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JPMA. the Journal of the Pakistan... Sep 2023The narrative review was planned to qualitatively analyse the experiences, factors and context of parents screening positive for perinatal depression in Karachi. Semi... (Review)
Review
The narrative review was planned to qualitatively analyse the experiences, factors and context of parents screening positive for perinatal depression in Karachi. Semi structured in-depth interviews were conducted to explore the experiences and perceptions of participants during pregnancy, birth and 10-12 weeks after birth. Seven men and 20 women participated in the in-depth interviews. Factors in the perinatal period that affected new parents included sleep disturbances, emotional stressors linked to preference for a male child, a lack of social support, financial burdens of perinatal care, personal frustrations caused by an inability to comprehend the signs and symptoms of perinatal depression, denial to admit challenging issues concerning mental health and social disapproval with expressing mental health issues. There is an imminent need for appropriate initiatives to raise awareness about perinatal depression, and the provision of adequate perinatal mental health services for Pakistani women and men.
Topics: Female; Humans; Male; Pregnancy; Depression; Depressive Disorder; Pakistan; Parents; Parturition; Qualitative Research; Infant; Infant, Newborn
PubMed: 37817701
DOI: 10.47391/JPMA.7934 -
Nurse Education Today Jul 2023Institutional racism within the United Kingdom's (UK) Higher Education (HE) sector, particularly nurse and midwifery education, has lacked empirical research, critical...
BACKGROUND
Institutional racism within the United Kingdom's (UK) Higher Education (HE) sector, particularly nurse and midwifery education, has lacked empirical research, critical scrutiny, and serious discussion. This paper focuses on the racialised experiences of nurses and midwives during their education in UK universities, including their practice placements. It explores the emotional, physical, and psychological impacts of these experiences.
METHODS
This paper draws on qualitative in-depth interviews with participants from the Nursing Narratives: Racism and the Pandemic project. Of the 45 healthcare workers who participated in the project, 28 participants obtained their primary nursing and midwifery education in UK universities. Interviews with these 28 participants were selected for the analysis reported in this paper. We aimed to employ concepts from Critical Race Theory (CRT) to analyse the interview data in order to deepen our understanding of the racialised experiences of Black and Brown nurses and midwives during their education.
FINDINGS
The interviews revealed that the healthcare workers' experiences coalesced around three themes: 1) Racism is an ordinary, everyday experience; 2) Racism is operationalised through power structures; and 3) Racism is maintained through denial and silencing. Experiences often touch on a series of issues, but we have highlighted stories within specific themes to elucidate each theme effectively. The findings underscore the importance of understanding racism as a pandemic that we must challenge in response to a post-pandemic society.
CONCLUSION
The study concludes that the endemic culture of racism in nurse and midwifery education is a fundamental factor that must be recognised and called out. The study argues that universities and health care trusts need to be accountable for preparing all students to challenge racism and provide equitable learning opportunities that cover the objectives to meet the Nursing and Midwifery Council (NMC) requirements to avoid significant experiences of exclusion and intimidation.
Topics: Pregnancy; Humans; Female; Midwifery; Qualitative Research; Health Education; United Kingdom; Nurses
PubMed: 37196491
DOI: 10.1016/j.nedt.2023.105840 -
BMC Geriatrics Oct 2023It is estimated that more than 57 million people have dementia worldwide, and it is one of the leading causes of care dependency in old age. Relatives and other...
BACKGROUND
It is estimated that more than 57 million people have dementia worldwide, and it is one of the leading causes of care dependency in old age. Relatives and other informal caregivers are the most important support for individuals with dementia, but caring for a loved one with dementia may burden the caregiver. Caregiver burden may have adverse outcomes for both the informal caregiver and the care recipient, including decreased quality of life. Caregiver burden is associated with several factors concerning the informal caregiver, the care recipient, and relational and other contextual factors. The aim of this study was to explore which factors are associated with informal caregivers' subjective burden when caring for individuals living at home with dementia.
