Psychosocial Losses Research Articles

Living with vaccine-induced immune thrombocytopenia and thrombosis: a qualitative study

ObjectivesTo explore the experiences of people up to 18 months after being diagnosed with vaccine-induced immune thrombocytopenia and thrombosis (VITT).DesignA semistructured qualitative study, conducted via Zoom, of a cohort of...

Stress, depression, and anxiety among undergraduate nursing students in the time of a pandemic.

Emerging literature reports on the challenges faced by nursing students internationally during the pandemic as they continue their education. The aim of this mixed methods study was to examine stress, depression, and anxiety among undergraduate nursing students at a Canadian university during the pandemic. Stress and coping and trauma theories informed this study. Mixed methods included an online questionnaire composed of the Depression Anxiety Stress scales (DASS), sociodemographic data, and quality of life items with open-ended questions. Sample included 280 participants. Mean scores for depression and stress were in the mild level, for anxiety in the moderate level; 24 , 37 and 23 % of the sample had scores of severe or extremely severe for depression, anxiety, and stress respectively. Written comments reflected the impact on participants' relationships, motivation, struggles with remote learning, perceived heavy workloads, and impact on health and self-care, while some described positive experiences, including improved study habits. Uncertainty, isolation, sudden and ongoing changes with program delivery and a variety of psychosocial losses, helped to explain the distress many shared. The disconnect between reported levels of use of mental health services and the higher levels of mental distress raises the question of access to and use of these services. The importance of developing and maintaining effective coping, including a support system, and committing to healthy self-care during challenging times was reinforced. This difficult time for nursing students emphasized the need to ensure attention to student well-being and mental health during their foundational educational experiences.

ATTITUDES TOWARD AGING AND WELLNESS ENGAGEMENT IN LIFE PLAN COMMUNITIES

Abstract Life Plan Communities, also known as Continuing Care Retirement Communities, typically offer a wide range of wellness programs and services, including fitness classes, educational lectures, volunteer opportunities, and social events. Despite the convenience of onsite wellness resources, some residents choose not to participate in wellness offerings available at the community. One factor that may influence engagement in wellness behaviors is older adults’ attitudes toward aging, which has been associated with differences in health and well-being over time. The purpose of this research was to examine the relationship between attitudes toward aging and wellness engagement among residents of Life Plan Communities. A total of 447 residents (ages 59 to 97; M = 81.82, SD = 6.55; 65% female) of 10 communities completed surveys that measured their attitudes toward aging, self-reported wellness, interest in improving wellness, participation in wellness programs, and barriers to wellness participation. Multiple regression analyses revealed that more positive attitudes toward aging were associated with better wellness, higher interest, more frequent participation, and fewer barriers, controlling for age, gender health, education, and marital status. Follow-up analyses revealed that these effects could be accounted for by specific types of aging attitudes (i.e., psychological growth, psychosocial loss, and physical change). For example, greater psychological growth was associated with greater wellness, interest in improving wellness, and wellness participation, whereas greater psychosocial losses was associated with greater perceived barriers and lower wellness. These findings have implications for the development, implementation, and promotion of wellness programs for older adults.

Portuguese Version of the Ageing Attitudes Questionnaire (AAQ): Validation of the Psychometric Properties.

The Ageing Attitudes Questionnaire-AAQ was validated for the Portuguese population to understand the importance of attitudes towards old age and their impact on the subjective well-being of older adults. A sample of 400 subjects (from 18 to 93 years) answered a socio-demographic questionnaire, and the AAQ, composed of three subscales (psychosocial losses, physical change, and psychological growth). The CFA confirmed the tri-factorial structure with very good adjustment of the model to the data, with the Cronbach alpha of the total scale scoring 0.84 and ranging from 0.65 to 0.77 for each factor. A total of nine items were omitted for poor factor loadings (<0.50), namely in factor 1 items 9-17-20, in factor 2 items 7 and 24 and, finally, in factor 3 we omitted items 4-18-19-21. Notwithstanding, three items below the criteria were maintained, as they conceptually fit into the factor. Of the final 15 AAQ items, 5 belong to the Psychosocial Loss Factor, 6 to Physical Change Factor, and 4 to Psychosocial Growth Factor. This tree factor model explained 50.1% of the total variance. In conclusion, this study supports that AAQ has acceptable validity, confirming the composite reliability and the discriminant validity, but not the convergent validity. Through multi-group analysis, the invariance of the scale was confirmed. This validation is of pivotal importance once it allows measuring attitudes towards ageing in the Portuguese population, thus facilitating the prevention of ageism and the promotion of well-being across the lifespan.

