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BACKGROUND: There is a critical global shortage of nurses in mental health, with workforce attrition due in large part to workplace stressors. Proactive strengths-based interventions to strengthen nurses' capacity to manage stress and improve mental health, wellbeing and resilience may also support workforce retention. OBJECTIVE: To determine the effects of a resilience-building programme on mental health nurses' coping self-efficacy (primary outcome), and psychological distress, wellbeing, resilience, posttraumatic growth, emotional intelligence behaviours, workplace belonging, and turnover intention (secondary outcomes). DESIGN: Partially clustered randomised controlled trial. SETTING: Large tertiary metropolitan mental health service in Australia. PARTICIPANTS: A total of 144 registered and enrolled nurses working clinically ≥0.6 full-time equivalent (73/intervention, 71/control), with 122 completing 3-month follow-up. METHODS: The Promoting Resilience in Nurses programme is an evidence-based workplace intervention delivered by trained facilitators across two workshops. Surveys were administered online upon registration and prior to randomisation (Time 1) into Intervention or Control (no intervention) arms, and immediately after the final workshop (Time 2), and at three months follow-up (Time 3). Linear mixed models for outcome measures were fitted to Time 2 and 3 responses. RESULTS: There were seven intervention groups, with seven to 13 participants per group. Coping self-efficacy improved at Time 2 (estimated intervention effect 21.2â¯units, 95â¯% Confidence Intervals: 13.3 to 29.0) and Time 3 (12.1â¯units, 4.7 to 19.6), as well as wellbeing (Time 2: 9.2â¯units, 5.0 to 13.4), resilience (Time 2: 0.24â¯units, 0.01 to 0.46) and posttraumatic growth (Time 2: 16.1â¯units, 7.0 to 25.3). Psychological distress reduced (Time 2: -3.7â¯units, -6.2 to -1.31). All were sustained at three months. Emotional intelligence behaviours were improved (Time 2: 3.5â¯units, 0.6 to 6.5) but not sustained. Workplace belonging improved at Time 3 (0.34â¯units, 0.02 to 0.65) only. No statistically significant effects for turnover intention. CONCLUSIONS: Despite major contextual challenges, the Promoting Resilience in Nurses programme achieved the aims of promoting nurses' efficacy to cope with stress and regulate their emotions and improving mental health and wellbeing. The findings support the programme as a feasible and successful intervention for nurses across other settings and contexts. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12620001052921). Registered 15/10/2020. First recruitment 04/02/2021. TWEETABLE ABSTRACT: Promoting Resilience in Nurses intervention improved coping self-efficacy, wellbeing, resilience, posttraumatic growth, emotional intelligence and psychological distress.
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Mental health nurses (MHNs) experience a range of stressors as part of their work, which can impact their well-being and turnover intention. There is no prior evidence, however, on MHNs' mental health, well-being, resilience, and turnover intention during the COVID-19 pandemic. The aims of this online survey-based cross-sectional study, conducted during the pandemic, were to explore the psychological distress, well-being, emotional intelligence, coping self-efficacy, resilience, posttraumatic growth, sense of workplace belonging, and turnover intention of n = 144 Australian mental health registered and enrolled nurses; and explore relationships between these variables, in particular, psychological distress, well-being, and turnover intention. There was a higher percentage of MHNs with high (27.78%) and very high psychological distress (9.72%) compared to population norms as measured by the K10. Emotional intelligence behaviours were significantly lower than the population mean (GENOS-EI Short). Coping self-efficacy was mid-range (CSES-Short). Resilience was moderate overall (Brief Resilience Scale), and posttraumatic growth was mid-range (Posttraumatic Growth Inventory; PTGI). Sense of workplace belonging was moderate, and turnover intention was low. Higher levels of psychological distress were associated with higher turnover intention, and lower workplace belonging, coping self-efficacy, well-being, resilience, and emotional intelligence behaviours. Despite the levels of psychological distress, nearly half the sample (n = 71) was 'flourishing' in terms of well-being (Mental Health Continuum Short-Form). To help prevent staff distress in the post-pandemic period, organisations need to proactively offer support and professional development to strengthen staff's psychological well-being, emotional intelligence, and resilience skills. These strategies and group clinical supervision may also support lower turnover.
