Paternal Perinatal Experiences during the COVID-19 Pandemic: A Framework Analysis of the Reddit Forum Predaddit

During the COVID-19 pandemic, new parents were disproportionately affected by public health restrictions changing service accessibility and increasing stressors. However, minimal research has examined pandemic-related stressors and experiences of perinatal fathers in naturalistic anonymous settings. An important and novel way parents seek connection and information is through online forums, which increased during COVID-19. The current study qualitatively analyzed the experiences of perinatal fathers from September to December 2020 through the Framework Analytic Approach to identify unmet support needs during COVID-19 using the online forum predaddit on reddit. Five main themes in the thematic framework included forum use, COVID-19, psychosocial distress, family functioning, and child health and development, each with related subthemes. Findings highlight the utility of predaddit as a source of information for, and interactions of, fathers to inform mental health services. Overall, fathers used the forum to engage with other fathers during a time of social isolation and for support during the transition to parenthood. This manuscript highlights the unmet support needs of fathers during the perinatal period and the importance of including fathers in perinatal care, implementing routine perinatal mood screening for both parents, and developing programs to support fathers during this transition to promote family wellbeing.

Moral Injury Among Frontline Long-Term Care Staff and Management During the COVID-19 Pandemic

Background A growing body of research highlights the experiences of moral injury among healthcare professionals during the COVID-19 pandemic. Moral injury (i.e., participating in or witnessing acts that violate one's central moral values), is associated with a host of psychological sequelae and corresponding negative psychosocial impacts. There is a lack of research examining the experiences of moral injury among those working in long-term care settings during the COVID-19 pandemic. Given the drastic impact that the COVID-19 pandemic has had on long-term care facilities in Canada, it is important to understand the experiences of moral injury among those working in long-term care settings to inform the development of effective prevention and intervention strategies. Objectives & Method The objectives of this study were to understand the experiences and impact of moral injury among Canadian frontline long-term care workers (staff and management) during the COVID-19 pandemic. Participants (N = 32 long-term care staff and management working in Ottawa and Manitoba) completed in-depth, semi-structured qualitative interviews and clinical diagnostic assessments (Mini International Neuropsychiatric Interviews;MINI;Version 7.0.2) between March 2021-June 2021. Findings The core category of our qualitative grounded theory model of moral injury in long-term care exemplified four shared types of morally injurious experiences, paired with cognitive, affective, and physiological symptom domains. Seven associated main themes emerged, contributing to the experiences and impact of moral injury in long-term care: 1) Beliefs about older adults and long-term care;2) Interpretation of morally injurious experiences;3) Management of morally injurious experiences;4) Long-term care pandemic impacts;5) Personal pandemic impacts;6) Structural impacts in long-term care;and 7) Mental health needs and supports. Clinical assessments demonstrated anxiety disorders (n = 4) and feeding and eating disorders (n = 3) were among the most frequently classified current psychiatric disorders among long-term care workers. Conclusions This is the first Canadian study to examine the experiences and impact of moral injury in long-term care during the COVID-19 pandemic using qualitative and clinical diagnostic methodologies. Implications and insights for screening and intervention are offered.

Moral Injury Among Frontline Long-Term Care Staff and Management During the COVID-19 Pandemic.

