Feasibility of a brief, in-patient coping and sleep intervention to reduce potentially preventable readmission of cardiac patients to hospital.

Background: Psychological distress is prevalent amongst hospital in-patient and may predispose patients to potentially preventable readmissions after discharge. A particularly vulnerable group are patients with cardiac disorders. This study tested the feasibility of a brief cognitive behavioural therapy consisting of an in-hospital coping session and a post-discharge healthy sleep session. Methods: Standardised questionnaire were used to assess sleep, coping/distress and wellbeing at baseline (pre-intervention) and one-month post-discharge (post-intervention). Treatment fidelity and acceptability were assessed at follow-up. Participants included 72 inpatients admitted with a cardiac disorder or reported to have a cardiac problem whilst in hospital from a single Australian public hospital. Results: Most (83 %) participants found the intervention helpful/very helpful. At baseline prior to admission, almost half of participants (46 %) reported poor wellbeing, 19 % high levels of distress and poor coping, and 47 % sleeping less than 7 h per night. Following the intervention, 45 % of participants with poor wellbeing at baseline had reliable change in wellbeing at follow-up. Conversely, only 22 % of patients with high levels of coping/distress at baseline demonstrated improved coping/distress at follow-up suggesting smaller gains. On average a large 43 min gain in sleep duration was observed post-treatment in patients with poor sleep at baseline. Fourteen percent of participants were readmitted to hospital within 34-days of discharge. Conclusions: The coping and sleep intervention was well received with positive outcomes in patients especially those reporting high levels of distress for sleep and to lesser extent coping and wellbeing. Future studies to assess the efficacy of the brief intervention at reducing hospital readmissions are needed.

Workplace sense of belonging and paramedic wellbeing using network analysis: A cross-sectional study.

BACKGROUND: Workplace sense of belonging is an important contributor to health and wellbeing. It may be even more important for paramedics to buffer against distress inherent in the workplace. To date, however, there has been no research on paramedic workplace sense of belonging and wellbeing. METHODS: Using network analysis, this study aimed to identify the dynamic relationships of workplace sense of belonging in paramedics with variables associated with wellbeing and ill-being-identity, coping self-efficacy and unhealthy coping. Participants were a convenience sample of 72 employed paramedics. RESULTS: The results showed workplace sense of belonging linked to other variables through distress, distinguishable by the relationship with unhealthy coping for wellbeing and ill-being. The relationships between identity (perfectionism and sense of self) as well as the relationship between perfectionism and unhealthy coping were stronger for those with ill-being than observed for those with wellbeing. CONCLUSIONS: These results identified the mechanisms by which the paramedicine workplace can contribute to distress and unhealthy coping strategies, which can lead to mental illnesses. They also highlight contributions of individual components of sense of belonging highlighting potential targets for interventions to reduce the risk of psychological distress and unhealthy coping amongst paramedics in the workplace.

How do paramedics and student paramedics cope? A cross-sectional study.

Despite threats to wellbeing inherent in paramedicine, little is known about how paramedics cope. This study explored the breadth of healthy and unhealthy coping strategies used by paramedics and student paramedics. A convenience sample of 198 paramedics and student paramedics completed an online survey. Wellbeing was measured using WHO-5 and coping using the Coping Index. Primary outcomes were summarised using descriptive statistics. Most of the sample had wellbeing (68%); student paramedics had significantly better wellbeing than paramedics. There was no significant difference between paramedics and student paramedics on healthy or unhealthy coping. Participants with ill-being had significantly fewer healthy and more unhealthy coping strategies than those with wellbeing, and relatively few used professional support (28%). Internationally, few studies have reported coping strategies in paramedics. This study expands our understanding of healthy and unhealthy coping strategies used by paramedics and student paramedics. The results support research that shows paramedic work affects wellbeing, however not that paramedics are at greater risk of unhealthy coping than students or the general population. The results have implications for both the prevention of overwhelming distress in the workplace and the need to increase the use of professional support to prevent unhealthy coping, including suicidality.

A review of Australian Government funding of parenting intervention research.

OBJECTIVES: Parenting is central to children's optimal development and accounts for a substantial proportion of the variance in child outcomes, including up to 40% of child mental health. Parenting is also one of the most modifiable, proximal, and direct factors for preventing and treating a range of children's problems and enhancing wellbeing. To determine the effectiveness of new approaches to parenting intervention, and to evaluate how to optimise reach and uptake, sufficient funding must be allocated for high quality research. METHOD: We reviewed funding awarded by the National Health and Medical Research Council (NHMRC) and Australian Research Council (ARC) for parenting intervention research during 2011-2020. RESULTS: Parenting intervention research received 0.25% of the NHMRC and ARC research budgets. CONCLUSIONS: There is a substantial mismatch between the funding of parenting intervention research and the impact of improved parenting on short- and long-term child outcomes. To rectify this, it is critical that Australian Government funding schemes include parenting interventions as priority areas for funding. IMPLICATIONS FOR PUBLIC HEALTH: Changes in allocation of funding to parenting research will support the establishment of evidence for the effective development, implementation and dissemination of parenting interventions to maximise health outcomes for children and their families.

