Mental Health Research Articles

Influence of Recreational Activities on Quality of Life in Retirees in Canada

Purpose: The aim of the study was to analyze the influence of recreational activities on quality of life in retirees in Canada. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Recreational activities significantly enhance retirees' quality of life in Canada by improving physical health, reducing loneliness, and increasing life satisfaction. Activities like walking, gardening, and community involvement boost well-being and mental health. Structured programs offered by community centers also contribute to retirees' sense of purpose and belonging. Access to varied recreational options and social networks is essential for maintaining high life quality. Tailoring activities to individual interests and abilities is key to long-term benefits. Unique Contribution to Theory, Practice and Policy: Activity theory, self-determination theory (SDT), socioemotional selectivity theory (SST) may be used to anchor future studies on influence of recreational activities on quality of life in retirees in Canada. Practitioners should design and implement customized recreational programs tailored to the specific needs, preferences, and health conditions of retirees. Policymakers should allocate resources and funding to support recreational programs specifically designed for retirees.

Personalized care for complex lives: initial outcomes of a behaviorally-informed complex care intervention

Background5% of patients account for the majority of healthcare spend, but standardized interventions for this complex population struggle to generate return on investment. The aim of this study is the development and proof of concept of an adaptive intervention to reduce cost and risk of readmission for medically high-risk individuals with any behavioral health diagnosis.MethodsA behaviorally-oriented, personalized care service was delivered using a consultative, team-based approach including a physician, counselor, dietitian and social worker in collaboration with nurse care coordinators. Iterative re-conceptualizations informed tailored treatment approaches to prevent acute decompensation while retraining behaviors that impeded recovery. This service was offered to a small set of members of the employee health plan at University Hospitals Cleveland with an existing behavioral health disorder from November of 2020 to March of 2023. 26 members receiving the service were identified and matched with 26 controls using a risk algorithm. Members and controls were then classified as high utilizers (n = 14) or standard utilizers (n = 38) based on utilization claims data.ResultsPrimary outcomes of this study included medical expenditures (delineated as planned and unplanned spend) and readmission risk scores. Compared to risk-matched controls, both planned and unplanned health care expenditures significantly decreased (p < .05) for 7 high utilizers, and unplanned spend only significantly decreased for 19 standard utilizers (p < .05). Risk scores, which predict future spend, decreased significantly for standard utilizers (p < .05), but not for high utilizers.DiscussionThe value of a behaviorally-oriented personalized care intervention for medically high-risk patients in a commercial insurance population was demonstrated through decreased spend for high utilizers and decreased risk for standard utilizers. Further expansion, refinement, evaluation and scaling are warranted.

Identification of Amino Acids and Polyphenolic Metabolites in Human Plasma by UHPLC-ESI-QTOF-MS/MS, after the Chronic Intake of a Functional Meal in an Elderly Population

Novel foods especially formulated and targeted for the elderly population should provide sufficient nutrients and bioactive ingredients to counteract the natural age-related deterioration of various organs and tissues. Dietary protein and phenolic compounds achieve this goal; however, older adults have alterations in their gastrointestinal system that may impact their bioavailability and few studies have been aimed at this population. Since phenolic compounds are the subject of multiple biotransformations by host and microbiome enzymes during the digestion process, identification of their bioavailable forms in human plasma or tissues represents a considerable analytical challenge. In this study, UHPLC-ESI-QTOF/MS-MS, chemometrics, and multivariate statistical methods were used to identify the amino acids and phenolic compounds that were increased in the plasma of elderly adults after a 30-day intervention in which they had consumed an especially formulated muffin and beverage containing Brosimum alicastrum Sw. seed flour. A large interindividual variation was observed regarding the amino acids and phenolic metabolites identified in the plasma samples, before and after the intervention. Three phenolic metabolites were significantly increased in the population after the intervention: protocatechuic acid, 5-(methoxy-4′-hydroxyphenyl) valerolactone, and phloretic acid. These metabolites, as well as others that were not significantly increased (although they did increase in several individuals), are probably the product of the microbiota metabolism of the major phenolic compounds present in the B. alicastrum Sw. seed flour and other food ingredients. A significant decrease in 4-ethyl-phenol, a biomarker of stress, was observed in the samples. Results showed that the incorporation of foods rich in phenolic compounds into the regular diet of older adults contributes to the increase in bioactive compounds in plasma, that could substantially benefit their mental, cardiovascular, and digestive health.

