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Objectives The importance of personalized and dignified care is increasingly being recognized in health care policy and practice. Despite the known impact of clothing on social identity and self-expression, the impact of hospital clothing on patient well-being has been widely overlooked. Patients are often required to wear hospital clothing, commonly a backless gown, during medical procedures and surgeries. The impact of wearing patient clothing on well-being, during this time of vulnerability, was explored. Design A sequential multi-method approach consisting of two studies. Methods Two studies were carried out to consider the impact of the hospital gown on well-being among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with a lifelong chronic health condition (congenital heart disease). The second study was a cross-sectional online survey exploring adults' views (n = 928) and experiences of wearing the hospital gown. Results Qualitative analysis identified the following master themes: (1) symbolic embodiment of the 'sick' role, (2) relinquishing control to medical professionals, and (3) emotional and physical vulnerability. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite a lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity. Conclusions The implications of these findings for health policy and practice are discussed, emphasizing the importance of challenging cultural norms in health care since dehumanizing aspects of care, as symbolically represented by the hospital gown, may adversely impact on patient well-being. Statement of contribution What is already known Getting dressed is a form of self-expression, which contributes to the construction of social identity, yet few studies have explored the impact of wearing hospital clothing on patient well-being. The few studies on hospital clothing that exist suggest it is predominantly associated with feeling depersonalized, stigmatized, and devitalized, being in the 'patient role', low status, and a lack of control and privacy. However, previous studies include a variety of hospital clothing including pyjamas (Edvardsson, 2009) and dressing gowns (Topo & Iltanen-Tähkävuori, 2010), whereas in the United Kingdom, a 'one-size-fits-all' backless gown, held together with ties at the back, is most commonly used. What this study adds This study furthers understanding about the lived experience of wearing hospital clothing for people living with a chronic health condition (congenital heart disease) and without. Wearing hospital clothing (most commonly the hospital gown) was associated with symbolic embodiment of the 'sick' role, relinquishing control to medical professionals, and emotional and physical vulnerability for people living with a chronic health condition. Findings from a wider sample, drawn from the general population, suggest that the hospital gown is often being used despite a lack of medical necessity often leaving patients feeling exposed, self-conscious, vulnerable, uncomfortable, cold, embarrassed, and disempowered. These findings are exacerbated for people living with a long-term health condition and women. Together, these studies suggest that the current design of the hospital gown is not fit for purpose and impacts negatively on patient well-being. [ABSTRACT FROM AUTHOR]

Over the last few decades, medical and surgical advances have led to a growing population of individuals living with congenital heart disease. The challenges of this condition can reach beyond physical limitations to include anxiety, depression and post-traumatic stress disorder. To date, these psychological outcomes have been neglected; yet, they need not be inevitable. The factors contributing to these difficulties are considered here, drawing on current evidence and neuropsychological theories including the novel application of polyvagal theory. Suggestions for developing psychologically informed medical and social care to improve mental health, wellbeing and recovery and influence policy and training are proposed (See supplemental material for video abstract). [ABSTRACT FROM AUTHOR]

Background: Self-esteem is an important factor in the development and maintenance of good psychological health. Low self-esteem can be a consequence of mental health disorders (such as depression, anxiety and panic) or it can be a vulnerability factor for the development of such problems. Aims and method: The current study reports pilot findings from a Cognitive Behavioural Therapy (CBT) group intervention for 37 adult women with low self-esteem, based on Fennell's Overcoming Low Self-Esteem Self-Help Course. Results: Findings suggest that the group is (statistically and clinically) effective at increasing levels of self-esteem and at reducing levels of depression and anxiety. Conclusions: Together, results suggest that the group provides an efficient and therapeutically beneficial service. However, since these findings are limited by the lack of control or follow-up data, they warrant further investigation. [ABSTRACT FROM PUBLISHER]

Context and focus: Advances in medicine and technology have improved the survival of children born with life threatening medical conditions. However, this gift of life entails potential psychological, emotional and social costs including the impact of enduring paediatric and adult medical trauma, growing up feeling different, tolerating discrimination and disempowerment and adjusting to a further loss of health. Here, these emotional issues are explored using congenital heart disease as a specific example. Currently, psychological difficulties are under diagnosed for this population which could impact not only on psychological well-being and quality of life but also recovery from illness. As such, the potential benefits of Interpersonal Psychotherapy (IPT) as a treatment option are explored. Conclusions: IPT seems a suitable treatment option for this population. Given that many of the issues faced by congenital heart disease survivors are likely to be shared with individuals born with other congenital conditions it seems likely that IPT generally offers a suitable treatment option for adults with a lifelong illness. A focus on the interpersonal difficulties faced by such individuals could benefit clients by validating the psychosocial cost that these individuals pay to live and endeavouring to develop an interpersonal network that better meets their complex psychological and emotional needs. Some potential limitations are discussed. [ABSTRACT FROM AUTHOR]

Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020–2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds. Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child. What is Known: • Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. • Professionals report uncertainty and tensions in applying evidence-based practice to children's procedural care. What is New: • This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives. • The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds. [ABSTRACT FROM AUTHOR]

The article discusses what patients think when medical professionals are able to accommodate their emotional needs, presenting the experience of the author growing up with pioneering treatment for her heart condition. Topics discussed include trust in medical professionals who listen and acknowledge the experience of the patient living with the condition, importance of patient involvement, and camaraderie, warmth and compassion felt when cared for by a nurturing, mutually responsive team.

