Smoothing consumption in times of illness: Household recourse mechanisms.

We study the welfare impacts of illness shocks on rural agricultural households in the semi-arid tropical and humid eastern regions of India. These regions are characterized by rainfed agriculture, missing markets for credit and insurance, and limited access to publicly funded healthcare infrastructure. We find that illness shocks increase households' medical expenditures and reduce wage income. However, aggregate non-medical, food, and non-food consumption expenditures are insensitive to illness shocks. Disaggregating illness by the age and the gender of the household members, we observe that illness in male children leads to the largest increase in medical expenditure, and illness in prime-aged adults leads to the largest decline in per-capita wage earnings. We also find illness shocks leading to changes in household dietary diversity, higher travel expenditures, and a compensating reduction in spending on education and entertainment. Analysis of risk-coping strategies reveals that households rely on transfers from kinship networks and loans from informal sources like local moneylenders to smooth consumption. While large landowners rely on gifts from kinship networks, landless and smallholders increase borrowings from informal sources.

The Role of Perceived Stress in the Relation between Childhood Maltreatment and Severity of Alcohol Use Disorder: A Mediation Analysis.

INTRODUCTION: Experiences of Childhood Maltreatment (CM) relate to relapse and lower treatment success in Alcohol Use Disorder (AUD), one of the most prevalent substance use disorders. However, the exact mechanisms of this relationship still remain unclear. This study examines perceived stress and "drinking to cope with negative affect" (coping) as possible mediators in this relationship. Moreover, it aims at uncovering the differential effects of the subtypes of CM. METHODS: N = 96 individuals (42% women; mean age 41 ± 13 years) including healthy controls and individuals with varying severity of AUD and CM completed the Alcohol-Dependence Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and German Inventory of Drinking Situations. Mediation analyses including perceived stress as a mediator between CM (and subtypes) and severity of AUD, as well as a serial mediation of the relationship between CM and AUD severity by perceived stress and coping were conducted. RESULTS: Perceived stress significantly mediated the relation between CM and AUD severity and the serial mediation by perceived stress and coping turned out significant. Subtype-specific analyses did not yield significant results. CONCLUSION: This study reinforces perceived stress as a potential mechanism in the relation between CM and AUD severity. Moreover, coping further mediated the relationship between CM and AUD severity. Our results suggest including screening for CM (subtypes) in clinical routine in order to individually emphasize interventions focusing on stress regulation, as well as on developing healthy coping mechanisms, in patients with AUD. This might prevent heightened stress sensitivity, relapse and further maintenance of AUD.

Exploring society-to-cells resilience among community members: A multidisciplinary study in outpatient clinics with diverse participant demographics.

AIM: This study explores and understands community members' resilience in outpatient clinics, considering various dimensions and types of resilience. DESIGN: A cross-sectional study. METHODS: This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index. RESULTS: Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains. CONCLUSION: This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience. IMPACT: This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work. PATIENT OR PUBLIC CONTRIBUTION: Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.

Navigating food price shocks in a pandemic: Food insecurity and coping mechanisms in Burkina Faso.

Global food prices rose substantially after the start of the COVID-19 pandemic. This paper examines the impact of rising food prices during the pandemic on food security in Burkina Faso. We aim to answer two primary questions. First, how do food price shocks affect household food insecurity? Second, what coping strategies do households adopt in response to these price shocks? Leveraging country-wide high-frequency longitudinal data, we employ household fixed effect models to examine the effects. In the absence of direct information on local food prices, we use household-reported price shocks to capture province-level price increases and show that the results are consistent with national-level price increases. We find significant and immediate increases in food insecurity following the price shocks, and this effect persists for at least two months. The price shocks most acutely affected the poorest households. Furthermore, food insecurity increased more in rural areas than in urban areas. The higher proportion of poorer households in rural areas explains part of this difference. We find that households primarily cope with the shock by relying on increased assistance from relatives in Burkina Faso and abroad. This study is the first to use panel data with household fixed effects to examine the repercussions of the rise in food prices during the pandemic on food insecurity in a developing country and to examine the coping mechanisms employed by households. Given that food prices are likely to remain high globally for an extended period, our findings carry implications for the broader developing world. Furthermore, given the disproportionate effect on the poorest and those living in rural areas, the findings highlight the need for policies to mitigate the negative impacts of the price shocks and enhance overall food security in countries like Burkina Faso.