Background: A growing body of research highlights the experiences of moral injury among healthcare professionals during the COVID-19 pandemic. Moral injury (i.e., participating in or witnessing acts that violate one's central moral values), is associated with a host of psychological sequelae and corresponding negative psychosocial impacts. There is a lack of research examining the experiences of moral injury among those working in long-term care settings during the COVID-19 pandemic. Given the drastic impact that the COVID-19 pandemic has had on long-term care facilities in Canada, it is important to understand the experiences of moral injury among those working in long-term care settings to inform the development of effective prevention and intervention strategies. Objectives & Method: The objectives of this study were to understand the experiences and impact of moral injury among Canadian frontline long-term care workers (staff and management) during the COVID-19 pandemic. Participants (N = 32 long-term care staff and management working in Ottawa and Manitoba) completed in-depth, semi-structured qualitative interviews and clinical diagnostic assessments (Mini International Neuropsychiatric Interviews; MINI; Version 7.0.2) between March 2021-June 2021. Findings: The core category of our qualitative grounded theory model of moral injury in long-term care exemplified four shared types of morally injurious experiences, paired with cognitive, affective, and physiological symptom domains. Seven associated main themes emerged, contributing to the experiences and impact of moral injury in long-term care: 1) Beliefs about older adults and long-term care; 2) Interpretation of morally injurious experiences; 3) Management of morally injurious experiences; 4) Long-term care pandemic impacts; 5) Personal pandemic impacts; 6) Structural impacts in long-term care; and 7) Mental health needs and supports. Clinical assessments demonstrated anxiety disorders (n = 4) and feeding and eating disorders (n = 3) were among the most frequently classified current psychiatric disorders among long-term care workers. Conclusions: This is the first Canadian study to examine the experiences and impact of moral injury in long-term care during the COVID-19 pandemic using qualitative and clinical diagnostic methodologies. Implications and insights for screening and intervention are offered.

Paternal Perinatal Experiences during the COVID-19 Pandemic: A Framework Analysis of the Reddit Forum Predaddit.

During the COVID-19 pandemic, new parents were disproportionately affected by public health restrictions changing service accessibility and increasing stressors. However, minimal research has examined pandemic-related stressors and experiences of perinatal fathers in naturalistic anonymous settings. An important and novel way parents seek connection and information is through online forums, which increased during COVID-19. The current study qualitatively analyzed the experiences of perinatal fathers from September to December 2020 through the Framework Analytic Approach to identify unmet support needs during COVID-19 using the online forum predaddit on reddit. Five main themes in the thematic framework included forum use, COVID-19, psychosocial distress, family functioning, and child health and development, each with related subthemes. Findings highlight the utility of predaddit as a source of information for, and interactions of, fathers to inform mental health services. Overall, fathers used the forum to engage with other fathers during a time of social isolation and for support during the transition to parenthood. This manuscript highlights the unmet support needs of fathers during the perinatal period and the importance of including fathers in perinatal care, implementing routine perinatal mood screening for both parents, and developing programs to support fathers during this transition to promote family wellbeing.

Sleep disturbance during COVID-19: Correlates and predictive ability for mental health symptomatology in a Canadian online sample.

BACKGROUND: Sleep disturbance is associated with mental health symptomatology, but this impact is understudied during COVID-19. The aims of this study are to: 1) examine correlates of sleep disturbance, and 2) examine the longitudinal relationship between sleep disturbance and mental health symptoms 6 months later, during the pandemic. METHODS: Data were analyzed from COVID-19 Survey Canada conducted between May 2020 (T1) and November 2021 (T2) (n = 489). We examined COVID-related baseline correlates of sleep disturbance at T1, and used multivariable regressions to examine the relationship between T1 sleep disturbance and T2 post-traumatic stress (PTS), health anxiety, generalized anxiety, and depressive symptoms, controlling for baseline mental health symptoms and sociodemographics. RESULTS: Females, ages 30-49, and those with an annual household income <$50,000, showed a higher prevalence of clinically significant sleep disturbance. After adjustment, compared to those without sleep disturbance at baseline, those with sleep disturbance showed a significant increase in PTS symptoms at 6 months (b = 11.80, 95% CI = [8.21-15.38], p < 0.001). LIMITATIONS: Results are not nationally representative. Data may be subject to response biases due to self-report methods and we are unable to determine causality. CONCLUSION: Being able to predict adverse mental health implications of sleep disturbance will help clinicians be equipped to target future impacts of the COVID-19 pandemic as well as any future potential pandemics or traumas. This study emphasizes the importance of screening individuals for sleep disturbance.

Pregnancy during the COVID-19 pandemic: a qualitative examination of ways of coping.

