Assessment of Emotions and Stress Coping Mechanisms of Healthcare Workers from the Department of Pediatrics at the Philippine General Hospital a Year after the Coronavirus Disease 2019 (COVID-19) Pandemic.

Objective: Healthcare workers (HCWs) are an often overlooked population in the face of a pandemic. With the myriad of researches focusing on the effect of Coronavirus Disease 2019 (COVID-19) on patients, this study aimed to illuminate the emotions, stressors and stress coping mechanisms of medical frontliners from the Department of Pediatrics working in Philippine General Hospital. Methods: A quantitative cross-sectional study was done among 130 HCWs ages 21-55 years old, mostly females (72%), recruited through convenience sampling. An adapted questionnaire from China was used and data were analyzed using means, T-test and Anova. Results: Results showed that HCWs predominantly felt a high sense of professional and ethical duty towards their jobs. Stressors include fear of transmitting the virus to their family and the shortage of manpower, while stress-relievers include knowing that their family are safe and having a good relationship with colleagues. Coping strategies include the use of personal protective measures and the hope of cure motivates them to continue working. Seeking psychiatric help is interestingly one of the least important motivational factors. Nurses, fellows, and residents significantly differ in responses about their feelings, stress-relievers, and coping strategies. Conclusion: HCWs are a vulnerable population since they endure multiple stressors but they are idealistic and resilient, hence the hospital should give adequate financial compensation and provide good work-life balance.

Economic burden and coping mechanisms by tuberculosis treatment supporters: a mixed method approach from Bono Region, Ghana.

BACKGROUND: The Directly Observed Therapy Short Course (DOTS) strategy recommended by World Health Organization for tuberculosis control requires multiple clinic visits which may place economic burden on treatment supporters especially those with low socio-economic status. The End tuberculosis goal targeted eliminating all tuberculosis associated costs. However, the economic burden and coping mechanisms by treatment supporters is unknown in Ghana. OBJECTIVES: The study determined the economic burden and coping mechanism by treatment supporters in Bono Region of Ghana. METHODS: Cross-sectional study using mixed method approach for data collection. For the quantitative data, a validated questionnaire was administered to 385 treatment supporters. Sixty in-depth interviews with treatment supporters to elicit information about their coping mechanisms using a semi-structured interview guide for the qualitative data. Descriptive statistics, costs estimation, thematic analysis and bivariate techniques were used for the data analysis. RESULTS: Averagely, each treatment supporter spent GHS 112.4 (US$21.1) on treatment support activities per month which is about 19% of their monthly income. Borrowing of money, sale of assets, used up saving were the major coping mechanisms used by treatment supporters. Highest level of education, household size, marital status and income level significantly influence both the direct and indirect costs associated with tuberculosis treatment support. The significant levels were set at 95% confidence interval and p < 0.05. CONCLUSION: We concludes that the estimated cost and coping mechanisms associated with assisting tuberculosis patients with treatment is significant to the tuberculosis treatment supporters. If not mitigated these costs have the tendency to worsen the socio-economic status and future welfare of tuberculosis treatment supporters.

Twelve tips for creating a multicultural mindfulness-based intervention in diverse healthcare settings.

High levels of stress and burnout, low help-seeking behaviour and unhealthy coping in healthcare professionals (HCPs), are a critical concern globally. Mindfulness-based interventions (MBIs) reduce stress, are a healthy coping mechanism and have become increasingly popular among HCPs, especially during the Covid-19 pandemic. Nevertheless, HCPs' busy schedules require the intervention to be accessible, pragmatic, and context specific. Key to this goal is approaching mindfulness from a multicultural perspective, especially in diverse settings such as Africa. This paper aims to provide practical tips to ensure that the MBI offered is effective with multicultural HCPs during intense stress. Four tips each discuss the curriculum, implementation, and sustainability, respectively. The tips are elucidated by practical examples of regulating stress in healthcare settings and to offer a guideline to help structure future MBIs to be culturally and context appropriate.

Chronomobility of international students under COVID-19 Australia.

