The use of the evidence-based practice process by experienced registered nurses to inform and transform clinical practice during the COVID-19 pandemic: A longitudinal national cohort study.

BACKGROUND: During the COVID-19 pandemic, many registered nurses (RNs) worked on the frontline caring for severely ill patients. They did so with limited knowledge of how to treat and prevent the disease. This extreme situation puts pressure on RNs to find evidence on which to base the care of their patients. AIMS: To examine: (1) the extent to which evidence-based practice (EBP) process was applied by Swedish RN cohorts 15-19 years after graduation during the pandemic, (2) whether there was any change to their EBP process from pre-pandemic to late pandemic, (3) the relationship between RNs' use of the EBP process and the duration of exposure to work situations severely affected by the COVID-19 pandemic, and (4) whether level of education, position and care setting were associated with the extent of RNs' EBP process. METHODS: In 2021, the level of EBP activities was investigated among 2237 RNs 15-19 years after graduation. The scale used to measure EBP consisted of six items of the EBP process. Unpaired t-tests or one-way analysis of variance (ANOVA) were used in the analysis. RESULTS: RNs used the EBP process to a moderate extent to inform and transform their clinical practice. There was a minor but significant decrease in practicing the EBP process from pre-pandemic to late in the pandemic. RNs who were most affected by the pandemic scored higher on the scale than less-affected colleagues. RNs in nonclinical positions reported more EBP activities, as did RNs in management positions. RNs working in outpatient settings reported more EBP activities than their colleagues in hospitals. LINKING EVIDENCE TO ACTION: It is imperative that RNs hone their skills in EBP if they are to be prepared for future healthcare crises. Healthcare providers have a duty to facilitate the development of EBP and, in this regard, RNs in clinical positions in hospitals need particular support.

Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study.

AIMS: Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later. METHODS: The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression. RESULTS: The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively. CONCLUSIONS: Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

Randomised control trial of a proactive intervention supporting recovery in relation to stress and irregular work hours: effects on sleep, burn-out, fatigue and somatic symptoms.

OBJECTIVES: To examine if a proactive recovery intervention for newly graduated registered nurses (RNs) could prevent the development of sleep problems, burn-out, fatigue or somatic symptoms. METHODS: The study was a randomised control trial with parallel design. Newly graduated RNs with less than 12 months' work experience were eligible to participate. 461 RNs from 8 hospitals in Sweden were invited, of which 207 signed up. These were randomised to either intervention or control groups. After adjustments, 99 RNs were included in the intervention group (mean age 27.5 years, 84.7% women) and 108 in the control group (mean age 27.0 years, 90.7% women). 82 RNs in the intervention group attended a group-administered recovery programme, involving three group sessions with 2 weeks between each session, focusing on proactive strategies for sleep and recovery in relation to work stress and shift work. Effects on sleep, burn-out, fatigue and somatic symptoms were measured by questionnaires at baseline, postintervention and at 6 months follow-up. RESULTS: Preventive effect was seen on somatic symptoms for the intervention group. Also, the intervention group showed less burn-out and fatigue symptoms at postintervention. However, these latter effects did not persist at follow-up. Participants used many of the strategies from the programme. CONCLUSIONS: A proactive, group-administered recovery programme could be helpful in strengthening recovery and preventing negative health consequences for newly graduated RNs. TRIAL REGISTRATION NUMBER: NCT04246736.

Psychosocial working conditions of shiftworking nurses: A long-term latent transition analysis.

AIM: This study aimed to identify profiles of working conditions to which nurses were exposed to over time and investigate how changes in working conditions relate to shiftworking and health. BACKGROUND: Previous studies rarely addressed the issue of working conditions development over long periods and the effects of such development on nurses' health. METHODS: Data from a national cohort of nurses in Sweden (N = 2936) were analysed using a person-centred analytical approach-latent profile and latent transition analysis. RESULTS: Nurses report better psychosocial working conditions as they progress into mid-career. Shiftworking nurses experience poorer working conditions than their dayworking counterparts and tend to move from shiftwork to daywork as they progress into mid-career. In mid-career, nurses in work environments characterized by low autonomy and support tend to report poorer health outcomes. CONCLUSION: Current analyses suggest that shiftworking nurses are particularly in need of interventions that address poor work environments. Not only do they experience more negative psychosocial working conditions than their dayworking counterparts, but they do so while having to contend with demanding schedules. IMPLICATIONS FOR NURSING MANAGEMENT: The findings highlight that organisational interventions should target different aspects of the work environment for nurses in diverse stages of their careers.

