Caring for people with intellectual disabilities: Insights from a cross-sectional study among nursing students.

BACKGROUND: Caring for people with intellectual disabilities poses substantial challenges. Nursing students' emotions, thoughts, and behaviors during their education in the context of people with intellectual disabilities, remain relatively unexplored. OBJECTIVES: To examine nursing students' emotions, thoughts, competence, and expected professional behaviors in care provision for people with intellectual disabilities, as well as to identify factors associated with their expected professional behaviors with this population. DESIGN: A cross-sectional study using a closed self-report questionnaire and one open-ended question. SETTING: The largest academic nursing department in Israel. PARTICIPANTS: Of 245 sophomore nursing students, 177 agreed to participate (71.4 % response rate). METHODS: The study measured feelings, thoughts, competence, and expected professional behaviors in care provision for people with intellectual disabilities based on the Multidimensional Attitudes Scale. One open-ended question addressed how students believe their competence in caring for people with intellectual disabilities could be improved during their nursing studies. A hierarchical linear regression analysis was performed to investigate the contribution of emotions, thoughts, and competence to explaining expected behaviors in care provision. The significance of the model and the R2 were calculated. The open-ended question was analyzed by the constant comparative method. RESULTS: Negative emotions and thoughts (ß = -0.37, 95 % CI -0.47; -0.15 and ß = -0.33, 95 % CI -0.39; -0.13, respectively), along with positive emotions (ß = 0.25, 95 % CI 0.07;0.33), showed significant associations with expected professional behaviors. Qualitative analysis revealed three key themes: communication concern, knowledge gap, and curiosity. The findings of the open-ended question corroborate the quantitative findings. CONCLUSION: It is important to realize that in order to develop quality professional skills for caring for people with intellectual disability, nursing educators must adopt a deep discussion of negative emotions and thoughts with their students regarding people with intellectual disabilities. Ignoring these negative emotions and thoughts can exacerbate the neglect of people with intellectual disabilities' health needs.

Perceived Threat of Alzheimer's Disease and Related Dementias Among Chinese Family Caregivers of Older Adults with Cognitive Impairment.

Perceived threat of Alzheimer's disease and related dementias (ADRD) has been found a widespread phenomenon in developed countries, but has not yet been fully explored in developing countries. Analyzing data from 300 family caregivers of older adults with cognitive impairment in China, this study found caregiver burden was positively associated with the perceived threat of ADRD, and this association was buffered by higher family income and longer caregiving time. To alleviate undue ADRD concerns, it suggests expanding respite care and community elder care beds, and initiating education programs on reducing unnecessary worries about developing ADRD.

Neural patterns associated with mixed valence feelings differ in consistency and predictability throughout the brain.

Mixed feelings, the simultaneous presence of feelings with positive and negative valence, remain an understudied topic. They pose a specific set of challenges due to individual variation, and their investigation requires analtyic approaches focusing on individually self-reported states. We used functional magnetic resonance imaging (fMRI) to scan 27 subjects watching an animated short film chosen to induce bittersweet mixed feelings. The same subjects labeled when they had experienced positive, negative, and mixed feelings. Using hidden-Markov models, we found that various brain regions could predict the onsets of new feeling states as determined by self-report. The ability of the models to identify these transitions suggests that these states may exhibit unique and consistent neural signatures. We next used the subjects' self-reports to evaluate the spatiotemporal consistency of neural patterns for positive, negative, and mixed states. The insula had unique and consistent neural signatures for univalent states, but not for mixed valence states. The anterior cingulate and ventral medial prefrontal cortex had consistent neural signatures for both univalent and mixed states. This study is the first to demonstrate that subjectively reported changes in feelings induced by naturalistic stimuli can be predicted from fMRI and the first to show direct evidence for a neurally consistent representation of mixed feelings.

Causal relationship between feelings and cognitive decline: An univariable and multivariable Mendelian randomization study.

