Objective and Subjective Factors as Predictors of Post-Traumatic Stress Symptoms in Parents of Children with Cancer – A Longitudinal Study

BACKGROUND: Parents of children with cancer report post-traumatic stress symptoms (PTSS) years after the child's successful treatment is completed. The aim of the present study was to analyze a number of objective and subjective childhood cancer-related factors as predictors of parental PTSS. METHODS: Data were collected from 224 parents during and after their child's cancer treatment. Data sources include self-report questionnaires and medical records. RESULTS: In a multivariate hierarchical model death of the child, parent's perception of child psychological distress and total symptom burden predicted higher levels of PTSS. In addition, immigrants and unemployed parents reported higher levels of PTSS. The following factors did not predict PTSS: parent gender, family income, previous trauma, child's prognosis, treatment intensity, non-fatal relapse, and parent's satisfaction with the child's care. CONCLUSIONS: Although medical complications can be temporarily stressful, a parent's perception of the child's distress is a more powerful predictor of parental PTSS. The vulnerability of unemployed parents and immigrants should be acknowledged. In addition, findings highlight that the death of a child is as traumatic as could be expected

Burnout in Mothers and Fathers of Children Surviving Brain Tumour

The aim of this paper was to investigate the occurrence of burnout among parents of brain tumour survivors. Burnout was assessed in 24 mothers and 20 fathers of childhood brain tumour survivors, using the Shirom–Melamed Burnout Questionnaire. Parents of children with no history of chronic or serious diseases served as a reference group. Mothers’ burnout scores were significantly higher compared with reference mothers. For fathers, no relation between burnout and being a parent of a brain tumour survivor was established, despite a nonsignificant tendency in the same direction as for the mothers. In conclusion, the parenting burden after a child’s brain tumour may include chronic strain, and this may be particularly taxing for mothers. The findings encourage further studies of psychological exhaustion among parents of children with special needs

Stress and coping in parents of children with cancer

The general aim of this thesis was to investigate disease-related stress and ways of coping in parents whose children were in active treatment for cancer, or had completed successful cancer treatment. Specifically, the research included examinations of: disease-related stress at various points in time after the child's diagnosis; strain and traumatic stress during and after the child's treatment; the relation of certain demographic and disease-related variables to parental stress; the use of various coping strategies, and the co-variation of coping strategies and level of emotional distress; and the relationships between perceived social support, support-seeking coping, and emotional distress. The four sub-studies of the thesis involved cross-sectional samples including 265, 413, 395, and 184 parents, respectively. Parents were recruited at Astrid Lindgren Children's Hospital, Stockholm, and at Linköping University Hospital. Both mothers and fathers were invited. The time elapsed since disclosure of the child's diagnosis varied from one week to fourteen years. All four studies were based on quantitative data, collected through self-report inventories. Fourteen various aspects of diseaserelated stress, and seven types of coping strategies were examined. Findings indicate that high levels of disease-related distress are particularly frequent among parents during the first period after the diagnosis. However, most aspects of disease-related strain were reported by parents later in time as well. Indeed, years after the diagnosis parents were more anxious than parents of healthy children. Furthermore, although particularly the treatment phase appeared to involve events that affect parents' experience of control, as well as elicit traumatic stress reactions, most of the assessed aspects of stress seemed to occur among parents of children off treatment as well. Positive perceptions of social support, and a coping style that included problemfocusing appeared to make parents less affected by strain. In contrast, the reliance on a coping style including a passive reaction pattern was associated with higher levels of anxiety and depression. An avoidant coping style was also associated with more distress. However, immediately after a child's cancer diagnosis, the distress seemed to be high regardless of whether parents relied on avoidant coping or not. Findings indicate that parents with lower education and non-Swedish origin may be less resilient to traumatic stress after end of treatment, than parents with higher education levels and a native Swedish background. In contrast, a good prognosis did not seem to make parents less vulnerable to distress than a worse prognosis or a relapse in the child. Moreover, cancer in a child appeared to affect mothers and fathers similarly. In conclusion, the data suggest that several aspects of disease-relate strain are relevant in various patterns to parents during the child's treatment as well as when treatment is completed, and that such strain can appear at any point in time after a child's cancer diagnosis. Factors other than the passing of time and the termination of treatment account for the majority of variation in parental stress

The meaning of decision latitude in registered nurses’ night work

Purpose For many employees today, the work situation and work content differ from those of the industrial workers that were originally in mind when the well-known demand-control-support model was developed. The aim of this study was to gain a deeper understanding of the meaning of control, i.e., decision latitude, in post-industrial society, using night-working registered nurses as an example. Methods As an example of a modern human service occupation in a value-based organization we choose registered nurses. Twenty-nine registered nurses from 11 departments at three different hospitals participated in semi-structured interviews. The analysis used a thematic approach and was deductive, based on an operationalization of decision latitude. Results Findings indicate that the specific meaning of decision latitude is influenced by the specific work organization. Moreover, decision latitude appears to interact in a complex way with demands and support at work. Conclusions Decision latitude appears to be influenced by the specific work organization. Thus, when we address self-reported decision latitude, it can have different meanings and potentially different effects in different contexts. Moreover, the interface and interplay between the three constructs decision latitude, demand and support seems to be relevant and complex

State Police officers empathy level connection of work experience.

