"Dancing on the edge of the abyss": Posttraumatic growth in men cancer survivors.

OBJECTIVE: Surviving cancer can lead to self-perceived beneficial changes and personal growth, commonly referred to as posttraumatic growth. However, the survivorship experience of men following cancer remains understudied. Thus, our objective was to obtain a comprehensive understanding of men's perceptions of the changes in their lives following cancer. METHODS: Twenty-four Israeli men who completed cancer treatment participated in five focus group meetings. Data analysis was performed using the thematic analysis method. RESULTS: Four themes were identified pertaining to both positive and negative changes in the men's lives following cancer: 1) negative manifestations of cancer survivorship; 2) changes in perceptions of life; 3) changes in perceptions of self; and 4) putting changes into action. CONCLUSION: Whereas earlier research indicated a minimal impact of cancer on men survivors' lives, this study demonstrates multidimensional changes in the lives of such men. Findings revealed a dialectic post-cancer experience that consisted of negative manifestations of cancer survivorship co-existing with positive developments in different aspects of the men's lives. Additionally, prioritizing one's self was a novel finding of the current study.

Well-being among parents of youth with multiple sclerosis: a preliminary longitudinal study.

Background: In 2021, the annual rate of pediatric-onset multiple sclerosis (POMS) in Israel among children was 1.5, and 4.5% among youth aged 14-18, out of a total of 5,000 multiple sclerosis cases nationwide. Children diagnosed with POMS often display various deficiencies across psychological, cognitive, sensory, and physical areas. As such, POMS poses significant challenges for parents' well-being, with heightened emotional, financial, and physical strains linked to both the immediate and long-term care requirements of their children. In this preliminary study, we examined changes over three time-points in two measures of well-being: satisfaction with life and psychological distress. In addition, the role of perceived social support (PSS) and coping flexibility was examined through a multilevel causal mediation model which suggested that PSS 1 month post-diagnosis would predict coping flexibility at 6 months post-diagnosis, which in turn would predict parents' life satisfaction and psychological distress at 12 months post-diagnosis. Methods: The research was conducted at a tertiary university-affiliated children's hospital in central Israel. Preliminary data were obtained from 36 parents at three times-points. Participants provided demographic information and filled out the following standardized self-report questionnaires: the Diener's Satisfaction with Life Scale, Kessler's inventory for measuring psychological distress (K6), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Perceived Ability to Cope with Trauma Scale (PACT) for measuring coping flexibility. Results: Over time (12 months), parents reported stable levels of PSS, coping flexibility, satisfaction with life, and psychological distress. In addition, mothers reported significantly greater PSS from friends than did fathers. Regarding the causal mediation model, greater PSS from friends at T1 was significantly associated with an increase in coping flexibility from T1 to T2. In turn, an increase in coping flexibility was associated with a decrease in psychological distress from T1 to T3 (after controlling for PSS). Yet the causal mediation path via coping flexibility to satisfaction with life was not significant. Conclusion: This preliminary study emphasizes the important role of both PSS and coping flexibility for the well-being of parents whose children are affected by POMS, a subject that merits heightened consideration among healthcare professionals dealing with long-term chronic diseases.

Perceived Social Support, Normalization, and Subjective Well-Being Among Family Members of a Child with Autism Spectrum Disorder.

The experience of family members of children with autism spectrum disorder (ASD) is not uniform. This study focused on mothers of a child with ASD (Study 1) and typically developing siblings (TDSs) during their emerging adulthood (Study 2). Similarities and differences were explored regarding a proposed model examining the paths of perceived social support (PSS) and normalization (a coping strategy) with subjective well-being: satisfaction with life (SWL) and positive affect (PA). Similarities were found in the paths between PSS, normalization, and SWL, in mothers and TDSs, but differences emerged regarding PA. These findings highlight the importance of PSS as a resource that contributes to normalization and SWL. Professional awareness of family members' PSS and their engagement in normalization is needed.