METHODS
This study was a cross-sectional survey among informal caregivers of home-dwelling individuals with dementia in all five geographical regions of Norway. There were 540 informal caregivers who participated, 415 of whom were included in the regression analyses. Caregivers' subjective burden was assessed with the Relatives' Stress Scale. Covariates included were classified into four levels: individual (twofold: informal caregiver and person with dementia), relational, community, and time. Linear multivariable regression analyses were used to identify associations between subjective burden and included factors.
RESULTS
Several covariates were statistically significantly associated with subjective burden at the four levels. These covariates included self-rated health, mental distress, age, coping through resignation and denial, emotional and instrumental support, substance use, and humor at the informal caregiver level; behavioral and psychological symptoms of dementia, dementia severity, and degree of disability at the care recipient level; the extent of care, being the primary caregiver, and previous relationship satisfaction at the relational context level; and informal caregivers spending time with friends, leisure activities, social restriction, and knowledge of available health services at the community context level.
CONCLUSIONS
Informal caregivers' mental distress and care recipients' neuropsychiatric symptoms were the factors with the strongest association with subjective burden.
Topics: Humans; Caregivers; Quality of Life; Cross-Sectional Studies; Dementia; Adaptation, Psychological
PubMed: 37817101
DOI: 10.1186/s12877-023-04358-3 -
Revista Brasileira de Enfermagem 2024to report an educational technology construction on nursing professionals' rights.
OBJECTIVES
to report an educational technology construction on nursing professionals' rights.
METHODS
an experience report on educational technology construction during the crediting of university extension hours in an undergraduate nursing course at a Brazilian public university, between March and June 2023. The Deming cycle was used as a procedural method.
RESULTS
four meetings were held between students and extension workers. Eight comic books were produced based on the Code of Ethics for Nurses, addressing professional autonomy, fair remuneration, risk-free work, denial of exposure in the media and others. The Deming cycle proved to be an important strategy for constructing products.
CONCLUSIONS
nursing professionals' rights must be discussed and improved. Educational technologies, such as comic books, provide playful and reflective learning.
Topics: Humans; Education, Nursing, Baccalaureate; Inventions; Students, Nursing; Educational Status; Learning
PubMed: 38511827
DOI: 10.1590/0034-7167-2023-0438 -
The American Surgeon Dec 2023The proportion of older patients on the liver transplant waitlist continues to increase. With limited existing data to guide liver transplant evaluation of elderly...
BACKGROUND
The proportion of older patients on the liver transplant waitlist continues to increase. With limited existing data to guide liver transplant evaluation of elderly patients, we aimed to study selection practices and outcomes of patients ≥70 years old. We hypothesized that 1-year patient and graft survival would not differ between appropriately selected elderly patients and those who are younger.
METHODS
All patients referred for liver transplantation between 2018 and 2020 were stratified into elderly (age ≥70) and young (age <70) cohorts. Evaluation data pertaining to medical, surgical, and psychosocial risk assessment were reviewed. Recipient characteristics and post-operative outcomes, primarily 1-year graft and patient survival, were compared, with a median follow-up of 16.4 months.
RESULTS
322 patients underwent transplant out of 2331 referred. Elderly patients represented 230 of these referrals and 20 underwent transplant. The most common reasons for denial of elderly patients were multiple medical comorbidities (49%), cardiac risk (15%) and psychosocial barriers (13%). The median MELD of elderly recipients was lower (19 vs 24, = .02), and proportion of hepatocellular carcinoma was higher (60% vs 23%, < .001). There was no difference in 1-year graft (elderly 90.9% vs young 93.3%, = .72) or patient survival (elderly 90.9% vs young 94.7%, = .88).
DISCUSSION
Liver transplant outcomes and survival are not affected by advanced age in carefully evaluated and selected recipients. Age should not be considered an absolute contraindication for liver transplant referral. Efforts should be made to develop guidelines for risk stratification and donor-recipient matching that optimize outcomes in elderly patients.
Topics: Humans; Aged; Liver Transplantation; Tissue Donors; Carcinoma, Hepatocellular; Risk Assessment; Graft Survival; Retrospective Studies; Liver Neoplasms; Age Factors; Transplant Recipients; Treatment Outcome
PubMed: 37142265
DOI: 10.1177/00031348231173998 -
Medycyna Pracy Dec 2023Professionals working with trauma victims can experience both negative and positive effects following exposure to secondary trauma. The aim of the study was to determine...
