Feelings Of Distress Research Articles

Moral Distress Amongst District Leaders: Intensity, Dilemmas, and Coping Mechanisms in the Context of Covid-19.

Purpose: This study examines the sources and intensity of moral distress among school district leaders during the first full school year of the Covid-19 pandemic and investigates their coping mechanisms for addressing issues that create moral dilemmas for them. Design and Evidence: We draw on semi-structured interviews with 26 school district leaders across 13 school districts in the Northwestern United States. Brief summaries detailing themes in each interview were prepared. Magnitude coding was used to understand the intensity of district leaders' feelings of distress. Open coding and axial coding allowed us to categorize the origins/sources of distress and the approaches/strategies district leaders used to reduce feelings of moral distress. Findings: Reported moral distress ranged from none to moderate but manageable amounts. Three types of problems were described as morally distressing: political problems with the community or unions, staff problems including staff stress, staff resistance, and collaboration amongst staff members, and an inability to meet student needs due to resource, policy, or community/family constraints. Leaders' coping mechanisms included social responses such as team building, but also drew on individual virtues such as persistence and patience. Implications: Within the ranks of district leaders, the extent to which leaders frame their challenges in a moral frame is varied. A sizable group articulated challenges with implications for moral action in primarily technical or political terms. If district leaders engage unevenly with the moral tradeoffs of their decisions, they risk adopting an overly managerialist frame.

The impact of health inequities on physicians' occupational well-being during COVID-19: A qualitative analysis from four US cities.

The aim of this study is to describe frontline physicians' perceptions of the impact of racial-ethnic and socioeconomic disparities in COVID-19 infection and mortality on their occupational well-being. One hundred and forty-five qualitative, semistructured interviews were conducted between February 2021 and June 2022 with hospital medicine, emergency medicine, pulmonary/critical care, and palliative care physicians caring for hospitalized COVID-19 patients in four UScities. Physicians reported encountering COVID-related health disparities and inequities at the societal, organizational, and individual levels. Encountering these inequities, in turn, contributed to stress among frontline physicians, whose concerns revealed how structural conditions both shaped COVID disparities and constrained their ability to protectpopulationsat risk from poor outcomes. Physicians reported feeling complicit in the perpetuation of inequities or helpless to mitigate observed inequities and experienced feelings of grief, guilt, moral distress, and burnout. Health inequities are an under-acknowledged source of physicians' occupational stress that requires solutions beyond the clinical context.

How does health information seeking from different online sources trigger cyberchondria? The roles of online information overload and information trust

Cyberchondria is conceptualized as excessive online searches for medical information, which is typically accompanied by feelings of emotional distress or anxiety. While previous studies in this nascent area have identified various psychological predictors of cyberchondria, a relative dearth of research has explored the role of different online information sources in its development. Informed by the stimulus-organism-response (SOR) model and the literature on cyberchondria, this study proposes a theoretical framework to explain why people develop cyberchondria when seeking medical information via different online sources. Based on a three-wave panel survey (N = 654), our findings suggest that health information seeking via online search engines increases online information overload (β = 0.11, p = .02), while health information seeking via social media platforms and health-specific websites increases online information trust (β = 0.13, p = .005; β = 0.25, p < .001). Additionally, online information overload is negatively related to online information trust (β = -0.39, p < .001). Subsequently, both online information overload and online information trust trigger cyberchondria (β = 0.73, p < .001; β = 0.15, p < .001). This study can contribute to the literature by expanding and deepening our understanding of cyberchondria developmental trajectory as well as emphasizing the pivotal role of online information sources in this complicated and dynamic process.

Predictors of Feeling of Threat Caused by COVID-19 Pandemic, the Distinctive Effects of Automatic vs. Reflective Emotions.

