The moral deliberation pathway in veterinary practice: a qualitative study.

BACKGROUND: Veterinarians may face various ethical decisions and potential moral conflicts in clinical practice. The ethical decision-making process often leads to a satisfying resolution. However, when such a process is accompanied by a perceived inability to act according to a person's values, it can lead to psychological distress that characterises moral distress. Theoretical models in professions such as nursing attempt to explain the evolution of moral conflict into moral distress. In veterinary professionals, a model has been proposed to explain this pathway (the moral deliberation pathway). However, empirical data are still lacking on whether veterinary clinicians experience a moral deliberation pathway as hypothesised. METHODS: Using thematic analysis, this qualitative study investigates veterinary clinicians' experiences with moral distress and aims to explain the moral deliberation pathway in these veterinarians. RESULTS: The results suggest that veterinarians' experiences with moral distress follow a deliberation process that can be explained by the proposed moral deliberation pathway. Experiencing a moral conflict leads to moral stress, then either to moral distress or resolution into moral comfort. LIMITATIONS: Self-selection of participants and possible recollection bias may have biased the findings. CONCLUSIONS: The empirical data provided by this study can inform future research and intervention strategies to identify, measure and manage moral distress in the veterinary context.

What Is Wellbeing?

The human interest in 'wellbeing' dates back thousands of years, with complex indigenous understandings [...].

Nurses' well-being during the coronavirus (2019) pandemic: A longitudinal mixed-methods study.

AIM: To determine prevalence, predictors and change over time of nurses' and student nurses' mental health and well-being, and explore nurses' perceptions, barriers and enablers of well-being. DESIGN: Longitudinal mixed-methods survey. METHODS: Forty-nine students and registered nurses participated from Victoria, Australia. Data were collected from December 2019 to July 2020. Validated psychometrics and free-text response questions were employed. Analysis used latent growth curve modelling, Pearson product-moment correlations and thematic analysis. RESULTS: A strong positive correlation was found between self-determination and work well-being, and a strong negative correlation between work well-being and flight risk. Several moderate relationships were found; a moderate positive correlation between work well-being and nurse manager ability, leadership and support, and a moderate negative correlation between burnout and staffing and resource adequacy. Collegial nurse-physician relationships deteriorated. Three themes, physical health, psychological well-being and social connection, were identified as important for nurses' well-being.

An Evaluation of the Psychometric Properties of the Temporal Satisfaction With Life Scale.

The Temporal Satisfaction with Life Scale measures judgements of life satisfaction using 15 items, according to three temporal dimensions: past, present, and future. However, only seven studies have looked at the psychometric properties of the Temporal Satisfaction with Life Scale, and this has been individually across vastly different countries and cultures (Canada, China, Germany, Spain, Switzerland, Turkey, and United-States), and with different populations, such as undergraduate students, adults, and older adults. In addition, these studies have highlighted issues regarding the replicability of the validity of the scale structure and optimal number of items. In this study we use a large international and multicultural sample (n = 6,912) from the International Wellbeing Study and investigate the scale structure of the Temporal Satisfaction with Life Scale, resulting in the recommendation that a shortened 12-item version provides a better model fit compared to the original 15-item version. More in-depth correlates with aspects of wellbeing and illbeing, in relation to past, present, and future life satisfaction, are also presented than have been previously, which found positive correlations between the temporal dimensions of the Temporal Satisfaction with Life Scale and wellbeing, as well as negative correlations with illbeing measures.

Predictors of Life Satisfaction in New Zealand: Analysis of a National Dataset.

The study aim was to determine prevalence and predictors of life satisfaction in New Zealand. In this observational cross-sectional study, a sample of 10,799 participants from NZ were drawn from the Gallup World Poll from 2006 to 2017. Data were analysed using regression analysis and ANOVA. Prevalence of life satisfaction across time varied little from a high of 7.61 (SD = 1.6) in 2007 to a low of 7.23 (SD = 1.73) in 2011 (range 0-10). Satisfaction with standards of living predicted life satisfaction regardless of age or gender. For males across all age groups and females up to age 40 years, positive experiences and satisfaction with household income were important predictors. Being married was an important predictor for males over 40 years and feeling satisfied with their current city was important for females across all ages and for men under 40. The levels of life satisfaction changed over time, possibly due to major national events. Satisfaction with standards of living was found to predict life satisfaction regardless of age or gender. These results provide a path for policy focus towards increased life satisfaction.

