A Role-Needs Framework: Rethinking Support for Informal Caregivers for Alzheimer's Across the Global South and Global North.

OBJECTIVE: Caregivers play an essential role in supporting people with Alzheimer's disease globally. User-informed research is vital to developing trans-cultural guidelines for dementia support organisations. While coping strategies of caregivers are well researched, the 'coping-effectiveness' framework falls short of representing all caregiver needs. Our aim was to develop a robust and inclusive, globally applicable framework of caregiver-informed support needs. METHODS: In partnership with Alzheimer's Disease International and Roche, we conducted qualitative online semi-structured interviews with 34 family caregivers from the Global North (UK, US) and Global South (Brazil, South Africa) in the COVID-19 context. Participant-generated photographs helped encourage discussions of hidden contextual issues. Iterative inductive narrative analysis of interviews and photographs was carried out with input from global and national charity and industry sectors. RESULTS: We identified a framework of four cross-cultural caring approaches with implications for support: (1) Empathising, using emotion-focused strategies to develop strong expertise and coping skills, with time specific information, psychosocial and peer support needs. (2) Organising, using problem-focused strategies, with strong narratives of expertise and advocacy which benefited from early structured information and professional confirmation. (3) Non-identifying caregiving, where daily aspects of caring occurred without specialist knowledge and expertise, and caregivers sought assistance in managing disease-related support. (4) Reluctance, where struggling with unwanted caring responsibilities meant caregivers looked to professionals to carry out daily care. CONCLUSION: Our findings move beyond the 'coping-effectiveness' framework of support to suggest a novel 'role-needs' framework. Our approach supports inclusive ways of tailoring support to fit individual caregiver circumstances globally.

Practitioner perspectives on the use of acceptance and commitment therapy for bereavement support: a qualitative study.

BACKGROUND: There is currently a high demand for bereavement support coupled with inconclusive findings as to the efficacy of existing approaches. Acceptance and Commitment Therapy (ACT) aims to improve human functioning and has shown efficacy across a wide range of conditions. ACT may be a promising means of supporting bereaved people, yet evidence on the use of ACT for bereavement support is lacking. The aim of this study is to explore how ACT is currently used for bereavement support and practitioner perspectives of how it helps following bereavement. METHODS: Semi-structured interviews were conducted online via MS Teams with practitioners experienced in using ACT for bereavement support. Data were analysed thematically guided by a framework approach. RESULTS: Nine participants were recruited. Three themes were identified: (i) creating psychological space around grief; (ii) using psychological space for value-directed action in the midst of grieving, and (iii) adapting ACT for bereavement support. Practitioners indicated that ACT improves clients' relationship with distressing internal experiences. Metaphors and mindfulness techniques were used to encourage acceptance of grief responses, taking perspective on distressing thoughts and images, and contact with the present moment. Better relationships with distressing experiences were regarded as less psychologically taxing, improving coping and well-being, while providing the psychological space to engage in value-directed action. Values exploration, sometimes using metaphors and exercises, was seen as supporting the bereaved person to rediscover a sense of purpose and engage in meaningful activities alongside their grief. Practitioners used ACT flexibly, integrating other interventions, and adapted ACT to the perceived sensitivities of bereaved people, and age-related and developmental factors. CONCLUSION: ACT is used to support people who have been bereaved to live effectively with the difficult thoughts and feelings associated with grieving and to enable them to gradually identify, reconnect with, and act in line with their values after loss.

The impact of caring on caregivers of patients with life-threatening organ failure.

