Facing amyotrophic lateral sclerosis under lockdown: The experiences of minors

Purpose: The purpose of this study is to assess the effect of social isolation of minors with a parent or grandparent suffering from amyotrophic lateral sclerosis (ALS) and to determine whether the psychological support offered by an Italian no-profit association helped them to manage stress. Methodology: This study followed a qualitative research design. The participants responded to in-depth interviews that were processed with inductive thematic analysis. Findings: Five themes emerged: feedback on the psychological intervention;learning and changes after the intervention;discourses on illness and death in the family;experiences and difficulties during the lockdown and suggestions for other peers who might face the same situation. Social Implications: Psychological support is necessary for these minors, and it helped them to manage both the stress of living with ALS and the limitations of social relationships during the pandemic. It showed the importance of authentic and honest communication about illness and death that allowed minors to manage anxiety and fear. Positive reinterpretation of these experiences by transforming them into opportunities was also revealed. Originality: Studies on families with ALS patients are numerous, but studies on children of these patients are still rare, and no study has investigated the impact of the COVID-19 pandemic on these children. This research investigated a topic that has not been covered previously and it also provided the opportunity to know how these children, preadolescents and adolescents living in an already complex environment, have experienced lockdown and restrictions. The study also enriched the literature on this important issue. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Italian adolescents' perception of tele-psychodrama treatment during the COVID-19 Pandemic.

BACKGROUND: Psychodrama is an experiential group psychotherapy that is used to enhance adolescents' wellbeing. The COVID-19 pandemic forced the adaptation of this method to an online setting. OBJECTIVE: This qualitative study investigated whether and how tele-psychodrama provides psychological support to adolescents, in order to better understand its strengths and weaknesses. PARTICIPANTS: 14 adolescents from Northern and Central Italy. METHOD: 14 interviews were conducted at the end of group tele-psychodrama treatment and were analysed with qualitative thematic analysis. RESULTS: Three themes were identified: (1) contribution of tele-psychodrama to adolescents' well-being; (2) implementation of psychodrama to the online setting; and (3) (the) shortcomings of tele-psychodrama. CONCLUSIONS: Despite the differences between online and in-person psychodrama, all the participants expressed their appreciation of group tele-psychodrama, which contributed to their overall psychological wellbeing and helped them process difficulties that emerged during the lockdowns.

Spirituality During the COVID-19 Pandemic: An Online Creative Arts Intervention With Photocollages for Older Adults in Italy and Israel.

The present study aimed to examine how expressions of spirituality were stimulated and reflected in an online creative arts intervention for older adults during COVID-19 lockdowns. The online process focused on the creation of digital photocollages together with narrative elements of dignity therapy. Twenty-four Israeli and Italian community-dwelling older adults aged 78-92 participated in a three-session online intervention involving the production of three photocollages. The visual and verbal data (participants' chosen photos and photocollages, and transcripts of the sessions) were qualitatively analyzed within an abductive framework. Four themes were generated, representing the four domains of spirituality that were stimulated by and expressed in the process: (1) Connectedness with the self, (2) connectedness with others, (3) connectedness with the environment, and (4) connectedness with the transcendent. The findings show how photographs can serve as projective visual stimuli which elicit personal content through spontaneous thinking, and they reveal the multifaceted nature of spirituality, wherein each domain nourishes the others. Overall, the findings illustrate how creative arts intervention guided by the tenets of dignity therapy can contribute to the spiritual care of older adults during periods of social isolation, or to the spiritual support provided in palliative care.

New Psychological Perspectives on Death and Dying-Between Normality and the COVID-19 Emergency.

In recent decades, there has been a constantly increasing preoccupation with physical perfection and the scientific urge to improve life expectancy [...].

