Coping Intervention Research Articles

Interventions to Reduce Loneliness Among Community-dwelling Older Adults: A Network Meta-analysis and Systematic Review.

This study aimed to evaluate the effectiveness of interventions in reducing loneliness among community-dwelling older adults. A network meta-analysis (NMA) and systematic review. Interventional studies were included if they contained original quantitative data on interventions to reduce loneliness among community-dwelling older adults. Qualitative studies were included if they contained views on loneliness coping strategies or intervention evaluation. Six English databases and 3 Chinese databases were searched for studies published before August 2023. We extracted mean and standard differences (SDs) for the NMA to examine the overall effectiveness and efficacy of different interventions on loneliness. Thematic analysis was used to derive perspectives on coping strategies to mitigate loneliness. Forty-six quantitative studies with 6049 participants and 40 qualitative studies with 1095 participants were included in the analysis. The pooled effect size was large and significant (standardized mean difference [SMD],-0.95; 95% CI,-1.32 to-0.58; P < .001), indicating a strong effect of interventions in reducing loneliness. Subgroup analyses revealed significant differences in effect sizes by study region and health risk. Results of the NMA suggested interventions seem to be most effective when having psychosocial interventions as the content, a combination of individual and group as the delivery mode, and a mixture of face-to-face and online methods as the contact mode. Findings of the qualitative synthesis revealed 2 main dimensions of activities for reducing loneliness, including delivery modes (individual or group or combination) and settings (indoor or outdoor or combination). Strategies for coping with loneliness at the social, cognitive, and behavioral levels were also identified. The present study identified the most effective components of loneliness interventions in reducing loneliness among older adults. Findings offer important insights for practice and policy-making on potential strategies that can be used to reduce loneliness among community-dwelling older adults.

An ecological momentary assessment of the stress and coping experiences of dual-career badminton athletes

A dual-career that combines academic and sporting pursuits can be stressful, as such, it is of importance to explore how dual-career athletes appraise and cope with stress. Existing dual-career literature is limited by retrospective methodologies. In seeking to address these limitations, this study utilized ecological momentary assessment three days a week for four consecutive weeks to explore the stress and coping experiences of six highly trained dual-career student badminton athletes aged between 18 and 26 years (Mage =20.75, SD = 2.4). Deductive thematic analysis of EMA diaries highlights that dual-career athletes experience various competitive, organizational, and personal stressors. Situational characteristics underpinning identified stressors were novelty, ambiguity, imminence, duration, and timing, which aligned predominantly with threat and harm appraisals and occasionally with challenge appraisals. The applied implications of study findings are discussed, particularly regarding EMA methodology for future dual-career research and coping interventions for dual-career student-athletes.

Assessing Regional Strategies to Cope with Drought, Climate, and Environmental Flow Policy Impacts for a Sustainable Water Supply: A Case Study of the Bay Area.

California's Bay-Delta watershed encompasses 40% of the state's runoff and serves water supply and irrigation needs throughout the state. A recently amended policy attempts to rebalance water supply and ecological outcomes by requiring 40% of the flow to remain in-stream in the Tuolumne River and other tributaries between February 1 and June 30 each year. This policy impacts water supply diversions serving millions of customers in the San Francisco Bay Area. This work analyzes possible regional coping responses in the context of climate and policy uncertainty, exploring the effectiveness of various strategies to mitigate climate and policy impacts and improve future water supply outcomes. We find that climate uncertainty has a dominant impact on three measures of water supply performance: the frequency of full storage reserves, minimum storage level, and uncaptured flow remaining. Coping interventions in the ranges considered (0-500,000 acre-feet/0-620 million m3 new storage; 0-60,000 acre-feet per year/0-70 million m3 per year new supplies) can serve to mitigate climate impacts and to fully or partially offset the impact of the in-stream flow policy. Regardless of the policy, coping interventions are needed to avoid critically low storage levels. Our analysis indicates that recharge may be an effective strategy to increase capture of Tuolumne River streamflow, with an expected yield of 0.15-0.51 units of flow captured per unit of recharge capacity added, compared to reservoir expansion, with an expected yield of 0.05-0.07 units of flow captured annually per unit of volume capacity added.

