An interactional model of occupational stress in health service employees

This large scale study (869 participants from a mental health Trust) employed a questionnaire based on an interactional model of occupational stress to investigate (i) burnout in psychiatric nurses, (ii) occupational stress in medics and the professions allied to medicine, (iii) job satisfaction in health service management and support staff, and (iv) the moderating effect of social support in health service personnel. A range of analytic procedures were used including hierarchical regression analysis. Levels of burnout in nurses were low overall, although a significant proportion reported higher levels of emotional exhaustion. Among nurses, negative affectivity and predictability acted as common factors across the three constructs of the burnout syndrome. Medics and professions allied to medicine (P.AM. 's) reported similar levels of stressors to each other. Role ambiguity, role conflict and predictability, in combination with negative affectivity, accounted for most of the reported work related stressors of medics and P.AM. 's. Levels of job satisfaction in management and support staff was on a par with their peers elsewhere. Role ambiguity, role conflict, job future ambiguity, control and non-occupational concerns had an influence on job satisfaction among management and support staff. A significant proportion of nurses, medics and P.AM.'s reported low levels of work support. Those most at risk in this regard appeared to be highly educated, community based, non-shift workers. Higher levels of support were associated with increased job satisfaction and lower levels of both emotional exhaustion and psychological distress. The model adopted in the present study, although not necessarily applicable to all occupational groups, had utility in understanding the complex relationships between variables in this population from a mental health Trust. Despite common themes emerging across occupational groups, clear differences were also apparent, reinforcing the need for tailor-made interventions in occupational stress. The results also highlighted the necessity of including individual characteristics and nonoccupational stressors in any consideration of occupational stress. Further recommendations for each occupational group and the NHS in general are discussed

Caught between compassion and control: exploring the challenges associated with inpatient adolescent mental healthcare in an independent hospital

Aim. To extend our understanding of how healthcare assistants construct and managedemanding situations in a secure mental health setting and to explore the effects ontheir health and well-being, to provide recommendations for enhanced support.Background. Contemporary literature acknowledges high rates of occupationalstress and burnout among healthcare assistants, suggesting the context in whichthey work places them at elevated risk of physical harm and psychologicaldistress. Yet, there is a deficit of qualitative research exploring the experiences ofhealthcare assistants in adolescent inpatient facilities.Design. An exploratory multi-method qualitative approach was used to collectdata about the challenges faced by healthcare assistants working on secureadolescent mental health wards in an independent hospital during 2014.Method. Fifteen sets of data were collected. Ten participants completed diaryentries and five participants were also interviewed allowing for triangulation.Data were analysed using Interpretive Phenomenological Analysis.Findings. The findings illustrated how inpatient mental healthcare is a unique anddistinctive area of nursing, where disturbing behaviour is often normalized anddetached from the outside world. Healthcare assistants often experienced tensionbetween their personal moral code which orientate them towards empathy andsupport and the emotional detachment and control expected by the organization,contributing to burnout and moral distress.Conclusions. This study yielded insights into mental health nursing andspecifically the phenomenon of moral distress. Given the ever-increasing demandfor healthcare professionals, the effects of moral distress on both the lives ofhealthcare assistants and patient care, merits further study

Qualified and Unqualified (N-R C) mental health nursing staff - minor differences in sources of stress and burnout. A European multi-centre study

<p>Abstract</p> <p>Background</p> <p>Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care.</p> <p>Methods</p> <p>A total of 196 nursing staff - 124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds - working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ).</p> <p>Results</p> <p>(a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems.</p> <p>Conclusion</p> <p>The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard to stress and burnout seem necessary. The results also suggest that centre-specific problems may cause more stress among N-R Cs compared to the qualified staff (e.g. professional self-doubt).</p

Predicting outcome of face-to-face and telephone counselling for occupational stress

The aim of the present study was to investigate predictors of outcome of counselling, using mean change scores of three outcome measures, at treatment completion and at 4-months follow-up, in a randomised trial of face-to-face (n=30) versus telephone counselling (n=30) for occupational stress. Factors associated with treatment outcome were investigated using regression analyses with the mean change scores in three self-rated measures, including the Clinical Outcomes in Routine Evaluation Scale (CORE), the Perceived Stress Scale (PSS) and the General Health Questionnaire (GHQ) from pre- to post-intervention and pre-intervention to 4-months follow-up as the dependent variables and demographics, intervention-related and personality measures as independent variables. Irrespective of outcome measures and assessment points, it was found that the more severe the baseline symptomatology, the higher the degree of change was achieved. Clinical relevance of the present results and directions for future research are discussed

Predicting Outcome of Counselling for Occupational Stress

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Correlates of HIV/AIDS knowledge in a Scottish prison sample

A sample of 559 inmates in Scottish prisons were administered a 48-item HIV/AIDS knowledge questionnaire. High levels of HIV-related knowledge were associated with: a history of drug offences, having had an HIV test, knowing someone who has had an HlV test, knowing someone who is HIV seropositive, a history of injecting drug use and having a sexual partner who is also an injecting drug user. Inmates who are objectively at high risk of contracting HIV by virtue of their drug injecting and sexual behaviour are also amongst the most knowledgeable inmates, with regard to HIV/AIDS. Unfortunately, such knowledge does not result in the adoption of risk reduction behaviours. Results are discussed in relation to the heterogeneity of inmate populations and the diversity of their educational needs

Intravenous drug use and HIV transmission amongst inmates in Scottish prisons

The intravenous drug use behaviour and HIV risk reduction strategies used by a group of Scottish inmates prior to prison, during imprisonment and as expected afier release was investigated. From a sample of 559 inmates (480 males and 79 females) 27.5% were involved in IVDU prior to imprisonment, 7.7% on at least one occasion during a period of imprisonment and 14.7% expected to do so after release. Prior to imprisonment 17.3% had shared needles, 5.7% at some time during imprisonment and 4.3% expected to do so afier release. Some form of HIV risk reduction strategies were practised by the majority of IVDU inmates prior to imprisonment, during imprisonment and were expected to continue afier release. The most at risk inmates were those who continued to share injecting equipment without reduction and without sterilizing. The reduction in IVDU and needle sharing during imprisonment in comparison to prior to imprisonment was paralleled ky a self-perceived reduction of personal risk from HIV during imprisonment

A randomized trial of face-to-face counselling versus telephone counselling versus bibliotherapy for occupational stress.

Objective The aim of the present study was to compare the effectiveness and acceptability of three interventions for occupational stress. Methods/design A total of 90 National Health Service employees were randomized to face-to-face counselling or telephone counselling or bibliotherapy. Outcomes were assessed at post-intervention and 4-month follow-up. Clinical Outcomes in Routine Evaluation (CORE), General Health Questionnaire (GHQ-12), and Perceived Stress Scale (PSS-10) were used to evaluate intervention outcomes. An intention-to-treat analyses was performed. Results Repeated measures analysis revealed significant time effects on all measures with the exception of CORE Risk. No significant group effects were detected on all outcome measures. No time by group significant interaction effects were detected on any of the outcome measures with the exception of CORE Functioning and GHQ total. With regard to acceptability of interventions, participants expressed a preference for face-to-face counselling over the other two modalities. Conclusions Overall, it was concluded that the three intervention groups are equally effective. Given that bibliotherapy is the least costly of the three, results from the present study might be considered in relation to a stepped care approach to occupational stress management with bibliotherapy as the first line of intervention, followed by telephone and face-to-face counselling as required.div_PaSpub1227pu