Psychological assessment and lived experiences of recovered COVID-19 patients who presented for convalescent plasma donation.

BACKGROUND: Increasingly, it has been seen that patients recovering from COVID-19 may face a second battle of coping with its mental health ramifications. These psychological issues can even be experienced by patients who were asymptomatic or had mild to moderate symptoms, potentially impacting their quality of life. METHODOLOGY: This was a prospective observational study to analyse the psychological impact of COVID-19 in recovered patients who presented as prospective convalescent plasma (CP) donors. An interview for the psychological assessment of the prospective donors was carried out. Depression and anxiety in the participants were assessed by HAM-A, and HAM-D scores and Quality of Life were assessed using the WHOQOL-BREF scale. RESULTS: A total of 51 prospective donors were assessed, with a mean age of 34.37 (±9.08) years, with the majority being males (46). No clinically significant depression and anxiety were found on the basis of HAM-D and HAM-A scores. The worst affected quality of life parameter, based on the WHOQOL-BREF scale, was physical quality of life followed by environmental, psychological, and social relationships. Moreover, due to infection, social stigma was experienced by 49.02% of the donors, while 21.97% had anxiety related to convalescent plasma donation as a common livid experience. CONCLUSION: Poor quality of life and social stigma during the recovery phase is prevalent in COVID-19 recovered patients, for which formulation of holistic support strategies are the need of the hour.

['Zero isolation', a care practice oriented towards recovery]. / "Zéro isolement", une pratique de soins orientée vers le rétablissement.

Some institutions do not have an isolation room. Agitation is managed otherwise, with the idea that restraint or isolation can only be a terrible experience. The care pathway is therefore designed to favour autonomy and to limit restrictions of freedom. In this context, professionals are in constant contact with the user. Example of a unit which advocates this concept of rehabilitation.

Prevalence and predictors of posttraumatic growth in accidentally injured patients.

This study examined prevalence and predictors of posttraumatic growth in 180 accidentally injured patients of mainland China in their convalescence stage, investigating its relationships with demographic and accidental injury variables, personality, posttraumatic stress disorder (PTSD) symptoms, and coping styles. Our results showed that posttraumatic growth (PTG) presented mostly in the domain of Relating to Others and indicated that PTG was significantly related to marital status, educational level, personality, coping styles, and PTSD symptoms. Avoidance of PTSD symptoms, Openness to experience, and positive coping were significant predictors of PTG. The findings emphasize that when promoting PTG of accidentally injured patients, healthcare providers should facilitate patients utilizing personal resources, understand PTG coexists with PTSD symptoms, and adjust interventions based on the coping styles the patients have adopted.

Development of need for recovery from work over one year: a person-centered approach.

This longitudinal questionnaire study conducted among 274 Finnish employees (57% women, average age 45.9 years) in a variety of jobs aimed at identifying groups of employees who share similar mean levels and changes in need for recovery and finding out whether factors regarded as antecedents of need for recovery distinguish between the different groups of need for recovery across one year. Using mixture modeling eight groups of need for recovery were identified. The individuals identified as closely resembling each other with respect to need for recovery and its change across one year were considered to belong to the same need for recovery group. Five of these groups indicated stable (low, moderately low, average, moderately high, and high) need for recovery and three showed change (mostly decreasing) in the level of need for recovery across one year. Employees in the favorable (low and moderately low) need for recovery groups (38%) reported to have more favorable work characteristics and better functioning recovery experiences and they spent more time on physical and social off-job activities than those in the unfavorable (high and moderately high) groups (23%). Thus, the antecedents examined play a significant role in maintaining need for recovery over time.

Ethnicity and cultural models of recovery from breast cancer.

