Mental illness due to homelessness: a qualitative case study in Melaka, Malaysia

Background: Extreme poverty can result in people barely surviving with poor living standards to the extent of living on the streets, often in fear. With limited access to healthcare services and a clean environment, they are more vulnerable to life adversities. Highly stressful living conditions like these can cause mental illnesses such as depressive disorders, anxiety disorders, psychological distress, and others. Purpose: This research aimed to investigate factors that led to the development of mental illness among homeless people under extreme poverty. Design/methodology/approach: This was a qualitative case study that involved a face-to-face interview with a key informant at the Pertubuhan Kebajikan Villa Harapan Melaka (Villa Harapan). Villa Harapan is a licensed caretaker centre established by the Department of Welfare, Melaka that provides shelter to homeless people with mental illness. Findings: Homeless people suffered from mental disturbances due to loss of jobs, lack of income, broken families, separation from their children, and other vulnerabilities. They are not getting appropriate care and attention for their problem and sickness. Non-supportive family, extreme poverty, and chronic stress were the main factors that led to mental illness among Villa Harapan residents. Research limitations: The study focused on the mental illness of dispossessed people who were brought to Villa Harapan by the Welfare Department. Originality/value: This was an empirical case study on mental illness among homeless people at a care centre known as Villa Harapan.

Learning from adversity: Occupational therapy staff experiences of coping during Covid-19

Introduction The Occupational Therapy profession is adaptable and flexible (Thorner (1991) and these characteristics have the potential to act as protective factors during the COVID-19 pandemic. Understanding the mechanisms that support coping during adversity can help promote future wellbeing. The aim of this study was to explore how Occupational Therapy staff felt and coped during the first peak of the pandemic. Method A questionnaire was developed to explore the experiences of Occupational Therapy staff during the first wave of the COVID-19 pandemic. The questions explored feelings, mechanisms of support and challenges to both practice and wellbeing. A total of 75 staff responded across one NHS Health Board and reflections were analysed using inductive content analysis. Findings Staff reflected on how their ability to adapt and remain flexible were protective factors. This combined with supportive family members, friends and colleagues led respondents to reflect on how well they coped. Barriers to coping included organisational challenges, personal challenges and professional challenges. Conclusion The importance of consistent communication, the need for staff to remain connected to their profession and the importance of engaging in meaningful occupations were highlighted as key to maintaining wellbeing during adversity.

Examining the Mental Health Presentations of Treatment-Seeking Transgender and Gender Nonconforming (TGNC) Youth

Recent research suggests that transgender and/or gender nonconforming (TGNC) youth present with heightened levels of mental health problems compared to peers. This study seeks to examine the mental health needs of a large sample of treatment-seeking TGNC youth by comparing them to cisgender males and females. Participants were 94,804 children and youth ages 4–18 years (M = 12.1, SD = 3.72) who completed the interRAI Child and Youth Mental Health Instrument (ChYMH) or Screener (ChYMH-S) at participating mental health agencies in the Ontario, Canada. Overall, the mental health presentations of TGNC youth were similar to cisgender females but at higher acuity levels. TGNC youth showed significantly higher levels of anxiety, depression, social disengagement, positive symptoms, risk of suicide/self-harm, and were more likely to report experiencing emotional abuse, past suicide attempts, and a less strong, supportive family relationship than cisgender females and males. Clinical implications of these findings are discussed.

Changes in Relationships in Bereaved Families: Perspectives of Mothers Who Lost a Child to Cancer

The loss of a child greatly affects the dynamics of interpersonal relationships in bereaved families. This study explored the relationships in bereaved Korean families from the perspectives of mothers after the death of a child due to cancer. We conducted in-depth interviews with 15 bereaved mothers of a deceased child with childhood cancer. Thematic analysis identified 12 subthemes related to bereaved mothers’ struggles in grief within three significant themes based on family relationships: (a) relationship with husband; (b) relationship with surviving child or children; and (c) relationships with extended family members. Findings highlight bereaved mothers’ need to build supportive family relationships while acknowledging bereaved family members’ different grieving styles and their own challenges in grieving the loss of a child.

