Effects of mindfulness meditation training offered in-person and via a virtual world on self-compassion: A study with U.S. military active duty and veterans.

BACKGROUND: Mindfulness-based, in-person programs are effective at reducing stress and enhancing resilience in military and civilian samples, yet few studies have examined or compared training offered via real-time, interactive social media. Such a program would have a wider-reach and could include those unable to attend in-person. There is also interest in resolving ambiguity about the effects of mindfulness training on individual difference variables, such as self-compassion. OBJECTIVE: The purpose of this research was to compare pre/post self-compassion for three interventions; Mindfulness-based Stress Reduction delivered in-person (IP), mindfulness meditation training delivered via a Virtual World (VW), and a wait-list Control Group (CG) among active duty and veteran U.S. military. METHODS: A 2 (pre/post)×3 (group) factorial design was conducted with 250 active duty and veteran U.S. Military service members, with self-compassion measures as dependent variables. RESULTS: Self Compassion improved 10% for the IP group and 14% for the VW group, while the CG group did not improve. Combined treatment groups yielded a 10.3% improvement in self-compassion compared with no change in the CG and with a group×time interaction effect (p < 0.01). Participants with lower initial self-compassion experienced greater benefits than those with higher baseline self-compassion (p < 0.01). CONCLUSION: IP and VW Mindfulness Meditation training were equally effective in increasing self-compassion. Adding effective on-line mindfulness delivery will promote self-compassion among a more extensive audience, likely yielding improved coping, confidence, connectedness, cheerfulness, steadiness, and self-satisfaction, while lessening anxiety, fear-of-failure, and stress among participants.

The Effect of Mindfulness-Based Empowerment Program on Self-Compassion, Self-Esteem and Ways of Coping With Stress of Women Experienced Violence: A Randomised Controlled Study.

The aim of this experimental research is to assess the impact of a mindfulness-based empowerment program applied to women who have experienced violence on their levels of self-compassion, self-esteem and coping with stress. The study was a randomised controlled trial with a control group. Participants were randomly assigned to the experimental group (EG, n1 = 27) and the control group (CG, n2 = 26) from women who had experienced violence. Descriptive statistical methods and t-tests for dependent and independent groups were employed in data analysis. After the mindfulness-based empowerment program, the intervention group exhibited a statistically significant high effect size in post-intervention measurements compared to the control group for the Self-Compassion Scale, Coopersmith Self-Esteem Inventory and Coping Styles Scale total and subscale mean scores (p < 0.001). The mindfulness-based empowerment program has been found to enhance self-compassion, self-esteem and coping levels in women who have experienced violence. Therefore, it is recommended to promote the widespread adoption of mindfulness-based interventions for individuals who have undergone trauma, such as violence, to facilitate their re-empowerment and functional recovery. Trial Registration: ClinicalTrials.gov identifier: NCT05310656.

Estrategias de afrontamiento al síndrome de burnout en médicos-docentes universitarios en postpandemia / Coping strategies to burnout syndrome in post-pandemic university physician-teachers / Estratégias de enfrentamento da síndrome de burnout em professores doutores de universidades pós-pandemia

Los médico-docentes han sufrido las secuelas de la pandemia y que sigue evidenciándose en la postpandemia como estrés laboral; por ello tuvieron que aprender estrategias de afrontamiento para superar este problema de salud mental. Objetivo. Analizar las características del Síndrome de burnout Académico de cuatro docentes-médicos universitarios y las estrategias de afrontamiento que utilizaron en un contexto de postpandemia. Metodología. Investigación cualitativa, fenomenológica, interpretativa, en la que se utilizó la entrevista en profundad a cuatro docentes-médicos (2 varones y 2 mujeres), permitió analizar y reflexionar acerca de las experiencias de los participantes de las secuelas que les dejó el SBA después de la pandemia generada por la COVID-19 y cómo realizaron el afrontamiento. Las categorías fueron SBA y afrontamiento. El trabajo se llevó a cabo en tres fases: (a) descriptiva, en ella se organizó y planificó el proceso metodológico y ético, (b) fase estructural, se elaboraron las guías de entrevista, la matriz para organizar la información, transcripción y codificación de la información y (c) fase de discusión, en la se confrontaron las experiencias discrepantes y semejantes que fueron contrastados con otros estudios. Hallazgos. La COVID-19 generó en los médico-docentes SBA, que se evidenciaron en problemas emocionales, cognitivos, conductuales-psicosomáticos y sociales. El afrontamiento integral con las técnicas cognitivo-conductuales, mindfulness, relajación y la religión permitieron revertir los efectos del SBA. A manera de conclusión. El integral de técnicas terapéuticas de afrontamiento a SBA postraumático mostraron ser eficientes.

