Impact of Virtual Reality-Based Group Activities on Activity Level and Well-Being Among Older Adults in Nursing Homes: Longitudinal Exploratory Study.

BACKGROUND: In addition to illness, inactivity is a risk factor for high mortality in nursing homes. Using innovative technology, such as virtual reality (VR), for meaningful group activities could provide new opportunities for solving this problem. VR interventions have already been approved as a promising method for enhancing the health of older adults. OBJECTIVE: In this study, we examined whether VR-based group activities can have a positive impact on activity level and group interaction among older adults living in nursing homes. METHODS: We conducted a longitudinal study and provided VR interventions as a group activity once a week for 4 consecutive weeks in nursing homes. Participants were recruited based on the experience of the nursing staff members and the natural decisions of the older adults. Within a virtual cottage, designed according to the needs of the target group, older adults were able to perform daily tasks that they were no longer able to do in real life, such as gardening and making pizza. Overall, 2 psychologists measured the psychosocial capacities, activities of daily life, and well-being before and after the interventions using standardized instruments. RESULTS: The results focus on a total of 84 older adults from 14 nursing homes who completed at least 3 VR interventions. The results indicate that several psychosocial capacities among the older adults improved, including adherence to regulations (P<.001; η²=0.122), flexibility (P<.001; η²=0.109), and group integration (P<.001; η²=0.141). Problems related to competence also showed a slight decrease (P=.04; η²=0.039). In addition, the VR intervention promoted their proactivity (P<.001; η²=0.104) and mobility (P=.04; η²=0.039). During the VR group intervention, older adults' well-being could be maintained at a high level. The results highlight the beneficial effects of VR intervention as a meaningful activity in nursing homes, showcasing the potential of VR applications in this setting. CONCLUSIONS: This study provides a novel and naturalistic perspective, offering new insights into the use of VR in nursing homes. The VR intervention was well accepted and fulfilled the aim of enhancing capacity and well-being. It could be a meaningful group activity in nursing homes to improve social group interaction. To provide stronger evidence, randomized controlled trials are necessary.

[Spectrum of Complex Partial Performance Disorders in Patients with Mental Illnesses]. / Spektrum komplexer Teilleistungsstörungen bei Patienten mit psychischen Erkrankungen.

INTRODUCTION: Recent research highlights a high prevalence of minimal cerebral dysfunctions (MCD) in patients with mental disorders. Nonetheless, empirical understanding of minimal cerebral dysfunctions and diffuse neuropsychological impairments in adult patients remains limited. METHOD: In our study, we examined 399 patients with diverse common mental disorders on minimal cerebral dysfunctions. 329 patients were in psychosomatic rehabilitation, 40 in forensic psychiatry, and 30 in an addiction ward of a psychiatric hospital at the time of the study. Symptom patterns and anamnesis of MCD and sociodemographic characteristics of the patients were recorded using structured questionnaires. RESULTS: Overall, about 29% of all patients reported MCD symptoms. Patients with MCD reported greater problem burden in everyday coping (attention, arithmetic, memory, sensitivity to noise, orientation) and social interaction (outsider, excitability) than patients without partial performance disorders. CONCLUSIONS: Patients with mental illness reported a heterogeneous pattern of minimal cerebral dysfunctions. These frequent disorders should be recognized in diagnostics and treatment. Further studies should investigate therapeutic approaches for MCD according to Baltes' Selective Optimization and Compensation model.

Wisdom-oriented coping capacities at work in challenging times.