The COVID-19 pandemic and related public health restrictions have impacted the mental health and coping strategies of many population groups, including people who are pregnant. Our study sought to explore the ways that pregnant people described coping with stressors associated with the pandemic. N = 5879 pregnant individuals completed the pan-Canadian Pregnancy During the COVID-19 Pandemic Survey between April and December 2020. We used descriptive statistics to quantify sociodemographic characteristics and thematic analysis (Braun & Clarke, 2006, 2019) to analyze n = 3316 open-ended text responses to the question "Can you tell us what things you are doing to cope with the COVID-19 pandemic?" The average age of participants was 32 years (SD = 4.4), with the majority identifying as White (83.6%), female (99.7%), married (61.5%), having completed post-secondary education (90.0%), and working full-time (75.4%). We categorized participant responses into two overarching thematic dimensions: (1) ways of coping and (2) coping challenges. Ways of coping included the following main themes: (1) taking care of oneself, (2) connecting socially, (3) engaging in pandemic-specific coping strategies, (4) keeping busy, (5) taking care of others, (6) creating a sense of normalcy, (7) changing perspectives, and (8) practicing spirituality. Coping challenges included the following: (1) the perception of coping poorly, (2) loss of coping methods, (3) managing frontline or essential work, and (4) worries about the future. Findings highlight important implications for targeted prenatal supports delivered remotely, including opportunities for social support, prenatal care, and mental health strategies.

Building Emotional Awareness and Mental Health (BEAM): study protocol for a phase III randomized controlled trial of the BEAM app-based program for mothers of children 18-36 months.

BACKGROUND: The prevalence of maternal depression and anxiety has increased during the COVID-19 pandemic, and pregnant individuals are experiencing concerningly elevated levels of mental health symptoms worldwide. Many individuals may now be at heightened risk of postpartum mental health disorders. There are significant concerns that a cohort of children may be at-risk for impaired self-regulation and mental illness due to elevated exposure to perinatal mental illness. With both an increased prevalence of depression and limited availability of services due to the pandemic, there is an urgent need for accessible eHealth interventions for mothers of young children. The aims of this trial are to evaluate the efficacy of the Building Emotion Awareness and Mental Health (BEAM) app-based program for reducing maternal depression symptoms (primary outcome) and improve anxiety symptoms, parenting stress, family relationships, and mother and child functioning (secondary outcomes) compared to treatment as usual (TAU). METHODS: A two-arm randomized controlled trial (RCT) with repeated measures will be used to evaluate the efficacy of the BEAM intervention compared to TAU among a sample of 140 mothers with children aged 18 to 36 months, who self-report moderate-to-severe symptoms of depression and/or anxiety. Individuals will be recruited online, and those randomized to the treatment group will participate in 10 weeks of psychoeducation modules, an online social support forum, and weekly group teletherapy sessions. Assessments will occur at 18-36 months postpartum (pre-test, T1), immediately after the last week of the BEAM intervention (post-test, T2), and at 3 months after the intervention (follow-up, T3). DISCUSSION: eHealth interventions have the potential to address elevated maternal mental health symptoms, parenting stress, and child functioning concerns during and after the COVID-19 pandemic and to provide accessible programming to mothers who are in need of support. This RCT will build on an open pilot trial of the BEAM program and provide further evaluation of this evidence-based intervention. Findings will increase our understanding of depression in mothers with young children and reveal the potential for long-term improvements in maternal and child health and family well-being. TRIAL REGISTRATION: ClinicalTrials.gov NCT05306626 . Registered on April 1, 2022.

Examining Anxiety Treatment Information Needs: Web-Based Survey Study

Background: Several treatments for anxiety are available, which can make treatment decisions difficult. Resources are often produced with limited knowledge of what information is of interest to consumers. This is a problem because there is limited understanding of what people want to know when considering help for anxiety. Objective: This study aimed to examine the information needs and preferences concerning treatment options for anxiety by assessing the following: what information people consider to be important when they are considering treatment options for anxiety, what information people have received on psychological and medication treatment in the past, how they received this information in the past, and whether there are any differences in information needs between specific samples and demographic groups. Methods: Using a web-based survey, we recruited participants from a peer-support association website (n=288) and clinic samples (psychology, n=113;psychiatry, n=64). Results: Participants in all samples wanted information on a broad range of topics pertaining to anxiety treatment. However, they reported that they did not receive the desired amount of information. Participants in the clinic samples rated the importance of information topics higher than did those in the self-help sample. When considering the anxiety treatment information received in the past, most respondents indicated receiving information from informational websites, family doctors, and mental health practitioners. In terms of what respondents want to learn about, high ratings of importance were given to topics concerning treatment effectiveness, how it works, advantages and disadvantages, what happens when it stops, and common side effects. Conclusions: It is challenging for individuals to obtain anxiety-related information on the range of topics they desire through currently available information sources. It is also difficult to provide comprehensive information during typical clinical visits. Providing evidence-based information on the web and in a brochure format may help consumers make informed choices and support the advice provided by health professionals.