Innovations in Preconception Care: Optimizing Health for All Individuals.

Optimizing the overall health of individuals prior to pregnancy can improve both pregnancy and lifelong health outcomes. Despite extremely high financial expenditure on birth in the United States, maternal and infant mortality rates continue to rise. Moreover, significant racial and ethnic disparities persist in perinatal health outcomes. Preconception care, or health care provided before or between pregnancies, has the capacity to meet these challenges. Preconception care can be integrated into every health care visit, including visits with primary care, reproductive health, and mental health care clinicians. Increasing awareness among clinicians of the benefits of preconception care and equipping them with innovative strategies to implement this care into practice, the number of people receiving optimal care could be increased. Recent innovations in preconception care include group care, health applications (apps), reminders in electronic health records, social marketing campaigns, social media movements, community-based partnerships, health care policy and access, and improving public and clinician education on preconception health topics. Ultimately, improving preconception health is best done in partnership between the consumer and clinician. Midwives, whose care is person-centered and partnership-focused, are well positioned to champion the innovation and implementation of equitable preconception care. The purpose of this State of the Science review, therefore, is to synthesize the literature on recent evidence-based innovations that may be used to improve preconception health and counseling.

A Prospective Study of Depression and Quality of Life After Kidney Transplantation.

Depression and diminished health-related quality of life (HRQOL) are common in kidney failure. In this study we investigate whether kidney transplant (KT), the treatment of choice for kidney failure, improves depression and HRQOL across lifespan and whether this effect is sustained. In this longitudinal observational cohort study, we assessed depression and HRQOL in patients on the KT waitlist and again at 3-months and 1-year after KT. We measured depression using the Beck Depression Inventory-II (BDI-II) and HRQOL using the Kidney Disease Quality of Life Short Form Version 1.3 (KDQOL-SF) physical health composite score (PCS) and mental health composite score (MCS). We used linear mixed effect models with random intercepts for patients to evaluate the effect of time, age, and KT status on BDI-II score, PCS, and MCS. For models with significant age interactions, we estimated this effect for baseline age groups. We analyzed 239 longitudinal BDI-II assessments completed by 99 patients and 143 KDQOL-SF assessments completed by 59 patients (16% Black, 79% White). The BDI-II scores improved pre- to post-KT (10 pre-KT vs 5 post-KT, p<0.001). PCS improved pre- to post-KT in younger patients, but the magnitude of change was lower with older age (p for interaction=0.01). In the sub-group analysis by age, there was improvement in PCS post-KT in patients <60 years (p=0.003 for 30-39, p=0.007 for 40-49, p=0.03 for 50-59). The MCS also improved from 47 pre-KT to 51 post-KT (p<0.001), and the magnitude of improvement was again lower with older age (p for interaction=0.03). Depression and HRQOL improve with KT. While depression improves in all ages, the improvement in HRQOL, especially PCS, is more evident in younger patients. This improvement in depression and HRQOL is sustained until at least 1-year post-KT. These data help frame expectations for patients and transplant teams.

Impactos biopsicossociais enfrentados por pacientes com vitiligo: Uma revisão sistemática

Objective: The aim of this review was to report current knowledge about the main signs and symptoms that affect the quality of life of individuals with vitiligo. Methodology: The searches were carried out through searches in the PubMed Central (PMC) databases. Three descriptors were used in combination with the Boolean term "AND": vitiligo; quality of life; depression; psychosocial impact; Medical Psychology. From this search, 275 articles were found, which were subsequently submitted to the selection criteria. Of which, after applying the inclusion and exclusion criteria, 36 articles were selected from the PubMed database, and a total of 19 studies were used to compose the collection. Discussion: Thus, studies denote that the skin, being the largest organ in the body, is crucial for personal image and diseases that alter its pigmentation, such as vitiligo, reduce the quality of life, especially for young people. From a biological and embryonic point of view, the skin and the brain have an intimate relationship, which suggests that changes in it can be associated with mental health problems, exacerbating or triggering dermatological conditions, which culminate in nervousness, decreased self-confidence, anxiety and even depression. Results: It is known that there may be a biomarker for the activity or severity of vitiligo where it is related to the prevalence of psychiatric problems, creating image distortions. In summary, being a multifactorial autoimmune dermatological disease, it would generate a great impact on the lives of patients, influencing individual self-image and the way the world will perceive it, and thus resulting in a worsening of quality of life.