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Background: Supporting wellbeing beyond symptom reduction is necessary in trauma care. Research suggests increased posttraumatic growth (PTG) may promote wellbeing more effectively than posttraumatic stress disorder (PTSD) symptom reduction alone. Understanding neurobiological mechanisms of PTG would support PTG intervention development. However, most PTG research to-date has been cross-sectional data self-reported through surveys or interviews.Objective: Neural evidence of PTG and its coexistence with resilience and PTSD is limited. To advance neural PTG literature and contribute translational neuroscientific knowledge necessary to develop future objectively measurable neural-based PTG interventions.Method: Alpha frequency EEG and validated psychological inventories measuring PTG, resilience, and PTSD symptoms were collected from 30 trauma-exposed healthy adults amidst the COVID-19 pandemic. EEG data were collected using custom MNE-Python software, and a wireless OpenBCI 16-channel dry electrode EEG headset. Psychological inventory scores were analysed in SPSS Statistics and used to categorise the EEG data. Power spectral density analyses, t-tests and ANOVAs were conducted within EEGLab to identify brain activity differentiating high and low PTG, resilience, and PTSD symptoms.Results: Higher PTG was significantly differentiated from low PTG by higher alpha power in the left centro-temporal brain area around EEG electrode C3. A trend differentiating high PTG from PTSD was also indicated in this same location. Whole-scalp spectral topographies revealed alpha power EEG correlates of PTG, resilience and PTSD symptoms shared limited, but potentially meaningful similarities.Conclusion: This research provides the first comparative neural topographies of PTG, resilience and PTSD symptoms in the known literature. Results provide objective neural evidence supporting existing theory depicting PTG, resilience and PTSD as independent, yet co-occurring constructs. PTG neuromarker alpha C3 significantly delineated high from low PTG and warrants further investigation for potential clinical application. Findings provide foundation for future neural-based interventions and research for enhancing PTG in trauma-exposed individuals.
Objective translational study designed to increase neural understanding of posttraumatic growth (PTG) and provide a basis for future neural-based interventions to enhance PTG.Results provide neural evidence of PTG as an independent construct that coexists, and shares limited neural relatedness with resilience and PTSD symptoms.Increased PTG was significantly related to higher alpha power in the left centro-temporal brain area around EEG electrode C3: This finding warrants further investigation for potential clinical application.
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Crescimento Psicológico Pós-Traumático , Transtornos de Estresse Pós-Traumáticos , Humanos , Adulto , Transtornos de Estresse Pós-Traumáticos/psicologia , Estudos Transversais , Pandemias , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Following the 2010-2011 floods and cyclones that affected 78% of Queensland, Australia, a State-wide mental health response was established. The response plan included a 24-hour access line. This study examines the effectiveness of the mental health screening program conducted via the State-wide health call center (13HEALTH) in 2012. METHODS: Callers to the 13HEALTH line were screened to assess the impact of the disaster. The 13HEALTH clinicians administered the Primary Care-Posttraumatic Stress Disorder Scale (PC-PTSD) screening measure. Those scoring more than two on the PC-PTSD Scale were provided information on the emotional impact of disasters and a referral to the post-disaster specialist mental health program (SMHP). For calls related to those under 18, a single-item question assessed behavioral or emotional changes since the natural disasters. Those with identified changes were offered a referral to a post-disaster SMHP.The study evaluates the relationship between disaster exposure and the likelihood of 13HEALTH callers experiencing physical health concerns and unacknowledged mental health symptoms. The program's cost for the 12 months of 2012 was assessed using data from the financial contract. RESULTS: In 2012, there were 205,064 calls to 13HEALTH: 19,708 identified as residing in a flood or cyclone-affected area, 7,315 adults indicated they were personally affected, and 907 scored more than two on the PC-PTSD Scale. Only 700 agreed to a referral to the SMHP. There were 290 children under 18 assessed as at risk; 207 accepted a referral to a SMHP.Regions that experienced a greater impact from the floods and cyclones were 1.3-2.3 times more likely to report being personally affected by the floods and cyclones. Similarly, these regions had more callers scoring more than two on the PC-PTSD Scale. The total cost of the 13HEALTH program for 2012 was $53,284 (AU) across all age groups. CONCLUSION: The 13HEALTH general health post-disaster screening program demonstrates opportunistic screening may assist identification of those with unmet mental health needs. The data indicate an increased likelihood of personal exposure in the more affected regions with an increased risk of unrecognized psychological symptoms as assessed by the PC-PTSD Scale. However, more than 20% declined referral to a SMHP.
