Assessment of emotions and stress coping mechanisms of healthcare workers from the Department of Pediatrics at the Philippine General Hospital a year after the Coronavirus Disease 2019 (COVID-19) Pandemic

Objective@#Healthcare workers (HCWs) are an often overlooked population in the face of a pandemic. With the myriad of researches focusing on the effect of Coronavirus Disease 2019 (COVID-19) on patients, this study aimed to illuminate the emotions, stressors and stress coping mechanisms of medical frontliners from the Department of Pediatrics working in Philippine General Hospital.@*Methods@#A quantitative cross-sectional study was done among 130 HCWs ages 21-55 years old, mostly females (72%), recruited through convenience sampling. An adapted questionnaire from China was used and data were analyzed using means, T-test and Anova.@*Results@#Results showed that HCWs predominantly felt a high sense of professional and ethical duty towards their jobs. Stressors include fear of transmitting the virus to their family and the shortage of manpower, while stressrelievers include knowing that their family are safe and having a good relationship with colleagues. Coping strategies include the use of personal protective measures and the hope of cure motivates them to continue working. Seeking psychiatric help is interestingly one of the least important motivational factors. Nurses, fellows, and residents significantly differ in responses about their feelings, stress-relievers, and coping strategies.@*Conclusion@#HCWs are a vulnerable population since they endure multiple stressors but they are idealistic and resilient, hence the hospital should give adequate financial compensation and provide good work-life balance.

Japan’s stable supply system for pharmaceuticals：its inspiration for enhancing the supply assurance capability of drugs in shortage in China / 中国药房

OBJECTIVE To provide insights for enhancing the supply assurance capability of drugs in shortage in China. METHODS By sorting out top-level design ideas for Japan’s stable supply system for pharmaceuticals， this study elaborates on its current policies for stabilizing drug supply. Policy suggestions were proposed for existing challenges in the supply of drugs in shortage in China. RESULTS & CONCLUSIONS To stabilize drug supply， Japan formulated a systematic 3-tier policy framework that ran through pre-prevention， early risk monitoring， and response mechanisms for supply problems. Pre-prevention measures included establishing a graded classification system for stable supply lists， strengthening government control over the drug production process， and implementing a continuous supply system and cessation reporting system for post-market drugs. Early risk monitoring included self-assessing risks in enterprises， disclosing information concerning supply assurance of enterprises， and providing enterprises with price protection and incentives measures. Response mechanisms for supply problems included establishing the mechanism of increasing production and coordinated supply in enterprises， opening fast-track review and approval channels for changes in raw materials， and establishing emergency systems of transferring drugs to supply. To balance supply assurance and strong regulation of drugs in shortage through refining the incentive and regulatory policies for them， it is recommended to refine the criteria for selecting drugs in shortage， strengthen the circulation of information， optimize price management methods， and clarify problem feedback and solving.

Stress among Parents of Children with Hearing Loss and How They Deal with It: A Systematic Review

Abstract Introduction Parenting a child with hearing loss may be accompanied by high stress levels and several challenges. Objectives The present systematic review was performed to compile the existing literature pertaining to parental stress in parents of children with hearing loss and coping strategies. Data synthesis The databases searched include PubMed/Medline, Scopus, Cochrane Library and Cumulative Index to Nursing, and Allied Health Literature. The systematic review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. The screening for studies was performed independently by two researchers. Methodological quality appraisal was done using the Mixed methods appraisal tool. Twenty-eight studies were identified and included in the present review, which discussed the stress factors and coping mechanism associated with having child with hearing loss reported by parents. The factors leading to stress were thematically classified into parent/family-related factors, child-related factors, and professionals/service-related factors. The coping strategies were thematically classified into improved support systems and better professional resources. Conclusion The present systematic review was an attempt at exploring the various stress causing factors among parents of children with hearing loss. The various coping strategies would help in better planning services for these parents and helping to lessen the stress.