Investigating fear, depressive symptoms and coping mechanisms among Egyptian nursing students amidst the covid-19 pandemic: a cross-sectional study.

BACKGROUND: Amidst the ongoing COVID-19 pandemic, nursing students' contribution to combating this global health crisis is becoming more significant. However, we need a more comprehensive understanding of the psychological impact of this crisis on these students. Therefore, this study holds immense importance as it offers valuable insights into the connection between COVID-19 pandemic fear, coping strategies, and depressive symptoms among nursing students. METHODS: A cross-sectional survey was conducted to collect and analyze data from 319 undergraduate nursing students. They participated in the study by responding to an online questionnaire. The questionnaire consisted of the Fear of the Coronavirus Questionnaire, Brief Coping Orientation to Problems Experienced, and the Beck Depression Inventory-II. RESULTS: The study revealed that 45.5% of the participants had a severe fear of COVID-19, 21.9% showed severe depressive symptoms, and 64.6% used moderate coping mechanisms. A positive correlation (r = 0.160, p = 0.01) was found between the fear of COVID-19 and depressive symptoms. Interestingly, this correlation turned negative (r = -0.074, p = 0.01) when adaptive coping strategies such as religion, acceptance, planning, positive reframing, instrumental support, emotional support, active coping, and humor were used. However, when participants resorted to maladaptive coping strategies like venting, self-distraction, self-blame, behavioral disengagement, denial, and substance abuse, the correlation between high fear levels and depressive symptoms became positive (r = 0.352, p = 0.01). CONCLUSION: The study demonstrated that the fear of COVID-19 and depressive symptoms among nursing students are significantly correlated. However, the nature of this correlation is influenced by the type of coping strategies employed. Adaptive coping mechanisms can mitigate the impact of fear on depressive symptoms. In contrast, maladaptive coping can exacerbate the relationship between fear and depressive symptoms. Therefore, promoting adaptive coping strategies could be a crucial approach to managing the psychological impact of the COVID-19 pandemic.

Health effects of caregiving and coping with severe mental disorders: A caregivers' experience.

Background: Informal caregivers are an essential health resource in the care of persons with severe mental disorders, particularly in South Africa where access to mental healthcare services is limited. Aim: The study aimed to explore and describe the coping strategies used by informal caregivers and the specific health impacts they face in the context of severe mental disorders in South Africa. Setting: The study was conducted in Bushbuckridge municipality situated in the northeastern parts of Mpumalanga province, South Africa. Methods: A descriptive qualitative methodology was used to conduct semi-structured interviews with 12 purposefully selected participants. Audio-recorded interviews were translated, transcribed and analysed inductively on NVivo12 using reflexive thematic analysis. Results: The themes identified were caregivers' experience of consequences of caregiving and caregivers' experience of coping with their caregiving role. Participants experienced negative consequences on their emotional, mental and physical health. The participants use internal and external resources to cope with the challenges they face, and many highlighted using emotion-focused coping strategies. Conclusion: The findings revealed an urgent need to develop support strategies to strengthen informal caregivers' coping and promote good health particularly in rural South Africa where informal caregivers play a crucial role in the management of severe mental disorders. Contribution: The finding demands that policymakers and healthcare providers prioritise the health and well-being of the informal caregivers. There should be policies targeted specifically at developing and implementing caregiver-orientated healthcare services.

Community stressors and coping mechanisms in accessing the health system during a double crisis: a qualitative case study from Yangon Region, Myanmar.

