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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health-Related Quality of Life and Well-Being".

Deadline for manuscript submissions: closed (28 March 2023) | Viewed by 26871

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Prof. Dr. Denise Marie Saint Arnault

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Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI 48104, USA
Interests: gender based violence recovery; help seeking; culture and mental health; women’s mental health; positive psychology; healing and recovery research; mixed methods research; narrative research
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Special Issue Information

Dear Colleagues,

Research has focused on risk variables for vulnerable populations, which can have the unfortunate result of pathologizing and “othering” vulnerable groups. However, while vulnerability is a critical dimension of populations, researchers should consider strengths, resources, and capacities in their models to promote empowerment-based research and service. Moreover, research has focused on psychological well-being without adequately considering the complex interactions between psychology and socialization, enculturation, and embodiment. Finally, theoretical models are needed to help researchers and clinicians discover critical junctures in well-being recovery (whether developmental, psychosocial, or phenomenological). This Special Issue invites research that conceptualizes and operationalizes elements of wellbeing, especially those that explicate elements of, and interactions between, well-known concepts such as coping, social support, or quality of life. We are also seeking papers that examine multidimensional aspects of wellbeing. Finally, process models or theories that examine “how” wellbeing is developed, strengthened, or maintained within vulnerability are welcomed.

Prof. Dr. Denise Marie Saint Arnault
Guest Editor

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Keywords

holistic models of wellbeing
theory development
healing and recovery
strength-based research
capacity-based research
multidimensional models
vulnerable groups (migrant, frail elderly, child, disabled, homeless, battered women, sexual and gender minorities)
vulnerability, fragility
violence and abuse
health inequalities
healthcare access
healthcare disparities
healthcare services
gender-differentiated impacts
maternal health
health outcomes
methodological approaches
well-being
public health

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Published Papers (9 papers)

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Research

15 pages, 388 KiB

Open AccessArticle

The Use of Qualitative Methods to Guide the Development of the Border Resilience Scale in a Participatory Research Study

by Maia Ingram, Karina R. Dueñas, Idolina Castro, Luis Vázquez, Rebecca M. Crocker, Emily K. Larson, Jill Guernsey de Zapien, Emma Torres and Scott C. Carvajal

Int. J. Environ. Res. Public Health 2023, 20(9), 5703; https://doi.org/10.3390/ijerph20095703 - 1 May 2023

Cited by 1 | Viewed by 2915

Abstract

U.S.-Mexico border residents experience pervasive social and ecological stressors that contribute to a high burden of chronic disease. However, the border region is primarily composed of high-density Mexican-origin neighborhoods, a characteristic that is most commonly health-promoting. Understanding factors that contribute to border stress and resilience is essential to informing the effective design of community-level health promotion strategies. La Vida en La Frontera is a mixed-methods, participatory study designed to understand factors that may contribute to border resilience in San Luis, Arizona. The study’s initial qualitative phase included interviews with 30 Mexican-origin adults exploring community perceptions of the border environment, cross-border ties, and health-related concepts. Border residents described the border as a Mexican enclave characterized by individuals with a common language and shared cultural values and perspectives. Positive characteristics related to living in proximity to Mexico included close extended family relationships, access to Mexican food and products, and access to more affordable health care and other services. Based on these findings, we co-designed the 9-item Border Resilience Scale that measures agreement with the psychosocial benefits of these border attributes. Pilot data with 60 residents suggest there are positive sociocultural attributes associated with living in border communities. Further research should test if they mitigate environmental stressors and contribute to a health-promoting environment for residents. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

18 pages, 1157 KiB

Open AccessArticle

“Going Forward Like a Grandmother in the Snow”: Personal Survival Strategies, Motherhood, and Nature as Resources for Mothers Who Have Experienced Intimate Partner Violence

by Minna Sorsa, Hulda S. Bryngeirsdottir and Eija Paavilainen

Int. J. Environ. Res. Public Health 2023, 20(7), 5389; https://doi.org/10.3390/ijerph20075389 - 4 Apr 2023

