Physical exercise in Chilean breast cancer survivors: Qualitative study of barriers, facilitators and preferences. / Actividad física en chilenas sobrevivientes de cáncer de mama: estudio cualitativo de barreras, facilitadores y preferencias.

Introduction: Breast cancer survivors often experience pre and post-treatment physical and psychological symptoms, negatively affecting their quality of life. Regular physical exercise is associated with better quality of life and lower recurrence of cancer, and therefore all oncological patients are recommended to practice it in a regular basis. Despite this, breast cancer survivors have low adherence to physical exercise. The purpose of this study is to identify barriers, facilitators and preferences of Chilean breast cancer survivors to practice physical exercise. Methods: Phenomenological qualitative study of 12 in-depth interviews with adjuvant radiation therapy concluded at least three months ago. Results: Breast cancer survivors ignored the benefits of physical exercise during and after treatment. The barriers were physical symptoms, psychological barriers, sociocultural barriers, health system barriers, disinformation and sedentary lifestyle. Facilitators were coping with physical symoptoms, psychological issues, having information and active lifestyle. The preferences were painless and familiar exercises. Preferred exercise was walking. Conclusions: Breast cancer survivors may adhere to physical exercise despite barriers when certain facilitators are present, which may be promoted by the health team when reporting the benefits of the physical exercise, prescribing personalized, safe and painless physical exercise and educating both patient and her family about the role of the physical exercise in cancer recovering process.

Introducción: Las sobrevivientes de cáncer de mama suelen ver afectada negativamente su calidad de vida por síntomas físicos y psicológicos pre y post tratamiento. La práctica regular de ejercicio físico se asocia a mejor calidad de vida y menor recurrencia del cáncer, por esto es recomendado a todos los pacientes oncológicos. Sin embargo, existe baja adherencia a este. El propósito de este artículo es identificar barreras, facilitadores y preferencias de sobrevivientes de cáncer de mama chilenas para realizar ejercicio físico. Métodos: Estudio cualitativo fenomenológico, basado en entrevistas en profundidad a 12 sobrevivientes de cáncer de mama que terminaron la radioterapia adyuvante hace tres o más meses. Resultados: Las sobrevivientes de cáncer de mama desconocían la importancia del ejercicio físico durante y después del tratamiento. Las barreras identificadas fueron síntomas físicos, barreras psicológicas, socioculturales, del sistema de salud; desinformación y sedentarismo. Los facilitadores fueron físicos, psicológicos, contar con información y práctica de ejercicio físico antes del diagnóstico. Las preferencias fueron ejercicios indoloros y familiares. El ejercicio preferido fue caminar. Conclusiones: Es posible que las sobrevivientes de cáncer de mama adhieran al ejercicio físico, a pesar de las barreras cuando hay ciertos facilitadores presentes. Estos pueden ser generados por el equipo médico al informar los beneficios del ejercicio físico, prescribir ejercicio físico personalizado, seguro e indoloro y educar a la paciente y a su familia sobre el rol del ejercicio físico en la recuperación de sobrevivientes de cáncer de mama.

Knowledge and strategies for coping with fibromyalgia.

OBJECTIVE: To analyze the knowledge about fibromyalgia of people with this diagnosis and its repercussions in coping with the disease. METHOD: Qualitative research, based on the Social Representation Theory framework. Thirty people over 18 years old and from the state of Rio de Janeiro, Brazil, participated. Snowball sampling was applied to recruit participants and a semi-structured interview was used to produce data, between April 2020 and January 2021. Statistical and lexicographic analysis was performed using Alceste. RESULTS: Most participants were women (93%); aged 41 to 60 years old (67%); of whom 63% were married; had been diagnosed 10 years ago or more (40%); and 40% participated in support groups. They did not know the name of the disease and its causes, but they mentioned its symptoms, mainly pain. Objectification of fibromyalgia occurs in painful symptoms and the lack of signs in the body generates misunderstanding among the people they live with. They share experiences in support groups to cope with the disease. CONCLUSION: The subjective phenomenon of pain generates distrust about the disease. Diagnosis difficulties delay treatment and insufficient information generates judgments and stereotypes for patients. Prejudices and rejections have repercussions on coping with the disease.