This article investigates the chronomobility of international students in Australia going through COVID-19. Existing literature on international students approaches them largely in two manners: a market or victims. Using Shanti Robertson's chronomobility, the study focuses on international students' coping mechanisms and strategies for their next moves. Drawing from 15 in-depth interviews with international students formally enrolled in Australian institutions in Melbourne, the longest lockdown city during the pandemic, the authors find various ways of short-term coping mechanisms through meditation, physical exercises, virtual escapism and counselling. Furthermore, despite pandemic immobility, students presented a high level of resilience in making future decisions for post-pandemic mobilities. We conclude that family support and social networks are key to realise full potentials of international students as skilled migrants and valued members of society. Our manuscript contributes to the field of migration and mobility by enriching Robertson's concept of chrono-mobility and adding the empirical case study from international students in Australia during the latest pandemic in 2020-2021.

Effects of Education and Guided Imagery Program on Stress Level and Coping Behaviors Among Pregnant Women at Risk of Preterm Birth.

Purpose: The rate of preterm birth continues to increase worldwide. Pregnant women at risk of preterm birth experience more stress during pregnancy, which directly impacts their mental well-being and preterm birth situation. Stress management can significantly reduce stress and promote appropriate coping behaviors in pregnant women at risk of preterm birth. The purpose of this study was to determine the effects of education and guided imagery program on stress level and coping behaviors among pregnant women at risk of preterm birth. Patients and Methods: Forty-eight pregnant women who visited the antenatal care unit at Ramathibodi Hospital and were at risk of preterm birth with moderate stress score were included. They were divided into two groups, each comprising 24 participants. The control group received standard nursing care, whereas the experimental group received an education and guided imagery program in addition to standard nursing care. The Perceived Stress Scale-10 and Coping Behavior Questionnaire were used to collect data. Results: The results revealed that the mean stress score in the experimental group after receiving the program was lower than before with statistical significance (t = 7.14, p < 0.001). Moreover, the experimental group had lower stress score (F1,45 = 16.92, p < 0.001) and greater coping behavior score (F1,45 = 7.85, p < 0.01) compared with the control group after receiving the program, and the differences were statistically significant. Conclusion: This research highlights the importance of preventing mental health problems in pregnant women at risk of preterm birth by using an education and guided imagery program to decrease stress and promote appropriate coping behaviors.

Potential impacts of Russo-Ukraine conflict and its psychological consequences among Ukrainian adults: the post-COVID-19 era.

Background: Since February 2022, the nation of Ukraine has become entangled in an escalating conflict that erupted after coronavirus outbreak fostering a situation of indeterminacy and precariousness, which adversely affected several facets, especially psychological well-being. However, there is a lack of empirical evidence on the psychological well-being of Ukrainians during the Russo-Ukraine war, as well as their coping strategies in response to the war's repercussions. Consequently, this investigation endeavors to explore the prevalence of symptoms associated with depression, anxiety, stress, and insomnia and to correlate these symptoms with Ukrainians' effective coping mechanisms during the ongoing war. Methods: An online survey was administered in Ukraine from June to August 2022 due to the ongoing Russo-Ukraine conflict. The survey employed a quota sampling technique, targeting 2,664 individuals (≥18 years). Out of the total sample, 1,833 valid responses were obtained, yielding a response rate of 68. 81%. Depression, anxiety, and stress were measured using the depression, anxiety, and stress scale-21 (DASS-21), while the Pittsburgh sleep quality index (PSQI) was utilized to evaluate insomnia symptoms. In addition, Brief-COPE was adopted to evaluate the coping mechanisms of the selected study participants. Results: Of 1,833 Ukrainian adults, 60.5% had symptoms of stress; 62.4% of them reported symptoms of anxiety; and 58.2% reported symptoms of depression. Symptom criteria for insomnia were found in about 21.8% of the study sample. The factors of sex, living area, area occupied by Russian forces, and having older adults and children in the house were statistically significant with symptoms of depression, anxiety, stress, and insomnia. The productive coping strategies of self-distraction, using instrumental support, planning, and behavioral disengagement, were observed as statistically significant with four psychological constructs. Conclusion: The study outcomes highlight a substantial prevalence of symptoms related to depression, anxiety, stress, and insomnia attributed to the accumulated consequences of ongoing conflict and the COVID-19 outbreak. The aforementioned findings emphasize the imperative of providing healthcare services and facilitating effective coping strategies among Ukrainians amid the ongoing war.