Assessment of stress and coping mechanisms in the 1st year MBBS students from English and Vernacular medium – An experience from a new All India Institute of Medical Sciences

Background: The stress levels among the 1st year MBBS students are high due to multiple factors. In this setting, an objective assessment of stress and coping strategies among medical students may provide a foundation to adopting specific measures to help them. Aims and Objectives: The specific objectives of the study were to compare stress levels and coping strategies among medical students from different backgrounds and mediums of instructions and to ategorize the stress level of students depending on Class X, XII marks, number of attempts, and annual family income. Materials and Methods: Forty-eight 1st year MBBS students were recruited for the study. Participants were divided into two groups, that is, Group 1 – English medium schools and Group 2 – Hindi medium schools and informed consent was taken. In a preferable time slot, the participants were given two questionnaires (Zung’s SDS and Way of Coping Revised scale) and a table of personal information to fill. Results: There were significantly higher stress scores among English medium students as compared to vernacular medium. There was no correlation between Class 10th and 12th marks with the stress. Proportion of students having high stress had AFI <1 lakh and proportion having low stress had AFI more than 5 lakh. Students having more than 3 attempts in medical qualifying examination had the least stress scores. Conclusion: Stress among medical students was found to more in students from English medium schools due to the urban background of these students. High family income acts a psychological security for the students, hence the low stress among them. Students with more than 3 attempts in qualifying examination were more mature, hence the low stress score among them.

Ego defense mechanisms among pediatric dental postgraduate students in India A descriptive cross-sectional study

Background: Ego defense mechanisms (EDMs) act as a major factor for overcoming stressful situations in life. Aims: The study aimed to assess the various patterns and factors of EDMs employed by pediatric dental postgraduate students in India. Settings and Design: Cross-sectional design, web-based questionnaire survey. Methods: A cross-sectional questionnaire study on EDM was conducted among 246 pediatric dental postgraduates in India from July to October 2019. The modified form of the Defense Style Questionnaire-20 included 10 EDMs under three major patterns– Mature, Immature, and Neurotic. The questionnaire was sent to all pediatric dental postgraduates enrolled in the Indian Society of Pedodontics and Preventive Dentistry and reminders were sent every week for 6 weeks. Results: Among the 1041 pediatric dental postgraduates who received the E-mail, two hundred and forty-six students responded to the same. The respondents included 89 males and 157 females. The mature pattern was found to be the most commonly employed EDM (males-47.20%; females-51.60%). Sublimation (72.76%), a mature type of defense was found to be the most common EDM factor employed by the majority of the students. The immature pattern was higher among males when compared to females (males-14.60%; females-5.70%). Conclusion: Most pediatric dental postgraduates exhibited a mature pattern, followed by a neurotic and immature pattern of EDM. The mature pattern of EDM was displayed more by the female students than the male students. Sublimation was found to be the maximum expressed factor followed by acting out.

Adult Personality and its Relationship with Stress Level and Coping Mechanism among Final Year Medical Students

@#Each human being exhibits their own personality traits and each aspect of stress and coping is essential and related. The relationship between the big five personality traits, coping mechanisms and stress level among final year medical students of Universiti Kebangsaan Malaysia (UKM) was investigated in this study. In this cross-sectional study, 152 final year medical students batch 2017/2018, were randomly selected, excluding those who had chronic diseases, married and repeated final year. The questionnaires used were Big Five Personality Inventory and 12-Item General Health Questionnaire. An open-ended question was used to determine how the respondents cope with their stress. Data was analyzed using SPSS 20.0. Agreeableness was the most common personality trait portrayed among the students, whereas Openness to Experience appeared to be the least. The relationship between the Big Five Personality Traits and coping mechanisms (p=0.016; p<0.05) were significantly related. Students with Neuroticism personality had the highest rate of practicing avoidant coping mechanism, while students with Extraversion personality had the highest rate of practicing active coping mechanism. Total score of stress were significantly difference between the different personality traits (p<0.001; p<0.05). However, the p value of 0.359 (p>0.05) and 0.94 (p>0.05) for the Big Five Personality Traits and level of stress showed no significant results on academic performance. Identified own personality were beneficial for final year medical students as it helps to identify the most effective coping mechanism in reducing stress during studying medicine.