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Tempestades Ciclônicas , Desastres , Transtornos de Estresse Pós-Traumáticos , Adulto , Criança , Humanos , Inundações , Queensland/epidemiologia , Saúde Mental , Austrália , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
INTRODUCTION: Following natural disasters, rural general practitioners (GPs) are expected to undertake several roles, including identifying those experiencing psychological distress and providing evidence-informed mental health care. This paper reports on a collaborative mental health program developed to support a rural GP practice (population <1,500) and a disaster response service. METHODS: The program provided specialized disaster mental health care via the placement of a clinician in the GP facility. In collaboration with the GP practice, the program offered opportunistic screening using the Primary Care Posttraumatic Stress Disorder (PTSD) Scale (PC-PTSD) for probable PTSD as the primary measure and the Kessler 6 (K6) as a secondary measure. Those scoring higher than two on the PC-PTSD scale were referred to the mental health clinician (MHC) for further assessment and treatment. RESULTS: Sixty screening assessments were completed. Fourteen patients (male = 3; female = 11) scored higher than two on the PC-PTSD. The referred group PC-PTSD mean score was 3.14 and K6 mean score of 19. Those not referred had a PC-PTSD mean score = 0.72 and K6 mean score = 7.30. The treatment and non-treatment groups differed significantly (PC-PTSD: P <.00001 and K6: P <.00001). A prior history of trauma exposure was notable in the intervention group. Eight reported a history of domestic violence, seven histories of sexual abuse, five childhood sexual abuse, and eight intimate partner violence (IPV). CONCLUSION: A post-disaster integrated GP and mental health program in a rural community can assist in identifying individuals experiencing post-disaster psychological distress using opportunistic psychological screening. The findings indicate that collaborative mental health programs may effectively support rural communities post-disaster.
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Desastres , Violência Doméstica , Transtornos de Estresse Pós-Traumáticos , Criança , Feminino , Humanos , Masculino , Saúde Mental , Atenção Primária à Saúde , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapiaRESUMO
BACKGROUND: Epigenetic aging is associated with a plethora of negative health outcomes and increased mortality. Yet, the dynamicity of epigenetic age after exposure to trauma and the factors that influence epigenetic age are not fully understood. This research evaluated longitudinal changes in epigenetic age before and after exposure to work-related trauma among paramedicine students. We further investigated psychological and social risk (psychological distress, posttraumatic stress disorder/PTSD symptom severity, professional quality of life) and protective factors (social support and organisational membership) that drive epigenetic aging at both time points. METHODS: The study comprised of 80 samples of University paramedicine students including 40 individuals at two time points - t0 (baseline) and t1 (post-trauma exposure). Epigenome-wide analysis was performed from t0 and t1 saliva using the Illumina EPIC arrays that cover >860k probes. Data analysis was performed using R via generalized regression models. The epigenetic age was calculated based on the Horvath algorithm, GrimAge and SkinBloodAge were calculated using the Horvath online calculator, and p-value for significance was corrected using the FDR method for multiple testing corrections. RESULTS: The epigenetic age at t0 and t1 were highly correlated with chronological age and with each other (r = 0.84-0.94). Baseline epigenetic age and follow-up epigenetic age were significantly associated with risk factors of psychological distress and PTSD symptom severity. Among the protective factors, a sense of psychological organisational membership at the start of the paramedicine course as measured at baseline significantly reduced epigenetic age at baseline and post-trauma exposure. On the other hand, receiving social support acted as a protective factor only after exposure to trauma (follow-up), decreasing epigenetic aging at follow-up. GrimAge acceleration at follow-up was significantly associated with increased PTSD symptom severity at baseline and follow-up. Moreover, increased social support at baseline and follow-up was associated with reduced follow-up GrimAge acceleration. CONCLUSION: These results demonstrate that epigenetic aging is dynamic and changes after exposure to trauma. Additionally, results demonstrate that different risk and protective factors influence epigenetic aging at different times. In conclusion, the research identified risk and protective factors associated with epigenetic aging pre- and post-trauma exposure, with implications for health and well-being among individuals exposed to trauma.