Adolescent siblings of children with cancer: Resource-based profiles, normalization, and search for meaning in life.

INTRODUCTION: Adolescent siblings of children with cancer jointly face the experience of having a brother or sister with cancer and being in the developmental period of adolescence themselves. Based on Hobfoll's conservation of resources theory, we aimed to identify profiles based on two distinct resources: sense of hope (personal resource) and perceived social support (social resource). Both have been found to be vital for optimal functioning during adolescence. Further, we examined differences in these profiles with regard to two distal outcomes: normalization (a coping strategy) and search for meaning in life (a commonly assumed adolescent developmental task). METHODS: One hundred and eleven Israeli adolescent siblings (aged 13-17) completed self-report measures. RESULTS: Two distinct resource-based profiles were identified: "high resources" and "low resources." Participants with "high resources" had a higher sense of hope and higher social support; were significantly more likely to live with married parents than with unmarried parents; had marginally fewer siblings; and scored higher on normalization and search for meaning in life than did participants with "low resources." CONCLUSIONS: The study outcomes highlight the essential role of resources for this population. Such resources seem to be helpful for normalization, a coping strategy whose focus is on facilitating regular family routines, and for the siblings' search for meaning in life. Practitioners who work with families in the context of childhood cancer should aim to help these siblings obtain key resources, such as social support, and to actively pursue their goals.

Coping with fibromyalgia - a focus group study.

PURPOSE: Fibromyalgia affects patients' quality of life. Therefore, an essential part of patients' medical management is to develop appropriate coping strategies. This study aimed to obtain a comprehensive picture of patients' cognitive and behavioural strategies to cope with fibromyalgia. METHODS: A qualitative design was conducted based on the grounded theory method. Two focus group discussion sessions were held with 15 Israeli women diagnosed with fibromyalgia. A constant comparative analysis method was utilized. RESULTS: The findings of themes related to women's coping with fibromyalgia included: Emotional coping, with two categories: (a) from repression and despair to acceptance and completion, and (b) a range of negative and positive emotions; Practical coping, with three categories: (a) the agonizing process of receiving/internalizing the diagnosis, (b) living with the symptoms, and (c) changing lifestyle; Coping with the social environment, with three categories: (a) sharing vs. concealing, (b) social connection-disconnection, and (c) environmental resources. In addition, we identified a theme on the patients' perceptions of the causes of their fibromyalgia that effect their coping, with three categories: (a) demanding lifestyle; (b) traumatic life events; and (c) personality trait-perfectionism. CONCLUSION: It would be desirable for rheumatology units to have an interdisciplinary professional team to work together with patients to consider how best to manage and effectively cope with their condition.

Psychological distress and perceived job stressors among hospital nurses and physicians during the COVID-19 outbreak.

AIMS: The study examined self-reported job-related stressors induced by the COVID-19 pandemic and psychological distress among hospital nurses and physicians. In addition, we explored the role of negative affect (NA) and background variables in relation to COVID-19-related job stressors and psychological distress. BACKGROUND: During COVID-19 pandemic, hospital nurses and physicians were exposed to highly enduring occupational stress, that stem from subjective appraisal of inadequate job resources (i.e., personal protection equipment, information on how to manage safely in the ongoing work and organizational attention to the needs arising from the ongoing work). DESIGN: Cross-sectional design. METHODS: Between May and July 2020, 172 nurses and physicians working at a medical centre in Israel filled in self-report questionnaires about sociodemographic data, COVID-19-related job stressors, psychological distress and NA. RESULTS: Our results confirmed the positive direct link between perceived COVID-19-related job stressors and psychological distress among hospital nurses and physicians. NA was found to serve as a mediator in this association (indirect link). Furthermore, nurses and physicians' seniority was related positively to psychological distress and also played a moderator role in the indirect link. CONCLUSION: We recommend to monitor the mental health of hospital nurses and physicians and to provide a platform to address their job stressor concerns related to COVID-19, and share helpful coping strategies. IMPACT STATEMENT: During the abrupt COVID-19 outbreak, hospital nurses and physicians face challenges that might raise NA and psychological distress. Our study revealed that among hospital nurses and physicians, COVID-19-related perceived job stressors and psychological distress were positively linked, and NA plays a mediating role in this association. Among nurses and physicians with moderate or high years of seniority (>11 years), higher COVID-19-related perceived job stressors associated with higher NA, which in turn was associated with greater psychological distress. Policymakers would be wise to provide a platform to address hospital nurses and physicians' mental health.

