Australian nurses' and midwives' perceptions of their workplace environment during the COVID-19 pandemic.

Background: Working as a front-line worker during a pandemic is a unique situation that requires a supportive work environment. An informed understanding of nurses' and midwives' workplace experiences during a pandemic, such as COVID-19, may enable better preparation and targeted support for future pandemics at an individual, organisational, and policy level. Aim: The aim of this study was to explore nurses' and midwives' workplace experiences during the COVID-19 pandemic response. Methods: A cross-sectional online survey consisting of open-ended questions was conducted with a convenience sample of nurses and midwives (n = 1003) working in New South Wales Health hospital settings, in Australia. Open-ended questions were analysed using content analysis. Results: Five themes were identified; 'organisational communication', 'workplace support', 'availability of personal protective equipment', 'flexible working', and 'new ways of working'. Nurses' and midwives' workplace experiences during COVID-19 were influenced by leaders who were perceived to be adaptive, authentic, responsive, transparent, and visible. While many expressed a number of workplace challenges, including access to personal protective equipment, there was opportunity to explore, develop, and evaluate new and alternate models of care and working arrangements. Conclusion: It is important that nurses and midwives are supported and well prepared to cope during pandemics in the workplace. Organisational leadership and timely dissemination of transparent pandemic plans may support nurses' adaptive workplace experiences.

The impact of COVID-19 pandemic-related stress experienced by Australian nurses.

Globally, the impact of COVID-19 on healthcare workers' mental health has been a major focus of recent research. However, Australian research involving nurses, particularly across the acute care sector, is limited. This cross-sectional research aimed to explore the impact of pandemic-related stress on psychological adjustment outcomes and potential protective factors for nurses (n = 767) working in the Australian acute care sector during the COVID-19 pandemic. Nurses completed an online questionnaire with psychometrically validated measures of pandemic-related stress, psychological adjustment outcomes (depression, anxiety, and subjective well-being), and protective factors (posttraumatic growth and self-compassion). Descriptive analyses revealed that pandemic-related stress was reported by 17.7% of the participants. Psychological adjustment outcome scores above normal for depression (27.5%) and anxiety (22.0%) were found, and 36.4% of the participants reported poor subjective well-being. Regression analyses suggest that pandemic-related stress predicted greater depression (B = 0.32, SE = 0.02, 95% confidence interval [0.28, 0.35]) and anxiety (B = 0.26, SE = 0.01, 95% confidence interval [0.24, 0.29]) and less subjective well-being (B = -0.14, SE = 0.01, 95% confidence interval [-0.16, -0.12]). Self-compassion weakened the relationship between pandemic-related stress and greater depression, however, exacerbated the relationship between pandemic-related stress and less subjective well-being. Posttraumatic growth reduced the negative relationship between pandemic-related stress and psychological adjustment outcomes. These findings will inform strategies to facilitate psychological resources that support nurses' psychological adjustment, enabling better pandemic preparedness at both an individual and organizational level.

The relationship between COVID-19 pandemic-related stress and meaning in life: testing the moderating effects of self-compassion and savoring.

BACKGROUND AND OBJECTIVES: The stress people experience in relation to a highly stressful event, such as the COVID-19 pandemic, can undermine their sense of meaning in life. This study examined the relationship between COVID-19 pandemic-related stress and meaning in life and whether self-compassion and savoring positive emotional experience moderated this relationship. METHODS: Participants (N = 498) completed measures of pandemic-related stress, dimensions of meaning in life (comprehension, purpose, mattering), self-compassion (self-kindness, common humanity, mindfulness), and savoring (savoring through anticipation, savoring the moment, savoring through reminiscence). RESULTS: Results of regression analyses showed that pandemic-related stress related to less meaning in life and that all dimensions of self-compassion and savoring (with the exception of savoring through reminiscence) related positively to a dimension of meaning in life. Only common humanity buffered the relationship between pandemic-related stress and a dimension of meaning in life (purpose) as expected. Unexpectedly, for people high on common humanity the relationship between pandemic-related stress and mattering was positive, and for people high on mindfulness, the relationship between pandemic-related stress and comprehension was negative. CONCLUSIONS: Although cross-sectional, this study's findings suggest that promoting common humanity might be important for protecting purpose and enhancing one's sense of mattering during a pandemic.

Self-compassion predicts less fear of childbirth in childless women: the mediating role of birth beliefs.