Coping Mechanisms of Psychiatric Nurses in Child Mental Health Environments in North West Province, South Africa: A Qualitative Call for Urgency.

There is currently a growing understanding of child mental health. However, with little attention and investment from decision-makers, the prevalence of child mental health challenges shows no signs of diminishing. Psychiatric nursing is a process in which the major knowledge and skills dealing with the interpersonal and intrapersonal dynamics of human beings are practised. These nurses have to cope with this demand in a scant clinical child psychiatric environment. An exploratory, descriptive, and contextual research design was used to postulate the coping mechanism of these nurses in a clinical child psychiatric environment. This study comprised psychiatric nurses, and data were collected through focused group interviews. The findings emphasised the importance of clinical support to enhance quality nursing care and adjustment related to the demands on psychiatric nurses to participate fully in the service. Conclusion: Child and mental health services ought to enable nurses to better deal with the service demands and quality of psychiatric health care. An increased understanding of child mental health challenges is needed so that nurses' roles and functions in child psychiatric practice can be defined. Effective management and support ought to enable psychiatric nurses and health care teams to make decisions that support international development targets.

Identifying psychosocial problems, needs, and coping mechanisms of adolescent Syrian refugees in Jordan.

Background: Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan. Methods: Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke. Results: The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance. Conclusion: Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.

The experiences and coping mechanisms of mothers caring for a child with cerebral palsy.

Mothers caring for a child with cerebral palsy suffer from many physical and psychosocial problems. Their quality of life is significantly lower than mothers with healthy children. The first step in improving these women's quality of life is to improve the understanding of their experiences and coping mechanisms in specific cultural contexts. Therefore, this study aimed to explore the experiences and coping mechanisms of mothers caring for a child with cerebral palsy through a qualitative study conducted in Turkey. The study took place in 2021. Ten mothers were selected to participate through purposeful sampling. Inclusion criteria were mothers who had cared for a child with cerebral palsy for over three years, had no chronic diseases, could speak Turkish fluently, and wanted to participate in the study. The data were collected through semi-structured interviews. Qualitative content analysis was used to analyze the data. Two main themes and three categories emerged from the data analysis. The themes were "dedication" and "seeking." The analysis showed that mothers were dedicated as they engaged in all aspects of care. Their coping mechanisms involved self-focused and problem-focused seeking. These mothers must be acknowledged and supported while considering cultural and religious beliefs.

Evaluation of Psychological Resources of Young Adults With Type 1 Diabetes Mellitus During the Transition From Pediatric to Adult Diabetes Clinics: Multicenter Cross-sectional Study.