Competent Witnesses: How Penitentiary Workers Explain the Violence in Italian Prisons during the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic, in the Italian prison of Santa Maria Capua Vetere (SMCV), prison police repressed a riot with extreme violence, bringing the state of prisons and the conditions of prisoners back to the attention of the Italian public opinion. OBJECTIVE: This exploratory study aimed to collect the experiences and the competent opinions of the social and health personnel of Italian prisons regarding the episode of violence that happened in SMCV; the general state of health of the Italian prison system was explored, too, together with the collection of proposals for interventions aimed at the eradication of violence in prison. METHOD: The study employed a qualitative research design. Eighteen social-health workers from 12 Italian prisons were interviewed using in-depth interviews of ~60 min each that were conducted and recorded via Skype video calls. The interview transcripts were analyzed with qualitative reflexive thematic analysis (RTA) to identify the most relevant and recursive themes. RESULTS: Four themes were identified: (1) reactions and thoughts about the events of SMCV; (2) structural problems of Italian prison police; (3) Italian prison system; and (4) reform proposals. CONCLUSIONS: A new and deeper awareness of the suffering of the current Italian penitentiary system emerged, together with courageous reform proposals that can restore dignity and centrality to the re-education of the detainees, preventing further future violence.

The impact of the COVID-19 pandemic on perinatal loss among Italian couples: A mixed-method study.

Background: Perinatal bereavement is an event that greatly impacts the emotional, psychological, and psychosocial aspects of those who want to have a child. Objectives: Since there are few studies on the psychological impact of the COVID-19 pandemic on couples grieving for perinatal loss, this research aimed to survey this experience. Participants: Between 2020 and 2021, in Italian provinces highly affected by the COVID-19 pandemic, 21 parents participated: 16 mothers (76%; mean age 36.2; SD: 3.1) and 5 fathers (24%; mean age 40.2; SD: 3.4), among which there were 4 couples. Methods: A mixed-method design was used through self-report questionnaires and in-depth interviews. Accompanied by a sociodemographic form, the following questionnaires were administered: Prolonged Grief-13, the Parental Assessment of Paternal Affectivity (PAPA) (to fathers), the Parental Assessment of Maternal Affectivity (PAMA) (to mothers), the Dyadic Adjustment Scale short version, the Daily Spiritual Experiences Scale, and the Impact of Event Scale-Revised. The texts obtained through the in-depth interviews underwent thematic analysis. Results: Fifty per cent of participants suffered from Post-Traumatic Stress Disorders (PTSD) symptoms and 20% suffered from relational dyadic stress. Four areas of thematic prevalence emerged: psychological complexity of bereavement, the impact of the COVID-19, disenfranchisement vs. support, and spirituality and contact with the lost child. Participants interpreted their distress as related to inadequate access to healthcare services, and perceiving the pandemic restrictions to be responsible for less support and lower quality of care. Furthermore, they needed psychological help, and most of them were unable to access this service. Spirituality/religiosity did not help, while contact with the fetus and burial did. Conclusion: It is important to implement psychological services in obstetrics departments to offer adequate support, even in pandemic situations.

Burnout following moral injury and dehumanization: A study of distress among Italian medical staff during the first COVID-19 pandemic period.

