sequential quantitative-qualitative design, person-centered analyses revealed two caregiver clusters: “Personalizing Stress” and “Meaning-making”. Exemplar case analyses characterized differences between clusters, particularly related to trauma symptoms, in which the “meaning-making” cluster endorsed higher levels of psychological functioning and wellbeing compared to the “personalizing stress” cluster, in which the process of creating meaning from adversity appeared to function as a resilience resource for the “meaning-making” cluster. While most indicators of caregiver–child wellbeing were not correlated, family legal vulnerability was strongly correlated with high resilience in children. (4) Conclusions: Clinicians should attend to the resilience resources that immigrant families from legally vulnerable communities utilize, including meaning-making.

Mothers' Perceived Co-Parenting and Preschooler's Problem Behaviors: The Mediating Role of Maternal Parenting Stress and the Moderating Role of Family Resilience.

Problem behaviors in preschoolers signals social adjustment challenges. This study investigates the mediating role of parenting stress in the relationship between co-parenting and these behaviors, and examines how family resilience impacts this dynamic. A detailed survey was conducted with 1279 mothers of 3-6-year-olds in Shanghai, China, focusing on co-parenting, family resilience, parenting stress, and children's behaviors. We employed SPSS 26 for initial tests and the Hayes PROCESS macro in SPSS 23.0 for advanced analysis, using bootstrap methods to assess mediation and moderation effects. The analysis revealed that maternal parenting stress mediates the relationship between co-parenting and children's problem behaviors. Specifically, unsupportive co-parenting or low levels of supportive co-parenting heightened maternal stress, which in turn increased children's problem behaviors. Family resilience was found to moderate this relationship, buffering the impact of unsupportive co-parenting on maternal stress. High family resilience levels were associated with lower parenting stress, regardless of co-parenting quality. These findings highlight the importance of enhancing family resilience and supportive co-parenting to mitigate parenting stress and reduce problem behaviors in children. It has practical implications for developing family-centred interventions and policies to strengthen family resilience and co-parenting skills.

Managing Multiple Chronic Conditions during COVID-19 Among Patients with Social Health Risks.

Optimal care for persons with multiple chronic conditions (MCC) requires primary and specialty care continuity, access to multiple providers, social risk assessment, and self-management support. The COVID-19 pandemic abruptly changed primary care delivery to increase reliance on telehealth and virtual care. We report on the experiences of individuals with MCC and their family caregivers on managing their health and receiving health care during the initial pandemic. Semistructured qualitative interviews with 30 patients (19 English speaking, 11 Spanish speaking) plus 9 accompanying care partners, who had 2+ primary care encounters between March 1, 2020, and November 30, 2020, 2+ chronic conditions, and 1 or more self-reported social risks. Questions focused on access to and experiences with care, roles for care partners, and self-management during the first 6 months of the pandemic. Participants experienced substantial changes in care delivery. The most commonly reported changes were a shift to more virtual relative to in-person care and shifting roles for care partners. Changes fostered new perspectives on self-management and an appreciation of personal resilience and self-reliance. Virtual care was an acceptable complement to in-person care, though not a substitute for periodic in-person visits. It was more acceptable for English speakers and with a usual provider. New models of care delivery that recognize patient and family resilience and resourcefulness, emphasize provider continuity, and combine virtual and in-person care may support self-management for individuals with MCC and social needs.

Family resilience of smallholder farmers in Indonesia’s oil palm plantation

Problems about family are still analyzed in general and do not specifically look at the livelihood aspect. Whereas from the social sciences lensed, livelihood is the main factor that significantly contributes to the resilience of family. One of the family issues which became a major problem in Indonesia is family resilience in the oil palm plantation context. Families in the plantation sector always have tremendous challenges either from internal, external, or structural layers. At the internal level, families have to bear with psychological and physical issues which may trigger them to become more vulnerable. From an external level, the work ambiance in palm plantations, as well as price fluctuation and access to financial capital, may threaten the families who work and live surrounding palm plantations. Furthermore, from a structural level, families have to deal with biased and unfair regulations which undeniably make them much poorer and more suffered. This study aimed to analyze the vivid condition of smallholder families in the oil palm plantation context and how they deal with those challenges. Besides, this study also aimed to formulate some strategies to make them become a resilient family. This study used qualitative methods, by conducting FGDs and in-depth interviews with smallholder farmers of oil palm plantations as key informants in two different plantation areas in Indonesia; Lampung and Kalimantan.

Adolescent Mental Health and Resilience Before and During the COVID-19 Pandemic

PurposeWe aimed to assess levels of depression, anxiety, and resilience factors before and during the COVID-19 pandemic in a school sample of adolescents. We also aimed to examine the compensatory and protective effects of individual, family, and school resilience factors on adolescent mental health. MethodsWe used fall 2019 and fall 2020 survey responses from a cluster randomized controlled trial implemented in 20 schools in a Midwestern county. The sample consisted of 3,085 responses from students in grades 5 and 6. Multilevel mixed-effects models with cluster robust standard errors were used to investigate the associations between exposure to the COVID-19 pandemic, mental health (anxiety, depression), and resilience factors (future orientation, family engagement, and having a caring school adult). ResultsAnxiety, but not depression, was higher in fall 2020 compared to fall 2019. Family engagement increased during the pandemic, while future orientation of the student body was lower during that time and the prevalence of having a caring adult at school was unchanged. A positive future orientation was associated with lower levels of anxiety and depression, while having a caring school adult was associated with lower depression. Adolescents with less positive future orientations, low family engagement, and no caring school adults experienced the greatest increases in anxiety. DiscussionPositive future orientations, family engagement, and supportive nonparental adult relationships had compensatory and protective effects on adolescent mental health during the COVID-19 pandemic. Adding these measures to the inventory of modifiable resilience factors during natural disasters may promote healthy adaptation among adolescents.