BACKGROUND: While the impact of depression on cognition is well-documented, the relationship between feelings and cognition has received limited attention. AIM: To explore the potential association between feelings and cognition with a two-sample Mendelian randomization (MR) analysis. METHODS: Our analysis utilized genome-wide association data on various feelings (fed-up feelings, n = 453071; worrier/anxious feelings, n = 450765; guilty feelings, n = 450704; nervous feelings, n = 450700; sensitivity/hurt feelings, n = 449419; miserableness, n = 454982; loneliness/isolation, n = 455364; happiness, n = 152348) in the European population and their impact on cognitive functions (intelligence, n = 269867). Conducting a univariable MR (UVMR) analysis to assess the relationship between feelings and cognition. In this analysis, we applied the inverse variance weighting (IVW), weighted median, and MR Egger methods. Additionally, we performed sensitivity analysis (leave-one-out analysis), assessed heterogeneity (using MR-PRESSO and Cochran's Q test), and conducted multiple validity test (employing MR-Egger regression). Subsequently, a multivariable MR (MVMR) analysis was employed to examine the impact of feelings on cognition. IVW served as the primary method in the multivariable analysis, complemented by median-based and MR-Egger methods. RESULTS: In this study, UVMR indicated that sensitivity/hurt feelings may have a negative causal effect on cognition (OR = 0.63, 95%CI: 0.43-0.92, P = 0.017). After adjustment of other feelings using MVMR, a direct adverse causal effect on cognition was observed (ORMVMR = 0.39, 95%CI: 0.17-0.90, PMVMR = 0.027). While a potential increased risk of cognitive decline was observed for fed-up feelings in the UVMR analysis (ORUVMR = 0.64, 95%CI: 0.42-0.97, PUVMR = 0.037), this effect disappeared after adjusting for other feelings (ORMVMR = 1.42, 95%CI: 0.43-4.74, PMVMR = 0.569). These findings were generally consistent across MV-IVW, median-based, and MR-Egger analyses. MR-Egger regression revealed pleiotropy in the impact of worrier/anxious feelings on cognition, presenting a challenge in identifying the effect. Notably, this study did not demonstrate any significant impact of guilty feelings, nervous feelings, miserableness, or loneliness/isolation on cognition. Due to a limited number of instrumental variables for happiness, this study was unable to analyze the relationship between happiness and cognition. CONCLUSION: This MR study finds that sensitivity/hurt feelings are associated with cognitive decline, while the link between worrier/anxious feelings and cognition remains inconclusive. Insufficient evidence supports direct associations between happiness, guilty feelings, nervous feelings, miserableness, loneliness/isolation, and cognition.

Exposure to heat wave risks across time and places: Seasonal variations and predictors of feelings of threat across heat wave geographical susceptibility locations.

Vulnerability to heat waves and their negative effects on health vary not only due to individual factors but also due to situational factors, such as time and geography. Hence, we explored seasonal variations and predictors of heat wave feelings of threat across different heat wave geographical susceptibility locations in Portugal. A total of 238 Portuguese residents responded to a web-based longitudinal survey: before the summer, during a heat wave in the summer, during the summer, and after the summer. Geographical location was used as an indicator of risk exposure, operationalized as heat wave occurrence susceptibility (low, moderate, high). Heat wave demands and resources perceptions were assessed to compute an indicator of heat wave feelings of threat. During the heat wave, feelings of threat were higher among participants in high-susceptibility locations, with demands outweighing resources perceptions, suggesting greater distress and coping difficulty. Regression analysis suggested that older participants and female participants living in moderate-high-susceptibility locations had greater difficulty in recovering. Heat wave risk perception and positive affect about heat were identified as the most consistent predictors of heat wave feelings of threat, with risk perception increasing and positive affect decreasing such feelings. Participants with (individual and geographical) vulnerability profiles, who had greater difficulty in coping and recovering from heat waves, could benefit from resource-building/enhancing interventions. In a climatic crisis context, monitoring psychological responses to heat waves (e.g., threat) may enable anticipated action to build resilience before, rather than after, the effects become damaging to physical and psychological health.

The sensual cell: Feeling and affect in unicellular species.