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Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos , Metilação de DNA , Epigênese Genética , Epigenômica/métodos , Humanos , Recém-Nascido , Fatores de Proteção , Transtornos de Estresse Pós-Traumáticos/genéticaRESUMO
OBJECTIVE: The current study aimed to assess the new theoretical model of PTG, alongside a measure of posttraumatic stress symptoms (PTSS) due to the ongoing distress that is often experienced by trauma survivors. The study examined the direct pathway to PTG and PTSS through previously identified predictors including core belief disruption, event centrality, and rumination, with the addition of self-disclosure as a predictor variable. METHOD: Participants (N = 231) who had experienced a traumatic event were recruited through online forums and completed an anonymous survey. Factor analysis revealed 2 distinct types of disclosure: helpful and unhelpful. Hypotheses were tested using hierarchical regressions. RESULTS: The findings supported a combination of event centrality, core-belief disruption, deliberate rumination, and helpful disclosure significantly predicting PTG, with event centrality and unhelpful disclosure being significant predictors of PTSS. CONCLUSIONS: The current findings provide support for the direct pathway described in the model of PTG, and that PTSS and PTG share some similar predictors, as well as distinct differences. These findings have the potential to assist clinicians and researchers in recognizing factors that are likely promote the development of PTG. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Crescimento Psicológico Pós-Traumático , Comportamento Problema , Transtornos de Estresse Pós-Traumáticos , Adaptação Psicológica , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Inquéritos e Questionários , SobreviventesRESUMO
Universities are providing short-term overseas study programs for healthcare students to increase their cultural competence (i.e., capacity to work effectively in cross-cultural situations). However, there is limited empirical research evaluating the effects of these programs using well-controlled research designs. In the present research study, undergraduate healthcare students in an Australian university were selected as participants. Group 1 (n = 32) participated in a short-term overseas study program in Asia (i.e., China, Vietnam, Singapore, and Taiwan), whereas Group 2 (n = 46) stayed in Australia to continue their university education as usual. All participants completed a self-developed demographic questionnaire, Cultural Intelligence Scale, and Multicultural Personality Questionnaire. Cultural competence was surveyed pre- and post-short-term overseas programs. After controlling for prior overseas experiences and the open-mindedness trait, an ANCOVA indicated that Group 1 had a significantly higher scores than Group 2 in cultural knowledge (p < 0.05), but not in cultural awareness, attitude, or skills. It is suggested that short-term overseas study programs may increase healthcare students' cultural knowledge, a component of competence, and that more needs to be accomplished to improve other areas of cultural competence.
