Challenges of and possible solutions for living with endometriosis: a qualitative study.

BACKGROUND: Endometriosis as a chronic gynecological disease has several negative effects on women's life, thereby placing a huge burden on the patients and the health system. The negative impact of living with endometriosis (impaired quality of life, diverse medical experiences) is detailed in the literature, however, we know less about patients' self-management, social support, the meaning of life with a chronic disease, and the needs of patients. To implement a proper multidisciplinary approach in practice, we need to have a comprehensive view of the complexity of endometriosis patients' life and disease history. METHODS: Four focus group discussions were conducted between October 2014 and November 2015 by a team consisting of medical and psychological specialists. 21 women (age: 31.57; SD = 4.45) with surgical and histological confirmation of endometriosis were included in the study. Discussions were audiotaped and transcribed verbatim, and a 62,051-word corpus was analyzed using content analysis. RESULTS: Four main themes emerged from the analysis: (1) the impact of endometriosis on quality of life, (2) medical experiences, (3) complementary and alternative treatments, and (4) different coping strategies in disease management. All themes were interrelated and highly affected by a lack of information and uncertainty caused by endometriosis. A supporting doctor-patient relationship, active coping, and social support were identified as advantages over difficulties. Finding the positive meaning of life after accepting endometriosis increased the possibility of posttraumatic growth. Furthermore, women's needs were identified at all levels of the ecological approach to health promotion. CONCLUSIONS: Our results highlight the need for multidisciplinary healthcare programs and interventions to find solutions to the difficulties of women with endometriosis. To achieve this goal, a collaboration of professionals, psychologists, and support organizations is needed in the near future.

[Types of conflicts and conflict management among Hungarian healthcare workers]. / Konfliktustípusok és konfliktuskezelés magyar egészségügyi dolgozók körében.

INTRODUCTION: Efficient communication, conflict management and cooperation are the key factors of a successful patient care. AIM: This study is part of an international comparative research. The aim of this study is to unfold conflicts among healthcare workers. METHOD: 73 healthcare workers were interviewed using a standardized interview protocol. The in-person interviews used the critical incident method. 30 interviews (15 doctors, 15 nurses) were analysed with the Atlas.ti 7 content analysis software. The sources, types, effects of conflicts and conflict management strategies were investigated. RESULTS: The content analysis unfolded the specificities of conflicts in healthcare based on personal experiences. Organizational hierarchy was a substantial source of conflict, especially among physicians, which originates from implicit rules. As a result of the avoiding conflict management the conflicts remain partly unresolved which has negative individual and group effect. CONCLUSIONS: Our conceptual framework helps to develop a proper intervention specific to healthcare. Orv. Hetil., 2017, 158(16), 625-632.

Posttraumatic stress disorder symptomology as measured by PCL-5 and its relationships to resilience, hostility and stress among paramedics and social professionals.

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage = 43.5 ± 9.96 years). Despite the acceptable fit indices gained with CFA when testing the original four-factor DSM-5 model of PCL-5, strong associations (r = 0.69-0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three-factor version of the DSM-5 model of PCL-5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean-and variance-adjusted χ2 = 503.750 (df = 270), comparative fit index = 0.948, Tucker-Lewis index = 0.939, root mean square error of approximation (90% confidence interval) = 0.064 (0.055-0.073), weighted root mean square residual = 1.024). Our analysis of the Hungarian version of PCL-5 contributes to the testing of a DSM-5-based questionnaire measuring posttraumatic stress disorder symptomology.

Psychometric validation of revised Olweus Bully/Victim Questionnaire (OBVQ-R) among adolescents in Bangladesh.

BACKGROUND: The assessment of bullying-related attributes is vital in developing anti-bullying intervention and prevention programs. The revised Olweus Bully/Victim Questionnaire (OBVQ-R) is one tool that has been widely used for this purpose. Thus, as we noticed a rising interest in research on bullying and there is a scarcity of proper psychometric tools to assess bullying-related attributes in Bangladesh, our study aimed to translate the OBVQ-R and test the psychometric properties of the Bangla version of this questionnaire on a large Bangladeshi adolescent sample. METHOD: In Bangladesh, we collected data from grade 8-10 students (N = 567, 309 females, 258 males, AgeMean±SD=15.12 ± 0.81). The participants completed Bangla OBVQ-R, Beck Youth Inventory (BYI), and Children's Revised Impact of Events Scale-13 (CRIES-13). RESULTS: The item response theory (IRT) analysis discarded five items and retained 15 items (Victimization=8, Perpetration=7). Both subscales had items with high discrimination (Victimization: 3.14 ± 0.67; Perpetration: 3.40 ± 1.04). Confirmatory factor analysis supported a correlated two-factor model (CFI=0.99; TLI=0.99). Both subscales (Victimization and Perpetration) and the 15-item full scale exhibited satisfactory reliability (>0.80). In line with our predictions, both subscales demonstrated significant positive correlations with BYI and CRIES-13, indicating satisfactory concurrent validity. CONCLUSION: The results of the psychometric analyses supported the reliability and validity of the 15-item Bangla-version OBVQ-R to assess bullying involvement. Hence, this new, adapted measurement can facilitate further bullying research in Bangladesh and, thus, the development of prevention and intervention programs.