The relationship between gender and coping mechanisms with burnout events in first-year medical students / 한국의학교육

PURPOSE: First-year students are susceptible to experiencing burnout if the coping mechanism being used is inadequate; therefore, employing effective coping mechanisms could help students to minimize burnout. Coping mechanisms are divided into five groups: problem-focused, emotion-focused, dysfunctional coping, adaptive, and maladaptive coping. The burnout dimension includes emotional exhaustion, cynicism, and decreased academic performance that may be influenced by gender. This study aims to elaborate on the relationship between gender and coping mechanisms with burnout events in first-year medical students. METHODS: This is a cross-sectional study using a total sample of first-year students from a medical school. RESULTS: A total of 167 respondents (response rate 98.9%) completed a Brief Coping Orientation to Problems Experienced Questionnaire and Maslach Burnout Inventory-Student Survey. The results showed that there was no significant relationship between gender and burnout (p>0.05). On the contrary, maladaptive/dysfunctional coping had a significant positive correlation with emotional exhaustion (r=0.403, p<0.001) and cynicism (r=0.372, p<0.001). Adaptive coping had a significant negative correlation with cynicism (r=-0.165, p=0.033) and a significant positive correlation with perception of personal accomplishment (r=0.417, p<0.001). CONCLUSION: In conclusion, there was no significant relationship between gender and burnout. However, maladaptive/dysfunctional coping had a positive correlation with emotional exhaustion and cynicism. On the other hand, adaptive coping had a negative correlation with cynicism and a positive correlation with perception of personal accomplishment.

The Effectiveness of Educational Programs on Parenting Stress and Coping Mechanism among Parents of Children with Autism Spectrum Disorder: A Systematic Review

Abstract@#The aim of this systematic review was to evaluate the effectiveness of educational programs on parenting stress and coping mechanism among parents of children with Autism Spectrum Disorder. Our current review retrieved the articles from databases such as CINAHL, Springer, Ovid, PubMed, Google Scholar, and EBSCO host. Only articles published between the years of 2000 and 2018 in these databases were recruited using keywords such as Autism Spectrum Disorder, education program, parenting stress, coping mechanism, and coping strategies. The search generated 17 articles; 8 articles were relevant. This systematic review provides an important opportunity to advance our understanding of the effectiveness of the educational program for reducing parenting stress and improving coping mechanism among parents of children with Autism Spectrum Disorder. Nurses could also have a pivotal role in delivering the educational program for parents of children with ASD.

A Study on Social Media and Substance Abuse as Coping Mechanisms in Indian College Students

Background: Increasing perceived stress directs college students to resort to a variety of copingmechanisms. Among the popular strategies, many college students are reaching out to social media, whilemany take to substance abuse. Like two sides of a coin, substance abuse and social media are used for bothnegative and positive purposes. The present study is designed to explore which coping mechanism -substance abuse or social media, do young adults employ to cope with their stress and the effectiveness ofthat mechanism.Methods: A sample of 167 male and female college students is selected. Data is collected through a selfdesigned questionnaire and Index of Clinical Stress (Abell, 1991). Descriptive statistics, student’s t-test andANOVA is employed to analyse the data.Results: Results indicate no significant differences in the perceived stress experienced by students who usesocial media, substance abuse and both as coping mechanisms. More students using social media ascoping measure reported a decrease in their stress. Also, students who perceived social support reportedthe least stress experienced. Dissatisfaction with their choice of coping measure also reported higher stressin the students. Almost half the sample reported that they would recommend neither social media norsubstance abuse as coping mechanisms.Conclusion:The results guide towards numerous future research ideas, as none of the two copingmechanisms seem to relieve stress in young adolescents and they do not qualify to be recommended. Theimportance of social support and satisfaction with one’s own choices is reiterated.

