Italian Adolescent Young Caregivers of Grandparents: Difficulties Experienced and Support Needed in Intergenerational Care-Giving: Qualitative Findings from a European Union Funded Project

The article aims to describe the experiences of 87 Italian adolescent young caregivers (AYCs) of grandparents (GrPs), with reference to the caregiving stress appraisal model (CSA) that provides a theoretical lens to explore the difficulties encountered and support needed in their caring role. Qualitative data were drawn from an online survey conducted within an EU Horizon 2020 funded project. An inductive thematic analysis was carried out, and the findings were critically interpreted within the conceptual framework of the CSA model. The analysis highlighted three categories of difficulties: material, communication and emotional/psychological. The most common material difficulty was the physical strain associated with moving “uncooperative” disabled older adults. The types of support needed concerned both emotional and material support. The study provides a deeper understanding of the under-studied experiences of AYCs of GrPs. Based on these findings, policies and support measures targeted at AYCs of GrPs should include early needs detection, emotional support and training on intergenerational caring in order to mitigate the stress drivers. Moreover, the study advances the conceptualisation of the CSA model by considering the above-mentioned aspects related to intergenerational caregiving.

Effects of Stress Exposure Versus Appraisal on Episodic Memory Trajectories: Evidence for Risk and Resilience among Black Older Adults

Objectives Chronic stressors, experienced disproportionately by Black older adults, are a risk factor for memory impairment. Racially patterned stress exposure may contribute to higher rates of Alzheimer’s disease and related dementias (ADRD) among Black older adults compared with Whites, but less is known about the role of stress appraisal. This study examined whether chronic stress exposure mediates racial disparities in memory and whether stress appraisal moderates these associations. Methods Participants included 16,924 older adults (Mage= 67.39, 21% Black) from the 2010 and 2012 waves of the Health and Retirement Study who completed measures of chronic stress exposure (health, financial, housing, relationships, and caregiving) and appraisal. Latent growth curves modeled longitudinal performance on a word list memory task over six years. Results Black older adults reported greater stress exposure than Whites, and greater stress exposure partially mediated Black-White disparities in initial memory (standardized indirect effect=–.002, p=.009). However, Black older adults appraised stressors as less upsetting than Whites. While stress appraisal did not moderate links between stress exposure and memory, appraising stressors as less upsetting was independently associated with better initial memory. Thus, Black-White disparities in initial memory was partially offset by Blacks participants' appraisal of stressors as less upsetting (standardized indirect effect=.002, p=.016). Discussion Reducing chronic stress exposure may reduce racial disparities in ADRD risk. The counteractive effect of stress appraisal on Black-White disparities in episodic memory highlights resilience factors among Black older adults that should be characterized in future research to move beyond deficit models of ADRD inequality.

Loneliness, Stress, and Depressive Symptoms Among Older Immigrants: A Moderating Role of Familial Relationships

Objectives Immigration is a stressful life event, and immigrants commonly experience loneliness, a risk factor for depression. However, little is known about how and whether older immigrants’ perceived stress exposure/appraisals mediate the association between loneliness and depressive symptoms. Further, this study explores whether familial relationships moderate the indirect or direct effects of the mediation models. Method: This study uses the 2012 Health and Retirement Study from a sample of 719 immigrants age 57 and older. A series of moderated mediation analyses were conducted across the total number of stress exposure and eight stress appraisal domains. Results The findings indicate that the total number of stress exposure and five domains of stress appraisals (health problems in self, physical/emotional problems in spouse/child, financial strain, housing problems, and close relationships in others) mediate the association between loneliness and depressive symptoms. In addition, the perceived negative strain from family moderated the mediating effect of health problems and housing problems in the relationship between loneliness and depressive symptoms. Discussion This study suggests that negative relationships with family may increase upsetting in stress appraisals on health and housing problems, which turn in increased depressive symptoms for lonely older immigrants. Practitioners need to assess older immigrants’ stressors and family relationships to understand their loneliness and depressive symptoms.

Stress and coping – Perceptions of final year nursing students returning to clinical practice during the COVID-19 pandemic, South Africa