OBJECTIVES: This study aimed at characterizing 3 populations of family/friend caregivers of patients with different life-threatening organ failure regarding health-related quality of life, caregiver burden, and dyadic coping. METHODS: Three cross-sectional (population) studies were conducted at a tertiary hospital in Denmark (2019-2020). Patients with renal failure (RF), cystic fibrosis (CF), and intestinal failure (IF) were asked to designate the closest person with ≥18 years old involved in the care (caregiver) to participate in this study. Number of caregivers included were RF = 78, CF = 104, and IF = 73. Electronic questionnaires were filled in by caregivers to assess health-related quality of life and caregiver burden and by caregivers and respective patients to assess dyadic coping. RESULTS: The 3 caregiver groups had self-perception of poor health and energy; however, caregivers of CF patients perceived their physical role functioning better than those caregiving for RF and IF patients (p = 0.002). The level of caregiver burden was reported as not high, but caregivers used in average 13 hours/day for caring. Moreover, cleaning tasks (p = 0.005) and personal care (p = 0.009) were more demanding in RF and IF patients. Caregivers also did not differ regarding dyadic coping. When comparing patients and caregivers, stress communication by oneself and the partner differed (p < 0.001). SIGNIFICANCE OF RESULTS: Caregivers spent many hours in the care role, they reported poor health, and dyadic coping may be improved. Interventions in caregivers of patients with life-threatening organ failure could help to improve care management at home, caregiver's health, and dyadic coping between caregiver and patient and consequently reduce caregiver burden.

Cognitive difficulties in people with systemic sclerosis: a qualitative study.

OBJECTIVES: This study used a qualitative approach to explore how people with SSc experience cognitive changes and how cognitive difficulties impact their functioning. METHODS: Four 90-min focus groups of adults with SSc and self-reported changes in cognition were recruited from a SSc research registry and targeted social media. A focus group guide elicited information from participants via open-ended questions. Content analysis was conducted using grounded theory methodology. RESULTS: There were 20 participants (mean age = 55.5 (11.4) years) comprising 16 (80%) females, 14 (70%) Caucasians, and 11 (55%) people with diffuse cutaneous SSc. Study themes included cognitive difficulties as part of daily life experience, impact of cognitive difficulties on daily life functioning, coping strategies and information seeking. Participants used different terms to describe their experience of cognitive difficulties, and most encountered deficits in short-term memory, language difficulties, decreased executive function, difficulties with concentration and focus, and slow processing speed. Participants expressed frustration with their cognitive difficulties and used coping strategies to lessen their impact. Participants were uncertain about the causes and wanted to understand factors contributing to cognitive difficulties as well as how to manage them. CONCLUSION: Participants with SSc reported cognitive difficulties that had a substantial negative impact on their lives. Improved understanding of cognitive changes could subsequently facilitate development of relevant therapeutic interventions or educational programmes for symptom self-management to reduce impact of cognitive difficulties in people with SSc.

Pain coping strategies and related factors including demographics, pain characteristics, functional mobility in postmenopausal women with chronic musculoskeletal pain.

This cross-sectional study investigated pain coping strategies and their relationship to demographic and clinical characteristics in postmenopausal women (PMWs) with chronic musculoskeletal pain (CMSP). PmW (n = 60) who presented to receive physiotherapy from a rehabilitation center participated. McGill Pain Questionnaire (MPQ) was used to assess pain intensity and characteristics, Pain Coping Inventory (PCI) was used to assess strategies of coping with pain, and Timed Up and Go-Test (TUG) was used to assess functional mobility. Data were analyzed using descriptive analyses, paired-samples t-test, independent-samples t-test, Mann Whitney U-test, one-way ANOVA, and Pearson's correlation analysis. There was no significant difference in terms of marital status, educational status, and exercise habits between the participants' statuses of using active and passive strategies of coping with pain. Younger women (50-59 years of age) preferred active strategies more than passive strategies to cope with pain (p = .047). There were significant differences among the age groups in terms of "pain transformation" subdomain of active strategies (p = .007) and "sensory" subdomain of MPQ (p = .053). Strategies of coping with pain and functional mobility of participants were not significantly related (p > .05). Results indicated that age is a significant factor in coping with pain and pain characteristics. Healthcare providers should consider PmW's preferences and experiences with pain management when recommending pain management strategies.

[Factor structure of coping behavior of curious elderly people.]