Physician-teachers have suffered the after-effects of the pandemic, which continues to be evidenced in the post-pandemic as occupational stress; therefore, they had to learn coping strategies to overcome this mental health problem. Objective. To analyze the characteristics of Academic Burnout Syndrome of four university teacher-physicians and the coping strategies they used in a post-pandemic context. Methodology. Qualitative, phenomenological, interpretative research, using in-depth interviews with four physician-teachers (2 men and 2 women), made it possible to analyze and reflect on the participants' experiences of the after-effects of BMS after the pandemic generated by COVID-19 and how they coped. The categories were BMS and coping. The work was carried out in three phases: (a) descriptive, in which the methodological and ethical process was organized and planned, (b) structural phase, in which the interview guides, the matrix to organize the information, transcription and codification of the information were elaborated, and (c) discussion phase, in which the discrepant and similar experiences were compared and contrasted with other studies. Findings. The COVID-19 generated BMS in the physician-teachers, which were evidenced in emotional, cognitive, behavioral-psychosomatic and social problems. Integrated coping with cognitive-behavioral techniques, mindfulness, relaxation and religion allowed reversing the effects of BMS. By way of conclusion. The integrated therapeutic techniques of coping with posttraumatic BMS proved to be efficient.

Os professores de medicina sofreram os efeitos colaterais da pandemia, que ainda são evidentes no período pós-pandemia como estresse relacionado ao trabalho, e tiveram de aprender estratégias de enfrentamento para superar esse problema de saúde mental. Objetivo. Analisar as características da Síndrome de burnout acadêmico em quatro professores-médicos universitários e as estratégias de enfrentamento que eles usaram em um contexto pós-pandêmico. Metodologia. A pesquisa qualitativa, fenomenológica e interpretativa, por meio de entrevistas em profundidade com quatro professores-doutores (2 homens e 2 mulheres), nos permitiu analisar e refletir sobre as experiências dos participantes em relação às sequelas da SBM após a pandemia gerada pela COVID-19 e como eles lidaram com isso. As categorias foram BMS e enfrentamento. O trabalho foi realizado em três fases: (a) descritiva, na qual o processo metodológico e ético foi organizado e planejado; (b) fase estrutural, na qual foram elaborados os guias de entrevista, a matriz para organizar as informações, a transcrição e a codificação das informações; e (c) fase de discussão, na qual experiências discrepantes e semelhantes foram comparadas e contrastadas com outros estudos. Resultados. A COVID-19 gerou BMS nos médicos-professores, que foram evidenciados em problemas emocionais, cognitivos, comportamentais-psicossomáticos e sociais. O enfrentamento integrado com técnicas cognitivo-comportamentais, atenção plena, relaxamento e religião permitiu reverter os efeitos da SGB. À guisa de conclusão. As técnicas terapêuticas integradas de enfrentamento da SGB pós-traumática mostraram-se eficazes.

Factors Affecting Disaster or Emergency Coping Skills in People with Intellectual Disabilities.

This study aimed to investigate the disaster or emergency coping skills of people with intellectual disabilities and the factors that affect these skills. The panel survey on the lives of people with disabilities from the 3rd dataset (2020) of the Korea Development Institute for the Disabled was used for this analysis. Response data from 275 people with intellectual disabilities aged 10 years or older were analyzed. Differences between disaster or emergency coping skill levels and sub-questions of skills, according to the general characteristics of people with intellectual disabilities, were identified, as well as factors affecting the level of disaster or emergency coping skills. The results show that the coping skills level was low; among the sub-questions, the use of fire extinguishers and awareness of the location of fire extinguishers or emergency bells in the event of a disaster or emergency were also low. Factors affecting the level of coping skills were found to be the level of education and experience in comprehensive disaster coping training. The results of this study suggest that training and education on disaster or emergency coping skills for people with intellectual disabilities are necessary and that programs should be developed for this purpose.