Our previous efforts to probe the complex, rich experiential lives of unicellular species have focused on the origins of consciousness (Reber, 2019) and the biomolecular processes that underlie sentience (Reber et al., 2023). Implied, but unexplored, was the assumption that these cognitive functions and associated unicellular organismal behaviors were linked with and often driven by affect, feelings, sensual experiences. In this essay we dig more deeply into these valenced (We're using the term valence here to cover the aspects of sensory experiences that have evaluative elements, are experienced as positive or negative ─ those where this affective, internal representation is an essential element in how the input is interpreted and responded to.) self-referencing features. In the first part, we examine the empirical evidence for various sensual experiences that have been identified. In the second part, we look at other features of prokaryote life that appear to also have affective, valenced elements but where the data to support the proposition aren't as strong. We engage in some informed speculation about these phenomena.

Role of child demographic, executive functions, and behavioral challenges on feelings about parenting among parents of youth with Down syndrome.

BACKGROUND: Living with a child with Down syndrome (DS) influences the entire family, including caregivers. AIMS: This study examined positive and negative caregiver feelings about parenting youth with DS and to what extent children's demographic, cognitive, behavioral characteristics, and co-occurring medical conditions are associated with those parental feelings. Specifically, the mediatory role of child behavioral challenges on the relationship between child executive functioning (EF) and parent feelings about parenting a child with DS was examined in a mediation analysis model. METHODS AND PROCEDURES: Parents of 113 youth with DS aged 6 to 17 year rated their positive and negative feelings about parenting, and their child's behavioral challenges and EF. OUTCOMES AND RESULTS: Externalizing and Internalizing behavioral challenges and emotional and behavioral regulations of EF were significantly associated with positive and negative parent feelings. Child behavioral challenges fully mediated the relationship between child EF and caregiver feelings about parenting, after controlling for identified covariates of child demographics. CONCLUSIONS AND IMPLICATIONS: Findings have implications for understanding the role of EF, through its impact on behavioral challenges, on the feelings of caregivers about parenting a child with DS. These findings play a role in understanding outcomes of interventions targeted at EF and behavioral challenges, in the context of other child variables.

Feeling safe together vs. longing for touch. Affective, multisensorial contact in inclusive intra-active virtual/physical dance during the COVID-19 pandemic.

This article explores how feelings of safety were experienced through inclusive virtual/physical dance in relation to experiences of touch during the COVID-19 pandemic in Finland. The following are the measures I took to achieve the aim of this study. First, I introduce the context through previous studies and an example from the ethnographic material I gained from the inclusive X-Dance festival organized in June 2021 in Finland. Second, I explore how inclusive virtual/physical dance might help us experience feelings of safety through multisensorial experiences of touch related to communality when responding to wellbeing challenges caused by isolation. Using Laura U. Mark's theory about haptic looking and Karen Barad's term intra-action, I discuss different possibilities to approach touch as a feeling sense, as affective multisensorial contact, and through relations between different materialities. Third, I contrast these ideas with sensations of longing for the physical touch that virtual/physical dancing evokes. These experiences of longing invite me to reflect on the ambivalence about feelings of safety related to intentions to restore experiences of touch and communality through digitality. I introduce two examples from my interviews with dancers during the pandemic to discuss these ambivalences. I reflect on these interviews through Magdalena Górska's theory about corpo-materiality and corpo-affectivity. I contribute to discussions on feelings of safety by showing that multi-sensorial experiences and anti-normative understandings of body and touch enabled by the non-verbal language of dance may help us to contribute toward more inclusiveness in society, allowing us to generate holistic experiences of safety, which is another critical aim for post-pandemic times.

A good life with psychosis: rate of positive outcomes in first-episode psychosis at 10-year follow-up.

BACKGROUND: More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap. METHODS: FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year). RESULTS: In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none. CONCLUSIONS: In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.

Feelings of tense and risk of incident dementia: A prospective study of 482,360 individuals.