BACKGROUND: Critical life events affect personal and professional lives, change working conditions, and require specific coping strategies. Wisdom is a multidimensional capacity for coping with life problems. Since wisdom can best be investigated in relation to concrete settings and problems, we investigated research employees during a pandemic. Research employees are constantly occupied with uncertainty and problem-solving in their everyday work. Thus, they develop capacities for factual and problem-solving knowledge which can be applied in different situations. OBJECTIVE: This study examines to what extent which wisdom capacities are applied by research personnel when dealing with changed working conditions. METHOD: During the coronavirus (COVID-19) pandemic in 2021, researchers were asked about work-related coping capacities in an online survey. The qualitative content analysis of the free-text responses of 131 research employees was based on a multidimensional wisdom model with 12 wisdom capacities. RESULTS: 50% of the reported coping strategies referred to factual and problem-solving capacities, 40% to interpersonal or emotional capacities, 10% did not reflect any wisdom capacity. Associations between wise coping capacities, social behavior at work, and eudaimonic well-being emerged. CONCLUSION: The study provides concrete qualitative examples of specific behavioral capacities in which wisdom may be applied in a work setting.

Are retired persons fitter in their psychological capacities than unemployed? A cross-sectional representative study in Germany.

OBJECTIVES: Beyond specific aspects of numerical or verbal intelligence or cognitive speed, a broad range of psychological capacities are generally important in school, job and social life for all age groups. People have to quit the labour market up from a certain age about 65, whereas (younger) unemployed are motivated for return to work. The question is which psychological capacity profiles can be found in different employment groups (employed, mini-jobbers, voluntary service, retired, unemployed). DESIGN: A representative cross-sectional survey was conducted in Germany, reaching 2528 persons. SETTING: Republic of Germany. PARTICIPANTS: Randomly selected inhabitants throughout Germany. PRIMARY AND SECONDARY OUTCOME MEASURES: Participants reported their sociodemographic and work characteristics, as well as their psychological capacity profiles (Mini-ICF-APP-S) and work-related specific mental health problems (work-anxiety, embitterment). RESULTS: The unemployed had-compared with all other groups-highest rates of work-anxiety and embitterment (16.3%). In contrast to the unemployed, the 'older' (70 aged) retired group, who were no longer working on the labour market, seldomly reported work-anxiety (2.6%) or embitterment (4.2%). The unemployed had the worst capacity profiles, most frequently no school degree (11.5%), most unemployment in their history (four times, as compared with once in the older retired). The psychological capacity profiles of the retired were similar to employed persons. CONCLUSIONS: Keeping older persons with high psychological capacity levels in working life could be an alternative to forced reintegration of people with chronic participation problems into the competitive labour market. Unemployed persons with chronic health and participation problems might benefit from other social inclusion means.

Type, distribution, and frequency of psychological capacity disorders in patients with different somatic illnesses.

PURPOSE: Somatic illnesses are often accompanied by (psychological) capacity impairments which impact on everyday life and work. The question is whether different somatic illnesses are associated with different capacity impairments, and whether impairment is more severe in cases of comorbid mental disorders. MATERIALS AND METHODS: Patients with neurological (N = 318), cardiological (N = 307) and orthopedic illness (N = 311) with and without comorbid mental illness according to MINI were investigated in a rehabilitation hospital. Psychological capacity impairments were assessed with the Mini-ICF-APP observer rating. RESULTS: The "baseline rate" of capacity impairment in patients without mental illnesses was 40.7% in orthopedic, in 36% of cardiology patients (36.1%) and in 74.9% of neurology patients. Patients with additional comorbid mental disorders had stronger impairments than those without mental illness. The most heavily impaired group overall were neurology patients with comorbid mental illness. CONCLUSIONS: Somatic patients also have psychological impairments; these are more pronounced in the case of comorbid mental illnesses. It should be clearly explored whether psychological symptoms and impairment are an expression of the somatic illness per se, or due to a comorbid mental illness. Rehabilitation diagnostics should consider capacity impairments routinely in order to make indications for capacity trainings or context adjustment.

A relevant number of patients with chronic somatic illnesses have psychological capacity impairments, and these are even more pronounced in the case of comorbid mental illnesses.Patients with neurological illness have more severe capacity impairments than patients with cardiological and orthopedic illness.Rehabilitation should routinely use capacity diagnostics (Mini-ICF-APP), in order to make indications for capacity training or compensative context adjustment.