People who contracted COVID-19: the mediating role of shame and guilt in the link between threatening illness perception and mental health measures.

Background and Objectives: The COVID-19 pandemic has affected the mental health of a range of people, including healthcare workers, the general population, and COVID-19 patients. This study examined the psychological distress, negative affect, and positive affect of people who contracted COVID-19 in Israel, and their relation to threatening illness perception, guilt, and shame.Design: Cross-sectional design.Methods: Three hundred and fifty-one participants who had contracted COVID-19 completed self-report questionnaires assessing the study variables.Results: The results revealed a direct positive link between threatening COVID-19 illness perception and psychological distress and negative affect, and a negative link with positive affect. In addition, shame and guilt were significant mediators; namely, threatening COVID-19 illness perception was linked with negative affect via guilt, and with psychological distress, negative affect, and positive affect via shame.Conclusions: Illness perception, shame, and guilt may have a significant negative effect on the mental health of people who contracted COVID-19, and should be acknowledged and addressed by professionals.

"It's like we're at war": Nurses' resilience and coping strategies during the COVID-19 pandemic.

The sudden outbreak of the COVID-19 epidemic forced healthcare workers to use all their professional and personal skills to battle it. The unexpected onset of the disease has led to extraordinary pressure on healthcare workers and has challenged their resilience. The study aimed to explore the subjective experiences of 18 Israeli nurses who are directly treating COVID-19 patients, and to identify the sources of resilience used by nurses to address national health crises. The data were gathered via semi-structured interviews and thematically analyzed. The analysis yielded three central analytic themes that described the nurses' experiences during the pandemic: maneuvering between professional demands and personal-family life; the nurses' coping strategies and resilience; and nurses' use of metaphorical military language as a way of coping with the difficulties. The findings show that in a time of severe health crisis, and despite the fear of infection, nurses adhere to the values of the profession and are willing to fight the virus to save lives. The nurses' extensive use of military metaphorical language reflected their experiences, strengthened them, and provided them with a source of empowerment in the face of a common enemy that needed to be overcome.

Post-traumatic Growth in Inflammatory Bowel Disease Patients: The Role of Illness Cognitions and Physical Quality of Life.

BACKGROUND AND AIMS: The symptoms and complications associated with inflammatory bowel disease [IBD] have been found to be associated significantly with impaired health-related quality of life. Nevertheless, there may also be a positive psychological change such as post-traumatic growth, as was noted among patients with other chronic diseases, but this remains understudied in patients with IBD. In this study, we explored associations between post-traumatic growth and illness cognitions (helplessness, acceptance and perceived benefits). In addition, we evaluated whether physical quality of life in IBD patients mediates the link between illness cognitions and post-traumatic growth. METHODS: The study employed a cross-sectional design. Two hundred patients diagnosed with IBD completed questionnaires assessing illness cognitions, physical quality of life and post-traumatic growth. RESULTS: There was a negative association between illness cognition of helplessness and post-traumatic growth, and positive associations between illness cognitions of acceptance and illness cognitions of perceived benefits, and post-traumatic growth. In addition, the association between an illness cognition of helplessness and post-traumatic growth was mediated via physical quality of life. Yet, the signs of the direct and the indirect paths of an illness cognition of helplessness on post-traumatic growth were opposite. CONCLUSIONS: This study extends the literature on the role of illness cognitions as an important component in facilitating the process of post-traumatic growth among IBD patients. Based on the findings, the management of IBD patients should incorporate more interventions aimed at exploring cognitive aspects of the illness in order to improve physical quality of life and enhance personal growth.