Registered Nurses' Evidence-Based Practice Revisited: A Longitudinal Study in Mid-Career.

BACKGROUND: To improve patient outcomes and patient safety and to reduce costs in health care, the implementation of evidence-based practice (EBP) is crucial. AIMS: To examine the use of the EBP process in Swedish health care. Specifically, to examine whether professional career development (years of experience, years in current position, specialist education, care setting) is associated with RNs' practice of EBP activities and changes in the extent of practicing the EBP process between early and mid-career. METHODS: In this observational longitudinal study, the extent of EBP activities was investigated in three national cohorts of 2,474 RNs. Nurses rated their own EBP levels 11-15 and three years after graduation. Six items measured the respondents' extent of practicing the EBP process. Comparisons of EBP levels between subgroups were tested using unpaired t-tests or one-way ANOVAs. RESULTS: On average, RNs used the EBP process occasionally every half year. RNs with specialist education reported a higher extent of EBP activities as did RNs who worked in outpatient and home care settings. There was a significant increase in the extent of EBP activities 11 to 13 years after graduation compared to three years after graduation. LINKING EVIDENCE TO ACTION: The findings raise some central questions for practice: How well equipped are RNs to practice the EBP process? What is needed to facilitate EBP in clinical settings? Building on the findings of this study, managers in clinical practice need to develop supportive organizational structures that facilitate EBP. This study suggests that mid-career RNs increased the extent of practicing the EBP process over time compared to previous reported practice in their first years as RNs. However, the level of EBP activities was low to moderate, and this modest increase took 11 to 13 years to achieve. To enhance the practice of EBP in nursing care, educational and organizational factors need to be considered.

Preventing Stress-Related Ill Health Among New Registered Nurses by Supporting Engagement in Proactive Behaviors-A Randomized Controlled Trial.

BACKGROUND: New registered nurses (RNs) are at risk of developing symptoms of stress-related ill health. OBJECTIVES: To evaluate the effect of a 3 × 3 hour group intervention aiming to prevent symptoms of stress-related ill health among new RNs by increasing engagement in proactive behaviors. The intervention involves discussions and models of newcomer experiences and stress and the behavior change techniques reinforcing approach behaviors, systematic exposure, and action planning. DESIGN: A randomized parallel group trial with an active control condition. PARTICIPANTS: The study sample consisted of 239 new RNs participating in a transition-to-practice program for new RNs in a large county in Sweden. METHODS: Participants were randomized to either the experimental intervention or a control intervention. Data on experiences of stress, avoidance of proactive behaviors, engagement in leisure activities, role clarity, task mastery, and social acceptance were collected before and after the intervention. Effects were evaluated using multilevel model analysis and regression analysis. Missing data were imputed using multiple imputation. RESULTS: The control group experienced a statistically significant increase in experiences of stress during the period of the study (t(194.13) = 1.98, p = .049), whereas the level in the experimental group remained stable. Greater adherence to the intervention predicted a greater effect on experiences of stress (ß = -0.15, p = .039) and social acceptance (ß = 0.16, p = .027). LINKING EVIDENCE TO ACTION: Transition-to-practice programs may benefit from adding an intervention that specifically addresses new RNs' experiences of stress to further support them as they adjust to their new professional role. However, replication studies with larger samples, more reliable measures, and longer periods of follow-up are needed.

Personality traits and the risk for Parkinson disease: a prospective study.

In this study, we explored the association between the personality traits, neuroticism and introversion, and risk of Parkinson disease (PD). A population-based cohort study was conducted using questionnaire data from the Swedish Twin Registry for twins born 1926-1958 (n > 29,000). Personality traits were assessed in 1973 by a short form of Eysenck's Personality Inventory. The cohort was followed from 1974 to 2012 through Swedish patient and cause of death registers for PD ascertainment. Cox proportional hazards regression was used to estimate subsequent risk of PD, adjusting for attained age, sex and smoking. A mediation analysis was performed to further explore the role of smoking in the relationship between personality trait and PD. Confounding by familial factors was explored using a within-pair analysis. During a mean follow-up time of 36.8 years, 197 incident PD cases were identified. Both neuroticism and introversion were associated with an increased risk of PD after adjustment. Smoking was a significant mediator in the relationship between personality traits and PD that partly accounted for the effect of introversion, whereas it acted as a suppressor for the effect of neuroticism on PD risk. In the within-pair analyses, associations for neuroticism and introversion were attenuated. In conclusion, our study provides evidence that neuroticism is associated with an increased risk of PD that is in part suppressed by smoking. There was a weak association between introversion and PD and this effect was at least partly mediated through smoking. The observed effects may partly be explained by familial factors shared by twins.

