The social and healthcare professional support drawn upon by women antenatally during the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis.

OBJECTIVE: To explore antenatal experiences of social and healthcare professional support during different phases of social distancing restriction implementation in the UK. DESIGN: Semi-structured interviews were conducted via telephone or video-conferencing software between 13 July 2020 - 2 September 2020. Interviews were transcribed and a recurrent, cross-sectional, thematic analysis was conducted. PARTICIPANTS: Twelve antenatal women were interviewed during UK social distancing restrictions (Timepoint 1; T1) and a separate sample of twelve women were interviewed in the initial easing of these restrictions (Timepoint 2; T2). FINDINGS: T1 themes were: 'Maternity care as non-essential' and 'Pregnancy is cancelled'. T2 themes were: 'Technology is a polarised tool' and 'Clinically vulnerable, or not clinically vulnerable? That is the question'. KEY CONCLUSIONS: At T1, anxieties were ascribed to the exclusion of partners from routine care, and to perceived insensitivity and aggression from the public. For T2, insufficient Governmental transparency led to disillusionment, confusion, and anger. Covert workplace discrimination also caused distress at T2. Across timepoints: deteriorated mental wellbeing was attributed to depleted opportunities to interact socially and scaled back maternity care. IMPLICATIONS FOR PRACTICE: Recommendations are made to: protect maternal autonomy; improve quality of mental health and routine care signposting; prioritise parental community support in the re-opening of 'non-essential' services; prioritise the option for face-to-face appointments when safe and legal; and protecting the rights of working mothers.

Older adults' experiences during the COVID-19 pandemic: a qualitative systematic literature review.

OBJECTIVES: Relatively little is known about the lived experiences of older adults during the COVID-19 pandemic. We systematically review the international literature to understand the lived experiences of older adult's experiences during the pandemic. DESIGN AND METHODOLOGY: This study uses a meta-ethnographical approach to investigate the included studies. The analyses were undertaken with constructivist grounded theory. RESULTS: Thirty-two studies met the inclusion criteria and only five papers were of low quality. Most, but not all studies, were from the global north. We identified three themes: desired and challenged wellbeing; coping and adaptation; and discrimination and intersectionality. Overall, the studies' findings were varied and reflected different times during the pandemic. Studies reported the impact of mass media messaging and its mostly negative impact on older adults. Many studies highlighted the impact of the COVID-19 pandemic on participants' social connectivity and well-being including missing the proximity of loved ones and in consequence experienced an increase in anxiety, feeling of depression, or loneliness. However, many studies reported how participants adapted to the change of lifestyle including new ways of communication, and social distancing. Some studies focused on discrimination and the experiences of sexual and gender minority and ethnic minority participants. Studies found that the pandemic impacted the participants' well-being including suicidal risk behaviour, friendship loss, and increased mental health issues. CONCLUSION: The COVID-19 pandemic disrupted and impacted older adults' well-being worldwide. Despite the cultural and socio-economic differences many commonalities were found. Studies described the impact of mass media reporting, social connectivity, impact of confinement on well-being, coping, and on discrimination. The authors suggest that these findings need to be acknowledged for future pandemic strategies. Additionally, policy-making processes need to include older adults to address their needs. PROSPERO record [CRD42022331714], (Derrer-Merk et al., Older adults' lived experiences during the COVID-19 pandemic: a systematic review, 2022).

The antenatal psychological experiences of women during two phases of the COVID-19 pandemic: A recurrent, cross-sectional, thematic analysis.

Initial COVID-19-related social distancing restrictions, imposed in the UK in March 2020, and the subsequent lifting of restrictions in May 2020 caused antenatal disruption and stress which exceeded expected vulnerabilities associated with this lifecourse transition. The current study aimed to explore the antenatal psychological experiences of women during different phases of pandemic-related lockdown restrictions in the UK. Semi-structured interviews were held with 24 women about their antenatal experiences: twelve were interviewed after the initial lockdown restrictions (Timepoint 1; T1), and a separate twelve women were interviewed after the subsequent lifting of those restrictions (Timepoint 2; T2). Interviews were transcribed and a recurrent, cross-sectional thematic analysis was conducted. Two themes were identified for each timepoint, and each theme contained sub-themes. T1 themes were: 'A Mindful Pregnancy' and 'It's a Grieving Process', and T2 themes were: 'Coping with Lockdown Restrictions' and 'Robbed of Our Pregnancy'. COVID-19 related social distancing restrictions had an adverse effect on women's mental health during the antenatal period. Feeling trapped, anxious, and abandoned were common at both timepoints. Actively encouraging conversations about mental wellbeing during routine care and adopting a prevention opposed to cure attitude toward implementing additional support provisions may serve to improve antenatal psychological wellbeing during health crises.