The transnational mental health burden of Haiti's alleged collapse: preliminary findings from The Haitian Well-Being Study.

Background: Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women. Method: Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States. Discussions revolved around the definition of mental health, stressors, coping mechanisms, risk and protective factors, and barriers to mental health care. Results: Six principal themes emerged: 1- Chronic Traumatic Stress: continued violence, political instability, unemployment, lack of social support, adverse childhood experiences, family separation, and forced displacement were significant sources of stress. 2- Increased Health Burden: Participants reported experiencing chronic physical and psychological symptoms [i.e., hypertension, anxiety, depression, sleep issues, substance abuse, suicidal ideations, characteristics of post-traumatic stress disorder (PTSD)], which were attributed to Haiti's social, political, and infrastructure collapse. 3- Risk Factors: limited access to mental health services, pervasive hopelessness, scarcity of opportunities, and stigma were identified as significant risks. 4- Future Uncertainty: widespread concerns regarding the future predominated. 5- Multigenerational Concerns: Significant anxiety concerning the mental health and development of children, as well as the functionality of mental health practitioners, was noted. 6- Coping and Protective Factors: Effective coping strategies include mental stimulation, peer support, managing digital consumption, engaging in leisurely activities, such as listening to music, and faith/spirituality. Conclusion: The study's findings underscore the sociopolitical and economic crisis in Haiti, which has resulted in violence and a dismantle of political, educational, financial, and health infrastructures. These factors were identified as the primary source of chronic distress, contributing to widespread mental health issues, adverse physical symptoms, and disruption in daily life. The implications for practice, healing, research & policy are discussed.

Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic. OBJECTIVE: This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants' symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants' satisfaction and acceptability. METHODS: A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change. RESULTS: A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects. CONCLUSIONS: Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention's usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users' perceived utility of the intervention, among other issues identified in the study. TRIAL REGISTRATION: ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/23117.

Effects of Anxiety, Stress and Perceived Social Support on Depression and Loneliness Among Older People During the COVID-19 Pandemic: A Cross-Sectional Path Analysis.

During the COVID-19 pandemic, older people were exposed to high levels of anxiety and stress leading to loneliness and depressive disorders. The purpose of the present study was to investigate the effects of anxiety, positive coping, perceived social support, and perceived stress on depression and loneliness among older people during the COVID-19 pandemic. This was a cross-sectional online/telephone survey. A non-probability convenience sampling method was used. Participants were 112 people aged 60 years and above, without cognitive impairment, who experienced confinement (from March 2020 onward) and had access to the internet or telephone. A path analysis model showed a direct significant effect of anxiety on both, depression (ß = .68, P < .001) and perceived stress (ß = .65, P < .001), as well as an indirect effect of anxiety on loneliness via perceived stress (ß = .65) * (ß = .40); and social support (ß = -.21) * (ß = -.20). The model showed adequate fit χ2(df = 4) =5.972, P = .201; RMSEA = 0.066 (0.000, 0.169), CFI = 0.992; TLI = 0.970. Anxiety had a significant effect on depressive symptoms as well as on loneliness via perceived social support and perceived stress. According to our findings, in order to reduce depressive symptoms and perceived loneliness, it is essential to develop timely interventions that decrease levels of anxiety and stress and increase levels of perceived social support in older people, particularly when there are any restrictions, physical or contextual, that prevent face-to-face contact. This can be achieved by implementing preventive community-based programs, enhancing accessibility to mental health services, and collaborating with local support groups, among others.

Are smartphones a tool to cope with the fear of childbirth? The correlation between the fear of loss of connection and the fear of childbirth.

