Mental health of Scandinavians during the first lockdown in the COVID-19 pandemic: Psychosocial resources and coping strategies as protective or risk factors for anxiety and depression.

BACKGROUND: The COVID-19 pandemic was a global health and economic crisis. In the early phase of the pandemic, studies found that populations were reporting lower levels of mental well-being and high levels of distress and worry. This study investigated potential protective and risk factors such as sociodemographics and psychological factors such as adaptation/coping. METHODS: Two convenience samples from Norway and Denmark were recruited during the early phase of the first lockdown in May 2020 using snowball sampling primarily by social media. Measures included the Patient Health Questionnaire-4 (PHQ-4) for screening anxiety and depression, COVID-19 distress, and coping strategies applied during the lockdown. Descriptive analyses were applied as well as bivariate correlations for associations between coping and mental health measures. RESULTS: Levels of anxiety and depression were not alarmingly high, but being young, single, and female constituted a higher risk for poorer mental health. Applying positive reframing strategies was negatively associated with poor mental health and high COVID-19 stress, whereas distraction coping strategies were positively correlated with poor mental health and high COVID-19 stress. CONCLUSION: Applying positive reframing as a coping strategy may constitute a protective factor for mental health in the early phase of a crisis such as a pandemic. This knowledge may inform public health agencies on how to promote mental health in similar situations in the future. However, longitudinal and qualitative studies are needed to investigate the long-term effects of the different coping strategies applied.

Embodied meaning-making in the experiences and behaviours of persons with dementia.

BACKGROUND: The aim of the study was to explore and articulate how meaning-making appears and how meaningfulness is experienced in persons with severe dementia. Although there is little knowledge about meaning-making and experience of meaningfulness for this group, this article assumes that persons with dementia are as much in need of meaningfulness in life as any others, and hence, that they are involved in the process of meaning-making. METHODS: The study was conducted using a qualitative method with exploratory design. Ten patients with severe dementia at a specialized dementia ward at an old age psychiatric department in hospital were observed through participant observation performed over four months. The field-notes from the observation contained narratives carrying with them a dimension of meaning played out in an everyday setting and thus named Meaning-making dramas. The narratives were analyzed looking for expressions where experiences of meaning-making and meaningfulness could be identified. RESULTS: The narratives demonstrate that persons with severe dementia are involved in processes of meaning-making. The narratives include expressions of meaning-making, and of interactions that include apparent crises of meaning, but also transitions into what may be interpreted as meaningfulness based on experiences of significance, orientation and belonging. The role of the body and the senses has proved significant in these processes. The findings also suggest that experiences of meaning contribute to experience of personhood. CONCLUSIONS: The relevance to clinical practice indicates that working from a person-centred approach in dementia care also includes paying attention to the dimension of meaning. This dimension is important both for the person living with dementia and for the people caring for them. Acknowledging meaning as a central human concern, it is crucial to seek understanding and knowledge about the significance of meaning in vulnerable groups such as persons with dementia.

Meaning in Life for Patients With Severe Dementia: A Qualitative Study of Healthcare Professionals' Interpretations.

The need for meaning in life is a key aspect of being human, and a central issue in the psychology of religion. Understanding experience of meaning for persons with severe dementia is challenging due to the impairments associated with the illness. Despite these challenges, this article argues that meaning in life is as important for a person with severe dementia as it is for everyone else. This study was conducted in a Norwegian hospital and nursing home context and was part of a research project on meaning in life for persons with severe dementia. The study builds on two other studies which focused on how meaning-making and experience of meaningfulness appeared in patients with severe dementia. By presenting the findings from these two studies for a group of healthcare professionals and introducing them to research on meaning in life, the aim of this study was to explore how healthcare professionals interpret the patients' experience of meaning in life in practise for patients with severe dementia in a hospital and nursing home context, and to highlight its clinical implications. The study was conducted using a qualitative method with exploratory design. The data were collected at a round table conference, a method inspired by a mode of action research called "co-operative inquiry." Altogether 27 professional healthcarers, from a variety of professions, with high competence in dementia care participated together with six researchers authoring this article. This study revealed that healthcare professionals were constantly dealing with different forms of meaning in their everyday care for people with dementia. The findings also showed clear connexions between understanding of meaning and fundamental aspects of good dementia care. Meaning corresponded well with the principles of person-centred care, and this compatibility allowed the healthcare professionals to associate meaning in life as a perspective into their work without having much prior knowledge or being familiar with the use of this perspective. The study points out that awareness of meaning in life as an integrated perspective in clinical practise will contribute to a broader and enhanced repertoire, and hence to improved dementia care. Facilitating experience of meaning calls for increased resources in personnel and competence in future dementia care.