How do paramedics cope? A scoping review.

Exposure to repeated trauma is an inherent component of paramedicine. Additionally, paramedics are exposed to threats that can undermine healthy workplaces, social connectedness, and health behaviour, predisposing them to overwhelming distress and unhealthy coping, including suicidality and psychiatric disorders. This scoping review aimed to identify how paramedics cope. PubMed, PsycINFO and CINAHL were searched between January 1, 2010, to April 21, 2021. Studies were included if they used any research design to identify specific coping strategies used by paramedics. Three studies met the inclusion criteria-two qualitative and one cross-sectional survey design. There was a high risk of bias across all studies. Studies were conducted in Israel, Poland, and the UK, primarily with males. Two studies only identified healthy coping strategies-self-soothing and social and professional support. Unhealthy strategies identified in the third study were limited to negative self-talk and alcohol use, with no mention of other harmful behaviours, social withdrawal, or suicidality. There is limited research describing how paramedics cope, and in particular, how female paramedics cope. Further research exploring the breadth of coping strategies used by paramedics is needed to understand the impact of the work paramedics undertake on coping and inform prevention and support activities.

How do university students cope? An exploration of the health theory of coping in a US sample.

ObjectiveDespite the increasing prevalence of psychological distress in university and college students, little is known about their use of coping strategies. This study explored healthy and unhealthy coping strategies in this population. Participants: A representative sample of 509 students at a large public university in the US. Methods: This study analyzed survey data from a special version of the Healthy Minds Study. Results: The most frequently used healthy strategies were distraction, deep breathing, relaxation and social activity. The most frequently used unhealthy coping strategies were spending time alone and eating. Students who used more unhealthy coping and fewer healthy strategies were more likely to have clinical levels of depression and anxiety symptoms. Relatively few students with clinical symptoms used professional support as a coping strategy. Conclusions: The results suggest that population-level monitoring and coping interventions may be promising avenues to improve university student wellbeing.

The modifiable biopsychosocial drivers of psychological distress for adolescents with asthma: Implications for Clinical Care.

PURPOSE: Overwhelming distress exceeds the capacity of healthy coping strategies to feel better using healthy coping strategies alone, resulting in the use of unhealthy coping strategies. Unhealthy coping strategies may exacerbate asthma symptoms and asthma can contribute to overwhelming distress. This study aimed to review the modifiable drivers of overwhelming distress in adolescents with asthma. METHODS: The biopsychosocial drivers of psychological distress for adolescents with asthma were explored within the domains of the modifiable biopsychosocial model of health and wellbeing. RESULTS: Asthma in adolescents is associated with problems in the domains of environment, developmental outcomes, sense of belonging, health behaviours, coping, and treatment of illness. CONCLUSIONS: The relationship between asthma and psychological distress highlights the need for holistic treatment of asthma. Further research is needed to establish causation between variables and to investigate whether interventions that address either asthma symptoms or biopsychosocial drivers of distress can improve both factors.

Self-perceptions of aging: A systematic review of longitudinal studies.

As the population of older adults increases, it is important to understand what may assist every older person to live well and longer. Using a systematic review, this study examined the longitudinal consequences of self-perceptions of aging (SPA), a measure of internalized stereotypes of aging, in participants 50 years or older. The sample comprised 21 studies published in English that used the Attitudes Toward Own Aging (ATOA) scale to measure SPA. Studies were conducted in the United States (10), Germany (7), Australia (2), and one each from Israel and Switzerland. Risk of bias was low, study design and assessment showed good to high quality, and the ATOA scale was reliable in all studies. Primary outcomes were physiological (N = 15; longevity and better health, health behaviors, and diseases) and psychological (N = 6; depression, cognitive function, and other psychological outcomes) rather than social. More positive SPA was consistently associated with healthier longitudinal outcomes, including better self-rated health and less obesity, greater longevity, better performance of the activities of daily living, less depression, and better cognitive functioning (including reductions in cognitive decline and incidence of dementia). These were both direct and indirect pathways and provide support for the consequences of aging stereotypes, providing support for Levy's Stereotype Embodiment theory. The results have public health implications, broadly as community messaging about the benefits of positive SPA and usual and healthy aging, and more narrowly in using ATOA to screen for middle-aged adults with negative SPA to prevent future physical and psychological decline. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Massively Multiplayer Online Games and Well-Being: A Systematic Literature Review.