OBJECTIVE: With the spread of smartphones, they have become an indispensable part of life, and nomophobia (No-Mobile-Phone Phobia) has emerged. METHODS: The present research is a cross-sectional study and was conducted with 3,870 primiparous pregnant women between April and May 2022. The research data were collected using the Personal Information Form, Nomophobia Questionnaire, and Wijma Delivery Expectancy/Experience Questionnaire. RESULTS: The Wijma Delivery Expectancy/Experience Questionnaire score of the pregnant women who participated in the study was 22.3% (n=863) had a clinical fear of childbirth and 19.5% (n=753) had extreme nomophobia. Considering the correlation of the Nomophobia Questionnaire and Wijma Delivery Expectancy/Experience Questionnaire scores with other variables, it was found that the Wijma Delivery Expectancy/Experience Questionnaire scores increased with the increasing Nomophobia Questionnaire total score (p=0.000, r=236) and the Nomophobia Questionnaire total score and fear of childbirth increased with an increase in the daily phone usage time. It was also revealed that women who had smartphone applications related to fetal development had higher nomophobia levels (p=0.0001), while they had a lower fear of childbirth. CONCLUSION: This study found that one in every five pregnant women was extremely nomophobic and had a clinical fear of childbirth and that nomophobia and the fear of childbirth were correlated at the clinical level. In this regard, women should prefer face-to-face communication rather than smartphones throughout the pregnancy period.

A Role-Needs Framework: Rethinking Support for Informal Caregivers for Alzheimer's Across the Global South and Global North.

OBJECTIVE: Caregivers play an essential role in supporting people with Alzheimer's disease globally. User-informed research is vital to developing trans-cultural guidelines for dementia support organisations. While coping strategies of caregivers are well researched, the 'coping-effectiveness' framework falls short of representing all caregiver needs. Our aim was to develop a robust and inclusive, globally applicable framework of caregiver-informed support needs. METHODS: In partnership with Alzheimer's Disease International and Roche, we conducted qualitative online semi-structured interviews with 34 family caregivers from the Global North (UK, US) and Global South (Brazil, South Africa) in the COVID-19 context. Participant-generated photographs helped encourage discussions of hidden contextual issues. Iterative inductive narrative analysis of interviews and photographs was carried out with input from global and national charity and industry sectors. RESULTS: We identified a framework of four cross-cultural caring approaches with implications for support: (1) Empathising, using emotion-focused strategies to develop strong expertise and coping skills, with time specific information, psychosocial and peer support needs. (2) Organising, using problem-focused strategies, with strong narratives of expertise and advocacy which benefited from early structured information and professional confirmation. (3) Non-identifying caregiving, where daily aspects of caring occurred without specialist knowledge and expertise, and caregivers sought assistance in managing disease-related support. (4) Reluctance, where struggling with unwanted caring responsibilities meant caregivers looked to professionals to carry out daily care. CONCLUSION: Our findings move beyond the 'coping-effectiveness' framework of support to suggest a novel 'role-needs' framework. Our approach supports inclusive ways of tailoring support to fit individual caregiver circumstances globally.

Experiences of living with severe mental disorder: narratives about the personal recovery process. / Experiências de convivência com o transtorno mental grave: narrativas sobre o processo de recuperação pessoal.

The article approaches the subject of recovery, a sociopolitical movement, field of studies and practices that aims, from the experience of people living with mental disorders, to promote a more optimistic outlook of the prognosis. Aiming to understand the recovery process of people who experience severe mental disorders, qualitative research was developed, based on Gadamerian hermeneutics. We conducted in-depth interviews, in the form of life narratives, with five people who recognize themselves in the process of recovery, and are part of a mental health patient group. Based on narrative analysis, three axes were organized: recovery process facilitators and coping strategies; barriers of recovery process; and relationship with diagnosis. The discussion is based on Canguilhem's theory; in the logic of psychosocial care, and in theories about the notion of recovery. We identified important intersubjective and sociocultural resources for recovery, however, we concluded that these same elements may constitute barriers to a creative existence, as the social norm remains crossed by the stigma that accompanies mental disorders, and by hierarchical power relations.

