Using Reflective Writing to Explore Resident Resilience during Global Health Electives

Pediatric residents participating in global health electives (GHEs) report an improved knowledge of medicine and health disparities. However, GHEs may pose challenges that include cost, personal safety, or individual mental health issues. The objective of this study was to describe the use of guided reflections to understand resident resilience during GHEs. Forty-five residents enrolled in two pediatric training programs were asked to respond in writing to weekly prompts during a GHE and to complete a post-trip essay. Analysis of the reflections and essays, including an inductive thematic analysis, was completed. Two coders performed a second analysis to support classification of themes within the Flinders Student Resilience (FSR) framework. Four themes emerged from the initial analysis: 1) benefits, 2) stresses and challenges, 3) career development, and 4) high-value care. Analysis using the FSR framework revealed the following themes: acknowledgment of personal limitations, importance of relationships in coping throughout the GHE, and discernment of career focus. Reflective writing provided insight into how residents mitigate GHE challenges and develop resilience. Despite statements of initial distress, residents focused on their personal benefits and growth during the GHE. The FSR framework revealed the residents’ robust self-awareness of limitations and that strong relationships on the ground and at home were associated with perceived benefits and growth. Programs should consider helping residents to identify healthy coping practices that can promote personal resilience during GHEs as part of pre-departure preparation and debriefing, as well as providing for supportive communities during the GHE.

Resiliensi Remaja dan Implikasinya Terhadap Kebutuhan Pengembangan Buku Bantuan Diri

Penelitian ini bertujuan untuk mengetahui gambaran resiliensi pada remaja di salah satu sekolah unggulan dan kebutuhan untuk mengembangkan resiliensi dengan buku bantuan diri. Sampel penelitian ini menggunakan teknik insidental sampling dengan jumlah sebanyak 106 remaja. Alat ukur yang digunakan adalah Child Youth Resilience Measure-Revised (CYRM-R) dan studi kebutuhan buku bantuan diri mengenai resiliensi. Hasil penelitian menunjukkan bahwa pada umumnya remaja memiliki tingkat resiliensi sedang dengan skor 67,2. Remaja yang memiliki resiliensi luar biasa sebanyak 3,74% (4 orang), resiliensi tinggi sebanyak 25,23% (27 orang), resiliensi sedang sebanyak 46,73% (50 orang), dan resiliensi rendah sebanyak 23,36% (25 orang). Tingkat resiliensi pada remaja laki-laki lebih tinggi dengan rerata 67,6 dibanding remaja perempuan dengan rerata 66,86. Rerata aspek personal resilience sebesar 39,93 lebih tinggi dibanding rerata aspek caregiver resilience sebesar 27,26. Meskipun tingkat resiliensi yang dimiliki remaja rata-rata pada kategori sedang, mereka tidak pernah mendapatkan materi pengembangan resiliensi dalam layanan bimbingan konseling di sekolah. Sebanyak 80% remaja tertarik untuk menggunakan media buku bantuan diri dalam layanan BK. Oleh karena itu, pengembangan buku bantuan diri sangat penting untuk membantu remaja dalam mengembangkan kemampuan resiliensi yang mereka miliki. Buku bantuan diri mengenai resiliensi berjudul “Terus Melangkah: Tak Perlu Takut Ketika Hidup Menjadi Sedikit Sulit” dengan materi dan lembar kerja yang tersedia untuk mengembangkan resiliensi mendapatkan hasil uji validasi dengan ahli media dengan skor 84,5% (sangat layak) dan hasil uji validasi dengan ahli materi dengan skor 80,3% (layak). Sehingga rata-rata kelayakan buku bantuan diri mengenai resiliensi yaitu 82,4% (sangat layak).

