Psychosocial Support Programs Research Articles

A Qualitative Inquiry Into the Occupational Challenges Faced by Home-Based Caregivers of People Living With HIV in South Africa’s Gauteng Province

Community home-based caregivers caring for people living with human immunodeficiency virus (PLWHIV) are instrumental in relieving the demand pressures experienced by healthcare service centers. Although their contributions to the healthcare system are essential, they do so under difficult conditions necessitating social work support. This study was conducted in the Gauteng province of South Africa in 2017 to explore the occupational challenges faced by community home-based care caregivers of PLWHIV. Following the qualitative research approach, eighteen caregivers were identified and sampled using purposive and snowball sampling techniques in semi-structured interviews. The data was manually analyzed according to Tesch’s eight steps of qualitative data analysis. This gave rise to four themes: reception by community members, uncooperative clients and families, unsupportive healthcare professionals, and working in unsafe conditions. Following relevant ethical principles such as informed consent, confidentiality, and anonymity throughout the study, trustworthiness was continuously upheld through the principles of prolonged engagement, triangulation, member checking, thick description, and audit trail. The need for psychosocial support programs for caregivers, community and family educational programs, and strengthening partnerships for caregivers, communities, and healthcare professionals is recommended, given the success of community home-based care (CHBC) services for PLWHIV.

Banditry’s Toll On Tomorrow: Exploring the Consequences on Youth in Northwest Nigeria

In recent years, the northwest region of Nigeria has experienced a surge in banditry activities, leading to profound repercussions on local communities. This paper aims at examining banditry’s toll on tomorrow, with a focus on the consequences on the youth in northwest Nigeria. The method adopted for this research is the qualitative method of investigation which tends to emphasize the description, meaning, and understanding of the phenomenon being studied. It relies on questioning and observation in the effort to discover or generate a profound understanding of the phenomenon or situation under investigation. This qualitative research uses a paradigm interpretive approach (naturalistic), which tries to understand the phenomenon from the subjective experiences of individuals. The study discovered that banditry has multiple consequences (economical, political, social, cultural, religious, etc) on the youth in Northwest Nigeria. The paper recommends that, despite the challenges posed by banditry, efforts can be made to promote resilience and develop coping strategies among youths in the Northwest, Nigeria. This may involve implementing psycho-social support programs, trauma-informed teaching practices, and community-based interventions to address the psychological impact.

Exploring the prevalence and predictors of low resilience and likely PTSD in residents of two provinces in Canada during the 2023 wildfires.

The recent wildfires in Canada serve as a stark example of the substantial and enduring harm they cause to the health of individuals and communities. Assessing the prevalence and correlates of Post-traumatic stress disorder (PTSD) and low resilience is valuable for policymakers in public health. The study aimed to assess the prevalence and predictors of low resilience and likely PTSD among subscribers of Text4Hope, an e-mental health program that delivered daily supportive messages to residents of Nova Scotia (NS) and Alberta(AB) during the recent wildfires. Data collection was through a self-administered online survey completed by residents of the affected regions of NS and AB from May 14 to June 23, 2023. Data were analyzed using Statistical Package for the Social Sciences. Out of 298 respondents, the prevalence of low resilience and likely PTSD in our sample were 52.0 and 39.3%, respectively. Unemployed respondents were about 3 times more likely to experience both low resilience and PTSD symptoms compared to those employed. Respondents with a history of mental health diagnosis were about 4 times more likely to experience likely PTSD compared to those with no history of mental health diagnosis. This study established that unemployment and a history of mental health diagnosis predicted likely PTSD, while unemployment was associated with low resilience during the wildfire. These findings offer insights for clinical interventions and the creation of psychosocial support programs for vulnerable populations.

Accessibility and Perceived Impact of a Group Psychosocial Intervention for Women in Ecuador: A Comparative Analysis by Migration Status.