BACKGROUND: Due to the COVID-19 pandemic and political crisis, Myanmar's health system has suspended routine services while struggling to respond to the pandemic. Many people who need continuous care, like pregnant women and people with chronic illnesses, have been facing challenges in seeking and receiving essential health services. This study explored community health seeking practices and coping mechanisms, including their views on health system stressors. METHODS: This was a cross-sectional qualitative study based on 12 in-depth-interviews with pregnant people and persons with pre-existing chronic health conditions in Yangon. Sampling was purposive, convenience-based and snowball sampling was also used. The 3-delays framework was used to understand how persons were interacting with and accessing health care services; community and health system stressors and coping mechanisms in relation to COVID-19 were also identified. RESULTS: Findings showed that Yangon region was the hardest hit with both the pandemic and political crisis and its health system was greatly affected. People were unable to access essential health services on time. The health facilities were not available to see patients, with serious shortages in human resources, medicines and equipment, resulting in interruption of essential routine services. The prices of medicines and consultation fees, and transportation costs, increased during this period. Limited options for accessing care were available due to travel restrictions and curfews. It became challenging to receive quality care because of unavailable public facilities and private hospitals being costly. Despite these challenges, the Myanmar people and health system have shown resilience. Cohesive and organized family support structures and extended and deep social networks played an important role in accessing health care. At times of emergency, people relied on community-based social organizations for transportation and accessing essential medicines. The health system also showed resilience through establishing new service provision options, such as teleconsultations, mobile clinics, and sharing medical advice through social media. CONCLUSIONS: This is the first study in Myanmar to explore peoples' perceptions on COVID-19, the health system and their healthcare experiences during political crisis. Although there is no easy way to cope with this dual hardship, the people and the health system, even in a fragile and shock-prone setting like Myanmar, stayed resilient by developing alternative pathways for seeking and providing health services.

Concerns and coping mechanisms of breast cancer survivor women from Asia: a scoping review.

PURPOSE: The incidence of breast cancer has increased significantly in Asia due to epidemiological transition and changes in human development indices. Advancement in medical technology has improved prognosis with a resultant increase in survivorship issues. The effects of breast cancer diagnosis and treatment are influenced by the patient's cultural beliefs and social systems. This scoping review aims to summarise concerns and coping mechanisms of women with breast cancer in Asia and understand gaps in the existing literature. METHODS: We performed a scoping review using the population-concept-context strategy. A systematic search of MEDLINE (PubMed, Web of Science), CINAHL, SCOPUS, and Embase was conducted for studies conducted in Asia on women diagnosed with breast cancer, identifying their concerns and coping mechanisms, published between January 2011 and January 2021. Data from included studies were reported using frequencies and percentages. RESULTS: We included 163 studies, of which most (81%) were conducted in hospital settings. Emotional and psychological concerns were reported in 80% of studies, followed by physical appearance and body-image concerns in 46%. Social support (59%), emotion-based coping (46%), spirituality, and problem-based coping (37%) were the major coping systems documented. CONCLUSION: The mapped literature documented that anxiety, depression, and fear of cancer recurrence dominated women's emotional concerns. Women coped with the help of social support, positive reappraisal, and faith in God and religion. Sensitization of caregivers, including healthcare professionals and family members, to context-specific concerns and inquiry into the patients' available support systems is essential in strengthening breast cancer women's recovery and coping.

Exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study.