Enhancing Mental Health and Medication Adherence Among Men Who Have Sex With Men Recently Diagnosed With HIV With a Dialectical Behavior Therapy-Informed Intervention Incorporating mHealth, Online Skills Training, and Phone Coaching: Development Study Using Human-Centered Design Approach.

BACKGROUND: Mental health problems are common among men who have sex with men (MSM) living with HIV and may negatively affect medication adherence. Psychosocial interventions designed to address these urgent needs are scarce in China. Incorporating behavioral health theories into intervention development strengthens the effectiveness of these interventions. The absence of a robust theoretical basis for interventions may also present challenges to identify active intervention ingredients. OBJECTIVE: This study aims to systematically describe the development of a mobile health-based intervention for MSM recently diagnosed with HIV in China, including the theoretical basis for the content and the considerations for its technological delivery. METHODS: We used intervention mapping (IM) to guide overall intervention development, a behavioral intervention technology model for technological delivery design, and a human-centered design and cultural adaptation model for intervention tailoring throughout all steps of IM. RESULTS: The dialectical behavior therapy (DBT)-informed intervention, Turning to Sunshine, comprised 3 components: app-based individual skills learning, group-based skills training, and on-demand phone coaching. The theoretical basis for the intervention content is based on the DBT model of emotions, which fits our conceptualization of the intervention user's mental health needs. The intervention aims to help MSM recently diagnosed with HIV (1) survive moments of high emotional intensity and strong action urges, (2) change emotional expression to regulate emotions, and (3) reduce emotional vulnerability, as well as (4) augment community resources for mental health services. Technological delivery considerations included rationale of the medium, complexity, and esthetics of information delivery; data logs; data visualization; notifications; and passive data collection. CONCLUSIONS: This study laid out the steps for the development of a DBT-informed mobile health intervention that integrated app-based individual learning, group-based skills training, and phone coaching. This intervention, Turning to Sunshine, aims to improve mental health outcomes for MSM newly diagnosed with HIV in China. The IM framework informed by human-centered design principles and cultural adaptation considerations offered a systematic approach to develop the current intervention and tailor it to the target intervention users. The behavioral intervention technology model facilitated the translation of behavioral intervention strategies into technological delivery components. The systematic development and reporting of the current intervention can serve as a guide for similar intervention studies. The content of the current intervention could be adapted for a broader population with similar emotional struggles to improve their mental health outcomes.

[A Predictive Model of Resilience in Mothers of Children with Developmental Disabilities].

PURPOSE: This structural model study was constructed and verified a hypothetical model to examine the effects of parenting stress, social resources, family resources, and positive coping on resilience among mothers of children with developmental disabilities. METHODS: Data were collected using self-report structured questionnaires, from October 19 to October 30, 2018, with 214 mothers caring for children with developmental disabilities under the age of 20 years. RESULTS: In the fitness test results of the hypothesis model, with the fit index χ² (p) = 69.27 (< .001), and the normed fit indices (χ² = 1.87, GFI = .94, CFI = .97, NFI = .93, and TLI = .95, RMSEA = .06, SRMR = .06), this study satisfies the good fitness in standards. There are seven statistically significant paths among the 10 paths set in the hypothetical model. The explanatory power of parenting stress and social resources, which affects the family resources was 41.4%, the explanatory power of parenting stress, social resources, and family resources affecting the positive coping was 58.9%, and the explanatory power of parenting stress, social resources, family resources, and positive coping affecting resilience was 55.5%. CONCLUSION: Positive coping, family resources, and social resources of mothers of children with developmental disabilities directly affect their resilience, and parenting stress indirectly affects it. Therefore, to improve the resilience of mothers of children with developmental disabilities, it is necessary to develop a systematic nursing intervention that considers parenting stress, social resources, family resources, and positive coping.

