A Quantitative Investigation Exploring the Psychological and Physiological Aspects of Individual Resilience, Rumination and Recovery

The psychological resilience literature has identified the need for clarity aboutwhether individual resilience should be considered a stable character trait or a dynamicprocess, and if there are biological markers of resilience. This thesis addressed the gaps in theliterature by assessing changes in resilience over time and psychological, physiological andwork-related factors associated with resilience.A systematic review and four quantitative research studies were conducted. Thefindings from most papers in the systematic review suggested resilience remains relativelystable over time with some minor fluctuations. This finding was partially supported in Study1, using a three-wave longitudinal study utilising the Connor-Davidson Resilience Scale (CDRISC) and the Resilience Scale for Adults (RSA) (N = 134). The model identified items ofthe CD-RISC were more trait based and the RSA contained a comparable percentage ofresidual trait and state factors. In Study 2, results from a two-wave study conducted duringthe Covid-19 pandemic and two years prior identified no group changes in employee’sresilience over time (N = 137) but identified individual fluctuations in resilience. In Study 3,results from a cross-sectional study suggested employee’s resilience mediates the associationbetween psychological job demands and work-related rumination (affective rumination anddetachment, N = 377) when working from home. Finally, Study 4 identified those with highresilience demonstrate enhanced cardiovascular recovery (heart rate variability, bloodpressure) following acute stress (N = 72).In summary, the results of this thesis suggest that the complexity of resilience may notbe able to be captured using psychometric resilience scales and the content of these scalesshould be explored further. The importance of resilience in recovery from work and acutestress has been highlighted amongst the need for additional support in the workplace toensure employees are happy and healthy at work

Stress, psychological distress and support in a health care organization during Covid-19: A cross-sectional study

The main aim of this study was to understand what health and wellbeing initiatives are helpful for health care workers' stress and psychological distress during the Covid-19 pandemic.Health care workers are at increased risk of poor mental health during health emergencies; understanding support required for health care workers is of paramount importance.Participants were health care workers at a health and social care organization (N = 159). The study included an online questionnaire including an evaluation of health and wellbeing initiatives and measures of perceived stress and psychological distress.The highest rated resources were counselling, personal protective equipment (PPE) and Covid-19 testing. Those who accessed yoga reported significantly less stress and psychological distress than those who did not access yoga.Health care workers with higher stress and psychological distress felt less supported by their organization, less listened to and less involved in organizational decisions.Practical implications are discussed such as forward planning for health emergencies (e.g., PPE supply), accessible Covid-19 testing as well as budgeting for counselling services and exercise classes. In addition, targeted support for those diagnosed with Covid-19 is recommended, alongside involvement of staff members in organizational decisions

Which wellbeing resources are helpful in managing stress during Covid-19?

Healthcare workers, including nurses, are at increased risk of poor psychological outcomes during Covid-19 due to the nature of their work. This article discusses factors contributing to stress in health and social care workers during the pandemic, and identifies the health and wellbeing support staff found most helpful for managing stress, based on a survey of staff at one health and social care organisation.</p

Disentangling change across the time and true stability of employees’ resilience using latent state model

There is debate within the literature about whether resilience should be considered a stable character trait or a dynamic, changeable process (state). Two widely used measures to assess resilience are the Connor-Davidson Resilience Scale (CD-RISC) and the Resilience Scale for Adults (RSA). The aim of this study was to evaluate the true stability (invariance) and change across time in resilience captured by these two measures. Using the perspective of Latent State-Trait theory, the aim was to decipher if the CD-RISC and the RSA are more trait-like or more state-like and to address whether true differences in resilience between participants increased (or decreased) across time. In this longitudinal study, UK-based employees (N = 378) completed the CD-RISC (10-item version) and the RSA (33-item version, aggregated and analyzed under six parcels) at three occasions over six months. A latent-state model and latent-state model with indicator specific residual factors were utilized. The analysis suggested that both questionnaires capture trait and state components of resilience. These results contribute to the discussion about how resilience scales are measuring change and stability, and how we define resilience as a more trait-like or state-like phenomena. The findings also highlight the issue of what resilience scales are measuring and whether resilience is a quantifiable construct.publishedVersio

The association between C-reactive protein, Interleukin-6 and depression among older adults in the community: a systematic review and meta-analysis

Previous research indicates there may be an association between inflammation and depression in older adults but results are inconsistent. Therefore, the aim of this review was to determine the cross-sectional and longitudinal associations of two inflammatory markers C-reactive protein (CRP) and Interleukin-6 (IL-6) with depression in older adults. We searched five databases for cross-sectional and longitudinal studies reporting an association between CRP or IL-6 with depression among adults sampled from the community aged 50 or older. We found 32 studies (23 cross-sectional, 7 longitudinal, and 2 assessing both cross-sectional and longitudinal associations) that met eligibility criteria. These studies were entered into a random-effects meta-analysis to determine the cross-sectional association and longitudinal direction of association between both IL-6 and CRP with depression. Results indicated a cross-sectional and longitudinal association between both CRP and IL-6 with depression in older adults, with inflammation leading to depression in longitudinal studies rather than depression to inflammation. However, there was notable heterogeneity between studies as results differed based on adjusting for confounders and on how inflammation and depression were measured. These sources of heterogeneity could explain differences in study results

Work-related rumination declines with age but is moderated by gender.