An increase in the share of elderly people in the total population of Russia determines the theoretical and practical significance of studies aimed at improving social adaptation and the productivity of a person's life in retirement age. The relevance of the study is due to the contradiction between the theoretical and practical significance of the problem of coping behavior of older people and its insufficient development in gerontopsychology. The purpose of the study was to establish the theoretical basis for conducting the factor analysis of coping behaviour in the elderly studying at the University and to analyse the findings. Some theoretical and empirical methods with psychodiagnostic techniques were used, such as Heim`s coping technique, Lazarus and Folkman's model of coping (adapted by T.Kryukova, E.Kuftyak), Maddi`s hardiness survey (adapted by D.Leontyev), and Vodopyanova and Stein`s scale of optimism and activity. We applied the following methods of the mathematical and statistical analysis: descriptive statistics, Pearson criterion χ2 (Chi-square test), exploratory factor analysis (EFA), principal component analysis with a Varimax rotation with Kaiser normalization using the statistical package program StatSoft Statistica for Windows 10.0 and IBM SPSS Statistics 23. The empirical research was conducted in the University for Elderly, the regional branch of the National Non-Governmental Organization «Znanie¼ in Chelyabinsk. The sample comprised 101 people with the median age of 68,2 years. The factor analysis detected and verified a latent structure of coping behaviour in the elderly consisting of 7 key components classified by the degree of preference. Adaptive and relatively adaptive behavioural and cognitive coping styles (based on 3 out of 7 factors) that are both problem and self-preservation oriented prevail in the factor structure of coping behaviour in the subjects.

Attempting to stop antipsychotic medication: success, supports, and efforts to cope.

PURPOSE: To explore supports and coping strategies used during attempts to discontinue antipsychotic medication and test for associations with success. METHOD: 144 people who were taking or had taken antipsychotics completed The Experiences of Antipsychotic Medication Survey. Among them, 105 people had made at least one discontinuation attempt and answered a series of questions about their most recent attempt to stop. Content analysis and Chi-square tests of independence were used to categorise the data and explore associations. Success was defined as stopping all AM use irrespective of the duration of the medication-free period or whether relapse occurred, which were explored separately. RESULTS: Among the 105 people who had attempted discontinuation, 61.9% described unwanted withdrawal effects and 27.6% of the group described psychotic or manic relapse during the withdrawal period. Within this group 55% described successfully stopping all AM for varying lengths of time, half reported no current use, and half described having some form of professional, family, friend, and/or service user or peer support for their attempt. Having support was positively associated with success and negatively associated with both current use, and relapse during withdrawal. A range of coping efforts were described, but having coping strategies failed to show significant associations with any of the dependent variables explored. Among those who described successfully stopping, some described returning to AM for short periods when needed, while others reported managing well with alternative methods alone. CONCLUSIONS: Findings cannot be readily generalised due to sampling constraints, but results suggest a wide range of supports and coping strategies may be used when attempting to discontinue antipsychotics. Many people may attempt to discontinue antipsychotics without any support. Those who have support for their attempts may be significantly less likely to relapse during withdrawal and more likely to succeed in their attempt. There is a pressing need for further research in this area.

[Psychological effects of preventive voice care training in student teachers]. / Psychologische Effekte eines präventiven Stimmtrainings im Lehramtsreferendariat.

BACKGROUND: Studies on the effectiveness of preventive voice care programs have focused mainly on voice parameters. Psychological parameters, however, have not been investigated in detail so far. OBJECTIVES: The effect of a voice training program for German student teachers on psychological health parameters was investigated in a longitudinal study. METHODS: The sample of 204 student teachers was divided into the intervention group (n = 123), who participated in the voice training program, and the control group (n = 81), who received no voice training. Voice training contained ten 90-min group courses and an individual visit by the voice trainer in a teaching situation with feedback afterwards. Participants were asked to fill out questionnaires (self-efficacy, Short-Form Health Survey, self-consciousness, voice self-concept, work-related behaviour and experience patterns) at the beginning and the end of their student teacher training period. RESULTS: The training program showed significant positive influences on psychological health, voice self-concept (i.e. more positive perception and increased awareness of one's own voice) and work-related coping behaviour in the intervention group. On average, the mental health status of all participants reduced over time, whereas the status in the trained group diminished significantly less than in the control group. Furthermore, the trained student teachers gained abilities to cope with work-related stress better than those without training. CONCLUSION: The training program clearly showed a positive impact on mental health. The results maintain the importance of such a training program not only for voice health, but also for wide-ranging aspects of constitutional health.

Coping strategies in anxious surgical patients.