BACKGROUND: Conflict is a complicated topic with a multidimensional consequences for community health. Its effects have a broad pattern, starting from direct war-related morbidity and mortality caused by bullets and bombs to indirect consequences due to the interruption of the delivery of preventive and curative health services. This study aimed to explore the health consequences of the northern Ethiopian conflict in the North Wollo zone, northeast Ethiopia, in 2022. METHODS: This descriptive qualitative study was conducted from May to June 2022 on six conflict-affected Woredas in the north Wollo zone. A total of 100 purposively selected participants, which included patients, pregnant women, elders, community and religious leaders, and health professionals, were interviewed using IDI and FGD. The data was entered, coded, and analyzed using Open Code version 4.03. Thematic analysis approach employed to conduct the interpretation. Data was presented using descriptive statistics in the form of texts and tables. RESULTS: The findings indicate that the conflict has caused a profound consequence on population health. It has resulted in a wide range of direct and indirect consequences, ranging from war-related casualties, famine, and disruptions of supply chains and forced displacement to instances of violence and rape associated with insecurity. The conflict also caused a breakdown in the health system by causing distraction of health infrastructure, fleeing of health workers and shortage of medication, together with insecurity and lack of transportation, which greatly affected the provision and utilization of health services. Additionally, the conflict has resulted in long-term consequences, such as the destruction of health facilities, interruption of immunization services, posttraumatic stress disorders, and lifelong disabilities. The coping strategies utilized were using available traditional medicines and home remedies, obtaining medications from conflict-unaffected areas, and implementing home-to-home healthcare services using available supplies. CONCLUSION: The Northern Ethiopian conflict has an impact on community health both directly and indirectly through conflict-related causalities and the breakdown of the health system and health-supporting structures. Therefore, this study recommends immediate rehabilitation interventions for damaged health infrastructure and affected individuals.

Psychosocial issues among paediatric health-care workers posted in intensive care unit during COVID-19 pandemic: A questionnaire-based survey (Psy-Co-19 survey).

AIM: To understand the moral distress experienced by health-care workers (HCWs) in the COVID paediatric intensive care unit (PICU). We also aimed to assess the psychological well-being and the coping mechanisms used by HCWs. METHODS: A prospective observational cross-sectional study was conducted from July to September 2021, involving all HCWs who worked in the COVID PICU. Moral distress using Moral Distress for Health-care Professionals (MMD-HPs) scale, psychological well-being using Trauma Screening Questionnaire (TSQ) and coping strategies adopted by HCWs using Brief-COPE (Coping Orientation to Problems Experienced) were measured. RESULTS: One hundred and eighty-four HCW data were examined. The most common causes of moral distress among HCWs were compromised patient care caused by a lack of resources and caring for more patients than they could safely handle. Moral distress was the same regardless of the HCWs' job profile, marital status, number of children or age. The TSQ revealed psychological stress in 23.3% of HCWs with Post-traumatic Stress Disorder, significantly higher in HCWs under the age of 30 and without children. Few HCWs turned to substance use, self-blame or denial as coping mechanisms; instead, acceptance, self-distraction and emotional support were the most frequently used. CONCLUSION: The most common reasons for moral and psychological distress perceived by participants were insufficient staff and organisational support. Younger HCWs and those without children experienced higher levels of psychological distress. HCWs' typical coping mechanisms are constructive, such as seeking help and support from others, reframing situations and meditation. Health-care administrators must develop a framework to assist HCWs in dealing with such serious issues.

Comparing Pain and Pain Coping Mechanisms in Patients Undergoing Total Joint Arthroplasty as Part of a Mission Trip to Those in the United States.

BACKGROUND: Access to total joint arthroplasty can be difficult in low-resource settings. Service trips are conducted to provide arthroplasty care to populations in need around the world. This study aimed to compare the pain, function, surgical expectations, and coping mechanisms of patients from one such service trip to the United States. METHODS: In 2019, the Operation Walk program conducted a service trip in Guyana during which 50 patients had hip or knee arthroplasties. Patient demographics, patient-reported outcome measures, questionnaires assessing pain attitudes and coping, and pain visual analog scales were collected preoperatively and at 3 months postoperatively. These outcomes were compared with a matched cohort of elective total joint arthroplasty at a US tertiary care medical center. There were 37 patients matched between the 2 cohorts. RESULTS: The mission cohort had significantly lower preoperative self-reported function scores than the US cohort (38.3 versus 47.5, P = .003), as well as a significantly larger improvement at 3 months (42.4 versus 26.4, P = .014). The mission cohort had significantly higher initial pain (8.0 versus 7.0, P = .015), but there were no differences with regard to pain at 3 months (P = .420) or change in pain (P = .175). The mission cohort had significantly greater preoperative scores in pain attitude and coping responses. CONCLUSION: Patients in low-resource settings were more likely to have preoperative functional limitations and pain, and they coped with pain through prayer. Understanding the key differences between these 2 types of populations and how they approach pain and functional limitations may help improve care for each group. LEVEL OF EVIDENCE: II, prospective study.