There is increasing guidance promoting the provision of mental health and psychosocial support programs to both migrant and host community members in humanitarian settings. However, there is a lack of information on the respective experiences and benefits for migrant and host community members who are participating in mental health and psychosocial support programming. We evaluated a community-based psychosocial program for migrant and host community women, Entre Nosotras, which was implemented with an international non-governmental organization in Ecuador in 2021. Data on participant characteristics and psychosocial wellbeing were collected via pre/post surveys with 143 participants, and qualitative interviews were conducted with a subset (n = 61) of participants. All quantitative analyses were conducted in STATA, and qualitative analysis was done in NVivo. Attendance was higher for host community members. Specifically, 71.4% of host community members attended 4-5 sessions, whereas only 37.4% of migrants attended 4-5 sessions (p = 0.004). Qualitative analysis shows that the intervention was less accessible for migrants due to a variety of structural barriers. However, this analysis also demonstrated that both groups of women felt a greater sense of social connectedness after participating in the program and expressed gratitude for the bonds they formed with other women. Some migrant women described negative experiences with the host community because they felt as though they could not confide in host community women and speak freely in front of them. These results underscore how the migratory context influences the implementation of mental health and psychosocial support (MHPSS) programs. As humanitarian guidelines continue to emphasize the integration of host community members and displaced persons, it is critical to account for how the same intervention may impact these populations differently.

Social support among chronically ill adolescent and young adult patients using a hospital-based online health community as part of a palliative care program: A qualitative study.

Chronically ill adolescent and young adult (AYA) patients experience barriers to accessing psychosocial support/palliative care, increasing their risk for negative psychosocial outcomes. Online health communities (OHCs) have been recommended for AYAs as part of palliative care support programs; however, we lack research investigating palliative care programs targeting AYAs' psychosocial support needs that are delivered virtually and able to engage with patients both during and beyond inpatient admissions. Streetlight is a palliative care program designed for chronically ill AYAs. Developed as a complementary component that extends beyond the hospital setting, Streetlight Gaming and Online Team (SGOT) is an OHC aimed at facilitating social support to influence psychosocial outcomes. We investigated the existence and enactment of social support among chronically ill AYAs using SGOT and compared this to existing online social support categories to determine which support types are present within SGOT. This was a qualitative phenomenological study. We performed deductive thematic analysis based on existing online social support categories. Nine semi-structured interviews were conducted with SGOT participants. Social companionship/belonging, esteem/emotional, and informational support were most prevalent within SGOT. Thirteen subthemes emerged representing how social support impacted AYAs' psychosocial wellbeing. Notably, coping with/managing illness, sense of community and normalcy, recommendations and advice, and shared interests unrelated to illnesses were subthemes that resonated with AYAs and added value to their experiences. SGOT is an impactful OHC used to meet AYAs' social support needs. What makes SGOT especially unique is its virtual delivery, wherein AYAs can conveniently maintain beneficial relationships with other chronically ill same-aged peers. AYAs need spaces where they can feel normal and access continuous support, both within and beyond inpatient admissions. This study enhances our understanding of online AYA psychosocial support programs. Findings can be used by healthcare professionals to implement similar palliative care and psychosocial support programs.

Navigating whiteness: affective relational intensities of non-clinical psychosocial support by and for culturally and linguistically diverse people.

Mental health is political, with intersecting economic, cultural, racialized, and affective dimensions making up the care assemblage, signalling how care is conceptualised and who is deserving of care. In this article, we examine emotions circulating in a non-clinical psychosocial support program for culturally and linguistically diverse people experiencing mental ill-health, foregrounding the relations between culture, race, economy, and assumptions underpinning understandings of care. The mental health program under study offers psychosocial support for culturally and linguistically diverse people to manage life challenges and mental ill-health exacerbated by navigating the complexities of Australia's health and social care systems. We draw on interviews with clients, staff, and providers of intersecting services, employing Ahmed's concept of affective economies and Savreemootoo's concept of navigating whiteness to examine the care assemblage within interview transcripts. We provide insight into affective intensities such as hate, anger, and indifference embedded in white Anglo-centric services, positioning culturally and linguistically diverse people on the margins of care. Non-clinical psychosocial support programs can counter such affective intensities by training and employing multicultural peer support workers-people with lived experience-prioritising relational and place-based approaches to care and supporting and providing clients with relevant skills to navigate an Anglo-centric care system. However, this support is filled with affective tensions: (com)passion, frustration and fatigue circulate and clash due to the scarcity of resources, further signalling what type of care (and with/for whom) is prioritised within Australian relations of care.