OBJECTIVE: Recovery narratives describe the culturally shared understandings about the ideal or desirable way to recover from an illness experience. This paper examines ethnic differences in recovery narratives among women participating in breast cancer support groups in Central Florida, USA. It compares groups serving African-American, Latina, and European American women, with the objective of better understanding the appeal of ethnic-specific illness support groups for culturally diverse populations. DESIGN: A mixed-method study design combined qualitative and quantitative measures, including in-depth interviews, participant observation at support group meetings, collection of printed documents, and a structured survey. RESULTS: Core elements of the recovery narrative drew from the dominant societal cancer discourse of optimism and personal transformation through adversity; however, important ethnic differences were evident in the meaning assigned to these themes. Groups gave distinctive salience to themes of faith and spirituality, empowerment through the migration experience, and becoming a better person through the journey of recovery. CONCLUSION: The findings suggest that ethnic cancer support groups draw upon dominant societal discourses about cancer, but they espouse distinctive recovery narratives that are consonant with the groups' cultural models of illness. Similarity between ethnic members' individual recovery narratives and that of the group may contribute to the appeal of ethnic illness support groups for culturally diverse populations.

Recovery after coronary artery bypass surgery: effect of an audiotape information programme.

AIM: The aim of the study was to test the effect of an audiotape giving concrete objective information and strategies to reduce symptoms, psychological distress and enhance physical functioning in patients having coronary artery bypass grafts. BACKGROUND: The period following hospital discharge is stressful for patients having coronary artery bypass grafts. Evident-based interventions are needed to improve outcomes in Thai populations following coronary artery bypass graft surgery. METHODS: A randomized controlled trial was conducted during 2004-2005. A sample of 120 Thai patients having coronary artery bypass grafts was randomly assigned to an intervention group or a control group. The intervention group was given an information audiotape the day prior to hospital discharge, and encouraged to listen to it as many times as necessary. Participants were interviewed using validated instruments predischarge and at 2 weeks and 4 weeks after discharge. FINDINGS: Participants in the intervention group had statistically significantly fewer symptoms of shoulder, back or neck pain and lack of appetite, and increased physical activity after discharge, compared to the control group. This effect remained statistically significant after controlling for age, gender, co-morbidity and presurgical cardiac functional status. However, no statistically significant difference in psychological distress was observed. CONCLUSION: Nurses can use an audiotape containing preparatory information to improve outcomes for patients having coronary artery bypass grafts during the few weeks after discharge from hospital. Further studies are recommended to improve its effect on psychological distress.

Understanding women's experiences of developing an eating disorder and recovering: a life-history approach.

Qualitative inquiry into eating disorders is burgeoning, offering valuable and innovative insights into various aspects of the condition. This study used life-history interviews with 20 women who had recovered from anorexia nervosa, bulimia nervosa or both and who had remained healthy. The interviews focused on the women's narratives and experience rather than a diagnostic therapeutic model. Three themes of control, connectedness and conflict emerged as significant in the development, experience of, and recovery from an eating disorder. The development of the condition was attributed to a lack of control, a sense of non-connectedness to family and peers and extreme conflict with significant others. Recovery occurred when the women re-engaged with life, developed skills necessary for conflict resolution and rediscovered their sense of self. Rather than viewing the development of, and recovery from an eating disorder as separate and discrete events, the data from the life-history interviews suggest they are better viewed as one entity - that is, the journey of an individual attempting to discover and develop their sense of self. This perspective challenges some current constructs of eating disorders; it is not a condition in and of itself but a symptom of deeper issues that if addressed, when the individual is 'ready' to make that choice, will lead to recovery.

Change in taste preference in undernourished elderly hospitalized subjects during periods of infection and convalescence.

AIM: To determine the impact of taste pleasure supplements on modifications of food intake in hospitalized frail elderly patients. METHODS: Thirty hospitalized frail elderly patients tasted different formulas of a high-protein coffee supplement: -supplement C, commercial version; - supplement CA with artificial coffee flavor; - supplement CS with sucrose and - supplement CAS with sucrose and artificial coffee flavor. The preference for the supplements was analyzed by the Friedman test followed by a post hoc Tukey's test. The food intakes in each period were compared by repeated ANOVA and the food intakes of the two periods were compared using Student's t test. All measurements were made during periods of infection and convalescence. RESULTS: The supplements CAS and CS were significantly more appreciated than the current commercial version C (P < .05). The patients could be classified into two groups: consumers (consuming the supplements) and nonconsumers (just tasting the supplements). Taking supplements can increase the total energy intake for consumers (P < .01), especially during periods of infection; no modification was observed in the non-consumers. CONCLUSION: The use of supplements to increase sensory pleasure can be one feasible way to increase energy intake in hospitalized elderly patients with an infectious disease.