The worldwide pandemic that started in December 2019 was a cause of a great rise in the feeling of threat in society. A feeling of threat and distress can be influenced by the span of emotions experienced by a person, and as it is rather clear, that the situation of pandemic evokes negative emotions, they can range from fear to depression, to even disgust. In this study, we wanted to verify the influence of the negative emotions of automatic origin, related to the well-being and homeostasis of the organism and the negative emotions of reflective origin, which are related to social constructs, on the feeling of threat caused by the pandemic outbreak. We expected automatic emotions to have a greater influence on the feeling of threat. We used an online questionnaire to measure the intensity of negative emotions and the feeling of threat among Polish participants in the time of the early outbreak of the pandemic (March-April 2020). Regression analyses were used to identify the predictors of the feeling of threat. The results show the distinctive effect of automatic and reflective groups of emotions. While automatic emotions always increased the feeling of threat, the reflective emotions suppressed the distress, especially in the group of middle-aged and elderly participants. As reflective emotions are developing in the process of socialization, the observed results could suggest, that young people do not process the situation of the pandemic in reflective categories, which leaves them more worried about the situation. We suggest, that promoting reflective thinking can be helpful in interventions in the cases of anxiety caused by the pandemic, as well as in social communication regarding the topic of the pandemic.

Patient-Reported Outcomes Collection at an Urban HIV Clinic Associated With a Historically Black Medical College in the Southern United States: Qualitative Interview Study Among Patients With HIV.

Black Americans, particularly in the southern United States, are disproportionately affected by the US HIV epidemic. Patient-reported outcome (PRO) data collection can improve patient outcomes and provide oft-overlooked data on mental health, substance use, and patient adherence to antiretroviral therapy. We piloted the use of an electronic tablet to collect PRO data on social and behavioral determinants of health among people with HIV at the Meharry Community Wellness Center, an HIV clinic affiliated with a Historically Black Medical College in Nashville, Tennessee. Our primary objective was to better understand patients' experiences and comfort with using an electronic PRO tool through patient interviews. We enrolled 100 people with HIV in care at the Meharry Community Wellness Center consecutively to completely validate PRO tools using the Research Electronic Data Capture platform on a hand-held tablet. Using a purposive sampling strategy, we enrolled 20 of the 100 participants in an in-depth interview (IDI). Interview guide development was grounded in the cognitive-behavioral model, in which thoughts, feelings, and behaviors are interrelated. IDIs were audio recorded, transcribed, deidentified, and formatted for coding. A hierarchical coding system was developed and refined using an inductive-deductive approach. Among the 100 people with HIV enrolled, the median age was 50 (IQR 42-54) years; 89% (n=89) were Black, 60% (n=60) were male, and 82% (n=82) were living below 100% of the federal poverty level in 2016. Five major interview themes emerged: overall experience, question content, sensitive topics, clinic visit impact, and future recommendations. IDI participants felt that the tablet was easy to use and that the question content was meaningful. Question content related to trauma, sexual and drug use behaviors, mental health, stigma, and discrimination elicited uncomfortable or distressing feelings in some participants. Patients expressed a strong desire to be truthful, and most would complete these surveys without compensation at future visits if offered. The use of an electronic tablet to complete PRO data collection was well received by this cohort of vulnerable persons in HIV care in the southern United States. Despite some discomfort related to question content, our cohort overwhelmingly believed this was a meaningful part of their medical experience and expressed a high desire for truthfulness. Future research will focus on scaling up the implementation and evaluation of PRO data collection in a contextually appropriate manner while obtaining input from providers and staff to ensure that the collected data are both applicable and actionable.

Relationship between Burden, Quality of Life and Difficulties of Informal Primary Caregivers in the Context of the COVID-19 Pandemic: Analysis of the Contributions of Public Policies

The study aimed to characterize and understand the difficulties experienced by informal caregivers from a bio-psychosocial and environmental perspective, taking into account the socio-demographic and health characteristics of the informal caregiver and the person cared for, quality of life, perceived burden, social support, and the impact of the COVID-19 pandemic on the informal caregiver and the person cared for. The participants were 371 informal primary caregivers, 80.9% female, aged between 25 and 85 years, mean 53.17 (SD = 11.45) years. Only 16.4% of the informal caregivers benefited from monitoring and training for informal caregiver skills; 34.8% received information on the rights of the person being cared for; 7.8% received advice or guidance on the rights and duties of the informal caregiver; 11.9% of the caregivers benefited from psychological support; and 5.7% participated in self-help groups. A convenience sample was used, and data were collected via an online questionnaire. The main findings show that the major difficulties experienced by caregivers are related to social constraints, the demands of caring, and the reactions of the person cared for. The results reveal that the burden of the main informal caregivers is explained by the level of education, quality of life, level of dependence of the person cared for, level of difficulties, and social support. The COVID-19 pandemic impacted caregiving by increasing the perceived difficulty of accessing support services, such as consultations, services, and support; causing distress feelings in the caregiver, such as, anxiety and worry; increasing the needs and symptoms of the person cared for; and increasing the degree of isolation, for both, the informal caregiver and the person cared for.