BAMBOO for Refugees—A Culturally Sensitive Positive Psychology Intervention: A Protocol for a Pilot Randomized Controlled Trial

AbstractThis protocol investigates the efficacy of a mental health and psychosocial support (MHPSS) program named BAMBOO. The goal of this program is to increase resilience and mental well-being among refugees. In recent years, there has been an increasing number of refugees fleeing to Europe and applying for permanent residence. In the Netherlands, a wide variety of programs that focus on increasing mental well-being among refugees is available. BAMBOO is a strengths-based intervention, which consists of five weekly two-hour group-based sessions. It is based on the theoretical framework of positive psychology and adapted according to the guidelines for the implementation of culturally sensitive cognitive behavioral therapy among refugees. The program does not focus on the treatment of trauma, mental disorders, or underlying problems, but aims to increase factors such as personal strengths, positive emotions, positive relations, and self-esteem. The first version of the program (BAMBOO 1.0) has been conducted at over 50 asylum centers in the Netherlands since January 2020. In the time period from September 2020 to September 2022, qualitative and quantitative data were collected among BAMBOO trainers and participants and the program was adapted, leading to a revised version (BAMBOO 2.0). A single-blinded parallel pilot randomized controlled trial, with an intervention group and awaiting list control group, with 34 participants per group will be used to test the program’s efficacy. Outcomes include resilience, satisfaction with life, positive and negative affect, and self-esteem. The study will be conducted among adult Arabic speaking refugees, residing at an asylum center in the Netherlands and/ or in a Dutch municipality, Baseline, post-intervention, and five-week follow-up assessments will be conducted. This paper describes the protocol for the evaluation of a novel and culturally adapted program. The study will shed light on the efficacy of a culturally sensitive strengths-based intervention as a preventive approach to increase refugee well-being. ERB Tilburg University, TSB RP623.

The impact of mental health and psychosocial support programmes on children and young people's mental health in the context of humanitarian emergencies in low- and middle-income countries: A systematic review and meta-analysis.

Humanitarian emergencies pose a significant global health challenge for children and young people's mental and psychological health. This systematic review investigates the effectiveness of mental health and psychosocial support (MHPSS) programmes delivered to children and young people affected by humanitarian emergencies in low- and middle-income countries (LMICs). Twelve electronic databases, key websites and citation checking were undertaken. Forty-three randomised controlled trials (RCTs) published in English between January 1980 and May 2023 were included in the review. Overall, the findings suggest that cognitive behavioural therapy may improve depression symptoms in children and young people affected by humanitarian emergencies. Narrative exposure therapy may reduce feelings of guilt. However, the impact of the other MHPSS modalities across outcomes is inconsistent. In some contexts, providing psychosocial programmes involving creative activities may increase the symptoms of depression in children and young people. These findings emphasise the need for the development of MHPSS programmes that can safely and effectively address the diverse needs of children and young people living in adversarial environments.

Enhancing mental health and well-being in adults from lower-resource settings: A mixed-method evaluation of the impact of problem management plus

Abstract Mental health conditions, recognised as a global crisis, were further exacerbated by the COVID-19 pandemic. Access to mental health services remains limited, particularly in low-income regions. Task-sharing interventions, exemplified by Problem Management Plus (PM+), have emerged as potential solutions to bridge this treatment gap. This study presents an evaluation of the PM+ scale-up in Sub-Saharan Africa (Ethiopia and Benin) and Eastern Europe (Croatia and Bosnia and Herzegovina) as part of a mental health and psychosocial support programming including 87 adult participants. A mixed-method approach assesses the impact of the intervention. Quantitative analyses reveal significant reductions in self-reported problems, depression, anxiety and improved functioning. Qualitative data highlight four main themes: general health, family relationships, psychosocial problems and daily activities. These thematic areas demonstrate consistent improvements across clients, irrespective of the region. The findings underscore the impact of PM+ in addressing a broad spectrum of client issues, demonstrating its potential as a valuable tool for mitigating mental health challenges in diverse settings. This study contributes to the burgeoning body of evidence supporting PM+ and highlights its promise in enhancing mental health outcomes on a global scale, particularly for vulnerable populations.