BACKGROUND: The transition period of patients with type 1 diabetes from pediatric to adult-oriented health care is associated with poorer glycemic control and less frequent clinic attendance. Fears and anxiety about the unknown, care approach differences in adult settings, and sadness about leaving the pediatric provider all contribute to a patient's reluctance to transition. OBJECTIVE: This study aimed to evaluate the psychological parameters of young patients with type 1 diabetes transitioning to an adult outpatient clinic during the first visit. METHODS: We examined 50 consecutive patients (n=28, 56% female) transitioning from March 2, 2021, to November 21, 2022, into adult care (3 diabetes centers from 3 regions in southern Poland: A, n=16; B, n=21; and C, n=13) and their basic demographic information. They completed the following psychological questionnaires: State-Trait Anxiety Inventory (STAI), Generalized Self-Efficacy Scale, Perceived Stress Scale, Satisfaction with Life Scale, Acceptance of Illness Scale, Multidimensional Health Locus of Control Scale Form C, Courtauld Emotional Control Scale, and Quality of Life Questionnaire Diabetes. We compared their data with those for the general healthy population and patients with diabetes from Polish Test Laboratory validation studies. RESULTS: During the first adult outpatient visit, patients' mean age was 19.2 (SD 1.4) years, with a diabetes duration of 9.8 (SD 4.3) years and BMI of 23.5 (SD 3.1) kg/m2. Patients came from diverse socioeconomic backgrounds: 36% (n=18) live in villages, 26% (n=13) live in towns with ≤100,000 inhabitants, and 38% (n=19) live in bigger cities. Regarding therapy type, 68% (n=34) were treated with insulin pump therapy, whereas 32% (n=16) were treated with multiple daily injections. Patients from center A had a mean glycated hemoglobin level of 7.5% (SD 1.2%). There was no difference regarding the level of life satisfaction, perceived level of stress, and state anxiety between the patients and reference populations. Patients had similar health locus of control and negative emotions control to the general population of patients with diabetes. Most patients (n=31, 62%) believe that control over their health depends on themselves, whereas 52% (n=26) believe that it depends mostly on others. Patients had higher levels of suppression of negative emotions-anger, depression, and anxiety-than the age-matched general population. Additionally, the patients were characterized by a higher acceptance of illness and higher level of self-efficacy compared to the reference populations: 64% (n=32) had a high level of self-efficacy and 26% (n=13) had a high level of life satisfaction. CONCLUSIONS: This study indicated that young patients transitioning to adult outpatient clinics have good psychological resources and coping mechanisms, which might result in adequate adaptation and adult life satisfaction including future metabolic control. These result also disprove the stereotypes that young people with chronic disease have worse life perspectives when entering adulthood.

Work-related stress, quality of life, and coping mechanism among lecturers in a Tertiary Educational Institution in Anambra State, Nigeria.

INTRODUCTION: Work-related stress (WRS) is a highly prevalent and pervasive problem that can result in loss of productivity and deterioration of a lecturer's health. Lecturing work requires coping with some of the stressful situations found in any workplace to have a favourable quality of work life. The study determined the influence of sex, years of teaching experience, and academic rank on work-related stress, coping mechanisms, and quality of work life among lecturers at Nnamdi Azikiwe University (NAU). METHOD: This was a cross-sectional survey involving 283 lecturers consecutively recruited from NAU after proportionate randomization of the lecturers in 101 departments. The Health and Safety Executive Work Related stress (HSE-WRS), Work-Related Quality of life (WRQL), and Brief-cope Questionnaires (BCQ) were applied to assess the participant's work-related stress, quality of work life, and coping mechanism (CM) respectively. Data were analyzed using Kruskal Wallis and Mann-Whitney U tests at a 0.05 level of significance. RESULT: Sex, years of teaching experience, and academic rank had statistically significant influence on 14 subsets of coping mechanism with p-values

Stress among Parents of Children with Hearing Loss and How They Deal with It: A Systematic Review

Abstract Introduction Parenting a child with hearing loss may be accompanied by high stress levels and several challenges. Objectives The present systematic review was performed to compile the existing literature pertaining to parental stress in parents of children with hearing loss and coping strategies. Data synthesis The databases searched include PubMed/Medline, Scopus, Cochrane Library and Cumulative Index to Nursing, and Allied Health Literature. The systematic review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. The screening for studies was performed independently by two researchers. Methodological quality appraisal was done using the Mixed methods appraisal tool. Twenty-eight studies were identified and included in the present review, which discussed the stress factors and coping mechanism associated with having child with hearing loss reported by parents. The factors leading to stress were thematically classified into parent/family-related factors, child-related factors, and professionals/service-related factors. The coping strategies were thematically classified into improved support systems and better professional resources. Conclusion The present systematic review was an attempt at exploring the various stress causing factors among parents of children with hearing loss. The various coping strategies would help in better planning services for these parents and helping to lessen the stress.

Stress among Parents of Children with Hearing Loss and How They Deal with It: A Systematic Review.