Dementia Caregiving Experiences and Health Across Geographic Contexts by Race and Ethnicity.

Few studies have examined how the intersectionality of geographic context and race/ethnicity influences dementia caregiving. Our objectives were to determine whether caregiver experiences and health (a) differed across metro and nonmetro areas and (b) differed by caregiver race/ethnicity and geography. We used data from the 2017 National Health and Aging Trends Study and National Study of Caregiving. The sample included caregivers (n = 808) of care recipients ages 65 and older with "probable" dementia (n = 482). The geographic context was defined as the care recipient's residence in metro or nonmetro counties. Outcomes included caregiving experiences (care situation, burden, and gains) and health (self-rated anxiety, depression symptoms, and chronic health conditions). Bivariate analyses indicated that nonmetro dementia caregivers were less racially/ethnically diverse (82.7% White, non-Hispanic) and more were spouses/partners (20.2%) than their metro counterparts (66.6% White, non-Hispanic; 13.3% spouses/partners). Among racial/ethnic minority dementia caregivers, nonmetro context was associated with more chronic conditions (p < .01), providing less care (p < .01), and not coresiding with care recipients (p < .001). Multivariate analyses demonstrated that nonmetro minority dementia caregivers had 3.11 times higher odds (95% confidence interval [CI] = 1.11-9.00) of reporting anxiety in comparison to metro minority dementia caregivers. Geographic context shapes dementia caregiving experiences and caregiver health differently across racial/ethnic groups. Findings are consistent with previous studies that have shown that feelings of uncertainty, helplessness, guilt, and distress are more prevalent among people providing caregiving from a distance. Despite higher rates of dementia and dementia-related mortality in nonmetro areas, findings suggest both positive and negative aspects of caregiving among White and racial/ethnic minority caregivers.

Mood and Emotions among Inmates after COVID-19 Pandemic

During imprisonment, inmates face many difficulties in adapting to life behind bars. The aim of the study was to find out (a) how challenging for inmates were the selected COVID-19 pandemic-related changes and stressors, (b) what moods and emotions are most commonly experienced by prisoners just after the difficult period of the COVID-19 pandemic, and (c) which of the selected factors determine the positive and negative mood of inmates. The research was conducted in July 2022 in six randomly selected Polish prisons. Prisoners (N = 250) were invited to participate. Comparative and regression analyses were carried out. Two scales measuring moods: the General Mood Scale and the Mood Scale (positive and negative), the Emotions Questionnaire by B. Wojciszke and W. Baryła, and a proprietary questionnaire were used. Sanitary restrictions implemented in prisons resulted in a moderate experience of discomfort among prisoners, mainly in terms of not being able to have direct contact with family and friends, limitation in their personal freedoms to do their jobs, self-development, and deterioration of mental and physical health. A depressed mood predominated among the prisoners, making them feel unhappy, discouraged, tense, and uptight. They reported dominant feelings of alienation, distress, anxiety, and worry at the time of the survey. The mood of inmates was changing from more positive to more negative; on average, it was described as moderate. Based on the regression coefficients, the significant predictors of inmates' positive mood were perceived happiness (for those who got sick with COVID-19 during their prison sentence) and joy, angst, and contentment (for the healthy ones). In the group of SARS-CoV-2-infected prisoners, unhappiness, age, concern, cheerfulness, and rage were found to be predictors of their negative mood. The feeling of joy appeared to be a significant predictor of negative mood for those inmates who had no personal experience with COVID-19. It is necessary to provide convicts with continuous psychological care and to monitor their mood. Such measures should be the foundation for restorative interventions.

