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Understanding healthcare workers' responses to violence and aggression at work.

By Annie Moreland


The primary objective of this study was to investigate whether there was evidence for the proposed mechanisms\ud within the Ehlers and Clark (2000) cognitive model of Post-Traumatic Stress Disorder( PTSD). Two principal relationships were to be investigated: firstly, whether\ud behavioural and cognitive strategies prevented change in the nature of the trauma memory and appraisals of the trauma and its sequelae over time; secondly, whether\ud aspects of trauma memory and subsequent appraisals of the trauma and its sequelae mediated the relationship between\ud peritraumatic cognitive processing and PTSD symptoms. The second research objective involved further validation of the Ehlers and Clark (2000) model. The study was conducted on a population of health service employees exposed to aggression and/or violence at work, using a prospective,\ud longitudinal design.A low response rate meant that there\ud was not sufficient power to test these relationships. The findings from Study I were a low response rate, low reporting of incidents of violenced rid aggression and low PTSD symptoms,particularly amongst ambulance workers.\ud \ud Findings from Study I led to a qualitative study being carried out to investigate: the possible reasons for the low response and reporting rate; the lack of PTSD symptoms; and to explore responses of ambulance workers to workplace\ud violence and aggression. Twenty-four interviews were carried out with ambulance workers, and the data was analyzed using Thematic Analysis. PTSD symptoms were described by interviewees in themselves and their colleagues following incidents of violence and aggression Low response rates were discussed in the context of a general reluctance to report incidents and to show\ud that they had not been affected by violence and\ud aggression. The responses to violence and aggression took two forms, a macho or tough response and a reflective, sensitive approach. Colleague relationships were an important source of support for many of the ambulance \ud workers and management were portrayed as uncaring. These\ud findings were considered in the context of the literature\ud and the Ehlers and Clark (2000) model

Publisher: School of Medicine (Leeds)
Year: 2006
OAI identifier:

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  1. (2000). A cognitive model of posttraurnatic stress disorder. Behaviour Research and Therapy, doi
  2. (2001). A cognitive neuroscience account of posttraurnatic stress disorder and its treatment. doi
  3. (1996). A dual representation theory of post-traumatic stress disorder. Psychological Review, doi
  4. (2001). A prospective investigation of the role of cognitive factors in. persistent posttraurnatic stress disorder (PTSD) after physical or sexual assault. Behaviour Research and. Therapy, doi
  5. (1954). A theory of social comparison processes. Human Relations, doi
  6. (2001). Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being. doi
  7. (1995). An Introduction to Social Constructionism. London: Routledge Charmaz, doi
  8. (2004). Assessment Devices. Retrieved April 28th, 2006, from http: //www.
  9. (2000). Attitudes of emergency nurses regarding patient assaults. doi
  10. (1982). Attributions and'psychological change: applications of attributional theories to clinical and education practice.
  11. (2002). Brief screening instrument for post-traumatic stress disorder.
  12. (2006). Bullies who threaten NHS staffare shown the red card as newfigures reveal 1 in 22 NHS workers suffer violence.
  13. (1998). cited in
  14. (2004). Cognitive approaches to posttraumatic stress disorder: the evolution of multirepresentational theorizing. doi
  15. (1989). Cognitive change processes in psychotherapy. doi
  16. (1997). Cognitive factors in persistent versus recovered PTSD after physical or sexual assault: a pilot study. doi
  17. (1999). Cognitive theories of post-traumatic stress disorder.
  18. (2005). Coping strategies of African American adult survivors of childhood violence. doi
  19. (1997). Doing qualitative research differently. doi
  20. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. Britishjournal ofclinical psychology, doi
  21. (2004). Intrusive and non-intrusive memories in a nonclinical sample: The effects of mood and affect on imagery vividness. doi
  22. (2004). Levels of mental health problems among UK emergency ambulance workers. doi
  23. (2004). Making sense of male rape: constructions of gender, sexuality and experience of rape victims. doi
  24. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal ofconsulting and clinical psychology, doi
  25. (1999). Narrative dynamics and psychodynamics. doi
  26. (2002). Negative coping as mediator in the relation between violence and outcomes: Inner-city African American youth. doi
  27. (2004). Overt Anger in Response to Victimization: Attributional Style and Organizational Norms as Moderators. doi
  28. (2000). Posttraurnatic stress disorder following political imprisonment: the role of mental defeat, alienation and perceived permanent change. doi
  29. (1999). Previous exposure to trauma and PTSD effects of subsequent trauma: results from the Detroit area survey of trauma.
  30. (2005). Profiles in Coping: Responses to Sexual Harassment Across Persons, Organizations, and Cultures. doi
  31. (1998). Psychological predictors of chronic pos. ttraumatic stress disorder after motor vehicle accidents. doi
  32. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, doi
  33. (1999). PTSD symptoms, response to intrusive memories and coping in ambulance service workers. doi
  34. (1979). The ecology ofhuman development: Experiments by nature and design.
  35. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. doi
  36. (2000). The social construction of the meaning of acute stressors: a qualitative study of the personal accounts of police officers using a stress counselling service. doi
  37. (2002). The validlity of the Hospital Anxiety and Depression Scale. An updated literature review. doi
  38. (1998). Thought suppression produces a rebound effect with analogue post-traumatic intrusions. doi
  39. (1997). Treating adult survivors of severe childhood abuse and neglect: Further development of an integrative model.
  40. (2006). Using thematic analysis in psychology. doi
  41. (2005). Workplace violence experienced by paramedics: relationships with social support, job satisfaction and psychological strain.

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