Over time: reflections after a myocardial infarction.

Self-care is especially important after a heart attack when daily lifestyle changes are needed. Performance of self-care behaviors after a myocardial infarction assists individuals in minimizing the progression of coronary heart disease. Uncovering patients' reflections after myocardial infarction provides a therapeutic window to target self-care interventions.

Journeys from addiction to recovery.

Addiction affects us all. It has wide-reaching consequences for the individual, the family, and society as a whole. This article attempts to assist providers and addicts in understanding the road to recovery. Transformation from addiction to recovery is best explained by recovering addicts themselves. In this qualitative study, nine participants describe their experiences with long-term recovery. The transtheoretical model of change (Prochaska & DiClemente, 1983) was combined with Mezirow's (1997) transformative learning theory to structure a framework that highlights the transition of these individuals as they moved from addiction to recovery. This new combination model can be used to anticipate behavior, support, and encourage patients in the change from active addiction to a healthier lifestyle without drugs and alcohol.

Helping partnerships that facilitate recovery from severe mental illness.

The intent of this study was to learn how consumers experience helping partnerships that assist them in recovery to inform families, professionals, and peers about meaningful actions and strategies that promote the healing process. In-depth interviews were conducted with a purposeful sample of 10 individuals who had a self-reported diagnosis of severe mental illness. Using the phenomenological research process, helping partnerships and how they develop were described. Six key themes emerged from the data and included Networks of Helping Partnerships, Teaching-Learning, Spirituality, Creative Drive, Time, and Medication Adherence. Characteristics and behaviors of helping partners were identified, as well as structures that promoted their development. Educating the public, consumers, and mental health professionals about how to promote recovery, the role of spirituality and creativity, the benefits of medication and therapy, and the impact of learning on progressing through recovery can go a long way toward eliminating the mystery and fear associated with mental illness.

[Recovery from persons living with schizophrenia]. / Le rétablissement de personnes vivant avec la schizophrénie.

The study gives a theoretical explanation of how people living with schizophrenia recover. The 41-participant study (clients, family and health professional) was conducted using the grounded theory approach, in three different settings. Based on analyses of the empirical data, the authors identified seven closely interrelated categories defining the participants' experiences and came up with a theory explaining how certain individuals manage to recover. Their theory may guide researchers and clinicians interested in understanding this phenomenon from a nursing point of view based on human responses to a disease.

Analysis of integration in nursing science and practice.

PURPOSE: To clarify the definition of integration and to identify universal aspects of the experience of integration related to healing, health, and nursing care. DESIGN: An integrative review concept analysis method was used. Relevant reports were identified by a computer-assisted search using the keyword integration in CINAHL from 1966 to 2004 and by reviewing the reference lists of retrieved reports. The final sample included 56 reports; 36 were empirical and 20 were theoretical. METHODS: Data were extracted from primary sources on the definition of integration, aspects of the process, antecedents, consequences, and facilitators. Data display matrices were used and were iteratively compared to derive a process model of integration related to health. FINDINGS: A wide range of primary sources indicated that integration is an important aspect of healing or recovery from illness. Integration is defined as a complex person-environment interaction whereby new life experiences (i.e., illness) are assimilated into the self and activities of daily living, thereby contributing to overall life balance. CONCLUSIONS: Results of this analysis indicate the importance of the concept of integration to the science and practice of nursing. The process of integration appears to be a significant phase that occurs between a diagnosis of illness and subsequent physical and emotional healing.

The impact of patient education and psychosocial supports on return to normalcy 36 months post-kidney transplant.