Psychological well-being and coping strategies among secondary school teachers: A cross-sectional study.

INTRODUCTION: Educators, academicians, and teachers are responsible for the development of the nation's human capital. Teacher coping methods are becoming more widely recognized as a key factor in determining teacher effectiveness. The aim of this study was to identify the various coping strategies adopted by high school teachers in Southern India. MATERIALS AND METHODS: A cross-sectional study was conducted in government, aided, and unaided schools of Udupi, a coastal district in Southern India. A self-administered questionnaire was used to collect the data from 460 high school teachers chosen based on convenience sampling. The coping strategies were identified using a modified version of Brief COPE(Coping Orientation to Problems Experienced) Inventory (Carver, 1997). Data were entered using SPSS version 15 and descriptive statistics was performed. RESULTS: The study found that teachers had moderate level of coping skills in all domains. The most popular coping techniques used by secondary school teachers were positive reframing, active coping, and planning; nevertheless, substance use was recognized as the least popular coping strategy. CONCLUSION: Positive reframing, active coping, and preparation were the most commonly used coping strategies by the teachers in the survey. Teachers are a vital resource who have received less attention than they deserve for their psychological well-being. A customized intervention program based on their perceived needs could be a good place to start.

Loneliness and coping skill mediate the association between child maltreatment and depression for rural males and females.

BACKGROUND: Child maltreatment is a prevalent and notable problem in rural China, and the prevalence and severity of depression in rural areas are higher than the national norm. Several studies have found that loneliness and coping skills respectively mediated the relationship between child maltreatment and depression. However, few studies have examined the roles of loneliness and coping skills in child maltreatment and depression based on gender differences. METHODS: All participants were from rural communities aged more than 18 years in Shandong province, and 879 valid samples (female:63.4%) ranging in age from 18 to 91 years old were analyzed. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Center for Epidemiologic Studies-Depression (CES-D), the Simple Coping Style Questionnaire (SCSQ), and the Emotional and Social Loneliness Scale (ESLS) were used to evaluate child maltreatment, depression, coping skills and loneliness. RESULTS: Child maltreatment was more common and severe in males than females (F = 3.99; p < 0.05). Loneliness and coping skills partially mediated the relationship between child maltreatment and depression in males, but loneliness fully mediated the relationship between child maltreatment and depression in females. CONCLUSION: In this study, males were more likely to experience child maltreatment. Child maltreatment and depression were correlated. We also found a mediating role of loneliness and coping skills for males and a mediating role of loneliness in females.

An Investigation into the Relation of Coping Skills with Mental Health and Quality of Life in Family Members of Nurses During the COVID-19 Pandemic.

OBJECTIVES: During the coronavirus disease (COVID-19) pandemic, health care workers, including nurses and their family members, experienced various psychological problems. Coping skills may help them deal with the current challenge and maintain their mental health and improve their quality of life. Therefore, this study investigated the relation of coping skills with mental health and quality of life of the nurses' family members during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted on the family members of the nurses working at Hajar Hospital of Shahrekord dedicated to admission and hospitalization of COVID-19 infected patients using a census sampling method in 2020. Participation in this study was voluntary and finally 220 persons were included in this study. To prevent the spread of COVID-19 through respiratory droplets or contact, a weblog was created using blogging software that contained questionnaires for collecting data on demographic information, mental health (PHQ-9), coping skills (coping responses inventory [CRI], Billings & Moos), and quality of life (SF-36). The collected data were analyzed using descriptive and inferential statistical tests in SPSS software version 22 (IBM Corp, Armonk, NY). RESULTS: Of the 220 participants in this study, 101 participants were male and 119 were female. The mean age of the subjects was 35.78 years, and 56.4% of them had an academic education level. The Pearson correlation analysis showed a significant relationship between coping skills and mental health, quality-of-life items, total quality-of-life score, and demographic variables of participants (except education) (P < 0.05). This was a direct relationship in such a way that as the score of coping skills increases, so does the score of mental health and quality of life. Based on the results of regression analysis, the predictive power of mental health, coping skills, and education level was obtained to be 0.634. The coping skill variable was the strongest predictor (ß = 0.467), and after that, the mental health variable (ß = 0.421) had the highest predictive power. CONCLUSION: The obtained results showed that coping skill is the association between psychological health and quality of life such that the coping skill has a significant direct effect on psychological health and quality of life. The results also showed that, at the time of crisis, further attention should be paid to coping skills to develop and improve the quality of life and psychological health.