O artigo aborda o tema da recuperação pessoal (recovery), movimento sociopolítico, campo de estudos e práticas que visa, a partir da experiência de sujeitos com transtornos mentais, promover uma visão mais otimista para o prognóstico desses quadros. Com o objetivo de compreender processos de recuperação pessoal de pessoas que vivenciam transtornos mentais graves, desenvolvemos uma pesquisa qualitativa, baseada na hermenêutica gadameriana. Realizamos entrevistas em profundidade, na modalidade de narrativas de vida, com cinco pessoas que se reconhecem em processo de recuperação pessoal e integram um coletivo de usuários de saúde mental. Com base na análise narrativa, organizamos três eixos: facilitadores do processo de recuperação pessoal e estratégias de lida; barreiras ao processo de recuperação pessoal; e relação com o diagnóstico. A discussão fundamenta-se na teoria canguilhemiana, na lógica da atenção psicossocial e nas teorizações sobre a noção de recuperação pessoal. Identificamos recursos intersubjetivos e socioculturais importantes para a recuperação pessoal, contudo, concluímos que esses mesmos elementos podem constituir barreiras para uma existência criativa, pois a norma social se mantém atravessada pelo estigma que acompanha a loucura e pelas relações de poder hierarquizadas.

Maladaptive behaviors in disasters: case study evaluation of Hurricane Hugo, Hurricane Katrina and the Haiti Earthquake.

Maladaptive behaviors during a disaster refer to actions that do not benefit the individual or society. Quarantelli highlights several maladaptive behaviors myths associated with disasters: widespread antisocial behavior, passivity, role conflict or abandonment, and sudden widespread mental health breakdowns (1). Despite early work reporting these myths, the common perception is that maladaptive behaviors such as rioting, looting, panic, and criminal conduct are prevalent in the wake of disasters. This is despite research by de Ville de Goyet and Arnold which has called on public officials and the media to stop propagating false disaster myths (2, 3). The classic academic response has been that this is a misconception and that, in fact, such behaviors are a very small part of the overall disaster and are mostly non-existent. Misconceptions about the prevalence of maladaptive behaviors can lead to inappropriate resource allocation, such as allocating extra police officers to prevent looting when the overall crime rate for the most part, decreases during disasters (4). Furthermore, while there are several persistent maladaptive behaviors myths, this is confounded by the presence of actual negative behaviors post disaster: false damage claims, insurance fraud, illegally obtaining relief supplies, failure to provide contracted repair services, hoarding of essential items, psychological trauma (which can lead to intergenerational transmission of the disaster memory) and medications and price gouging (5).When reading lay-press articles about recent disasters, it appears that these behaviors are on the rise. This raises the question: Has there been a change in the basic human reaction to disasters and are maladaptive behaviors on the rise? This review article focuses on case studies from three natural disasters: Hurricanes Hugo and Katrina, and the Haiti Earthquake. The goal of this review article is to evaluate these three natural disasters for evidence of maladaptive behaviors.

Care management and leadership according to nurses' perception in the hospital context of COVID-19.

OBJECTIVE: To understand how nursing care management occurred during the COVID-19 pandemic. METHOD: A qualitative study conducted at a university hospital in São Paulo, Brazil. The sample consisted of eight nurses who worked caring for patients who tested positive for COVID-19. Data collection was carried out through semi structured interviews about experiences in managing care in coping with the pandemic. Thematic analysis and interpretation based on psychodynamics of work were used in data analysis. RESULTS: The results allowed constructing three thematic categories: The invisible that limits: biosafety, distress, uncertainty and fear of the pandemic, protecting oneself and ensuring the protection of others; Management work process instruments: team training, staff sizing, materials management, creative practice in the face of insufficiency; The competencies involved with the team, teamwork and leadership. CONCLUSION: Care management in COVID-19 was permeated by objective and subjective conditions, with situations of distress, pleasure, fear, insecurity and creative adaptation. Teamwork and leadership competencies, when present, can alleviate the distress that occurs in nursing work.

Sociocultural Implications in the Development of Early Maladaptive Schemas in Adolescents Belonging to Sexual and Gender Minorities.