"And then came COVID-19": Manitoban reflections on the emergence of the pandemic

The growing body of research on COVID-19 has demonstrated physical, mental, social, and financial impacts on global populations. There is an absence of research, told through the unique voices of the general public, during early, critical stages of the emergence of the pandemic and pandemic-related restrictions, describing Canadians' experiences. The Winnipeg Free Press sent out a public call through their print and online journal for personal reflections related to COVID-19 starting on March 22, 2020. A total of 44 reflections were published in this column (March 28-April 24, 2020). Authors de-identified and compiled reflections for qualitative analysis using Interpretive Description (Thorne, Interpretive Description, 2008, Left Coast Press). Reflections were written by a range of Manitobans, including health care workers, teachers, childcare workers, business owners, grandparents, mothers, fathers, daughters, travelers, veterans, young adults, and older adults. The central theme, "And then came COVID-19," was highlighted across writers' reflections, describing the sudden and significant impact of the pandemic on many facets of life. Following from this central, overarching theme are four related themes describing: Longing for normalcy;Layers of uncertainty;Lack of support;and "Hardy Winnipeggers": How are we coping? Findings contribute to a significant gap in our understanding concerning early COVID-19 experiences in Canada and offer insight regarding needs for educational and health-related supports. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (French) Le nombre croissant de recherches sur la COVID-19 a demontre les impacts physiques, mentaux, sociaux et financiers sur les populations du monde entier. Or, il y a une absence de recherche, racontee par les voix uniques du grand public, durant les premieres etapes critiques de l'emergence de la pandemie et des restrictions liees a la pandemie, decrivant les experiences des Canadiens. La Winnipeg Free Press a envoye un appel public par l'entremise de son journal imprime et en ligne pour obtenir des reflexions personnelles liees a la COVID-19 a partir du 22 mars 2020. Au total, 44 reflexions ont ete publiees dans cette rubrique (du 28 mars au24 avril 2020). Les auteurs ont desidentifie et compile des reflexions pour une analyse qualitative en utilisant la description interpretative (Thorne, Interpretive Description, 2008, Left Coast Press). Les reflexions ont ete redigees par un eventail de Manitobains, notamment des travailleurs de la sante, des enseignants, des educateurs, des proprietaires d'entreprises, des grands-parents, des meres, des peres, des filles, des voyageurs, des anciens combattants, des jeunes adultes et des personnes agees. Le theme central, << L'arrivee de la COVID-19 , a ete mis en evidence a travers les reflexions des ecrivains, decrivant l'impact soudain et significatif de la pandemie sur de nombreuses facettes de la vie. Ce theme central et global est suivi de quatre themes connexes decrivant : le besoin de normalite;les couches d'incertitude;le manque de soutien;et << la resilience des habitants de Winnipeg : Comment nous y adaptons-nous? Les resultats contribuent a combler une lacune importante dans notre comprehension des premieres experiences de la COVID-19 au Canada et offrent un apercu des besoins en matiere de soutien educatif et sanitaire. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement <strong xmlns:lang="en">Significance Statement-This is the first Canadian study to examine the early experiences of COVID-19 among the general public in central Canada during a critical time in the pandemic with regard to initiation of widespread provincial and national restrictions to slow the spread of the virus. Findings highlight the voices of the public and demonstrate a need for additional resources and supports. (PsycInfo Database Record (c) 2021 APA, all rights reserved)