Background: The novel nature of the coronavirus disease 2019 (COVID-19) pandemic places challenges on nursing students as they try to complete the clinical requirement of their training. Nursing faculties need to understand these challenges to support and equip nursing students to enter the workforce.Aim: To explore and describe the anticipated and subsequent perceptions of final year Bachelor of Nursing students returning to clinical practice during the COVID-19 pandemic in South Africa.Setting: The study was conducted at two universities in the Western Cape and KwaZulu-Natal, South Africa. Both universities offer 4-year Bachelor of Nursing programmes accredited by the South African Nursing Council and were in ‘hot spot areas’ for SARS-CoV-2.Methods: A qualitative study with focus groups discussions of final year undergraduate nursing students from both universities were conducted. Data were analysed through content analysis using Lazarus and Folkman’s Stress Appraisal Coping Model.Results: Five focus groups discussions with a total of 25 participants were conducted. Three themes with eight sub-themes emerged, the key themes being: primary appraisal and anticipation of returning to clinical practice; contextual influence on primary appraisal and reappraisal to facilitate positive return to clinical practice.Conclusion: Primary perceptions of returning to clinical practice revolved around uncertainty and stress. However, through preparation and the process of reappraisal, participants were able to adapt and cope with the challenges in returning to clinical practice during the pandemic.Contribution: It is important to recognise the role of faculty in supporting nursing students’ transition into situations of uncertainty such as the pandemic.

THREAT OF COVID-19 AND PERCEIVED STRESS: THE MEDIATING ROLE OF CHALLENGE, UNCONTROLLABILITY AND STRESSFULNESS

Objective: To find out the mediating role of challenge, uncontrollability, and stressfulness in predicting perceived stress from threat during COVID-19 pandemic in the general public. Study Design: Cross-sectional survey. Place and Duration of Study: Bahawalpur City, from Mar to May 2020. Methodology: A total of 360 participants (men=154, women=206) were recruited from different cities of Punjab province. The stress appraisal measure, perceived stress scale, and coping scale were administered through Google forms using social media platforms. The participation in the online survey implied signing the written informed consent available in the survey. Results: The primary and secondary appraisals of challenge (IE=0.84, SE=0.27, 95% LL=0.31, 95% UL=1.40), uncontrollability (IE=1.03, SE=0.36, 95% LL=0.34, 95% UL=1.76), and stressfulness (IE=-0.28, SE=0.12, 95% LL=-0.56, 95% UL=-0.08) fully mediated the relationship between threat of COVID-19 and perceived stress. Additionally, there was statistically significant positive relationship between threat of COVID-19 and use of coping strategies (r=0.14, p<0.01). The statistics of women regarding appraisals of threat, uncontrollability, stressfulness and perceived stress (2.94 ± 0.88); (2.49 ± 0.84); (2.87 ± 0.73); (19.92 ± 6.08), were found to be slightly higher on as compared to men (2.76 ± 0.82); (2.25 ± 0.81); (2.58 ± 0.76); (18.41 ± 5.37) respectively with p=0.01, Cohen’s d=0.21); p=0.001, Cohen’s d=0.29); p=0.001, Cohen’s d=0.38); (p=0.01, Cohen’s d=0.26). Conclusion: The threat of COVID-19 significantly led to the experience of perceived stress through the mediating role of primary and secondary appraisals of challenge, uncontrollability, and stressfulness.

Understanding Rural Women’s Domestic Work Experiences (DWE) in Ibadan, Nigeria: Development of a Measurement Tool Using Confirmatory Factor Analysis

Gender norms prescribe domestic labor as primarily a female’s responsibility in developing countries. Many domestic tasks depend on access to water, so the physical, emotional, and time demands of domestic labor may be exacerbated for women living in water-insecure environments. We developed a set of domestic work experience (DWE) measures tailored to work in rural areas in developing countries, assessed rural Nigerian women’s DWE, and examined relationships among the measures. Interviewer-administered survey data were collected between August and September from 256 women in four rural Nigerian communities. Latent factors of DWE were identified by analyzing survey items using confirmatory factor analysis. Pearson’s correlation was used to examine relationships among latent factor scores, and multivariate linear regression models were used to determine if factor scores significantly differed across socio-demographic characteristics. The DWE measures consisted of latent factors of the physical domain (frequency of common domestic tasks, water sourcing and carriage, experience of water scarcity), the psychosocial domain (stress appraisal and demand–control), and the social domain (social support). Significant correlations were observed among the latent factors within and across domains. Results revealed the importance of measuring rural Nigerian women’s DWE using multiple and contextual approaches rather than relying solely on one exposure measure. Multiple inter-related factors contributed to women’s DWE. Water insecurity exacerbated the physical and emotional demands of domestic labor DWE varied across age categories and pregnancy status among rural Nigerian women.

