Evaluating the GAD-2 to screen for post-stroke anxiety on an acute stroke unit.

Post stroke anxiety is associated with reduced quality of life, worse rehabilitation outcomes and poor social functioning in stroke survivors. Despite its clinical relevance, there are a lack of screening tools to identify post-stroke anxiety. The Hospital Anxiety and Depression Scale (HADS-A) and Geriatric Anxiety Inventory (GAI) are the only self-report screening test for anxiety validated in stroke patients. However, both of these measures have limitations associated with their clinical utility, length of time to administer and cost to purchase. This study aimed to assess the classiciation accuracy of a freely available and shorter alternative, the Generalized Anxiety Disorder 2-item (GAD-2) for use in the acute stroke setting. This study used retrospective analysis of a sequential sample in a clinical database of mood and cognitive scores. Patients' scores on the GAD-2 and HADS-A were compared. The GAD-2 demonstrated strong convergent validity with the HADS-A and good specificity and sensitivity for clinical anxiety. In conclusion, the GAD-2 may be a useful screening assessment of post-stroke anxiety in the acute setting; however, it should be used with due consideration of the methodological limitations of this study.

A survey of psychological practitioner workplace well-being.

The well-being of the psychological workforce is an area of concern. However, it has been sparsely studied in a holistic manner encompassing workplace well-being as well as burnout. This study reports a survey of 1,678 psychological practitioners accessed through professional networks. The short Warwick Edinburgh Mental Well-being Scale (SWEMWBS) and the Psychological Practitioner Workplace Well-being Measure (PPWWM) were administered with a demographic questionnaire. The mean for the SWEMWBS was below that of a national population survey. The intercorrelation of these tests was .61. Subgroup analyses showed significant differences: assistant psychologists, counsellors and psychological well-being practitioners demonstrated better than average workplace well-being. But for general well-being (SWEMWBS), trainee clinical psychologists and assistant psychologists showed lower than average well-being, whereas psychological well-being practitioners were higher than average. Other factors associated with well-being were contract type-both measures (higher workplace well-being in those with temporary contracts and the self-employed); employment sector-for PPWWM only (private organisation/independent workers and third sector/charitable organisation workers scored above the PPWWM mean); ethnicity-for both measures (Asian groups except Chinese had higher well-being than average for the PPWWM and SWEMWBS) and disability was strongly associated with lower well-being on both measures. Harassment, feeling depressed or a failure and wanting to leave the National Health Service (NHS) were associated with lower well-being. Greater age, pay and years of service were negatively correlated with well-being. A five-factor structure was obtained with this sample. The results confirmed psychological practitioners as an at-risk group and identified a number of factors associated with workplace well-being.

A measure to assess the workplace well-being of psychological practitioners.

The well-being of psychological practitioners is a key factor in the effective delivery of psychological therapies and the effectiveness of mental health services. Despite this, there are no measures of well-being for this professional group. The 26-item psychological practitioner workplace well-being measure (PPWWM) measures psychological well-being for psychological practitioners and was informed by a qualitative study. Items were generated and then verified by groups of practitioners using sorting tasks. The items reflect a broad range of issues relevant to the workplace well-being of psychological practitioners. The PPWWM was validated with a sample of 400 psychological practitioners recruited through professional networks. Internal consistency (α = .92) and test-retest reliability (r = .94) were high. Construct validity was indicated by positive correlations with the Health and Safety Executive Management Standards Indicator Tool and Satisfaction with Life Scale and negative correlation with the General Health Questionnaire. Exploratory factor analysis produced six factors, explaining 61.2% of the variance: professional and organizational; support and flexibility; professional role; physical environment; clinical supervision; and external personal. PPWWM scores were not significantly associated with a range of demographic variables (gender, health/disability, profession, and type of organization), but it did correlate significantly and negatively with age. The PPWWM has potential application as a brief measure, suitable for large-scale surveys that specifically measures workplace well-being in psychological practitioners. Future research could include cross validation with new samples and validation with subgroups of psychological practitioners.