Anticipatory Grief and Compassion Fatigue: Definitions and Guidelines for Caregivers

Anticipatory grief is characterized as grief that an individual experiences prior to an expected loss of a terminally ill loved one. Anticipatory grief can occur in advance of losses other than death, and is considered a normal grief reaction. Anticipatory grief follows a distinct pattern, though no two individuals process grief the same way. The beneficial effects of anticipatory mourning have prompted caregivers to help individuals and families cope with future losses so that when such losses occur they will be more prepared for them. Professionals who serve as caregivers to those who will experience grief and loss have the potential to be affected in similar ways, experiencing many of the symptoms as those they serve, which are compounded over time. This phenomenon is called compassion fatigue. This paper provides definitions of anticipatory grief and its dimensions, contrasting that process to compassion fatigue which affects those who assist individuals who are coping with loss. Conclusions will be offered as to whether the self-care strategies offered to those experiencing anticipatory grief can be used for those experiencing compassion relief

MULTIFACTORIAL SCREENING FOR FALL RISK IN COMMUNITY-DWELLING OLDER ADULTS IN THE PRIMARY CARE OFFICE: DEVELOPMENT AND VALIDATION OF THE FALL RISK ASSESSMENT & SCREENING TOOL (FRAST)

Background: Unintentional falls are an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists (PTs) and other primary care practitioners (PCPs) caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. Purpose: This manuscript describes the content selection, development and validation of a simple-to-administer, multifactorial Fall Risk Assessment & Screening Tool (FRAST). The FRAST is designed specifically for use in primary care settings by minimally-trained staff to identify those older adults with heightened fall risk requiring PCP intervention. The FRAST incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Methods: Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. The FRAST was then validated via data collection across Montana in 2010 and included 99 subjects fitting specified inclusion/exclusion criteria: aged 65+, community-dwelling, independent ambulators (with or without assistive devices). Results: FRAST has been developed and validated to assess fall risk in the target population. Many fall risk factors have been considered and 15 items selected for inclusion. FRAST includes four previously validated measures to assess balance, depression, falls efficacy, and home safety. Conclusion: Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing PCPs with a very simple screening tool is imperative. FRAST was created and validated to allow for safe, quick, and low-cost fall risk screening by minimally-trained office staff with interpretation and follow-up provided by the PCP

Dispositional mindfulness and working memory in the context of acute stress.

The neuropsychological domain of working memory and the nearly 3000 year-old Buddhist construct of mindfulness appear to be disparate concepts. However, the measurable decline of working memory capacity (WMC) under stress, in combination with the stress-reducing and attention-focusing effects of mindfulness suggest potential augmentation of working memory through the engagement of mindful practice. A theoretical process through which dispositional mindfulness exerts a moderating effect on WMC reduction following an acute stressor is proposed. To investigate processes within this theoretical framework, a sample of undergraduate college students (N = 67) were assessed across various measures, including level of dispositional mindfulness, affective state, WMC, and physiological indices. Participants were then presented with an acute emotional stressor, in the form of death and injury images of the International Affective Picture System (IAPS; Lang, Bradley, & Cuthbert, 2005). Following stress induction, participants were reassessed for WMC and affective changes. Scores on affective measures underwent significant changes from pre- to post-stressor in the predicted direction, while scores on a measure of WMC increased, in contrast to a priori predictions. Dispositional mindfulness was not found to play a mediational role in affective, cognitive, or physiological changes from pre- to post-stressor. Implications of analyses for the present study, as well as for future research, are discussed

FAMILY SCAPEGOATING AND ADOLESCENT DEVELOPMENT

The clinical literature on families refers to the scapegoating of children by parents as a serious problem in certain dysfunctional families. This study explores scapegoating as a more general phenomenon that occurs in normal (i.e., non-clinical) families as well. The study utilized self-reports of 403 adolescents to assess the frequency and distribution of scapegoating in normal families and what adolescent difficulties are associated with family scapegoating. Most adolescent respondents reported experiencing family scapegoating. The pattern of family scapegoating self-reports varied more with the type of family conflict scapegoated than with the family member doing the scapegoating. Reports of family scapegoating were related to adjustment problems reported by the adolescent respondents. Also, there were less significant relationships between some forms of scapegoating and low self-esteem, delinquency and peer delinquency. Theoretical and clinical implications of the results were noted, as well as suggestions for future research

Am J Ind Med

Background:The public safety sector includes law enforcement officers (LEO), corrections officers (CO), firefighter service (FF), wildland firefighting (WFF), and emergency medical services (EMS), as defined in the National Occupational Research Agenda (NORA) of the National Institute for Occupational Safety and Health (NIOSH). Across these occupations, shiftwork, long-duration shifts, and excessive overtime are common. Our objective was to identify research gaps related to working hours, sleep, and fatigue among these workers.Methods:We used a scoping review study design that included searches of MEDLINE, Embase, CAB Abstracts, Global Health, PsychInfo, CINAHL, Scopus, Academic Search Complete, Agricultural and Environmental Science Collection, ProQuest Central, Cochrane Library, Safety Lit, Homeland Security Digital Library, and Sociological Abstracts using a range of occupational search terms and terms related to working hours, sleep, and fatigue.Results:Out of 3415 articles returned from our database search, 202 met all inclusion criteria. Six common outcomes related to working hours, sleep, and fatigue emerged: sleep, fatigue, work performance, injury, psychosocial stress, and chronic disease. Nearly two-thirds (59%, n = 120) of the studies were observational, of which 64% (n = 77) were cross sectional and 9% were (n = 11) longitudinal; 14% (n = 30) of the studies were reviews; and 19% (n = 39) were experimental or quasi-experimental studies. Only 25 of the 202 articles described mitigation strategies or interventions. FFs, LEOs, EMS, and WFFs were the most studied, followed by COs.Conclusions:In general, more longitudinal and experimental studies are needed to enrich the knowledge base on the consequences of long working hours, poor sleep, and fatigue in the public safety sector. Few experimental studies have tested novel approaches to fatigue mitigation in diverse sectors of public safety. This gap in research limits the decisions that may be made by employers to address fatigue as a threat to public-safety worker health and safety.CC999999/ImCDC/Intramural CDC HHSUnited States

2018 Program

University of Missouri-St. Louis Undergraduate Research Symposium Progra