Cited by 1 | Viewed by 2485

Abstract

After suffering interpersonal violence (IPV), women survivors can access various interdisciplinary services and programmes to guide their recovery. Nevertheless, many vulnerable women postpone seeking help, sometimes indefinitely. Motherhood especially complicates help-seeking because mothers often want to protect both the perpetrator and their children. Understanding women’s resilience, resources, and capacities in surviving IPV, however, could guide the development of helpful services that women actually access. Thus, in our study, we sought to explore the agency, resources, and reinforcing survival experiences of survivors of IPV. Our data, gathered in Finland during the COVID-19 pandemic, consisted of 12 narratives of mothers told in Clinical Ethnographic Narrative Interviews that were subsequently subjected to thematic analysis. Five themes describing personal resources, motherhood, and nature were identified under the overarching metaphor of “going forward like a grandmother in the snow”. Recognising the agency, resources, capacities, and coping mechanisms of women who have suffered IPV can help in developing professional outreach programmes, promoting women’s early access to useful resources, and, in turn, helping them to stop the possible intergenerational transmission of violence. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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12 pages, 668 KiB

Open AccessArticle

Disparate Emotions as Expressions of Well-Being: Impact of Festival Participation from the Participants’ Subjective View

by Saeid Abbasian

Int. J. Environ. Res. Public Health 2023, 20(1), 329; https://doi.org/10.3390/ijerph20010329 - 26 Dec 2022

Cited by 3 | Viewed by 2872

Abstract

The purpose of this research is that through festival participants’ subjective views get a better understanding of how their participation results in positive feelings and well-being. The paper has a qualitative approach based on a delimited part of a larger survey and the content analysis method has been employed. A total of 280 participants, mainly of immigrant origin, answered one of the open-ended questions in the survey: What emotions does celebrating the Fire Festival evoke in you? Please justify your answer. The most common meaning in the answers has been good feelings followed by feelings of integration and community, the return of spring, and nostalgia. The results show that the festival has significance for these peoples’ good feelings and well-being, even though it lasts five hours. This study contributes to increased knowledge of festivals’ positive impacts on individuals, especially on immigrants living in Western countries. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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15 pages, 340 KiB

Open AccessArticle

Competent Witnesses: How Penitentiary Workers Explain the Violence in Italian Prisons during the COVID-19 Pandemic

by Ines Testoni, Davide Viezzoli, Gianmarco Biancalani, Maria Armezzani and Adriano Zamperini

Int. J. Environ. Res. Public Health 2022, 19(21), 13717; https://doi.org/10.3390/ijerph192113717 - 22 Oct 2022

Viewed by 1721

Abstract

Background: During the COVID-19 pandemic, in the Italian prison of Santa Maria Capua Vetere (SMCV), prison police repressed a riot with extreme violence, bringing the state of prisons and the conditions of prisoners back to the attention of the Italian public opinion. Objective: This exploratory study aimed to collect the experiences and the competent opinions of the social and health personnel of Italian prisons regarding the episode of violence that happened in SMCV; the general state of health of the Italian prison system was explored, too, together with the collection of proposals for interventions aimed at the eradication of violence in prison. Method: The study employed a qualitative research design. Eighteen social-health workers from 12 Italian prisons were interviewed using in-depth interviews of ~60 min each that were conducted and recorded via Skype video calls. The interview transcripts were analyzed with qualitative reflexive thematic analysis (RTA) to identify the most relevant and recursive themes. Results: Four themes were identified: (1) reactions and thoughts about the events of SMCV; (2) structural problems of Italian prison police; (3) Italian prison system; and (4) reform proposals. Conclusions: A new and deeper awareness of the suffering of the current Italian penitentiary system emerged, together with courageous reform proposals that can restore dignity and centrality to the re-education of the detainees, preventing further future violence. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

14 pages, 330 KiB

Open AccessArticle

Coping and Resilience Strategies among Ukraine War Refugees

by Lluis Oviedo, Berenika Seryczyńska, Josefa Torralba, Piotr Roszak, Javier Del Angel, Olena Vyshynska, Iryna Muzychuk and Slava Churpita