Unhelpful thoughts and distress regarding symptoms are associated with recovery from upper extremity fracture

BackgroundThere is evidence that thoughts and emotions regarding symptoms are strongly associated with levels of comfort and capability for a given injury or disease. Longitudinal data from a large cohort of people recovering from an upper extremity fracture provided an opportunity to study how these mindset factors evolve during recovery. MethodsSeven hundred and four adults (66% women, mean age 59 ± 21 years) recovering from upper extremity fracture completed two measures of reaction to symptoms (the Pain Catastrophizing Scale and the Tampa Scale of Kinesiophobia), a visual analog scale of pain intensity, and two measures of magnitude of incapability 1 week, 3 to 4 weeks, and 6 to 9 months after fracture. ResultsExploratory factor analysis identified distinct groupings of questions addressing unhelpful thoughts and feelings of distress regarding symptoms. The number of distinct question groupings of mindset factors diminished over time. Variations in those groupings of mindset factors were associated with a notable amount of the variation in comfort and capability at all time points. Questions pertaining to unhelpful thoughts about symptoms had stronger associations with comfort and capability than questions measuring distress about symptoms, more so as recovery progressed. ConclusionsThe need to integrate mental health into musculoskeletal is bolstered by the observation that mindsets—interpretation of symptoms in particular–are key contributors to comfort and capability.

Teachers’ job demands, resources and their job satisfaction: Satisfaction with school, career choice and teaching profession of teachers in different career stages

Teachers' job demands and resources can have a crucial impact on a school's ability to retain teachers. Analyses of Talis 2018 data from 24 European countries using the Job Demands and Resources model showed that a safe school climate, and a collaborative and participative school culture were the main job resources, whereas feelings of distress and perceived barriers for professional development were the main job demands. Findings were similar for teachers at different stages in their careers, but differed for satisfaction with their school, career choice and the teaching profession in general.

Techniques to strengthen entrepreneurship: is mindfulness a useful concept for resilience development?

Purpose The purpose of this study is to increase the resilience capacity of residential health-care professionals to achieve intrapreneurial development in workers. Through training based on the development of emotional competencies and the application of mindfulness techniques, the aim is for the individual to become aware of his or her role, learn to manage emotions and reduce feelings of distress and anxiety. Design/methodology/approach The proposed programme has a duration of eight weeks. Every four days of training, mindfulness sessions are integrated, and at the beginning and end of the working day, 10 min are spent with superiors to give feedback on what happened during the day and the setting of new objectives. A control group is also established where they do not undergo such training. After the delivery of the programme, the results obtained after the application of the methodology to a sample of 91 residential health-care professionals are presented. By means of a validated resilience questionnaire composed of 25 items, the aim is to measure the resilience capacity of the participants before and after training and to observe the impact of the programme. Findings The results of this study show that the training has led to an improvement in the overall resilience capacity by 3.93% and has been able to reduce the existing gap between those over 45 years of age and younger people, although the age-related variable still represents a significant difference. Originality/value This study provides an innovative way of fostering entrepreneurship. While participants work on resilience management through mindfulness techniques, organisational commitment is achieved.

The mind and the hand.

Symptoms are determined in large part by mindsets. Feelings of distress and unhelpful thoughts (misinterpretations) of symptoms account for much of the variability in comfort and capability with the severity of the underlying pathophysiology making a more limited contribution. Incorporating this experimental evidence into the daily practice of hand surgery will help us find ways to develop healthy mindsets, to prioritize the alleviation of distress and the gentle redirection of unhelpful thoughts, to avoid unnecessary surgery, and to provide better psychological and social support for people recovering from injury and surgery.

Problems of children’s involvement in interpreter-mediated meetings between their teachers and their parents

Abstract This paper focuses on six interpreter-mediated interactions between teachers, migrant parents, and their children in Italian primary schools, a topic that has not yet been widely examined in the literature on public service interpreting. The analysis draws on audio-recorded interpreter-mediated interactions collected in Italy during a European Horizon 2020 project. The paper shows the barriers that exist in engaging children in these interactions. The difficulties observed are varied and more challenging to overcome than those hindering parental involvement. While Childhood Studies shows that the important enhancement of children’s agency in social contexts needs particular non-hierarchical structures of interaction, in the analysed interpreter-mediated interactions the mutual positioning of teachers, parents and mediators does not allow this enhancement. Thus, the involved children stay silent, they provide minimal responses when addressed, they show feelings of distress, and their few initiatives are not supported by the other participants. The paper shows the reasons for the failure of both teachers’ actions and mediators’ coordination to involve children and support their exercise of agency.

