Psychosocial Costs Research Articles

“There’s Something Very Wrong with the System in This Country”: Multiracial Organizations and Their Responses to Racial Marginalization

Multiracial organizing since the 1980s has centered around the need to define and make visible the term multiracial (e.g., U.S. Census). In the contemporary era when multiple race populations are a growing and institutionally recognized demographic, how do multiracial organizations characterize and seek to combat collective experiences of racial marginalization? Here, we draw on in-depth interviews with officers from diverse multiracial organizations in the U.S. and Canada (N = 19) collected from 2017 through 2018 to examine this question. The findings revealed that multiracial individuals experience distinct forms of exclusion, which we call categorical invisibility, that target individuals who do not “fit” into established monoracial categories, and mixture as pathology, a less common frame but representing more overt forms of bias targeting those of mixed backgrounds. The lived impacts of these experiences prompt the expressed need for “safe” spaces from the psychosocial costs of categorical invisibility. Multiracial organizations, located mostly in the United States with one in Canada, engage in diverse community building and advocacy efforts to address these needs and, thus, represent critical sites of resistance to the trauma of racial (in)visibility. This work amplifies the need to center Critical Multiracial Theory to expose how monoracial paradigms as a central feature of White supremacy continue to shape the lives of multiracial people and expand our knowledge on how multiracial organizations shape the (re)negotiation of racial categories that challenge the racial status quo.

Mapping Patients' Perceived Facilitators and Barriers to In-Center Hemodialysis Attendance to the Health Belief Model: Insights from a Qualitative Study.

Previous research has shown that deliberate withdrawal, skipping, and/or shortening hemodialysis sessions has become a major health problem associated with poor clinical outcomes and early mortality in patients with end-stage renal disease (ESRD). However, patients' experiences with this treatment remain largely unexplored. This study aimed to explore patients' perceived facilitators and barriers to in-center hemodialysis attendance and map these findings to the Health Belief Model. A qualitative exploratory study was conducted with a purposive sample. Semi-structured interviews were conducted and submitted to thematic analysis. Twenty-four patients (66.2 ± 12.3years old; length of time on hemodialysis: 35.2 ± 51.5months) were interviewed. Five major facilitators (social support, perceived benefits, self-efficacy, time on dialysis, and risk/susceptibility perception) and two barriers (lack of knowledge about ESRD and hemodialysis, and psychosocial costs) were identified. Adherence to the prescribed regimen of hemodialysis attendance is a complex and multidimensional phenomenon that involves an interaction between modifying factors (social support, disease and treatment knowledge, time on dialysis) and patients' perceived benefits, perceived risks, self-efficacy, and treatment costs. This study findings expand knowledge by suggesting that perceiving health benefits from the beginning of treatment, self-efficacy to deal with dialysis demands, and purpose in life are important facilitators of adherence to in-center hemodialysis sessions. Furthermore, it suggests that the impact of the hemodialysis regimen on the emotional well-being of family members is an important barrier. Future interventions should focus on skills training to promote self-efficacy and family coping with the demands of in-center hemodialysis, improve disease and treatment knowledge, and help balance perceived benefits with dialysis costs.

White-collar crime: a neglected area in forensic psychiatry?

White-collar crime (WCC) causes considerable societal harm, the economic and psychosocial costs of which exceed those of conventional crime. Despite the impact, it has received scant attention from the academic literature in forensic psychiatry. This narrative literature review covers important topics in our understanding of white-collar crime, including offender characteristics such as demographics, criminal history, mental illness, personality and psychopathy, the link with violent offending and the trajectory of the white-collar offender (WCO) through the criminal justice system. White-collar crime is under-researched, particularly with regards to psychopathology, and the field of forensic psychiatry may have important contributions to make to our understanding of this important and harmful type of crime.

The Psychosocial Burden of Families with Childhood Blood Cancer.

Cancer is the second leading cause of death for children, and leukemias are the most common pediatric cancer diagnoses in Chile. Childhood cancer is a traumatic experience and is associated with distress, pain, and other negative experiences for patients and their families. Thus, psychosocial costs represent a large part of the overall burden of cancer. This study examines psychosocial experiences in a sample of 90 families of children with blood-related cancer in Chile. We provide a global overview of the family experience, focusing on patients, caregivers, and siblings. We find that most families report a negative impact upon diagnosis; disruptions in family dynamics; a range of negative feelings of the patient, such as depression, discouragement, and irritability; and difficulty with social lives. Additionally, they report negative effects in the relationship between the siblings of the patient and their parents, and within their caregivers’ spouse/partner relationship, as well as a worsening of the economic condition of the primary caregiver. Furthermore, over half of the families in the sample had to move due to diagnosis and/or treatment. Promoting interventions that can help patients, siblings, and parents cope with distress and promote resilience and well-being are important.