BACKGROUND: Anaesthesia and surgery provoke preoperative anxiety and stress. Patients try to regain control of their emotions by using coping efforts. Coping may be more effective if supported by specific strategies or external utilities. This study is the first to analyse coping strategies in a large population of patients with high preoperative anxiety. METHODS: We assessed preoperative anxiety and coping preferences in a consecutive sample of 3087 surgical patients using validated scales (Amsterdam Preoperative Anxiety and Information Scale/Visual Analogue Scale). In the subsample of patients with high preoperative anxiety, patients' dispositional coping style was determined and patients' coping efforts were studied by having patients rate their agreement with 9 different coping efforts on a four point Likert scale. Statistical analysis included correlational analysis between dispositional coping styles, coping efforts and other variables such as sociodemographic data. Statistical significance was considered for p < 0.05. RESULTS: The final analysis included 1205 patients with high preoperative anxiety. According to the initial self-assessment, about two thirds of the patients believed that information would help them to cope with their anxiety ("monitors"); the remainder declined further education/information and reported self-distraction to be most helpful to cope with anxiety ("blunters"). There was no significant difference between these two groups in anxiety scores. Educational conversation was the coping effort rated highest in monitors whereas calming conversation was the coping effort rated highest in blunters. Coping follows no demographic rules but is influenced by the level of education. Anxiolytic Medication showed no reliable correlation to monitoring and blunting disposition. Both groups showed an exactly identical agreement with this coping effort. Demand for medical anxiolysis, blunting or the desire for more conversation may indicate increased anxiety. The use of the internet was independent of the anxiety level and the demand of information. CONCLUSION: Conversation with medical staff proved to be the most popular coping strategy. Acknowledgment of the division between information-seeking and blunting-like personalities is central to supporting the patient's individual coping efforts. Internet access may be the easiest way to support coping today.

Intimate partner violence and ways of coping with stress: cross-sectional survey of female patients in Russian general practice.

BACKGROUND: Despite World Health Organization guidelines on health service responses to intimate partner violence (IPV) against women general practitioners (GPs) often overlook the problem. Training on IPV addresses GPs' barriers to asking women patients about abuse and responding appropriately. One of the barriers is stereotype of women as passive victims. Little is known about coping behaviour of women patients with a history of IPV. OBJECTIVES: The objectives are (i) to compare problem- and emotion-focused coping used by patients who have experienced IPV with those who have not; (ii) to examine whether greater coping resources (health, education, employment and income) would be associated with more problem-focused coping. METHODS: The Russian Ways of Coping Questionnaire was administered to every fifth woman who participated in a cross-sectional survey on IPV prevalence in 24 St Petersburg general practices. Linear regression was used (n = 159) to test associations between life-time IPV, coping resources and ways of coping. RESULTS: Mean problem-focused coping scores were 0.2-4.7 units higher in those patients who have experienced IPV compared with those who have not [95% confidence interval (CI): -4.2, 11.9; P = 0.16-0.92], while mean emotion-focused coping scores were 2.5-4.2 units higher (95% CI: -3.0, 11.0; P = 0.12-0.57). After adjustment for coping resources there was no evidence for an association between IPV and problem-focused coping. CONCLUSIONS: Patients who have experienced IPV use as much problem-focused and emotion-focused coping, as those patients who have not experienced IPV. These findings should be incorporated into training on IPV to address GPs' stereotypes towards patients who have experienced IPV.

The study of perceived stress, coping strategy and self-efficacy of Chinese undergraduate nursing students in clinical practice.

The aim of the study was to explore the coping strategy and the effects of self-efficacy of Chinese undergraduate nursing students when they face the stress in clinical practice. Convenience sampling was used to recruit undergraduate nursing students in Mainland China who have practiced 3 months in hospitals in their final college year. Self-report questionnaires including demographics, Perceived Stress Scale, coping behaviour inventory and Generalized Self-Efficacy Scale were collected. The results showed that during clinical practice, assignments and workload were the most common stress to students; transference was the most frequently used coping strategy by students. Self-efficacy not only had a positive main effect in predicting the frequency of use of staying optimistic and problem solving strategies but also moderated the effects of stress from taking care of patients on transference strategy, as well as stress from assignments and workload on problem solving strategy. It is essential to bolster the students' self-efficacy to reduce stress and adopt positively the coping strategies during clinical practice.

'Not a job for a man': factors in the use of touch by male nursing staff.