Introduction Parenting a child with hearing loss may be accompanied by high stress levels and several challenges. Objectives The present systematic review was performed to compile the existing literature pertaining to parental stress in parents of children with hearing loss and coping strategies. Data synthesis The databases searched include PubMed/Medline, Scopus, Cochrane Library and Cumulative Index to Nursing, and Allied Health Literature. The systematic review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. The screening for studies was performed independently by two researchers. Methodological quality appraisal was done using the Mixed methods appraisal tool. Twenty-eight studies were identified and included in the present review, which discussed the stress factors and coping mechanism associated with having child with hearing loss reported by parents. The factors leading to stress were thematically classified into parent/family-related factors, child-related factors, and professionals/service-related factors. The coping strategies were thematically classified into improved support systems and better professional resources. Conclusion The present systematic review was an attempt at exploring the various stress causing factors among parents of children with hearing loss. The various coping strategies would help in better planning services for these parents and helping to lessen the stress.

Allegory Analysis from M. Theresa - A Case Study.

In the following article, I will briefly introduce the method of Allegory Analysis (AA) (Guenther, 2020, 2021, in press) and then outline it in its application to the case study of. The goal of this article is to introduce AA and illustrate it using the particularly illustrative case of Theresa. It will be shown how AA can be a new psychotherapeutic method in the therapist's toolbox, with which the human psyche in its individual uniqueness can be understood in the clinical context through creative means. Allegories of patients are defined here as complex linguistic constructs of multiple metaphors and as expressions of complex affective perception and experience. In order to understand a human psyche through its allegories, AA proceeds in four steps: (1) picking up and describing the allegories, (2) summarizing them into a so-called allegory poem, (3) interpreting the allegories on the part of the therapist, and (4) participatory interpretation of the allegories with the patient. The present case of Theresa illustrates the application of the AA method in an outpatient psychotherapeutic context and shows how through AA. In Theresa's case, the client was found to be ideologically guided by values such as autonomy, freedom, honesty, sustainability, charity, and connectedness. Her psychosis represented an autopoietic self-healing attempt to recover these values, which had been inaccessible to her in the antecedent process. The AA showed that Theresa believes that crises in the market economy, interpersonal coexistence, and climate change are at a critical point that threatens the existence of the world and thus her psychological stability. Moreover, in Theresa's allegories, it is evident that she had managed to use her values and beliefs autopoietically to stabilize her crisis through her coping strategy: externalization through poetic-allegorical language.

Coastal Erosion and Flood Coping Mechanisms in Southern Thailand: A Qualitative Study.

Communities in coastal regions are affected by the impacts of extreme climatic events causing flooding and erosion. Reducing the impacts of flood and erosion in these areas by adopting coping strategies that fortify the resilience of individuals and their localities is desirable. This study used summative content analysis to explore the coping mechanisms of coastal communities before, during, and after various dangers relating to flooding and erosion. The findings from the study show that effective surveillance systems, disaster preparedness, risk mapping, early warning systems, availability of databases and functional command systems, as well as reliable funding are essential to efficiently cope with hazards of coastal flooding and erosion. As flooding and erosion have been predicted to be more severe due to climate change in the coming years, the adoption of effective natural and artificial mechanisms with modern technologies could help coastal regions to be more resilient in coping with the dangers associated with flooding and erosion. Pragmatic policies and programs to this end by actors are critical to averting crises induced by flooding and erosion in coastal areas.

Women experiencing homelessness in Dire Dawa city: Coping mechanisms and suggestions to stakeholder, 2021.

BACKGROUND: In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people. OBJECTIVES: To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021. DESIGN: A community-based phenomenological qualitative study was conducted at Dire Dawa city. METHODS: Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up. RESULTS: Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation). CONCLUSION: Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society's mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.

Prevalence of Anxiety and Burnout, and Coping Mechanisms among Clinical Year Medical Undergraduate Students in Universiti Kebangsaan Malaysia Amidst the COVID-19 Pandemic.