‘Learning to Hold a Paradox’: A Narrative Review of How Ambiguous Loss and Disenfranchised Grief Affects Children in Care

Separation and loss characterise a child’s experience in care, yet losses in the care-experienced population have rarely been studied as a possible source of trauma or as events that may justify a grief response. A literature search of five databases yielded 592 publications. 41 full text articles were reviewed, 16 publications were included. Thematic analysis revealed: children in care are affected by two broad type of ambiguous loss, relationship losses and psychosocial losses; behaviours labelled as ‘problem’ behaviours may in fact be indicators of the manifestations of ambiguous loss and disenfranchised grief; manifold ambiguous losses associated with multiple placement moves has a cumulative effect that can generate long-term negative consequences; the effects of ambiguous loss can be offset by supporting children in care to understand that their losses may not be resolvable, to build tolerance to this ambiguity, to rebuild their identity through forging permanent connections, and to make meaning of their situations. Social workers have a key role in supporting those in care to understand, process and cope with their ambiguous losses but diminishing the burden of loss must also be a systemic focus if meaningful change is to be realised for this community of vulnerable young people.

Capturing the experiences of patients with inherited optic neuropathies: a systematic review of patient-reported outcome measures (PROMs) and qualitative studies

PurposeTo identify and comprehensively evaluate studies capturing the experience of individuals affected by an inherited optic neuropathy (ION), focusing on patient-reported outcome measures (PROMs) and qualitative studies where the health status and quality of life (QoL) of these individuals have been explored.MethodsSystematic review of five databases using a search strategy combining four concepts: (1) ION; (2) QoL and health status; (3) PROMs; and (4) qualitative research. Studies assessing the impact of ION on any QoL domain using a PROM or qualitative methodology were included and appraised, using criteria based on the COSMIN checklist (for PROM studies) and the CASP checklist (for qualitative studies).ResultsOf 1326 unique articles identified, six studies were included. Five PROMs were identified: Visual Function Index (VF-14); Hospital Anxiety and Depression Scale (HADS); a novel graphical online assessment tool (NGOAT) for reporting emotional response to vision loss; a new PROM informed by the DSM-V Criteria for Major Depressive Disorder; and an interpersonal and career ‘impact rating’ PROM. The psychometric performance of included PROMs were poorly described. Qualitative studies found that vision loss resulted in psychosocial losses including loss of social and communication skills and loss of independence and freedom. Factors that modified the response to vision loss were also identified.ConclusionThe current PROMs used by individuals with ION have poor content coverage, primarily measuring activity limitation and emotional well-being, and insufficient reporting of psychometric performance. There is a need to develop a PROM for individuals ION to report their experiences of living with their condition.

DAILY FLUCTUATIONS IN SUBJECTIVE AGE AND MENTAL HEALTH: THE ROLES OF CHRONOLOGICAL AGE AND ATTITUDES TO AGING

Studies indicate that subjective age – individuals’ perception of their own age as older or younger than their chronological age, is related to their depressive symptoms. Less is known about the role that attitudes towards aging might play in this regard. 334 participants (age 30-90, M=58.15) reported their subjective age and depressive symptoms every day for a period of 14 days. Attitudes to aging were measured at baseline. Results indicated that daily subjective age was related to daily variation in depressive symptoms. Furthermore, we found that attitudes to aging (psychosocial losses, gains and physical changes) moderated the subjective age-depression relationship, such that it was stronger when psychosocial losses were high, and when physical changes and gains were low. The moderating effect of losses was especially prominent for older participants. This indicates that the general perception of aging moderates the toll that feeling old takes on mental health.