Meanings of at-homeness at end-of-life among older people.

Maintaining the well-being of older people who are approaching the end-of-life has been recognised as a significant aspect of well-being in general. However, there are few studies that have explicitly focused on at-homeness among older people. This study aims to illuminate meanings of at-homeness among older people with advancing illnesses. Twenty men and women, aged 85 or older, with advancing illnesses and who lived in their own homes, in nursing homes or in short-term nursing homes in three urban areas of Sweden were strategically sampled in the study. Data were generated in narrative interviews, and the analysis was based on a phenomenological hermeneutical method. After obtaining a naïve understanding and conducting structural analyses, two aspects of the phenomenon were revealed: at-homeness as being oneself and at-homeness as being connected. At-homeness as being oneself meant being able to manage ordinary everyday life as well as being beneficial to one's life. At-homeness as being connected meant being close to significant others, being in affirming friendships and being in safe dependency. Here, at-homeness is seen as a twofold phenomenon, where being oneself and being connected are interrelated aspects. Being oneself and being connected are further interpreted by means of the concepts of agency and communion, which have been theorised as two main forces of the human being.

New Graduate Nurses' Developmental Trajectories for Capability Beliefs Concerning Core Competencies for Healthcare Professionals: A National Cohort Study on Patient-Centered Care, Teamwork, and Evidence-based Practice.

BACKGROUND: This study aimed to describe the developmental trajectories of registered nurses' capability beliefs during their first 3 years of practice. The focus was on three core competencies for health professionals-patient-centered care, teamwork, and evidence-based practice. METHODS: A national cohort of registered nurses (n = 1,205) was recruited during their nursing education and subsequently surveyed yearly during the first 3 years of working life. The survey included 16 items on capability beliefs divided into three subscales for the assessment of patient-centered care, teamwork, and evidence-based practice, and the data were analyzed with linear latent growth modeling. RESULTS: The nurses' capability beliefs for patient-centered care increased over the three first years of working life, their capability beliefs for evidence-based practice were stable over the 3 years, and their capability beliefs for teamwork showed a downward trend. LINKING EVIDENCE TO ACTION: Through collaboration between nursing education and clinical practice, the transition to work life could be supported and competence development in newly graduated nurses could be enhanced to help them master the core competencies. Future research should focus on determining which factors impact the development of capability beliefs in new nurses and how these factors can be developed by testing interventions.

Which instruments to support diagnosis of depression have sufficient accuracy? A systematic review.

BACKGROUND: Instruments are frequently used in case finding, diagnosis and severity grading of major depression, but the evidence supporting their utility is weak. AIM: To systematically review the specificity and sensitivity of instruments used to diagnose and grade the severity of depression. METHODS: MEDLINE, PsycInfo, Embase and the Cochrane Library databases were searched until April 2014. Fifty studies fulfilled the inclusion criteria. Risk of bias was assessed with QUADAS. The average sensitivity and specificity of each instrument was estimated with hierarchical summary receiver operating characteristics analyses and the confidence in the estimates was evaluated using GRADE. Minimum acceptable sensitivity/specificity, with structured interview as the reference, was 80%/80% for structured interviews and 80%/70% for case-finding instruments. The minimum acceptable standard for severity measures was a correlation of 0.7 with DSM-IV classification. RESULTS: Twenty instruments were investigated. The average sensitivity/specificity was 85%/92% for the Structured Clinical Interview for DSM-IV-Axis-I Disorders (SCID-I), 95%/84% for the Mini International Neuropsychiatric Interview (MINI), < 70%/85% for the Primary Care Evaluation of Mental Disorders (PRIME-MD), 88%/78% for the Patient Health Questionnaire-9 (PHQ-9) with a cut-off score of 10, 69%/95% for PHQ-9 as a diagnostic algorithm and 70%/83% for the Hospital Anxiety and Depression Scale (HADS) with a cut-off score of 7. The confidence in the estimates for the other instruments was very low. CONCLUSIONS: Only the SCID-I, MINI and PHQ-9 with a cut-off score of 10 fulfilled the minimum criteria for sensitivity and specificity. The use of the PRIME-MD and HADS is not supported by current evidence.