A Comprehensive Evaluation of the Role of Social Workers in Reducing Burnout among Nursing Technicians in High-Stress Hospital Environments

Nursing technicians are a vulnerable population that experiences burnout due to working in context of high stress hospitals and this phenomenon reduces the health of the nurses and the quality of care afforded to the patients. Based on their knowledge and practice backgrounds in mental health, crisis, as well as, coping interventions, social workers are well-suited for addressing this problem. In this paper a performance assessment of social workers is conducted, based on a study of strategies and interventions averted to decrease burn out among nursing technicians in a hospital sector. Employing both the qualitative and quantitative approaches, this study evaluates the results of the studies performed to reduce the burnout level and provides the qualitative information of the strategies that the social workers should use to assist the nursing technician under great pressure. This research shows that social workers are strategic in offering support, helping clients work through stress, and fighting for systems that reduce stress. However, the research also outlines some difficulties for integrating social work with clinical teams in the future.

Feasibility and preliminary efficacy of a systematic transaction model-guided dyadic coping nursing intervention for patients with breast cancer and their spousal caregivers: A pilot study

ObjectiveThis study aimed to assess the feasibility, acceptability, and preliminary efficacy of a Systematic Transaction Model (STM)-guided dyadic coping nursing intervention for patients with breast cancer and their spouses. MethodsA single-arm, pre-test/post-test pilot study was conducted at a tertiary hospital in Wuxi, China, recruiting 28 breast cancer patient–caregiver pairs. Each dyad participated in six hybrid intervention sessions. Paired t-tests were used to evaluate pre- and post-intervention changes, and effect sizes were calculated. Feasibility was assessed by recruitment and retention rates, acceptability via the Client Satisfaction Questionnaire-8 (CSQ-8), and preliminary efficacy through measures of body image, dyadic coping, post-traumatic growth, and marital satisfaction. ResultsAll 28 dyads completed the intervention. Patients showed small-to-moderate improvements in body image, post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.4–0.5, P ​≤ ​0.022), with clinically meaningful changes observed in 39%–68% of patients. Spousal caregivers also demonstrated improvements in post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.3–0.6, P ​≤ ​0.033), with 36%–46% showing clinically important differences. ConclusionsThis pilot study supports the feasibility and initial efficacy of an STM-guided dyadic coping intervention, which may benefit breast cancer patients and their spouses as a unit. Further large-scale trials are recommended to validate these findings. Trial registrationChina Clinical Trial Registry (ChiCTR2400083416).

Study protocol for a randomized controlled trial of Adapt 2 Asthma (A2A), a culturally relevant coping skills and asthma management intervention for Latinx Families

BackgroundLatinx children in the United States experience disparities in asthma control and asthma-related functional outcomes compared to non-Latinx White children, including more school absences, emergency department visits, and hospitalizations for asthma. Stress appears to play a role in asthma control, but interventions designed to address the role of stress in asthma control for Latinx children are limited.MethodThe current randomized controlled trial tests the effects of Adapt 2 Asthma (A2A), a family-based coping skills and asthma management intervention tailored to the stressors, strengths, and cultural beliefs of Latinx families, compared to an asthma self-management control arm (the Asthma Plan for Kids; APK). Latinx families of children ages 8 to 14 years old with asthma (target N = 280) are identified and enrolled from primary care clinics and randomly assigned to either A2A or APK. The intervention is delivered by lay health workers trained and receiving ongoing consultation from the study team. The primary outcome is child- and parent-reported asthma control, while secondary outcomes are child’s quality of life, lung function, school absences, and emergency department visits, and child and parent coping and family asthma management behaviors. Participants will be assessed at baseline, post-intervention, and at 6- and 12-month follow-up timepoints.DiscussionThis study has the potential to provide new evidence regarding the effects of culturally relevant coping and asthma management intervention strategies for Latinx children with asthma.Trial RegistrationClinicaltrials.gov NCT05118282. Registered on 11 November 2021.

The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study.

Self-harm in young people is a growing concern and reducing rates a global priority. Rates of self-harm documented in general practice have been increasing for young people in the UK in the last two decades, especially in 13-16-year-olds. General practitioners (GPs) can intervene early after self-harm but there are no effective treatments presently available. We developed the GP-led COPING intervention, in partnership with young people with lived experience and GPs, to be delivered to young people 16-25 years across two consultations. This study aims to examine the feasibility and acceptability of conducting a fully powered effectiveness trial of the COPING intervention in NHS general practice. This will be a mixed-methods external non-randomised before-after single arm feasibility study in NHS general practices in the West Midlands, England. Patients aged 16-25 years who have self-harmed in the last 12 months will be eligible to receive COPING. Feasibility outcomes will be recruitment rates, intervention delivery, retention rates, and completion of follow-up outcome measures. All participants will receive COPING with a target sample of 31 with final follow-up data collection at six months from baseline. Clinical data such as self-harm repetition will be collected. A nested qualitative study and national survey of GPs will explore COPING acceptability, deliverability, implementation, and likelihood of contamination. Brief GP-led interventions for young people after self-harm are needed to address national guideline and policy recommendations. This study of the COPING intervention will assess whether a main trial is feasible. ISRCTN (ISRCTN16572400; 28.11.2023).