Research group as helpers due to the war in Ukraine: Focus group experiences of women researchers.

Introduction: World Health Organization studies have shown that one in every five people who have experienced war or other conflicts suffers from a mental health disorder, the most vulnerable groups being children and women. According to international guidelines, mental health care should be made available immediately in the event of disaster. With the first influx of Ukrainian refugees to Hungary at the outbreak of the war, the Research Group of Childhood Mental Health at Eötvös Loránd University and Semmelweis University in Budapest immediately decided to help by transforming itself into a support group for refugee families. The members of the support group are all women. The aim of the present study is to explore the motivation behind the transformation of the research group and the help it provided. A further aim was to compare the group's experiences with descriptions in the literature of impacts on helpers who work with refugees. Methods: The current paper reflects on the transformation from researchers to helpers and the effects of that transformation at group and individual level using the focus group method and consensual text analysis. The transformation of the support group necessitated the involvement of students, whose experiences are also examined. Results: We identified five main categories: context; the help recipients' perspective; the personal level; the professional level; and the level between the personal and professional. Discussion: The analysis revealed the way in which the voluntary helping developed, the resulting difficulties, and coping options. Volunteering among Ukrainian refugees has both positive and negative psychological consequences. While stress and trauma threaten the psychological well-being of the helpers, positive aspects, such as flexibility and professional development, are also reported. Due to the strong motivation among group members and their experience in practical work, the all female research group was quickly able to transform itself into a support group.

Why do people use new psychoactive substances? Development of a new measurement tool in six European countries.

INTRODUCTION: New psychoactive substances (NPS) pose a public health threat. Many studies have tried to identify the reasons of NPS use; however, none of them have so far used any standardised measures. The aim of this study was (i) to develop and cross-culturally validate the New Psychoactive Substance Use Motives Measure (NPSMM) and (ii) to compare motives of NPS use across countries and user types. METHODS: Three subgroups (socially marginalised users, nightlife attendees and members of online communities) of NPS users (N = 3023) were recruited from six EU member countries. Demographics, motives and types of NPS used were assessed. NPS use motives were measured by adapting the extended six-factor version of the Marijuana Motives Measure. RESULTS: Exploratory and confirmatory factor analysis resulted in a similar five-factor solution across most of the countries: coping, enhancement, social, conformity and expansion motives. Marginalised users scored higher on coping and conformity motives, nightlife groups showed higher endorsement of social motive, whereas online community users showed higher scores on expansion motives. Various types of NPS were also associated with different motives. CONCLUSION: NPS use motives might be associated with both the groups of users and the specific types of NPS being consumed. Expansion (psychedelics) and enhancement (stimulants) motives seemed to be linked to the chosen NPS product type, while coping, social and conformity motives were rather associated with user groups. NPSMM was found to be a valid instrument to measure NPS motives.

Health and Social Problems Associated with Recent Novel Psychoactive Substance (NPS) Use Amongst Marginalised, Nightlife and Online Users in Six European Countries.

Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of 'herbal blends' and 'synthetic cannabinoids obtained pure' was most reported in Germany, Poland and Hungary, and use of 'branded stimulants' and 'stimulants/empathogens/nootropics obtained pure' was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted.

The experience of voice hearing and the role of self-help group: An interpretative phenomenological analysis.

BACKGROUND: Auditory verbal hallucinations (AVHs) played an important role in the psychiatric diagnostics, but in the last few decades the diagnostic-free complex phenomenological understanding of the phenomena of voice hearing became the focus of studies. MATERIALS: Six semi-structured interviews with recovering voice hearers were conducted and analysed using interpretative phenomenological analysis (IPA). DISCUSSION: The self-help group gives significant help in identification and dealing with the voices; therefore, it serves as turning point in the life story of voice hearers. CONCLUSION: Applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.