The role of community resilience as a protective factor in coping with mental disorders in a sample of psychiatric migrants.

Background: Over the past decade migration to Italy has increased significantly for various reasons including armed conflicts. Generally, the migration process is exposed to different risk factors during different periods of migration, which can compromise well-being and promote the onset or exacerbation of mental disorders. A community with resources and the perception of one's community as resilient can be important protective factor in the context of migration. Purpose: This study aims to understand which variables in migration predict an increase in perceived community resilience and to understand the role of community resilience in the relationship between mental disorders and subjective well-being in a sample of 100 adult migrants at the first consultation interview in the ambulatories of Psychiatry Unit. Methods: After defining the inclusion and exclusion criteria, migrants were asked to fill out self-report questionnaires to collect socio-demographic data and to assess perception of mental disorders, perceived community resilience and perception of subjective well-being. Descriptive analysis, simple regression, and moderation analyses were conducted to test the hypotheses. Results: The results show that the variable meaning attributed to the community with reference to the host community, migration with someone, and longer duration of stay in Italy contribute to increased perceptions of community resilience. In addition, a direct negative effect of mental disorders on subjective well-being and the moderating role of community resilience in relationship between mental disorders and subjective well-being have been demonstrated. Conclusions: This result underscores the importance of perceived community resilience in mitigating the negative effects of mental disorders on subjective well-being. Perceiving one's community as more resilient seems to protect against the impact of mental disorders on subjective well-being. Our results support an ecological model of migrants' mental health that values the community and its resources in coping with mental disorders in the context of migration.

Inclusiveness of Access Policies to Maternity Care for Migrant Women Across Europe: A Policy Review.

INTRODUCTION: Despite the interconnectedness of the European Union, there are significant variations in pregnant women's legal status as migrants and therefore their ability to access maternity care. Limited access to maternity care can lead to higher morbidity and mortality rates in migrant women and their babies. This study aimed to investigate and compare maternal health access policies and the context in which they operate across European countries for women who have migrated and are not considered citizens of the host country. METHODS: The study adopted a mixed-methods research design exploring policies on migrant women's access to maternity care across the migration regimes. Data were extracted from legal documents and research reports to construct a new typology to identify the inclusiveness of policies determining access to maternity care for migrant women. RESULTS: This study found inconsistency in the categorisation of migrants across countries and significant disparities in access to maternity care for migrant women within and between European countries. A lack of connection between access policies and migration regimes, along with a lack of fit between policies and public support for migration suggests a low level of path dependency and leaves space for policy innovation. DISCUSSION: Inequities and inconsistencies in policies across European countries affect non-citizen migrant women's access to maternity care. These policies act to reproduce structural inequalities which compromise the health of vulnerable women and newborns in reception countries. There is an urgent need to address this inequity, which discriminates against these already marginalised women.

Cumulative trauma and perceived community resilience: A serial mediation model.

Communities affected by cumulative trauma can experience negative psychological reactions but also posttraumatic growth and community resilience, which promote adaptation and preparation for future traumatic events. This study aims to investigate the mechanisms that mediate the relationship between traumatic events and perceived community resilience. Participants were 118 Italian adults who experienced cumulative trauma and were recruited to complete an online survey. A serial multiple mediation model was estimated to assess whether the impact of the Morandi bridge collapse and posttraumatic growth mediated the relationship between the psychological impact of the Covid-19 pandemic and perceived community resilience. The impact of the collapsed bridge and posttraumatic growth in serial partially mediated the relationship between the impact of the Covid-19 pandemic and perceived community resilience. The impact of cumulative trauma can be considered through an ecological perspective that considers the consequences of these events in relation to community resilience.

Through a relational lens: reflections about foster care experience in Italian emancipated foster youth.

The study aimed to investigate relational outcomes of Italian emancipated foster youth across open-ended reflections about their perceptions of their relationships with the biological and foster family, with partner and peers. A total of 26 Italian emancipated foster youth (19-25 years old) recruited by social services completed a single in-depth interview. A qualitative thematic analysis was selected for this study. The results revealed two major themes of foster care experience that emerged often simultaneously from the participants' narration: (1) Positive Relational Outcomes including "Feeling supported," "Sense of belonging," "Good memories," "Relationship with family of choice," and "Staying in touch"; and (2) Negative Relational Outcomes referring "Devaluation," "Refuse," "Bad memories," and "Isolation." Foster care experience leads to complex relational perceptions in emerging adulthood according to different relational outcomes and ways of processing foster care experience. Professionals could work on relational outcomes and memories, especially during a critical transition like emerging adulthood, to support youth in making sense of their past experiences.