Personal Resilience, Social Support, and Organizational Support Impact Burnout among Nurses During COVID-19

Background: Nurses have been under heavy workloads since the outbreak of COVID-19 and are at a high risk of infection, leading to a high level of psychosocial risk. This can adversely affect nurses both psychologically and physically. Burnout is caused by prolonged stress during work. In the nursing profession, burnout is common, potentially affecting the well-being of nurses and their productivity. The identification of factors that may contribute to maintaining mental health and reducing burnout among frontline nurses during a pandemic is essential. Purpose: The purpose of this study was to explore how personal resilience, social support, and organizational support impact burnout among frontline staff nurses. Methods: This study involved 129 registered nurses from a COVID-19 designated hospital using four standardized scales. Results: The mean age of the respondents was 29.46 years (standard deviation = 4.89). The mean number of years respondents worked in this organization was 5.60 years and the nursing profession was 4.16 years. Most of the respondents were female and held a bachelor's degree in nursing. Multiple regression analysis was performed to predict burnout. Burnout was statistically significantly predicted by the multiple regression model (R2 = .420, F (3, 125) = 10.941, p < .0001; adjusted R2 = .406). Personal resilience, social support, and organizational support added statistically significantly to the prediction of burnout (p < .05). Conclusion: Findings from multiple regression analysis showed that nurses with low resilience and those who perceived inadequate social and organizational support had a higher risk of reporting more burnout. As a result of a bivariate analysis, there was no significant correlation between nurse variables and burnout level, except for age, which was negatively correlated with burnout level. Accordingly, young nurses tend to experience burnout, and nurse directors and managers must address this problem.

Social Support and Personal Resilience of Government Employees

The study primarily aims to determine which domain of social support significantly influences the personal resilience of government employees. The study utilized a descriptive correlational design and employed a survey method to attain the research objectives. The selected respondents were the 210 government employees who were selected through a stratified random sampling technique. The researchers made use of the pilot-tested and enhanced adapted questionnaires. The statistical tools used were mean, pearson r and regression. As reflected on the results, social support and personal resilience of government employees obtained different mean scores but both belong to high descriptive levels. Further, it was found out that there is a significant relationship between social support and the personal resilience of government employees. Furthermore, it was found that social support significantly influences personal resilience having three out of four domains contributed to its significant influence. Lastly, it was emotional support emerged as the best predictor in this study. Keywords: public administration, social support, personal resilience, emotional support, Philippines

Iconic war images and the myth of the ‘good American Soldier’

This article explores the ‘good American soldier’ as a gendered ideal type shaped by, and reproductive of, myths about American military success, romantic notions of small-town working and white America, notions of heterosexual virility, and ableist stereotypes about personal resilience. Drawing from an analysis of 10 years of media coverage of an iconic image dubbed the ‘Marlboro Marine’, the article outlines three specific myths linked to the ‘good American soldier’, in order to provide an insight into ideals of militarized masculinity and the gendered myths that shape American nationalism and identity. In developing this analysis, the article extends existing work on military masculinities by introducing the ‘good American soldier’ ideal type and explores the multiple myths associated with this ideal type. The article also demonstrates how a media narrative analysis that covers an extended period of time makes it possible to observe shifting narratives associated with the ‘good American soldier’.

Sources of Resilience in Frontline Health Professionals during COVID-19

Background: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used to cope with frontline challenges during the COVID-19 pandemic. Methods: Semi-structured interviews were conducted with 20 frontline health professionals, across five Australian hospitals, between October 2020 and April 2021. The interviews were recorded and transcribed, and the results were analysed using thematic analysis based on a phenomenological approach. Results: Three sources of resilience were identified by respondents: personal, relational, and organisational. A positive mindset, sense of purpose, and self-care behaviours emerged as key sources of personal resilience. Teamwork, altruism, and social support from family and friends contributed to relational resilience. Leadership, effective communication, and effective implementation of COVID-19 policies were associated with resilience at the organisational level. Frontline healthcare workers also voiced the need for the implementation of further strategies to support personal resilience whilst nurturing resilience within clinical teams and across entire healthcare organisations. Conclusions: Trust in healthcare systems, organisation leaders, colleagues, and personal support teams was an overarching theme supporting resilience.

Morally Distressing Experiences, Moral Injury, and Burnout in Florida Healthcare Providers during the COVID-19 Pandemic