Predicting households’ attitudes and product adoption intentions

PurposeThe present study aims to examine the households’ attitudes and intentions to adopt an indoor air purifier against the smog crisis in India by using a comprehensive theoretical framework based on the combination of the Protective Action Decision Model (PADM) and the Theory of Planned Behavior (TPB). The United Nations Sustainable Development Goals (SDGs) 2030 also emphasized ensuring a healthy and safe life, especially by achieving SDG-3, SDG-11 and SDG-13.Design/methodology/approachUsing purposive sampling, the data were collected through a survey questionnaire distributed to 382 households, and study hypotheses were assessed by using partial least squares structural equation modeling employing SmartPLS.FindingsThe results revealed that mental health risk perception (MHRP) was the most influential determinant of households’ attitudes toward adopting air purifiers, followed by smog knowledge, physical health risk perception (PHRP), information seeking and product knowledge. Notably, results revealed that households’ attitude is a leading determinant of their adoption intention toward the air purifier compared to subjective norms (SN) and perceived behavioral control (PBC).Originality/valueTo the best of the authors’ knowledge, the present study is the first to provide new insights into an individual’s protective behavior response toward ecological hazards by examining the households’ adoption intention toward the air purifier against the smog crisis using PADM and TPB model inclusively. In addition, the present study analyzes the impact of both PHRP and MHRP on individuals’ protective behavior separately. Also, this study provides theoretical contributions and important practical implications for the government, manufacturers and air purifier sellers.

The impact of teachers’ perceived competence in information and communication technology usage, and workplace anxiety on well-being, as mediated by emotional exhaustion

IntroductionThe 2030 Sustainable Development Goals (SDGs) were adopted by the United Nations in 2015, emphasizing the importance of achieving peace, prosperity, and well-being for all people. With the outbreak of the COVID-19 pandemic, sustainable health has become an important issue. Teachers were forced to adopt distance teaching, necessitating rapid upgrading of their ICT skills and integration into e-learning, which caused tangible and intangible pressures on teachers and impacted their well-being. This study examined the effects of ICT competence on teachers’ workplace anxiety, emotional exhaustion, and well-being during the pandemic from the perspective of Social Cognitive Theory (SCT).MethodsA quantitative research methodology and a questionnaire survey with a total of 21 questions were used as the primary research design. The snowball method was employed as a sampling method for online questionnaires from September to October 2021. A total of 216 questionnaires were collected, of which four incomplete questionnaires were excluded, leaving 212 valid questionnaires, with a valid questionnaire recovery rate of 98.1%. The valid questionnaires were analyzed using Smart Pls 4.0 Partial Least Square Method Structural Equation Modeling (PLS-SEM).ResultsThe study found that teachers’ ICT competence could significantly reduce emotional exhaustion and enhance teachers’ well-being. However, there was no significant effect on workplace anxiety. Additionally, well-being was not directly affected by workplace anxiety, and teachers’ well-being needs to be mediated by emotional exhaustion to be indirectly affected. Emotional exhaustion plays an important mediating role between teachers’ ICT competence and workplace stress, both of which are important mediators of well-being.DiscussionFrom a practical point of view, to achieve the Sustainable Development Goals (SDGs) 2030, it is ideal to have good health and well-being for the whole person. This study facilitates the development of strategies to improve the well-being of teachers, which provides an empirical basis for the enhancement of mental health and well-being of educators.

A Scoping Review on Staff Attitudes towards the Use of Coercion in Mental Healthcare

Attitudes of mental health professionals towards the use of coercion are highly relevant concerning its use coercion in mental healthcare, as mental health professionals have to weigh ethical arguments and decide within a legal frame in which situations to use coercion or not. Therefore, assessment of those attitudes is relevant for research in this field. A vital instrument to measure those attitudes towards the use of coercion is the Staff Attitude to Coercion Scale. This scoping review aims to provide a structured overview of the advantages and limitations in the assessment of attitudes toward coercion. We conducted a scoping review in Medline, PsycINFO, CINAHL, and Web of Science, based on the PRISMA-ScR. Inclusion criteria were empirical studies on the attitudes of mental health professionals. We included 80 studies and systematically mapped data about the main results and limitations in assessing attitudes toward coercion. The main results highlighted the relevance and increased interest in staff attitudes towards coercion in mental healthcare. Still, the majority of the included studies relied on a variety of different concepts and definitions concerning attitudes. The data further indicated difficulties in developing new and adapting existing assessment instruments because of the equivocal definitions of underlying concepts. To improve the research and knowledge in this area, future studies should be based on solid theoretical foundations. We identified the need for methodological changes and standardized procedures that take into account existing evidence from attitude research in social psychology, nursing science, and other relevant research fields. This would include an update of the Staff Attitude to Coercion Scale based on the limitations identified in this review.