BACKGROUND: Italy was the first country outside Asia to deal with the early phase of the COVID-19 pandemic, and health care facilities and medical staff were not fully prepared. Research worldwide has documented the enormous effect of the COVID-19 pandemic on health care providers' mental health, including experiences of dehumanization, but less work has focused on factors which may influence the development of these outcomes in response to COVID-19-related stress. OBJECTIVE: This study examined the association of dehumanization, self-efficacy, and alienation to burnout, depression, and PTSD among medical staff. Potential moderators included moral injury, professional role, COVID workload, and work in a critical care unit (CCU). METHOD: Participants were recruited through the Internet. The sample consisted of 270 medical staff members who completed a self-report survey online. Instruments included: Human Traits Attribution Scale for dehumanization; NYP-Queens Survey-Self-Efficacy Subscale for self-efficacy; Moral Injury Events Scale for moral injury; Alienation Scale for alienation; PTSD-8 for posttraumatic stress disorder; Patient Health Questionnaire-9 for depression; and a single item for burnout. The analytic plan included ANOVAs, zero-order correlations, logistic regression analyses, multiple linear regression models, and parallel mediation. RESULTS: Results show that dehumanization was associated with higher levels of burnout, PTSD, and depressive symptoms and effects were consistent across professional role and work context. Dehumanization was significantly associated with PTSD symptoms only among those who had increased COVID-19-related caseloads. Moral injury was positively associated with dehumanization, displayed an independent association with all 3 mental health outcomes, over and above dehumanization, and tended to exacerbate the effects of dehumanization. The effect sizes across analyses were small to medium. CONCLUSION: This research confirms that the COVID-19 pandemic stressed Italian medical staff in a way not documented in the prepandemic literature. There is a need to support staff in their complex relationships and communication with patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Reconstructing Social Relationships in a Post-Lockdown Suburban Area of Southern Italy Using Pastoral Counselling.

The growing interest in spirituality has enabled numerous avenues of pastoral counselling support, which can be a useful resource for improving quality of life in the context of significant social deprivation. The aim of this research was to investigate the role of the spiritual dimension of pastoral support interventions created to help the inhabitants of a strongly deprived territory in Southern Italy during the COVID-19 pandemic. Eight people between the ages of 28 and 67 took part in the study. A qualitative research design was applied via online interviews with the participants, who were operators of a pastoral counselling service located on the outskirts of a suburban town. The main emergent themes were the importance of religiosity and spirituality in the lives of the participants, the role that these two aspects play in the lives of those who carry out activities devoted to helping others, and the ways in which these dimensions are used within support programmes responding to the needs of an area characterized by socioeconomic and psychosocial problems. The interviews revealed how pastoral counselling can be useful in situations of stress in highly deprived areas.

Facing Muscular Dystrophy During Covid-19 Pandemic: The Role of Support Associations and Spirituality.

Several researches in scientific literature analyze the theme of Muscular Dystrophy (MD), As well as many others focus on the theme of the Covid-19 pandemic; however, there is a rather limited number of studies that analyse how the pandemic has affected the life of people suffering from MD, especially during the time of the first lockdown in the spring of 2020. The present study has applied a qualitative research design with the aim to investigate how patients with MD have lived the social restrictions imposed for the contagion containment and whether the assistance of associations for their support has contributed to make the participants feel closer or more distant from the spiritual dimension. The analysis involved 12 participants, and they were presented with a semi-structured interview. The data obtained from the interviews have been analysed through a thematic analysis from which 4 thematic areas have emerged: (1) the impact of the pandemic on an emotional level; (2) the illness management and the role of family; (3) the role of the associations; (4) aspects related to spirituality. The crucial role that the closeness of family and the activities promoted remotely by the associations for patients' support has emerged, since they have allowed the participants to feel united by something beyond, to discover new aspects of themselves, to give more value to Life and to move closer to their spiritual dimension.

Spiritual Counseling During the COVID-19 Pandemic in Italy: a Qualitative Study.

The COVID-19 pandemic has created profound upheavals in today's society, accompanied by psychological effects. The discomfort experienced during the pandemic accompanied by the increased availability of time has offered many people the chance to reconnect with their spiritual dimension, which is considered a vital resource in managing the stress produced by the perception of risk to their health. This study addresses the motivations that led research participants to choose to receive spiritual support via a 10-week training. The work also explores the changes perceived by the participants as they overcame the difficulties resulting from the pandemic. The research involved nine people between the ages of 19 and 59 who took part in an online experience focused on the spiritual dimension. Almost all the participants came from an area in Northern Italy most affected by the pandemic. A qualitative research design was used, with semistructured interviews designed to understand participants' views on the topic under investigation. The areas that emerged from the interviews concerned the motivations that led the participants to choose a spiritual support process, the role of spirituality in daily life, and the changes participants experienced after the conclusion of the experience related to managing the stress caused by the pandemic. In agreement with the existing literature, the results show that spiritual support can be useful in counteracting the negative effects of the pandemic, producing improvements in the quality of life.

