Novel Definitions of Wellness and Distress among Family Caregivers of Patients with Acute Cardiorespiratory Failure: A Qualitative Study.

Rationale: Family caregivers of patients with acute cardiorespiratory failure are at high risk for distress, which is typically defined as the presence of psychological symptoms such as anxiety, depression, or posttraumatic stress. Interventions to reduce caregiver distress and increase wellness have been largely ineffective to date. An incomplete understanding of caregiver wellness and distress may hinder efforts at developing effective support interventions. Objectives: To allow family caregivers to define their experiences of wellness and distress 6 months after patient intensive care unit (ICU) admission and to identify moderators that influence wellness and distress. Methods: Primary family caregivers of adult patients admitted to the medical ICU with acute cardiorespiratory failure were invited to participate in a semistructured interview 6 months after ICU admission as part of a larger prospective cohort study. Interview guides were used to assess caregiver perceptions of their own well-being, record caregiver descriptions of their experiences of family caregiving, and identify key stress events and moderators that influenced well-being during and after the ICU admission. This study was guided by the Chronic Traumatic Stress Framework conceptual model, and data were analyzed using the five-step framework approach. Results: Among 21 interviewees, the mean age was 58 years, 67% were female, and 76% were White. Nearly half of patients (47%) had died before the caregiver interview. At the time of the interview, 9 caregivers endorsed an overall sense of distress, 10 endorsed a sense of wellness, and 2 endorsed a mix of both. Caregivers defined their experiences of wellness and distress as multidimensional and composed of four main elements: 1) positive versus negative physical and psychological outcomes, 2) high versus low capacity for self-care, 3) thriving versus struggling in the caregiving role, and 4) a sense of normalcy versus ongoing life disruption. Postdischarge support from family, friends, and the community at large played a key role in moderating caregiver outcomes. Conclusions: Caregiver wellness and distress are multidimensional and extend beyond the absence or presence of psychological outcomes. Future intervention research should incorporate novel outcome measures that include elements of self-efficacy, preparedness, and adaptation and optimize postdischarge support for family caregivers.

Racialized emotion recognition accuracy and anger bias of children's faces.

Research suggests that individuals are racially biased when judging the emotions of others (Elfenbein & Ambady, 2002) and particularly regarding attributions about the emotion of anger (Halberstadt, Castro, Chu, Lozada, & Sims, 2018; Hugenberg & Bodenhausen, 2003). Systematic, balanced designs are rare, and are comprised of adults viewing adults. The present study expands the questions of racialized emotion recognition accuracy and anger bias to the world of children. Findings that adults demonstrate either less emotion accuracy and/or greater anger bias for Black versus White children could potentially explain some of the large racialized disciplinary discrepancies in schools. To test whether racialized emotion recognition accuracy and anger bias toward children exists, we asked 178 prospective teachers to complete an emotion recognition task comprised of 72 children's facial expressions depicting six emotions and divided equally by race (Black, White) and gender (female, male). We also assessed implicit bias via the child race Implicit Association Test and explicit bias via questionnaire. Multilevel modeling revealed nuanced racialized emotion recognition accuracy with a race by gender interaction, but clear racialized anger bias toward both Black boys and girls. Both Black boys and Black girls were falsely seen as angry more often than White boys and White girls. Higher levels of either implicit or explicit bias did not increase odds of Black children being victim to anger bias, but instead decreased odds that White children would be misperceived as angry. Implications for addressing preexisting biases in teacher preparation programs and by children and parents are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).