Depression And Anxiety In Mothers Of Children With Cancer And How They Cope With It: A Cross-Sectional Hospital Based Study In Eastern India

Objective: Cancer is a chronic, long-term illness that affects not only the child but also the family as a whole. The family faces objective as well as subjective difficulties, e.g. stress, anxiety and depression. The burden is often experienced by mothers, since they take on the major responsibility of care giving. We conducted a study in mothers of children with acute lymphoblastic leukemia (ALL) and determined whether their coping mechanisms were acceptable and if these mechanisms were helpful to reduce depression. Methods: Mothers of 58 children with Pre (precursor) B cell leukemia were evaluated using Beck's depressive inventory (BDI), Coping Health Inventory for Parents (CHIP), and State-Trait Anxiety Inventory (STAI). Results: Coping with behaviors used by mothers of children with ALL was ineffective. The mothers mostly used coping behavior, which involved family life and relationships, and the parents' outlook on life of the affected child. The use of CHIP sub scale-type I, ie.“talking with other individuals/parents in my same situation” was significantly related to more use of sub scale-type II, ie. “doing things together as a family, involving all members of the family” are both were significantly related to STAI (p < 0.001). However total BDI score was not significantly related with any of the coping scores (BDI scores more than 9). Patients with higher BDI scores had lower scores in all sub scales of CHIP. Conclusions: Our subjects did not use social support and did not understand the medical situation through communication with other parents, or medical professionals. Fewer depressed patients used more coping skills. Educating the parents about healthy coping mechanism can be a good way to reduce stress. Encouraging social support networking and providing information about the disease may help to increase the acceptance among the mothers with ALL. A

Complejo ira - hostilidad y mecanismos de afrontamiento en pacientes que han sufrido un evento cardiovascular / Anger - hostility - aggression syndrome: mechanisms of coping in patients who have suffered a cardiovascular event

Introducción: Se ha relacionado el complejo ira - hostilidad - agresión con la enfermedad cardiovascular. Asimismo, los mecanismos de afrontamiento juegan un papel central en el proceso de rehabilitación cardiaca. El propósito de este estudio fue valorar la presencia del complejo ira - hostilidad - agresividad y sus mecanismos de afrontamiento en personas con enfermedad coronaria. Materiales y métodos: Se estudió un grupo de 19 pacientes que asisten al Programa de Rehabilitación Cardiaca de la Escuela Ciencias del Deporte de la Universidad Nacional. Se aplicó el cuestionario de agresión, para identificar el complejo ira - hostilidad - agresión, y el cuestionario COPE, para identificar mecanismos de afrontamiento. Ambos cuestionarios fueron aplicados en dos momentos: en versión retrospectiva, antes de sufrir el evento cardiovascular y una semana después. Resultados: En la evaluación retrospectiva del complejo ira-hostilidad se registraron promedios que oscilaron entre 1.84 y 2.51; los valores más altos fueron para las dimensiones hostilidad, 2.51, y agresividad verbal 2.49. En la evaluación actual, los promedios variaron entre 1.73 y 3.0, siendo los valores más altos para las dimensiones hostilidad, 2.28, e ira, 3.01. La única diferencia significativa se encontró en la dimensión ira, la cual en la evaluación actual fue superior a la retrospectiva, p menor 0.05. Por otro lado, los mecanismos de afrontamiento más utilizados fueron: la religión, el apoyo social, la aceptación, la planificación y afrontamiento activo y la reinterpretación positiva. Conclusión: Este estudio mostró un perfil de reacción emocional y de afrontamiento en los pacientes cardiópatas encuestados, que evidencia la necesidad de considerar los aspectos psicológicos en el proceso de rehabilitación cardiaca

Psychological Responses and Coping Mechanism Of Sexually Abused Teenagers : Basis for Psychiatric Nursing Care