Validation of the irritation scale on a representative German sample: new normative data.

The irritation scale is a widely used and reliable self-report scale for measuring cognitive and emotional strain related to the work environment. It extends existing measures by providing a sensitive assessment for pre-clinical stress at work. Existing normative data are based on convenience samples and are therefore not representative. This study provides new normative data for the irritation scale based on a representative German sample (N = 1480). The new normative data indicate that the overall level of irritation in the German workforce is significantly lower compared to previously published data. Convergent and discriminant validity is confirmed by correlations with depression and anxiety (Patient Health Questionnaire-4 for Depression and Anxiety), somatic symptom scales (Bodily Distress Syndrome 25 checklist, Somatic Symptom Scale-8, Giessen Subjective Complaints List-8, comorbidity), psychological functioning (Mini-ICF rating for activity and participation disorders in mental illness), work-related stressors (overcommitment and bullying) and individual resources (self-efficacy). The results confirm the utility of the irritation scale and provide new benchmarks that avoid an underestimation of the levels of irritation in future studies.

[Similar wisdom strategies for different life problems]. / Ähnliche Weisheitsstrategien für unterschiedliche Lebensprobleme.

OBJECTIVE: Wisdom can be understood as the ability to solve unsolvable problems. Wise persons are better in coping with difficult life situations. Wise strategies help them to do so. The question is whether the same or different wisdom strategies make sense for different life problems. METHODS: A total of 416 persons (40.4 years old) read two situational vignettes, one about a work problem and one about a private problem. After each situational vignette, they were asked about their wisdom strategies regarding the respective situation. Wisdom strategies were measured by means of a self-rating wisdom scale. RESULTS: People agreed similarly with wisdom strategies for both situations. For both situations, participants agreed most strongly to use factual and procedural knowledge, perception and acceptance of emotions, value relativism and relativization of problems and aspirations. The order of the remaining eight wisdom strategies was the same for both situations. DISCUSSION AND CONCLUSION: People agreed similarly with wisdom strategies regardless of the situation type. Wisdom strategies seem to be meaningful across different life problems. This is of interest for the design of interventions to promote psychological resilience.

Effects of talking about side effects versus not talking about side effects on the therapeutic alliance: A controlled clinical trial.

INTRODUCTION: Side effects of psychotherapy are common. Therapists and patients must recognize negative developments to take countermeasure. Therapists can be reluctant to talk about problems of their own treatment. The hypothesis could be that talking about side effects can impair the therapeutic relationship. METHODS: We examined whether a systematic monitoring and discussion of side effects has a negative effect on therapeutic alliance. Intervention group (IG) therapists and patients filled in the UE-PT scale (unwanted events in the view of patient and therapists scale) and discussed their mutual ratings (IG, n = 20). As unwanted events can be independent of therapy, but also be treatment-related side effects, the UE-PT-scale first asks for UE and then for their relation to the ongoing treatment. In the control group (CG, n = 16) treatment was done without any special side effect monitoring. Both groups filled in the Scale for Therapeutic Alliance (STA-R). RESULTS: IG-therapists reported various unwanted events in 100% and patients in 85% of cases: complexity of problems, burdensome or overdemanding therapy, problems with work, and symptom deterioration. Any side effect was reported in 90% by therapists and in 65% by patients. Most frequent side effects were demoralization and worsening of symptoms. IG therapists observed an improvement of global therapeutic alliance in STA-R (M = 3.08 to M = 3.31, p = 0.024, interaction effect in ANOVA with two groups and measurement repetition), and reduced patient fear (M = 1.21 to M = 0.91, p = 0.012). IG patients perceived improvement in bond (M = 3.45 to M = 3.70, p = 0.045). In the CG no comparable changes were seen (alliance M = 2.97 to M = 3.00; patient fear M = 1.20 to M = 1.36; patient-perceived bond M = 3.41 to M = 3.36). CONCLUSION: The initial hypothesis must be rejected. The results suggest that monitoring, and discussion of side effects can even improve the therapeutic alliance. Therapists must not be afraid that this will endanger the therapeutic process. The use of a standardized instrument like the UE-PT-scale seems helpful.