Barriers and facilitators to the implementation of mental health and psychosocial support programmes following natural disasters in developing countries: A systematic review.

Climate change is leading to more frequent and intense natural disasters, with developing countries particularly at risk. However, most research concerning mental health and natural disasters is based in high-income country settings. It is critically important to provide a mental health response to such events, given the negative psychosocial impacts they elicit. The aim of this systematic review is to explore the barriers and facilitators to implementing mental health and psychosocial support (MHPSS) following natural disasters in developing countries. Eight databases were searched for relevant quantitative and qualitative studies from developing countries. Only studies reporting barriers and/or facilitators to delivering MHPSS in response to natural disasters in a low- or middle-income country were included and full texts were critically appraised using the McGill University Mixed Methods Appraisal Tool. Reported barriers and facilitators were extracted and analysed thematically. Thirty-seven studies were included in the review, reflecting a range of natural disaster settings and developing countries. Barriers to implementing MHPSS included cultural relevance, resources for mental health, accessibility, disaster specific factors and mental health stigma. Facilitators identified included social support, cultural relevance and task-sharing approaches. A number of practical approaches can be used to facilitate the implementation of MHPSS in developing country settings. However, more research is needed on MHPSS in the developing country natural disaster context, especially in Africa, and international policies and guidelines need to be re-evaluated using a decolonial lens.

STAR CAREGIVERS: IMPLEMENTATION OF AN EVIDENCE-BASED PROGRAM IN REAL-WORLD SETTINGS

Abstract Evidence-based non-pharmacological community programs to improve care of older adults with dementia are growing. However, many programs have historically been tested in research studies that fail to reach medically underserved populations or communities with unique service needs. STAR-Caregivers (STAR-C, also known as STAR-Community Consultants) is an evidence-based psychosocial support and skill training program designed to teach family caregivers how to identify and increase pleasant events, improve communication, and use behavioral problem-solving skills to reduce the problems experienced by their family member with dementia while improving quality of life for both persons in the caregiver-care receiver dyad. Since its original randomized controlled trial in 2005, STAR-C has been translated in a variety of real-world settings, including in Area Agencies on Aging throughout Oregon and Washington state. This symposium describes three recent new translation efforts: (1) implementation of STAR-C as a virtual training program (STAR-VTF) for caregivers of persons with dementia who are part of the Kaiser Permanente Washington health care system; (2) cultural adaptation of STAR-VTF for Latino caregivers, and (3) incorporation of STAR-C into a largely rural community care setting in Illinois during the COVID-19 pandemic using Amazon Echo technology to conduct telehealth community dyad STAR-C sessions and connect clients to supplemental services. Each presenter will discuss the dementia care needs in their respective populations, the challenges encountered in translation of STAR-C to serve target caregiving dyads, and lessons learned regarding treatment effectiveness and program sustainability.

Analyzing physical environment of Child Friendly Spaces in emergencies: in the context of Rohingya crisis at Cox’s Bazar, Bangladesh

Purpose Child friendly space (CFS) has been introduced worldwide as an effective Child Protection response to the affected children in emergency to restore their life through psychosocial support programs. An effective physical environment is crucial to accommodate the psychosocial activities of a CFS. Several guidelines have stated minimum standards regarding design and implementation of a CFS. However, different case studies show that the physical set-up of CFS varies in different contexts. Therefore, there is a scope to analyze the physical environment of CFSs in the context of Rohingya camps based on those standards. Design/methodology/approach Very few guidelines have solely discussed the criteria of physical design and implementation of a CFS. First, the study develops an assessment tool by sorting out those standards from available sources. Secondly, the study follows multiple case study research approach to assess physical environment of four CFSs in Rohingya camps, Cox’s Bazar based on those standards using direct observation, photographic analysis and key informant interview as survey tools. Findings Major findings reveal that local factors such as topography, availability of land and density have great impact on physical environment on CFSs in Cox’s Bazar beyond the minimum standards, which indicates the importance of considering local factors while designing a CFS for a given context. Originality/value Solely demonstrates the need of considering the benchmarks as well as local factors, which will contribute to the knowledge of policymakers and implementers during designing and implementing a CFS for a specific context.