BACKGROUND: The relationship between feelings of tense, as a significant emotional distress, and dementia remains unclear. This study aimed to evaluate the association between feelings of tense and dementia. METHODS: In UK Biobank, feelings of tense were measured with a standard item. The primary outcome was all cause of dementia (ACD) and its subtypes (Alzheimer's disease (AD), vascular dementia (VD), and other dementia). Cox regression models analyzed the association between feelings of tense and dementia risk, while linear regression examined the correlation with neuroimaging outcomes. The potential association and joint effects of AD and tenseness were evaluated based on the established genetic risk score (GRS). RESULTS: During a median follow-up of 12.7 years among 482,360 participants, 7331 dementia cases were identified. Individuals with feelings of tense had a significantly increased risk of ACD (HR, 1.194; 95 % CI: 1.115-1.278), VD (HR, 1.164; 95 % CI: 1.007-1.346), and other dementia (HR, 1.181; 95 % CI: 1.081-1.289), but not AD in multi-adjusted models. This association persisted across various sensitivity analyses and exhibited some heterogeneity in subgroup analyses. Furthermore, feelings of tense are associated with total brain volume shrinkage, higher white matter hyperintensities, and decreased partial subcortical volume, particularly in the hippocampus. No interaction between tenseness and AD genetic susceptibility was observed (P for interaction =0.346). LIMITATIONS: Our study only considered feelings of tense measured at a one-time point. CONCLUSIONS: Our findings demonstrate a significant association between feeling of tense and elevated dementia risk, indicating that tenseness could serve as a modifiable psychological determinant for dementia.

Well-being in institutionalised adolescents.

BACKGROUND: For adolescents who have criminal convictions, achieving a positive progress including desistance from offending may depend on a sense of well-being. Factors associated with growth in well-being are not widely researched, but there is some work that suggests that qualities in other internal states as well as in the environment may foster well-being. AIMS: To examine the well-being of young male incarcerated offenders, and its relationship with frequency of contacts with the family, perceptions of socio-educational environment, feelings about the future and self-efficacy. METHODS: Participants were recruited from three secure education institutions in the Federal District of Brasília, Brazil, under the management of the Secretariat of Justice. They were invited to complete anonymous self-report questionnaires, which included the Psychological Well-Being Scale, the Perception of the Socio-Educational Environment Scale, the Feelings about the Future Scale and the Multidimensional Scale of Perceived Self-Efficacy, and to provide limited sociodemographic data. RESULTS: 195 young male offenders participated and their mean age was 16.8 years (SD = 1.58, range 14-20). There was a positive correlation between well-being and perceptions of the socio-educational environment, positive feelings about the future and self-efficacy self-ratings. Multiple linear regression analyses confirmed that the frequency of family contacts, positive perceptions of the socio-educational environment, positive feelings about the future, and self-efficacy in leisure and social activities independently contributed to the well-being of young offenders. CONCLUSION: Although well-being has been associated with desistance from committing crimes, the factors that may predispose to well-being have been researched less and never before examined among inmates in Brazil. While longitudinal work is needed to be certain of the direction of the relationship, the fact that the results are broadly consistent with a similar study carried out on the other side of the world is encouraging in terms of indicating ways forward in rehabilitation. It is necessary to develop interventions that support family relationships and promote personal relationships and personal development, not only of useful skills but also of personal confidence in those skills.

Human aggression in everyday life: An empirical test of the general aggression model.

With the general aggression model (GAM), Anderson and Bushman (2002) provided an integrative framework to explain the complex nature of aggression. Based on the GAM, we examined whether personological and situational factors (interactively) have an impact on the person's internal state (consisting of aggressive cognition, affect, and physiological arousal), which in turn is assumed to lead to aggressive behaviour. In a large-scale experience sampling study, 403 participants answered 7558 questionnaires over a period of 2 weeks. As hypothesized, participants were more likely to exhibit an aggressive internal state the higher they scored on antagonistic personality traits (trait aggression, narcissism, psychopathy, sadism, anger rumination) and the more interpersonal, intrapersonal, and environmental triggers they experienced. Aggressive behaviour was positively related to trait aggression, psychopathy, sadism, anger rumination, and all situational triggers. Furthermore, the impact of antagonistic personality traits and situational triggers on aggressive behaviour was considerably reduced when the aggressive internal state was taken into account. Contrary to predictions, the relationship between antagonistic personality traits and the aggressive internal state was most pronounced when situational triggers were low. Overall, however, the process by which personal and situational variables predict aggression in daily life can be well explained by the GAM.

Evaluation of mailed results versus telephone disclosure of normal cancer genetic test results in a low-risk underserved population.