Dopamine D1 receptor availability is related to social behavior: a positron emission tomography study.

Dysfunctional interpersonal behavior is thought to underlie a wide spectrum of psychiatric disorders; however, the neurobiological underpinnings of these behavioral disturbances are poorly understood. Previous molecular imaging studies have shown associations between striatal dopamine (DA) D2-receptor binding and interpersonal traits, such as social conformity. The objective of this study was to explore, for the first time, the role of DA D1-receptors (D1-Rs) in human interpersonal behavior. Twenty-three healthy subjects were examined using positron emission tomography and the radioligand [(11)C]SCH23390, yielding D1-R binding potential values. Striatal D1-R binding was related to personality scales selected to specifically assess one dimension of interpersonal behavior, namely a combination of affiliation and dominance (i.e., the Social Desirability, Verbal Trait Aggression and Physical Trait Aggression scales from Swedish Universities Scales of Personality). An exploratory analysis was also performed for extrastriatal brain regions. D1-R binding potential values in the limbic striatum (r = .52; p = .015), associative striatum (r = .55; p = .009), and sensorimotor striatum (r = .67; p = .001) were positively related to Social Desirability scores. D1-R binding potential in the limbic striatum (r = -.51; p = .019) was negatively associated with Physical Trait Aggression scores. For extrastriatal regions, Social Desirability scores showed positive correlations in the amygdala (r = .60; p = .006) and medial frontal cortex (r = .60; p = .004). This study provides further support for the role of DA function in the expression of disaffiliative and dominant traits. Specifically, D1-R availability may serve as a marker for interpersonal behavior in humans. Associations were demonstrated for the same dimension of interpersonal behavior as for D2-R, but in the opposite direction, suggesting that the two receptor subtypes are involved in the same behavioral processes, but with different functional roles.

The concept of research utilization as understood by Swedish nurses: demarcations of instrumental, conceptual, and persuasive research utilization.

BACKGROUND AND AIMS: The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses' RU, which could facilitate the evaluation of interventions to support the implementation of evidence-based practice. In this paper, we explored nurses' demarcation of instrumental RU (IRU), conceptual RU (CRU), and persuasive RU (PRU) using an item pool proposed to measure IRU, CRU, and PRU. METHODS: The item pool (12 items) was presented to two samples: one of practicing registered nurses (n = 890) in Sweden 4 years after graduating and one of recognized content experts (n = 7). Correlation analyses and content validity index (CVI) calculations were used together with qualitative content analysis, in a mixed methods design. FINDINGS: According to the item and factor analyses, CRU and PRU could not be distinguished, whereas IRU could. Analyses also revealed problems in linking the CRU items to the external criteria. The CVIs, however, showed excellent or good results for the IRU, CRU, and PRU items as well as at the scale level. The qualitative data indicated that IRU was the least problematic for the experts to categorize, whereas CRU and PRU were harder to demarcate. CONCLUSIONS: Our findings illustrate a difficulty in explicitly demarcating between CRU and PRU in clinical nursing. We suggest this overlap is related to conceptual incoherence, indicating a need for further studies. The findings constitute new knowledge about the RU concepts in a clinical nursing context, and highlight differences in how the concepts can be understood by RNs in clinical practice and experts within the field. We suggest that the findings are useful for defining RU in nursing and further development of measures of RU.

Critical incidents and post-traumatic stress symptoms among experienced registered nurses during the COVID-19 pandemic: A cross-sectional study.

Background: Registered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual's ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients. Objective: To assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents. Design: Cross sectional study. Settings: The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden. Participants: A total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation). Methods: The data were analyzed using descriptive statistics, unpaired t-tests, and one-way analysis of variance. Cohen's d was employed to quantify differences in mean levels between subgroups. Results: The response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high. Conclusions: This study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses' pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage.

Effectiveness of formal onboarding for facilitating organizational socialization: A systematic review.