OBJECTIVE: Women can have fear of childbirth (FOC) in advance of their first pregnancy and such fear can have implications for reproductive and eventual childbirth choices. This study aims to further our understanding of the role of self-compassion in FOC in young childless women, including possible pathways through which self-compassion might relate to less FOC: through natural and medical birth beliefs. DESIGN AND MAIN OUTCOME MEASURES: In this correlational study, 316 young childless Australian women completed measures of self-compassion, natural and medical birth beliefs, and FOC. RESULTS: Self-compassion predicted less FOC, and although self-compassion as a total score did not relate to natural birth beliefs, it did relate to lower scores on medical birth beliefs. The indirect effect through medical birth beliefs was supported; greater self-compassion predicted lower scores on medical birth beliefs, which in turn predicted less FOC. CONCLUSIONS: The findings, although cross-sectional, support the study of self-compassion in FOC, which is in part because self-compassion predicts less medical birth beliefs. With further research, self-compassion training might be incorporated into public health initiatives targeting FOC in young childless women.

Meaning in Life Following Intimate Partner Psychological Aggression: The Roles of Self-Kindness, Positive Reframing, and Growth.

Psychological aggression is experienced by a large proportion of people in intimate relationships, and the negative impact of this experience has the potential to weaken one's sense of meaning in life. This study aimed to understand a mechanism through which the experience of psychological aggression in a past intimate relationship relates to less meaning in life. By applying self-compassion and meaning-making theory, we proposed that the experience of psychological aggression decreases one's ability to be kind toward oneself in times of suffering (i.e., self-kindness), which decreases positive reframing of the experience, which sequentially decreases growth from the experience, which in turn decreases meaning in life. Participants were 253 people who experienced psychological aggression in a past intimate relationship. Participants completed measures of psychological aggression, self-kindness, positive reframing, growth, and meaning in life. Results found that psychological aggression experienced in a past intimate relationship related to less meaning in life and that the serial mediation model proposed was supported. As such, the results indicate that greater psychological aggression experienced relates to less self-kindness, which in turn relates to less positive reframing, which is sequentially associated with less growth, which is associated with less meaning in life. The findings indicate the need for counseling and psychotherapies to bolster self-kindness in people who have experienced psychological aggression in a past intimate relationship. This is because levels of self-kindness might be depleted after experiencing psychological aggression and because self-kindness appears to support adaptive meaning-making processes.

Stress, savouring, and coping: The role of savouring in psychological adjustment following a stressful life event.

There is increasing research on the role of savouring positive emotional experience in the context of stress. As such, we need a better understanding of how savouring and coping relate to each other and to psychological adjustment outcomes following a stressful life event. In particular, this study seeks to understand whether savouring is better conceptualized as a coping resource or a coping response. Three hundred people who experienced a highly stressful event in the past year completed measures of impact of event, savouring, coping, positive emotions, depression, anxiety, and life satisfaction. Results of bivariate correlations showed that savouring is positively correlated with positive coping (i.e., mastery and meaning-based coping) and socially-supported coping (i.e., using emotional and instrumental support) and negatively correlated with negative coping (i.e., self-judgement and avoidance coping). The results of path analyses support a model that positions savouring as a coping response that relates to other coping responses and indirectly relates to better psychological adjustment through positive emotions (when psychological adjustment is conceptualized as depression or life satisfaction but not anxiety). Findings provide preliminary support for conceptualizing savouring as a coping response; future research should consider measuring savouring as a coping response to further our understanding of savouring following a stressful life event.

When Times Get Tough: Savoring and Relationship Satisfaction in Couples Coping with a Stressful Life Event.

BACKGROUND AND OBJECTIVES: When couples face a stressful life event, this can adversely impact relationship satisfaction. Because savoring positive experiences is thought to enhance intimate relationships and there is evidence that savoring buffers the negative effects of stress at the intrapersonal level, this study examined savoring as an interpersonal resource for couples who experienced a stressful life event. METHODS: One hundred and twenty-eight opposite-sex couples completed measures of impact of event, savoring, positive affect, and relationship satisfaction. RESULTS: Results from actor-partner interdependence models found that: (1) For couple members who reported a relatively low impact of event, their own savoring was positively predicted by their partner's impact of event; (2) For women, their own savoring the moment predicted their own and their partner's greater relationship satisfaction; (3) The relationship between one's own impact of event and relationship satisfaction was buffered by one's partner's savoring the moment; and (4) The relationship between one's own savoring and relationship satisfaction was mediated by one's own positive affect. CONCLUSIONS: The findings support the study of savoring as an interpersonal resource in times of stress and have implications for couples-based interventions.

