Exploring the nature of resilience in paramedic practice: A psycho-social study

Previous research has identified that paramedics experience high levels of stress and sickness rates which have escalated in recent years due to changes to workforce restructuring. While a number of studies have investigated resilience among healthcare professionals, there is little research exploring how paramedics address work challenges and how they become resilient. Using psychosocial methodology, seven paramedics participated in Free Association Narrative interviewing; all were based at one regional centre. In line with the study design, data analysis adopted a psycho-social approach that generated four themes and 10 sub-themes which, characterised participants’ experiences. Coping and resilience was impacted upon via formal methods of support including management, debriefing and referral to outside agencies. Alongside this, more informal methods aided resilience. Informal methods included peer support, support from family and friends and the use of humour. Uniquely, this study uncovered how detachment is used to manage emotions. The study has implications for the services need to support the emotional needs of paramedics

Technology for the Formulation and Expression of Specifications - Volume II: Program User's Manual

National Bureau of Standards Contract 5-3584

Technology for the Formulation and Expression of Specifications - Volume III: Technical Reference Manual

National Bureau of Standards Contract 5-3584

Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy

Aim: To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. Background: Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. Methods: A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. Results: The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P < 0.001); and (2) intention to resign (r = 0.244, P < 0.0001). The frequency of occurrence of moral distress was associated with the intention of nurses to resign (r = -0. 209, P < 0.0001). Conclusion: Moral distress seems to be associated with the intention to resign, whereas poor nurse-physician collaboration appears to be a pivotal factor accounting for nurses' moral distress. Implications for nursing management: Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession. © 2013 John Wiley & Sons Ltd

Access to sexual health services for sub-Saharan communities in Avon Project report

SIGLEAvailable from British Library Document Supply Centre-DSC:m01/16646 / BLDSC - British Library Document Supply CentreGBUnited Kingdo