Prevalence and Correlates of Embitterment in a National Representative Sample.

INTRODUCTION: Embitterment may occur after stressful but normal life events, such as job loss, divorce, or unjust events. Embitterment is a normal affect, but it may become clinically relevant in case it becomes very strong and long-lasting, and impairs daily functioning. OBJECTIVE: Until now, no epidemiological data on the frequency of high embitterment in the general population have been available. METHODS: A national representative survey of 2,531 people was carried out in Germany in 2019. The participants gave ratings for their embitterment due to perceived events (Posttraumatic Embitterment Scale), their psychological capacity profile (Mini-ICF-APP-S), sick leave duration, and sociodemographics. RESULTS: About 11.7% of the investigated representative population report moderate embitterment, and another 3.8% high embitterment. Embitterment was only low correlated with other psychopathology, here work anxiety (r = 0.281**). There are no differences between embittered and nonembittered in respect to age, sex, household members, and professional distribution. Those with the highest embitterment have been unemployed more often and have lower income. At least 7.2% of those with high embitterment have a severe psychological capacity impairment and are in need of support by thirds to fulfill daily duties. In 55% of the 802 who reported a stressful event, injustice by an important person has been reported. Injustice by an institution (14%) or societal injustice (12%) was least often reported as a relevant stressful event. CONCLUSION: Physicians, therapists, and public health must be aware of embitterment as a specific mental health problem which occurs frequently and may become chronic with work and life participation problems.

[Patienten mit komorbiden somatischen und psychischen Erkrankungen haben ähnliche Fähigkeitsbeeinträchtigen wie Patienten mit psychischen Erkrankungen]. / Patients with Somatic and Comorbid Mental Disorders have Similar Psychological Capacity Impairment Profiles like Patients with Mental Disorders.

OBJECTIVES: In patients with somatic illness and additional mental disorder, not only motor or sensory functions may be impaired, but also psychological capacities. These become more and more important for work ability in our modern working world. There are presently no data about the type and distribution of psychological capacity impairments in patients with comorbid somatic and mental disorders. These data are however important for estimation of diagnostic and therapy requirements. METHODS: 402 orthopedic, cardiological, and neurological patients with additional mental disorders were investigated with a structured clinical assessment for mental disorders (MINI) and psychological capacity impairments (Mini-ICF-APP). RESULTS: In all three somatic indications at least half of the comorbid patients had any clinically relevant psychological capacity impairment. Neurological patients (67%) and orthopedic patients (72%) were more often affected than cardiological patients (50.5%). Orthopedic patients are slightly more impaired in self-care; neurological and orthopedic patients are more impaired in mobility; and cardiological patients are less impaired in assertiveness. CONCLUSION: In comparison of all three somatic patient groups with mental disorders the number of psychological capacity impairments is similar. In contrast to patients with mental disorders only (i. e. those without somatic comorbidity), the psychological impairment quality in comorbid patients may be influenced by the somatic illness. The data from this study are important in order to estimate diagnostic and therapeutic needs, such as capacity training or compensation of psychological capacity impairments.

Self- and observer ratings of capacity limitations in patients with neurological conditions.

OBJECTIVE: The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients' ability to participate in work and social life and improving collaborative patient-clinician relationships. METHOD: The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S). RESULTS: Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings. CONCLUSIONS: The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.

Dietary identity and embitterment among vegans, vegetarians and omnivores.