Culture is a central theme across various theories and disciplines, influencing behavior and self-perception through interactions within social groups, families, and legal systems. This influence extends to the general population and particularly impacts sexual and gender minorities (SGMs), resulting in minority stress that contributes to mental health issues and the development of Early Maladaptive Schemas (EMSs). Adolescents within these groups face typical developmental stressors-such as hormonal changes and societal pressures-compounded by prejudice, increasing their vulnerability to depression, anxiety, stress, substance abuse, and eating disorders. Despite these challenges, Schema Therapy (ST) lacks comprehensive studies on the sociocultural aspects influencing EMS acquisition in SGM adolescents. This theoretical review aims to fill this gap by exploring the impact of society and culture on EMS development within SGM adolescents. We recognize the broad spectrum of cultural influences and emphasize the importance of cultural sensitivity and diversity. This review specifically addresses how societal and cultural dynamics impact SGM individuals, acknowledging that while ethnic or other cultural factors are not the focus of this paper, they merit future research. This manuscript will discuss central topics and their impact on LGBTQIA+ youth, including (1) the background (definition of culture, lack of studies on ST focusing on culture, and studies on adverse psychological outcomes), (2) minority stress theory and prejudice against sexual and gender diversity (distal and proximal stressors and sociocultural aspects), (3) EMSs and unmet emotional needs, (4) ST affirmative strategies (working with schema modes, imagery rescripting, chair work, and photo techniques), and (5) final considerations (limitations and research agenda).

Exploring the experiences of Haitians/Haitian Americans in Miami-Dade County, Florida during the COVID-19 pandemic: how this community coped with the public health emergency.

Objective: To explore and describe the experiences of Haitians/Haitian Americans in Miami-Dade County, Florida during the COVID-19 pandemic, including their attitudes and practices towards vaccination. Design: We interviewed 15 community members and 15 stakeholders in the Haitian/Haitian American community in Miami-Dade County, Florida using a semi-structured interview guide. The qualitative interviews were conducted between February 4, 2021, and October 1, 2021. They were conducted in both English and Haitian Creole, audio recorded transcribed/translated, and coded using thematic content analysis. Results: The analyses revealed 9 major themes: (1) thoughts about the pandemic, (2) concerns about the COVID-19 vaccines, (3) healthcare access, February-October 2021, (4) intrapersonal relationship dynamics, (5) thoughts about individuals diagnosed with COVID-19, (6) thoughts about prevention measures (e.g., wearing masks, hand hygiene, social distancing, vaccination), (7) mental health struggles and coping, (8) food insecurity, and (9) overall experiences of the pandemic. The findings reveal that the COVID-19 public health emergency negatively affected Haitians/Haitian Americans across several domains, including employment, healthcare access, personal relationships, and food security. Conclusion: This research echoes the compounding negative experiences reported by multiple disadvantaged groups during the COVID-19 pandemic. From loss of employment to healthcare barriers, the pandemic forced many Haitians/Haitian Americans into greater economic and social instability. Interventions addressing these issues should recognize how these factors may interact and compound the experiences of this group. Health and public health agencies should work alongside community partners to build trust so that preventive efforts will be more readily accepted during public health emergencies.

Armed violence in Manguinhos/RJ, Brazil: health and daily life of health and education workers. / Violência armada em Manguinhos/RJ, Brasil: saúde e cotidiano de trabalhadoras(es) de saúde e educação.

The article presents the results of qualitative action research on armed violence with health and education professionals and territorial community services in Manguinhos, Rio de Janeiro, Brazil. It is justified by the urgent nature of this violence in the territory and aims to identify its impacts on their health and work, coping, protection, and care strategies. The effects of armed violence on health and education professionals and the territory are discussed through interviews and focus groups with participant observation, identifying some of its transversalities, such as the Brazilian State racist public security policy based on a warlike logic of confrontation with groups with armed control of the territory, which makes life precarious by exposing residents and workers to constant risks, weakening the community fabric and preventing full access to health and education.