Scalable models for result disclosure are needed to ensure large-scale access to genomics services. Research evaluating alternatives to genetic counseling suggests effectiveness; however, it is unknown whether these findings are generalizable across populations. We assessed whether a letter is non-inferior to telephone genetic counseling to inform participants with no personal or family history of cancer of their normal results. Data were collected via self-report surveys before and after result disclosure (at 1 and 6 months) in a study sample enriched for individuals from underserved populations. Primary outcomes were subjective understanding of results (global and aggregated) and test-related feelings, ascertained via three subscales (uncertainty, negative emotions, and positive feelings) of the Feelings About genomiC Testing Results (FACToR) measure. Secondary outcomes related to satisfaction with communication. Non-inferiority tests compared outcomes among disclosure methods. Communication by letter was inferior in terms of global subjective understanding of results (at 1 month) and non-inferior to telephoned results (at 6 months). Letter was non-inferior to telephone for aggregated understanding (at 6 months). Letter was superior (at 1 month) to telephone on the uncertainty FACToR subscale. Letter was non-inferior to telephone on the positive-feelings FACToR subscale (at 6 months). Letter was non-inferior to telephone for satisfaction with mode of result delivery and genetic test results. Communication via letter was inferior to telephone in communicating the "right amount of information." The use of written communication to relay normal results to low-risk individuals is a promising strategy that may improve the efficiency of care delivery.

Genetic counseling services delivered in the usual way­during clinic visits­can take up a lot of time for patients and genetic counselors. Alternatives to this practice have been studied among genetic counseling patients to spare genetic counselors' time and expand access and flexibility for patients. Yet, in these studies, the participants have lacked diversity. So, it is not known how these research findings pertain to all populations. In this study, we looked at the use of an alternative care model, a mailed letter, for sharing normal genetic test results with study participants from underserved populations. We tested whether patients viewed the mailed letter as no worse than a telephone conversation with a genetic counselor, which has been shown to be well received by patients. We learned that study participants felt they understood their results, were not distressed to receive the results, and were satisfied with how their results were delivered. Lastly, we found that participants were more satisfied with the amount of information provided about their test results during the telephone conversation compared with the mailed letter. This study provides new information about different ways to deliver test results to individuals receiving genetic services.

Metacognitive Feelings: A Predictive-Processing Perspective.

Metacognitive feelings are affective experiences that concern the subject's mental processes and capacities. Paradigmatic examples include the feeling of familiarity, the feeling of confidence, or the tip-of-the-tongue experience. In this article, we advance an account of metacognitive feelings based on the predictive-processing framework. The core tenet of predictive processing is that the brain is a hierarchical hypothesis-testing mechanism, predicting sensory input on the basis of prior experience and updating predictions on the basis of the incoming prediction error. According to the proposed account, metacognitive feelings arise out of a process in which visceral changes serve as cues to predict the error dynamics relating to a particular mental process. The expected rate of prediction-error reduction corresponds to the valence at the core of the emerging metacognitive feeling. Metacognitive feelings use prediction dynamics to model the agent's situation in a way that is both descriptive and directive. Thus, metacognitive feelings are not only an appraisal of ongoing cognitive performance but also a set of action policies. These action policies span predictive trajectories across bodily action, mental action, and interoceptive changes, which together transform the epistemic landscape within which metacognitive feelings unfold.

The Role of Dietary Ingredients in Mental Energy - A Scoping Review of Randomized Controlled Trials.