Stories of hope created together: A pilot, school-based workshop for sharing eco-emotions and creating an actively hopeful vision of the future.

The climate and ecological crises challenge all communities across the world, with the greatest impact upon the most vulnerable and the youngest. There are multiple impacts on mental health, including the psychological burdens that arise with increasing awareness of the loss, threat and injustice caused by these crises. Large numbers of young people globally are understandably concerned and distressed about these crises, whilst simultaneously reporting that their concerns are regularly dismissed and ignored, particularly by those in power. This can increase feelings of isolation and distress, particularly if they have no recourse to effect change. This pilot project sought to explore how a schools-based, co-created workshop for school pupils aged 16 to 18 years could use a community-oriented space to explore their eco-emotions, address feelings of isolation and engender a sense of realistic, active hope, using storytelling and images of possible futures. A 3-h workshop for delivery in schools was co-designed with young people, researchers, educators and clinicians, using principles of Youth Participatory Action Research (YPAR). Six school pupils aged 16-18 years consented and four completed the workshop, which involved a range of group-based activities to explore their understanding of the climate and ecological crises, support emotional expression related to these and engage in storytelling about hopeful and realistic futures. A live illustrator in attendance created shared images of the participants' fears and hopes. The workshop was recorded, transcribed and analysed using Thematic Analysis and sentiment analysis. Feedback was sought from participants at 1 and 4 weeks after completion and analysed using content analysis. Results indicated that participants reported a range of painful and positive emotions about the crises. They highly valued having space to express their experience alongside others. Storytelling and creativity appeared to help them articulate their feelings and hopes for the future, and gave them greater motivation and confidence in talking to others about these topics. This innovative pilot study suggests that a school-based youth participatory group could offer a novel way of helping young people to engage more with the climate and ecological crises in a way that supports their wellbeing. It provides strong support for future, larger-scale projects in this area.

Exploring ethical challenges in Singapore physiotherapy practice: Implications for ethics education

Introduction: Workplace contexts, including political and sociocultural systems influence health professions’ perception and experience of ethical issues. Although established health ethics principles are relevant guiding values, they may be experienced and interpreted differently within different health contexts. How should ethics education account for this? This paper presents ethical dilemmas and concerns encountered by physiotherapists practicing in Singapore and discusses the implications for ethics education. Methods: Qualitative methods informed by interpretivism and phenomenology were employed. In-depth interviews with 42 physiotherapists from different workplace settings in Singapore were conducted. Participants described everyday ethical challenges they encountered. Inductive content analysis was used to analyse the interview transcript data. Results: Ethical issues occurred within and across three spheres of ethics: micro, meso and macro. Ethical issues at the micro sphere centered around physiotherapist-patient relationships, interactions with colleagues, and therapists’ feelings of moral distress. In the meso sphere, ethical challenges related to influences arising from the organizational resources or systems. In the macro sphere, ethical challenges developed or were influenced by sociocultural, religious, economic, and political factors. Conclusion: The findings reflect current literature indicating that context can influence ethical situations, as experienced and perceived by physiotherapists in their unique settings. Such empirical data might inform the development of ethics curricula to ensure that universal ethical principles are situated within the realities of clinical practice. Locally relevant and realistic ethical case studies will better enable students to recognise and address these situations.

Mattering, Stress, and Burnout in Feelings of Distress, Defeat, and Entrapment Among Chinese High School Students

Mattering, Stress, and Burnout in Feelings of Distress, Defeat, and Entrapment Among Chinese High School Students

A Study on the Impact of Depression on Self-Confidence of Students

Depression occurs when you feel as though you are being suffocated every moment of every day and that no one can help you. It refers to feelings of extreme distress and loss. In short words, it will in general be feeling much better by three straightforward practices. Which are proactive, urgent and difficult? Indeed, practicing feelings of despair can bring about a significant shift in a person's life and prepare them for unanticipated bouts of misery. In contrast, discouragement can manifest itself in a variety of ways, including as a perception, a psychological illness, or a mood swing, each of which has distinct stages. Serotonin irregularity in the mind is clinical sadness.