Are sperm parameters able to predict the success of assisted reproductive technology? A retrospective analysis of over 22,000 assisted reproductive technology cycles.

BackgroundAn explosive increase in couples attending assisted reproductive technology has been recently observed, despite an overall success rate of about 20%–30%. Considering the assisted reproductive technology‐related economic and psycho‐social costs, the improvement of these percentages is extremely relevant. However, in the identification of predictive markers of assisted reproductive technology success, male parameters are largely underestimated so far.Study designRetrospective, observational study.ObjectivesTo evaluate whether conventional semen parameters could predict assisted reproductive technology success.Materials and methodsAll couples attending a single third‐level fertility center from 1992 to 2020 were retrospectively enrolled, collecting all semen and assisted reproductive technology parameters of fresh cycles. Fertilization rate was the primary end‐point, representing a parameter immediately dependent on male contribution. Pregnancy and live birth rates were considered in relation to semen variables. Statistical analyses were performed using the parameters obtained according to the World Health Organization manual editions used for semen analysis.ResultsNote that, 22,013 in vitro fertilization and intracytoplasmic sperm injection cycles were considered. Overall, fertilization rate was significantly lower in patients with abnormal semen parameters compared to normozoospermic men, irrespective of the World Health Organization manual edition. In the in vitro fertilization setting, both progressive motility (p = 0.012) and motility after capacitation (p = 0.002) significantly predicted the fertilization rate (statistical accuracy = 71.1%). Sperm motilities also predicted pregnancy (p < 0.001) and live birth (p = 0.001) rates. In intracytoplasmic sperm injection cycles, sperm morphology predicted fertilization rate (p = 0.001, statistical accuracy = 90.3%). Sperm morphology significantly predicted both pregnancy (p < 0.001) and live birth (p < 0.001) rates and a cut‐off of 5.5% was identified as a threshold to predict clinical pregnancy (area under the curve = 0.811, p < 0.001).DiscussionInterestingly, sperm motility plays a role in predicting in vitro fertilization success, while sperm morphology is the relevant parameter in intracytoplasmic sperm injection cycles. These parameters may be considered reliable tools to measure the male role on ART outcomes, potentially impacting the clinical management of infertile couples.

Procrastination, Perfectionism, and Other Work-Related Mental Problems: Prevalence, Types, Assessment, and Treatment-A Scoping Review.

Work-related mental problems can be defined as behaviors, emotions and cognitions that impede the successful completion of a task in a given time frame, i. e., the difficulty or inability to achieve important work-related goals. They are highly prevalent but have been neglected in psychology in general and as a target of psychotherapy in particular. Although work-related problems do not represent a mental disorder per se, they are associated with severe distress and high psychosocial costs. In this article, the prevalence of work-related problems, associated burden, diagnostic assessment and treatment are reviewed. So far, research has primarily focused on procrastination, i.e., the act of postponing or delaying tasks until the last minute or past the deadline. However, procrastination represents just one type of work-related problems among several others. Further forms of work-related problems are presented (e.g., perfectionism, or work-related problems in the context of specific personality types). The relation of work-related problems to specific mental disorders is discussed. Psychosocial interventions are the treatment of choice for work-related mental problems. However, response rates for the treatment of procrastination are limited, which calls for further research into which treatments work for whom. No evidence-based treatments are currently available for other types of work-related problems, with the exception of perfectionism, a personality trait that is also linked to problems in the field of work. Thus, there is a need to further improve the treatment of work-related problems including procrastination. For other types of work-related problems, effective treatments need to be developed and validated. They may be based on existing manualized treatments and extended by specific aspects or modules focusing on work-related problems.

Diabetic Wound-Healing Science.

Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.

Psychosocial benefits and costs of activism among female migrant domestic workers in southern Spain.

Economic migrant women often experience oppressive living and working conditions in the receiving societies. Activism is a liberatory behavior these women may employ to transform such situations. This study explores the activism experience of female migrant domestic workers from Latin America settled in southern Spain, in terms of its psychosocial benefits and costs. A purposeful sample of eleven activist migrant women engaged in a grassroots organization of domestic workers and eight members of social organizations supporting their activities were interviewed in-depth individually. After a qualitative content analysis approach to the data, the study presents activism as a community engagement behavior with benefits such as the strengthening of social ties, sense of community, opportunities for sharing stories of oppression, and psychological empowerment. Activism also emerged as a demanding activity requiring high investments in time by activists and producing interpersonal conflicts, hopelessness, and burnout in some cases. Such costs may pose limits to its potential to produce well-being and liberation, implying challenges for research, intervention, and activism sustainability.