Assessment of Haemophilia Patients' and Other Bleeding Disorders Needs of Psychosocial Support and Health Care Needs and Their Utilization in Haemophilia Treatment Centres (ILLUSTRATE Study)

Background: Psychological support for chronically ill patients as an integral component of medical care could improve health-related quality of life (HRQoL) of patients and contribute to a reduction in treatment costs. A meta-analysis including almost 3,000 patients revealed that persons with hemophilia (PWH) are at increased risk for depression, anxiety, and ADHD compared to the general population (Al-Huniti et al., 2020). Studies have shown that the self-efficacy, coping mechanisms, and HRQoL of parents of hemophilic children were improved by self-help programs, and depression, anxiety, and parenting stress were reduced. Although different psychological interventions have been used to help PWH to cope with their psychological problems, there is a gap between patients' need for psychosocial support from the perspective of health care professionals (HCPs) and their utilization by PWH. The aim of the ILLUSTRATE study was to assess the need for psychosocial support and medical care in patients with inherited bleeding disorders (IBD) and in HCPs and their use in hemophilia centers. Methods: Patients with IBD (PIBD) were invited by different German patient organizations (Deutsche Bluthilfe, DHG, IGH, Hämophilie 2000) to participate in an on-line surevey (from December 2022-June 2023). In addition, HCPs were asked to complete a similar on-line survey via the mailing list of the German Society for Thrombosis and Hemostaseology. A positive ethical approval for the study was obtained by the Local Psychological Ethics Committee at the University Medical Centre in Hamburg, Germany (LPEK-0578). The questionnaire for patients consisted of the following aspects: socio-demographic data, medical background, care services and psycho-social support, dealing with stress and difficult situations, dealing with special situations that may arise or be exacerbated by the bleeding disorder, offer of psycho-social counseling/support, and need for expansion. The questionnaire for HCPs contained the following themes: personal background, need of patients for psycho-social counseling/support (PSCS), supply of PSCS and need for expansion, utilization, and benefits of PSCS. Results: In total, 154 patients and parents of children with an IBD participated (72 PIBD,80 parents, 2 others) with a mean age of 41.06±13.3 years, 60.4% were female. In addition, 65 HCPs completed the respective survey (34 physicians, 27 nurses and 4 others) with a mean age of 48.11 ± 12.7 years, in average they worked since 13.1±10.8 years in haemostaseology, 78.5% worked in a hemophilia comprehensive care center (HCCC), 20% in a hemophilia treatment center (HTC) and 1.5% in a homecare service. In the IBD group (patients, parents) most were married (59.1%), lived with a partner (83.8%) and worked full- or part-time (66%). Most PIBD had hemophilia (74%) with a severe form (81.8%). 28.6% of the IBD group felt little to not at all supported to overcome psycho-social challenges. It was demonstrated that they had an intermediate stress resilience (14.76±3.1), with 1/3 showing a low resilience. When asking what coping strategies they used in stress situations, 26% mentioned that they ignore difficult situations and 16% compensated their stress with drugs and alcohol. 20% often to always felt helpless and overwhelmed due to their IBD and 31% rarely to never received support in these situations. 71% reported to have a need for PSCS, 57% wished more support services (69% mainly at the HTC), 71% felt not to have enough information about these services and 64% would use them more often if they were more accessible. 52% of HCPs found that the IBD group has a need of PSCS, they assumed that parents and adolescent patients would benefit most of these services and expected the highest advantage from psychological counseling. 60% thought that there is a need for information and education. The IBD group and HCPs preferred PSCS in presence, the IBD group would use services as well via phone or digital. Conclusions: Although offered psycho-social support programs are rarely used by patients, a large proportion of the IBD group and HCPs confirmed a need for it. Increased accessibility to PSCS and more information were identified as a factor for increased use of this support programs. Additional digital psycho-social support services were desired and represent a helpful alternative if services are not available on site.