Disability in Obsessive-Compulsive Disorder and its Impact on Caregiver’s Burden and Quality of Life

Abstract Background: Obsessive-compulsive disorder (OCD) is a chronic illness that can cause marked anguish and disability. OCD negatively affects the quality of life (QoL) and brings disability in marital, occupational, emotional, and social functioning. Family members of OCD patients unknowingly start adjusting their personal and family routine to lessen the patient’s anxiety or irritability due to compulsive behaviors. Their involvement with compulsive behaviors of OCD patients compromise their social activities that lead to feelings of social isolation and marked distress. Studies carried out on family members have also reported poor QoL in the domains of physical well-being, psychological well-being, and social well-being. Methods: This is a cross-sectional, observational, hospital-based study. Fifty adult patients with OCD were recruited in the study along with their caregivers, who were visiting the Department of Psychiatry, ABVIMS, Dr. R. M. L. Hospital, New Delhi, India. Patients diagnosed with OCD as per diagnostic and statistical manual 5 criteria were assessed on Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom Checklist, Y-BOCS to know about the severity and Indian Disability Evaluation and Assessment Scale was used to assess disability. The primary caregivers, who were continuously staying with patient for last 2 years, were assessed on Zarit Burden Interview to assess caregiver’s burden and WHOQOL-BREF was used to assess the QoL. Results: There was a negative correlation between total YBOCS score, global disability score of patients, burden of caregivers with all domains of QoL of caregivers of patients, and statistically significant values were seen in psychological health and social domains. Caregiver burden was positively correlated with disability. Both QoL and severity of illness have more significant negative impact on caregiver QoL and burden. Conclusion: Severity of illness and disability in patients with OCD cause significant negative impact on QoL and brings about huge burden on caregivers.

Family Recovery from Addiction and Trauma: An Interpretative Phenomenological Analysis of Mothers' Lived Experience.

Addiction has a devastating impact in the lives of millions of people worldwide. Mothers constitute a hidden population. Previous research did not focus on mothers' experience of recovery. An Interpretative Phenomenological Analysis was used to analyze the experiences of 10 mothers whose young adult son/or daughter was in recovery from addiction. Four themes delineated mothers' lived experience of the long journey from traumatic loss and isolation to traumatic growth and connection: (a) Trauma and despair. Loss of relationships and healthy family life, (b) coping strategies, (c) finding meaning and constructing a new identity, and (d) connection and gratitude. Overall, halting the descent into despair involved a perceptual shift that restored meaning, relationships, and hope and alleviated mothers' feelings of chronic grief and distress over their adult child's addiction problems. Addiction can have a damaging traumatic impact on mothers which is enhanced by social and self-stigmatizing processes. Ambiguous loss can occur when one's child uses substances, as the child may be physically present yet be psychologically absent in terms of the mother (and the family). Understanding the experience of mothers may help health and social care professionals to develop compassion, patience, and empathy towards mothers of persons with addiction problems. Mental health professionals need to be aware of the devastating impact of addiction problems on all family members in order to validate their experiences and support them in recovering from trauma and loss in the family.

Prevalence and Spectrum of Occupational Injury Among Orthopaedic Surgeons: A Cross-Sectional Study.

An electronic survey was developed to assess both physical and mental occupational hazards among orthopaedic surgeons. Descriptive statistics were analyzed for all survey items and compared using chi-square and paired t tests, as appropriate. The 1,645 responding orthopaedic surgeons (7% response rate) reported a total of 2,702 work-related musculoskeletal injuries, 17.9% of which required surgical treatment. Of the 61 who filed a disability claim, only 66% returned to work and 34% retired early. Additionally, 17.4% of respondents reported having been diagnosed with cancer since starting practice, and 93.8% reported experiencing a finger stick at some point in their career. Over one-half (55.8%) had experienced feelings of psychological distress since beginning practice, and nearly two-thirds (64.4%) reported burnout from work. This study captured a spectrum of occupational injuries that pose longitudinal risks to an orthopaedic surgeon's physical and mental well-being. Our hope is that this analysis of occupational hazards will help to raise awareness among the orthopaedic and medical communities and lead to efforts to reduce these risks. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.