This study was undertaken to provide basis for the “Psychological Response and Coping Mechanism of Sexually Abuse Teenagers: A Basis for Psychiatric Nursing Care” which discover the different responses and coping mechanism of sexually abused teenagers. Respondents (50) were from the government institutions supervised by the Department of Social Welfare and Development (DSWD) namely residents of Marillac Hills at Town Center North Gate Avenue, Filinvest, Corporate City, Alabang, Munting Lupa City. Age of the respondents from 11-17 years old was included as the subject of the study.The study used a descriptive correlation research. The instrument used was a personal information sheet which includes their demographic variables, relationship to the Perpetrator, and reason for abused. Statistical measurements used are measures of Central Tendencies and Kruskall Wallis Two Way Anova by Ranks. This determines the respondents of the sample as to different area of functioning and coping mechanism. Also establish differences and correlation between two age groups (11-14 and 15-17 years old) based on the mentioned mechanism.In conclusion, the age group ratio was 3:1 (for 11-14 and 15-17 years old) distributed nationally from four regions of the country. Occupations of the parents were of blue-collar nature (driver, laborer, house maid) belong to the low socio-economic income of the society. Respondent educational attainment falls only up to the primary level of education. Majority of the respondents were abused by their father while other of their family relatives indicating that occurred within the household where the perpetrator tended to have close family relation with the victim. Result show there is no significant difference among the selected sexually abused teenagers when grouped as to birth of origin, father nature of work and five categories of coping mechanism.Based on the findings of the study, special programs for sexually abused teenagers should be conducted by the agency concerned and assisted by the NGO’s (the government centers). Their rights under the existing laws, victims of sexually abused women should be observed and respected. The center/ agency in charge of sexually abused teenagers provide assistance for them to continue their education, constant counseling, ensure reintegration in their family and community. That the agencies in-charge of keeping peace and order should enforce strictly rules in order to avoid/or minimize sexual abused. Further study maybe conducted in other agencies.

The Associations of Coping Mechanism with Arterial Stiffness in Hwa-Byung Patients

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.

The Associations of Coping Mechanism with Arterial Stiffness in Hwa-Byung Patients

OBJECTIVE: The goal of this study is to assess the relationship between stress coping mechanisms and the risk of atherosclerosis in patients with Hwa-Byung. METHODS: The Korean version of the Ways of Coping Checklist (WOCC) was administered to 50 patients with Hwa-Byung (49.1+/-10.1 years, 6 males). Brachial-ankle pulse wave velocity (baPWV) and serum cholesterol level were assessed in all participants. RESULTS: After controlling for age, sex, diagnosis of hypertension, Body Mass Index (BMI), and serum cholesterol level, the score of seeking social support in coping strategies was negatively correlated with right and left baPWV (r=-0.356, p=0.016; r=-0.373, p=0.012, respectively). In addition, the score of active coping mechanism was negatively correlated with both sides of baPWV (r=-0.383, p=0.009; r=-0.389, p=0.008, respectively). CONCLUSION: The seeking social support and active coping mechanism were inversely related to the severity of arterial stiffness in Hwa-Byung patients. Therefore, our result may suggest a possibility that coping strategies in Hwa-Byung patients are associated with the risk of atherosclerosis.

Prevalence of Stress and Coping Mechanism among Staff Nurses in the Intensive Care Unit

The working environment of intensive care unit (ICU) nurses is a constant source of stress. Researchers have described ICU as a stressful environment because of the complex nature of patients’ health problems requiring an extensive use of very sophisticated technology. This study aimed to identify the prevalence of stress among staff nurses working in ICU, Hospital Universiti Kebangsaan Malaysia (HUKM), factors influencing stress and to explore the symptoms of stress experienced. This descriptive study was conducted on 67 staff nurses working in ICU, HUKM. Data was collected using selfadministered questionnaires. The questionnaires included sections on socio-demographic data, factors influencing stress and symptoms of stress experienced. Data was analysed using frequency and percentage. The Chi square test was used to examine the relationship between socio-demographic data and factors influencing stress. Findings indicated that stress symptoms were experienced by 100 per cent (n =67) of staff nurses. Knowledge, working experience, critically ill patients, and environmental factors were one of the many factors contributing to the stress experienced by the ICU nurses in HUKM. Nurses working in ICU, HUKM are found to have a high level of stress. Recommendations like encouraging ICU nurses to take up post basic ICU courses and increasing the nurses quota can reduce the prevalence of stress among ICU nurses. Hospital management has an important role to play in reducing the stress levels of nurses working in ICU as stress has an effect on job performance and quality of nursing care.