ONLINE PRACTICE TEST BANK SOLUTION: A WEB-BASED REVIEW PLATFORM FOR LIBRARY AND INFORMATION SCIENCE PRACTITIONERS

Test construction and test administration in most institutions still adopt the traditional pen-and-paper method of examination, which is very tedious (Kotwal et al., 2016). Its lengthy process can limit the time instructors in devoting to their proactive instruction and assessment. The general purpose of the study is to develop an Online Practice Test bank for Library and Information Science Practitioners. To actualize the Online Practice Test bank, the researcher followed the three phases of the modified rapid application model: Planning or Analyze Phase, Design and Development or Prototyping Phase, and Testing. The result of the study revealed that the developed system was able to execute its different operations. Specifically, by providing an avenue to the contributors/review masters and the reviewees to communicate and interact regarding the different reviewers provided. The reviewees can also track their progress through the learning analytics feature of the system. The contributors/review masters can monitor if the review materials they have provided has efficient test items by accessing the test item analysis. The system also has undergone functionality testing through conducting test cases, which have also gained positive remarks. Based on the results of the developed Online Practice Test bank, it is concluded that the system attained its three objectives in having integrated features that would be a great help, especially to the future licensed professional librarians as they will have a platform where they do their review and assess their knowledge on the six core subjects of library science. It is therefore recommended that mobile or android-based user modules must be developed for it to be more accessible to the users. And also an automated intervention or scaffolding for coping with the results from the performance of the review. And it must have an option or platform for contributors outside the institution who want to share their review materials relevant to the Library and Information Science profession.

Causes and Coping Strategies for Technology Anxiety Among the Elderly in the Digital Age

In the digital age, technology anxiety among the elderly has emerged as a significant challenge, affecting their ability to participate fully in modern society and posing serious threats to their mental health. This paper explores the root causes of technology anxiety among older adults, including the generational technological divide, cognitive decline, physical limitations, fears of cybersecurity threats, and lack of tailored training and support. The impact of this anxiety is profound, leading to increased social isolation, reduced access to health information and services, heightened stress, and diminished self-esteem. To address these issues, the paper proposes several coping strategies and interventions, such as inclusive digital literacy programs, intergenerational mentorship, the design of age-friendly technologies, and the promotion of positive attitudes toward technology use. These strategies aim to empower older adults to navigate the digital landscape more comfortably, turning potential barriers into opportunities for growth, social engagement, and improved mental health. The findings highlight the need for a collaborative approach among policymakers, technology developers, and communities to create a more inclusive digital environment that supports the elderly in overcoming technology anxiety and thriving in the digital era.

Effectiveness of the Dyadic Coping Intervention of Social Participation (DCISP) for stroke survivors: study protocol for a randomized controlled trial

BackgroundEnhancing social participation is not only the main goal of stroke survivors' community rehabilitation but also a protective factor affecting their physical and emotional health. The current state of stroke survivors' social participation is not encouraging due to the high disability incidence of stroke. Spouses may play a facilitating role in the social participation of patients by providing them with support and assistance. However, there remains a lack of evidence specifically regarding dyadic coping interventions of social participation for stroke survivors, and the intervention strategies are still underdeveloped without clear theoretical frameworks. Therefore, this proposed study aims to develop and evaluate the effectiveness of the Dyadic Coping Intervention of Social Participation (DCISP) for survivors of first-episode homebound stroke.MethodsA single-blind (assessor-blinded), randomized controlled trial will be conducted to verify the effectiveness of DCISP. The randomized controlled trial will be preceded by a feasibility study (N = 20) of DCISP in stroke survivors. Stroke survivors will be randomly classified (1:1) into either a control (N = 50) or an experimental group (N = 50). In addition to routine care, participants in the experimental group will receive six 40 ~ 45 min sessions of guidance, once every two weeks. The primary outcome is social participation of stroke survivors, measured using Impact on Participation and Autonomy Questionnaire (IPA) and Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), and the secondary outcomes will be measured by Knowledge Questionnaire for Stroke Patients (SPKQ), Stroke-specific Quality of Life Scale (SS-QOL), Dyadic Coping Inventory (DCI), Modified Rankin Scale (mRS) and Zarit Caregiver Burden Interview (ZBI-22). These will be measured at baseline(T0), during the intervention (T1 = 1 month), and after intervention completion (T2 = 3 months, T3 = 6 months).DiscussionFindings from the study will provide evidence of the effects of DCISP on improving the social participation of first-episode homebound stroke survivors. The results of this study may support the implementation of survivor–spouse dyads care support in stroke survivors and provide a reference for clinical rehabilitation nursing practice, offering new insights into nursing interventions for stroke patients.Trial registrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2400083072. Registered on 20 July 2023.