Nurse wellbeing during the coronavirus (2019) pandemic: A qualitative descriptive study.

BACKGROUND: The wellbeing of individuals influences organisational outcomes. Insight into nurses' wellbeing is crucial to a sustaining a high-quality workforce. AIM: To describe nurses' perceptions and experiences of wellbeing, work wellbeing, and mental health. METHOD: Using a qualitative descriptive design, semi-structured interviews were conducted, transcribed verbatim, analysed inductively and thematically, and reported per consolidated criteria for reporting qualitative research. FINDINGS: Nine Australian nurses were interviewed in 2020, each for 60 to 90 minutes. These nurses had a broad range of clinical roles and years of experience in metropolitan healthcare organisations. Six themes, each related to nurse wellbeing, depicted: (i) value and sense of purpose from nursing, yet also negative consequences of losing sight of oneself within the nursing role; (ii) work nurses did to disengage from their job and create a balance within their life; (iii) significance of the team and senior team as a source of both strength and opportunity for wellbeing; (iv) a range of wellbeing initiatives with a perception these were often developed, and for use, in response to crisis as opposed to preventative or proactive measures; (v) value of additional nurse wellbeing education and promotion of available support; and (vi) novel challenges and ways to wellbeing during times where resources were stretched and usual support systems impacted. DISCUSSION: Identified positive and negative consequences of nursing must be addressed when developing targeted wellbeing interventions. CONCLUSION: New ways of working and supporting individual, team and organisational wellbeing are needed for flourishing working environments. Potential strategies to either leverage or mitigate the positive and negative consequences of nursing are offered.

Resilience of veterinarians at different career stages: The role of self-efficacy, coping strategies and personal resources for resilience in veterinary practice.

BACKGROUND: The aim of this study was to determine the effect of demographic and psychological factors on resilience in new graduate-, mid- and late-career veterinarians working in Australia. METHOD: An online cross-sectional survey of 800 veterinarians collected demographic and descriptive data in two stages from late 2015 to 2017, such as gender, average hours worked per week, type and region of practice and intention to leave veterinary medicine. Psychological factors were measured utilising the Brief Resilience Scale, the Veterinary Resilience Scale-Personal Resources, the Brief COPE and General Self-Efficacy measures. RESULTS: Using a full-factorial univariate General Linear Model, no significant difference in general resilience was evident between the three career-stage groups (p > 0.05). However, higher self-efficacy, higher personal resources for resilience in veterinary practice, and lower problem-focused, higher emotion-focused and lower dysfunctional coping strategies were related to higher resilience. In the model for mid- and late-career veterinarians, a weak positive relationship existed between higher average hours worked per week and higher resilience, while intention to leave veterinary practice was also related to lower resilience in mid- and late-career veterinarians. CONCLUSION: This study supports the value of personal resources, rather than career stage, gender or region of work, as influential in developing veterinarian resilience.

New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review.

BACKGROUND: The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice. OBJECTIVE: To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health. DESIGN: Systematic review of quantitative research. DATA SOURCES: Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health. REVIEW METHODS: Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis. RESULTS: Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity. CONCLUSIONS: For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).

Wellbeing Literacy: A Capability Model for Wellbeing Science and Practice.

Wellbeing science is the scientific investigation of wellbeing, its' antecedents and consequences. Alongside growth of wellbeing science is significant interest in wellbeing interventions at individual, organizational and population levels, including measurement of national accounts of wellbeing. In this concept paper, we propose the capability model of wellbeing literacy as a new model for wellbeing science and practice. Wellbeing literacy is defined as a capability to comprehend and compose wellbeing language, across contexts, with the intention of using such language to maintain or improve the wellbeing of oneself, others or the world. Wellbeing literacy is underpinned by a capability model (i.e., what someone is able to be and do), and is based on constructivist (i.e., language shapes reality) and contextualist (i.e., words have different meanings in different contexts) epistemologies. The proposed capability model of wellbeing literacy adds to wellbeing science by providing a tangible way to assess mechanisms learned from wellbeing interventions. Moreover, it provides a framework for practitioners to understand and plan wellbeing communications. Workplaces and families as examples are discussed as relevant contexts for application of wellbeing literacy, and future directions for wellbeing literacy research are outlined.