UNLABELLED: While the numbers of male nursing staff are growing in both the UK and the USA, there remains a significant imbalance both in terms of the total number and the specialities in which male staff choose to work. Management, education and technology-dominated roles, characterised as 'high-tech, low-touch' specialities attract disproportionately larger numbers of male nursing staff. AIM: The aim of this narrative literature review was to explore and critically review the factors that influence the perception and use of touch by male nursing staff in contemporary healthcare settings. METHOD: A comprehensive review of the literature was undertaken using significant online databases focusing on evidence from peer-reviewed journals published in English. RESULTS: Key influential factors arising from 11 selected studies included male nurses' definitions of touch; fear of touch misinterpretation; coping strategies employed; the assessment of certain groups of patients; gender-derived stressors; the emotional experiences of male staff; and the limited consideration of these issues in the pre-registration nursing curriculum. CONCLUSION: A range of factors regarding touch impact on the way male nurses use touch when caring for patients. A lack of research-based education in the preparation of male students leads to the development of various protective strategies. There is a need for the particular challenges facing male students and staff to be explicitly addressed within undergraduate and post-qualifying education and training programmes.

The association between coping method and distress in infertile woman: A cross-sectional study from Turkey.

OBJECTIVES: To assess the distress level in infertile women and their coping skills. METHODS: One hundred and twenty-seven infertile women who had been referred to the Family Planning and Infertility Research and Practice Center (IRPC) of a university hospital to receive therapy between June 2012-2013 were enrolled in this study. Several surveys, including the "Infertile Woman Identification Form", the "Infertility Distress Scale (IDS)" and the "Ways of Coping Inventory (WCI)," were used as data collection tools. RESULTS: The mean age of the women who participated in the study was 32.34 ± 5.44. They had been on therapy for 3.95 ± 3.21 years and had been referred for therapy 2.73 ± 1.76 times. The mean score of the IDS was determined to be 37.0 ± 9.7 (23-66), and the mean score of the WCI subscale was 1.86 ± 0.55 (0.5-3.0). In the IDS and WCI subscales, statistically significant negative relationships were detected between "Optimism" (r=-0.327), "Seeking Social Support" (r=-0.255), and "Self-Confidence" (r=-0.305), whereas there were statistically significant positive relationships between "Helplessness" (r=0.376) and "Submissiveness" (r=0.278) (p<0.01). CONCLUSION: The women who developed negative coping strategies had higher infertility distress scores than other women.

The moderating effects of locus of control and job level on the relationship between workload and coping behaviour among Finnish nurses.

AIM: This study examined a two-fold moderating effect of the locus of control (LOC) and the nurses' job level on the stress-coping relationship. BACKGROUND: The literature on stress lacks studies examining whether control, either as a personality trait or job characteristic, would overtake coping efforts. METHODS: A three-way interaction effect (workload × LOC × job level) was applied to test the moderation model. Participants were hospital staff nurses and nurse managers (n = 934) in Finnish hospitals. They responded to an electronic-questionnaire that sought their work loads, coping behaviours and LOC. RESULTS: The results provided support for the moderation model. Staff nurses with external LOC exerted more coping behaviours when experiencing a high workload. Job level significantly altered the moderating effect of LOC; staff nurses with an internal LOC and nurse managers with an external LOC disregarded coping efforts. CONCLUSION: Extrinsic control inherent in higher job levels appeared to undertake the lacking disposition of control among externals diminishing coping efforts. IMPLICATIONS FOR NURSING MANAGEMENT: Job level interacts with LOC on the perception of control in hospitals. Staff nurses with internal LOC and nurse managers with external LOC could make a greater balance between personal and job resources effectively to deal with role overload.

Coping Strategies Associated with Emotional Adjustment during the Dyadic Experience of Infertility and Its Treatment: A Systematic Review.