Psycho-social challenges faced by caretakers of children and adolescents aged 0-19 years with sickle cell disease admitted in a tertiary hospital in Eastern Uganda.

BACKGROUND: Families of children and adolescents living with sickle cell disease face several challenges ranging from psycho-social to social-economic challenges. This study aimed to explore psycho-social challenges experienced by caretakers of children and adolescents aged 0-19 years with SCD and the various coping mechanisms. METHODS: A mixed-methods cross-sectional study was carried out among caregivers of children with SCD who were admitted to the pediatric wards of the Mbale Regional Referral Hospital from September 2019 to November 2019. A total of 333 participants were interviewed using a pretested questionnaire and 11 in-depth interviews were conducted. RESULTS: Most participants 285(85.59%) reported that they experienced psychological challenges and almost all the participants in this study 297(89.19%) experienced social challenges during the care of their patients. Only 36(10.81%) reported not experiencing any social challenges. Almost all the participants reported coping with the situation in various ways of which, 296(88.89%) used acceptance, 9(2.7%) still lived in denial, while 9(2.7%) used talking with others and getting counseled to reduce the intensity of the feelings experienced. Three themes were generated from the in-depth interviews; knowledge of the child's health condition; common symptoms and care, the experience of psycho-social challenges, and coping strategies. CONCLUSION: Sickle cell disease has affected two sets of people; the people living with the disease and those who are caring for their loved ones. Being conscious of this will help health practitioners to be more empathetic to patients and caregivers when treating people living with sickle cell disease. The biggest proportion of caretakers of children and adolescents 0-19 years experienced psycho-social challenges. The main coping strategy used by the caretakers was acceptance.

How did the COVID-19 crisis affect different types of workers in the developing world?

This paper examines how the COVID-19 pandemic affected the employment of different groups of workers across 40 mostly low and middle-income countries. Employment outcomes during the crisis are tracked through high-frequency phone surveys conducted by the World Bank and national statistics offices. Our results show that larger shares of female, young, less educated, and urban workers stopped working at the beginning of the pandemic. Gender gaps in work stoppage stemmed mainly from gender differences within sectors rather than differential employment patterns of men and women across sectors. Differences in work stoppage between urban and rural workers were markedly smaller than those across gender, age, and education groups. Preliminary results from 10 countries suggest that following the initial shock at the start of the pandemic, employment rates partially recovered between April and August 2020, with greater gains for those groups that had borne the brunt of the early jobs losses. Although the high-frequency phone surveys over-represent household heads and therefore overestimate employment rates, a validation exercise for five countries suggests that they provide a reasonably accurate measure of disparities in employment levels by gender, education, and urban/rural location following the onset of the crisis, although they perform less well in capturing disparities between age groups. These results shed new light on the distributional labor market consequences of the COVID-19 crisis in developing countries, and suggest that real-time phone surveys, despite their lack of representativeness, are a valuable source of information to measure differential employment impacts across groups during an unfolding crisis.

Exploring the lived experiences of women with children during COVID-19: Maternal stress and coping mechanisms.

This paper presents the results of a qualitative study of mothers' lived experiences during the COVID-19 lockdown in the United States. An analysis of open-ended interviews with 44 mothers who had children ages zero-to-five identified two main themes: (1) increased stress among mothers; and (2) resilience through the use of coping mechanisms. The findings indicate that the COVID-19 pandemic has led to higher stress among mothers due to issues of work-family life balance, family and children's needs, decision-making about getting sick, concerns for children's development, and lack of clarity from government officials. Mothers described using a variety of problem-focused and emotion-focused methods to cope with this stress. The lived experiences of mothers during the pandemic highlights the need for innovations in childcare modalities, paid leave policies to relieve stress, and strengthening whole family processes and resilience through the use of coping mechanisms.