Influence of Resilience and Optimism on Distress and Intention to Self-Isolate: Contrasting Lower and Higher COVID-19 Illness Risk Samples From an Extended Health Belief Model.

The study investigated the influence of resilience and dispositional optimism on, first, emotional distress and, second, the intention to self-isolate, experienced by people with a lower and higher illness risk, during the lockdown imposed in Spain during the first COVID-19 wave. These effects were investigated against the background of the Health Belief Model (HBM). A convenience sample of N = 325 participants completed an online survey including an ad-hoc questionnaire measuring the HBM core factors: Perceived health threat (susceptibility and severity of getting infected), and perceived quarantine benefits and costs. Self-efficacy and perceived social pressure were also measured. Based on reviews regarding pandemic outbreaks, quarantine benefits were conceptualized as the perceived effectiveness and solidary contribution of self-isolating in line with the quarantine protocols. Quarantine “psychosocial” costs were conceptualized as a composite of perceived boredom, loneliness, and economic concerns. Findings revealed an asymmetrical pattern of results so that (i) people at higher risk were more distressed by the perceived severity of getting infected whereas people at lower risk were more distressed by the psychosocial costs. Moreover, (ii) resilience and optimism were more “protective” against distress within the lower and higher risk groups, respectively. In addition, (iii) quarantine benefits and self-efficacy promoted the intention to self-isolate within both groups. However, (iv) optimism hindered such intention. This finding is discussed in the light of links between dispositional optimism and optimistic bias; the underestimation of experiencing negative events, which can relax the perceived health risk. Based on these findings, communication campaigns should prioritize information about the effectiveness of the implemented preventive behaviors rather than the costs of not implementing them, and be cautionary in encouraging excessive optimism.

Pediatric sarcoma survivorship: A call for a developmental cascades approach.

Survivors of pediatric sarcomas often experience greater psychological and psychosocial difficulties than their non-afflicted peers. We consider findings related to poorer outcomes from a developmental cascade perspective. Specifically, we discuss how physical, neurocognitive, psychological, and psychosocial costs associated with pediatric sarcomas and their treatment function transactionally to degrade well-being in long-term pediatric sarcoma survivors. We situate the sarcoma experience as a broad developmental threat - one stemming from both the presence and treatment of a life-imperiling disease, and the absence of typical childhood experiences. Ways in which degradation in one developmental domain spills over and effects other domains are highlighted. We argue that the aggregate effect of these cascades is two-fold: first, it adds to the typical stress involved in meeting developmental milestones and navigating developmental transitions; and second, it deprives survivors of crucial coping strategies that mitigate these stressors. This position suggests specific moments of intervention and raises specific hypotheses for investigators to explore.

Image-Based Sexual Abuse in a Culturally Conservative Nigerian Society: Female Victims' Narratives of Psychosocial Costs.

BackgroundIn the last few years, many countries have introduced laws combating image-based sexual abuse (IBSA), colloquially known as “revenge pornography.” However, the significant growth in the body of literature on the legal perspectives on IBSA, and the media coverage of high profile cases have not been equally met with appreciable victimization studies. Meanwhile, the need for a victim-centered approach in studying IBSA in Nigeria is underscored by the pervasiveness and normalization of sexual violence as a result of societal attitudes about gender and sexuality in the country. Therefore, this study explored the social and psychological implications of IBSA victimization.MethodsUsing qualitative methods, 27 adult women whose sexual images have been non-consensually shared publicly through online channels were purposively selected and interviewed for the study, between September 2019 and April 2020, and a thematic analysis of the participants’ narratives carried out.ResultsVictims of IBSA were found to be subjected to higher social condemnation, stigmatization, and isolation based on greater attribution of blames to them by their social network. Evidences of institutional re-victimization were documented. Victims also reported self-blame, paranoia, anger, guilt, depression, suicidal ideation and attempt in dealing with the abuse, secondary victimization, and social isolation.ConclusionIBSA victims are faced with peculiar social and psychological consequences which separate them from victims of other forms of sexual abuse. The study suggests a review of appropriate laws and social policies to prevent IBSA, deploy more victim support services and perpetrator programs, and protect victims from secondary victimization.