Can Cycling Be Addictive? A Qualitative Interview Study Among Amateur Female Cyclists

Exercise and healthy eating are proposed as a recommended lifestyle by the World Health Organization with several positive outcomes, including a decrease in pathologies such as diabetes and reduction in mortality rates. However, research suggests that there is the potential for exercise behaviour to become addictive among a small minority of individuals, which detrimentally impacts their lives. The risk of exercise addiction increases for endurance sports, of which cycling is considered one, given the intense physical and psychological demands, due to elevation and distance, in amateur cycling events. Understanding the risk factors specific to cycling is worthy of investigation, as it is not clear whether cycling can become an addiction. Using the ‘addiction component model’ as a framework, qualitative analysis was used to determine whether symptoms of addiction were present among a sample of eight female cyclists. Through the use of thematic analysis, the results showed that symptoms of addiction were reported by participants. Three themes were generated from research interviews comprising ‘addiction components’ (i.e. salience, conflict, mood modification, tolerance, withdrawal, and cycling despite health problems), ‘enabling infrastructure’ (i.e. supportive work, supportive family and friends), and ‘striving for excellence’ (i.e. needing to be the best, pushing too far, and having unrealistic expectation), currently measured in the ‘addiction component model’. There were also novel themes including ‘cycling above health’ where the participant continues to cycle against medical advice; ‘enabling infrastructure’ where work, family, and friends are accepting of cycling; and ‘striving for excellence’ where the participants ‘needing to be the best’ when comparing themselves to their peers, ‘pushing too far’ to achieve the goal set, and finally ‘unrealistic expectations’ resulting in negative comparison to peers. These findings suggest that addiction to cycling should be investigated further, and implications may necessitate clinical intervention to find alternative coping mechanisms when exercise is not available to an individual as there is a likelihood that individuals will continue to exercise in spite of injury and against medical advice.

Family Experience during Patient Assistance Process in General Intensive Care Unit: A Phenomenology Study

BACKGROUND: Intensive care unit (ICU) treatment can lead to fear, anxiety, depression, panic, and tension in the family. Place of the family as active presence, guardian, facilitator, historian, and coaching of the family cannot be separated from the recovery process. During the assistance of ICU patients, the family is faced with a strange environment, strict rules, emotional stress, and everyday life changes that have caused them to encounter psychological and physiological concerns. AIM: This study aims to describe and interpret of the family’s experience during assistance patient in the ICU. METHODS: A phenomenological methodology is used to explore experience of family. In-depth interviews were conducted on nine participants who were selected using purposive sampling. Data were analyzed by Colaizzi techniques, began with read transcripts, look for phenomenon, formulated data, organized, and verified to the participants. RESULTS: The result is presented in three themes; physically and psychologically tired; good language is a medicine, strengthens each other’s companion. CONCLUSION: The support of the patient in the ICU helps the family face a number of stressful circumstances. Adaptive coping and psychosocial help from health care workers and friends build a supportive family to cope with the difficulties when supporting patients in the ICU.

Exploring dementia family carers’ self-initiated strategies in managing behavioural and psychological symptoms in dementia: a qualitative study