Exploring the Role of Birth Environment on Italian Mothers' Emotional Experience during Childbirth.

The physical environment is one of the factors that affect mother's experience of childbirth and psychological health. A woman's childbirth experience has been found to influence not only the mother's own health and future births but also the well-being of her child and family. The present study's objective was to investigate mothers' perceptions of spatial-physical humanization, affective quality of place, and emotions during childbirth. To achieve this goal, the first part of our work was dedicated to selecting two birth environments (hospital and birth center) with different degrees of humanization. The methods include observations and field survey which mainly concerned the environmental quality of the spaces and the layout of the birth unit, and self-report questionnaire about perceived environment, affective quality attributed to place, and delivery experience. Participants are 66 low-risk women, choosing hospital or birth center. The findings indicate an enhanced perception of both the spatial-physical aspects and the social and functional aspects of the care unit among mothers who give birth at the birth center. These same mothers also report a more positive perception of the childbirth experience. In conclusion, this study contributes to the understanding of the role of birth environments in shaping mothers' emotional experiences during childbirth.

Home Away from Home: Comparing Factors Impacting Migrants' and Italians Sense of Psychological Home.

Psychological home is an understudied concept within community psychology, especially focused on migrants. Previous literature on psychological home found a positive relationship with well-being and resilience in general populations and migrants. Studying psychological home in migrants may provide important tools to buffer various stresses associated with migration. The present study explored the relationship between psychological home and demographic factors, including dwelling type and situation between migrants (n = 132) and Italian citizens' population (n = 76). Results offer theoretical reasons explaining the differences in the meaning of home between migrant and non-immigrant populations.

A Broad Study to Develop Maternity Units Design Knowledge Combining Spatial Analysis and Mothers' and Midwives' Perception of the Birth Environment.

OBJECTIVES: This article investigates how the physical birth environment is perceived by the users (women and midwives) in different settings, a midwife-led unit and an obstetric-led unit, placed in Italy. BACKGROUND: In the field of birth architecture research, there is a gap in the description of the spatial and physical characteristics of birth environments that impact users' health, specifically for what concerns the perception by women. METHODS: The study focuses on multi-centered mixed methods design, employing both quantitative and qualitative research methods (questionnaire, spatial analysis) and covering different disciplines (architecture, environmental psychology, and midwifery). RESULTS: The results revealed significant differences between the two settings and some associations between perceived and spatial data concerning: calm atmosphere, greater intimacy, spacious birth room, clarity of service points, clarity in finding midwives, sufficient space for labor, noise, privacy, and the birth room adaptability. CONCLUSIONS: The findings confirm the importance of the spatial layout and indicate documented knowledge as an input to consider when designing birth spaces in order to promote user well-being.

Unaccompanied migrant minors in Europe and U.S.: A review of psychological perspective and care challenges.

Unaccompanied migrant minors are youth under the age of 18 who migrate alone, traveling separately from both parents. These youth may be asylum seekers, recognized refugees, or other externally displaced persons. Unaccompanied migrant minors have become an increasingly prevalent global issue. However, this phenomenon might be better understood considering the peculiarities of their contexts, since there are differences related to specific conditions and reception systems. The present study reviewed and compared visually previously reported psychological perspective of unaccompanied migrant minor receiving services from select European countries and the U.S. Unaccompanied migrant minors create a challenge on a nation's care system because these minors are the most vulnerable group in the context of migration. Our explorative assessment suggested underlining similarities and differences between contexts, reflecting the unique needs of the unaccompanied migrants and proposed services and intervention models.

Migration in the context: Perspectives, methodologies, and cultural issues.

The present article introduces the issue migration in the context: perspectives, methodology, and cultural issues. International migrations and their changing patterns pose new challenges to community social psychologists and new questions to be explored. Community psychologists' attention is necessary to develop a perspective about migration more suitable to effective interventions in global and local communities. Therefore, methods aimed at study migration issues should be implemented at micro-system, community, and national levels. Through this series of papers, we aim to contribute to the debate about how social and community psychologists can engage in community development strategies aimed at improving migrant well-being too. Indeed, they can give relevant contributions to the deepening of migration issues through research, methodologies, and interventions in different contexts and at different levels of analysis.

Community dimensions and emotions in the era of COVID-19.