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Cognição , Competência Cultural , Ásia , Austrália , China , Humanos , Singapura , Taiwan , VietnãRESUMO
BACKGROUND: Cultural intelligence reflects the competence to adapt to new cultural settings. Universities offer students various opportunities to gain cultural learning and develop cultural intelligence. However, there has been little empirical research to compare the effects of cultural learning and other related psycho-social factors in this process. OBJECTIVE: This study explores the importance of cultural learning and identifies the unique contribution of cultural education in universities to health care students' cultural intelligence. DESIGN: Cross-sectional survey study. METHODS: 271 health care students completed a survey measuring social desirability, demographics, personality, prior cultural exposure, previous cultural learning and cultural intelligence. RESULTS: Hierarchical regressions showed that cultural learning could affect cultural intelligence and its three components (i.e., metacognition, cognition, motivation, and behaviour) under the control for related psycho-social factors. However, its effect on the behavioral component was not significant. Considering the different types of cultural learning, overseas study experiences were more related to cultural intelligence, compared to in-class cultural learning. CONCLUSION: Cultural learning, especially overseas study experiences, plays a significant role in the development of health care students' cultural intelligence.
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Estudantes , Universidades , Estudos Transversais , Competência Cultural , Atenção à Saúde , Humanos , Inteligência , Inquéritos e QuestionáriosRESUMO
BACKGROUND: PTSD Coach Australia is an app for serving and ex-serving defense members and was adapted for the Australian context in 2013 from PTSD Coach, which was created in the United States. OBJECTIVE: This study aimed to provide a user-centered evaluation of the app from the perspective of serving and ex-serving members of the Australian Defence Force. METHODS: Qualitative data were collected in response to questions to participants in 1 of 5 workshops (n=29) or in telephone interviews (n=24). Quantitative data were collected using the user version of Mobile Apps Rating Scale (uMARS). RESULTS: Analysis of the qualitative data demonstrated mixed support for the app. While some people found it extremely useful, especially as an adjunct to therapy, others pointed out limitations and cautioned against the app potentially triggering symptoms in people with PTSD. This perceived risk was usually found to stem from frustration with the app's functionality rather than its content. Participants spoke about the helpful and unhelpful aspects of the app and barriers to its use and made suggestions for improvement. Many participants encouraged its continued use and highlighted the need for it to be promoted more broadly, as many were not aware of it until they were invited to participate in this research. CONCLUSIONS: PTSD Coach Australia was seen in a positive light by some participants, but others thought it had too much text and the potential to trigger a traumatic response in users with PTSD. A need to update the app was also a common comment as was the need to increase awareness of the app's existence.
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Aplicativos Móveis/normas , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Idoso , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Applications or "mobile apps" are a potentially important source of assistance for serving and ex-serving Defence members with mental health problems. PTSD Coach Australia is a modified version of an application developed by the US Department of Veteran Affairs. Clinician perceptions of mobile apps are important as they influence the dissemination and adoption of apps. This study aimed to explore the perceptions of PTSD Coach Australia by clinicians with experience in assisting Defence members with mental health problems. METHOD: The study involved two samples of participants who were asked about their perceptions of PTSD Coach Australia. The first involved 33 clinicians who participated in one of five focus groups. The second comprised 30 clinicians who were individually interviewed by telephone. Qualitative responses to questions regarding PTSD Coach Australia were analysed to identify representative themes. Participants in the focus group sample also rated the app on the user version of the Mobile Apps Rating Scale (uMARS). RESULTS: On the uMARS, clinicians rated the mobile app's subjective quality as 'average' to 'good'. Participants generally saw the app as a useful to help track symptoms, improve engagement and help implement strategies between sessions. However, they also expressed concerns with the app not being user-friendly (e.g. too wordy, poor layout/navigation) and having technical issues (freezing or crashing on Android devices). DISCUSSION: PTSD Coach Australia is generally seen as being acceptable and useful by mental health clinicians. However, it is important to include their concerns in future developments of PTSD Coach Australia and similar mobile apps in order to maximize their utilisation in Defence members.
