Self-Perceived Stress in Association with Emotional Experiences Following Patient Death and Coping Adequacy among Clinical Nurses in Lithuania: A Cross-Sectional Study.

(1) Background: Stress is defined as a psychological sensation related to a change in both human physiology and behavior in response to a threat or challenge. As the prevalence of stress is increasing globally, nurses represent a risk group for exposure to stress-related psychological alterations. The aim of this study was to explore how clinical nurses in Lithuania cope with the perceived chronic stress in relation to additional emotional experiences following the death of a patient. (2) Methods: During a four-week period of October 2023, a total of 283 female nurses, aged between 20 and 70 years old, were enrolled in a single cross-sectional study. The PSS-10 (perceived stress scale) and the Brief-COPE (Coping Orientation to Problems Experienced) questionnaires were applied to assess the level of self-perceived stress and the use of coping styles along with the adequate strategies. Furthermore, the nurses' emotions, evoked following patient death, were classified depending on their valence. Both the multiple linear and logistic regression statistical analyses were conducted to examine the associations between dependent and independent variables. (3) Results: The study identified that more than half of the nurses experienced patient death several times a month. A moderate-to-high level of the symptoms of mental chronic stress were suffered by 76% of caregivers. The psychological arousal following the death of a patient may induce the occurrence of emotional complexity that refers to competitive feelings, namely, helplessness (adjusted odd ratio (AOR) 1.7, 95% confidence interval (95% CI) 1.1; 2.9), disappointment (AOR 1.9, 95% CI 1.1; 3.5), anxiety (AOR 1.9, 95% CI 1.2; 4.2), and guilt (ORadj 4.7, 95% CI 1.4; 5.7), and can serve as a potential trigger for chronic stress development in clinical nurses. In terms of emotion-focused stress control (ß 0.1, 95% CI -0.1; -0.2, R2 = 0.12), Lithuanian nurses had low control of the perceived chronic stress. The use of problem-focused coping (ß -0.2, 95% CI -0.3; -0.1, R2 = 0.09) was also not addressed to an appropriate extent. The use of the avoidance coping style was associated with moderate-high levels of chronic stress perceived by nurses (ß 0.5, 95% CI 0.4; 0.7, R2 = 0.24). Furthermore, the avoidant coping strategy related to behavioral disengagement was significantly related to resilience to chronic stress in an adverse way. The cognitive process of self-blame was considered as a meaningful maladaptive behavior component for magnifying chronic stress in nurses. (4) Conclusions: The study highlights the need to implement the recommendations for boosting the nurses' mental health. Hospitals should contribute to psychological assistance along with providing necessary training on stress-coping strategies for clinical nurses. In order to promote the sustainability of mental health through additional social support interventions, it would be useful to upgrade the clinical nurses' daily routines with mindfulness-based trainings.

Dominant Somatotype Development in Relation to Body Composition and Dietary Macronutrient Intake among High-Performance Athletes in Water, Cycling and Combat Sports.

Relevant properties of the somatotype as important indicators can be associated with the body composition characteristics as well as both metabolic and bio-mechanical efficiency of athletes in the sport concerned. The primary aim of this single cross-sectional study was to determine the somatotype profiles in association with body composition and nutritional profiles among Lithuanian elite athletes (n = 189) involved in water, cycling and combat sports. The body composition along with the somatotype profiles and the nutritional status of athletes were evaluated using a battery of multiple frequency (5, 50, 250, 550, and 1000 kHz) bioelectrical impedance analysis (BIA) and a 3-day food record analysis. In terms of the prediction for athletes to be classified as endomorphs, mesomorphs or ectomorphs, the linear discriminant analysis was conducted to assess the grouping of samples. Both the multiple linear regression and multivariate logistic regression statistical analyses were performed to explore the associations between the independent and dependent variables. The central tendency values for the somatotype components of endomorphy, mesomorphy and ectomorphy in athletes playing water, cycling and combat sports were 4.3-4.9-3.4, 4.3-4.8-3.4 and 4.5-5.5-2.9, respectively. The central mesomorph somatotype with a trend towards endomorphy was dominant and varied according to a high muscle-to-fat ratio in elite athletes. Significant (p ≤ 0.001) positive associations between both endomorphy and mesomorphy values and higher body fat percentage as well as lower and upper limb muscle mass were identified. The lower levels of trunk muscle mass were related to athletes' endomorphy and mesomorphy, too. Furthermore, in the athletes' sample under analysis, high-level mesomorphs were prone to consume low-carbohydrate (adjusted odd ratio (AOR) 0.5, 95% confidence interval (CI) 0.2; 0.9) and high-protein diets (AOR 2.5, 95% CI 1.1; 5.5). Contrastingly, the elite athletes with a higher expression of endomorphy were on high-carbohydrate (AOR 5.4, 95% CI 1.1; 8.3) and high-fat diets (AOR 4.6, 95% CI 1.5; 7.1) along with insufficient protein diet (AOR 0.3, 95% CI 0.1; 0.9). Finally, whilst nutrition goals as a mediator can play a significant role in undergoing the maintenance of balance between the optimal body composition for athletic performance and the development of an ecto-mesomorphic somatotype, the elite athletes with higher levels of endomorphy value should be aware of lowering the body fat percentage coupled with dietary fat reduction and higher protein intakes. The findings obtained from the study may serve as an antecedent for a more targeted management of the elite athletes' training process. Somatotyping as an additional assessment method can be successfully deployed in choosing correct coaching techniques, contributing to talent recognition processes or identifying reference morphometric parameters in elite athletes competing in water, cycling and combat sports.

Association between Variation in Body Fat Mass Magnitude and Intake of Nutrients, including Carbohydrates, Fat, and B Vitamins, in a Cohort of Highly Trained Female Athletes.

The most common sports nutrition strategies were constructed not only for maximizing musculoskeletal adaptations to exercise, but also to minimize health risks in athletes. Given the lack of research highlighting the potential effects of the intake of carbohydrates, fats, and B vitamins on body fat percentage in a population of female athletes, this study aimed to elucidate whether the intake of macronutrients and B vitamins could be associated with the variation in body fat percentage in a cohort of professional female athletes. This cross-sectional study was weighted to represent Lithuanian elite female athletes (n = 89). The dietary assessment of the female athletes was carried out using a 3-day dietary recall method. Their body composition was assessed using the bioelectrical impedance analysis method. For females, the reported average intakes of energy, carbohydrates, protein, and fat were 2475 kcal/day, 5.1 g/kg/day, 1.5 g/kg/day, and 36.7%, respectively. Excess B vitamin intake was revealed, ranging within plus 1-2 standard deviations (SDs) around the mean requirements. As a consequence, excessive body fat percentage was potentially factored as a negative outcome in maintaining optimal body composition in female athletes. Multivariate logistic regression analysis of a sample of female athletes revealed that, despite a slightly positive energy balance (∆ 95 kcal/day), the carbohydrate-deficient diet (adjusted odds ratio (aOR) 0.3, 95% confidence interval (CI) 0.1; 0.7), along with higher intakes of vitamin B1 (aOR 2.9, 95% CI 2.6; 7.8), vitamin B2 (aOR 6.7, 95% CI 1.1; 8.3), and vitamin B3 (aOR 1.8, 95% CI 1.4; 7.8) from food, was associated with a lower percentage of body fat. Therefore, more attention should be given to the intake of B vitamins in professional athletes with a range of body fat mass percentages for the purpose of achieving long-term goals of maintaining body composition and fitness.