INTRODUCTION: Improvements in immunosuppression, and expansion of immunosuppression coverage by Medicare now necessitate beginning to define success in transplantation from a holistic or whole person approach rather than the historical emphasis on patient and graft survival alone. In a new transplant environment, efforts will have to be made to redefine practice so that kidney transplant recipients are prepared for 10 or more years of life with a transplanted graft. Currently, 83% of transplanted patients will never return to work. The purpose of this study is to determine how targeted education and specific psychosocial supports affect the transplant patient's return to normalcy 36 months after kidney transplant. Normalcy is defined as age and socially appropriate activities for that patient. METHODS: This is a synopsis of a 1-year cross-sectional study of 51 patients who received kidney transplants in 1999 at or near their 36-month anniversary date. Thirty-six months was chosen because this is the date when most patients will lose their Medicare coverage for immunosuppression. In 1999, a multidisciplinary plan was initiated to restructure the transplant recipient evaluation process, such that education about kidney transplantation and expectations for return to normalcy were addressed at the initial 'introduction to transplant session'. These measures were then consistently reinforced with each subsequent contact. At the second contact, written verbal plans for medication purchase and return to normalcy were identified. The team made a conscious effort to develop relationships with the recipients and their significant others, with the intention to better empower them to return to normalcy post-transplant. These measures (education and psychosocial support) were this study's independent variables. At 36 months, all patients were contacted by telephone and a 12-item questionnaire was administered. The questionnaire sought information about the study's dependent variables - employment and insurance status, pre- and post-transplant. RESULTS: In this study, 44% of pre-transplant patients were non-disabled compared with 62% of transplanted patients at 36 months post-transplant (P = 0.06, Chi square). Non-disabled includes persons who are employed, homemakers, students, retired or otherwise involved in age and socio-economically appropriate activities. Pre-transplant, 23% of recipients utilized Medicare and Medicaid for health insurance coverage. At 36 months post-transplant, only 11 or 20% of patients were dependent on Medicare and Medicaid. Pre-transplant, 17 recipients had private insurance coverage vs. 23 patients 36 months later (P < 0.02, Chi square). Fifty-six per cent of the patients received a living donor transplant. CONCLUSION: A targeted multidisciplinary programme of education and psychosocial support that emphasizes return to normalcy and non-disability, beginning with the first exposure to transplant and continuing throughout the first 6 months post-transplant, yielded high rates of return to normalcy for kidney transplant recipients.

Mother-daughter relationships expressed in the food context of postpartum convalescence --- findings from a preliminary study.

The aim of this study was to explore mother-daughter interaction as represented by provision of food during the traditional month-long postpartum convalescence. The clinical field research method was employed. A convenience sample of three pairs of mothers and postpartum daughters were recruited from a medical center. Data from recorded interviews were analyzed. Content analysis was applied to analyze the interaction between the mothers and daughters. The study demonstrated that the mothers exhibited caring behavior toward their daughters during this period. The postpartum daughters reacted to their mothers with approach, nostalgia, and appreciation behaviors. The results of this study deserve the cognitive recognition of nurses, so that they can be aware of and respect the indigenous beliefs and practices that link the events of childbearing, the health status of women, and family relationships especially between the woman and her own mother in order to provide better maternity care for postpartum women.

Spirituality of patients recovering from an acute myocardial infarction. A grounded theory study.

The purposes of this study were to discover what spirituality means to patients recovering from an acute myocardial infarction and to identify patients' perceptions of how spirituality influences recovery. Using the Glaserian method, spiritual concepts were used for theory building. Spirituality was described as a life-giving force nurtured by receiving presence of the divine, family, friends, health care providers, and creation (core category). Supporting categories were: developing faith, discovering meaning and purpose, and giving the gift of self. Five phases to discovering meaning and purpose were: (a) facing mortality, (b) releasing fear and turmoil, (c) identifying and making lifestyle changes, (d) seeking divine purpose, and (e) making meaning in daily life. Spirituality influenced recovery by providing the participants with inner strength, comfort, peace, wellness, wholeness, and enhanced coping. This substantive theory can be used by holistic nurses to facilitate spirituality in patients recovering from an acute myocardial infarction.

Biofeedback-assisted relaxation training with brain injured patients in acute stages of recovery.

There are few published accounts or empirical studies of biofeedback-assisted relaxation training with brain injured patients still in acute stages of recovery. Given the efficacy of biofeedback-assisted relaxation training with other medical populations, brain injured patients in acute stages of recovery with anxiety-based symptoms may also stand to gain some benefits from this form of treatment. It has yet to be determined, however, if severe cognitive impairment or disorientation contraindicate biofeedback treatment. The cases profiled here tentatively suggest that consideration of biofeedback-assisted relaxation training, even for severely cognitively impaired brain injured patients in acute stages of recovery, may be appropriate. Empirical investigations will be needed to determine selection criteria and contraindications for biofeedback treatment in the acute brain injury population.