No moderating effect of coping skills on the association between bullying experience and self-esteem: Results from K-CHILD study.

Introduction: Few studies have investigated the moderating effect of coping skills on the association between bullying experience and low self-esteem. The aim of this study was to examine whether coping skills have a moderating effect on the association between bullying experience and self-esteem among Japanese students. Methods: Data from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study conducted in 2016 were analyzed. Participants included fifth-and eighth-grade students living in Kochi Prefecture, Japan. A questionnaire for the students (n = 5,991) assessed the bullying experience, self-esteem (the Japanese Edition of the Harter's Perceived Competence Scale for Children), and coping skills that comprised six types (The shortened version of coping skills for elementary school children). Multivariate linear regression analyses were conducted to examine the association between bullying experience and self-esteem and then the moderating effects of six types of coping as interaction terms on the association were considered. Results: Bullying experience was inversely associated with self-esteem. All six types of coping did not moderate the relationship between bullying experience and low self-esteem even after adjusting for cofounders (all P for interaction > 0.15). Conclusion: Coping skills did not moderate the association between bullying experience and self-esteem, suggesting that intervention to boost coping skills to mitigate the adverse effect of bullying experience may not be promising.

Stress level and heart rate variability in police post-occurrence of bank robbery: an experience report.

Introduction: The expectation of armed confrontation is among the most stressful elements in police work. Knowledge about perceived stress and cardiovascular markers in police officers comes from simulations. However, to date, information about psychophysiological responses during high-risk occurrences is scarce. Objectives: To assess stress levels and heart rate variability in policemen before and afer atending a bank robbery. Methods: Elite police officers (30.4 ± 3.7yrs) filled in a stress questionnaire and had their heart rate variability monitored at the beginning (7:00 am) and at the end (7:00 pm) of a work shif. At about 5:30 pm, these policemen were called to respond to a bank robbery in progress. Results: No significant changes in sources or symptoms of stress were found between before and afer the incident. However, statistical reductions were found in heart rate range interval (R-R interval [-13.6%]), pNN50 (-40.0%), and low frequency (-28%) and the low frequency/high frequency ratio increased (200%). These results suggest that although no change in the level of perceived stress was found, a significant reduction in heart rate variability may be atributed to a reduction in activation of the parasympathetic system. Conclusions: The expectation of armed confrontation is among the most stressful occurrences in police work. Research knowledge about perceived stress and cardiovascular markers in police officers comes from simulations. Data on psychophysiological responses post-occurrence of high-risk scenarios are scarce. This research may help law enforcement organizations find means to monitor police officers' acute stress levels afer any high-risk occurrences.

Introdução: No trabalho policial, a expectativa do confronto armado está entre as ocorrências mais estressantes. O conhecimento sobre as alterações dos níveis de estresse e marcadores cardiovasculares são oriundas de condições simuladas. Até o momento, a descrição das reações psicofsiológicas após ocorrência de alto risco são escassas. Objetivos: Verificar o nível de estresse e a variabilidade da frequência cardíaca em policiais após uma ocorrência de roubo a banco. Métodos: Oito policiais de elite (30,4±3,7 anos) preencheram um questionário de estresse e tiveram sua variabilidade da frequência cardíaca monitoradas no início (7h) e no final (19h) do turno de trabalho. Entretanto, por volta das 17h30, esses policiais atenderam uma ocorrência de roubo a banco. Resultados: Não foram encontradas alterações significantes entre o início e o final do plantão para as fontes e sintomas de estresse. Entretanto, houve redução significante para o intervalo da variação de frequência cardíaca [intervalo R-R (-13.6%)], pNN50 (-40.0%), baixa frequência (-28%) e aumento para razão baixa frequência/alta frequência (+200%). Dessa forma, nossos resultados sugerem que embora nenhuma mudança no nível de estresse percebido tenha sido encontrada, uma redução importante na variabilidade da frequência cardíaca pode ser atribuída a uma redução na ativação do sistema parassimpático. Conclusões: A associação de indicadores qualitativos e quantitativos (questionário e variabilidade da frequência cardíaca) contribui para um melhor entendimento de como gerenciar e treinar as habilidades emocionais dos policiais. Esta pesquisa pode ajudar as organizações de aplicação da lei a encontrar propostas para monitorar os níveis de estresse agudo dos policiais após qualquer ocorrência de alto risco.