Following an ecological perspective, reactions to a disaster-such as the COVID-19 pandemic-should be analysed in the interdependence between individual and community dimensions. The present study aims to analyse individual emotional dimensions (anxiety, joy, fear or depressive feelings) and their community dimensions (connectedness, emotional sharing and solidarity) with a longitudinal approach among university students from Italian universities. Participants were 746 university students at t1 (during the lockdown) and 361 at t2 (after the lockdown) recruited in six Italian universities from different areas of Italy. Comparing emotional dimensions in the two times, t2 is characterized by a generalized ambiguity: both happiness or joy because of the end of limitations and a kind of 'post-lockdown anxiety' because of a sense of individual inadequacy in facing the return to normality, conducting daily activities and attending community spaces. Data confirms that after the so-called 'honeymoon phase' in community dimensions (first phase of t1 time), a sort of 'depressive reaction' arises at t2: Italian university students seem more aware of the need for individual and social responsibility and that many events are not under their personal control. The reconstruction phase and exit from the emergency are perceived as necessary but also as a difficult and risky period. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Fear of hypoglycemia in Italian mothers of children with type 1 diabetes: the mediating role of resilience.

OBJECTIVE: Fear of hypoglycemia for children with diabetes influences parental life and could increase parental stress. The present study aimed to explore the association between resilience, the self-perception of the parental role, and fear of hypoglycemia in mothers of children with type I diabetes (T1DM). METHODS: Ninety mothers (mean age: 44.20 years) of children with a T1DM diagnosis (mean age: 11.48 years) were recruited from an association for parents and completed an online self-report questionnaire packet that includes: Fear of Hypoglycemia Survey, Self-Perception of the Parental Role and Resilience Scale for Adults. Participants were recruited in 2017. Data collection lasted 10 months. Data analysis was performed using the SPSS statistical package, version 22, and the PROCESS macro program by Hayes. RESULTS: The analysis of the mediation model shows that resilience assumes a mediational role in the relationships between the parental role and preoccupation with hypoglycemia. In particular, the mother's perceived competence and role balance can influence the development and increase of the mother's resilience, which in turn can allow a decrease in the mother's worry about the possible hypoglycemic episode of her child. CONCLUSION: The findings suggest that resilience is a significant topic to focus on in interventions designed to increase the self-perception of the parental role and reduce fear of hypoglycemia in mothers.

Gender matters and the challenge for improving community health and well-being.

The present paper introduces present issue focused on community gender perspective and health in an Italian context. After a brief analysis of the disparity and inequity that persist in Europe and Italy, we present six papers from different Italian regions that demonstrate different elements of the complex gender matters and challenges of well-being and health in the community. Considering the differences in social vulnerability and risk between men and women, the unequal power relationships between the sexes could improve the efficacy of intervention and preventative actions. Through this series of papers, we aim to contribute to the debate about how gender perspective can shape studies and interventions that promote both individual and community health and well-being. Gender, one of the key determinants of health, is revealed in many ways; it is necessary to better understand and plan health service interventions to improve the health of women and men. Furthermore, more attention and reflection are needed to promote policy interventions for health and to consider the contribution of women to the health of the community.

Challenging gender perspective in the community to promote well-being and health.

The community is an excellent potential arena in which to challenge gender perspective and change power structures in society because of its pivotal role in socializing gender and shaping social context. The community influences the availability of positive and negative role models, the accessibility of specific settings, the ease with which relationships are formed, and a variety of emotions and attitudes. The literature shows that paying attention to gender equity affects numerous indicators of community well-being. Attention to gender equity makes communities more competent, which creates human and social capital that enables community well-being. We will examine the role of gender not only as a social construction but also as a context to create a healthy setting in the community and to promote the health and wellness of gender perspectives in the scientific domain, which seems resistant to change.

Psychological well-being and healthy communities: Women as makers of relational well-being by social street strategies.

This paper presents a Social Street experience born of the perception of a lack of solidarity among neighbors and the desire to create a new neighborhood model. The goal was to explore the Social Street phenomenon through the relationship between individuals and their community. Furthermore, the goals include promoting the awareness of the critical issues of the territory to activate empowerment and change, analyzing the effectiveness of Social Street through the study of social networks, and investigating differences in social participation and in social cohesion. The most relevant result is that gender emerges as a context variable because Social Street members are mostly women. In fact, the role of women is relevant in structuring relational contexts and improving community networks and relationships.

How Could Self-Determination Theory Be Useful for Facing Health Innovation Challenges?

This paper offers a presentation of the characteristics of self-determination theory (SDT) in the health context as well as attempts to identify how this theory could be useful for facing health innovation challenges. Health innovation is based on scientific advances that have more complex relationships with health. This paper encourages the use of the SDT approach to face health innovation, both for physiological and pathological processes. In particular, the focus is on the changes and lifestyle choices related to physiological pregnancy and birth and to oncological genetic tests in the Italian context. The health innovation paradigm focuses on patients taking responsibility for making important health-related choices, and we think that SDT can offer new stimuli in light of the changes implemented from innovations in the field of health. The aim is that this manuscript will stimulate researchers to test the potential of this theory in the field of changing health-related processes. Practitioners are called upon to revise their orientation toward patients and, according to SDT, they should support autonomy rather than control the promotion of health-related change.