Impact of Home Assignment on the Achievement of Students in Makawanpur District, Nepal

The main goal of the study is to analyze the impact of home assignment on the achievement of students. The null hypothesis states there is no association between practices of home assignment and the achievement of the students. The study was guided by Achievement Goal Theory of Nicholls as well as descriptive and analytical research design was applied. At the same time, the cross-sectional data collection method was administered. The study was carried out among 386 students of 14 sampled schools of Makawanpur district, Nepal 2024 AD. The students were selected with the stratified random sampling method. The study shows that the students of educated parents spent less time in doing home assignment as compared with the students of illiterate parents. The parental support seems to have positive result on doing home assignment of the students. The location of school and students did not have any effect on doing home assignment. The result shows that there was the positive impact of home assignment on the achievement of the students and statistically, there significant association (p=0.022≤ 0.05) between home assignment and the achievement of students. Home assignment for both the students and parents is a burden. There was a debate on home assignment that it harmed the mental health of the children, at the same time some studies claimed that it had a positive impact on the achievement of the students if administered effectively. The study also emphasized the importance of home assignment for the better achievement of the student in school life. The study helps educational institutions to form a strategic plan and develop the model of home assignment that enhance the achievement of students.

Demographic differences in perceived effectiveness for policies to prevent school shootings: results from a representative survey in New Jersey

ObjectiveTo determine what firearm policies New Jersey residents believe will prevent school shootings and the extent to which this varies by sex, firearm ownership status, and political affiliation.MethodsA representative sample of New Jersey residents (N = 1,018) was collected via the Eagleton Center on Public Interest Polling (ECPIP). Data were weighted to reflect the state's population. Participants were asked to rate how helpful they perceived different firearm-related policies to be for preventing school shootings.ResultsFindings indicate that participants perceived universal and expanded background checks, increased mental health funding, and requiring a license for firearm purchases as most effective for preventing school shootings. Arming school personnel, prayer in schools, decreasing the number of entrances at schools, and secure storage requirements were viewed as less effective. Firearm ownership, sex, and political affiliation significantly influenced perceptions of the effectiveness of these policies.ConclusionThe study examined the perceived effectiveness of policies to prevent school shootings. The study highlights disparities and commonalities in policy support among different groups, emphasizing the importance of collective efforts to address gun violence in schools.

Urgency to secure funding for the promised national school food program amidst the rise of food costs and chronic disease

An overwhelming number of Canadians believe that a national school food program (SFP) would benefit children, but concerns around limited funding are frequently raised. SFPs across Canada are struggling to meet increasing demands due to rising food costs, meaning that food quality and quantity within existing SFPs are suffering. This paper discusses the urgency to implement a cost-shared and federally funded SFP amidst the current economic context and lack of clear direction from the federal government. The paper also explores ways in which federal funding for school meals can help to reduce the rate of chronic diseases and actualize many proven physical and mental health benefits for Canadians, all of which have positive and long-term downstream effects on the country’s economy.

Treatment of Cognitive Impairment Associated with Schizophrenia Spectrum Disorders: New Evidence, Challenges, and Future Perspectives

Cognitive impairment associated with schizophrenia (CIAS) represents one of the core features of the disorder and has a significant impact on functional and rehabilitation outcomes of people living with schizophrenia spectrum disorders (SSD). The aim of this critical review is to highlight the most recent evidence on effective treatments available for CIAS, to discuss the current challenges in this field, and to present future perspectives that may help to overcome them. Concerning psychopharmacological approaches, among the most indicated strategies for the management and prevention of CIAS is to favor second-generation antipsychotic medications and avoid long-term and high-dose treatments with anticholinergic medications and benzodiazepines. Moreover, non-pharmacological approaches such as cognitive remediation and physical exercise-based programs represent evidence-based interventions in the treatment of CIAS that have shown reliable evidence of effectiveness on both cognitive and functional outcomes. These treatments, however, are still delivered to people accessing mental health services with a diagnosis of CIAS in an uneven manner, even in high-income countries. Academic and clinical partnership and collaboration, as well as advocacy from service users, families, carers, and stakeholders’ organizations could help to reduce the bench to bedside gap in the treatment of CIAS. Future perspectives include the development of novel pharmacological agents that could be effective in the treatment of CIAS, the implementation of novel technologies such as telemedicine and virtual reality in the delivery of evidence-based interventions to improve accessibility and engagement, and further research in the field of non-invasive brain stimulation.