Posttraumatic growth and burnout in pediatric nurses: The mediating role of secondary traumatization and the moderating role of meaning in work.

The current study focused on pediatric nurses. It explored the direct link between posttraumatic growth as a coping resource and burnout and the indirect link between posttraumatic growth and burnout via secondary traumatic stress (mediating effect). Moreover, meaning in work was examined as a moderator variable in relation to the direct link and the indirect link. One hundred and thirty-eight nurses working at a pediatric medical center filled out self-report questionnaires regarding personal and professional data, burnout, posttraumatic growth, secondary traumatic stress, and meaning in work. Posttraumatic growth was found to be a coping resource that linked to pediatric nurses' burnout directly and indirectly. Directly, there was an inverse correlation between the two; indirectly, posttraumatic growth linked negatively to secondary traumatic stress, and secondary traumatic stress linked positively to burnout. Moreover, meaning in work played a dual moderating role. First, it moderated the relationship between posttraumatic growth and secondary traumatization. Second, it moderated the direct relationship between posttraumatic growth and burnout, namely, the negative link between posttraumatic growth and burnout became stronger as meaning in work increased. As such, we recommend enhancing personal and professional posttraumatic growth, as well as designing interventions that promote meaningful work among pediatric nurses.

Children with epilepsy: assessing state anxiety through drawings and a self-report questionnaire.

BACKGROUND: Children and adolescents with epilepsy are at increased risk for anxiety disorder. The aim of this preliminary study was to examine children and adolescents' self-report on state anxiety by utilizing drawings and a structured questionnaire. METHOD: The sample consisted of 30 patients (7 - 13 years) diagnosed with epilepsy. Each participant was asked to complete self-report questionnaire and to draw two drawings: one depicting himself/herself today and one depicting himself/herself before the illness. RESULTS: The mean score of children and adolescents' state anxiety on the structured questionnaire was moderate, and the administration of the projective Draw-A-Person method added nonverbal approval to this result. CONCLUSIONS: The findings indicate that despite potential critiques and limitations of the use of figure drawings as a research tool, future studies can incorporate both art therapy assessments and psychometric measures to address psychosocial aspects of epilepsy in children and adolescent.

Burnout and perceived social support: The mediating role of secondary traumatization in nurses vs. physicians.

AIMS: The study aimed to examine differences between paediatric nurses and physicians regarding burnout syndrome, secondary traumatic stress (STS) and perceived social support (PSS). BACKGROUND: Paediatric nurses and physicians encounter cumulative effects of treating sick and injured children and helping their families, in situations that might promote burnout and STS. DESIGN: Cross-sectional design. METHOD: Nurses (n = 158) and physicians (N = 76) completed self-report questionnaires on STS, PSS and burnout. RESULTS: Nurses and physicians had similar rates of STS and burnout but showed significant differences in PSS. Furthermore, STS mediated the association between PSS and burnout for both groups; however, the effect was stronger for nurses in comparison to physicians. CONCLUSION: Paediatric nurses and physicians would benefit from participating in interventions geared towards reducing STS, thus minimizing burnout. Moreover, advocating social support within the organization is needed to bolster the ability for coping with sources of stress. IMPACT STATEMENT: Nurses' and physicians' involvement in the physical, physiological and mental needs of their paediatric patients might lead to burnout and secondary traumatic stress (STS). However, research on social support in the context of burnout and STS among nurses and physicians is scant. Secondary traumatic stress and burnout were similar for nurses and physicians, though perceived social support (PSS) was higher for nurses. Secondary traumatic stress plays a mediating role in the association between PSS and burnout among nurses and physicians. However, the mediation effect was stronger for nurses. Policy makers would be wise to advocate institutional stress management interventions to reduce secondary traumatic and to reinforce organizational support for nurses and physicians.