Spirituality During the COVID-19 Pandemic: An Online Creative Arts Intervention With Photocollages for Older Adults in Italy and Israel

The present study aimed to examine how expressions of spirituality were stimulated and reflected in an online creative arts intervention for older adults during COVID-19 lockdowns. The online process focused on the creation of digital photocollages together with narrative elements of dignity therapy. Twenty-four Israeli and Italian community-dwelling older adults aged 78–92 participated in a three-session online intervention involving the production of three photocollages. The visual and verbal data (participants’ chosen photos and photocollages, and transcripts of the sessions) were qualitatively analyzed within an abductive framework. Four themes were generated, representing the four domains of spirituality that were stimulated by and expressed in the process: (1) Connectedness with the self, (2) connectedness with others, (3) connectedness with the environment, and (4) connectedness with the transcendent. The findings show how photographs can serve as projective visual stimuli which elicit personal content through spontaneous thinking, and they reveal the multifaceted nature of spirituality, wherein each domain nourishes the others. Overall, the findings illustrate how creative arts intervention guided by the tenets of dignity therapy can contribute to the spiritual care of older adults during periods of social isolation, or to the spiritual support provided in palliative care.

Facing Amyotrophic Lateral Sclerosis Under Lockdown: The Experiences of Minors

Purpose: The purpose of this study is to assess the effect of social isolation of minors with a parent or grandparent suffering from amyotrophic lateral sclerosis (ALS) and to determine whether the psychological support offered by an Italian no-profit association helped them to manage stress.Methodology: This study followed a qualitative research design. The participants responded to in-depth interviews that were processed with inductive thematic analysis.Findings: Five themes emerged: feedback on the psychological intervention;learning and changes after the intervention;discourses on illness and death in the family;experiences and difficulties during the lockdown and suggestions for other peers who might face the same situation.Social Implications: Psychological support is necessary for these minors, and it helped them to manage both the stress of living with ALS and the limitations of social relationships during the pandemic. It showed the importance of authentic and honest communication about illness and death that allowed minors to manage anxiety and fear. Positive reinterpretation of these experiences by transforming them into opportunities was also revealed.Originality: Studies on families with ALS patients are numerous, but studies on children of these patients are still rare, and no study has investigated the impact of the COVID-19 pandemic on these children. This research investigated a topic that has not been covered previously and it also provided the opportunity to know how these children, preadolescents and adolescents living in an already complex environment, have experienced lockdown and restrictions. The study also enriched the literature on this important issue.

Spirituality for Coping with the Trauma of a Loved One's Death During the COVID-19 Pandemic: An Italian Qualitative Study.

Spirituality may be a key factor in reducing the negative psychological effects of traumatic events and a means by which the experience of grief can be processed. The objective of the present research is to assess whether and how spirituality provided concrete support in those who lost a loved one during the COVID-19 pandemic. The participants are 8 people from the most affected cities in northern Italy. They were interviewed in depth, the interviews were transcribed and the texts were analyzed through Interpretive Phenomenological Analysis. The results show that spirituality has been found to be a protective factor with regard to the processing of grief in crisis situations such as the COVID-19 pandemic, in particular with regard to the belief that the deceased loved one is now in an otherworldly dimension. In addition, the celebration of a funeral rite offers support to the grieving person in the early stages of mourning thus laying the foundation for a healthy grieving process. It is therefore important to support individual spirituality, which can be a useful tool for processing the traumatic experience, especially in difficult times such as the COVID-19 pandemic.

Spirituality during COVID-19 in Northern Italy: The experience of participating in an online prayer group.