Associations between stress, perfectionism, and imposter phenomenon among dental hygiene students.

Imposter phenomenon (IP) depicts the feeling of being a fraud. Stress and perfection are associated with IP, impairing professional and academic performance and negatively impacting mental health. The purpose of this study was to explore the prevalence of IP and perfectionism in dental hygiene students and the relationship with stress. This study used cross-sectional survey research with a nonprobability sampling of dental hygiene students (n=258). The study used three validated instruments: the Imposter Profile (IPP30) with six subscales, the Frost Multidimensional Perfectionism Scale Brief with two subscales, and the Perceived Stress Scale (PSS10). Descriptive, correlation, and linear regression were used for analysis. The completion rate was 74.8% (n=193). Linear regression analysis found the competence doubt (CD) subscale of the Imposter-Profile and perfectionistic striving (PS) were the only statistically significant predictors of stress (F=10.01, p<.001, R2=.16). CD (b=0.36, p<0.001) was twice as strong as PS (b=0.15, p<0.05) in predicting stress in dental hygiene students. In this sample of dental hygiene students, the doubt about competence aspect of imposter phenomenon increased stress more than the striving for perfectionism. Faculty may minimize stress and support students by identifying the feelings associated with imposter phenomenon and highlighting student achievements to build confidence and feelings of self-efficacy.

Using joint probability density to create most informative unidimensional indices: a new method using pain and psychiatric severity as examples

BackgroundDimension reduction methods do not always reduce their underlying indicators to a single composite score. Furthermore, such methods are usually based on optimality criteria that require discarding some information. We suggest, under some conditions, to use the joint probability density function (joint pdf or JPD) of p-dimensional random variable (the p indicators), as an index or a composite score. It is proved that this index is more informative than any alternative composite score. In two examples, we compare the JPD index with some alternatives constructed from traditional methods.MethodsWe develop a probabilistic unsupervised dimension reduction method based on the probability density of multivariate data. We show that the conditional distribution of the variables given JPD is uniform, implying that the JPD is the most informative scalar summary under the most common notions of information. B. We show under some widely plausible conditions, JPD can be used as an index. To use JPD as an index, in addition to having a plausible interpretation, all the random variables should have approximately the same direction(unidirectionality) as the density values (codirectionality). We applied these ideas to two data sets: first, on the 7 Brief Pain Inventory Interference scale (BPI-I) items obtained from 8,889 US Veterans with chronic pain and, second, on a novel measure based on administrative data for 912 US Veterans. To estimate the JPD in both examples, among the available JPD estimation methods, we used its conditional specifications, identified a well-fitted parametric model for each factored conditional (regression) specification, and, by maximizing the corresponding likelihoods, estimated their parameters. Due to the non-uniqueness of conditional specification, the average of all estimated conditional specifications was used as the final estimate. Since a prevalent common use of indices is ranking, we used measures of monotone dependence [e.g., Spearman’s rank correlation (rho)] to assess the strength of unidirectionality and co-directionality. Finally, we cross-validate the JPD score against variance–covariance-based scores (factor scores in unidimensional models), and the “person’s parameter” estimates of (Generalized) Partial Credit and Graded Response IRT models. We used Pearson Divergence as a measure of information and Shannon’s entropy to compare uncertainties (informativeness) in these alternative scores.ResultsAn unsupervised dimension reduction was developed based on the joint probability density (JPD) of the multi-dimensional data. The JPD, under regularity conditions, may be used as an index. For the well-established Brief Pain Interference Inventory (BPI-I (the short form with 7 Items) and for a new mental health severity index (MoPSI) with 6 indicators, we estimated the JPD scoring. We compared, assuming unidimensionality, factor scores, Person’s scores of the Partial Credit model, the Generalized Partial Credit model, and the Graded Response model with JPD scoring. As expected, all scores’ rankings in both examples were monotonically dependent with various strengths. Shannon entropy was the smallest for JPD scores. Pearson Divergence of the estimated densities of different indices against uniform distribution was maximum for JPD scoring.ConclusionsAn unsupervised probabilistic dimension reduction is possible. When appropriate, the joint probability density function can be used as the most informative index. Model specification and estimation and steps to implement the scoring were demonstrated. As expected, when the required assumption in factor analysis and IRT models are satisfied, JPD scoring agrees with these established scores. However, when these assumptions are violated, JPD scores preserve all the information in the indicators with minimal assumption.