Low mental energy can contribute to decreased productivity, altered life balance, decreased physical performance, and ultimately affect quality of life. As such, there is a great demand for food and beverage products that positively impact mental energy. Numerous products claim to alter mental energy making continued review of the scientific evidence critical. The objective of this study was to conduct a scoping review of randomized controlled trials to evaluate the effect of 18 dietary ingredients on mental energy outcomes in adults without severe disease. Methods: A literature search, completed using PubMed, resulted in the identification of 2261 articles, 190 of which met eligibility from initial abstract review. Full-text review was completed on the 190 studies which resulted in 101 articles that fully met eligibility for inclusion in this study. The search strategy for two ingredients did not yield any eligible studies, leaving studies for 16 ingredients that were extracted and summarized by reported significantly improved outcomes for cognition, mood and perceived feelings, and sleep assessments. The preliminary results for several dietary ingredients directionally suggested a mental energy benefit (≥20% of outcomes), including ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, tart cherries, turmeric, and valerian root. The results of this scoping review suggest that of the 16 dietary ingredients reviewed, 11 may be promising for further exploration on their potential benefits in supporting mental energy. Given consumer demand and market growth for food and beverage products that positively impact mental energy; continued efforts in assessment method alignment and additional evaluation in well-designed trials is warranted.KEY TEACHING POINTSOf the 16 dietary ingredients reviewed, 11 (ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, melatonin foods, turmeric, and valerian root) may be promising for further exploration on their potential mental energy benefits.Dark chocolate, ginseng, ashwagandha, and lion's mane mushroom were the most promising ingredients for further evaluation in the cognition domain of the ingredients evaluated.Turmeric, maca, lavendar, and ashwagandha were the most promising ingredients for further evaluation in the mood and perceived feelings domain of the ingredients evaluated.Ashwagandha, chamomile, green tea, melatonin foods, valerian root were the most promising ingredients for further evaluation in the sleep domain of the ingredients evaluated.Additional, well-designed, consistent, clinical trials and systematic reviews are warranted as the challenge of heterogeneity in mental energy study design remains.

NEOS: An odour-induced affect scale for use in the cosmetic industry.

This work proposes an odour-induced affect scale for use in the cosmetic industry that relies on the approach that produced the UniGEOS, a universal odour-related emotional scale from the Swiss Center for Affective Sciences. The Natura Emotion and Odor Scale (NEOS) was built on experiments conducted with a larger set of participants (491) and a set of 35 scents that combine seven commercial perfumes from Natura & Co cosmetic company with 28 odours from different olfactory classes important for the cosmetic industry. The results showed the stability of 60 Emotion-Related terms in Brazilian Portuguese split into five emotion-related dimensions: Romance, Attention, Energy, Well-being and Negative feelings. The association of the scents evoking these five dimensions has direct implications in the design of new products.

Ce travail propose une échelle d'affect induite par des odeurs passible d'être utilisée dans l'industrie cosmétique. Cette échelle s'appuie sur l'approche qui a produit l'UniGEOS, une échelle affective universelle liée aux odeurs du Swiss Center for Affective Sciences. L'échelle Natura Emotion and Odor Scale (NEOS) a été construite sur la base d'expériences menées avec un plus grand nombre de participants (491) et un ensemble de 35 arômes combinant sept parfums commerciaux de la compagnie Natura & Co avec 28 odeurs de différentes classes olfactives importantes pour l'industrie cosmétique. Les résultats ont montré la stabilité de 60 termes liés aux émotions en portugais brésilien, répartis en cinq dimensions liées aux émotions : Romance, Attention, Énergie, Bien-être et Sentiments négatifs. L'association des arômes évoquant ces cinq dimensions a des implications directes dans la conception de nouveaux produits.

Validating a Caregiving Rewarding Feelings scale among family caregivers of those diagnosed with schizophrenia in China.

INTRODUCTION: A culturally adaptive and easy-to-administer 12-item Caregiving Rewarding Feelings (CRF) scale has been developed in China yet never published in English and validated in another population. AIM: The current study aimed to validate the CRF among a community sample of Chinese caregivers of those diagnosed with schizophrenia. METHOD: A sample of 449 family caregivers was recruited for scale validation that included factorial validity, construct validity, measurement invariance, item analysis, internal consistency reliability, test-retest reliability, known-group validity, convergent validity and divergent validity. RESULTS: Confirmatory factor analysis supported the a priori three-factor structure. Construct validity was supported by high standard regression weight (SRW) and average variance extracted (AVE), measurement invariance across age and gender groups. The CRF showed good internal consistency and test-retest reliability. Known-group validity was confirmed by the higher CRF scores among caregivers with certain socio-demographics. The convergent validity of the CRF was supported by its positive correlations with social support, active coping and family functioning. The divergent validity of the CRF was supported by its negative associations with stigma, stress and depressive symptoms. CONCLUSIONS: This study confirmed the reliability and validity of the CRF specifically designed for caregivers in Chinese culture. IMPLICATIONS FOR PRACTICE: The CRF may be further applied and validated in other populations and other countries.

Patients' recollections of helmet-CPAP treatment during COVID-19 pandemic: A qualitative study.

