The relationship between COVID-19-induced death thoughts and depression during a national lockdown

Evidence suggests that the COVID-19 pandemic has increased rates of depression worldwide. Many factors have been identified to relate to this increase depression, but according to Terror Management Theory, the heightened awareness of death during the pandemic has the potential to increase depression for those with low self-esteem. This hypothesis was examined in a U.K. sample during the first national lockdown where depression, self-esteem and death-thought accessibility (DTA) were measured, and a COVID Index (COVID-19 cases and deaths on date of participation) was produced. The COVID Index was positively related to DTA. Additionally, DTA mediated the relationship between the COVID Index and depression scores when participants had low levels of self-esteem. These findings suggest that heightened existential concerns may be a neglected factor increasing depression during the pandemic.

THE EMERGENCE OF EXISTENTIAL EXPERIENCES: THE IMPACT OF THE PANDEMIC ON KAZAKHSTANIS

The consequences of the pandemic caused by the spread of the COVID-19 virus have led to existential concerns. As a result, the human race, realizing the brevity of life, began to pay attention to existential issues. In order to identify this problem, a survey was conducted as part of the research project “The Emergence of Existential Experiences in the Worldview of Kazakhstanis in Connection with the Pandemic”. This is a way to take an empirical view of human existential considerations in order to conduct a deep epistemological and axiological analysis of the meaning and content of human life during a pandemic. The abstract presents the existential reflections of modern people, based on the results of the survey. Thus, the relevance of the study of the problem of a person and the meaning of his life appears as a need, which is significant not only in social but in personal terms as well.

Difficult pain

A child in pain needs not only appropriate medical treatment, but specific attention to psychosocial, cultural, and spiritual issues in order to allow meaningful exploration of wider fears or concerns. Management requires a collaborative, multimodal approach; optimal use of non-pharmacological strategies, targeted analgesic pharmacotherapy, and if necessary, specific interventional therapies. Although managing pain is only one aspect of providing palliative care for children, however, it is a core task. The experience of severe pain demands an individual’s whole attention, leaving little chance of addressing wider psychosocial or existential concerns while it remains uncontrolled. Difficult pain is a highly prevalent symptom among children with life-limiting conditions (LLC). It is complex, usually multifactorial and multifaceted. It is encountered in every dimension; the physical perception and experience of pain will be dictated by the existential and psychosocial context in which it occurs for the individual child.

Frontline clinician concerns during the COVID-19 pandemic: A qualitative inquiry

Objective: The COVID-19 pandemic has strained healthcare systems worldwide, placing a high psychological burden on frontline clinicians. There is an urgent need to better understand their stressors and determine if stressors differ by clinical role. The present study assessed the concerns among frontline clinicians across a large healthcare system during the COVID-19 pandemic to inform the development of tailored supportive services.Methods: From March – June 2020, frontline clinicians across the Mass General Brigham healthcare system were invited to register for an adapted mind-body resiliency group program. Clinicians completed pre- and post-program assessments asking them to report their COVID-19-related concerns. Qualitative data were analyzed in aggregate and by clinical role using content analysis to identify overarching domains.Results: Frontline clinicians’ concerns fall within seven domains: concerns for self, patients, family members, staff, existential concerns, systems-level concerns, and job-level concerns. Concerns for self and existential concerns were most commonly reported across clinical roles. Long-term care clinicians were highly concerned about patients’ wellbeing while rehabilitation therapists were highly concerned about their family members’ health. Across groups, nurse practitioners and physician assistants more often reported job-level concerns. Concerns for staff and systems level concerns were less frequently reported across clinical roles.Conclusions: Frontline clinicians share common pandemic-related concerns, but nuances exist among the concerns most frequently reported across clinical roles. Interventions that offer stress management and resiliency training may be helpful for addressing pandemic-related concerns overall. Future research should determine if tailored support services by clinical role may be warranted.

Existential distress in patients with advanced cancer and their caregivers: study protocol of a longitudinal cohort study

IntroductionAt the end of life, patients with advanced cancer and their informal caregivers may confront multiple existential concerns. Despite the strong potential to alleviate existential distress through psychosocial interventions, existential distress and its impact on healthcare outcomes have not yet been studied systematically. We aim to investigate the frequency, longitudinal trajectory and predictive impact of existential distress on end-of-life outcomes. We further aim to determine patients’ and caregivers’ specific need for and utilisation of psychosocial support for existential distress.MethodsThis longitudinal cohort study will consecutively recruit 500 patients with advanced cancer and 500 caregivers from oncological outpatient and inpatient clinics. Participants will complete self-report questionnaires (sociodemographic and disease-related characteristics, existential distress, end-of-life outcomes, resources and support needs) at five points of assessment (at baseline and after 3, 6, 9 and 12 months). At baseline and 6-month follow-up, we will conduct structured diagnostic interviews to assess mental disorders. Statistical analyses will include descriptive statistics to determine the prevalence of existential distress, mental disorders and end-of-life outcomes; multiple linear and logistic regression analyses to calculate the predictive impact of existential distress on end-of-life outcomes; and growth mixture models to analyse longitudinal trajectories of existential distress.DiscussionThis study will provide comprehensive knowledge about patients’ and caregivers’ existential concerns. The longitudinal empirical data will allow for conclusions concerning the frequency and course of existential distress throughout 1 year. This important extension of existing cross-sectional research will contribute to further develop targeted psychosocial interventions. Profiles of existential distress may be applied by clinicians from multiple professions and help to address existential concerns effectively.Ethics and disseminationThe study was approved by the institutional research ethics committee (reference number LPEK-0177). Results will be presented at scientific conferences and published in peer-reviewed journals. Other forms of dissemination will include sharing results on the psychometric properties of the structured demoralisation interview with international research groups and communication with healthcare professionals providing psychosocial treatment for patients and caregivers. Following scientific standards, our progress will be regularly updated on ClinicalTrials.gov.Trial registration numberNCT04600206.

Mentoring Youth for Joy in Anxious Times

In this article, the authors set forward a theory of joy built upon adolescent development and describe how anxiety sometimes interferes. They elaborate why adolescence is a time of joy and the type of future-oriented adolescent imagination that fosters joy. Describing adolescent development from neurological, biological, social, sexual orientation, racial identity, and stages of faith perspectives, they show how joy and development are linked in adolescent flourishing. After defining anxiety, showing its prevalence, and distinguishing it from worry they indicate how the existential concerns of anxiety interferes with joy and how mentorship can help. Exploring pertinent Scriptures, they examine some ameliorative effects against anxiety through attachment based play that challenges a competitive culture and mentorship that evokes already-emergent strengths.