Cervical cancer patients often experience significant psychological distress, including symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression. Cognitive Processing Therapy (CPT), a structured trauma-focused intervention, has shown promise in reducing such distress, but evidence in oncology settings remains limited. This study evaluated the effectiveness of CPT in alleviating psychological distress among outpatient cervical cancer patients attending two referral hospitals in Western Kenya. A quasi-experimental pretest-posttest design was employed with 68 participants (mean age = 42.6 years, SD = 8.9), recruited through purposive sampling and assigned to experimental and control groups. Key clinical characteristics such as cancer stage and treatment status were documented to contextualize findings. The experimental group received CPT, delivered in 12 weekly sessions of approximately 90 minutes each, while the control group received treatment as usual (standard medical support). Psychological distress was assessed using the Harvard Trauma Questionnaire (HTQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) at baseline, 3-month follow-up, and 6-month follow-up. Results showed significant reductions in PTSD, anxiety, and depression symptoms in the experimental group compared to the control group. Mean scores decreased from baseline to 6-month follow-up for PTSD (M = 2.35 to 1.12), anxiety (M = 21.35 to 5.03), and depression (M = 21.10 to 7.86), while no meaningful changes were observed in the control group. Analysis of variance (ANOVA) confirmed statistically significant differences between groups post-intervention (after 12 weeks) and 6-month follow-ups (p < 0.001). Difference-in-Differences (DiD) estimators revealed mean declines of 0.97 (95% CI: 0.80-1.15) for PTSD, 16.78 (95% CI: 14.17-19.38) for anxiety, and 14.44 (95% CI: 11.64-17.25) for depression. Effect size analysis using partial eta squared (η 2 p) revealed medium effects for PTSD (η 2 p = .067) and depression (η 2 p =.064), and a medium-to-strong effect for anxiety (η 2 p =.073). These findings suggest that CPT is a promising intervention for reducing psychological distress among cervical cancer patients. Given the quasi-experimental design and relatively small sample, conclusions should be interpreted with caution. Nevertheless, integrating CPT alongside medical care could enhance quality of life outcomes in this population.
Infection prevention and control (IPC) is a critical component of healthcare delivery, particularly for vulnerable populations at increased risk of healthcare-associated infections. Hospice patients may receive care in dedicated hospice facilities, long-term care facilities, or other healthcare environments, where infection prevention must coexist with broader therapeutic goals, including comfort, privacy, family involvement, and a home-like atmosphere. Although environmental design has been widely investigated in relation to IPC in healthcare settings, much of the existing evidence focuses on hospitals, with comparatively limited attention to hospice and long-term care environments. This study aimed to identify environmental design strategies that may enhance IPC in hospice facilities and examine their applicability within a hospice-specific therapeutic framework. A scoping literature review was conducted using PubMed and CINAHL for English-language studies published between 2015 and 2025. Following three rounds of screening, 30 studies were included. Data were extracted using standardized matrices documenting study characteristics, environmental and behavioral variables, outcomes, and key findings. Environmental findings were coded, compared, and analyzed using the environmental therapeutic goals and design criteria of the Hospice Environmental Assessment Protocol (HEAP) as an analytical framework. Three overarching themes and 14 subthemes emerged: ventilation and airborne infection control, including ventilation, filtration, airflow, and supplemental air disinfection; spatial planning, zoning, and circulation, including separation, shared spaces, circulation, access control, and room configuration; and environmental hygiene, surfaces, and cleaning, including high-touch surfaces, antimicrobial materials, environmental cleaning, disinfection technologies, and hand-hygiene-supportive design. The findings demonstrate that IPC in hospice environments extends beyond clinical safety and intersects with multiple therapeutic goals, including privacy, social interaction, autonomy, family accommodation, and staff support. Integrating IPC evidence with HEAP provides a framework for designing hospice environments that support infection prevention while preserving their therapeutic, residential, and family-centered qualities.
The study aimed to determine the levels of both (Self.Awa.) and (Psy. Emp.) among individuals with (Vi. Imp.), as well as to examine whether there are statistically significant differences in (F. Th.) attributable to gender (male/female) and grade level (third, fourth, fifth, sixth). The study also sought to investigate the extent to which (F. Th.) can be predicted by self-awareness and (Psy. Emp.) in this population. The descriptive method was employed, and the sample consisted of (50) students with a mean age of (172.30) months and a standard deviation of (11.23) months. The study utilized three instruments developed by the researcher: a (Self.Awa.) Scale, a (Psy. Emp.) Scale, and a (F. Th.) Scale. The findings revealed moderate levels of both self-awareness and (Psy. Emp.) among individuals with (Vi. Imp.). Additionally, no statistically significant differences at the (0.05) level were found in (F. Th.) based on gender or grade level. The results also indicated that (Self.Awa.) and (Psy. Emp.) are weak predictors of (F. Th.) among individuals with (Vi. Imp.), They contribute 4.1% to predicting (F. Th.) among the visually impaired. The F-value for determining the possibility of predicting (F. Th.) through (Self.Awa.) with (Psy. Emp.) among the visually impaired reached (0.789), which is a statistically insignificant value at the 0.05 level. This indicates that the possibility of (F. Th.) through self-awareness with (Psy. Emp.) among the visually impaired is weak. The partial correlation coefficient reached (0.202), and the coefficient of determination reached 0.041, which is the value of r2 for the explanatory coefficient associated with the entry of variables into the regression equation.
Human behaviour and interactions are complex, encompassing both what is immediately observable and what remains beneath the surface. Understanding these layers is particularly important in group therapeutic settings, where subtle dynamics can significantly influence outcomes. Literature explicitly addressing “manifest and latent processes” in group work remains limited. Most mainstream theories of group development, such as Tuckman’s stages, emphasize overt, measurable behaviours and structured task accomplishment, leaving latent processes, such as unspoken norms, emotional undercurrents, power dynamics, and unconscious motivations, underexplored. Recent trauma-focused group psychotherapy literature highlights this same gap, emphasising how latent relational and neurophysiological processes shape group functioning. This paper examines the interplay of manifest and latent processes in group development, emphasizing the importance of addressing both observable behaviours and hidden dynamics. The author intentionally anchors the conceptual foundation of this paper in classical groupwork theories, such as Tuckman’s stages of group development, Bion’s psychoanalytic insights, Vygotsky’s social constructivism, and the Johari Window due to their enduring relevance and widespread scholarly recognition. Concepts from the social unconscious sphere are also used to expand the understanding of latent dynamics beyond the individual psyche, acknowledging broader societal influences that shape the group space. This conceptual paper critically synthesizes these established and contemporary theories to explore the complex interaction between observable (manifest) and hidden (latent) processes within groupwork. Rather than proposing a new theory, it offers an integrated interpretation of existing scholarship by bringing classical and contemporary perspectives into dialogue. This synthesis advances a more nuanced understanding of group dynamics and highlights practical considerations for facilitation that attends to hidden or unspoken processes through a reflective, multidimensional lens. Practical implications are highlighted. This includes how facilitators can enhance group effectiveness by attending to both observable behaviours and underlying group dynamics, integrating reflective practice and awareness of personal bias to promote trust, psychological safety, and cohesive participation.