Registered Nurses' experiences of psychological well-being and ill-being in their first year of practice: A qualitative meta-synthesis.

AIM: To synthesize Registered Nurses' self-reported perceptions and experiences of psychological well-being and ill-being during their first year of practice. DESIGN: Qualitative meta-synthesis. DATA SOURCES: Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Qualitative studies were considered for inclusion if published in English, from 2009-2019, reporting primary data analysis including psychological well-being and ill-being experiences of graduate nurses in first year of practice. REVIEW METHODS: Qualitative studies were systematically identified and critically appraised. A meta-synthesis was applied using an open card sort technique to organize empirical data into a matrix of graduate nurses' voices of psychological well-being and ill-being. RESULTS: Twenty-two studies were included. Analysis revealed patterns of positive experiences and emotions. These included feeling valued and part of the team and learning from and feeling supported by other nurses. Negative experiences and emotions such as feeling overwhelmed, stressed, alone and inadequately prepared were also identified. CONCLUSION: Graduate nurses' perceptions and experiences of their psychological well-being and ill-being revealed both positive and negative dimensions during this transition period. Specific examples of strategies that may promote transition nurses' well-being and prevent ill-being were identified such as social connection and support. IMPACT: Increasing the numbers of new nursing graduates world-wide is required to strengthen health systems. Developing strategies to retain these graduates in the workforce is paramount. This review found some graduate nurses experience the transition period as a time of personal growth and fulfilment, for others this period was a stressor. These findings were illustrated in a model of 'ways to well-being'. The potential for knowledge translation of this model extends from graduate nurses as individuals, to nurse entry to practice programs and graduate nurse programs, to organizational policy targeting future health workforce. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42020148812.

Uncovering strengths within community dwelling older adults: What does it mean for health care practice?

The aim of this paper is to present the psychological strengths we identified from interviews with community dwelling older adults. Data for this paper is drawn from participants in a community dwelling older adult study. The latter involved qualitative in-depth interviews with the participants exploring their well-being. All participants were community dwelling and living in a region in the North Island of New Zealand. Interviews took place between March 2017 to September 2017. Thirty-seven older adults between the ages of 66-99 took part in semi-structured interviews and all interviews were audio-recorded. Interviews ranged from 1 to 3 hr. Analysis was informed by the Values in Action Character strengths framework. We were able to identify strengths within the VIA conceptual framework comprising; cognitive strengths, emotional strengths, social and community strengths, protective strengths and transcendental strengths. Throughout this study we found that participants experienced difficulties in identifying and talking about their strengths. In many ways this may reflect participants' strength of humility, demonstrating modesty in talking about themselves. This study has highlighted the challenges older adults experienced in identifying their own strengths. However, the study has demonstrated how narratives can be one way of uncovering psychological strengths with older adults. In particular, these findings highlight the range of strengths, for example, bravery, gratitude, hope, humour, kindness, perseverance, spirituality, that older adults have and give a voice in highlighting these. However, more practical ways of making strength-based practices workable in daily practice, for example, in clinical assessment and health promotion programs are required.

An exploration of how community-dwelling older adults enhance their well-being.