The Sibling Relationship in the Context of Child Maltreatment: What Do We Know? What Are the Directions for the Future?

Siblings share a common and unique bond. It is one of the most enduring relationships during an individual's life span. Thus, the impact of child maltreatment on sibling relationships is an important area of research to explore. The current article carries out a scoping review targeted at determining the existing knowledge and then identifying research priorities within the field of sibling relationship in the context of child maltreatment. The method elaborates on the various stages that were taken to perform the scoping review, and later, the article provides three results for the readers: The first result is a detailed mapping of the existing literature in the area of sibling relationship in the context of maltreatment. The second result is a thorough thematic analysis that was carried out on this literature that focused on several relevant domains: sibling exposure to intimate partner violence, sibling relationship and experiences in the context of child maltreatment, risk assessment for siblings following maltreatment, and sibling relationships and out-of-home placement. The third result is a set of conclusions targeted mainly at recommending future directions to researchers.

From My Own Brother in My Own Home: Children's Experiences and Perceptions Following Alleged Sibling Incest.

Sibling incest is an understudied field despite its high prevalence rates. The current study was designed to characterize the way children describe their experiences and perceptions following alleged sibling incest. The sample consisted of 20 forensic investigations with children who were referred to forensic investigation following suspected sibling incest. The age range of the children was between 6 and 12 years old, including 17 girls and three boys. Thematic analysis was conducted on all the interviews and the children's perceptions greatly echoed the ecological framework while they elaborated on three levels: family level, in which children discussed the context of the abuse and the disclosure; sibling level, in which children discussed their siblings' behaviors and the grooming process; and the child level, in which the children discussed their own behavior during the abuse. The discussion highlights the relevance of the ecological framework to the study's results and stresses the complexity of this phenomenon and the challenges it raises for practitioners in various contexts-child protective, forensic, and clinical.

Quality of life among parents of children with epilepsy: A preliminary research study.

PURPOSE: The current preliminary study was based on the principles of positive psychology orientation when examining the multidimensional construct of quality of life (QOL): the physical functioning, psychological functioning, functional state, and social functioning among parents of children with epilepsy. We assessed the contribution of loneliness and personal resources, namely optimism and flexibility, to parents' QOL. METHOD: The study was conducted at a multidisciplinary center for epilepsy in a central hospital in Israel. Forty-eight parents agreed to participate in a preliminary research study and completed a battery of self-report questionnaires. RESULTS: Significant negative correlations were found between flexibility and the scores on the four components of QOL (higher scores on the QOL scales indicated lower QOL). Optimism was not found to be associated with the scores on QOL. High levels of loneliness were found to be associated with higher scores on the four components of parents' QOL. Among sociodemographic variables, only the economic situation (due to illness) was linked negatively to the scores on QOL components. Flexibility and economic situation were the significant variables that accounted for the explained variance of total QOL. CONCLUSION: The results of this study highlight the importance of flexibility in effectively managing the stressors that might be associated with childhood epilepsy. These results suggest that psychosocial intervention providing coping strategies for the family might improve QOL. Moreover, a parent's economic situation seems to be an essential part of the psychosocial assessment, and assurance of the optimal utilization of financial rights and facilities may improve their QOL.

Personal values and attitudes toward people living with HIV among health care providers in Kazakhstan.

Our study investigates the relationship between health care providers' personal value preferences and their attitudes toward people living with HIV (PLWH). The study was conducted among nurses (n = 38) and physicians (n = 87) working in HIV Centers in Kazakhstan. Significant relationships were found between the providers' personal value preferences and their attitudes toward PLWH: higher preferences for tradition and power values and lower preferences for benevolence values were associated with more negative attitudes toward PLWH. In addition, more years of experience working with PLWH was associated with more positive attitudes toward this population. Age, gender, family status, religiosity, occupation, and number of years working in health care were not related to the health care providers' attitudes toward PLWH. Theoretical and practical implications of the results obtained are discussed.