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OBJECTIVE: Understandings of the biological mechanisms underpinning posttrauma responses are limited. This pilot study aimed to expand research in this area by examining the relationship between DNA methylation of stress genes nuclear receptor subfamily 3 group C member 1 (NR3C1) and FK06 binding protein 5 (FKBP5) with an array of posttrauma responses of posttraumatic stress disorder (PTSD) symptom severity, posttraumatic growth (PTG), and resilience. METHOD: First-year paramedicine students (N = 47) completed self-report measures of PTSD symptom severity, PTG, and resilience and provided a saliva sample for methylation analysis. Surrogate variable analyses identified covariates after which generalized regression models were performed to identify genomic sites significantly associated with PTSD symptom severity, PTG, or resilience. RESULTS: Methylation of different FKBP5 and NR3C1 sites was significantly associated with PTSD symptom severity, PTG, and resilience. Methylation in FKBP5 site cg07485685 was a predictor of both PTSD symptom severity and resilience in opposite directions. CONCLUSIONS: This is the first study investigating methylation changes in PTG, and overall the results suggest that NR3C1 and FKBP5 methylation is associated with both positive and negative posttrauma responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Crescimento Psicológico Pós-Traumático , Receptores de Glucocorticoides/genética , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/genética , Proteínas de Ligação a Tacrolimo/genética , Adolescente , Adulto , Metilação de DNA , Feminino , Humanos , Masculino , Projetos Piloto , Índice de Gravidade de Doença , Adulto JovemRESUMO
Most people will experience a traumatic event within their lifetime. One commonly recognized response to trauma exposure is posttraumatic stress disorder (PTSD). The biological underpinnings of PTSD, including epigenetic mechanisms of DNA methylation and gene expression, have been studied intensively. However, psychological posttrauma responses vary widely and can include positive outcomes, such as posttraumatic growth (PTG) and, more commonly, resilience. The aim of this systematic review was to summarize the current DNA methylation and gene expression data with respect to three potential posttrauma responses: PTSD, PTG, and resilience. A literature search identified 486 studies, 51 of which were deemed eligible for inclusion (total N = 10,633). All included studies examined PTSD and consistently implicated DNA methylation and gene expression changes in hypothalamic-pituitary-adrenal axis and inflammatory genes. Ten studies acknowledged resilience as a posttrauma response, but only two studies examined epigenetics and gene expression using a scale to measure resilience. Low resilience was associated with gene expression patterns in immune and dopamine genes, and high resilience was associated with a blunted inflammatory response. No studies examined epigenetic or gene expression changes associated with PTG. These findings highlight a focus on pathogenic research, which has failed to adequately acknowledge and measure positive posttrauma outcomes of PTG and resilience. Future research should examine DNA methylation and gene expression changes associated with PTG and resilience in addition to PTSD in order to gain a more comprehensive picture of an individual's well-being following exposure to trauma.
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Regulação da Expressão Gênica/fisiologia , Crescimento Psicológico Pós-Traumático , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/genética , Adaptação Psicológica , Metilação de DNA , Humanos , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Estresse Fisiológico/genéticaRESUMO
OBJECTIVES: This study aimed to explore the relationship between well-being and perceived stress, and the functional dimensions of social support in older adults. METHOD: Data from 306 older adults were obtained in a survey containing the two-way Social Support Scale (2-Way SSS). Also, a subset of the sample (N = 165) was filled out with measures of well-being and perceived stress, and a follow-up survey was completed 3 months later (N = 111). RESULTS: Confirmatory factor analyses and reliability analyses provide evidence for a 12-item Brief 2-Way SSS as a reliable and valid measure of the four domains of Social Support. Correlations and regression analyses indicated the scale displayed good concurrent and predictive validity across time points, with receiving emotional support positively associated with well-being at Time 1 (T1) and Time 2 (T2), and Receiving Instrumental Support negatively associated with perceived stress at TI and T2. CONCLUSIONS: This study provides support for the importance of examining the influence of separable elements of social support on psychological outcomes in older adults. The Brief 2-Way SSS was found to have good psychometric properties in this sample of older adults.