Background: Although vegetarian and vegan dietary can positively contribute to animal welfare, the environment and health, they also entail social costs for the people following them. These costs may be an increased risk of stigmatization and, presumably, feelings of embitterment. Methods: In this study, we investigated for the first time the association between feelings of embitterment and dietary identity centrality and motivation. Dietary motivation, dietary pattern centrality for identity (DIQ-D), and embitterment (PTED scale) were assessed in and compared between people with vegan (n = 489), vegetarian (n = 339) and omnivorous (n = 319) dietary pattern. Results: The vegan group reported higher embitterment and discrimination perception than the vegetarian and omnivorous groups. High (vegan) dietary centrality, eating disorder, moral motivation, discrimination perception was associated with embitterment. Conclusions: The association between vegan dietary centrality and moral motivation with embitterment is relevant for actions in dietary education and counseling in clinical and public health settings. When dietary pattern becomes relevant for identity building this may come along with problems when it makes the person prone for discrimination perception.

Mental health, partnerships, and sexual behavior of German university students after the third wave of the COVID-19 pandemic.

Objective: This study examined the state of mental health, partnerships, and sexual activity of German university students after the third wave of the COVID-19 pandemic. Participants and methods: In June and July 2021, 928 students (23.6 years; 63.5% female) from four universities in Germany participated in an online survey that assessed depressive and anxiety symptoms as well as data on partnerships and sexuality. Results: Of the students, 56.4% were above the cutoff for clinically relevant depressive symptoms and 35.7% were above the cutoff for clinically relevant anxiety symptoms. Female gender, higher academic-related stress, lower financial resources, higher strain due to COVID-19, and more loneliness were associated with more severe symptoms. A quarter of the students each reported an improvement or deterioration in their partnerships. Conclusions: Student mental health appears to be worse compared to pre-pandemic and first wave data. It should be examined whether symptoms decrease when universities reopen.

Children, care time, career priority - What matters for junior scientists' productivity and career perspective during the COVID-19 pandemic?

BACKGROUND: The coronavirus (COVID-19) pandemic brought about restrictions, additional workload, insecurity, or need for inventing new routines for professionals worldwide. The pandemic and its restrictions have been discussed as a career shock. OBJECTIVE: Adding knowledge to this, our study investigated the academic and family (care) situation of young scientists in a German technical university. METHODS: We conducted an online survey including young scientists from a technical university in Germany in April 2021. 346 participants (mean age 33 years, 37% women) gave self-ratings on academic and life situation during the pandemic year, care work, preferences for scientific career and family life. RESULTS: Family and career were independent priorities (r = 0.021, p = 0.676). Two thirds (68%) of the young scientists reported no deterioration in scientific outcome during the pandefmic year. But, care times and number of children impacted negatively on scientific productivity in terms of publications. This was true for both women and men. CONCLUSIONS: Young scientists need individual support for their career perspective, according to their concrete career level and life situation.

Capacity limitations in neurology patients, with and without comorbid mental disorders.

BACKGROUND: According to the International Classification of Functioning, Disability, and Health (ICF) symptoms of illness and capacity limitations must be kept apart and assessed separately. Psychological capacities are more important than physical capacities in today's world. Patients with neurological disorders not only show limitations in physical but also in psychological capacities. As in many cases there is comorbidity of neurological and mental disorders the question is to what degree this can increase psychological incapacity. METHODS: Using a cross-sectional study design, neurological patients with and without mental comorbidity were recruited in a department of neurological phase D rehabilitation. A total of 114 inpatients with both neurological and mental disorders (NM) were compared with 214 unselected patients with neurological disorders only (N). Mental comorbidity was diagnosed with the standardized "International Neuropsychiatric Interview". Capacity limitations were assessed with the "Activities and Participation in Psychological Disorders according to the International Classification of Functioning, Disability and Health" scale (Mini-ICF-APP). Qualitative reports of patients were used to validate the Mini-ICF-APP ratings. Clinical diagnoses were taken from the routine patient evaluation. RESULTS: Severe capacity limitations, which are in need of support by others, could be observed especially for endurance (NM: 73.7% vs. N: 59.8% of patients), flexibility (NM: 43.0% vs. N: 22.4%), professional competency (NM: 36.0% vs. N: 16.8%), structuring of tasks (NM: 32.5% vs. N: 15.0%). Least frequent were impairment in dyadic relationships (NM: 23.7% vs. N: 7.9%). The rank order and the qualitative descriptions of impairments were similar in both groups. CONCLUSION: Patients with neurological disorders in general show a relevant degree of capacity limitations. This is further substantially increased by mental comorbidity. Specific treatment is necessary.

