RESUMO
Background: Newborns' deaths and life-threatening conditions represent extremely stressful events for parents and professionals working in NICUs, facilitating the onset of secondary traumatic stress symptoms. The STRONG study aims to better understand the psychological impact on Italian NICUs staff of bereavement care. Methods: The STRONG (STress afteR lOss in NeonatoloGy) study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic, CommuniCARE-Newborn questionnaire, the Maslach Burnout Inventory and the Impact of Event Scale-Revised. Results: 227 NICU workers (42.7% nurses, 23.3% midwives, 22.2% physicians, 11.8% other HCPs) answered the survey. The hardest tasks were "communicating baby's death" and "informing on autopsy results"; 44.7% of HCPs did not receive formal training in communicating bad news, 44.2% 'learned from the field' by watching other colleagues; 41.2% declared that they do not have any communication strategy. More than 90% of professionals thought that training on bereavement care is necessary. The majority of HCPs showed some degree of post-traumatic stress symptoms: 34% medium and 35.3% severe. Professionals with training in bereavement care and/or in communication had less probability to develop stress symptoms. A multivariate analysis showed that higher levels of burnout were associated with 4 or more monthly losses and medium or severe stress symptoms. Having a well-defined communication strategy for breaking bad news was independently associated with a better personal accomplishment. Conclusion: Dealing with newborns' deaths is a highly stressful task; professionals should receive proper support such as debriefing, psychological support and training in order to prevent post-traumatic stress symptoms and reduce professional burnout.
RESUMO
S. L. Neuberg, T. N. Judice, and S. G. West (1997) faulted our work with the Need for Closure Scale (NFCS) on grounds that the NFCS lacks discriminant validity relative to S. L. Neuberg's and J. T. Newsom's (1993) Personal Need for Structure (PNS) Scale and is multidimensional, which, so they claim, renders the use of its total score inadmissible. By contrast, the present authors show that neither of the above assertions is incompatible with the underlying need for closure theory. Relations between NFCS and the PNS are to be expected, as these were designed to operationalize the very same construct (of need for closure). Furthermore, no unidimensionality of the NFCS has been claimed, and none is required to use its total score for testing various theoretically derived predictions. An instrument's ultimate utility hinges on theoretical considerations and empirical evidence rather than on questionable psychometric dogma unrelated to the substantive matters at hand.
Assuntos
Inventário de Personalidade/estatística & dados numéricos , Teoria Psicológica , Percepção Social , Humanos , Individualidade , Psicometria , Reprodutibilidade dos TestesRESUMO
PIP: This study uses factor analysis to analyze whether in Italy it is possible to differentiate women at greater risk of unwanted pregnancy from those using effective contraception on the basis of their degree of adherence to traditional definitions of the role of women as centered on motherhood, their degree of aversion to use of highly effective contraceptive methods, the positiveness or negativeness of their self-image, and their self-image, and their perception of the locus of control of personal behavior as external or internal. 164 middle-class women aged 15-40 residing in Rome who attended a family planning center were studied through questionnaires completed at the initial interview. Subjects were classified into 4 groups depending on the degree of effectiveness of their past and present contraceptive methods: permanent security, decreased security, increased security, and permanant insecurity. They were also classified according to whether or not they had ever undergone elective abortion. A favorable attitude toward effective contraceptive methods and their use was clearly associated with rejection of the traditional model of women. Subjects who had never resorted to voluntary abortion had a low adherence to traditional sex roles. The greatest degree of traditionalism was found among women using coitus interruptus, while the least traditional women were those using diaphragms. 3 subgroups were distinguished on the basis of traditionalism or nontraditionalism and positive or negative perception of personal efficacy. In a group of 67 essentially nontraditional women who used reliable contraceptive methods, 64.2% were aged 20-29 and 76.1% had higher education. 59.7% of the group had never had an abortion compared with 45.7% of the complete sample. Among 33 women with traditional sex role orientations and positive perceptions of their personal efficacy, the choice of contraceptive tended toward somewhat reliable methods such as condoms and the use of voluntary abortion was about average for the sample as a whole. 66.7% of the women had not attended school beyond the primary level and 54.5% were married. The 51 women in the 3rd group had traditional sex role orientations and they also had negative perceptions of their personal efficacy. They tended to be older than women in the other groups and their contraceptive methods were the least effective. 70.6% had undergone voluntary abortions compared with 54.3% of the sample as a whole.^ieng