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Mental health settings are recognized as complex, unpredictable environments, and challenging interpersonal situations are common for nurses in acute adult mental health services. Occupational stressors include verbal aggression and physical assault and are correlated with poor physical and mental health outcomes for nurses. There is a clear need for proactive approaches that address the negative impacts of stressors on the mental health nursing workforce. Resilience interventions are a preventive approach to strengthening skills for addressing workplace stress, improving health and well-being, and preventing adverse outcomes associated with occupational stressors. The aim of this study was to evaluate the feasibility of a workplace resilience education programme for nurses in high-acuity adult mental health settings. The outcomes were measured using a single-group pretest post-test design with follow-up at 3 months postintervention. The feasibility and acceptability of the programme were identified with descriptors of mental health, well-being, resilience, facilitator fidelity checklists, and participant satisfaction questionnaires. The programme was found to be feasible for nurses working in high-acuity inpatient settings. There were significant changes to mental health, well-being, and workplace resilience. The programme was delivered with fidelity by facilitators and accepted with high levels of satisfaction by participants. The study findings indicated that nurses can benefit from resilience education that equips them with cognitive, emotion regulation, and relational skills, in conjunction with available external supports and resources, to address workplace challenges. There is a need for comprehensive organizational approaches that include individual, work unit, and organizational-level strategies to support staff well-being.
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Estresse Ocupacional/prevenção & controle , Enfermagem Psiquiátrica/educação , Resiliência Psicológica , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/psicologia , Local de Trabalho/psicologia , Adulto JovemRESUMO
AIM: A standardised tool was needed to measure a generalist dietitian's confidence about working with clients experiencing psychological issues in order to effectively evaluate mental health-related professional development activities. The aim of this study was to develop, pilot and validate a robust instrument that measures a generalist dietitian's professional confidence for working with clients experiencing psychological issues. METHODS: The Dietetic Confidence Scale (DCS) was developed. Two cross-sectional samples of practicing dietitians (n = 185; 458) from various settings and locations were recruited. Study 1: principal components analysis (PCA) helped refine scale items and derive a model, which was then validated using confirmatory factor analysis (CFA, Study 2). Cronbach's alpha estimated scale reliability. Correlations assessed associations between factors. RESULTS: Study 1: A 13-item, two-factor solution accounted for 69.1% of the total variance. Total Cronbach's α = 0.92. Dietetic confidence was associated with: (i) Confidence using the Nutrition Care Process and (ii) Confidence Advocating for Self care and Client care. Study 2: The CFA supported the proposed scale and model. A Good Fit Index of 0.95 indicated a strong fit. Item-factor correlations ranged from r = 0.50 to 0.91. The final scale showed good reliability (α = 0.93). CONCLUSIONS: This is the first self-efficacy scale for dietetic practitioners subjected to PCA and CFA using two independent samples. The DCS is a psychometrically robust instrument with strong internal consistency. It can be used to measure dietetic confidence about working with clients experiencing psychological issues and to highlight areas where additional support or training may be needed. Further validity and reliability testing is needed to enhance scale generalisability and use.
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Confidence is frequently used to assess practitioner effectiveness, and its evaluation requires valid and reliable domain-specific tools. However, the quality of existing measures is unknown. This review identifies studies measuring dietitians' confidence in working with individuals; assesses psychometric (measurement) qualities of relevant tools; and identifies areas for future research. Seven electronic databases, the internet, and reference lists were searched to identify the development or use of relevant confidence measurement scales. A quality assessment of psychometric properties was conducted using guidelines developed by Terwee and colleagues. Of the 15 measures reviewed, 4 were subject to factor analysis. Overall, content validity was strong. However, many measures rated poorly due to lack of factor analysis, inadequate sampling, or poor reporting. Of the dietetics-specific instruments, the Dietetic Confidence Scale and Nutrition Counselling Self-Efficacy Scale received the best ratings. The General Self-Efficacy Subscale also rated highly due to validation with the general population. This article highlights the need for dietitians to incorporate evidence-based methods into practice evaluation and instrument development. Dietitians need an awareness of the terminology and key criteria used to evaluate instrument quality to effectively collaborate with statisticians and scale development experts, and critically evaluate the quality of existing measures. Future scale development and reporting must incorporate psychometric evaluation, such as factor analysis, which should be used to explore and/or confirm scale dimensionality. There is broad scope for future methodological research with existing and new measures for nutrition and dietetics practitioners.