Relationship between the number of breaths that maximizes heart rate variability and height in patients with incurable cancers.

INTRODUCTION: Resonant frequency breathing is a coping skill used for relaxation. A resonant frequency varies from person to person and is only investigated by specialized medical institutions. METHODS: The relationships between patients' resonant frequencies and age, sex, height, and body weight were assessed using an analysis of variance. RESULTS: The average resonant frequency among the 50 patients with incurable cancers was 6.05 breaths per minute. There was a significant difference in height between the resonant frequencies of 5, 5.5, 6, 6.5, and 7 breaths per minute (p < 0.001). CONCLUSION: Resonant frequency may be correlated with height in patients with incurable cancers. TRIAL REGISTRATION: UMIN000029820. Registered on November 4, 2017.

Depression in Mexican medical students: A path model analysis.

BACKGROUND: Depression is a mental health disorder present in medical students that foster cumulative disadvantages throughout life and that may compromise patient care. Yet, in Mexico there is a dearth of research concerning prediction models for depression in this population. METHODS: The aim of this cross-sectional study was to develop and test a path model analysis of depression in 103 freshmen Mexican medical students ages 18-23 years old selected non-randomly. Anxiety, emotion dysregulation, and coping skills were used as factors influencing depression. Mexican self-report scales were used as assessment measures. RESULTS: Main results showed that anxiety and emotion dysregulation had a significant direct influence on depression. Emotion dysregulation had a significant direct effect on coping skills and anxiety, while anxiety had a significant direct effect on problem drinking and alcohol problems. Fit indexes obtained indicate an excellent adjustment to data. R square indicates that 53.7% of the variance in depression can be explained by this model. LIMITATIONS: The results are exploratory rather than confirmatory. The sample size was not large enough and the research focused on only Mexican freshmen medical students. Other factors associated to depression in medical students were not considered. CONCLUSIONS: The current research provides unique findings in terms of a model of depression in Mexican medical students through which it is possible to design and implement interventions that decrease depression, thus positively affecting their well-being, their future careers as medical doctors and their abilities to serve the society adequately, especially in the context of Latin American cities.

Protective and risk factors for depressive mood and anxiety against occupational stress: examining temperament character and coping strategy among civil servants.

This study investigated protective and risk factors for depressive mood and anxiety against occupational stress, including temperament character and coping strategy, among civil servants. We administered a questionnaire that included demographic factors and psychological scales to 1197 Korean civil servants. High levels of occupational stress, temperaments of novelty seeking and harm avoidance, a character of cooperativeness, and using emotion-focused coping were risk factors for depressive mood, while living with a partner, having a character of self-directedness, and using problem-focused strategies were protective factors. Additionally, female gender, high level of occupational stress, and temperaments of novelty seeking and harm avoidance were risk factors for anxiety, while having a character of self-directedness was a protective factor. Assessment of temperament character and training on effective coping strategies may help address depressive mood and anxiety for civil servants.

Factors Influencing Disaster-Incident-Related Impacts on Korean Nursing Students.