Cancer Coping, Family Support, and Post-traumatic Growth in Female Genital Cancer Patients––A Secondary Publication

Objective: The purpose of this study was to identify the relationship between cancer coping, family support and degree of post-traumatic growth in female genital cancer patients receiving chemotherapy and provide evidence for nursing intervention to enhance post-traumatic growth. Methods: A cross-sectional study was conducted with 114 participants. The cancer coping, family support and post-traumatic growth were measured using a self-reported questionnaire. The collected data were analyzed with independent t-test, one-way ANOVA and Pearson correlation using the SPSS/win 28.0 statistical programs. Results: The mean score of cancer coping was 62.65 ± 13.53, that of intrapersonal coping 38.32 ± 8.34, and that of interpersonal coping was 24.32 ± 6.56. The mean score of family support was 49.06 ± 7.32 and post-traumatic growth was 59.66 ± 17.92. Post-traumatic growth showed a statistically significant positive correlation among intrapersonal coping (r = 0.80), interpersonal coping (r = 0.61), and family support (r = 0.42, p &lt; 0.001). Conclusion: To increase post-traumatic growth, it is necessary to develop coping interventions so that cancer patients can effectively and positively cope with various difficulties and problems in the process of chemotherapy.

Effectiveness of Family Coping Interventions in Improving Problem-Solving Skills in the Care of Children and Adolescent Cancer Survivors during and after Treatment: A Scoping Review.

(1) Context: Cancer triggers significant changes in family dynamics. It is noteworthy that coping and problem-solving skills, particularly in situations involving cancer in children and adolescents, have not been adequately explored in the context of family adaptation. This study aims to analyze the effectiveness of family interventions in coping to improve problem-solving skills in parents and/or caregivers of children and adolescents during and after oncological treatment. (2) Methods: This is a scoping review following the recommendations of the Joanna Briggs Institute and the Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), from 2014 to 2024, in the databases LILACS, CINAHL, SCOPUS, Web of Science, and PUBMED. (3) Results: Forty-five studies were eligible. Coping strategies were categorized as follows: (1) positive attitudes (including a sense of courage and hope, family support to enhance resilience, and future planning), (2) caregiver empowerment (involving acceptance of diagnosis, emotional distancing, and coping through religiosity), and (3) communication skills (encompassing professional communication, horizontal dialogue with healthcare teams, and sincere communication with friends and family). (4) Conclusions: Over time, families develop coping and problem-solving strategies that influence changes in family functioning patterns, aiding them in accepting, reinterpreting, and reframing ideas and feelings associated with neoplasia.

The linguistic and construct validity of the Malay version of the Coping Self-Efficacy Scale (CSES-My): Evidence from a sample of Malaysian parents of children with leukemia or lymphoma.

Parents of children with hematological cancers such as leukemia and lymphoma need to cope with stress related to their child's diagnosis. The Coping Self-Efficacy Scale is a widely used and validated tool to measure an individual's confidence in dealing with stressful situations. Appropriate translation and validation are needed to produce a localized language version suitable for Malaysian contexts. The study aimed to examine the linguistic and construct validity of the Malay version of the Coping Self-Efficacy Scale (CSES-My) among parents of children with hematological cancer. The CSES-My was created through a sequential series of steps, starting with the translation of the original English version, followed by cultural adaptation, and then cognitive interviewing. The 26-item CSES-My was self-administered in a sample of parents of children with leukemia and lymphoma from October 2021 until February 2022. They were recruited via online or face-to-face methods. Exploratory factor analysis was performed to examine the construct validity of the CSES-My. A total of 165 complete responses were analyzed. The scale has two factors, including Personal Coping and Social Coping, accounting for 58.3% of the variance. Personal Coping (19 items, Cronbach's alpha = 0.958) represented the respondents' self-efficacy for independently executing coping strategies, whether through solving problems or changing the way they think about the situation. Social Coping (6 items, Cronbach's alpha = 0.867) represented their confidence in executing coping strategies, which involved using social resources such as seeking external support, distraction, and avoiding loneliness. The CSES-My had reliable and valid psychometric properties, providing evidence for its utility in evaluating coping self-efficacy among parents of children with leukemia or lymphoma in Malaysia. The CSES-My is a valuable tool for nurses and other healthcare professionals investigating coping self-efficacy in Malay-speaking populations, and it may also aid in the development of future coping interventions.