Couple adjustment to a stressful life event: a dyadic investigation of the roles of positive reframing and perceived benefits.

BACKGROUND AND OBJECTIVES: This study examines positive reframing (a form of meaning making), perceived benefits (a form of meanings made) and adjustment in couples who experienced a stressful life event in the past year. This study tested whether couple members' scores were nonindependent and whether one's own perceived benefits was predicted by their own positive reframing (actor effect) as well as their partner's positive reframing (partner effect). Further, this study tested actor and partner effects for the link between perceived benefits and adjustment and whether positive reframing (the initial variable) works through perceived benefits (the mediator) to affect adjustment (the outcome) at the dyadic level. DESIGN: A standard dyadic design was used. METHODS: Eighty couples completed measures of positive reframing, perceived benefits, and adjustment (depression, anxiety, positive affect, life satisfaction, and relationship satisfaction). RESULTS: Partners' scores on study variables were related, and although only actor effects were found for the path between positive reframing and perceived benefits, both actor and partner effects were found for the path between perceived benefits and adjustment. Mediation was found for actor-actor and actor-partner indirect effects. CONCLUSIONS: Results indicate that a greater focus on interpersonal factors is needed to further meaning-making theory and inform practice.

A dyadic and longitudinal investigation of adjustment in couples coping with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) can affect adjustment at both the individual and couple level. PURPOSE: This study examined differences and associations between MS patient and spouse adjustment, and whether one partner's adjustment predicts the other partner's adjustment over time. METHODS: A total of 160 couples at Time 1 and 98 couples at Time 2 completed questionnaires. RESULTS: Mixed-model ANOVAs found that patients reported poorer adjustment than their spouse on a range of adjustment indicators and that positive affect and relationship satisfaction declined over time for both patients and spouses. Intraclass correlations found that patient and spouse scores on all adjustment indicators were related at Time 1. Multilevel modelling showed that one's partner's relationship satisfaction at Time 1 positively predicted one's own relationship satisfaction at Time 2. CONCLUSIONS: The findings indicate that a focus on the interpersonal nature of adjustment to MS may be beneficial for future research and practice.

The protective role of compassion satisfaction for therapists who work with sexual violence survivors: an application of the broaden-and-build theory of positive emotions.

Therapists who work with trauma survivors, such as survivors of sexual violence, can experience compassion satisfaction while experiencing negative effects of trauma work, such as secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by compassion satisfaction and whether the broaden-and-build theory of positive emotions could be applied to examine the factors (positive emotions and positive reframing) that relate to compassion satisfaction. Sixty-one therapists who work with sexual violence survivors completed measures of secondary traumatic stress, compassion satisfaction, adjustment, positive emotions and positive reframing. Hierarchical multiple regression analyses found that compassion satisfaction buffered the negative impact of secondary traumatic stress on therapist adjustment when adjustment was conceptualised as anxiety. Using non-parametric bootstrapping, we found that the relationship between greater positive emotions and greater compassion satisfaction was partially mediated by positive reframing. The findings indicate that compassion satisfaction is likely to be helpful in ameliorating the negative effects of secondary traumatic stress on anxiety in therapists who work with sexual violence survivors and that the broaden-and-build theory of positive emotions may provide a strong theoretical basis for the further examination of compassion satisfaction in trauma therapists.

Couples coping with multiple sclerosis: a dyadic perspective on the roles of mindfulness and acceptance.

This study investigated the roles of mindfulness and acceptance on adjustment in couples coping with multiple sclerosis (MS) by examining the effects of an individual's mindfulness and acceptance on their own adjustment (actor effects) and the effects of their partner's mindfulness and acceptance on their adjustment (partner effects) using the Actor-Partner Interdependence Model. The study was a cross-sectional standard dyadic design that collected data from couples coping with MS. Sixty-nine couples completed measures of mindfulness, acceptance and adjustment (depression, anxiety, life satisfaction, positive affect and relationship satisfaction). As hypothesised there were actor effects of mindfulness and acceptance on better adjustment, however, the beneficial actor effects of mindfulness were only evident on depression and anxiety. The actor effects of both mindfulness and acceptance on relationship satisfaction were moderated by MS status. Regarding partner effects, there was support for the beneficial impact of acceptance on partner relationship satisfaction. In addition, the partner effect of acceptance moderated the actor effect of acceptance on depression, such that the actor effect on lower depression was weaker when the partner reported high acceptance. Findings support the roles of mindfulness and acceptance in shaping individual and dyadic adjustment in couples coping with chronic illness.