The frequency of earthquakes in South Korea is increasing. This study aimed to examine and identify the factors influencing the degree of disaster-incident-related impacts among Korean nursing students who have actual disaster experience. The study sample consisted of 153 nursing students living around the Phohang-si area in Gyeongsang-do, South Korea, and who have actual disaster-incident-related experience. Measures used in this study were the Impact of Event Scale, Perceived Health Status Scale, Psychological Well-Being Scale, and Coping Strategy Indicator (Korean version). The data collection period was from October to December 2018. Factors that influence disaster-incident-related impacts among Korean nursing students in descending order are as follows: perceived health status (ß = 0.48), gender (ß = -0.28), coping skill (ß = 0.18), psychological well-being (ß = 0.14), need for disaster education (ß = 0.12), and major satisfaction (ß = -0.12). This study provides preliminary evidence that perceived health status is a major and primary predictor of disaster-incident-related impacts among Korean nursing students, followed by coping skill and psychological well-being. The findings can be reflected in a pertinent curriculum by actively considering these factors in designing nursing education interventions for managing disaster-incident-related impacts among Korean nursing students.

Positive Coping and Resilience as Mediators Between Negative Symptoms and Disability Among Patients With Schizophrenia.

Objective: This study proposes a schizophrenia disability model to describe the associations between negative symptoms and disability to test the possible mediating roles of positive coping and resilience and to compare the relative weights of the indirect effects of these two mediators in an integrated whole. Methods: A total of 407 hospitalized Han Chinese patients diagnosed with stable schizophrenia or schizoaffective disorder were included. Patients were evaluated using the following scales: the Simplified Coping Style Questionnaire (SCQ) for positive coping, the Connor-Davidson Resilience Scale (CD-RISC) for resilience, the Positive and Negative Syndrome Scale (PANSS) for negative symptoms, and the World Health Organization Disability Assessment Schedule, Version II (WHO-DAS II) for the severity of disability. The schizophrenia disability distal mediation model was constructed using the structural modeling (SEM) approach. Bootstrapping procedures and the PRODCLIN program were used to examine the mediating roles of positive coping and resilience. Results: The schizophrenia disability model was well-fitted to the observed data. Positive coping and resilience together with negative symptoms explained 66% of the variance in disability. Positive coping and resilience partly mediated the negative symptoms-disability relationship. The bootstrapped unstandardized indirect effect was 0.319, and the direct effect was 0.224. Positive coping also has a significant positive effect on resilience. In addition, the ratio of the specific indirect effect of positive coping to the total indirect effect (48%) is higher than that of resilience (30%). Conclusion: Positive coping and resilience are two key causal mediators of the negative symptoms-disability relationship. Positive coping and resilience are important personal resources for patients with schizophrenia. We found that the indirect effect of positive coping was relatively more important than that of resilience. This result suggests that personalized treatments aimed at resilience and positive coping can effectively buffer the impact of negative symptoms for patients with schizophrenia and promote rehabilitation.

Awareness of comfort immediately after a relaxation therapy session affects future quality of life and autonomic function: a prospective cohort study on the expectations of therapy.

BACKGROUND: High expectations regarding therapy are reported to have positive effects on future therapeutic course and related behavior. Some individuals are aware of feelings of comfort immediately after a relaxation therapy session. METHODS: Heart rate variability biofeedback (HRV-BF) therapy using a relaxation technique called resonant breathing was administered to 44 family caregivers who felt burdened by their work caring for family members with cancer. We prospectively evaluated how the level of comfort participants were aware of immediately after an initial therapy session affected their expectations regarding the therapy, as well as future quality of life (QOL) and autonomic function. This study was a secondary analysis of a randomized, open-label study titled "Self-care system for family caregivers of cancer patients using resonant breathing with a portable home device". RESULTS: Among the participants, 56.8% were aware of a feeling of comfort immediately after an initial therapy session. Participants were then divided into two groups according to the presence or absence of their awareness of comfort. Expectation levels regarding the therapy were significantly increased in the awareness group after the therapy session (P = 0.003). No main effect between groups was observed for heart rate variability (HRV) during therapy (P = 0.949). Four weeks after the initial therapy session, QOL improved and HRV increased in the awareness group (P < 0.001). CONCLUSIONS: Better outcomes in the awareness group were not associated with HRV during therapy. A feeling of comfort immediately after a therapy session may have positive effects on future QOL and autonomic function by raising participants' expectations of the therapy. TRIAL REGISTRATION: UMIN000021639. Registered 27 March 2016.