Int. J. Environ. Res. Public Health 2022, 19(20), 13094; https://doi.org/10.3390/ijerph192013094 - 12 Oct 2022

Cited by 43 | Viewed by 6465

Abstract

(1) Background: The war in Ukraine has triggered a huge humanitarian crisis: millions of refugees have escaped from their homes looking for shelter beyond Ukraine’s borders. This emergency offers a unique opportunity to investigate and to document those characteristics of the human condition that emerge in exceptional circumstances provoked by war. Based on considerations derived from recent studies on resilience, the research at the base of this paper was conducted to better understand the circumstances, states of mind, and coping mechanisms of the refugees leaving their homes looking for security. (2) Methods: A qualitative approach was applied, resorting to semi-structured interviews (n = 94) to closely explore the traumatic experiences lived by refugees and to identify their coping strategies. (3) Results: The data obtained pointed to a plurality of coping and resilience strategies. Maintaining communication with separated loved ones as well as experiencing accompaniment by helpers and hosts emerged as principal elements for coping and resilience. It was found that a prior development of interior life or practice of prayer served as psychological “capital” that increased their resilience. (4) Conclusion: The results point to the need to care for social networking, attention by hosts, and cultivating interior life as keys for resilience. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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15 pages, 539 KiB

Open AccessArticle

Demoralization and Its Association with Quality of Life, Sleep Quality, Spiritual Interests, and Suicide Risk in Breast Cancer Inpatients: A Cross-Sectional Study

by Ting-Gang Chang, Chih-Chiang Hung, Pei-Ching Huang, Chiann-Yi Hsu and Ting-Ting Yen

Int. J. Environ. Res. Public Health 2022, 19(19), 12815; https://doi.org/10.3390/ijerph191912815 - 6 Oct 2022

Cited by 8 | Viewed by 2348

Abstract

With decreasing mortality, the quality of life, spiritual needs, and mental health of breast cancer patients have become increasingly important. Demoralization is a poor prognostic factor for cancer patients. The extent of demoralization in breast cancer patients and its association with these factors remains unclear. This cross-sectional study was conducted at a Taiwanese medical center. We enrolled 121 participants (34 with high demoralization and 87 with low demoralization, as per the Mandarin Version of Demoralization Scale). High demoralization was associated with reduced quality of life, sleep quality, and spiritual interests. Multivariate analyses revealed that the scores of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ≥ 62.5 (OR = 0.21, p = 0.002) and Spiritual Interests Related to Illness Tool Chinese Version ≥ 3.66 (OR = 0.11, p < 0.001) were associated with low demoralization. Demoralized patients with depression had a poorer quality of life and sleep quality. Although not statistically significant, depressed and demoralized participants were at a higher risk of suicide. Cancer patients with both depression and demoralization had the worst prognosis. Breast cancer patients exhibited demoralization when they had unmet bio-psycho-social-spiritual needs. An early assessment of demoralization may improve holistic healthcare for breast cancer patients. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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13 pages, 568 KiB

Open AccessArticle

“Knitting Together the Lines Broken Apart”: Recovery Process to Integration among Japanese Survivors of Intimate Partner Violence

by Sachiko Kita, Kiyoko Kamibeppu and Denise Saint Arnault

Int. J. Environ. Res. Public Health 2022, 19(19), 12504; https://doi.org/10.3390/ijerph191912504 - 30 Sep 2022