Exploring the process of adjustment following partner death in younger, widowed individuals: A qualitative systematic review.

Age influences the experience of widowhood and the likelihood of adverse outcomes. This review synthesizes 13 qualitative studies that explored adjustment following the death of a partner at a younger age, within a Western-cultural context. Thematic synthesis identified six analytical themes: unique challenges; identity changes; levels of distress; coping; support; and adapting following the loss. Bereavement challenges younger widow(er)'s life expectations, identity, and friendships. Social support, faith, and access to age-specific support may facilitate positive adjustment. The findings inform the development of effective interventions to support positive adjustment in younger widowhood.

"And I'm in another world". A qualitative examination of the experience of participating in creative arts groups in Palestine.

Background: We examine the experience of participating in creative arts groups for Palestinians living under the shadow of military conflict.Methods: 14 men and women aged 17-50 were recruited from community creative arts groups to participate in one of three semi-structured group interviews. Interviews explored participants' perceptions of the creative arts groups, including how they came to participate in the group and how they felt about their involvement.Results: An inductive thematic analysis identified three central themes: "An emptying", "Growth in the face of challenge", and "A rare freedom". The themes capture the extreme challenges participants faced and the protective effects of the creative arts groups on wellbeing. Participating in creative arts activities, such as writing, drawing, and music, encourages self-expression and release, personal exploration and escapism.Conclusions: In the face of traumatic experiences, restrictions, and poverty associated with living in an occupied land, creative arts groups can be liberating and support wellbeing.

How does carer resilience change over time and care status? A qualitative longitudinal study.

Objectives: Little research examines trajectories of carer resilience or the factors that facilitate or hinder resilience over time. We use qualitative longitudinal methods to examine trajectories of resilience and which assets and resources are associated with resilience and care status transitions in spousal dementia carers. Method: Based on an original sample of 23 spousal dementia carers (Donnellan, Bennett, & Soulsby, 2015 ), we conducted 13 follow-up interviews, including: 5 continuing home carers, 3 former carers (institutionalised), and 5 former carers (widowed). Results: Five participants remained resilient (stable resilient), three remained non-resilient (stable non-resilient) and four participants became resilient (non-resilient to resilient). Only one participant became non-resilient (resilient to non-resilient). Stable resilience was characterised by continuing individual assets and community resources. Carers who became resilient returned to previous resources, or gained new resources. Conclusion: Institutionalisation and widowhood are not always barriers to resilience; spousal dementia carers can remain or even become resilient over time despite deteriorating health, institutionalisation, or death of the care recipient.

Exploring the nature of illness perceptions in people with end-stage kidney disease.

BACKGROUND: Diagnosis and treatment for End-Stage Kidney Disease (ESKD) results in vast lifestyle changes. Despite the high prevalence of depression in people with ESKD, the psychosocial impacts of ESKD are still often overlooked. Illness perceptions enable people to make sense of their illness and are closely associated with depression. Due to the high levels of depression within ESKD, this study sought to understand the nature of illness perceptions in people with ESKD. METHODOLOGY: In this qualitative study, eleven participants were identified through hospital and online patient support groups. Semi-structured interviews were audio-taped, transcribed and analysed using grounded theory techniques. RESULTS: Three themes emerged from the data: Renal Conflicts, Forced Adjustment and Coping. The main dimensions of illness perception discussed by participants were Consequences, Control, Timeline and Identity. CONCLUSION: The results of this study have practical implications for informing practitioners about the psychosocial effects of ESKD diagnosis and treatment.

