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      Viral time capsule: a global photo-elicitation study of child and adolescent mental health professionals during COVID-19

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          Abstract

          Objective

          To examine, through photo-elicitation, the personal and professional impact of the COVID-19 pandemic on mental health professionals working with children and adolescents around the globe.

          Methods

          We invited the submission of images collected about the pandemic between May and August 2020. We encouraged participants to yoke personal reflections or voice memos to their images. Using snowball sampling, we began with two invitations, including one to the graduates of a mentorship program continuously hosted since 2004 by the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP). We analyzed de-identified images and anonymized transcripts through iterative coding using thematic analysis informed by rich picture analysis and aided by NVivo software.

          Results

          We collected submissions from child and adolescent mental health professionals (n = 134) working in 54 countries spread across the five continents. We identified four overarching domains with component themes that revealed both the commonality and the uniqueness of the pandemic experience around the globe: (1) Place (adjusting to emptiness and stillness; shifting timeframes; blending of spaces); (2) Person (disruption to life rhythms; emotional toll; positives of the pandemic); (3) Profession (changing practices; outreach efforts; guild pride—and guilt); and (4) Purpose (from pandemic to syndemic; from lamenting to embracing; planning toward a better tomorrow).

          Conclusions

          Photo-elicitation provided a disarming and efficient means to learn about individual, regional, and global similarities and differences regarding the professionals charged with addressing the mental health needs of children and adolescents around the globe. These findings may help inform practice changes in post-pandemic times.

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          Most cited references51

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          Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

          Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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            Saturation in qualitative research: exploring its conceptualization and operationalization

            Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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              The outbreak of COVID-19 coronavirus and its impact on global mental health

              The current outbreak of COVID-19 coronavirus infection among humans in Wuhan (China) and its spreading around the globe is heavily impacting on the global health and mental health. Despite all resources employed to counteract the spreading of the virus, additional global strategies are needed to handle the related mental health issues. Published articles concerning mental health related to the COVID-19 outbreak and other previous global infections have been considered and reviewed. This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally. Collective concerns influence daily behaviors, economy, prevention strategies and decision-making from policy makers, health organizations and medical centers, which can weaken strategies of COVID-19 control and lead to more morbidity and mental health needs at global level.
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                Author and article information

                Contributors
                andres.martin@yale.edu
                Journal
                Child Adolesc Psychiatry Ment Health
                Child Adolesc Psychiatry Ment Health
                Child and Adolescent Psychiatry and Mental Health
                BioMed Central (London )
                1753-2000
                2 February 2021
                2 February 2021
                2021
                : 15
                : 5
                Affiliations
                [1 ]GRID grid.47100.32, ISNI 0000000419368710, Yale School of Medicine, ; New Haven, CT USA
                [2 ]GRID grid.47100.32, ISNI 0000000419368710, Department of Psychiatry, Yale School of Medicine, ; New Haven, CT USA
                [3 ]GRID grid.7429.8, ISNI 0000000121866389, Public Health and Sociology, , Inserm (Institut National de La Santé et de La Recherche Médicale) and CESP (Centre de recherche en Epidémiologie et Santé des Populations), ; Paris, France
                [4 ]GRID grid.468637.8, ISNI 0000 0004 0465 6592, GGZ Drenthe (Geestelijke Gezondheids Zorg: Mental Health Care), ; Beilen, The Netherlands
                [5 ]GRID grid.4494.d, ISNI 0000 0000 9558 4598, Center for Educational Development and Research in Health Sciences (CEDAR), , University Medical Center Groningen, ; Groningen, The Netherlands
                [6 ]GRID grid.38142.3c, ISNI 000000041936754X, Bioethics Program, , Harvard University, ; Cambridge, MA USA
                Author information
                http://orcid.org/0000-0001-6425-5158
                Article
                359
                10.1186/s13034-021-00359-5
                7852478
                33531051
                3e3061cb-8c91-47e1-9083-3f04bac8e741
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 4 November 2020
                : 16 January 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000025, National Institute of Mental Health;
                Award ID: R25 MH077823
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100006698, Child Study Center, Yale School of Medicine;
                Award ID: Riva Ariella Ritvo Endowment
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Clinical Psychology & Psychiatry
                photo-elicitation,professional identity,mental health professionals,covid-19 pandemic,qualitative methods,thematic analysis,rich picture analysis

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