BACKGROUND: The aim of this systematic review was to reveal which of the coping strategies used by one partner are protective of and which pose a risk to the other partner's psychological adjustment during the treatment of infertility. MATERIAL AND METHODS: A systematic search of four electronic databases (PubMed, APA PsycINFO, SCOPUS, ScienceDirect), as well as the references of the retrieved articles, was performed between May and September 2023 for studies published from 1990 until 2023, using appropriate MeSH terms and associated text words. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Using an a priori developed pilot data extraction form, authors performed an independent extraction of articles. Information on participants, coping mechanisms, and psychological adjustment was extracted from each study. Relevant articles were critically appraised, and a narrative synthesis was conducted based on the different designs and outcome measures among the included studies. RESULTS: A total of 194 articles were retrieved, and 187 were excluded for not meeting the inclusion criteria. After duplicates had been removed, five studies were included in the review. The results revealed that the psychological adaptation of infertile couples at an interpersonal level may be correlated with both the type of coping and the stage of the stressor (infertility treatment or in vitro fertilisation - IVF). CONCLUSION: This systematic review suggests that health professionals could design and apply interventions based on modifying the coping mechanisms of infertile spouses to increase levels of well-being and decrease levels of distress.

Coping trajectory of social isolation in individuals with maintenance haemodialysis: A descriptive qualitative study.

Background: : The number of individuals undergoing maintenance haemodialysis has continued to increase in recent years. This treatment method can lead to social isolation, which has a significant impact on an individual's health. Unfortunately, research on this issue is insufficient, and no effective interventions have been developed. Moreover, existing research lacks attention to and understanding of patient aspirations-a critical area that warrants further exploration. Objectives: : We aimed to reveal the natural coping trajectory of individuals undergoing maintenance haemodialysis in the context of social isolation to provide a useful reference for further research and the development of effective interventions. Design: : This was a descriptive qualitative study. Setting s: This study was conducted at a haemodialysis centre in a provincial capital city of northern China. Participants: Using maximum variant and purposive sampling, we recruited 15 patients undergoing maintenance haemodialysis. Methods: : The interviews were transcribed verbatim, and data were analysed using deductive content analysis. Results: Three themes were identified: (a) prerequisites for coping with social isolation; (b) maintaining the bond between coping and social isolation; and (c) the results of coping with social isolation. These themes revealed the natural trajectory of individuals undergoing maintenance haemodialysis in dealing with social isolation. Conclusion: : We interpreted the findings to mean that it was necessary to establish a three-way linkage among family, hospitals, and society to develop multicomponent and multilevel intervention measures. Tweetable abstract: : A study of the response of individuals undergoing maintenance haemodialysis to social isolation revealed their coping trajectory and conveyed their aspirations.

Cognitive and self-regulation skills for employment among people with brain injury: A comparison of employed and non-employed people using mixed analysis.

BACKGROUND: Employment for people with brain injuries is challenging, and identifying the factors that can be improved by rehabilitation and establishing appropriate intervention methods are imperative. OBJECTIVE: To examine whether differences in cognitive functions and self-regulation skills exist between employed and non-employed people with brain injuries. In addition, we explored the self-regulation skills characteristic of employed people by qualitatively comparing them to those of non-employed people. METHODS: Using a mixed research method, demographic data, neuropsychological tests, self-efficacy, and self-regulation skills were compared between 38 people with brain injuries (16 employed and 22 unemployed) in the community. Subsequently, self-regulation skills were assessed by the Self-Regulation Skills Interview (SRSI), and participants' responses were qualitatively compared. RESULTS: No significant differences were observed in demographic data and neuropsychological tests, but employed people showed significantly better SRSI scores than unemployed people (p <  0.01). The qualitative analysis of the SRSI showed that employed people recognised themselves as having more specific symptoms than unemployed people. For example, they recognised the behaviour 'when having more than one errand, forgetting it', whereas non-employed people only recognised the category 'failure of prospective memory'. Furthermore, employed people reviewed their behaviour and developed ingenious coping strategies, such as 'looking back on appointments that have been made', 'writing down as soon as having a schedule', whereas unemployed people only exhibited categories such as 'writing schedules on the cell phone'. CONCLUSIONS: Self-regulation skills, such as recognising specific symptoms and developing relevant coping strategies, are effective for gaining employment.

Chronic sleep restriction during juvenility alters hedonic and anxiety-like behaviours in a sex-dependent fashion in adolescent Wistar rats.

