Older adults' lived experiences of physical rehabilitation for acquired brain injury and their perceptions of well-being: A qualitative phenomenological study

Abstract Aim To explore the experiences of older adults (65+) living with acquired brain injury regarding their sense of well-being during physical rehabilitation within the Greek Healthcare System. Background With the increasing ageing population and the life-changing effects of acquired brain injury, there is a need to focus on care for older people and their potential to live well. Rehabilitation systems deserve greater attention, especially in improving the well-being of those who are using them. Design A qualitative study design with a hermeneutic phenomenological approach was used. Methods Fourteen older adults living with acquired brain injury and undergoing physical rehabilitation in Greece were purposively sampled. Semi-structured interviews were conducted to collect data and were thematically analysed using van Manen's and Clarke and Braun's methods. The COREQ checklist was followed. Results Four themes emerged from the analysis: (1) Challenges of new life situation, (2) Seeking emotional and practical support through social interaction, (3) Identifying contextual processes of rehabilitation, (4) Realising the new self. Conclusions The subjective experiences, intersubjective relations and contextual conditions influence the sense of well-being among older adults living with acquired brain injury, thus impacting the realisation of their new self. The study makes the notion of well-being a more tangible concept by relating it to the degree of adaptation to the new situation and the potential for older adults to create a future whilst living with acquired brain injury. Relevance for Clinical Practice Identifying the factors that impact older adults' sense of well-being during rehabilitation can guide healthcare professionals in enhancing the quality of care offered and providing more dignified and humanising care. Patient or Public Contribution Older adults living with acquired brain injury were involved in the study as participants providing the research data

The Experience of Gender in Spousal Caregiving: A Phenomenological Psychological Study (Greece)

Purpose/Objective: To explore how spousal caregivers of older people undergoing rehabilitation experience gender within the Greek community. Research method/Design: A psychological phenomenological design and analysis were used to illuminate the unique meanings eleven spousal caregivers attribute to their experience of gender by gathering qualitative data via interviews. Results: The data provided an insight into the structure of the experience of gender for the spousal caregivers as a normative diachronic identity in a succession of phases: normative constitution, alienation, and reparation. Conclusions/ Implications: The findings highlight the influence of gender stereotypes on spousal caregivers' self-concept, agency, caregiving evaluations, and practices, emphasizing the importance of adopting an intersectional perspective in future research and interventions, considering various factors such as ethnicity, gender, sexuality, age, power dynamics, and cultural norms. Spousal caregivers experience alienation on entering the caregiving journey, with gender-related vulnerabilities affecting their psychological well-being. Addressing these vulnerabilities can improve caregivers' mental health and foster effective coping strategies. The study emphasizes the moral aspect of caregiving, highlighting the relationship between a sense of obligation, feelings of guilt, gender norms, and motivations calling for challenging self-sacrificial morals and societal norms associated with them to empower caregivers to prioritize their well-being while maintaining their caregiving motivations. This shift in perspective can lead to a more positive and fulfilling caregiving experience

Understanding nurses’ psychosomatic complications that relate to the practice of nursing

The literature acknowledges that nursing practice can create physical and emotional stresses for its practitioners. This study aimed to acquire an in-depth understanding of being a nurse in the Greek National Health System. Interpretive phenomenology was used and Van Manen’s method of analysis was implemented. Conversational interviews were conducted with a purposive sample of nine nurses employed at the University Hospital of Ioannina in Greece. The findings produced three essential themes: a dissonance between the images and reality of nursing, emotional burnout, and psychosomatic entanglement.The dissonance between the idealization of nursing and the reality of nursing, along with the emotional crisis created by daily practice, constituted the two fundamental factors for developing psychosomatic complications. These impacted negatively on the participants’ personal and professional well-being. Psychosomatic complications can be prevented by clearly delineating roles, enabling collaboration between education and practice, developing mentorship programs, and using reflection in practice

O R I G I N A L P A P E R Effects of Childhood Trauma on Hostility, Family Environment and Narcissism of Adult Individuals

Abstract Aim: This study aimed to investigate the effects of childhood trauma on hostility, family functioning and narcissism in adulthood. 595 healthy individuals participated, classified into two groups-trauma and no-trauma -based on experienced traumatic events. Methodology: The Hostility and Direction of Hostility Questionnaire, the Aggression subscale of The Symptom Checklist-90-R, the Family Environment Scale and The Narcissistic Personality Inventory were administered. Results: Higher levels of hostility (p=.040) and aggression (p=.041) were observed among participants reported exposure to a traumatic event. Apart from the conflict subscale (p=.018), no dysfunctional family environment was found. Narcissistic traits did not differ between the two groups (p=.199). Logistic regression models found that participants experienced childhood trauma had a higher risk of overall hostility (OR=0.92, 95% CI=.89-.99)

Gendered Experiences of Providing Informal Care for Older People: A Systematic Review and Thematic Synthesis

