Lived experiences of Filipino Red Cross volunteer nursing students in COVID-19 vaccination programs / The Health Sciences Journal

INTRODUCTION@#Student volunteers in COVID-19 vaccination activities help augment the health care workforce. However, there is a lack of literature that explores student volunteerism in the Philippines. This paper analyses the shared meanings of the lived experiences of volunteer nursing students during a pandemic.@*METHODS@#Student nurses who had joined Red Cross vaccination activities were recruited by purposive sampling and interviewed online using a pilot-tested interview guide with open-ended questions. Participants were recruited until data saturation. The data collected was analyzed using Colaizzi’s Seven-Step Method.@*RESULTS@#The study has identified two main themes that describe the phenomenon of student- nurse volunteerism during COVID-19 vaccination programs: 1) personal motivation and 2) perceived benefits and outcomes. There were four sub-themes under personal motivation - desire for personal growth, intrinsic altruism, past experiences and involvement in volunteer work, and opportunity for advocating against vaccine hesitancy. Perceived benefits and outcomes had two sub-themes - sense of fulfillment in the act of volunteering and opportunity for actual nurse-patient interaction. @*CONCLUSION@#The findings from the study suggest that, despite the lack of experience of working as frontliners during the COVID-19 vaccination programs, nursing students volunteered due to personal motivations and perceived benefits and outcomes.

How children's anxiety symptoms impact the functioning of the hypothalamus-pituitary-adrenal axis over time: A cross-lagged panel approach using hierarchical linear modeling.

Anxiety symptoms in childhood and adolescence can have a long-term negative impact on mental and physical health. Although studies have shown dysregulation of the hypothalamus-pituitary-adrenal axis is associated with anxiety disorders, it is unclear how and in what direction children's experiences of anxiety symptoms, which include physiological and cognitive-emotional dimensions, impact the functioning of the hypothalamus-pituitary-adrenal axis over time. We hypothesized that higher physiological symptoms would be contemporaneously associated with hypercortisolism, whereas cognitive-emotional symptoms would be more chronic, reflecting traitlike stability, and would predict hypocortisolism over time. One hundred twenty children from the Concordia Longitudinal Risk Research Project were followed in successive data collection waves approximately 3 years apart from childhood through midadolescence. Between ages 10-12 and 13-15, children completed self-report questionnaires of anxiety symptoms and provided salivary cortisol samples at 2-hr intervals over 2 consecutive days. The results from hierarchical linear modeling showed that higher physiological symptoms were concurrently associated with hypercortisolism, involving cortisol levels that remained elevated over the day. In contrast, longitudinal results over the 3 years between data collection waves showed that chronic worry and social concerns predicted hypocortisolism, showing a low and blunted diurnal cortisol profile. These results have implications for broadening our understanding of the links between anxiety, the stress response system, and health across the course of development.

Unconscious Repetition of a Patient's Dynamics on an Inpatient Unit: Treatment Challenges.

This article focuses on the unconscious repetition of a patient's dynamics among a multidisciplinary inpatient treatment team. The patient was diagnosed as having bipolar affective illness and borderline personality traits. The prominent borderline traits displayed by the patient during hypomanic episodes evoked a parallel process of the patient's internal conflicts, rendering the team temporarily divided regarding treatment plans. This divide was resolved by holding dedicated multidisciplinary team meetings in which the patient's projections onto the team were explained and understood. The article highlights some of the therapeutic complexities of and challenges in treating a patient with bipolar illness and borderline traits on an inpatient unit.

Children's anxiety symptoms and salivary immunoglobulin A: A mutual regulatory system?

Anxiety can impact the immune system resulting in negative health outcomes. Salivary immunoglobulin A (sIgA) is a first line of defense against foreign antigens, with lowered levels indicative of weakened mucosal immunity. Little is known about how anxiety symptoms affect the diurnal rhythm of sIgA secretion, or the longitudinal transactional sequence between the two in children and adolescents. The goals of the two studies were to: (i) explore the concurrent associations between self-reported anxiety symptoms and diurnal variations of sIgA across the day using repeated daily samples of sIgA; and (ii) examine transactional relations between children's anxiety and aggregated total amount of sIgA levels across successive periods from middle childhood (Wave 1; ages 9-12) to early adolescence (Wave 2; ages 12-15), and from early to mid- adolescence (Wave 3; ages 15-18). Concurrent results showed a steeper (positive) rise in diurnal slope of sIgA from awakening to 5 hr post-awakening in children with higher anxiety. Longitudinally, higher levels of total anxiety, and specifically, worries at Wave 1 significantly predicted lower cumulative daily levels of sIgA 3 years later at Wave 2. Lowered sIgA levels at Wave 2 in turn predicted higher anxiety at Wave 3, illustrating a "vicious cycle" feedback loop. These findings broaden our understanding of the developmental links between anxiety symptoms, the immune system, and health.