The psychometric properties of the Iranian version of revised prenatal coping inventory (Nu PCI) in healthy pregnant women: a confirmatory factor analysis.

The Revised Prenatal Coping Inventory (Nu PCI) is a self-report instrument that focuses on the coping styles of pregnant women during the prenatal period. The present study aimed to translate the scale and evaluate the psychometric properties of the Iranian version of the Nu PCI in healthy pregnant women. Beaton's recommendations have been used for the translation and cultural adaptation of this scale. Reliability, content, and face validity were performed to assess the psychometric properties of the scale. The results indicated that the Nu PCI was successfully translated into the Persian language, with both the total scale and subscales exhibiting both content validity and internal consistency. Confirmatory factor analyses revealed that the conceptual three-factor structure of the measure had good fit indices. Reliability was evaluated using internal consistency. Cronbach Alpha coefficient was 0.92 and intra-class correlation coefficient (ICC) was 0.91. Therefore, the Nu PCI is a reliable instrument to measure prenatal coping patterns in primigravida healthy pregnant women.

[Structural Equation Modeling on Successful Aging in Elders with Chronic Obstructive Pulmonary Disease Based on Selection-Optimization-Compensation Strategy].

PURPOSE: The focus of the study was on the selection-optimization-compensation (SOC) strategy to predict successful aging mediated by dyspnea symptoms in older adults with chronic obstructive pulmonary disease. The model was constructed based on the hypotheses that coping strategy and social support of the elders predict successful aging through the SOC strategies. METHODS: Participants were 218 outpatients with chronic obstructive pulmonary disease recruited for the study. Data collection was done from March 25 to September 11, 2015, and analyzed using SPSSWIN 22.0 and AMOS 21.0. RESULTS: The hypothetical model appeared to be fit to the data. Seven of eight hypotheses selected for hypothetical model were statistically significant. The SOC strategy has only significant indirect effects through dyspnea symptoms on successful aging. Coping strategy, social support, SOC strategies and dyspnea symptoms explained 62% of variance in successful aging. CONCLUSION: The SOC strategies with social support and dyspnea symptoms significantly explained successful aging among patients with chronic obstructive pulmonary disease. Nursing strategies should be focused on social support and coping strategies to optimize SOC strategies so that older adults with chronic obstructive pulmonary disease are able to manage dyspnea symptoms and eventually achieve successful aging.

Effectiveness of Problem-Focused Coping Strategies on the Burden on Caregivers of Hemodialysis Patients.

BACKGROUND: Studies have shown that family caregivers of hemodialysis patients experience high levels of burden. However, these caregivers are often neglected, and no studies are available on the effectiveness of coping strategies on the burden of care among these caregivers. OBJECTIVES: This study aimed to examine the effectiveness of problem-focused coping strategies (communication skills, anger management, and deep breathing) on the burden on caregivers of hemodialysis patients. PATIENTS AND METHODS: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad hemodialysis center in Tehran, Iran. The subjects were equally allocated into two groups of 38. Through a coin-tossing method, caregivers of patients who referred on even or odd days of the week were randomly assigned into the intervention group or the control group, respectively. The intervention group received four training sessions on problem-focused coping strategies, but the control group did not receive any intervention. Both groups answered the caregiver's burnout inventory at the start and six weeks after the last educational session. Descriptive statistics, chi-square, Fisher's exact test, independent-samples t-test, and Mann-Whitney U test were used to analyze the data. RESULTS: The majority of caregivers (54%) were in the age range of 35 - 55 years, female (68.4%), and married (70%). No significant difference was found between the baseline mean caregivers' burden scores of the intervention and control groups (88.56 ± 11.74 vs. 84.97 ± 15.13, P = 0.308). However, the mean caregivers' burden in the intervention group decreased, and the two groups were significantly different at the end of the study (58.77 ± 6.64 vs. 87.84 ± 11.74, P < 0.001). CONCLUSIONS: The current study showed the effectiveness of problem-focused coping strategies on reducing the burden on caregivers of hemodialysis patients. Authorities and policymakers in the healthcare system are responsible for developing strategies to integrate educational programs, such as the program implemented in the current study, into the country's healthcare system.