Somatosensory psychophysic losses in inhabitants of riverside communities of the Tapajós river basin, Amazonas, Brazil: The possible involvement of exposure to methylmercury

The objective of this study was to evaluate the somatosensory system of riparian fish exposed to the diet of fish in two communities of the Tapajós river basin, and to compare the same measurements performed in the inhabitants of the Tocantins river basin. Mercury analysis was performed on hair samples through atomic absorption spectrophotometry. Three somatosensory psychophysical tests were performed: tactile sensation threshold (Semmes-Weinstein 20 monofilaments), duration of vibration sensation (128 Hz tuning fork) and two-point discrimination (two-point discriminator). The concentration of mercury was significantly higher in the Tapajós riparian communities than in the Tocantins riparian communities (p < 0.01). The tactile sensation threshold is greatest in all parts of the body, except in the left breast; the duration of the lower vibration sensation in all parts of the body, except in the upper sternum; and a threshold of discrimination of two points greater in all the parts of the body were observed in riverside of the Tapajós, when compared to the riverside of the Tocantins. The rivers exposed to mercury in the Tapajós region presented impaired somatosensory function in comparison with individuals from the control region. The long-term exposure to mercury in riparian communities in the Tapajós basin is a possible cause, however, new studies should be encouraged in order to definitively confirm the somatosensory psychosocial losses observed in this population.

EVALUATION OF ATTITUDES TOWARDS OLD AGE AMONG OLDER ADULTS IN AN INSTITUTIONAL FACILITY

Aim: The aim of the research was to determine attitudes towards old age in older adults living in institutional facilities, and to compare them with the population standard. A further aim was to determine differences in attitudes towards old age by gender, age, level of education, and self-sufficiency in the older adults surveyed. Design: A cross-sectional study. Methods: A research sample consisting of 121 elderly people living in retirement homes. Data were collected using a Czech version of the AAQ questionnaire (Attitudes to Ageing Questionnaire), and Barthel's test of Activities of daily living was used to assess levels of self-sufficiency. Results: Older adults awarded the highest score (most positive attitude) in the domain of psychosocial losses. In comparison with the population standard, older adults rated the domain of physical change (p < 0.001) and psychological growth (p < 0.001) negatively. The domain of psychosocial losses was assessed more positively by men (p < 0.001) and the elderly with moderate dependence (p < 0.001); the domain of physical changes was also positively assessed by men (p = 0.001), and older adults with university education (p = 0.002); the domain of psychological growth was rated more positively by adults over 85 years (p = 0.001), and the elderly with basic education (p = 0.040). Conclusion: Determining older adults' attitudes towards ageing in institutional care may help in the preparation of individual care plans aimed at supporting clients in areas that have been evaluated negatively.

What is the lived experience for people with Leber Hereditary Optic Neuropathy?

This study aimed to hear the voices of seven people living with Leber Hereditary Optic Neuropathy (LHON), to examine their lived experience. The participants were recruited through a website and social networking sites designed for this community; they discussed their experiences in semi-structured interviews. The analytical process was informed by Interpretive Phenomenological Analysis (IPA) principles. This process illustrated a lived experience that was initially consumed by psycho-social losses and conflicts around identity. However, through pragmatic and resilient attitudes, the participants developed practical methods and emotional coping mechanisms that permitted their adjustment to sight loss and progression in life. Consistent with other studies, the fundamental finding was that the associated feeling of loss and frustration are chronic if, episodic, throughout life.

Alcohol abuse-induced health and psychosocial losses among residents of social care institutions

Introduction. Alcoholism is one of the most serious social issues of modern times. In Poland, the importance of problems resulting from alcohol abuse or misuse is significant, both in the context of health, economic and social consequences. Aim. The aim of the present study was to determine health and psychosocial losses of alcohol abuse among residents of social care institutions. Material and methods. A diagnostic survey was conducted using the authors questionnaire. The study was carried out among 30 residents of the nursing home in Kielce. The inclusion criterion was alcohol abuse. Results. In the study group, the largest group consisted of divorced residents - 66.67%. All of them admitted that alcohol abuse was the cause of divorce. Lack of contact with families was declared by 56.67% of respon- dents. None of the residents (100%) was visited by friends from outside the nursing home. Psychotic symptoms (hallucinations after alcohol) were found in 73.33% of residents. Somatic symptoms (headache, stomachache) and sleep disorders were confirmed by 90% of respondents. Attempts to cope with addiction were undertaken by 76.67% of residents; 73.33% declared their readiness to limit alcohol consumption. Conclusions. Adverse consequences of alcohol abuse involve somatic, family-related, social and emotional spheres. Respondents have large deficits in social relations due to long-term alcohol abuse and excessive preoccupation with alcohol. Alcohol in nursing homes fills the time, eliminates the feeling of loneliness, kills boredom and helps to forget about problems. Residents abusing alcohol on a daily basis feel alienated and have low self-esteem.