BACKGROUND: During the pandemic outbreak, helmet continuous positive airway pressure (CPAP) was widely used as respiratory support for COVID-19 patients, inside and outside of intensive care units. The available literature suggests specific interventions to improve the comfort of patients treated with helmet-CPAP. Few reports are available on the experiences of patients undergoing this treatment. AIM: This qualitative study aimed to explore the views and recollections of COVID-19 patients undergoing helmet-CPAP. STUDY DESIGN: We conducted semi-structured interviews with thematic analysis. Participants were recruited from the follow-up programme for COVID-19 patients discharged from an Italian general intensive care unit. Participants were interviewed by telephone. Data analysis followed the principles of thematic synthesis approach. FINDINGS: We conducted 29 phone calls in patients eligible for the study. Five participants declared that they did not remember the time spent in hospital on helmet-CPAP. Twenty-four patients were then included. Two themes and six subthemes were generated from their interview data: (1) The helmet-CPAP as a life-saving treatment (subthemes: recognition of the usefulness of treatment and resilience); (2) the negative feelings related to helmet-CPAP application (subthemes: communication problems, entrapment, mental confusion, fear of dying). Each patient's experience was unique, but some discomfort elements such as noise, gas flow turbulence, choking sensation and thirst were found to be very common. CONCLUSIONS: The application of helmet-CPAP treatment generated positive and negative memories and feelings in COVID-19 patients during the pandemic. The patients' experience has provided an overview of the main factors of discomfort. This can be a starting point for taking corrective measures to promote greater helmet tolerance and subsequent treatment success. RELEVANCE TO CLINICAL PRACTICE: This study has provided an insight into the patient's recollections about helmet-CPAP treatment during a worldwide pandemic. The findings suggested strict applications of interventions aimed to reduce some issues that participants reported, to improve their compliance to treatment. Results from this study could help nurses in understanding the needs of patients treated with helmet-CPAP and may foster a care focused on patient-centred outcomes.

Situações difíceis e sentimentos no cuidado paliativo oncológico / Difficult situations and feelings in palliative oncology care / Situaciones difíciles y sentimientos en el cuidado paliativo oncológico

O ato de cuidar cotidianamente de pessoas com dor, falta de ar e em morte iminente pode potencializar situações difíceis para profissionais da área. Contudo, raramente são discutidas nos serviços e no processo de formação profissional. Objetivou-se, então, analisar situações difíceis e sentimentos que emergem do cuidado de saúde. Esta é uma pesquisa de perspectiva fenomenológica e qualitativa, baseada em 30 situações difíceis de profissionais de saúde que atuam exclusivamente no cuidado paliativo oncológico. As entrevistas foram realizadas de agosto de 2019 a fevereiro de 2020. Os resultados mostram que as principais dificuldades foram motivadas pela identificação (quando o profissional vê semelhança com o paciente que cuida), morte ruim (com sofrimento), quando o paciente era jovem, morte de mãe com filho pequeno e quando havia divergência entre o proposto pelo profissional e a recusa do paciente. Percebeu-se relação entre tipos de situações difíceis e categoria profissional. Os profissionais expressaram tanto sentimentos desagradáveis (tristeza, impotência, angústia, medo) quanto agradáveis (compaixão, gratidão). Os resultados mostram que o ocultamento do processo de morrer ao longo do desenvolvimento civilizatório transformou-o em tabu, angustiante inclusive para quem trabalha com cuidados paliativos. Contribuem, também, para mostrar uma importante dimensão subjetiva do cuidado, geralmente negligenciada, que gera sofrimento, mas também ressignificação. Para que alguém cumpra seu propósito, é necessário encontrar sentido no trabalho, possibilitado pela modificação do estado interno do profissional pela experiência, que gera transformação e novo significado e saber a partir da práxis.

