use of portraiture to foster humanistic care

It has been said that a picture says a thousand words, that art should speak for itself. Within the social sciences, there is recognition that images are not merely illustrations, but “texts” that can be read, studied and interpreted in different ways: they are visual narratives. When we look at a work of art, we respond with our own thoughts, feelings and ideas about what it communicates. When we look at a portrait specifically, we are not just looking at a picture of an individual, we are looking at a picture of someone being looked at. It is a visual record of an interaction, as much as a likeness of the person. The artist-sitter relationship has much in common with the doctor patient relationship involving trust, attention, and an openness to ambiguity and creativity. As clinicians that are tired and feeling overwhelmed, we may objectify patients. Engaging with art can help hone our skills to consistently see the whole person. It provides freedom to sit with ambiguity and maintain curiosity and can help us become more flexible in our thinking, to hold multiple possibilities in mind at the same time. Viewing art in a group provides opportunities to understand and appreciate others’ perspectives. Drawing on multiple portraiture projects related to pediatric epilepsy, youth mental health and dementia, this presentation will provide constructive ways in which portraiture can be used to foster humanistic, patient centred care, and to understand the power of distributed cognition.

School Nursing for the Novice: How Do I Begin?

Obtaining a position as a school nurse is an exciting career opportunity, but the reality of a new position in a new specialty area can quickly lead to anxiety and feeling overwhelmed. Your first thoughts might be “Can I really do this job?” and “Where and how do I begin?” The answer to these questions will depend on your situation—are you a nurse hired for a previously established school nurse position or are you the first nurse at your school, charged with initiating a school health program? The purpose of this article is to offer guidance for the novice school nurse in establishing a school health program and school nurse office, as well as to encourage and provide direction for the development of your school nursing practice.

Optimism Is Prospectively Associated With Resilience During the COVID-19 Pandemic

Emerging research has identified how protective factors—like optimism—are associated with resilience to stress during the COVID-19 pandemic. However, the majority of research is cross-sectional, which creates ambiguity around the causal direction because these very protective factors might have also changed due to the pandemic. In the current study, we used longitudinal data from the Health and Retirement Study (N = 921; Mage = 64.54, SD = 10.71; 59.6% female; 57.5% White) to examine how optimism measured in 2016 predicted adjustment during the pandemic (in 2020). Higher baseline levels of optimism were subsequently associated with less worrying and stress resulting from changes in social contacts (βs > |.10|), less loneliness and not feeling overwhelmed (βs > |.16|), and greater COVID-related resilience and benefit-finding (β = .21). The findings will be discussed in the context of mechanisms that facilitate the protective functions of optimism and other psychological characteristics.

Psychosocial Predictors of Psychological Well-Being During the COVID-19 Pandemic

People worldwide have been largely affected by the COVID-19 outbreak. In addition to worries about physical health, it also causes concerns about psychological and mental health. This research aims to explore predictors affecting psychological well-being during the pandemic using the 2018 Health and Retirement Study (HRS) RAND longitudinal data (N = 42,233) and the 2020 HRS COVID-19 module (N = 3,266). Demographics (i.e., gender, age, and education), psychosocial (i.e., personality traits), and health (i.e., comorbidity) variables were included in multivariate logistic and ordinary least square regression analyses predicting feeling “overwhelmed,” “stressed,” and “lonely” during the pandemic. Our results indicated that neuroticism was positively associated with all outcomes. Women were more likely to feel overwhelmed, stressed, and lonely compared to men. Age negatively predicted the overwhelmed and stressed feelings. Furthermore, the effect of depressive symptoms in 2012, 2014, 2016, and 2018 on psychological well-being was assessed by conducting a latent growth curve model. Findings indicate that initial level and increasing change of depressive symptoms over four-time points (waves 11-14) were positively related to psychological feelings. A higher level of depressive symptoms at the initial level of 2012 and increasing reports of depression symptoms predicted higher rates of being stressed, feeling overwhelmed, and lonely during the COVID-19 pandemic. The results have implications for future research and interventions that should target the emotional antecedents and consequences of pandemics.

Prolonged Mechanical Ventilation At Home Versus Long Term Care: Caregiver Characteristics And Strain

Although the number of Prolonged Mechanical Ventilation (PMV) patients and their informal caregivers (CGs) is rising both at Home or Long Term Care (LTC), little is known concerning CG characteristics or strain. We enrolled 120 patients and 106 informal CGs: 34/46 and 72CGs/74 PMV patients from Home Hospital and LTC respectively. CGs were married (82%), female (60.4%), mean age 59 ±14 years; spouses (29%) or children (40%) of the PMV patient. The 13-item Modified Caregiver Strain Index (MCSI) (Maximum severity=26) was 13.6± 6.5, similar at Home vs. LTC (14.3±7.5 vs. 13.3±6.0, p=0.9). Most frequent complaints were distress concerning patient’s changes (93%) or upsetting behaviours (82%), feeling overwhelmed (82%), sleep disturbance (69%) and emotional adjustments (67%). Home CGs reported significantly more physical and financial burden, confinement, and need for work adjustment, while LTC CGs reported greater emotional disturbance and upsetting patient behaviours. Hierarchical clustering identified three clusters of CG strain: burden (physical/time/financial), emotional (upsetting adjustment/ behaviours/overwhelmed) and disturbance (work/plans/confinement). Emotional strain was most frequent, irrespective of site of care; however CGs at Home vs. LTC experienced significantly higher burden and disturbance vs. higher emotional strain respectively. In multivariate models, after adjusting for numerous patient and CG variables, increasing CG strain was consistently associated with rising patient symptomatology. This relationship was pronounced among CGs of Home PMV patients, with a significant interaction variable of Home*Patient symptomatology. Our findings identify specific patterns of strain among caregivers of PMV patients whether at home or LTC, and highlight the importance of addressing their unique needs.