Response rates to surveys are decreasing. The purpose of this study was to evaluate the use of lottery tickets as incentives in an epidemiologic control group. A self-administered questionnaire was sent to parents in the municipality of Stockholm, Sweden, who were to be used as a control group in a study addressing stress in parents of children with cancer. A stratified random sample of 450 parents were randomized into three incentive groups: (a) no incentive; (b) a promised incentive of one lottery ticket to be received upon reply; (c) a promised incentive of one lottery ticket to be received upon reply and an additional lottery ticket upon reply within 1 week. The overall response rate across the three groups was 65.3%. The response rate was highest in the no incentive group (69.3%) and lowest in the one plus one lottery ticket group (62.0%). In a survival analysis, the difference between the two response curves was significant by the log-rank test (P = 0.04), with the no incentive group having a shorter time to response than the incentive group. Our findings suggest that the use of lottery tickets as incentives to increase participation in a mail questionnaire among parents may be less valuable or even harmful. Incentives may undermine motivation in studies in which the intrinsic motivation of the respondents is already high.The original publication is available at www.springerlink.com:Marika Wenemark, Åsa Vernby and Annika Lindahl Norberg, Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?, 2010, EUROPEAN JOURNAL OF EPIDEMIOLOGY, (25), 4, 231-235.http://dx.doi.org/10.1007/s10654-010-9434-8Copyright: Springer Science Business Mediahttp://www.springerlink.com

Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?

Response rates to surveys are decreasing. The purpose of this study was to evaluate the use of lottery tickets as incentives in an epidemiologic control group. A self-administered questionnaire was sent to parents in the municipality of Stockholm, Sweden, who were to be used as a control group in a study addressing stress in parents of children with cancer. A stratified random sample of 450 parents were randomized into three incentive groups: (a) no incentive; (b) a promised incentive of one lottery ticket to be received upon reply; (c) a promised incentive of one lottery ticket to be received upon reply and an additional lottery ticket upon reply within 1 week. The overall response rate across the three groups was 65.3%. The response rate was highest in the no incentive group (69.3%) and lowest in the one plus one lottery ticket group (62.0%). In a survival analysis, the difference between the two response curves was significant by the log-rank test (P = 0.04), with the no incentive group having a shorter time to response than the incentive group. Our findings suggest that the use of lottery tickets as incentives to increase participation in a mail questionnaire among parents may be less valuable or even harmful. Incentives may undermine motivation in studies in which the intrinsic motivation of the respondents is already high.The original publication is available at www.springerlink.com:Marika Wenemark, Åsa Vernby and Annika Lindahl Norberg, Can incentives undermine intrinsic motivation to participate in epidemiologic surveys?, 2010, EUROPEAN JOURNAL OF EPIDEMIOLOGY, (25), 4, 231-235.http://dx.doi.org/10.1007/s10654-010-9434-8Copyright: Springer Science Business Mediahttp://www.springerlink.com

Hållbart arbetsliv för nattarbetande sjuksköterskor och barnmorskor : Upplevelser av nattarbetets för- och nackdelar

Det övergripande syftet med det här projektet var att bidra med kunskap som kan användas för attmöjliggöra att natt- och skiftarbete ska kunna kombineras med god hälsa, motivation och engagemang i en stabil personalstyrka i hälso- och sjukvården. Rapporten beskriver resultat baserade på29 intervjuer som gjordes med sjuksköterskor och barnmorskor i Region Stockholm under hösten2018 och våren 2019. Inte oväntat var möjligheten till återhämtning ett viktigt område, då nattarbete är nära sammankopplat med efterföljande trötthet. Resultaten pekar mot att individuella psykologiska, biologiskaoch sociala variationer kan påverka vad som är ett optimalt schema. Nattarbetets effekter på livetutanför arbetet var ett annat område där återhämtning hade stor betydelse. Men nattarbete handlar inte bara om trötthet och återhämtning. I sjuksköterskans och barnmorskans nattarbete fanns också vissa speciella arbetsorganisatoriska förhållanden. En av de viktigastepusselbitarna i nattarbetets karaktär är kravet på stor självständighet, som – om förutsättningarnaär de rätta – har möjlighet att öka arbetstillfredsställelsen och bidra till en berikad arbetssituation.Under sämre förutsättningar, ofta handlar det om begränsad bemanning, kan kravet på självständighet istället medföra stress och oro för patientsäkerheten och upplevelsen av att vara ensam omett alltför stort ansvar. En annan aspekt av nattarbetets organisation handlade om att det kan gemöjlighet till klinisk kompetensutveckling inom vård och omvårdnad.