Sense making and benefit finding in couples who have a child with Asperger syndrome: an application of the Actor-Partner Interdependence Model.

Parents of children with Asperger syndrome face many challenges that may lead them to search for meaning by developing explanations for (sense making) and finding benefits (benefit finding) in having a child with special needs. Although family theorists have proposed that finding meaning occurs interpersonally, there is a dearth of empirical research that has examined finding meaning at the couple level. This study examined sense making and benefit finding in 84 couples who have a child with Asperger syndrome by using the Actor-Partner Interdependence Model (Kenny et al., 2006) to examine actor effects (i.e. the extent to which an individual's score on the predictor variable impacts his or her own level of adjustment) and partner effects (i.e. the extent to which an individual's score on the predictor variable has an impact on his or her partner's level of adjustment) of sense making and benefit finding on parental adjustment. Results demonstrated that parents' benefit finding related to greater anxiety and parents' sense making related to not only their own adjustment but also their partner's adjustment. Results highlight the importance of adopting an interpersonal perspective on finding meaning and adjustment. Limitations, future research and clinical implications are also discussed.

Alexithymia in relation to parental alcoholism, everyday frontal lobe functioning and alcohol consumption in a non-clinical sample.

BACKGROUND: Recent studies have indicated that 45-67% of those in treatment for alcohol use disorders suffer from alexithymia, a multifaceted personality trait characterized by difficulties identifying and describing emotions and an externally oriented cognitive style. The high reported prevalence rates of alexithymia among those with alcohol dependence led to speculation that alexithymia is a personality dimension that may predispose to risky or problematic alcohol use. METHODS: This notion was examined in 314 adult volunteers (54% female) aged 18-45 years (M=27.6 years), all of whom reported at least occasional alcohol consumption, who completed online surveys assessing alexithymia (Toronto Alexithymia Scale, or TAS-20), parental alcoholism (Children of Alcoholics Screening Test, or CAST), everyday signs of frontal lobe dysfunction (Frontal Systems Behavior Scale, or FrSBe) and risky alcohol use (Alcohol Use Disorders Identification Test, or AUDIT). RESULTS: TAS-20 scores were positively correlated with the index of parental alcoholism CAST, index of frontal lobe dysfunction FrSBe and measure of alcohol-related problems AUDIT. Chi-square test showed an association between TAS-20-defined alexithymia and being the offspring of an alcoholic parent as defined by CAST. Regression analysis showed that frontal lobe dysfunction (FrSBe) mediated the relationship between alexithymia (TAS-20 total score) and risky alcohol use (AUDIT). CONCLUSIONS: The findings suggest that alexithymia is related to deficiencies in frontal lobe functioning that may reflect a heritable predisposition to alcohol problems.

Adjustment in mothers of children with Asperger syndrome: an application of the double ABCX model of family adjustment.

The present study examined the applicability of the double ABCX model of family adjustment in explaining maternal adjustment to caring for a child diagnosed with Asperger syndrome. Forty-seven mothers completed questionnaires at a university clinic while their children were participating in an anxiety intervention. The children were aged between 10 and 12 years. Results of correlations showed that each of the model components was related to one or more domains of maternal adjustment in the direction predicted, with the exception of problem-focused coping. Hierarchical regression analyses demonstrated that, after controlling for the effects of relevant demographics, stressor severity, pile-up of demands and coping were related to adjustment. Findings indicate the utility of the double ABCX model in guiding research into parental adjustment when caring for a child with Asperger syndrome. Limitations of the study and clinical implications are discussed.

Finding meaning in parenting a child with Asperger syndrome: correlates of sense making and benefit finding.

This study explored the nature of two construals of meaning, benefit finding and sense making, in parents of a child with Asperger syndrome, and examined relations between both meaning constructs and the Double ABCX family stress model variables (initial stressor and pile-up of demands, appraisal, social support, coping strategies and adjustment) [H.I. McCubbin, J.M. Patterson, Social Stress and the Family: Advances and Developments in Family Stress Theory and Research, Haworth, New York, 1983, pp. 7-37]. A total of 59 parents completed questionnaires. Content analyses of parents' responses to questions inquiring about gains and sense making explanations revealed 8 benefit and 12 sense making themes. Results of correlations indicated that one or more of the meaning variables were related to each of the Double ABCX model predictors of parental adjustment. The meaning variables were positively related to adaptive coping processes: social support, self-efficacy, and problem-focused and emotional approach coping strategies.