OBJECTIVE: To investigate the effectiveness of formal onboarding programs and practices for new professionals. INTRODUCTION: New professionals may experience high levels of stress and uncertainty. Formal onboarding programs and practices aim to facilitate the socialization of new professionals by structuring early experiences. However, there is a lack of evidence-based recommendations of how to onboard new professionals. METHODS: This review considered studies that compares the effect of formal onboarding practices and programs for new professionals between 18-30 years of age (sample mean) to the effect of informal onboarding practices or 'treatment as usual' in professional organizations internationally. The outcome of interest for the review was the extent to which new professionals were socialized. The search strategy aimed to locate both published studies (dating back to year 2006) and studies accepted for publication written in English using the electronic databases Web of Science and Scopus (last search November 9 2021). Titles and abstracts were screened and selected papers were assessed by two independent reviewers against the eligibility criteria. Critical appraisal and data extraction were performed by two independent reviewers using Joanna Briggs Institutes templates. The findings were summarized in a narrative synthesis and presented in tables. The certainty of the evidence was assessed using the grading of recommendations, assessment, development and evaluations approach. RESULTS: Five studies including 1556 new professionals with a mean age of 25 years were included in the study. Most participants were new nurses. The methodological quality was assessed as low to moderate and there were high risks of bias. In three of the five included studies, a statistically significant effect of onboarding practices and programs on new professionals' adjustment could be confirmed (Cohen's d 0.13-1.35). Structured and supported on-the-job training was shown to be the onboarding strategy with the strongest support to date. The certainty of the evidence was rated as low. CONCLUSION: The results suggests that organizations should prioritize on-the-job training as a strategy to facilitate organizational socialization. For researchers, the results suggest that attention should be given to understanding how to best implement on-the-job training to ensure strong, broad, and lasting effects. Importantly, research of higher methodological quality investigating effects of different onboarding programs and practices is needed. Systematic review registration number: OSF Registries osf.io/awdx6/.

Psychopathic Traits in a Swedish Court-Ordered Forensic Sample: Preferential Associations of Boldness, Meanness, and Disinhibition.

The construct validity of the triarchic psychopathy model has yet to be evaluated in the Swedish forensic psychiatric context. We examined associations between the three phenotypic constructs of the triarchic model of psychopathy (i.e., boldness, meanness, disinhibition), self-assessed empathy and anxiety, and clinical variables in 91 individuals undergoing pretrial forensic psychiatric evaluation in Sweden. Participants completed the Triarchic Psychopathy Measure (TriPM) and self-report measures of empathy and anxiety. Clinical variables, including psychiatric diagnoses and criminal behavior, were collected from the forensic psychiatric evaluations (FPE). All three subscales of the TriPM displayed significant and predominantly anticipated correlations with empathy and trait anxiety measures. TriPM Disinhibition was the only subscale with significant associations with the clinical variables collected from the FPEs. The results provide evidence for the reliability and construct validity of the Swedish translation of the TriPM in a pretrial forensic setting.

Educational support for research utilization and capability beliefs regarding evidence-based practice skills: a national survey of senior nursing students.

AIM: The aim of the study was to investigate Swedish university nursing students' experience of educational support for research utilization and capability beliefs regarding evidence-based practice skills. BACKGROUND: Nursing programmes are offered at 26 universities in Sweden and even though there are common regulations for nursing education at the national level, substantial variations are found in local curricula. Little is known about students' capability beliefs regarding evidence-based practice skills, particularly in comparison across universities. METHODS: A cross-sectional survey design using self-administered postal questionnaires was conducted in 2006. A total of 1440 students (from 26 different universities) participated, constituting 68% of the national population of nursing students in their 6th and final semester. RESULTS: Campus education supported the students to a greater extent than clinical education in following the development of knowledge in an area of interest, using research findings, and acquiring knowledge on how to pursue changes in clinical practice. Perceived support during campus education varied between universities. Students reported high capability beliefs regarding evidence-based practice skills, but large differences were found between universities for: stating a searchable question, seeking out relevant knowledge and critically appraising and compiling best knowledge. CONCLUSION: The identified differences between universities concerning the students' perceived support for research utilization and their capability beliefs regarding evidence-based practice skills have implications for curricula, pedagogical perspectives in nursing education and the potential to implement evidence-based practice in healthcare settings. Further studies are warranted to investigate students' individual characteristics and organizational characteristics as determinants of research utilization support and capability beliefs regarding evidence-based practice skills.

The Importance of Effective Organizational Socialization for Preventing Stress, Strain, and Early Career Burnout: An Intensive Longitudinal Study of New Professionals.