Spirituality has ascendant value during times of adversity. Religious activities have beenfound to increase spirituality, and therefore might be considered a coping resource for the individual. The present research aims to explore participants' experience in an online Catholic prayer group in northern Italy that was held throughout the period of COVID-19 social restrictions. The group comprised 16 Catholic individuals aged 34 to 85, who were interviewed in writing following a protocol of four open-ended questions. The results reported four main thematic areas: (1) the benefits of the spiritual journey while coping with the pandemic; (2) the potential of the online setting; (3) the challenges of the online setting; and (4) the bond with God and how it evolved during the pandemic. The findings confirm the valuable contribution of the on-line group religious activity to the participants'    wellbeing, particularly during the time of social distancing.

Spirituality and Children's Coping with Representation of Death During the COVID-19 Pandemic: Qualitative Research with Parents.

The coronavirus disease 2019 (COVID-19) pandemic and the related lockdown measures have had intense negative impacts on the psychological well-being of both adults and children. Among such impacts is a significant increase in mortality salience and changes in how people deal with grief and losses. This qualitative research used semi-structured interviews with 23 Italian parents to draw insights on the impact of the pandemic on children aged 5-15 years with regard to their representation of death and the eventual role that family spirituality/ religiosity played in helping them understand both the concept of dying and possibly the pandemic itself. From the data analysis, four main thematic areas emerged: "Lockdown experience," "Fears and worries related to COVID-19," "Emergence of thoughts on the process of dying," and "Representation of death and the impact of religious beliefs." The participants highlighted how stressful the lockdown measures have been for their children and the anxiety that their children have experienced because of fears related to the pandemic. The interviews also surfaced how living in a religious family has contributed significantly to shaping children's representation and understanding of death and sometimes even helped both the parents and their children to face difficult moments such as those caused by the pandemic.

Crafting Life Stories in Photocollage: An Online Creative Art-Based Intervention for Older Adults.

Creative arts therapies (CAT) provide a safe and creative environment for older adults to process life experiences and maintain personal growth while aging. There is a growing need to make creative arts therapies more accessible to the aging population, as many have limited access to these services. This need has been catalyzed by the advent of the COVID-19 pandemic. Tele-CAT offers a possible solution. This study explored the experiences of older adults who participated in an online creative process of digital photocollage based on CAT. Twenty-four Italian and Israeli community-dwelling older adults aged 78 to 92 participated in this research through Zoom teleconferencing software. Transcriptions of the sessions and the art produced through the photocollage were qualitatively analyzed through Thematic Analysis. The findings show that the projective stimuli of digital photographs supported older adults' narratives and engaged them in a more embodied emotional experience. Participant experiences involved artistic enjoyment within a positive and safe interaction with therapists. The creation of digital photocollages allowed the participants to process their life experiences and create an integrative view of their life, a vital developmental task in late life. These results point to the advantages and challenges of tele-CAT for older adults.

Death Notification in Italian Critical Care Unites and Emergency Services. A Qualitative Study with Physicians, Nurses and Relatives.

This qualitative study was conducted in critical care units and emergency services and was aimed at considering the death notification (DN) phenomenology among physicians (notifiers), patient relatives (receivers) and those who work between them (nurses). Through the qualitative method, a systemic perspective was adopted to recognise three different categories of representation: 23 clinicians, 13 nurses and 11 family members of COVID-19 victims were interviewed, totalling 47 people from all over Italy (25 females, mean age: 46,36; SD: 10,26). With respect to notifiers, the following themes emerged: the changes in the relational dimension, protective factors and difficulties related to DN. With respect to receivers, the hospital was perceived as a prison, bereavement between DN, lost rituals and continuing bonds. Among nurses, changes in the relational dimension, protective factors and the impact of the death. Some common issues between physicians and nurses were relational difficulties in managing distancing and empathy and the support of relatives and colleagues. The perspective of receivers showed suffering related to loss and health care professionals' inefficacy in communication. Specifically, everyone considered DNs mismanaged because of the COVID-19 emergency. Some considerations inherent in death education for DN management among health professionals were presented.