The association between online learning, perceived parental relationship, anxiety, and depression symptoms among secondary school students: insight from symptom network and cross-lagged panel network approach

IntroductionAnxiety and depression often co-occur in adolescents, with factors from family and school playing a significant role in the comorbidity. However, network analysis has not examined and clarified the detailed bridge and central symptoms of this comorbidity caused by online learning and perceived parental relationships across different COVID-19 times.MethodsOver four months, 2,356 secondary school students completed the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7. Participants were divided into harmonious and disharmonious groups based on their answers to a question about parental conflicts.ResultsThe results indicated that adolescents perceiving more parental conflicts showed a denser comorbidity network after four months of online learning. Significant bridge symptoms decreased from three to two across two waves in the harmonious group, while in the disharmonious group, they increased from two to three. The number of central symptoms increased from one in wave 1 to three in wave 2 for the harmonious group, while four in wave 1 decreased to two in wave 2 for the disharmonious group. Furthermore, the CLPN analysis revealed that the strongest positive cross-lagged edge intensity between symptoms was anhedonia—energy in the harmonious group, with anhedonia being the most trigger symptom. In contrast, for the disharmonious group, guilt—suicide and trouble relaxing—excessive worry were the strongest cross-lagged edge, and trouble relaxing was the most trigger symptom.ConclusionThese findings may have implications for interventions designed to promote adolescent mental health in the context of online learning and parental conflicts.

A Concept Analysis of Maternal Resilience against Pregnancy-Related Mental Health Challenges in Low- and Middle-Income Countries

Suicide accounts for 33% of deaths of women during the postnatal period in many low- and middle-income countries (LMICs). Resilience refers to an ability to adapt and recover from adversity or misfortune. Resilience building against mental health challenges during pregnancy and the postnatal period is critical for women to raise their child efficiently and maintain a healthy life. The exploration of maternal resilience against mental health challenges including its developmental processes and the determinants of its successful or unsuccessful cultivation among mothers during pregnancy and childbirth is of paramount importance. Understanding why a subset of mothers effectively develops resilience while others significantly struggle is critical for devising targeted interventions and support mechanisms aimed at improving maternal well-being. This inquiry not only seeks to delineate the factors that contribute to or hinder the development of resilience but also aims to inform the creation of comprehensive support systems that can bolster maternal health outcomes. This paper endeavors to present a comprehensive analysis of maternal resilience, aiming to cultivate a nuanced and profound understanding of the concept within the framework of previous traumatic events and adverse pregnancy outcomes in LMICs. The eight-step method approach proposed by Walker and Avant was utilized for this concept analysis. Several defining attributes were identified in the analysis including social adaptation, support system, optimistic approach, and mindfulness. This analysis contributes to knowledge advancement regarding maternal resilience and provides nurses and other healthcare professionals with a clear understanding of the concept of maternal resilience to help promote resilience among mothers.