Experiences of Patients in Turkey with Breast Cancer throughout the COVID-19 Pandemic and their Coping Mechanisms: A Qualitative Study.

This research was conducted in Turkey to determine the experiences and coping mechanisms of breast cancer patients during the COVID-19 pandemic. The research was conducted using qualitative descriptive phenomenology. Data were collected from ten patients via in-depth interviews through semi-structured questionnaires. Content analysis, incorporating a combination of deductive and inductive approaches, was conducted to determine the themes and subthemes. Interviews were transcribed verbatim, simultaneously with the analysis and collected data. The study data were categorized into 3 contexts, 7 themes and 39 subthemes. The first context titled "Problems accompanying the disease" includes the effects of the pandemic, the fear of being infected with COVID-19 and hospital-related themes. The second context titled "Coping strategies" comprises the themes of coping behaviors and healthy lifestyle behaviors. The last context is titled "Anxiety about being infected, and suggestions for the future". In the study, problems experienced by patients with breast cancer throughout the COVID-19 pandemic were investigated from a broad perspective. Patients treated in chemotherapy units constitute the vulnerable group affected by the pandemic most. Therefore, it is important to investigate the experiences of oncology patients, particularly of patients with breast cancer and their coping strategies, and to take necessary precautions accordingly.

Mental health stigma experiences among caregivers and service users in South Africa: a qualitative investigation.

The study aimed to understand the nature and context of mental health stigma among people living with a mental health condition and the subsequent effect on their caregivers. Semi-structured qualitative face to face interviews were conducted by trained mental healthcare professionals with mental health service users (n = 26) and caregivers (n = 24) in private rooms at a tertiary health facility, where service users were admitted. Following transcription and translation, data was analysed using framework analysis. There was limited knowledge about their mental health diagnosis by service users and generally low mental health literacy among service users and caregivers. Mental health service users reported experiences of stigma from their own families and communities. Caregivers reported withholding the patient's diagnosis from the community for fear of being stigmatised, and this fear of stigma carries the risk of negatively affecting care treatment-seeking. Limited mental health knowledge, coupled with a high prevalence of perceived family and community stigma among caregivers and service users, impedes the capacity of caregivers to effectively cope in supporting their family members living with mental illness. There is a need for interventions to provide psychoeducation, reduce community stigma, and support coping strategies for caregivers and people with mental health conditions.

Living alone in lockdown: Impact on mental health and coping mechanisms among young working adults.

In the wake of declaration of Covid-19 as a pandemic by the World Health Organization, the Prime Minister of India announced a nationwide lockdown to curb its spread. Subsequently, some groups of people found themselves away from their family or friends, and were unable to return to them. The aim of the research was to explore the lives of young adults who were living alone and working, during the lockdown in India. Focus was on their daily living, their relationships and their mental health. Twelve participants residing in various cities of India were included via the Internet. Focus group discussions were used to attain the objectives of the study. The data that emerged from the discussions, was analysed using thematic analysis. All participants had experienced different kinds of disruptions in their life due to the lockdown. This effect was mediated by their financial situation, their general comfort and preference for living alone, media, opportunities for non-virtual interactions and other kinds of recreation, quality of relationships and more. Though there were similarities in their coping methods, their perspective on the lockdown, the meaning they attributed to their current situation and their vision for their future was unique.

Effects of personality traits on mindful self-care practices of healthcare workers.