Online Dignity Therapy and Photo Collages: The Narratives of Israeli and Italian Older Adults in the COVID-19 Era

The social isolation imposed by the Covid-19 pandemic has significantly affected older adults, and has impacted both their physical and mental health. The pandemic has led to an increase in ageism associated with poorer mental health and a lower sense of dignity, self-esteem and contribution to society. This cross-cultural study involved 24 participants from Italy and Israel aged 79 to 92. The aim was to develop a brief art-based online intervention to enhance the participants’ sense of dignity and sense of meaning in life during this time of crisis. The process focused on the creation of digital photo-collages that captured the participants’ values through three perspectives: their past experiences, legacy, and future perspectives. It employed an arts-based research methodology to explore the participants’ experiences by analysing their relationship with the artistic expression, the photo collage, and its creative process.

The Integration of Stressful Life Experiences Scale and the Inventory of Complicated Spiritual Grief: The Italian Validation of Two Instruments for Meaning-Focused Assessments of Bereavement.

BACKGROUND: Bereavement is an inevitable event that can cause pain, discomfort, and negative consequences in daily life. Spirituality and religiosity can help people cope with loss and bereavement. Sometimes, however, the death of a loved one can challenge core religious beliefs and faith, which has been found to be a risk factor for prolonged mourning. OBJECTIVES: (1) Determine whether the Italian versions of the Integration of Stressful Life Experiences Scale (ISLES) and Inventory of Complicated Spiritual Grief (ICSG) are valid in translation; (2) Evaluate the impact of socio-demographic variables on ISLES and ICSG dimensions; (3) Test whether Complicated Spiritual Grief mediates the relation between meaning reconstruction after loss and integration of the loss experience; (4) Test whether the representation of death as a form of passage or annihilation further moderated the relation between Complicated Spiritual Grief and integration of the loss. METHODS: The sample is composed of 348 participants who had lost a loved person in the prior two years. RESULTS: The ISLES and ICSG were validated in Italian and are more appropriately interpreted as having a unifactorial structure. A greater spiritual crisis was manifested in participants with less education, who did not actively participate in religious life, and who had lost a friend rather than a close relative. As hypothesised, spiritual struggle in grief mediated the role of continuing bonds, Emptiness and Meaninglessness, and Sense of Peace in predicting integration of the loss. Furthermore, death representation moderated the impact of spiritual grief on loss, such that those participants who viewed death as a form of annihilation rather than passage reported greater integration of the loss. CONCLUSION: The role of meaning making in integrating significant loss is partly accounted for by spiritual struggle in a way that can be analysed in Italian contexts through the use of these newly validated instruments.

Tele-psychodrama therapy during the COVID-19 pandemic: Participants' experiences.

Italy was severely hit by the COVID-19 pandemic. In early March 2020, a series of legislative decrees have been issued, establishing the restrictions that all Italian citizens are required to respect, according to which it is strictly forbidden to leave the house if not for reasons of necessity, health, or work. This qualitative study investigated which aspects clients find helpful or hindering in shifting to group tele-psychodrama due to the COVID-19 pandemic, after participation in an in-person psychodrama group. Participants were 15 adults who were members of a pre-existing in-person psychodrama group that shifted to a tele-psychodrama group format facilitated by two psychodrama therapists. The Client Change Interview was used at the end of the tele-psychodrama as a post-treatment assessment. All the interviews were transcribed and then underwent a thematic analysis. The analysis yielded six shared themes: the role of tele-psychodrama sessions during COVID-19 pandemic; perceived effectiveness of tele-psychodrama; main advantages of tele-psychodrama; limitations encountered during the online intervention; the termination of tele-psychodrama; and the relationship with the therapist. The findings provide preliminary evidence for the clinical practice of tele-psychodrama and lays the groundwork for further studies that can contribute to the use of electronic platforms in psychodrama interventions.