Attending work with chronic pain is associated with higher levels of psychosocial stress

ABSTRACT Background and Aims: Much is known about the impact of pain in terms of medical costs and missed work. Less is known about its associations when individuals are present for work. This study examines “presenteeism” by analyzing the psychosocial costs of pain in the workplace, using the 2015 European Working Conditions Survey (EWCS). Methods: We conducted cross-sectional analysis of 2384 individuals with chronic pain and 2263 individuals without pain (matched by age and sex) using data from the 2015 EWCS. We compared groups in terms of the following psychosocial factors: supervisor support, job responsibility, team cohesion, discrimination, threats/abuse, job competency, job reward, sexual harassment, stress, and job security. The groups were also compared in terms of days lost due to illness. Results: People with pain were 64% less likely to view their job as rewarding (odds ratio [OR] = 0.61; 95% confidence interval [CI], 0.57–0.65), 47% more likely to be subjected to threats/abuse in the workplace (OR = 0.68; 95% CI, 0.63–0.73), 30% more likely to report poor supervisor support (OR = 0.77; 95% CI, 0.73–0.82), and 28% more likely to perceive discrimination in the workplace (OR = 0.78; 95% CI, 0.71–0.85). People with pain missed approximately nine more days of work per year than respondents without pain. Conclusions: Chronic pain was associated with lower vocational fulfillment and feelings of being ostracized in the workplace. These findings suggest that the presence of pain in the workplace goes well beyond lost productivity due to absenteeism.

Chronic wounds and novel therapeutic approaches.

In the past decade, the frequency of chronic wounds in older population has increased, and their impact on quality of life is substantial. Chronic wounds are a public health problem associated with very high economic and psychosocial costs. These wounds result from various pathologies and comorbidities, such arterial and venous insufficiency, diabetes mellitus and continuous skin pressure. Recently, the role of infection and biofilms in the healing of chronic wounds has been the subject of considerable research. This paper presents an overview of various methods and products used to manage chronic wounds and discusses recent advances in wound care. To decide on the best treatment for any wound, it is crucial to holistically assess the patient and the wound. Additionally, multiple strategies could be used to prevent or treat chronic wounds.

Can management buffer pasture loss and fragmentation for Sami reindeer herding in Sweden?

Today, climate change and competing land use practices are threatening rangelands around the world and the pastoral societies that rely on them. Reindeer husbandry practised by the indigenous Sami people is an example. In Sweden, approximately 70% of the most productive lichen pastures (important in winter) has been lost, either completely or because of a reduction in forage quality, as a result of competing land use (primarily commercial forestry). The remaining pastures are small and fragmented. Yet, the number of reindeer in Sweden shows no general decline. We investigated the strategies that have allowed reindeer herders to sustain their traditional livelihood despite a substantial loss of pastures and thus natural winter forage for their reindeer. Changes in harvest strategy and herd structure may partially explain the observed dynamics, and have increased herd productivity and income, but were not primarily adopted to counteract forage loss. The introduction of supplementary feeding, modern machinery, and equipment has assisted the herders to a certain extent. However, supplementary feeding and technology are expensive. In spite of governmental support and optimized herd productivity and income, increasing costs provide low economic return. We suggest that the increased economical and psychosocial costs caused by forage and pasture losses may have strong effects on the long-term sustainability of reindeer husbandry in Sweden.

The psychosocial cost burden of cancer: A systematic literature review.

Background and ObjectivePsychosocial costs, or quality of life costs, account for psychological distress, pain, suffering and other negative experiences associated with cancer. They contribute to the overall economic burden of cancer that patients experience. But this category of costs remains poorly understood. This hinders opportunities to make the best cancer control policy decisions. This study explored the psychosocial cost burden associated with cancer, how studies measure psychosocial costs and the impact of this burden.MethodsA systematic literature review of academic and grey literature published from 2008 to 2018 was conducted by searching electronic databases, guided by the Institute of Medicine’s conceptualization of psychosocial burden. Results were analyzed using a narrative synthesis and a weighted proportion of populations affected was calculated. Study quality was assessed using the Ottawa‐Newcastle instrument.ResultsA total of 25 studies were included. There was variation in how psychosocial costs were conceptualized and an inconsistent approach to measurement. Most studies measured social dimensions and focused on the financial consequences of paying for care. Fewer studies assessed costs associated with the other domains of this burden, including psychological, physical, and spiritual dimensions. Fourty‐four percent of cancer populations studied were impacted by psychosocial costs and this varied by disease site (38%‐71%). Two studies monetized the psychosocial cost burden, estimating a lifetime cost per case ranging from CAD$427753 to CAD$528769. Studies were of varying quality; 60% of cross‐sectional studies had a high risk of bias.ConclusionsConsistency in approach to measurement would help to elevate this issue for researchers and decision makers. At two‐thirds of the total economic burden of cancer, economic evaluations should account for psychosocial costs to better inform decision‐making. More support is needed to address the psychosocial cost burden faced by patients and their families.