The Influence of Depression on Biased Diagnosis of Premenstrual Syndrome and Premenstrual Dysphoric Disorder by the PSST Inventory

The diagnosis of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) poses a challenge for clinicians due to the overdiagnosis of retrospective methods and overlapping symptoms with depression. The present study utilized an Item Response Theory analysis to examine the predictive utility of the Premenstrual Symptom Screening Tool (PSST) in women with and without depression. Two hundred and fifteen women aged 20–35 completed the PSST, a daily symptom calendar, SCID-I, and CES-D for two consecutive menstrual cycles. PSST items: fatigue, depressed mood, feeling overwhelmed, anxiety/tension, and decreased interest in everyday activities were the best predictors of PMS. Unlike the daily symptom ratings, the PSST over-diagnosed PMS/PMDD in the depressed group but not in the group of women without PMS/PMDD. While diagnosing premenstrual disorders, clinicians should be aware that a retrospective diagnosis with PSST can be more sensitive to mood disorders and cycle phases than a prospective diagnosis with a daily symptoms calendar.

Social Media for Social Support

Based on 15 in-depth interviews, the present study aims to understand the common challenges international graduate students face and the coping strategies they employed, types of SNS used, and social support sought from their relationship during graduate school. Common challenges faced are loneliness, stress, feeling overwhelmed with graduate school, and difficulties adjusting to a new culture. Coping strategies include sharing experiences with relations whom they trust and understand their situation, and joining online communities via SNS. The participants use both public and private SNS to seek social support depending on the various functionalities offered. SNS use depends on the affordances such as convenience, affordability, trust issues, and privacy. Most sought-after type of social support are emotional and informational via SNS.

“Sometimes I think my frustration is the real issue”: A qualitative study of parents’ experiences of transformation after a parenting programme

Introduction Parenting programmes help to alleviate conduct problems in children, but ensuring that all parents feel supported to attend, complete and learn from these programmes has proven difficult. Parents can feel overwhelmed and struggle to change their parenting. This article aims to inform the future refinement of parenting programmes by examining parents’ narratives of how programmes motivated them to change and enabled them to put changes into practice. Method and results Forty-two parents, most of whom had attended Incredible Years group sessions, were interviewed about their views and experiences of parenting programmes that focused on positive parenting practices. Analysis of interview transcripts drew on thematic approaches. Parents perceived that parenting programmes helped them to better understand their child and themselves and to let go of anxieties surrounding their child’s behaviour. Better understanding included greater awareness of emotions and of behaviours their child could and could not control. Parents believed this awareness helped them to change the ways that they interacted with their child, which, in turn, helped them and their child to feel calmer. With greater understanding and calmness parents believed they became more able to see for themselves the changes that they could make in their parenting and everyday lives, and to feel more confident in putting these into practice. Discussion By supporting parents to reflect on their own and their child’s situation, parents perceived that programmes enabled them to improve interactions with their children without getting stuck in self-blame or feeling overwhelmed. Parents of children whose behaviour remained challenging believed that programmes led to beneficial changes in the way they felt about their child’s behaviours. Enhanced support for reflection by parents could potentially help more families to benefit from parenting programmes.

Academic integrity of university students during emergency remote online assessment: An exploration of student voices

Background: This article examines the phenomenon of academic integrity during the coronavirus disease 2019 (COVID-19) pandemic, with particular reference to emergency online assessments in 2020.Aim: It explores academic dishonesty, cheating and plagiarism of university students during emergency remote online assessment, from the perspective of South African students.Setting and Methodology: The authors explore the approaches of different universities worldwide, as well as the extant literature on the topic. An examination of the current literature related explicitly to the COVID-19 online assessments reveals a dearth of engagement by researchers in the South African context. In order to address this lacuna, the authors rely on data generated from an institutional forum on academic dishonesty at a University in South Africa. It focuses specifically on the voices of students presented during the forum, which explained both why students are dishonest and ways to curb dishonesty.Results and Conclusion: The data generated show whilst some students were dishonest due to pandemic-related issues (like lack of monitoring), there are also other reasons, such as lack of time management, feeling overwhelmed and stressed and struggling with technology that contributes to student dishonesty. Students suggest that assessments be approached differently online to curb academic dishonesty. The paper concludes by providing some fundamental changes needed to address academic dishonesty.

Research participation in palliative medicine—benefits and barriers for patients and families: rapid review and thematic synthesis

BackgroundResearch is essential for gathering evidence to inform best practice and clinical decision making, for developing and testing new treatments and services in palliative and end-of-life care (PEoLC). The participation of patients, carers and family members is essential, however, personal and ethical concerns are often cited by professionals as barriers to recruitment. There is evidence that patients and family members can benefit from participation in PEoLC research.AimTo synthesise the evidence regarding patients’, family members’ and carers’ experiences of participating in PEoLC research. To identify recommendations for enhancing the experience of participants.DesignA qualitative rapid review and thematic synthesis.Data sourcesMEDLINE, PsycINFO and PubMed were searched from 2010 to 2020. Studies reporting patients’, family members’ or carers’ experiences of participating in PEoLC research were included.Results4 studies were included and 7 themes identified relating to the benefits of, and barriers to, participation in PEoLC research. Both altruistic and personal benefits of participation were reported. Barriers (negative aspects) to participation included feeling overwhelmed, practical issues, reminders of being a patient, not seeing the research as relevant to them and unmet needs.ConclusionsA number of benefits (positive aspects) surround participation in PEoLC research. However, several barriers (negative aspects) can prevent or discourage participation. This review has identified recommendations for research teams to enhance the experience, and number of people who those participating in research in this field.