Feasibility and potential effects of a dyadic coping intervention for patients with spinal cord injury and their spouses: a study protocol for a pilot randomised controlled trial

IntroductionIt remains difficult for patients with spinal cord injury (SCI) to fully recover their sensory and motor functions; thus, they must rely on the assistance of caregivers to complete activities...

Unveiling silent stories of women with stillbirth at Shai Osudoku District Hospital

BackgroundStillbirth remains a prevalent issue worldwide, particularly affecting low-income and middle-income countries, where it brings immense sorrow and suffering to families, especially mothers. Sadly, support for women coping with this...

Utilizing sociocultural identity to cope with poverty-related stress: methodological insights from developing a coping intervention

ABSTRACT Cultural identity affirmation, pride, and belongingness are known to protect youth from negative outcomes in the face of uncontrollable stresses such as discrimination, economic hardship, and community violence. Scholars have argued that racial, cultural, and other social identities serve as important coping resources, encouraging active coping and the use of social support and mitigating the impact of stress for marginalized youth. The Building a Strong Identity and Coping Skills (BaSICS) program was designed to improve mental health by targeting the skills, assets, and resources known to protect against developing emotional and behavioral symptoms and disorders. In the BaSICS intervention, youth explore their cultural and social identities to strengthen their understanding of, and connection to, positively supportive social groups via exploration of family and community cultural heritage. Youth are then encouraged to engage their collaborative coping skills founded in their sociocultural identities, working together on a project of collective community action. This methodological paper will describe the theory and development of the BaSICS identity development and collective coping module.

O-176 Hoping for the best, expecting the worst: pregnancy after loss

Abstract Recurrent pregnancy loss (RPL) is an extremely distressing condition and can be both physically and emotionally traumatising. The condition is compounded by the fact that even after diagnostic procedures, the majority of cases, remain unexplained. The early waiting period of a new pregnancy, when confirmation by ultrasound scan of an ongoing and viable pregnancy is awaited, represent a particularly challenging time for those affected by this condition. This waiting period is associated with high levels of distress due to the anxiety of possibly experiencing a further miscarriage. However, there is a lack of understanding amongst some health professionals of the emotional burden of this difficult waiting period, furthermore, limited support and counselling is available, and many women are left to manage their distressing emotions without coping support. While some seek frequent confirmation of viability by ultrasound scans, this approach is not feasible in most clinical settings and, in any case, appears to be of limited efficacy in reducing anxiety. An alternative approach was to provide the woman with tools that could bolster their ability to cope with this challenging period. Our programme of research has investigated the use of the Positive Reappraisal Coping Intervention (PRCI), a self- administered coping technique, based on the principles of positive reappraisal, as a method of providing much needed emotional support. Qualitative research findings have provided deep insight into the lived experience of RPL during the early waiting stages of a new pregnancy, establishing that for those with a history of RPL, this is a traumatic time of great uncertainty, emotional turmoil and immense personal significance, where those affected ‘hope for the best, but expect the worst.’ Whilst our programme of research is still ongoing, studies to date, have demonstrated that study participants were receptive to the use of the PRCI and that it appeared to convey benefits, with no apparent downside. It was a ‘go to’ resource in times of strong emotional need and one that stimulated positive coping, providing respite from the stressor of uncertainty. There is a compelling need to provide those experiencing RPL with increased emotional support to help them manage the stressful early waiting period of a new pregnancy. Findings suggest that PRCI could provide a useful adjunct to care pathways and has the potential to be made more widely available as an effective, safe, convenient, and low-cost intervention to provide emotional support in RPL clinics.

Investigating the association between discrimination, internalizing symptoms, and alcohol use among Latino/a immigrants in the United States.