AIM AND OBJECTIVES: To explore community-dwelling older adults approaches to enhancing their psychological well-being. BACKGROUND: Older adults who are living with long-term or chronic health conditions are particularly at risk of experiencing low psychological well-being. Little attention has been paid to preventive strategies that enhance psychological well-being and, in particular, to understanding how older adults enhance their own well-being. METHODS: Using Seligman's PERMA model of well-being (2011) as an organisational framework, this qualitative study interviewed 48 older people aged between 66 and 99 years. Of these, 17 men and 20 women participated in semi-structured interviews. Additionally, 11 women, all widows with a mean age of 81 years, participated in a focus group. The data were analysed with reference to the five aspects of PERMA (Positive emotion, Engagement, Relationships, Meaning, Accomplishment) with a focus on identifying what actions the older people were taking to enhance their well-being. Further analysis involved coding the data into processes or practices and also influencing factors. FINDINGS: Most participants used a range of strength-based strategies or practices to enhance their well-being. For a small number of participants (n = 3), these practices were supported by the presence of partners as carers. However, using PERMA as our conceptual model illustrated that despite Seligman's view that individuals can take positive action within each of the five aspects of PERMA to enhance well-being, external factors, for example economic circumstances or mobility, can influence the ability of older adults to undertake well-being practices. CONCLUSIONS: Older adults have a range of strategies or practices that they use to enhance their well-being. However, well-being is not a static concept and it is important to recognise the influence of health, social and environmental factors as enablers and enhancers of well-being. IMPLICATIONS FOR PRACTICE: Nurses can play a central role in supporting older adults who may be at risk of lower well-being. Nurses can do this by developing interventions to enhance well-being and ensuring better person-activity fit of strategies and practices. Our findings support the need for nurses to be involved in providing opportunities for older people to discuss well-being to support the development of individual, as well as community, models of well-being.

Gratitude across the life span: Age differences and links to subjective well-being.

Gratitude has been described as an adaptive evolutionary mechanism that is relevant to healthy psychological and interpersonal outcomes. Questions remain as to whether the presence and benefits of gratitude are consistent from young adulthood to old age; prior research has yielded mixed evidence. We examined the magnitude and direction of age differences in gratitude in three samples (combined N = 31,206). We also examined whether gratitude was associated with greater/lesser well-being at different periods in the life course. We found that the experience of gratitude was greatest in older adults and least in middle aged and younger adults. Further, we found that the associations between gratitude and subjective well-being remained relatively constant across the lifespan. Findings are discussed from a developmental perspective.

Positive Aging: The Impact of a Community Wellbeing and Resilience Program.

Objectives: To test the effect of a community wellbeing intervention, delivered by community partners, on the wellbeing, resilience, optimism, and social connection of older adults in the general population (Study 1) and older adult carers (Study 2), a population at risk for low wellbeing. Methods: Participants self-selected to take part in an 8-week multi-component wellbeing and resilience program consisting of weekly training sessions, and optional mentoring/peer support. Program participants and a natural control group were compared, post-intervention, on all outcomes of interest. Results: Intervention participants (Study 1) reported significantly lower scores of social isolation, but no significant difference in wellbeing, optimism, or resilience. Intervention participants (Study 2) showed significantly higher scores on all measured outcomes except social isolation. Conclusion: These studies point towards the potential benefits of wellbeing interventions for older adult from the general population and older adult carers, when delivered by community partners. Clinical implications: Early interventions promoting mental health may contribute to reducing the burden of mental health conditions on individuals and the health care system. Studies with more rigorous designs and extended follow-up measurements are required to consolidate these positive initial findings.

Maximising the Opportunity for Healthy Ageing: Online Mental Health Measurement and Targeted Interventions.

Longevity is a valuable resource for society, as older people are increasingly looking for new ways to contribute after retirement. Their contribution is however dependent upon their physical health, mental health and wellbeing. The potential role that mental health and wellbeing, two separate but interrelated constructs, play often are both under-recognised and insufficiently targeted. Positive ageing is a positive and constructive view of ageing, where older people actively work on maintaining a positive attitude, work towards keeping fit and healthy, and strive to maximize their wellbeing. Interventions stimulating positive ageing show promising results for both mental health and wellbeing, and telehealth can play an important role in improving the reach and effectiveness of positive ageing interventions. Telehealth solutions can also help researchers reliably measure and better understand the drivers of wellbeing at individual and population levels; results that can both form the basis for advancing the field of positive ageing and help inform public policy.

The impact of children's exposure to greenspace on physical activity, cognitive development, emotional wellbeing, and ability to appraise risk.