This study aimed to determine the prevalence of anxiety and burnout, and the coping mechanisms among clinical year undergraduate medical students in Universiti Kebangsaan Malaysia (UKM) during the coronavirus disease 2019 (COVID-19) pandemic. In total, 378 clinical year undergraduate medical students in UKM participated in this cross-sectional study from May to July 2021. A self-administered questionnaire consisting of questions on the participant's sociodemographic data and items from the DASS-21, CBI, and Brief-COPE was distributed. Chi-square and Spearman's correlation tests were used to calculate the correlation coefficient between both anxiety and burnout, and coping mechanisms. The prevalence of anxiety and burnout were 44.2% and 22.2%, respectively. There was a significant difference in the percentage of students with extremely severe anxiety in the presence and absence of burnout, 23.8% vs. 4.8% (p < 0.001). Among the three coping mechanisms, avoidant coping had a significant positive moderate correlation with both the presence of anxiety (r = 0.3966, p < 0.001) and the presence of burnout (r = 0.341, p < 0.001). Meanwhile, coping that was neither approach nor avoidant had a positive weak correlation with the presence of burnout (r = 0.176, p = 0.001). The prevalence of anxiety and burnout was concerning. Increased anxiety and burnout among students may negatively impact aspects of their personal, professional, and academic lives. Early recognition and preventive measures should be emphasised to prevent negative ramifications.

The Pattern of Substance Use among People Who Use Drugs (PWUD) Receiving Treatment at University Malaya Medical Centre (UMMC) during the COVID-19 Pandemic and the Associated Factors.

There was a change in the pattern of substance usage among people who use substances during the COVID-19 pandemic period. This study aims to determine the effects of the COVID-19 pandemic on the pattern of substance usage among people who use drugs (PWUD) receiving treatment at the University Malaya Medical Centre (UMMC) as well as levels of anxiety and depression together with coping mechanisms and the factors affecting the pattern of substance use during COVID-19 pandemic period. A cross-sectional study was applied. The questionnaire used was the Mini-European Web Survey on Drugs (EWSD): COVID-19, Hospital Anxiety and Depression Scale (HADS), and Brief COPE Scale. In total, 130 PWUD were recruited. Of the participants, 36.2% of PWUD had not used/stopped the usage of illicit drugs/alcohol, 26.2% increased their usage, 20% decreased, and 14.6% used the same amount of illicit substances/alcohol during the COVID-19 pandemic period/restrictions. In addition, 28.5% of PWUD had an increased intention to seek professional support for drug counseling/treatment during the COVID-19 pandemic period. The prevalence anxiety and depression symptoms in PWUD according to HADS was 33% and 41.5%, respectively, with depression (p = 0.05) and isolation status (adjusted OR = 2.63, p < 0.05) being associated with an increase in alcohol/illicit substance use during the COVID-19 pandemic. PWUD who had increased their intention to seek professional support had significantly higher odds (adjusted OR = 4.42, p < 0.01) of reducing their alcohol/illicit substance use during the COVID-19 pandemic period. There were increased odds of maintaining alcohol/illicit substance usage among PWUD who practiced dysfunctional coping (adjusted OR = 3.87, p < 0.025) during the COVID-19 pandemic period. In conclusion, depression, isolation status, dysfunctional coping, and intention to seek professional support affected the pattern of alcohol/illicit substance use during the COVID-19 pandemic period. Strategies, substance rehabilitation/counseling, and proper mental health screening and the associated risk factors must be emphasized to prevent a further epidemic of substance use during the pandemic.

Exploring the Impact and Lived Experiences of Hospice Staff Working in End-of-Life Care: An Interpretative Phenomenological Analysis (IPA).

Current research surrounding the experiences of hospice staff is significantly underdeveloped. Additionally, the stigmatisation of death in Western society has formed delusions of hospice care amongst the general public. These findings gained an insight of the lived experiences of six hospice staff across England and Wales, through an interpretative phenomenological analysis. Eight superordinate themes were identified; 'COVID-19 as a barrier to care delivery', 'Discomfort is key for personal growth', 'Self-preservation is paramount', 'Psychological impact of hospice environment', 'Internal conflict surrounding life and death', 'Complexities of a firm belief system', 'Utopian view of hospices' and 'Colleagues are a pillar of support'. All narratives shared overarching themes on growth, acceptance, and morality. These findings have future implications at the organisational level, identifying areas for adjustment for employee wellbeing. Furthermore, this may also educate aspiring end-of-life care staff in preparation for the reality of hospice environments.