Internalizing symptoms associated with anxiety and depression have been correlated with harmful alcohol use among Latino/as, but little attention has been paid to assessing the association between perceived discrimination and harmful alcohol use. The present study was designed to investigate the association between perceived discrimination, internalizing symptoms associated with anxiety and depression, and harmful alcohol use among Latino/a immigrants living in the United States (US). Our sample included 426 Latino/a immigrants. Their mean age was 40.05 years (SD = 6.50), 65.50% were women, 80.00% had a partner, 54.20% lived on less than $2,000 a month, and 41.50% reported having attained a college degree. Perceived discrimination was assessed using the Perceived Discrimination Scale, anxious symptoms were assessed using the GAD-7, depressive symptoms were assessed using the CES-D short form, and harmful alcohol use was assessed using AUDIT. We estimated a linear regression model using cross-sectional, self-reported data. The model was statistically significant, R 2 = 0.38, F (8, 425) = 32.09, p < 0.01. Discrimination was significantly associated with AUDIT scores, (β = 0.21, p < 0.01) after accounting for covariates and for symptoms of anxiety and depression. Our results indicate that experiences of discrimination in the US are associated with increased harmful alcohol use even after controlling for other variables. These findings may be useful in designing coping interventions specifically for Latino/a immigrants to reduce the risk of alcohol use disorder. This study also has political and public health implications for acknowledging the detrimental health consequences of experiencing discrimination, providing support to the position that reducing racism and discrimination represent important public health priorities.

Coping strategies and interventions to alleviate moral distress among pediatric ICU nurses: A scoping review.

Moral distress significantly affects pediatric ICU nurses, leading to nurse burnout, increased turnover and reducing patient care quality. Despite its importance, there's a notable gap in knowledge on how to manage it effectively. This review aimed to systematically identify and analyze coping strategies and interventions targeting moral distress among pediatric nurses in ICU, uncovering research gap and future studies directions. A scoping review was conducted followed framework by Levac, Colquhoun, and O'Brien and Arksey and O'Malley. Searches were performed in 11 electrical databases, like PubMed and China Biology Medicine disc, within a timeframe of the database construction to November 2023, and performed literature screening and data extraction. Sixteen articles were ultimately included. Coping strategies adopted by pediatric ICUs nurses can be categorized into adaptive and maladaptive strategies, with the latter including passive acceptance, taking leave, and drinking, while the former involve pursuing interests outside of work, reflection and philosophizing, and communication. Nine articles described and evaluated the effectiveness of interventions for moral distress, categorizing them into individual and institutional levels. Individual-level interventions include Interprofessional Perspective-Taking, the PICU Resiliency Bundle, Ethics Education/Skills, and the Center for Caring. Institutional-level interventions encompasses Comprehensive Care Round, Goals of Care Conversations, Pediatric Ethics and Communication Excellence Rounds, Nursing Ethics Council, and Medical Ethical Decision-Making, though not all were effective in alleviating moral distress. Nurses often use self-adjustment strategies for moral distress, institutional ethical support focusing on enhancing nurses' moral resilience, promoting reflective thinking and improving communication remains crucial. Various interventions for moral distress are currently available, but nurse engagement is low and their effectiveness remained to be verified. Future studies should explore what aids or hinders these interventions. There's also a need for large, multicenter trials and ongoing evaluations to create effective support systems for pediatric ICU nurses.

The CO-produced Psychosocial INtervention delivered by GPs to young people after self-harm (COPING): protocol for a feasibility study

Background Self-harm in young people is a growing concern and reducing rates a global priority. General practitioners (GPs) can intervene early after self-harm but there are no effective treatments presently available. We developed the GP-led COPING intervention, in partnership with young people with lived experience and GPs, to be delivered to young people 16–25 years across two consultations. This study aims to examine the feasibility and acceptability of conducting a fully powered effectiveness trial of the COPING intervention in NHS general practice. Methods This will be a mixed-methods external non-randomised before-after single arm feasibility study in NHS general practices in the West Midlands, England. Patients aged 16–25 years who have self-harmed in the last 12 months will be eligible to receive COPING. Feasibility outcomes will be recruitment rates, intervention delivery, retention rates, and completion of follow-up outcome measures. All participants will receive COPING with a target sample of 31 with final follow-up data collection at six months from baseline. Clinical data such as self-harm repetition will be collected. A nested qualitative study and national survey of GPs will explore COPING acceptability, deliverability, implementation, and likelihood of contamination. Discussion Brief GP-led interventions for young people after self-harm are needed and address national guideline and policy recommendations. This study of the COPING intervention will assess whether a main trial is feasible. Registration ISRCTN (ISRCTN16572400; 28.11.2023).