COVID-19 anxiety and related factors amid adjusted epidemic prevention policies: a cross-sectional study on patients with late-life depression in China

ObjectivesTo explore the prevalence and associated factors of COVID-19 anxiety in patients with late-life depression (LLD) during the adjustment of epidemic prevention policies in China.DesignCross-sectional study.SettingThe data analysed in this...

The Relationship between Wellbeing, Self-Determination, and Resettlement Stress for Asylum-Seeking Mothers Attending an Ecosocial Community-Based Intervention: A Mixed-Methods Study.

Psychosocial support programs have been increasingly implemented to protect asylum seekers' wellbeing, though how and why these interventions work is not yet fully understood. This study first uses questionnaires to examine how self-efficacy, satisfaction of basic psychological needs, and adaptive stress may influence wellbeing for a group of asylum-seeking mothers attending a community-based psychosocial program called Welcome Haven. Second, we explore mothers' experiences attending the Welcome Haven program through qualitative interviews. Analysis reveals the importance of relatedness as a predictor of wellbeing as well as the mediating role of adaptive stress between need satisfaction and wellbeing. Further, attending Welcome Haven is associated with reduced adaptive stress and increased wellbeing, which correspond with the thematic analysis showing that attendance at the workshops fostered a sense of belonging through connection with other asylum seekers and service providers as well as empowerment through access to information and self-expression. The results point to the importance of community-based support that addresses adaptive stress and the promotion of social connection as key determinants of wellbeing. Nonetheless, the centrality of pervasive structural stressors asylum seekers experience during resettlement also cautions that relief offered by interventions may be insufficient in the face of ongoing systemic inequality and marginalization.

Психологічна підтримка осіб з ознаками соціально тривожного розладу, який асоціюється з травматичним досвідом

Background. Considering the high prevalence of social anxiety disorder and its impact on quality of life and occupational functioning, research aimed at effective and accessible interventions can help reduce the burden of this disorder and improve patient well-being. Understanding traumatic experiences' influence on social anxiety development is critical for developing effective interventions. Studies exploring the link between traumatic experiences and the severity of anxiety disorders can shed light on this mechanism and provide more effective support to those who have experienced trauma. One of the challenges in treating social anxiety disorder is the low readiness of individuals to seek professional help. Low-intensity interventions may become more accessible and acceptable to patients, increasing their awareness of mental health issues and motivation for self-help or seeking specialized assistance. Previous research has shown the effectiveness of specific intervention methods for social phobias, but further studies are needed to test the stability of these results over time. Considering the above, research can help improve the understanding and psychological support for individuals with social anxiety disorder and develop more accessible and effective preventive measures for patients with a history of traumatic experiences. Objective. To study the effectiveness of a low-intensity cognitive-behavioral therapy psychosocial support program for individuals with social anxiety disorder associated with a history of traumatic experiences. Materials and Methods. The study group consisted of 179 individuals who reported significant emotional and psychological discomfort due to avoiding social situations and exhibited symptoms typical of social anxiety disorder for over six months in the past. At the initial stage, 109 individuals without signs of social phobia but with limitations in social interaction, including issues with adaptation and traumatic experiences in the past, were included as a control group. The mental state was assessed using The MINI: International Neuropsychiatric Interview. Psychopathological symptoms were analyzed using self-report questionnaires and the IAPT complex scales, while the quality of life was assessed using the self-report Q-LES-Q-SF questionnaire. In the second stage of the program evaluation, data analysis was conducted solely within the leading group, excluding the control groups, based on their classification according to associated traumatic experiences. Results. In the study, for the subgroup of individuals who participated in combat, experienced immediate life-threatening situations, or witnessed such events, it was found that traumatic experiences and distress related to social avoidance accounted for 56% of the variance in overall and work-related functioning after the program and throughout one month. Depressive symptoms ceased to be statistically significant predictors after participating in the program. The reduction in the impact of traumatic experiences and anxiety-related avoidance accounted for 27% of the variance in social interaction limitations and overall distress. In the subgroup of individuals who experienced loss and were influenced by social events they considered traumatic, no initial reduction in distress related to social avoidance was observed after the interventions. However, further reduction in distress in daily life and work was associated with reduced social phobia symptoms and increased awareness and acceptance of their emotional experiences. Depressive symptoms and the impact of traumatic experiences ceased to be predictive factors for overall distress. The research confirms the importance of understanding the influence of traumatic experiences and social avoidance on the development and manifestation of comorbid conditions in social phobia during the planning and implementation of psychosocial support. Furthermore, it is considered essential to consider that the role of traumatic experiences may be mediated by the circumstances of the study's time frame. Additional research will help better understand the relationships between traumatic experiences and vulnerability to comorbid psychopathology during adaptation to emergency circumstances and develop more effective psychosocial interventions for individuals with social phobia.

