Hope and Optimism as an Opportunity to Improve the “Positive Mental Health” Demand

Background: The positive component of Mental Health Literacy (PMeHL) refers to a person’s awareness of how to achieve and maintain good mental health. Although explored recently, the term still lacks a clear definition among healthcare practitioners.Aim: To identify the attributes and characteristics of PMeHL, as well as its theoretical and practical applications.Methods: Literature search (using the Medline and CINAHL databases) and review, covering the last 21 years, followed by concept analysis according to the steps described by Walker and Avant approach.Results: Positive component of Mental Health Literacy is considered one component of MHL, integrating positive mental health. The concept’s attributes include: (a) competence in problem-solving and self-actualization; (b) personal satisfaction; (c) autonomy; (d) relatedness and interpersonal relationship skills; (e) self-control; and (f) prosocial attitude. Four case scenarios (model, borderline, related and contrary cases) were used to clarify the antecedents (individual factors and social/contextual factors) and consequences (individual sphere; relational/social sphere; contextual/organizational sphere) of PMeHL.Conclusion: Positive component of Mental Health Literacy is considered a component of MHL, which deserves attention throughout the lifespan, in different contexts and intervention levels. Considering PMeHL as a multi-faceted and dynamic construct will help understand the mechanisms that improve mental health and promote healthy behaviors. Priority should be given to robust primary research focused on nursing interventions that enhance and sustain PMeHL in people and families.

Patient therapeutic adherence lies at the core of mental health care. Health Care professionals and organizations play a major role in promoting adherence among people with mental disorders. However, defining therapeutic adherence remains complex. We used Rodgers’ evolutionary concept analysis to explore the concept of therapeutic adherence in the context of mental health. We conducted a systematic literature search on Medline/PubMed and CINAHL for works published between January 2012 and December 2022. The concept analysis showed that major attributes of therapeutic adherence include patient, microsystem and meso/exosystem-level factors. Antecedents are those related to patients, such as their background, beliefs and attitudes, and acceptance of mental illness–and those related to patient-HCP therapeutic engagement. Lastly, three different consequences of the concept emerged: an improvement in clinical and social outcomes, commitment to treatment, and the quality of healthcare delivery. We discuss an operational definition that emerged from the concept analysis approach. However, considering the concept has undergone evolutionary changes, further research related to patient adherence experiences in an ecological stance is needed.

The COVID-19 pandemic has caused substantial disruptions in the lives of higher education students, with detrimental repercussions for academic performance and overall mental health. Therefore, we aimed to evaluate the prevalence of depression, anxiety, and stress symptoms among Portuguese higher education students during the first wave of the coronavirus pandemic and investigate DASS-21’s psychometric characteristics and whether it functions effectively during a pandemic. A convenience sampling procedure was used to recruit 1522 participants (75.1% women and 79.2% undergraduate students) for this cross-sectional research. Participants completed an e-survey created using DASS-21. The results revealed a considerable prevalence of symptoms of depression [≥10] (N = 434, 28.5%), anxiety [≥7] (N = 551, 36.2%), and stress [≥11] (N = 544, 35.7%). Confirmatory factor analysis (CFA) revealed the scale’s three-factor structure, which matched the three DASS-21 subscales. Subsequently, the heterotrait–monotrait (HTMT) correlation ratio evaluated the scale’s discriminant validity, which was relatively good. Cronbach’s alpha measured the internal consistency of the DASS subscales, which was excellent (Cronbach’s α > 0.90). DASS-21 was shown to be a reliable and appropriate measure for assessing students’ mental health. Furthermore, DASS-21 is recommended for use by academics and healthcare professionals in measuring students’ psychological distress. Further validation studies of this scale are needed with larger and more representative samples.

The ‘satisfaction with life scale’ (SWLS) is a concise instrument for comprehensive and self-rated assessment of subjective well-being. The objective was to evaluate the reliability (test–retest), internal structure and discriminant validity of the SWLS in Portugal. The reliability was studied in general medical patients hospitalised in a general medical ward. The SWLS was administered on two occasions and the correlation coefficients (‘r’) between both interviews were calculated. Its discriminant validity was studied statistically comparing the average score in a group of patients with arthritis (with presumed lower subjective well-being) and the average score in a group of students and health professionals (with presumed higher subjective well-being). A high reliability r = 0.86 was found for the total score. The discriminant validity study found a significant difference between mean total score in the samples of presumed higher (5.96) and lower (3.45) subjective well-being. A high Cronbach's alpha (0.89) was also documented. The results reported that the SWLS is reliable, has a high internal consistency, is capable of discriminating groups of presumed different subjective well-being levels, and is quite efficient and easy to use.