BACKGROUND
Professionals working with trauma victims can experience both negative and positive effects following exposure to secondary trauma. The aim of the study was to determine the relationship between secondary traumatic stress (STS), secondary posttraumatic growth (SPTG) and cognitive coping strategies and to establish the mediating role of cognitive coping strategies in the relationship between STS and SPTG.
MATERIAL AND METHODS
A group of 500 professionals working with trauma survivors were surveyed. The , the and the was used.
RESULTS
The results indicated that 29% of professionals demonstrate a high intensity of STS, and nearly 34% exhibit a high level of SPTG. Denial and regret were positively correlated with STS; positive cognitive restructuring, resolution/acceptance and downward comparison were positively related to SPTG. Two cognitive coping strategies, i.e., positive cognitive restructuring and downward comparison, were found to act as mediators in the relationship between STS and SPTG.
CONCLUSIONS
Understanding the effects of secondary exposure to trauma and the coping responses of professionals working with trauma survivors will support the development of prevention and intervention actions aimed at protecting them from the deleterious impact of exposure to secondary trauma at work and promoting secondary posttraumatic growth. Med Pr Work Health Saf. 2023;74(6):449-60.
Topics: Humans; Coping Skills; Adaptation, Psychological; Compassion Fatigue; Stress Disorders, Post-Traumatic; Emotions
PubMed: 38160418
DOI: 10.13075/mp.5893.01432 -
Linguistics and Philosophy 2024This paper discusses a set of observations, many of which are novel, concerning differences between the adjectival modals and and their adverbial counterparts and ....
This paper discusses a set of observations, many of which are novel, concerning differences between the adjectival modals and and their adverbial counterparts and . It argues that the observations can be derived from a standard interpretation of / as universal and / as existential quantifiers over possible worlds, in conjunction with the hypothesis that the adjectives quantify over knowledge and the adverbs quantify over belief. The claims on which the argument relies include the following: (i) knowledge implies belief, (ii) agents have epistemic access to their belief, (iii) relevance is closed under speakers' belief, and (iv) commitment is pragmatically inconsistent with explicit denial of belief.
PubMed: 38344658
DOI: 10.1007/s10988-023-09391-4 -
Journal of Anaesthesiology, Clinical... 2023Health care workers (HCWs) are caught in the middle of the COVID-19 pandemic storm and are exposed to a large degree of physical and emotional stress. This study was...
BACKGROUND AND AIMS
Health care workers (HCWs) are caught in the middle of the COVID-19 pandemic storm and are exposed to a large degree of physical and emotional stress. This study was planned to describe the stressors, stress levels, emotional responses, and coping strategies adopted by HCWs amidst this pandemic.
MATERIAL AND METHODS
This cross-sectional, web-based survey was conducted after ethics approval, using a structured performa incorporating standardized stress (PSS-10 C), emotional responses (PANAS-10), and coping strategy (Brief COPE) scales. The snowball sampling technique was used to conduct the study and collect data. Data were analyzed using SPSS 26 version (SPSS Inc., Chicago, IL, USA) statistical software. A value of <0.05 was considered significant.
RESULTS
Out of 402 participants (65% doctors and 35% nurses), 87% perceived moderate stress levels, and nearly half of the participants were interns, residents, and medical officers. Infection to self or family members (77.1%), survival of sick patients (75.6%), aggression by patients and relatives (70.3%), and long duty hours (67%) were some of the major stressors as reported by HCWs. The most common positive emotion felt was being alert (19.17 ± 5.57) and negative emotion perceived was being upset (15.6 ± 6.06). Many participants adopted emotion and problem-focused coping strategies such as planning and strategization (68%) and positive reframing (67.6%), whereas dysfunctional coping strategies such as venting and denial were adopted less commonly.
CONCLUSION
Moderate stress levels perceived by HCWs are a cause for concern. Emotional responses of HCWs to stress vary; however, appropriate coping strategies including emotional and problem-focused coping strategies are the need of the hour to tackle pandemic-related stress.