Enuresis - children's predictions of their treatment's progress and outcomes.

AIMS AND OBJECTIVES: To investigate how nurses can use children's ability to predict treatment outcomes as a possible feature contributing to successful therapeutic processes targeting enuresis. BACKGROUND: Prediction of outcomes was viewed both as a self-efficacy component or belief (based on self-efficacy theory), and also as a skill for actually influencing change. DESIGN: The study was conducted in a mental health community center, located in a large city in central Israel, which was well known for treatment of children with enuresis. For the purpose of the study, the children and their parents completed three questionnaires and underwent training to maintain bedwetting records. METHODS: The study compared three groups of children aged 8-14 years who: made predictions only at baseline (n = 32), predicted progress every week during treatment (n = 38), or did not use prediction at all (n = 31). RESULTS: Findings pinpointed the role of practice in improving predictions. Children who predicted weekly showed the highest congruence with outcomes. RELEVANCE TO CLINICAL PRACTICE: Based on self-efficacy, skills acquisition, and learning and training in the change process, nurses may help children overcome enuresis.

Teaching a systematic and evidence-based approach in an ambivalent context: a case example from Israel.

Systematically planned intervention (SPI) and evidence-based practice (EBP) have become widely known and influential concepts in Israeli social service administration and provision. Nevertheless, the lack of success in implementing SPI and EBP in the social work field has returned the discussion regarding its importance and development to social work scholars and educators. The following article presents a case example describing an attempt to build social workers' capacity to use SPI and EBP among graduate (Master level) Israeli social work students in a university-based practical workshop. A detailed description of contextual considerations and manifestations, alongside main teaching challenges and responses, general assessment of the attainment of the workshop's goals, concluding comments, and recommendations for SPI and EBP capacity builders are offered.

Mothers' acceptance-rejection of their children infected with HIV: the role of the mothers' social axioms, psychological distress, and relationships with the partner.

OBJECTIVE: The present study examines the effect of having a child infected with HIV on the mother-child relationship. The study also examines how the mother's social axioms, psychological distress, and relationships with her partner affect her parenting of the child infected with HIV. METHOD: The study was conducted in Kazakhstan in the wake of a children's HIV epidemic. Mothers of children infected with HIV (n = 53) were compared to mothers of healthy children (n = 97). RESULTS: Compared to mothers of healthy children, mothers of children infected with HIV reported a higher level of acceptance of their children as well as a stronger belief in the "reward for application" axiom, a higher level of religiosity, and better relationships with their partner. Among mothers of both healthy children and children infected with HIV, the belief in the "reward for application" axiom, a low level of social cynicism, and good relationships with their partner was associated with a higher level of acceptance of their children. Among mothers of healthy children but not among mothers of children infected with HIV, psychological distress was associated with a lower level of acceptance of their children. CONCLUSIONS: Mothers of children infected with HIV demonstrated a mobilization pattern of adjustment to their child's illness.

Therapy for a healthy sibling of a child diagnosed with cancer: a case study.

This article presents a case study for skills-directed intervention aiming to help healthy siblings of children with cancer control their emotions and gain self-control skills. Case study application of the intervention was with a boy aged 9 years and 8 months who had the verbal, cognitive, and motivational ability to learn and apply the skills. Intervention included the "Feeling Wheel" to enhance emotional identification, expression, understanding, acceptance, and control. Intervention also focused on teaching him to observe his automatic thoughts, change them to mediated ones, engage in internal dialogue, and seek/adopt alternative behaviors to gain self-control. In postintervention feedback, he reported less anxiety than previously, less inclination toward negative thinking, and more empowerment to deal with day-to-day difficulties he encountered.