Family close but friends closer: exploring social support and resilience in older spousal dementia carers.

OBJECTIVES: Spousal dementia carers have unique support needs; they are likely to disengage from their existing social networks as they need to devote more time to caring as the disease progresses. Previously we showed that support resources can facilitate resilience in carers, but the relationship is complex and varies by relationship type. The current paper aims to explore social support as a key component of resilience to identify the availability, function and perceived functional aspects of support provided to older spousal dementia carers. METHOD: We conducted 23 in-depth qualitative interviews with spousal carers from two carer support groups and a care home in North West England. RESULTS: Family and friends served a wide range of functions but were equally available to resilient and non-resilient participants. Family support was perceived as unhelpful if it created feelings of over-dependence. Participants were less likely to resist involvement of grandchildren due to their relatively narrow and low-level support functions. Friend support was perceived as most helpful when it derived from those in similar circumstances. Neighbours played a functionally unique role of crisis management. These perceptions may moderate the effect of support on resilience. CONCLUSION: Family and friend support is not always sufficient to facilitate resilience. Support functions facilitate resilience only if they are perceived to match need. Implications of these findings are discussed.

Resilience amongst Older Colombians Living in Poverty: an Ecological Approach.

Older Colombians face significant adversities: poverty, violence and displacement. However, there is evidence that Latinos are often resilient. We examine resilience in older Colombians living in poverty using an ecological framework that identifies three levels: individual; community; and societal. In this paper we examine data from 16 semi-structured interviews with older Colombians that explore resilience within the context of poverty. We analyze our data using three stages: (1) modified grounded theory; (2) assignment of resilience status; (3) identification of components of the ecological framework which contribute to resilience in these participants. The most striking feature is that some participants are able to adapt to their situation, demonstrating resilience, whilst others are not. Individual characteristics such as psychological and material resources contribute to resilience. At the community level, family, social support, participation and cohesion promote resilience. Finally, at the societal level, social and welfare services, finance, religion and social policy, are important factors. These different levels of resilience are co-dependent, and we illustrate how this is so. We suggest that older Colombians living in poverty often demonstrate resilience, but that more can be done to enhance their lives. This includes interventions at the individual and community levels alongside changes in social policy.

What are the factors that facilitate or hinder resilience in older spousal dementia carers? A qualitative study.

OBJECTIVES: Much is known about the factors making caring for a spouse with dementia burdensome. However, relatively little is known about factors that help some spouses become resilient. We define resilience as 'the process of negotiating, managing and adapting to significant sources of stress or trauma'. We aimed to assess whether spousal dementia carers can achieve resilience and to highlight which assets and resources they draw on to facilitate or hinder resilience, using an ecological framework . METHOD: Twenty in-depth qualitative interviews with spousal carers from two carer support groups and a care home in North West England. RESULTS: Eight participants were resilient and 12 were not. A resilient carer was characterised as someone who stays positive and actively maintained their relationship and loved one's former self. Resilient carers were knowledgeable and well supported by family but especially friends, with whom they shared this knowledge. They were more actively engaged with services such as respite care. CONCLUSION: There is a need to move towards more ecological models of resilience. We propose that access to assets and resources is not always sufficient to facilitate resilience. Implications of these findings are discussed.

"You're not getting married for the moon and the stars": The uncertainties of older British widowers about the idea of new romantic relationships.

Older widowers are more likely to remarry than older widowed women. However, relatively little is known about the attitudes of older widowers to new romantic relationships and remarriage or repartnering. In this study of 60 widowers, more than half spontaneously discussed their attitudes toward, and experiences of, these relationships. However, none of the widowers had remarried and of those who described themselves as repartnered only one was cohabiting. We examine these data in the light of Lopata's concept of 'husband sanctification' (1981). We identify four themes. First, some widowers do sanctify their late wives. Second, we argue that wife sanctification contributes to widowers' uncertainties about repartnering. Third, when widowers make decisions to repartner, wife sanctification does not appear to make an important contribution. Finally, there is evidence to suggest that wife sanctification influences how men refer to their new women friends. Thus, we conclude by arguing that wife sanctification influences widowers' decisions surrounding remarriage/repartnering.