PubMed: 38269173
DOI: 10.4103/joacp.joacp_196_22 -
International Journal of Environmental... Jul 2023Our study aimed to investigate the correlation between medicine, health perception, and music as well as the role of music in the healthcare setting. To gain insights...
Our study aimed to investigate the correlation between medicine, health perception, and music as well as the role of music in the healthcare setting. To gain insights into the dynamics between these two fields, we gathered opinions from attendees and presenters at an international conference on music medicine, musicians' health, and music therapy. A team of six interviewers conducted a total of 26 semi-structured interviews. The interview guide focused on four predetermined themes: (1) "music in medicine", (2) "performing arts medicine", (3) "music for the individual", and (4) "music for society". The responses were analyzed using grounded theory methods as well as thematic and content analysis. To enhance the analytical strength, investigator triangulation was employed. Within the predefined themes, we identified several subthemes. Theme 1 encompassed topics such as "listening and performing music for treating diseases and establishing non-verbal relationships", "the value of music in specific disorders, end-of-life care, and pain management", and "the design of sound spaces". Theme 2 explored aspects including the "denial and taboo surrounding physical and mental health issues among musicians", "the importance of prevention", and an antithesis: "pain and suffering driving creativity". Theme 3 addressed the "mental role of music in ordinary and extraordinary life" as well as "music's ability to enable self-conditioning". Lastly, Theme 4 examined the role of music in "cultural self-identification" and "development and education for children". Throughout the interviews, participants expressed a lack of knowledge and awareness regarding interdisciplinary research and the fields of music and medicine. Our findings affirm the significance of music therapy and performing arts medicine as well as the broader relationship between music and medicine. They highlight the potential benefits of perception and experiential pathways for individuals and, consequently, for human society.
Topics: Child; Humans; Music; Music Therapy; Auditory Perception; Pain Management; Delivery of Health Care
PubMed: 37510618
DOI: 10.3390/ijerph20146386 -
The Oncologist Feb 2024Few studies examine how patients with advanced cancer cope with stress. The objective of our study was to evaluate coping strategies adopted by patients with cancer and...
BACKGROUND
Few studies examine how patients with advanced cancer cope with stress. The objective of our study was to evaluate coping strategies adopted by patients with cancer and their relationship with symptom burden.
METHODS
A secondary data analysis of a prospective cross-sectional survey of patients with cancer and tobacco use was conducted, which examined demographics, symptom burden (Edmonton Symptom Assessment System), and coping strategies (the Brief COPE Questionnaire). Demographic characteristics were summarized by standard summary statistics; we also examined associations between patient characteristics and coping strategies using t-test, rank-sum test, chi-squared test, or Fisher's exact test depending on the distribution of data.
RESULTS
Among 399 patients, the majority were female (60%), Caucasian (70%), the mean age was 56.5 (±12.0) years, and the most common malignancies were gastrointestinal (21%) and breast (19%). Patients with cancer adopted multiple adaptive coping strategies, most frequently acceptance (86.7%) and emotional support (79.9%), with humor (18.5%) being the least. Common maladaptive strategies included venting (14.5%) and self-distraction (36.6%), while substance use (1.0%) was infrequently reported. Of the adaptive strategies, female gender was significantly associated with higher engagement with emotional and instrumental support, positive reframing, religious coping, and acceptance (P < .05 for all). College educated patients reported significantly higher implementation of humor, planning, and acceptance. Maladaptive coping strategies such as denial were associated with increased pain and depression, while patients adopting emotional-focused strategies rated decreased emotional distress.
CONCLUSIONS
The majority of patients with advanced cancer reported adopting multiple, adaptive coping strategies, and a minority utilized maladaptive or avoidant strategies, rarely substance use, and may need additional psychological support.
Topics: Humans; Male; Female; Middle Aged; Adaptation, Psychological; Coping Skills; Symptom Burden; Cross-Sectional Studies; Prospective Studies; Substance-Related Disorders; Neoplasms; Surveys and Questionnaires; Psychological Tests; Self Report
PubMed: 37669020
DOI: 10.1093/oncolo/oyad253