Childbirth fear, birth-related mindset and knowledge in non-pregnant women without birth experience.

BACKGROUND: Childbirth fear and interventions during childbirth might be related to the mindset and knowledge non-pregnant women have regarding childbirth. Non-pregnant women before their first birth experience may be particularly at risk for childbirth fear. METHODS: The present study examined the expressions and associations of birth-related mindset, knowledge, and fear among 316 young, non-pregnant women without birth experience. They participated in a cross-sectional online study and completed the Childbirth Fear Prior to Pregnancy, the Mindset and Birth Questionnaire, and a birth knowledge test. RESULTS: Most women (44%) had a natural mindset and low fear, 29% had a medical mindset and low fear, 8% natural mindset and higher fear, and 19% medical mindset and higher fear. There were no differences in knowledge between the four groups. Some gaps in knowledge appeared concerning signs of beginning birth, and non-medical approaches to pain relief. From women with natural mindset and low childbirth fear, a higher percentage (13%) has already watched a birth, as compared to the other groups. Natural mindset was associated with lower childbirth fear, whereas knowledge was independent from childbirth fear. Higher knowledge was low associated with natural mindset. Mindset and childbirth fear were independent from age and education degree. CONCLUSIONS: Gynecologists, midwifes and other health professionals may develop an awareness for birth as a natural event in their non-pregnant patients, and take birth-related fear into account in their counseling, with focus on women's self-efficacy and non-medical approaches to pain relief.

Attentional bias in German Armed Forces veterans with and without posttraumatic stress symptoms - An eye-tracking investigation and group comparison.

BACKGROUND AND OBJECTIVES: Most eye tracking based paradigms evidence patterns of sustained attention on threat coupled with low evidence for vigilance to or avoidance of threat in posttraumatic stress symptoms (PTSS). Still, eye tracking data on attention bias is particularly limited for military population. This eye tracking study investigated attentional bias in PTSS in a sample of German Armed Forces veterans. METHODS: Veterans with deployment-related PTSS (N = 24), veterans with deployment-related traumatization without PTSS (N = 28), and never-deployed healthy veterans (N = 18) were presented with pairs of combat and neutral pictures, pairs of general threat and neutral pictures, and pairs of emotional and neutral faces. Their eye gazes were tracked during a free viewing task. 3 x 3 x 2 mixed general linear model analyses were conducted. Internal consistency of attention bias indicators was calculated for the entire sample and within groups. RESULTS: Veterans with PTSS dwelled longer on general threat AOIs in contrast to non-exposed controls and shorter on general threat and combat associated neutral AOIs in contrast to both control groups. Veterans with PTSS entered faster to general threat AOIs than non-exposed controls. Veterans with PTSS showed circumscribed higher attention fluctuation in contrast to controls. Internal consistency varied across attention bias indicators. LIMITATIONS: Statistical power was reduced due to recruitment difficulties. CONCLUSIONS: Evidence is provided for the maintenance hypothesis in PTSS. No robust evidence is provided for hypervigilant behavior in PTSS. Findings on attention bias variability remain unclear, calling for more investigations in this field.

Students or medical professionals: whose knowledge improved after social-medicine training? Results from a quasi-experimental evaluation study.

PURPOSE: Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity. Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students' knowledge changes after social medicine training. METHODS: This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire. Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities. Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons. RESULTS: All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test. After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities. CONCLUSIONS: Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups' knowledge levels.