The Attitudes of Older Adults Living in Institutions and Their Caregivers to Ageing

The aim of this study was to explore the attitudes of older people living in institutions and their caregivers to ageing. Recent outcomes showed prevailing negative social stereotype to ageing in CR. The Attitudes to Ageing Questionnaire (AAQ-24) was used in two waves of data collection to measure attitudes of 400 randomly selected residents of 19 Senior Residential Homes. The reduced sample of 220 seniors and 276 professional carers employed at twelve Senior Residential Homes completed 12 items of general form (AAQ-12). All respondents expressed their agreement or disagreement with the statements presented in the questionnaire regarding positive or negative attitudes to ageing. The AAQ total score proved significant influence of gender, having children, self-perceived health, depression, and quality of life. Subscale scores (psychosocial losses, physical changes, psychological growth) were significantly influenced by gender, age, activities limitations, having own children, depression, self-perceived health status, and quality of life. Globally, the attitudes of professional caregivers to ageing were more positive compared to the attitudes of older people living in institutions. Older adults showed higher agreement with negative statements about ageing. There was no difference between professional caregivers and older people in the positive attitudes to ageing expressed as the growth potential. Physical activity, wisdom, better ability to cope with life and contacting young generation were effective in the positive attitudes of both groups.

Therapeutic Benefits of Horticulture for Dialysis Patients

Therapeutic Benefits of Horticulture for Dialysis Patients

Family context of mental health risk in Tsunami-exposed adolescents: Findings from a pilot study in Sri Lanka

Using survey data from 325 Tsunami-exposed adolescents and mothers from two villages in southern Sri Lanka, this pilot study investigated influences of Tsunami exposure and subsequent psychosocial losses on adolescent depressive and post-traumatic stress disorder (PTSD) symptoms. Findings generally support the study hypotheses: disaster exposure (for example experiences of property destruction and deaths of close others) contributes to depressive and PTSD symptoms in adolescents. Findings also show that psychosocial losses associated with Tsunami exposure, such as prolonged displacement, social losses, family losses, and mental health impairment among mothers, contribute to depressive and PTSD symptoms in adolescents. Results suggest that the influence of Tsunami exposure on adolescent mental health operates partially through Tsunami-related psychosocial losses. As expected, positive mother–child relationships provide a compensatory influence on both depressive and PTSD symptoms of adolescents. In addition, high levels of depressive symptoms among mothers increases the detrimental influence of other Tsunami-related psychosocial losses on adolescent mental health. These preliminary findings suggest ways to improve ongoing recovery and reconstruction programs and assist in formulating new programs for families exposed to both the Tsunami and other natural disasters. More importantly, findings from this pilot study emphasize the urgent need for larger systematic studies focusing on mental health following disaster exposure.

The effectiveness of a bibliotherapy in increasing the self-management ability of slightly to moderately frail older people

Objective Self-management ability (SMA) is the ability to obtain those resources necessary for the production of well-being. With age, SMA becomes increasingly important, if one has a large variety of resources, physical and psychosocial losses due to the aging process can be substituted or compensated for. This study examined whether an increase in SMA would ensure sustainable levels of positive well-being among slightly to moderately frail older people. Methods A bibliotherapy was developed to increase the SMA of slightly to moderaterly frail older people, and to help these persons to sustain a certain level of well-being. The effectiveness of this bibliotherapy was examined by comparing the SMA, mastery, and subjective well-being of 97 older people participating in the bibliotherapy to those of 96 older people in a delayed-treatment control condition. Results The bibliotherapy resulted in a significant increase in SMA and mastery compared to the delayed-treatment control condition, and for SMA, this effect still existed 6 months after the intervention. The increase in SMA among older people who received the bibliotherapy prevented a decline in well-being as expected, but only in the short-term. Conclusion The current findings show that it is possible to counteract an age-related decline in well-being, even with only slight to moderate levels of frailty. Practice implications Cheap and easily accessible interventions, like the self-management bibliotherapy described in this article, may provide a useful addition to more traditional gerontological interventions.

Antepartum Support Group for Women Hospitalized on Bed Rest

To identify the themes of discussion spontaneously voiced during an antepartum support group by high-risk pregnant women who were hospitalized on bed rest. Descriptive and exploratory, using content analysis. Support groups were held weekly in a tertiary level hospital in a Midwestern state. The convenience sample consisted of 27 women hospitalized for treatment of either preterm labor, incompetent cervix, placenta previa, premature rupture of membranes, or multiple gestation. The group, which was led by the investigator, was unstructured and nondirective. Process recordings of women's spontaneous verbalizations were made during each of 13 antepartum support group sessions. The women identified seven discussion themes: methods of coping, concerns about family, negative emotions, relationships with caregivers, psychosocial losses associated with bed rest treatment, side effects of medical treatments, and concerns for the safety for self and/or fetal health. An unstructured support group that provides women on hospital bed rest with an opportunity to talk in a confidential and supportive environment may be an important antepartum nursing intervention in helping them cope.