Cited by 3 | Viewed by 1505

Abstract

Objective: This study used narrative interviewing and grounded theory analysis to discover the phases of trauma integration for Japanese women who had experienced intimate partner violence (IPV). Method: We interviewed 23 Japanese women who had experienced IPV using the Clinical Ethnographic Narrative Interviews (CENI) from November 2017 to September 2018 in Tokyo, Japan. The data from 11 participants who had achieved trauma integration using the Trauma Recovery Rubric were analyzed using a modified grounded theory approach. Results: Six phases of the trauma integration journey after IPV were discovered: (1) Chaos, (2) Burning out, (3) Focusing, (4) Challenging, (5) Deepening insights, and (6) Re-building. The survivors described the processes of exploration of themselves and their reactions to their concurrent challenges. They focused on finding ways to protect, re-discover, and re-embrace themselves by healing from physical, psychological, and spiritual distresses. They also rebuilt relationships with others and acquired knowledge and skills to achieve a new life. Notably, the primary components of their recovery processes were changes in self-perception and self-interpretation of the trauma itself and its impacts on one’s life and within oneself from multiple angles. In addition, traditional Japanese norms and gender roles, such as beliefs concerning the “ideal life of a woman” and fear of not behaving differently from others, profoundly influenced their recovery process. Conclusion: This study highlights the importance of incorporating individuals’ cultures and their phase, needs, and personal self-development timeframes when developing trauma integration interventions. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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17 pages, 692 KiB

Open AccessArticle

Trauma Recovery Rubric: A Mixed-Method Analysis of Trauma Recovery Pathways in Four Countries

by Kleio Koutra, Courtney Burns, Laura Sinko, Sachiko Kita, Hülya Bilgin and Denise Saint Arnault

Int. J. Environ. Res. Public Health 2022, 19(16), 10310; https://doi.org/10.3390/ijerph191610310 - 19 Aug 2022

Cited by 5 | Viewed by 2713

Abstract

Research is beginning to examine gender-based violence (GBV) survivors’ recovery, but little is known about diverse recovery trajectories or their relationships with other distress and recovery variables. This interdisciplinary, international multisite mixed-method study developed and used the TRR to identify and classify survivors’ trauma pathways. This study describes the phases of the initial development of the preliminary TRR (Phase 1), refines and calibrates the TRR (Phase 2), and then integrates the TRR into quantitative data from four countries (Phase 3). Seven recovery pathways with six domains emerged: normalizing, minimizing, consumed/trapped; shutdown or frozen, surviving, seeking and fighting for integration; finding integration/equanimity. Depression scores were related to most recovery domains, and TRR scores had large effect sizes. At the same time, PTSD was not statistically related to TRR scores, but TRR had a medium effect size. Our study found that the TRR can be implemented in diverse cultural settings and promises a reliable cross-cultural tool. The TRR is a survivor-centered, trauma-informed way to understand different survivorship pathways and how different pathways impact health outcomes. Overall, this rubric provides a foundation for future study on differences in survivor healing and the drivers of these differences. This tool can potentially improve survivor care delivery and our understanding of how to meet best the needs of the survivor populations we intend to serve. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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15 pages, 690 KiB

Open AccessArticle

Civic Engagement in Socially Excluded Young Adults Promotes Well-Being: The Mediation of Self-Efficacy, Meaning in Life, and Identity Exploration

by Irit Birger Sagiv, Limor Goldner and Yifat Carmel

Int. J. Environ. Res. Public Health 2022, 19(16), 9862; https://doi.org/10.3390/ijerph19169862 - 10 Aug 2022

Cited by 3 | Viewed by 2722

Abstract

Civic engagement is thought to contribute to well-being among young adults. However, less is known about the ways in which civic engagement promotes well-being in general and in particular in socially excluded populations. This study investigated whether civic engagement contributes to life satisfaction and hope in a sample of 127 socially excluded young Israeli women who participated in social activism programs for a period of eight months. A mediation model incorporating self-efficacy, meaning in life, and identity exploration was used to examine the contribution of positive attitudes toward civic engagement, civic engagement skills, and political awareness to the participants’ life satisfaction and hope. Indirect effects were found between positive attitudes toward civic engagement, civic engagement skills, and political awareness and the participants’ life satisfaction and hope via self-efficacy. Positive attitudes toward civic engagement and political awareness also predicted the participants’ life satisfaction via meaning in life. A positive direct effect was found between political awareness and hope. However, contrary to the hypothesis, a negative direct effect was found between positive attitudes toward civic engagement and life satisfaction. Civic engagement skills and political awareness also predicted identity exploration. These findings underscore the need for clinicians to be aware of the potential benefits of civic engagement for the well-being of socially excluded populations. Full article

(This article belongs to the Special Issue Holistic Wellbeing of Vulnerable Populations)

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