The act of caring for people in pain, shortness of breath, and imminent death on a daily basis can intensify difficult situations for health professionals. However, difficult situations are rarely discussed in the services and in the professional training process. This study aimed to analyze difficult situations and feelings that emerge from healthcare. This is a phenomenological and qualitative study based on 30 difficult situations of health professionals who work exclusively in palliative oncological care. The interviews were conducted from August to February 2020. The results show that the main difficulties were motivated by identification (when the professional recognizes similarities in the patient they are caring for), a bad death (with suffering), caring for young patients, the death of a mother with a small child, and when there was a divergence between what the professional proposed and the patient's choice. There was a relationship between types of difficult situations and professional category. The professionals expressed both unpleasant feelings (sadness, impotence, anguish, fear) and pleasant feelings (compassion, gratitude). The results show that the concealment of the dying process throughout the societies' development turned it into a taboo, causing distress even in those who work in palliative care. They also show an important subjective dimension of care, usually neglected, which generates suffering, but also resignification. To properly provide care, health professionals must find meaning in the work, made possible by the modification of the their internal mindset via experience, which generates transformation, new meaning, and knowledge from praxis.

El acto de atender diariamente a personas con dolor, dificultad para respirar y muerte inminente puede potenciar situaciones difíciles para los profesionales del área. Sin embargo, casi nunca se discuten en los servicios y en el proceso de formación profesional. El objetivo fue analizar situaciones difíciles y sentimientos que emergen del cuidado de la salud. Investigación de perspectiva fenomenológica y cualitativa, basada en 30 situaciones difíciles de profesionales de la salud que actúan exclusivamente en el cuidado paliativo oncológico. Las entrevistas se realizaron entre agosto y febrero de 2020. Los resultados enseñan que las principales dificultades se motivaron por la identificación (cuando el profesional ve similitud con el paciente que atiende), mala muerte (con sufrimiento), cuando el paciente era joven, muerte de una madre con hijo pequeño y cuando hubo discrepancia entre lo propuesto por el profesional y el rechazo del paciente. Se observó una relación entre tipos de situaciones difíciles y categoría profesional. Los profesionales expresaron tanto sentimientos desagradables (tristeza, impotencia, angustia, miedo) como agradables (compasión, gratitud). Los resultados indican que ocultar el proceso de morir a lo largo del desarrollo de la civilización lo convirtió en un tabú e, incluso, es angustiante para las personas que trabajan con cuidados paliativos. También contribuye a mostrar una importante dimensión subjetiva del cuidado, generalmente ignorada, que genera sufrimiento, pero también resignificación. Para que cumpla con su propósito es necesario encontrar sentido en el trabajo, posibilitado por la modificación del estado interno del profesional a través de la experiencia, generando transformación y un nuevo significado y conocimiento a partir de la praxis.

Carlos Castilla del Pino: resistir, explorar, comunicar / Carlos Castilla del Pino: Resisting, Exploring, Communicating

A partir de una experiencia en común, se intenta resaltar alguna característica personal descollante de Carlos Castilla del Pino que le permitió resistir la atonía socio-cul-tural y profesional del franquismo y desarrollar, a pesar de todo, una vida profesional y teó-rica relevante. Tuvo que resistir esa atonía y amordazamiento de la larga noche de piedra y argamasa del franquismo en una ciudad de provincias duramente represaliada durante la guerra y posguerra civil española, dominada por tanto durante decenios por el fascismo institucional e ideológico. A pesar de ello, Carlos Castilla logró desarrollar una obra teórica (en especial en psicopatología, antropología e ideología) sumamente avanzada, coherente y arriesgada, para cuya compresión propongo un marco pragmático. El lema republicano, resistir es vencer, podría ser un buen resumen de su vida profesional y teórica, aunque es más dudoso que tal afirmación pueda tener el mismo valor para su vida personal. (AU)

Based on a common experience, we try to highlight some outstanding perso-nal characteristic of Carlos Castilla del Pino that allowed him to resist the socio-cultural and professional lethargy of Francoism and develop, despite everything, a relevant pro-fessional and theoretical life. To do so, he had to resist that lethargy and gagging of the long night of stone and mortar of Francoism and, on top of that, in a provincial city hars-hly retaliated during and after the Spanish civil war; therefore dominated for decades by institutional and ideological fascism. Despite this, Castilla del Pino managed to develop a highly advanced, coherent and risky theoretical work, especially in psychopathology, anthropology and ideology, for whose understanding I propose a pragmatic framework. The Republican motto, “to resist is to win”, could be a good summary of his professional and theoretical life, although it is more doubtful that such statement can have the same value for his personal life. (AU)