O artigo apresenta resultados de uma pesquisa qualitativa sobre violência armada, do tipo pesquisa-ação, com profissionais de saúde e de educação e serviços comunitários territoriais em Manguinhos/RJ. Justifica-se pela premência dessa violência no território, tendo como objetivo identificar seus impactos na saúde e no trabalho, assim como as estratégias de enfrentamento, proteção e cuidado empreendidas. A partir de entrevistas e grupos focais com profissionais de saúde e da educação e observação participante, discutem-se os efeitos da violência armada sobre elas(es) e o território, identificando algumas de suas transversalidades, como a política de segurança pública racista empreendida pelo Estado brasileiro, baseada numa lógica bélica de confronto com grupos que têm domínio armado de território, que precariza a vida ao expor moradoras(es) e trabalhadoras(es) a riscos constantes, enfraquece o tecido comunitário e impede o pleno acesso à saúde e à educação.

Adaptation strategies for preparing for childbirth in the context of the pandemic: Roy's Theory.

OBJECTIVES: to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women. METHODS: a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo's methodology and Roy's Adaptation Model. RESULTS: various types of stimuli - focal, contextual, and residual - were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women's adaptation, offering significant support and generating positive feedback for childbirth preparation. FINAL CONSIDERATIONS: the importance of pregnant women's groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.

The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills.

Objective: This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods: The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results: In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p < 0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion: The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.

The Association Between Mindfulness Facets and Substance Use via Emotional Psychopathology and Coping Motives in Argentinian College Students.

Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences.

Efficacy of a program in increasing coping strategies in firefighters: randomized clinical trial.

OBJECTIVE: to evaluate the effectiveness of a program in increasing coping strategies focused on military firefighters' problems and emotions. METHOD: randomized, parallel, single-masked clinical trial. The sample consisted of 51 participants in the intervention group and 49 in the control group. The intervention group received the intervention program including coping strategies based on the Nursing Interventions Classification, lasting six consecutive weeks, one day a week. The control group followed the Service Unit routine. Descriptive statistics, Student's T test with Welch's correction and the Mann-Whitney test were used for the analyses. The magnitude of the intervention effect was calculated using Cohen's d index. A p-value of ≤0.05% was considered. RESULTS: in the analysis of the mean difference between the scores in the groups, the means of the intervention group increased significantly for the coping strategies: social support (p = 0.009), acceptance of responsibility (p = 0.03), problem solving (p = 0.05) and positive reappraisal (p = 0.05). The impact of the intervention was moderate in magnitude for social support (d = 0.54). CONCLUSION: the intervention program enabled the increase of coping strategies focused on military firefighters' problems and emotions. ReBEC: RBR-8dmbzc. (1) The intervention program increases coping strategies. (2) The study included military firefighters. (3) Social support was the main strategy of the study. (4) Intervention group presented better results than the control group. (5) The use of the Nursing Intervention Classification was effective.

Physical activity, anxiety, depression, and coping in Turkish men and women during the first wave of COVID-19.

A need exists to better understand the relationships between COVID-19, coping behaviors, physical activity and stress, and COVID-19's impact on way of life. A cross-sectional study design was used to examine adult physical activity, hope, depression, anxiety, and coping status by gender during the COVID-19 pandemic, and to determine the impact of these variables on the coping process. The study also examined the effect of gender on the relation between physical activity and dependent variables. A global survey instrument was used in this study, including 1,400 Turkish adults. This study identified significant gender-based differences regarding physical activity, hope, depression, anxiety, and coping status of adults, although no significant gender-based difference was found regarding hope scores. Furthermore, physical activity directly influenced coping (ß = 0.10), hope (ß = 0.12), and anxiety (ß = -0.08). Hope directly and positively influenced coping (ß = 0.45) and directly and negatively influenced anxiety (ß = -0.25) and depression (ß = -0.28). Moreover, gender did not directly affect physical activity, but it was associated with decreased coping and increased depression and anxiety. Finally, gender had no effect on the relation between physical activity and hope, coping, depression, and anxiety (p > 0.01). These outcomes support the critical importance of physical activity and hope when coping with COVID-19 regardless of gender.