Perfectionism, neuroticism, and daily stress reactivity and coping effectiveness 6 months and 3 years later.

The present study addressed a fundamental gap between research and clinical work by advancing longitudinal explanatory conceptualizations of stress and coping processes that trigger daily affect in the short- and long-term for individuals with higher levels of personality vulnerability. Community adults completed measures of 2 higher order dimensions of perfectionism (personal standards [PS], self-criticism [SC]), neuroticism, and conscientiousness. Then, 6 months later and again 3 years later, participants completed daily questionnaires of stress, coping, and affect for 14 consecutive days. PS was associated with aggregated daily problem-focused coping and positive reinterpretation, whereas SC was uniquely associated with daily negative social interactions, avoidant coping, negative affect, and sadness at Month 6 and Year 3. Multilevel modeling results demonstrated that both individuals with higher PS and those with higher SC were emotionally reactive to event stress, negative social interactions, and avoidant coping at Month 6 and Year 3 and to less perceived control at Year 3. Positive reinterpretation was especially effective for individuals with higher SC at Month 6 and Year 3. The effects of PS on daily stress reactivity and coping (in)effectiveness were clearly distinguished from the effects of neuroticism and conscientiousness, whereas the SC effects were due to shared overlap with PS and neuroticism. The present findings demonstrate the promise of using repeated daily diary methodologies to help therapists and clients reliably predict future client reactions to daily stressors, which, in turn, could help guide interventions to break apart dysfunctional patterns connected to distress and build resilience for vulnerable individuals.

Advancing complex explanatory conceptualizations of daily negative and positive affect: trigger and maintenance coping action patterns.

The present study addressed a fundamental gap between research and clinical work by advancing complex explanatory conceptualizations of coping action patterns that trigger and maintain daily negative affect and (low) positive affect. One hundred ninety-six community adults completed measures of perfectionism, and then 6 months later completed questionnaires at the end of the day for 14 consecutive days to provide simultaneous assessments of appraisals, coping, and affect across different stressful situations in everyday life. Multilevel structural equation modeling (MSEM) supported complex explanatory conceptualizations that demonstrated (a) disengagement trigger patterns consisting of several distinct appraisals (e.g., event stress) and coping strategies (e.g., avoidant coping) that commonly operate together across many different stressors when the typical individual experiences daily increases in negative affect and drops in positive affect; and (b) disengagement maintenance patterns composed of different appraisal and coping maintenance factors that, in combination, can explain why individuals with higher levels of self-critical perfectionism have persistent daily negative affect and low positive mood 6 months later. In parallel, engagement patterns (triggers and maintenance) composed of distinct appraisals (e.g., perceived social support) and coping strategies (e.g., problem-focused coping) were linked to compensatory experiences of daily positive affect. These findings demonstrate the promise of using daily diary methodologies and MSEM to promote a shared understanding between therapists and clients of trigger and maintenance coping action patterns that explain what precipitates and perpetuates clients' difficulties, which, in turn, can help achieve the 2 overarching therapy goals of reducing clients' distress and bolstering resilience.

Negative attachment cognitions and emotional distress in mainland Chinese adolescents: a prospective multiwave test of vulnerability-stress and stress generation models.

The present study examined the relation between attachment cognitions, stressors, and emotional distress in a sample of Chinese adolescents. Specifically, it was examined whether negative attachment cognitions predicted depression and anxiety symptoms, and if a vulnerability-stress or stress generation model best explained the relation between negative attachment cognitions and internalizing symptoms. Participants included 558 adolescents (310 females and 248 males) from an urban school in Changsha and 592 adolescents (287 female, 305 male) from a rural school in Liuyang, both in Hunan province located in mainland China. Participants completed self-report measures of negative attachment cognitions at baseline, and self-report measures of negative events, depression symptoms, and anxiety symptoms at baseline and at regular 1-month intervals for an overall 6-month follow-up (i.e., six follow-up assessments). Higher levels of negative attachment cognitions predicted prospective depression and anxiety symptoms. Furthermore, support was found for a stress generation model that partially mediated this longitudinal association. No support was found for a vulnerability-stress model. Overall, these findings highlight new developmental pathways for development of depression and anxiety symptoms in mainland Chinese adolescents.