Because healthcare providers may be experiencing moral injury (MI), we inquired about their healthcare morally distressing experiences (HMDEs), MI perpetrated by self (Self MI) or others (Others MI), and burnout during the COVID-19 pandemic. Participants were 265 healthcare providers in North Central Florida (81.9% female, Mage = 37.62) recruited via flyers and emailed brochures that completed online surveys monthly for four months. Logistic regression analyses investigated whether MI was associated with specific HMDEs, risk factors (demographic characteristics, prior mental/medical health adversity, COVID-19 protection concern, health worry, and work impact), protective factors (personal resilience and leadership support), and psychiatric symptomatology (depression, anxiety, and PTSD). Linear regression analyses explored how Self/Others MI, psychiatric symptomatology, and the risk/protective factors related to burnout. We found consistently high rates of MI and burnout, and that both Self and Others MI were associated with specific HMDEs, COVID-19 work impact, COVID-19 protection concern, and leadership support. Others MI was also related to prior adversity, nurse role, COVID-19 health worry, and COVID-19 diagnosis. Predictors of burnout included Self MI, depression symptoms, COVID-19 work impact, and leadership support. Hospital administrators/supervisors should recognize the importance of supporting the HCPs they supervise, particularly those at greatest risk of MI and burnout.

Work-related stress among headteachers in Wales: Prevalence, sources, and solutions

The purpose of this study was to investigate the prevalence, sources, and underlying causes of work-related stress among headteachers in Wales and to identify possible solutions. An online questionnaire was sent to all 1588 headteachers across Wales. The questionnaire included demographic questions, Cohen’s Perceived Stress Scale (PSS), the Health and Safety Executive (HSE) Management Standards Tool, a list of known stressors, and open questions exploring the underlying causes and possible solutions. A total of 359 (22.6%) headteachers completed the survey. Two-thirds of participants reported experiencing levels of stress that were rated as ‘high’. Pressures of managing greater demands and increasing workload with fewer financial resources and a lack of support from local authorities were the main sources of stress. Solutions focused on improved funding to enhance staffing and resources at a school level, reduced accountability, and improved support. The findings indicated that a multi-faceted, multi-level, intervention approach, extending beyond improving personal resilience and individual school improvements, into regional and national opportunities for change, is likely to be most effective in reducing work-related stress within the profession.

Building Resilience in At-Risk Adolescents: Comparing the mechanisms and outcomes of two school-based prevention programmes

<p>This study sought to confirm and expand literature on psychological health by comparing and contrasting the effects of two prevention programmes, one focused on reducing negative affect and the other focused on enhancing positive affect, and by revealing possible pathways that might lead to increased wellbeing and resilience and reduced negative affect and depressive symptoms. Two school-based intervention approaches were examined: Kiwi ACE (Adolescents Coping with Emotions) and PAL (Positive Approaches to Life), to investigate which techniques would prevent the occurrence of depression, increase wellbeing, and help build resilience in Year 9 students (13-yr-olds). Kiwi ACE is a programme based on a CBT (Cognitive-Behavioural Therapy) model and was trialled previously with success. PAL kept within the same structure as Kiwi ACE but used strategies aimed at building a capacity within students to develop positive emotions in order to build resources for present and future challenges. Both programmes aimed to build resilience and prevent the development of depression in at-risk adolescents. Nine schools from the wider Wellington region in New Zealand participated in the current study. Sixty-five students identified as at-risk, participated in one of the two programmes, and 69 students constituted the control group. All students in the current study were at risk of developing depression, pre-intervention, as suggested by a mild-moderate score on the CDI (Children's Depression Inventory). Both programmes consisted of weekly one hour sessions enacted over 12 weeks during which a group of approximately 10 students met with a clinical psychologist and school counsellor. A survey consisting of a range of scales, measured students' scores pre- and post- programme, at six months and one year after the programme was completed. Kiwi ACE and PAL both decreased depressive symptoms and increased well-being for up to one year after the programme. However, PAL had stronger effects in promoting gratitude, satisfaction with life, happiness, and resilience. Mediation analysis revealed that Kiwi ACE helped to decrease depressive symptoms by increasing students' sense of environmental mastery and increased students' well-being scores by decreasing the intensity and frequency of participants’ negative emotions. In contrast, PAL helped to decrease depressive symptoms, and increase well-being and resilience through many routes, namely through increasing gratitude, meaning, happiness and satisfaction with life. The findings of this study reveal that building a capacity for positive emotions can help develop many resources that protect students from depressive symptoms and increase their psychological well-being and personal resilience. In addition, using positive emotions as a resource is equally effective as using CBT strategies in preventing depression and is more effective in increasing positive outcomes, including personal resilience. Finally the results from PAL indicate that cultivating positive emotions such as gratitude and happiness is an effective way to build personal resilience in adolescence.</p>