Our findings provide evidence that railway workers showed low levels of mental wellbeing during the third period of lockdown during the COVID-19 pandemic in the United Kingdom (December 2020–March 2021). The benefits of fostering both individual and team resilience as well as encouraging mental health help-seeking is emphasised. Objective: Railway workers have provided an essential service throughout the COVID-19 pandemic. This study explored the effects of COVID-19 on the mental well-being of railway workers (N = 906) in the United Kingdom during the third lockdown period. Method: The online survey included measures of COVID-19–related risk factors (perceived risk, stress, burnout, trauma) and protective factors (resilience coping, team resilience, general help seeking) associated with mental well-being. Responses were analyzed using multiple regression and content analysis. Results: COVID-19–related risk factors negatively predicted well-being. Higher scores on adaptive resilience, intentions to seek help, and team resilience significantly predicted higher mental well-being scores. Mental health decline throughout the COVID-19 pandemic and concerns for the future were reported. Conclusions: Building a resilient railway workforce requires attention to staff mental well-being and to ensuring that support systems are robust and accessible. [ABSTRACT FROM AUTHOR]

The article looks at the potential of cognitive behavioural therapy (CBT) in supporting women with low self-esteem. Topics discussed include a controlled trial being done on women aged at least 18 years using measures like The Robson Self-Concept Questionnaire, the Beck Depression Inventory 2nd edition and the Beck Anxiety Inventory, results showing 41 participants attended an average of 7.1 out of 8 sessions, and the role of a CBT centered on self-esteem in depression management.

A growing body of research has highlighted the adverse impact of COVID‐19 stressors on health and social care workers' (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental well‐being of HSCWs during the third lockdown period in Scotland. Using a cross‐sectional design, participants (n = 1364) completed an online survey providing quantitative data and free open‐text responses. A multi‐method approach to analysis was used. The majority of HSCWs were found to have low well‐being scores, high levels of COVID‐19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut‐off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental well‐being. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help‐seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental well‐being. Our findings illuminate the complexity of the effects of the COVID‐19 pandemic on HSCWs' well‐being and will inform future intervention development seeking to increase positive adaptation and improve staff well‐being. Addressing barriers to mental health help‐seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics. [ABSTRACT FROM AUTHOR]

Frontline railway workers have provided an essential service throughout the COVID-19 pandemic. Although railway workers are known to be at risk of developing traumatic stress-related conditions, little is known about the effects of COVID-19 on the mental wellbeing of railway workers in the UK. We tested two hypotheses: (1) increased scores in COVID-19-related risk factors will predict decreased mental wellbeing and (2) protective factors will mediate the relationship between COVID-19-related risk factors and mental wellbeing. The study consisted of a cross-sectional online survey exploring the effects of COVID-19 on the mental wellbeing of railway workers (n=906) in the UK, using data collected during third lockdown (between Dec 1, 2020, and March 24, 2021). The survey, advertised on social media and internal platforms of the Associated Society of Locomotive Engineers and Firemen, included measures of COVID-19-related risk factors (COVID-19 Perceived Risk Scale, COVID-19 Stress Measure, COVID-19 Burnout Scale, and PTSD Checklist–Civilian Version) and protective factors (brief resilience coping, team resilience, general help-seeking questionnaire) associated with mental wellbeing (Warwick Edinburgh Mental Wellbeing Scale–Short Form). We analysed responses via multiple regression and parallel mediation analyses. Open-ended questions, exploring railway workers' views of risks and protective factors for their mental wellbeing, were analysed using content analysis. The institutional ethics committee granted ethical approval and participants gave informed consent. COVID-19 related risk factors negatively predicted wellbeing (r2=0·50, F=273·556 [3 variables, n=813], p<0·0001). Protective factors significantly mediated the relationship between wellbeing and burnout (indirect effect [IE] –0·0252, 95% CI –0·0364 to –0·0152), stress (IE –0·0252, –0·0364 to –0·0152), post-traumatic stress disorder (IE –0·0311, –0·0493 to –0·0145), and risk perception (IE –0·0244, –0·0411 to –0·0089). Content analysis found self-reported mental health decline throughout the COVID-19 pandemic, perceived loss of workplace supports, need for psychological support, and concerns for the future. These findings emphasise the importance of adaptive coping and team-based resilience in alleviating the negative impact that COVID-19 has on railway workers' mental wellbeing and in preventing burnout. Work-based supports and access to psychological input for railway workers who need it is highlighted. Building a resilient railway workforce moving forward requires attention to staff mental wellbeing and to ensuring that support systems are robust and accessible. None. [ABSTRACT FROM AUTHOR]