The Caregiving Experiences of Fathers and Mothers of Children With Rare Diseases in Italy: Challenges and Social Support Perceptions.

Family caregiving is a growing phenomenon with the increased prevalence of chronic illness and shorter hospitalizations. Rare diseases pose significant challenges not only to patients living with these kinds of pathologies but also to those who care for these patients. The caregiving role has specific characteristics. The present work aims to increase knowledge of the challenges that are common or specific to fathers and mothers of children diagnosed with a rare disease. Moreover, the paper analyses the kinds of social support they experience according to gender. A descriptive study was conducted using grounded theory methodology. A semi-structured interview with open-ended questions was conducted with 15 parents of children with a rare disease. The interview was organized into three main areas: personal experiences in caring for a child with a rare disease, family changes and perceived social support. The transcriptions were analyzed using NVivo 11 software. From data analysis, themes emerged regarding the challenges shared by fathers and mothers, but some aspects also emerged that were gender-specific. The analyses of differences between mothers' and fathers' narratives showed that there is a specific experience of the impact that caregiving has on parents' relationships with their jobs and on their worries. Self-help group is the main source of social support for all respondents. We discuss these findings in relation to possible appropriate specific interventions and support for family caregiving.

A qualitative study on decision-making about BRCA1/2 testing in Italian women.

OBJECTIVE: In the era of cancer panel testing, new models of genetic counselling providing effective decision-making support are needed. As little is known about Southern European patients' and families' needs and experiences in this regard, we explored Italian women's experiences of clinical BRCA1/2 counselling and testing. METHODS: We interviewed 19 Italian women with a strong family history but no personal history of cancer who had had clinical BRCA1/2 testing. Interviews were recorded and transcribed, and qualitative data were organised into themes. RESULTS: Most respondents had decided to pursue testing before pre-test counselling. Although half the sample reported having reached the decision without thinking through its implications, most participants qualified their choice as unequivocally "the right one." CONCLUSION: A subset of Italian women may arrive at their first cancer genetic consultation having already made a firm decision about testing. To empower women's decision-making, new models of cancer genetic counselling could usefully take into account differences in how they approach the testing process. This includes understanding decision-making from different cultural perspectives. In familistic countries like Italy, for example, decisional support may involve exploring widely shared assumptions regarding responsibilities towards family members and the prioritisation of family over self.

Family Acculturation in Host and Immigrant Couples: Dyadic Research in an Italian Context.

The purpose of this research is to study acculturation strategies and attitudes in central and peripheral domains of host and immigrant couples in an Italian context. The participants were 60 dyads (30 host couples and 30 immigrant couples) who completed a questionnaire based on the Relative Acculturation Extended Model (RAEM). Based on the analysis, we found that the general acculturation attitude preferred by immigrant couples is integration, and Italian couples prefer that immigrants adopt it. Furthermore, Italian partners show moderate internal agreement, whereas immigrant couples show a high degree of agreement. In both groups, the level of agreement between dyadic members is only partially determined by their membership within a social group. The socio-cultural context has a significant role in the internal similarity of Italian couples. In contrast, there is dyadic agreement within immigrant couples.

Domestic Violence in Separated Couples in Italian Context: Communalities and Singularities of Women and Men Experiences.

Relationship breakdown and separation represent a critical aspect in domestic violence. Few studies have investigated domestic violence in separated couples. Moreover, there is a need for a more in depth analysis of gender differences that could enhance the comprehension of the phenomenon. The primary aim of this research was to analyze, through a qualitative approach, which kinds of domestic violence are characteristic or major in separated couples in the Italian context, where this phenomenon has not yet been sufficiently investigated. Participants are 60 separated couples (mean age: M = 48; F = 44) who attended a Family Mediation Center. A descriptive study was conducted using grounded theory methodology. A brief narrative task was administered to both ex-partners separately. The transcriptions were analyzed using NVivo 11 software. From data analysis, some themes emerged regarding typology of domestic violence specific of the separation context and shared by both men and women. The analyses of gender differences showed that there is a gender specific experience of domestic violence. Results highlight that women narrate both physical and psychological violence, while men relate only psychological abuse focused on limiting access to children. We discuss these findings in relation to possible appropriate gender specific intervention and prevention efforts.