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Competência Clínica , Nutricionistas/psicologia , Escalas de Graduação Psiquiátrica/normas , Autoeficácia , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: Ambulance personnel provide emergency medical services to the community, often attending to highly challenging and traumatic scenes in complex and chaotic circumstances. Currently, the assessment of predictors of psychological well-being remains limited. The current study investigated whether workplace belongingness was significant in predicting psychological distress as well as the presence of resilience in ambulance personnel while controlling for more routinely examined factors. METHOD: Australian ambulance officers (N = 740) completed a survey battery including the Kessler 10, Brief Resilience Scale, and Psychological Sense of Organizational Membership scale. RESULTS: Controlling for more commonly examined factors such as severity of trauma exposure and length of service, hierarchical multiple regression analyses demonstrated that workplace belongingness was significantly associated with reduced distress levels and enhanced resilience levels. CONCLUSIONS: Results suggest that strategies to enhance a sense of workplace belongingness in emergency service organizations could promote the well-being of emergency workers despite routine exposure to potentially traumatic events. (PsycINFO Database Record
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Serviços Médicos de Emergência , Doenças Profissionais/psicologia , Trauma Psicológico/psicologia , Resiliência Psicológica , Transtornos de Estresse Traumático/psicologia , Local de Trabalho/psicologia , Adulto , Ambulâncias , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: Pregnancy loss is common and can be devastating for those who experience it. However, a historical focus on negative outcomes, and grief in particular, has rendered an incomplete portrait of both the gravity of the loss, and the potential for growth in its wake. Consistent with contemporary models of growth following bereavement, this study explored the occurrence of posttraumatic growth following pregnancy loss and further assessed the role of core belief disruptions and common loss context factors across perinatal grief, posttraumatic stress symptoms, and posttraumatic growth. METHOD: Women who had experienced a miscarriage or stillbirth (N = 328) were recruited through perinatal loss support groups and completed an online survey that assessed core belief disruption, perinatal grief, posttraumatic stress symptoms, posttraumatic growth, loss context factors, and demographics. Hypotheses were tested via hierarchical multiple regression. RESULTS: All hypotheses were supported. Specifically, (a) moderate levels of posttraumatic growth were reported; (b) core belief disruptions predicted perinatal grief, posttraumatic stress symptoms, and posttraumatic growth; and (c) perinatal grief predicted posttraumatic stress symptoms and growth. CONCLUSION: Findings suggest that pregnancy loss can be a traumatic event, that core belief disruptions play a significant role in posttrauma outcomes, and that other factors may contribute to grief, posttraumatic stress symptoms, and posttraumatic growth following pregnancy loss that warrant further research (e.g., rumination). Despite potential methodological and sampling limitations, the use of validated measures to assess posttraumatic growth in a large sample represents a robust attempt to quantify the occurrence of posttrauma change following pregnancy loss. (PsycINFO Database Record
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Aborto Espontâneo/psicologia , Pesar , Natimorto/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Análise de Regressão , Grupos de AutoajudaRESUMO
RATIONALE: Previous research with emergency service workers has examined the relationship between operational and organizational stress and negative indicators of mental health, and generally found that organizational stress is more strongly related to pathology than operational stress. METHOD: The current study aimed to create and test a model predicting both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) simultaneously in a sample of firefighters (N = 250). RESULTS: The results found that the model demonstrated good fit for the data. In contrast to previous research operational stress was directly related to PTSD symptoms, whereas organizational stress was not. Organizational stress was indirectly related to PTG, through the mediating role of organizational belongingness. CONCLUSION: This research identified organizational belongingness as a good target for psychosocial interventions aimed at promoting positive adaptation following the experience of trauma in emergency services. (PsycINFO Database Record