Chronic reduction of sleep time in children and adolescents has been related to increased incidence of anxiety and depression. In rats, protocols of protracted sleep deprivation or chronic sleep restriction (CSR) are considered a stressor. In previous studies we showed that post-weaning CSR in male rats induces anxiety-like behaviour and changes in neurotransmission in emotion-related brain areas. In the present study we examined whether the effects of this adversity are sex-dependent. Twenty-two litters, containing four males and four females were distributed into control (CTL) and CSR groups. CSR began on postnatal day (PND) 21 and lasted for 21 days; each day the animals were placed onto small platforms immersed in water for 18 h and were allowed to sleep freely in their home-cages for the remaining 6 h. Throughout the CSR, all animals underwent the sucrose splash test once/week to assess their self-care and hedonic behaviours. Body weight was measured on PNDs 21 and 42. At the end of CSR period, the adolescents were allowed to sleep freely for 2 days, after which, behavioural tests began. Within each litter, one male and one female (pair) were not tested and provided blood and brain for determination of basal corticosterone (CORT) levels and hippocampal BDNF. One pair was tested in the sucrose preference test (SPT), one pair on the elevated plus maze (EPM) and one pair in the forced swim test (FST). CORT was measured after all conditions. CSR impaired self-care behaviour and body weight gain in males and females and increased relative adrenal weight only in males. There were no changes in sucrose intake in the SPT; CSR females displayed less immobility in the FST and CSR males displayed more anxiety-like behaviour in the EPM. CORT levels were similar between CTL and CSR males, whilst lower in CSR females than CTL ones in all experimental conditions. No changes in BDNF levels were detected in the dorsal hippocampus of CSR rats. The results indicate that CSR impaired self-care behaviour in both sexes, but only males displayed anxiety-like behaviour, whilst sleep recovery in females appeared to normalise their behaviour.

Measuring occupational stress in emergency departments.

OBJECTIVE: EDs are highly demanding workplaces generating considerable potential for occupational stress experiences. Previous research has been limited by a focus on specific aspects of the working environment and studies focussing on a range of variables are needed. The aim of the present study was to describe the perceptions of occupational stress and coping strategies of ED nurses and doctors and the differences between these two groups. METHODS: This cross-sectional study was conducted at a public metropolitan hospital ED in Queensland, Australia. All ED nurses and doctors were invited to participate in an electronic survey containing 13 survey measures and one qualitative question assessing occupational stress and coping experiences. Descriptive statistics were employed to report stressors. Responses to open-ended questions were thematically analysed. RESULTS: Overall, 104 nurses and 35 doctors responded (55.6% response rate). Nurses reported higher levels of both stress and burnout than doctors. They also reported lower work satisfaction, work engagement, and leadership support than doctors. Compared with doctors, nurses reported significantly higher stress from heavy workload/poor skill mix, high acuity patients, environmental concerns, and inability to provide optimal care. Thematic analysis identified high workload and limited leadership and management support as factors contributing to stress. Coping mechanisms, such as building personal resilience, were most frequently reported. CONCLUSIONS: The present study found organisational stressors adversely impact the well-being of ED nurses and doctors. Organisational-focused interventions including leadership development, strategic recruitment, adequate staffing and resources may mitigate occupational stress and complement individual coping strategies. Expanding this research to understand broader perspectives and especially the impact of COVID-19 upon ED workers is recommended.

Exploring the Mental Health Challenges and Coping Behaviour of Lesbian, Gay, and Bisexual Students at an Institution of Higher Learning.

The South African university community is predominantly heterosexual, which fosters stigmatisation and discrimination against LGBTQI students despite the efforts to create conditions where LGBTQI students can succeed academically, socially, and personally. The study aimed to explore and describe the challenges experienced by LGBTQI students and their mental well-being as well as the coping behaviours adopted in a university in South Africa. This was accomplished using a descriptive phenomenological approach. A snowballing sampling method was used to select ten students who identified themselves as gay, lesbian, and bisexual (LGB). Semi-structured one-on-one interviews were conducted, and data were analysed thematically. The students perceived character defects stigma from fellow students and lecturers in and out of class. The mental health challenges experienced included a diminished sense of safety, lack of a sense of belonging, low self-esteem, and acting out of character. As a result, confrontation, passive withdrawal, and active dependent behaviour were utilised as different types of coping behaviour. The LGB students were subjected to stigma that negatively affected their mental health. Therefore, creating awareness about the rights of LGBTQI students to education, safety, and self-determination is recommended.