Background and Purpose: The caregiving's impact on informal carers' quality of life and gender-based stereotypes make older individuals' informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers' experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020. Design and Methods: The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework. Results: This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers' experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers' healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers' negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men's and women's mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role Conclusion and Implications:. Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people's care

Psychometric properties and factor structure of the Greek version of the Cardiac Anxiety Questionnaire (CAQ)

The present study assesses the psychometric properties and factor structure of the Greek version of the Cardiac Anxiety Questionnaire (CAQ). The questionnaire was administered to 598 healthy individuals from 15 different regions of Greece with a measure of socioeconomic characteristics and the Symptom Checklist-90–Revised (SCL-90–R). The sample was split into two random halves, and exploratory factor analysis indicated a three-factor solution. This solution was tested using a confirmatory factor analysis on the second half of the sample. In terms of latent dimensions, the Greek version retains the three-factor structure as proposed by the initial authors. However, adequate fit was achieved only after omitting eight items. The shorter (10-item) version was submitted to further analysis. The shorter version provided satisfactory internal reliability and evidence indicating the validity of the scale with respect to SCL-90–R subscales. The stability of the questionnaire was verified by a high test-retest reliability over a 3-mo. period ( r = .86). Sex and age differences were assessed. The 10-item version appears to be a practical, brief tool for clinical use. </jats:p

Impact of the COVID-19 pandemic on the mental health of hospital staff : An umbrella review of 44 meta-analyses

Background: Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problemswith comprehensive analysis among hospital staff during the COVID-19 pandemic. Objectives: To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic. Design: A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic. Review methods: Systematic searcheswere conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The randomeffects model was used for the meta-analysis, and the I-2 indexwas employed to assess between-study heterogeneity. Publication bias using Egger test and LFK indexwas examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence. Results: Forty-four meta-analyses from1298 individual studieswere included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence: 28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff. Conclusions: The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed. (C) 2022 The Author(s). Published by Elsevier Ltd

Personality Traits, Burnout, and Psychopathology in Healthcare Professionals in Intensive Care Units—A Moderated Analysis

This study explored the associations between personality dimensions, burnout, and psychopathology in healthcare professionals in intensive care units (ICUs). This study further aimed to discern the differences in these relationships when considering the variables of critical care experience (less than 5 years, 5–10 years, and more than 10 years), profession (nurses versus intensivists), and the urban size of the city where the ICU is located (metropolitan cities versus smaller urban cities). This cross-sectional investigation’s outcomes are based on data from 503 ICU personnel, including 155 intensivists and 348 nurses, in 31 ICU departments in Greece. Participants underwent a comprehensive assessment involving a sociodemographic questionnaire, the Eysenck Personality Questionnaire (EPQ), the Maslach Burnout Inventory (MBI), and the Symptom Checklist-90 (SCL-90). To analyze the interplay among critical care experience, burnout status, and psychopathology, a moderation analysis was conducted with personality dimensions (i.e., psychoticism, extraversion, and neuroticism) serving as the mediator variable. Profession and the urban size of the ICU location were considered as moderators influencing these relationships. Male healthcare professionals showed higher psychoticism levels than females, aligning with prior research. Experienced nurses reported lower personal achievement, hinting at potential motivation challenges for professional growth. Psychoticism predicted high depersonalization and low personal achievement. Neuroticism and psychoticism negatively impacted ICU personnel’s mental well-being, reflected in elevated psychopathology scores and burnout status. Psychoticism appears to be the primary factor influencing burnout among the three personality dimensions, particularly affecting intensivists. In contrast, nurses are more influenced by their critical care experience on their mental health status

Agreement between Family Members and the Physicians View in the ICU Environment: Personal Experience as a Factor Influencing Attitudes towards Corresponding Hypothetical Situations

Background: It is not known whether intensive care unit (ICU) patients family members realistically assess patients health status. Objectives: The aim was to investigate the agreement between family and intensivists assessment concerning changes in patient health, focusing on family members resilience and their perceptions of decision making. Methods: For each ICU patient, withdrawal criteria were assessed by intensivists while family members assessed the patients health development and completed the Connor-Davidson Resilience Scale and the Self-Compassion Scale. Six months after ICU discharge, follow-up contact was established, and family members gave their responses to two hypothetical scenarios. Results: 162 ICU patients and 189 family members were recruited. Intensivists decisions about whether a patient met the withdrawal criteria had 75,9% accuracy for prediction of survival. Families assessments were statistically independent of intensivists opinions, and resilience had a significant positive effect on the probability of agreement with intensivists. Six months after discharge, family members whose relatives were still alive were significantly more likely to consider that the family or patient themselves should be involved in decision-making. Conclusions: Resilience is related to an enhanced probability of agreement of the family with intensivists perceptions of patients health progression. Family attitudes in hypothetical scenarios were found to be significantly affected by the patients actual health progression