Coping Strategies Utilized in the Caregiving Situation and Predictors of Health Responses among Informal Caregivers of Older Adults / 간호학회지

The sample of this study consisted of 140 informal caregivers who provided care to the older adults(over 60 years of age) in Great Cleveland, USA. Self-rated questionnaires were utilized to collect information. The purpose of the study was to identify coping strategies most frequently utilized by informal caregivers of older adults and to examine predictors of the caregivers' health responses to the caregiving situation applying Lazarus and Folkman stress model(1984). Stepwise multiple regression was used to identify significant predictors among caregivers' demographic-socio-economic factors, older adult's dependency of activities of daily living(ADLs), caregiver's appraisal to the caregiving situation, and coping strategies. Informal caregivers (N=140) included in the study utilized help-seeking and problem-solving coping strategies more than self-blame and minimization of threat coping strategies. Caregivers' responses to the caregiving situation were observed by caregivers' perceived physical health, depression and life satisfaction. For perceived physical health, threat appraisal, older adult's dependency on ADLs, existential growth coping strategy, and monthly income accounted for 25% of the variance. Caregivers who appraised the caregiving situation as more threatening, reported higher dependency on ADLs, used more existential growth coping strategy, and had higher monthly income reported better physical health. For depression, threat appraisal, stress appraisal, existential growth coping strategy, self-blame coping strategy, and monthly income accounted for 48% of the variance. Caregivers who used more existential growth coping and less self-blame coping, appraised the situation as less threatening, less stressful, and had higher monthly income reported less depression. For life satisfaction, self-blame coping, existential growth coping, monthly income, stress appraisal accounted for 49% of the variance. Caregivers who used more existential growth coping, less self-blame coping, less stress appraisal, lower monthly income reported better life satisfaction. In conclusion, informal caregivers in this study utilized positive coping strategies such as problem-focused, existential growth, help-seeking, rather than negative coping strategies including self-blame. When they utilized positive coping strategies more often, caregivers experienced higher perceived physical health, higher life satisfaction and lower depression. Therefore, nursing intervention which utilized positive coping strategies is needed to enhance informal caregivers to have positive health responses to the caregiving demands.

The Relationship between Coping Mechanisms and Psychological Symptoms in Vitiligo Patients / 대한피부과학회지

BACKGROUND: Vitiligo is an acquired disorder which causes body disfiguring and may provoke emotional stress, functional impairment, and psychiatric symptoms. OBJECTIVE: (1) To assess whether the psychiatric symptoms are more frequent in vitiligo patients than control patients. (2) To investigate whether the vitiligo patients with more severe psychiatric symptoms use more negative and passive coping mechanisms than patients with less severe psychiatric symptoms. To carry out this study we evaluated psychiatric symptoms, problems in daily activities, and the relation-ship between coping mechanisms and psychiatric symptoms. METHODS: A clinical study was done on 150 vitiligo patients. Other dermatology patients were used as a control group. Both groups had visited the dermatology clinic of the Severance hospital. Questionaires regarding age, sex, severity of disease, duration of disease, SCL-90(symptom check list 90), the coping list of Weisman, and items for adaptability of daily activity were recorded. Results : Male vitiligo patients showed more psychological symptoms than female patients. Vitiligo patients had many more difficulties in daily activities than the control patients. The patients who had more severe psychiatric symptoms used more negative and passive coping mechanisms than less severe patients. Conclusion : Vitiligo provoked psychiatric symptoms and difficulties in daily activities. Psychiatrically more severe patients used negative and passive coping mechanisms. Comprehensive dermatologic and psychiatric treatment may be required in the treatment of vitiligo.