Does COVID-19 Revamp Nurses’ Compassion? Post-Pandemic Approach in Qatar

Aim: This study aimed to identify self-compassion among staff nurses after the COVID-19 pandemic in Qatar. Design: Descriptive cross-sectional survey design. Methods: Anonymous data were collected through an online survey using Microsoft Forms from 300 nurses in 14 health facilities in Qatar. The organization had almost 10,000 nursing staff working in different facilities. Data were gathered using a structured online questionnaire and included socio-demographic information, and the Self-Compassion Scale—Short Form was used to collect the remaining data. Correlation, t-test, and ANOVA analyses were conducted. Results: Nurses in the study showed high self-compassion. Among the sub-domain ‘mindfulness’, they showed comparatively high scores (7.96 ± 1.55), and the lowest score was for ‘isolation’ (6.15 ± 1.99). The score for ‘self-kindness’ was 7.29 ± 1.55, that for ‘self-judgement’ was 6.79 ± 2.01, that for ‘common humility’ was 6.62 ± 1.47, and that for the sub-domain ‘over-identified’ was 6.47 ± 1.91. Mindfulness scores were high among the nurse leaders. Moreover, over-identified scores were high among the nurses who were currently working under COVID-19 at the time of data collection. Conclusions: Nurses faced many difficulties while working during the COVID-19 pandemic, including a heavy workload and tension. The current study’s findings add to our understanding of how COVID-19 affected the development of self-compassion. A rise in mindfulness, which aids nurses in managing stress at work and building resilience, further underscores an increase in nurses’ acceptance of the COVID-19 pandemic. The findings also highlight how crucial it is to encourage self-compassion in individuals and offer them emotional support at such times, especially when there is a significant risk factor for mental health, such as COVID-19.

From diagnosis to dialogue – reconsidering the DSM as a conversation piece in mental health care: a hypothesis and theory

The Diagnostic and Statistical Manual of Mental Disorders, abbreviated as the DSM, is one of mental health care’s most commonly used classification systems. While the DSM has been successful in establishing a shared language for researching and communicating about mental distress, it has its limitations as an empirical compass. In the transformation of mental health care towards a system that is centered around shared decision-making, person-centered care, and personal recovery, the DSM is problematic as it promotes the disengagement of people with mental distress and is primarily a tool developed for professionals to communicate about patients instead of with patients. However, the mental health care system is set up in such a way that we cannot do without the DSM for the time being. In this paper, we aimed to describe the position and role the DSM may have in a mental health care system that is evolving from a medical paradigm to a more self-contained profession in which there is increased accommodation of other perspectives. First, our analysis highlights the DSM’s potential as a boundary object in clinical practice, that could support a shared language between patients and professionals. Using the DSM as a conversation piece, a language accommodating diverse perspectives can be co-created. Second, we delve into why people with lived experience should be involved in co-designing spectra of distress. We propose an iterative design and test approach for designing DSM spectra of distress in co-creation with people with lived experience to prevent the development of ‘average solutions’ for ‘ordinary people’. We conclude that transforming mental health care by reconsidering the DSM as a boundary object and conversation piece between activity systems could be a step in the right direction, shifting the power balance towards shared ownership in a participation era that fosters dialogue instead of diagnosis.

Public involvement in an aggregate and individual participant data meta-analysis of mindfulness-based programmes for mental health promotion

BackgroundInvolving the public in evidence synthesis research is challenging due to the highly analytic nature of the projects, so it is important that involvement processes are documented, reflected upon, and shared to devise best practices. There is a literature gap on the involvement of the public in individual participant data meta-analyses, particularly in public health projects. We aimed to document and reflect on our collective experiences of involving and being involved as public stakeholders at all stages of a systematic review and individual participant data meta-analysis project.MethodsWe formed a stakeholder group made of four members of the public at the beginning of our evidence synthesis project comprising a systematic review, an aggregate data meta-analysis, and an individual participant data meta-analysis of mindfulness-based programmes for mental health promotion in non-clinical adults. Following each group meeting, members and participating researchers completed written reflections; one group member collected and collated these. At the end of the project, a reflective writing workshop was held before all members completed their final reflections. Everyone completed an adapted, open-ended questionnaire which asked about what did and did not work well, the overall experience, what could be improved, and the felt impact the stakeholder group had on the research.ResultsOverall, the stakeholders and researchers reported a positive experience of working together. Positives from the stakeholders’ point of view included learning new skills, experiencing research, and making new friends. For the researchers, stakeholders helped them focus on what matters to the public and were reinvigorating research partners. The challenges stakeholders experienced included having long gaps between meetings and feeling overwhelmed. The researchers found it challenging to strike the balance between asking stakeholders to be involved and for them to learn research-related skills without overburdening them and making sure that the learning was engaging. When looking back at their experience, stakeholders described seeing their impact on the project in hindsight but that this was not felt while the project was being carried out.ConclusionSuccessfully involving the public in complex evidence synthesis projects is possible and valuable from the points of view of the researchers and the stakeholders. However, it requires a significant time, skill, and resource investment that needs to be factored in from project inception. Further guidance and stakeholder training materials would be helpful. Specific suggestions are provided.