Effect of daily stressors and collective efficacy on post-traumatic stress symptoms among internally displaced persons in post-war northern Sri Lanka.

Daily stressors have been shown to mediate the relationship of war trauma and trauma-related distress among refugees and internally displaced persons exposed to war and conflict. To examine the extent to which the relationship between war-related trauma and mental distress was mediated by daily stressors and collective efficacy among internally displaced communities a decade after exposure to war. In a cross-sectional study, we recruited a random sample of residents in villages severely affected by conflict in five districts in the Northern Province of Sri Lanka. Measures of war trauma, daily stressors, collective efficacy and post-traumatic stress symptoms (PTSS) were examined. Statistical analyses of the mediating and moderating effects of daily stressors were conducted using regression based methods. Daily stressors mediated the association of war trauma and PTSS, as both paths of the indirect effect, war trauma to daily stressors and daily stressors to PTSS, were significant. The predictive effect of war trauma on PTSS was positive and significant at moderate and high levels of daily stressors but not at low levels. Higher levels of neighbourhood informal social control, a component of collective efficacy, function as a protective factor to reduce effects of war trauma and daily stressors on mental distress in this population. Daily stressors are an important mediator in the well-established relationship between war exposure and traumatic stress among internally displaced persons, even a decade after the conflict. Mental health and psychosocial support programmes that aim to address mental distress among war-affected communities could reduce daily stressors and enhance collective efficacy in this context.

Nurses' COVID-19-related fear and anxiety and their attitudes to the COVID-19 vaccine: A descriptive and correlational study.

The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine-related information and have a primary role in building confidence regarding vaccines. The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID-19) and their attitudes towards the COVID-19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated. A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling. Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID-19. Age and fear were also positively associated with anxiety related to COVID-19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine. Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination.

COVİD-19 PANDEMİ SÜRECİNDE GEBELERDEKİ KAYGI DÜZEYLERİNİN ZAMANLA DEĞİŞİMİ

Aim: To examine the changes in the anxiety levels of pregnant women in the last two years, since the onset of the COVID-19 pandemic and to determine how sociodemographic characteristics have affected these levels.
 Materials / Method: State-Trait Anxiety Inventory (STAI) was given to 400 low-risk pregnant women visiting the antenatal outpatient clinic within a two years interval regardless of their gestational age. Besides the anxiety inventory, the sociodemographic characteristics of the participants were also noted. The results were evaluated at the end of two years.
 Results: Gestational week, working status, whether the pregnancy was planned or not, and partner support were not statistically significant between groups(p|>0.001). The averages of state and trait anxiety of pregnant women were higher at the beginning of the pandemic than the pregnant women were after two years period(p=0,000,p=0,038, respectively). While there was no difference related to age at the beginning of the pandemic, the level of trait anxiety increased as the mother’s age increased in the period after two years(p=0.047). The anxiety level of primigravidas was found to be higher compared to the multiparas. Pregnant women who were working while the social restrictions were being imposed due to the pandemic had lower anxiety levels than those who were not(p=0.049).
 Conclusion: Even though working during social restrictions seems quite risky because of the disease transmission, it has a positive effect on reducing the level of anxiety in pregnant women with social support. Therefore, psycho-social support programs for pregnant women should be kept ready in major disasters.

"It just made me feel better": qualitative examination of the implementation of a novel virtual psychosocial support program for adolescents with cancer.

Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact. We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens, and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programming in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents' and clinicians' acceptability, feasibility, and perceived utility. Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming, such as Teens4Teens, is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.