INTRODUCTION: The current study utilised objective techniques to investigate the relationship between children's time spent in greenspace (open land covered in grass or other vegetation) with various physical and psychological variables. Potential relationships between physical activity and greenspace with body composition, emotional wellbeing, sensation seeking tendencies, ability to appraise risk, and cognitive development are investigated. METHODS: 108 participants aged 11-14 years from three intermediate schools in Auckland, New Zealand, were assessed. Moderate-to-vigorous physical activity (MVPA) and geolocational data were recorded using accelerometers and portable global positioning system (GPS) receivers (respectively) over a 7-day period in September-December 2014. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated from height, weight, and waist circumference. Participants also completed online cognitive testing, a computerised risk appraisal tool, and a questionnaire for assessing emotional wellbeing and sensation seeking characteristics. Data analysis took place during February to May 2015. Generalised linear mixed models were used to quantify the associations between MVPA, greenspace exposure, and secondary outcome variables. RESULTS: Findings confirmed that greenspace exposure is positively associated with MVPA in children (B=0.94; p<0.05). Furthermore, both greenspace exposure and MVPA were related to greater emotional wellbeing, with the former exhibiting a stronger relationship than the latter. Risk-taking and sensation seeking scores were positively associated with MVPA, but not with greenspace exposure. No associations were detected between BMI, WHtR, cognitive domains, and either MVPA or greenspace exposure. CONCLUSIONS: Findings support the theory that for children, greenspaces are an important environmental influence on physical activity and emotional wellbeing.

Different types of well-being? A cross-cultural examination of hedonic and eudaimonic well-being.

A large international sample was used to test whether hedonia (the experience of positive emotional states and satisfaction of desires) and eudaimonia (the presence of meaning and development of one's potentials) represent 1 overarching well-being construct or 2 related dimensions. A latent correlation of .96 presents negligible evidence for the discriminant validity between Diener's (1984) subjective well-being model of hedonia and Ryff's (1989) psychological well-being model of eudaimonia. When compared with known correlates of well-being (e.g., curiosity, gratitude), eudaimonia and hedonia showed very similar relationships, save goal-directed will and ways (i.e., hope), a meaning orientation to happiness, and grit. Identical analyses in subsamples of 7 geographical world regions revealed similar results around the globe. A single overarching construct more accurately reflects hedonia and eudaimonia when measured as self-reported subjective and psychological well-being. Nevertheless, measures of eudaimonia may contain aspects of meaningful goal-directedness unique from hedonia. (PsycINFO Database Record

Flourishing in New Zealand Workers: Associations With Lifestyle Behaviors, Physical Health, Psychosocial, and Work-Related Indicators.

OBJECTIVE: To investigate the prevalence and associations of flourishing among a large sample of New Zealand workers. METHODS: A categorical diagnosis of flourishing was applied to data from the Sovereign Wellbeing Index, a nationally representative sample of adults in paid employment (n = 5549) containing various lifestyle, physical, psychosocial, and work-related indicators. RESULTS: One in four New Zealand workers were categorized as flourishing. Being older and married, reporting greater income, financial security, physical health, autonomy, strengths awareness and use, work-life balance, job satisfaction, participation in the Five Ways to Well-being, volunteering, and feeling appreciated by others were all positively associated with worker flourishing independent of sociodemographics. CONCLUSIONS: Flourishing is a useful additional indicator for evaluating the prevalence, and identifying the drivers, of employee well-being. Employers may benefit from promoting these indicators among staff.

Personality, effective goal-striving, and enhanced well-being: comparing 10 candidate personality strengths.

In a three-wave, year-long, large-sample dataset (N = 755), 10 candidate "personality strengths" (Grit, Gratitude, Curiosity, Savoring, Control Beliefs, Meaning in Life-Presence, Strengths Use, and Engagement, Pleasure, and Meaning-Based Orientations Toward Happiness) were compared as predictors of 6-month increases in goal attainment, and as moderators of goal attainment effects upon boosted subjective well-being (SWB). Seeking internal replication, we tested our models twice, both during T1-T2 and during T2-T3. We also examined whether any Personality × Attainment moderator effects upon change in SWB at T2 still persisted at T3. Grit was the only candidate strength that predicted increased goal attainment from T1 to T2 and from T2 to T3, and Curiosity was the only candidate strength that moderated attainment effects on well-being from T1 to T2 and from T2 to T3. T2 Goal attainment effects on SWB were best sustained at T3 when Meaning Orientation increased from T1 to T2. Implications for identifying keystone constructs in personality (and positive) psychology are discussed.