ObjectivesCarer’s self-initiated management strategies of behavioural and psychological symptoms of dementia (BPSD) can inform intervention development. These strategies are affected by cultural values. Little is known about non-Western dementia carers’ BPSD management strategies. This study aimed to explore self-initiated strategies in managing BPSD adopted by Chinese carers.DesignQualitative study using thematic framework method.SettingCommunity setting in Hong Kong.Participants16 dementia carers with purposive sampling to include carers of different relationships to the people living with dementia (PLwD), education level and living arrangement.ResultsSix overarching themes emerged from the data: (1) maintaining personhood in PLwD, (2) responding positively to BPSD, (3) explanation and bargaining, (4) responding negatively to BPSD, (5) controlling upsetting thoughts, and (6) getting respite care. Chinese carers treasured warm and supportive family relationships. They identified and minimised triggers to alleviate BPSD. Some carers struggled with care tasks and reacted with confrontation and avoidance. Changing attitudes and getting social and emotional support were described to manage carers’ distress. Few self-care strategies including getting respite care were reported.ConclusionsCarers’ self-initiated strategies largely aligned with existing theoretical frameworks in BPSD management, such as person-centred approach, and echoed Asian culture, which advocates filial piety and supportive family relationships. While these cultural values encourage the engagement of people living with dementia in the normal process of family life, they may also prevent carers from taking time away from care. Interventions could support carers by enhancing their knowledge and skills in managing BPSD, providing social and emotional support, and providing guidance in self-care. Future cross-cultural research could explore factors contributing to how carers manage BPSD and how interventions could be culturally adapted to facilitate carers to apply learnt skills in daily practice and hence benefit the people living with dementia and carer population.

Emergency Remote Online Course Experience From Students Perspective: A Case Study

The Coronavirus has changed the world in many ways, including education. The epidemic outbreak led to the conversion of courses in many schools and universities from traditional face-to-face classrooms to virtual courses. This situation is a major challenge in a country like Kenya, where IT facilities remain basic. Not all students have the advantage of technological conditions or a supportive family environment. This qualitative case study design is aimed to explore how students portrayed their participation in remote online courses. This study focuses on the experiences of six Standard Eight students in one of the elementary schools in Kisii, Kenya, with ages between 13-15 years old, to cope with multilevel challenges during the Covid-19 pandemic. The data were collected through semi-structured telephone interviews with each participant after permissions were acquired from the students’ parents or guardians. The findings of the study show six emergent themes and sub-themes. The themes that emerged from the interviews are 1) Course descriptions; 2) learning experience; 3) Delivery methods; 4) Materials; 5) Interactions; 6) Challenges.

Explaining Individual Differences in Advantageous Inequity Aversion by Social-Affective Trait Dimensions and Family Environment

Humans are averse to both having less (i.e., disadvantageous inequity aversion [IA]) and having more than others (i.e., advantageous IA). However, the social-affective traits that drive individual differences in IA are not well understood. Here, by combining a modified dictator game and a computational model, we found in a sample of incarcerated adolescents ( N = 67) that callous-unemotional traits were specifically associated with low advantageous but not disadvantageous IA. We replicated and extended the finding in a large-scale university student sample ( N = 2,250) by adopting a dimensional approach to social-affective trait measures. We showed that advantageous IA was strongly and negatively associated with a trait dimension characterized by callousness and lack of social emotions (e.g., guilt and compassion). A supportive family environment negatively correlated with this trait dimension and positively with advantageous IA. These results identify a core set of social-affective dimensions specifically associated with advantageous IA.

The association between supportive social ties and autonomic nervous system function—differences between family ties and friendship ties in a cohort of older adults

Supportive family and friendship ties can serve different functions and thus might show different associations with an individual’s health. Particularly, older adults might show varying health benefits of different types of supportive ties depending on their marital and retirement status. Our aim is to analyze relationships between different types of supportive social ties and autonomic nervous system (ANS) function, a physiological indicator of health that can help to establish the biological plausibility of the association—measured by heart rate variability (HRV). We present cross-sectional linear regression analyses of a German cohort of community-dwelling older adults (2008–2010; n = 1,548; mean age = 68.7 years). Our findings indicate that supportive friendship ties show significant positive associations (i.e., higher HRV) in individuals that are either not married or above retirement age. Supportive family ties show significant positive associations in individuals below retirement age. Significant results vanish or are reduced after accounting for behavioral/physical and psychological/cognitive indicators. We conclude that programs supporting the development or maintenance of friendship ties might be especially beneficial in unmarried older adults and adults above retirement age.