Much is known about the physical effects of work and health, but less is known about how older workers unwind mentally from work, and their post-work ruminative thinking. The present study aimed to explore the association between age, gender and two types of work-related rumination, affective rumination, and problem-solving pondering. This study utilized a sample of 3991 full-time employees (working 30 or more hours per week), who were stratified into five age bands (18-25, 26-35, 36-45, 46-55, and 56-65 yrs.). Affective rumination was found to significantly decline in the older age groups (46 + yrs.), but this finding was moderated by gender. Males reported lower work-related rumination over the entire age range, but the greatest difference between males and females was observed in the 56-65 age category. The results for problem-solving pondering mirrored those of affective rumination but with the only exception that there was no significant difference in gender between those aged 18-25 years. These findings add to our understanding about how workers (between different age groups) mentally switch off from work and highlight the need for interventions to help older workers mentally recover from the effects of work

Use of a Biofeedback Breathing App to Augment Poststress Physiological Recovery: Randomized Pilot Study

Background: The speed of physiological recovery from stress may be a marker for cardiovascular disease risk. Stress management programs that incorporate guided breathing have been shown to moderate the stress response and augment recovery. Objective: The aim of this study was to examine the effectiveness of an app-based brief relaxation intervention (BioBase) for facilitating physiological recovery in individuals exposed to a brief psychological stressor. Methods: A total of 75 participants (44 women) completed a stressor speech task and were randomly assigned to one of three conditions: control, rumination, or an app-based relaxation breathing (BioBase) conditions. Heart rate variability (HRV) was assessed as a measure of autonomic function at baseline (6 min), during stress (6 min), and during recovery (6 min). Results: There was a significant increase in subjective stress following stress exposure, but the ratings returned to baseline after recovery in all three groups. In addition, there was a significant decrease in vagally mediated HRV in the poststress period. During recovery, the root mean square of successive differences (P˂.001), the percentage of successive interbeat (RR) intervals that differ by ˃50 ms (pNN50; P˂.001), and high-frequency (P˂.02) HRV were significantly higher in the BioBase breathing condition than the rumination and control conditions. There was no difference in HRV values between the rumination and control conditions during recovery. Conclusions: App-based relaxed breathing interventions could be effective in reducing cardiovascular disease risk. These results provide additional utility of biofeedback breathing in augmenting physiological recovery from psychological stress.</p

The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: study protocol for an interventional feasibility randomised controlled trial

INTRODUCTION: Accurate and timely dispatch of emergency medical services (EMS) is vital due to limited resources and patients' risk of mortality and morbidity increasing with time. Currently, most UK emergency operations centres (EOCs) rely on audio calls and accurate descriptions of the incident and patients' injuries from lay 999 callers. If dispatchers in the EOCs could see the scene via live video streaming from the caller's smartphone, this may enhance their decision making and enable quicker and more accurate dispatch of EMS. The main aim of this feasibility randomised controlled trial (RCT) is to assess the feasibility of conducting a definitive RCT to assess the clinical and cost effectiveness of using live streaming to improve targeting of EMS. METHODS AND ANALYSIS: The SEE-IT Trial is a feasibility RCT with a nested process evaluation. The study also has two observational substudies: (1) in an EOC that routinely uses live streaming to assess the acceptability and feasibility of live streaming in a diverse inner-city population and (2) in an EOC that does not currently use live streaming to act as a comparator site regarding the psychological well-being of EOC staff using versus not using live streaming. ETHICS AND DISSEMINATION: The study was approved by the Health Research Authority on 23 March 2022 (ref: 21/LO/0912), which included NHS Confidentiality Advisory Group approval received on 22 March 2022 (ref: 22/CAG/0003). This manuscript refers to V.0.8 of the protocol (7 November 2022). The trial is registered with the ISRCTN (ISRCTN11449333). The first participant was recruited on 18 June 2022.The main output of this feasibility trial will be the knowledge gained to help inform the development of a large multicentre RCT to evaluate the clinical and cost effectiveness of the use of live streaming to aid EMS dispatch for trauma incidents. TRIAL REGISTRATION NUMBER: ISRCTN11449333. https://bmjopen.bmj.com/content/bmjopen/13/4/e072877.full.pdf This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/openhrt-2015-00028