A study of the experiences of women living with HIV/AIDS in Uganda.

This small descriptive study investigated the experiences of Ugandan women living with a diagnosis of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), exploring what assisted them to cope and identifying their future concerns. A purposeful sample of seven HIV-positive women was accessed through two indigenous non-governmental organizations in Eastern Uganda. Single semi-structured interviews were conducted on location. Following analysis of the narrative data, three principal aspects of their experiences emerged: loss and adversity, constructive living, and future uncertainties. Loss and adversity encompassed bereavements, multiple psychosocial losses and physical suffering. Constructive living related to the ability to adopt positive living activities, rebuilding shattered lives, sometimes from the brink of despair. Since the participants were all mothers, future concerns focused on child care anxieties. Stress and uncertainty surrounding HIV testing of children was also evident. Despite the cultural contrast, many of the findings were remarkably similar to those documented in Western literature. The women related their experiences with an absence of self-pity or resentment. Resilience, resourcefulness and hope were typically, perhaps instinctively, demonstrated.

Psychosocial resource loss as a mediator of the effects of flood exposure on psychological distress and physical symptoms.

This study used the Conservation of Resources stress model to examine the role of psychosocial resource loss in the aftermath of Midwest flooding. Questionnaires were distributed through churches and completed by 131 adults in flood-affected communities 6 weeks and 6 months after the flood's crest. Frequent psychosocial losses included losses of routine, sense of control, sense of optimism, accomplishing goals, and time with loved ones. Path analysis revealed that psychosocial resource loss mediated the effects of flood exposure on both psychological distress and physical symptoms at 6 months post-flood. The findings suggest that interventions designed to prevent psychosocial resource loss may reduce the long-term effects of disasters.

Neonatal intensive care and premature birth - maternal perceptions and coping

Premature birth and neonatal intensive care are distressing events for mothers requiring active coping. 42 consecutive mothers of infants treated on a NICU were interviewed prospectively during the first week postpartally, after 4–6 weeks and after 5–6 months with a semistructured interview. The mothers had a high rate of previous psychosocial stressors, medical complications and past perinatal losses. The groups with infants under (VLBW) and over 1,500 g were compared. In the first postpartal week, the VLBW mothers showed a significantly higher degree of distress, fears concerning death and handicaps of the child and negative or ambivalent feelings at first contact than mothers with newborns over 1,500 g. In the next weeks, most mothers were able to cope well with social and professional support and the differences between the two groups were no longer significant. Still, fears concerning their child continued at high rates and disturbing memories occurred often, so that at least subgroups do require more intense help during the early stages of adaptation postpartally. One of the subgroups at risk are the VLBW mothers.

ECT in the elderly.

Depression is a common clinical problem in the elderly. Risk factors in this population include genetic vulnerability, psychosocial losses, medical comorbidity, cerebrovascular disease, and neurodegenerative disorders. Depression in the elderly may have severe consequences, including high rates of suicide, malnutrition or dehydration, high utilization of medical services, impaired recovery from medical illnesses, and inappropriate placement in residential care facilities. A significant number of older depressed patients may not respond to anti-depressant medications, suffer intolerable medication side effects, or have illnesses with symptoms or consequences so severe that it is not feasible to wait the time required for one or more antidepressant trials to work. For many of these patients ECT can be a dramatically effective treatment. With appropriate evaluation and monitoring, ECT can be performed with relative safety even for patients with serious concurrent medical illnesses. Serious adverse effects are rare, and cognitive consequences of ECT are generally circumscribed and of limited duration; there is no evidence of "brain damage" or permanent change in cognitive ability from ECT. After a recovery period memory function is often better than it was during the episode of depression. For patients who have been refractory to or intolerant of medication, maintenance ECT can be an effective strategy for preventing early relapse. Further research is needed, however, to clarify the optimum use of MECT schedules and pharmacotherapy combinations to most effectively and safely prevent relapse of depression in different elderly populations and to help predict who will best respond to which treatment modalities.