Difference in stress-related indicators between employees experiencing partial and complete lockdowns during the COVID-19 pandemic in Pakistan

Objectives: The present study aimed to compare the stress experience of employees facing to differentiated types of lockdown situations: total vs. partial. It also aimed to identify the cognitive appraisal, coping, stress, and fear of contracting COVID-19 associated with lock down situations among employees. Method: A cross-sectional research design was employed. The sample comprises two groups (n = 490 in each group), complete lockdown (people working from home) and partial lockdown (people going to workplace), and was drawn from Pakistan using purposive sampling technique. Stress Appraisal Measure, Brief COPE Inventory, Perceived Stress Scale, and Fear of Contracting COVID-19 Questionnaire were used to measure cognitive appraisal, coping, stress, and fear, respectively.Results: Independent sample t-test showed that the threat and uncontrollable appraisal was high in people going to workplace as compared to people working from home. Results of binary logistic regression showed that people going to workplace were more likely to cope with COVID-19 situation through seeking instrumental support, behavior disengagement, acceptance, and religion as compared to people working from home. Moreover, people working from home were 0.84 times more likely to cope through emotional support than people going to workplace. Fear was found to be 1.1 times more likely associated with people going to workplace than people working from home.Conclusion: This study would help administrative authorities and government institutions in designing mental health services for working population. It would help the emergency departments in devising first aid management plan to deal with the psychological needs of the workers under pandemic/lockdown situations.

Late Adulthood, COVID-19-Related Stress Perceptions, Meaning in Life, and Forgiveness as Predictors of Mental Health During the COVID-19 Pandemic

The purpose of this study was to examine multiple direct and indirect pathways of the association between older age and mental health through COVID-19-related stress perceptions, meaning in life, and forgiveness of situations. Participants were 1,382 U.S. adults who were part of the Harvard Digital Lab for the Social Sciences panel who volunteered to complete a 12 min survey in the spring of 2020. The sample had an average age of 56 years, was slightly more male (55%) than female (44%) or other (2%), mostly White (88%), well-educated (70% bachelors degree or more), and middle-income ($60,000–$75,000 annually). Measures included: COVID-19-related stress perceptions (e.g., concerns about infection, job, lack of necessities), presence of and search for meaning in life, forgiveness of situations, psychological distress, hopelessness, and optimism. A latent mental health variable was created that was comprised of psychological distress, hopelessness, and optimism. All hypothesized direct effects were in evidence, and all but one indirect effect were observed. Specifically, older age was related to better mental health through higher presence of meaning and lower search for meaning. Older age was also related to better mental health through a serial indirect pathway from lower COVID-19-related stress perceptions to higher presence of and lower search for meaning and higher forgiveness of situations to mental health. The proposed model was largely supported and confirms existing theory and research on aging, positive psychological processes, and mental health. Findings also offer new insights on the unique potential role of forgiveness of situations and its theoretical relevance to offending situations such as the COVID-19 pandemic. The present study offers a beginning for theorists, researchers, and practitioners to consider the connections between aging and mental health and the intricate interconnections between stress appraisal and positive coping resources that may serve to support it.

Older Adults in the United States and COVID-19: A Qualitative Study of Perceptions, Finances, Coping, and Emotions

Introduction: Older adults have the poorest coronavirus (COVID-19) prognosis with the highest risk of death due to complications, making their COVID-19 experiences particularly important. Guided by the stress-appraisal-coping theoretical model, we sought to understand COVID-related perceptions and behaviors of older adults residing in the United States.Materials and Methods: We used convenience sampling to recruit persons with the following inclusion criteria: Aged ≥ 65 years, English fluency, and U.S. residency. Semi structured in-depth interviews were conducted remotely and audio recorded between April 25, 2020 and May 7, 2020. Interviews were professionally transcribed with a final study sample of 43. A low-inference qualitative descriptive design was used to provide a situated understanding of participants' life experiences using their naturalistic expressions.Results: The mean age of participants was 72.4 ± 6.7. Slightly over half were female (55.8%), 90.6% were White, and 18.6% lived alone. The largest percentages of participants resided in a rural area (27.9%) or small city (25.6%). We identified four themes, including (1) risk perception, (2) financial impact, (3) coping, and (4) emotions. Most participants were aware of their greater risk for poor COVID-19 outcomes but many did not believe in their increased risk. Financial circumstances because of the pandemic varied with largely no financial impacts, while others reported negative impacts and a few reported positive impacts. Coping was problem- and emotion-focused. Problem-focused coping included precautionary efforts and emotion-focused coping included creating daily structure, pursuing new and/or creative activities, connecting with others in new ways, and minimizing news media exposure. Overall, emotional health was negatively affected by the pandemic although some participants reported positive emotional experiences.Conclusions: Perceiving themselves as high risk for COVID-19 complications, older adults used precautionary measures to protect themselves from contracting the virus. The precautionary measures included social isolation, which can negatively affect mental health. Older adults will need to be resourceful and draw on existing resources to cope, such as engaging in creative activities and new strategies to connect with others. Our findings underscore the importance of the preservation of mental health during extended periods of isolation by taking advantage of low-to-no-cost existing resources.