Background: Coronavirus disease 2019 (COVID-19) placed healthcare professionals (HCPs) at a higher risk for stress-related conditions. Implementing a brief online mindfulness-based intervention (MBI) was hypothesised to transform the HCPs' ability to cope with stress by enhancing their self-care. Aim: This study aimed to explore the impact of an online MBI on HCPs' self-care practices and determine if personality traits were a moderating variable. Setting: An online MBI was implemented for HCPs working in South Africa during the COVID-19 pandemic lockdowns. Methods: A quantitative study design included a pre-assessment and post-assessment component, which allowed paired comparison and regression analysis to confer correlations. Data were collected via two validated instruments: the Mindful Self-Care scale-2018 and the Big Five Personality test. Results: Forty-nine HCPs participated in the study. Significant improvements were found in all the major self-care subscales post-intervention (p < 0.05). No significant associations were found between the personality traits and self-care except for neuroticism, which appeared to be an essential moderating variable. Conclusion: An online MBI significantly impacted health professionals' ability to care for themselves, despite their personality styles. Contribution: The impact of an online MBI on HCPs' self-care during the most intense time of stress and with a cohort of people known to be the most vulnerable to stress, namely those with neuroticism to date, has not been commented on.

Nurses' mental health from early COVID-19 pandemic to vaccination.

AIMS: The influence of the COVID-19 vaccine and the evolution of the pandemic over time on nurses' mental health have not been thoroughly examined. This study aimed to explore the changes in nurses' mental health from the early pandemic to the early vaccination period over a 1-year time span and examine vaccination and coping mechanisms as predictors of nurses' poor mental health and burnout. METHODS: Three cross-sectional surveys were conducted: Early-pandemic (n = 320), pre-vaccination (n = 228), and early-vaccination cohorts (n = 292). FINDINGS: About 72% of nurses in the early-vaccination cohort were fully vaccinated with two doses of mRNA COVID-19 vaccines. There were significant decreases in moderate/severe anxiety and moderate/severe depression for the early-vaccination cohort compared to the other cohorts. In multivariate analyses, vaccination had almost three-fold higher odds of moderate/severe anxiety (Odds Ratio [OR] = 2.87; 95% Confidence Interval [CI] = 1.28-6.44). High resilience, family functioning, and spirituality were associated with two- to five-fold lower odds of poor mental health and burnout. CONCLUSIONS: Although nurses in the early-vaccination cohort had lower anxiety and depression than earlier cohorts, COVID-19 vaccination had minimal associations with nurses' mental health. Coping mechanisms and organizational support appear to be important predictors of nurses' poor mental health and burnout. CLINICAL RELEVANCE: The evidence gathered over 1 year of the pandemic may be helpful for a better understanding of the challenges facing frontline nurses and preparing for future healthcare crises. As a part of the preparedness plan for the future, evidence-based interventions that raise frontline nurses' resilience, as well as family and spiritual support, should be considered.

Psychological aspects of living with an artificial eye.

PURPOSE: Artificial eye clinics address physical and aesthetic aspects of orbital prostheses, but psychological effects may not be formally addressed. In general, without effective coping mechanisms, stress can lead to anxiety and depression. This study aims to determine, in the context of having an artificial eye, whether coping strategies, as well as perception of illness and other demographic and clinical variables are associated with anxiety or depression. METHODS: Consecutive patients attending two artificial eye clinics were invited to participate in this audit. Participants completed questionnaires: HADS, Brief IPQ and Brief COPE. Variables with a correlation coefficient of ≥0.2 with anxiety or depression were included in regression modeling. The extent to which the participants' emotional and cognitive representations of their artificial eye related to feelings of anxiety and depression was determined. RESULTS: In the cohort of 208, clinically significant anxiety was present in 29.5% and clinically significant depression was present in 8.4%. Perceptions of the impact of the artificial eye and self-blame as a coping strategy were correlated with anxiety. Depression levels were higher when participants believed that their artificial eye had a greater impact on their life, when they lived alone, and when they used substances as a coping strategy. CONCLUSION: Significant levels of anxiety exist in those living with artificial eyes, with various coping strategies used. Addressing this and offering alternative coping strategies may improve patient well being and overall satisfaction.