Burnout was originally conceptualized based on experiences of new professionals. Role clarity, task mastery, and social acceptance are recognized as key resources enabling new professionals' management of the challenges of the new profession. However, relations between these resources and stress, strain, and burnout have not yet been thoroughly investigated at professional entry. Increased understanding of these relations could have implications for strategies to prevent burnout. The aim of the study was to investigate within- and between-individual effects over the first months and relations to burnout at one-year post-entry. Data (n = 322) was collected weekly over the first 13 weeks and again 9 months later. Relationships were modelled using a multilevel regression model and correlation analysis. Results showed that on weeks when participants experienced higher role clarity, task mastery, and social acceptance, they reported significantly less stress, and that participants who experienced higher levels of the resources in general, reported significantly less strain. Levels of the resources at three months were related to symptoms of burnout at 12 months. The study findings provide support of the role of task mastery, role clarity, and social acceptance as resources buffering the impact of demands at professional entry on experiences of stress, strain, and burnout.

What matters to persons living with brain tumors and their informal caregivers? An interview study of qualities in interpersonal relations.

BACKGROUND: Brain tumor is a severe cancer that may make the person with the illness and their informal caregivers dependent on support in self-care. Social network mapping is a method to assess an individual's social relations and resources, which may help to identify high-quality relations and potential sources of support. Yet, which relations matter for individuals living with brain tumors and their informal caregivers and how social network mapping could be used in self-care need further investigation. AIM: To explore how persons living with brain tumors and informal caregivers perceive the potential usefulness of a social network-mapping tool in their self-care and to describe the qualities in the interpersonal relations that they map. METHODS: Seven persons living with brain tumors and 12 informal caregivers (whereof six bereaved) participated in in-depth interviews and tested a social network-mapping tool developed by an informal caregiver (CareMaps). Data were analyzed inductively using thematic analysis. The COREQ checklist was used for reporting. FINDINGS: Participants expressed positive opinions about the CareMaps tool but raised some questions regarding its design, how to use it in their self-care, and the optimal timing of introducing the tool. Two themes reflecting qualities in relations were found: self-care supportive relations during which daily management of the brain tumor is in focus and identity-preserving relations that allow individuals to disconnect from their brain tumor experiences. Both types of relations were described as important, were found in different contexts (e.g., social life, work life, and healthcare), and emphasized contrasting qualities. CONCLUSION: The CareMaps tool was helpful in elucidating qualities in interpersonal relations that contribute to individuals' self-care. Future research should investigate how social network-mapping tools that capture quality in social relations should be designed and used to support individuals in their self-care.

Do men with excessive alcohol consumption and social stability have an addictive personality?

The existence of an "addictive" personality has been extensively debated. The current study investigated personality in male individuals with excessive alcohol consumption (n=100) in comparison to a population-based control group (n=131). The individuals with excessive alcohol consumption were recruited by advertisements in a regional daily newspaper and controls from a population based Swedish Twin Registry. Personality was assessed by the Karolinska Scales of Personality (KSP). Comparisons were made with normative data. Furthermore, by using a multivariate projection-based approach (Principal Component Analysis; PCA), hidden structures of traits and possible relationships among the individuals with excessive consumption and the controls was investigated. The individuals with excessive alcohol consumption as well as the controls had mean values within the normative range in all scales of the KSP. Moreover, the PCA analysis revealed no systematic between-group separation. Taken together, this result demonstrates that male individuals with excessive alcohol consumption do not have a personality different from that of a general population, which supports the notion of no "addictive personality".

Investigating the Validity Evidence of the Swedish TriPM in High Security Prisoners Using the PCL-R and NEO-FFI.

The triarchic model of psychopathy was developed to bridge opposing descriptions of psychopathy by separating the core construct in three domains; boldness, meanness, and disinhibition. The Triarchic Psychopathy Measure (TriPM) operationalizes the model through a 58-item self-report questionnaire. The current study examined the psychometric properties of the Swedish translation by investigating intercorrelations and associations to expert-rated psychopathy, general personality and psychopathy-related traits in male high-security prisoners (n = 191). Psychopathy rated with TriPM and the Psychopathy Checklist Revised (PCL-R) demonstrated expected convergence, as did empathy and impulsivity measures. The Disinhibition and Meanness scales were highly correlated, indicating that the scales might not be adequately differentiated. Nevertheless, the divergent association patterns to other important variables, particularly neuroticism and empathy, also points to meaningful differences. However, the lack of association between Disinhibition and Boldness may put into question if these domains are related at all, especially since there was a lack of similarity in the association patterns with other clinical variables. The influence of antisocial behavior in the TriPM operationalization might amplify the similarities of the Meanness and Disinhibition scales, while diluting the associations between Meanness and Boldness. In conclusion, the Swedish TriPM is effective in measuring the domains of triarchic model in forensic settings, even though a revision of the scales might improve the psychometric properties of the instrument.