Shame and the Psychosocial Costs of Contemporary Work: Implications for Career Intervention

This article explores the concept of shame and integrates it into career development and career counseling. The article begins with an overview of shame from a diverse conceptual framework, describing shame as a self‐conscious emotion that occurs in response to interactions or events that evoke embarrassment, humiliation, self‐doubt, and psychological distress. We discuss the prevalence of shame in work‐based interactions and contexts, which is referred to as work shame. Building on this integrative review of shame within the working context, we describe the counseling implications and provide a case study to illustrate the ways in which shame emerges in clients' lives and potential strategies to resist and transcend shame.

Bouncing back from Workplace Stress: From HRD’s Individual Employee’s Developmental Focus to Multi-facetted Collective Workforce Resilience Intervention

The ProblemHuman resource development (HRD) research has sought to demarcate a human developmental problem by identifying learning interventions through which individuals can contribute towards group and organizational growth. However, there remains the fundamental problem, which is how to go beyond individualized employee development to a more collective resilience model building against workplace stress. Such lesser effectiveness has led to financial, emotional and psycho-social costs to individuals and collectives. Based on the theoretical analysis of human capital theory, HRD research and literature are lacking in how to more effectively operationalize collective resilience against workplace stress.The SolutionA multi-faceted collective workforce resilience intervention conceptual model is proposed to enable both management and employees to overcome ineffective implementation of human development and thereby bounce back from workforce stress. Four aspects of the model’s practical operationalization are proposed as steps to help the HRD community of practitioners and scholars to engrain resilience as a workplace culture in resolving stress. Implications on (1) the identification of workplace stress, (2) the effective design and operationalization of development capacities. (3) the resilience intervention initiatives, and (4) the management of collective workforce resilience are highlighted.The StakeholdersThe proposed model is designed for the HRD community, including scholars, practitioners, employees and managers in related HRD contexts.

Battle Scars and Resilience at the Health Care Frontline.

The COVID-19 pandemic has created an historic global crisis, resulting in unprecedented stressors on frontline healthcare systems. The population remains on edge, and hospitals are stretched to capacity. This is not our first pandemic. We have learned from prior outbreaks that, in addition to the sheer physical burden, there are also likely to be important but often unacknowledged behavioral and psychosocial costs.1 Frontline healthcare workers, may be particularly vulnerable to harmful psychological consequences.

Are organizations committed to stress management interventions?

PurposeWork-related stress causes individual, societal and economic costs. Stress management interventions (SMIs) are implemented to decrease those costs, reduce the psychosocial harms and increase workers' productivity. This article reports on a study of a substantial sample of enterprises to verify what types of SMIs they implemented and how they assessed the results of these interventions.Design/methodology/approachSpecially designed surveys were collected in 2015–2017 from 408 organizations of different sizes and sectors in Poland, including multinationals. The reliability of the questionnaire was satisfactory (Cr. 0.84).FindingsResults show that 59% of enterprises are aware of SMIs but only about 30% implemented one within the last three years. The implementations usually covered both organizational and individual-level interventions. The assessment of SMI effectiveness was conducted in just about one-third of the organizations and was based on estimations of the levels and sources of stress. Hardly any companies compared economic and psychosocial costs of stress before and after SMIs.Research limitations/implicationsThe most important recommendation from this study is to increase the awareness of causes of stress among managing directors. Also, organizations and HR staff need more assistance from specialists who know how to measure and help reduce work stress.Originality/valueThe literature on stress interventions at work usually focusses on their psychological effects. This paper explores the organizational perspective and the commitment to implement the interventions in companies.

COVID-19 Control: Can Germany Learn From China?

The coronavirus disease 2019 (COVID-19) outbreak started in China in December 2019 and has developed into a pandemic. Using mandatory large-scale public health interventions including a lockdown with locally varying intensity and duration, China has been successful in controlling the epidemic at an early stage. The epicentre of the pandemic has since shifted to Europe and The Americas. In certain cities and regions, health systems became overwhelmed by high numbers of cases and deaths, whereas other regions continue to experience low incidence rates. Still, lockdowns were usually implemented country-wide, albeit with differing intensities between countries. Compared to its neighbours, Germany has managed to keep the epidemic relatively well under control, in spite of a lockdown that was only partial. In analogy to many countries at a similar stage, Germany is now under increasing pressure to further relax lockdown measures to limit economic and psychosocial costs. However, if this is done too rapidly, Germany risks facing tens of thousands more severe cases of COVID-19 and deaths in the coming months. Hence, it could again follow China’s example and relax measures according to local incidence, based on intensive testing.