Background: Massively multiplayer online games (MMOs) evolve online, whilst engaging large numbers of participants who play concurrently. Their online socialization component is a primary reason for their high popularity. Interestingly, the adverse effects of MMOs have attracted significant attention compared to their potential benefits. Methods: To address this deficit, employing PRISMA guidelines, this systematic review aimed to summarize empirical evidence regarding a range of interpersonal and intrapersonal MMO well-being outcomes for those older than 13. Results: Three databases identified 18 relevant English language studies, 13 quantitative, 4 qualitative and 1 mixed method published between January 2012 and August 2020. A narrative synthesis methodology was employed, whilst validated tools appraised risk of bias and study quality. Conclusions: A significant positive relationship between playing MMOs and social well-being was concluded, irrespective of one's age and/or their casual or immersed gaming patterns. This finding should be considered in the light of the limited: (a) game platforms investigated; (b) well-being constructs identified; and (c) research quality (i.e., modest). Nonetheless, conclusions are of relevance for game developers and health professionals, who should be cognizant of the significant MMOs-well-being association(s). Future research should focus on broadening the well-being constructs investigated, whilst enhancing the applied methodologies.

Pharmacological interventions for the treatment of psychological distress in patients with asthma: a systematic review and meta-analysis.

Objective: To evaluate the effectiveness and safety of pharmacological interventions for the treatment of psychological distress in people with asthma.Data sources: Electronic searches were performed in Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PubMed/Medline, Embase, PsycInfo, Health Technology Assessment Database and Web of Science (inception to April 2019).Study selections: Included studies were randomized controlled trials (RCT) or controlled clinical trials investigating the effect of pharmacological interventions for psychological distress in people with asthma. Records were screened and data extracted by two independent authors into standardized pilot-tested extraction templates. Data was analyzed according to standard Cochrane methodology and entered into Review Manager Software version 5.3.Results: From 5,689 studies, six RCTs (n = 215) met inclusion criteria and were included in the systematic review, of which four studies were included in the meta-analysis. A meta-analysis of four studies (n = 158) indicated no evidence of an effect for selective serotonin reuptake inhibitors (Citalopram or Escitalopram) on reduction of psychological distress in adult patients with asthma. Similarly, antiepileptic medication (Levetiracetam) was no better than placebo in the treatment of psychological distress in people with asthma. Adverse events were poorly reported across all studies but were slightly increased among intervention participants compared to control participants.Conclusions: There was great heterogeneity between studies and overall poor methodological quality providing insufficient evidence to make recommendations for or against the use of pharmacotherapy in asthma patients with psychological distress. Further confirmatory trials are warranted to make recommendations for clinical practice.

The alignment of law, practice and need in suicide prevention.

Help-seeking is important for patients with suicidal ideation. Currently, a risk management paradigm is used with patients who express suicidality; however, this may limit support and increase stigma, reducing future help-seeking. Coping planning is proposed as a paradigm shift that overcomes these problems by focusing on patient needs and strengths. Declaration of interest None.

Medication induced sleepwalking: A systematic review.

Medications that trigger sleepwalking may inadvertently put the patient at risk of injury to themselves and/or others, and contribute to poor treatment adherence. The aim of this study was to systematically review the literature to identify drugs that may increase the risk of sleepwalking. A search of CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted with the keywords 'sleepwalking' OR 'somnambulism'. Of the original 83 sourced papers, 62 met the inclusion criteria and were subsequently included for review. Twenty-nine drugs, primarily in four classes-benzodiazepine receptor agonists and other gamma aminobutyric acid (GABA) modulators, antidepressants and other serotonergic agents, antipsychotics, and ß-blockers-were identified as possible triggers for sleepwalking. The strongest evidence for medication-induced sleepwalking was for zolpidem and sodium oxybate. All other associations were based on case reports. This research highlights the importance of considering sleepwalking in risk profiles in clinical trials, particularly for drugs that enhance GABA activity at the GABAA receptor, enhance serotonergic activity, or block the activity of noradrenaline at ß receptors. The results also have implications for prescribers to consider sleepwalking as a potential adverse effect and ensure that: 1) the patient is educated about a safe sleep environment; 2) they are encouraged to report the onset or exacerbation of sleepwalking, and 3) alternative treatments are considered if sleepwalking occurs.

Coping planning: a patient-centred and strengths-focused approach to suicide prevention training.

OBJECTIVES: Suicide is a leading cause of premature death and, despite significant investment, the prevalence rate has remained relatively stable for more than a decade. Theoretically, the use of 'safety planning' as a response to suicidality likely maintains suicide as a potential solution for vulnerable people. This paper describes a theoretically-supported paradigm shift from safety planning to 'coping planning' to improve patient outcomes and improve the confidence and competence of clinicians working with people with suicidality. CONCLUSIONS: Coping planning is a strategy used to support people with acute distress. Its components of 'caring', 'collaborating' and 'connecting' reinforce existing strengths, promote self-efficacy and link people with more intensive supports, as needed. Coping planning overcomes the limitations of existing approaches. It reframes suicide prevention from managing patients disclosing suicidality to ensuring patients have minimally sufficient temporary support to help them cope. This approach has the potential to promote coping self-efficacy and prevent deterioration that leads to suicide.