Burnout and Social Connectedness: Predictors of PTSD and Well-Being in the Police

In their day-to-day tasks, police officers are repeatedly subjected to stressful and traumatic events and as such are at significant risk of developing post - traumatic stress disorder (PTSD). There is a wealth of literature exploring risk and protective factors, however there is still a need to develop our understanding of specific factors which may be unique to the police. In light of this need, two potential factors have been identified for this current research, burnout and social connectedness. Burnout relates to a culmination of stress which is unmanaged and untreated. Social connectedness relates to the internal experience of feeling connected to others and the world around. This thesis is primarily concerned with exploring the relationship between these factors and PTSD and general distress within the context of the police force. This research took place within one UK police force. In total, 93 participants from specialist departments at high risk of exposure to trauma took part in an online survey. The survey included self-report measures of burnout, social connectedness, Post-Traumatic Stress Disorder (PTSD) and general distress. Non-standardised measures also sought to capture demographic information and an additional outcome variable of sickness absence. A series of multiple forced-entry regressions were carried out. Increased symptoms of exhaustion (one aspect of burnout), significantly predicted increased PTSD symptom severity. Further exploratory analyses found that exhaustion significantly predicted two of the four PTSD symptom clusters: intrusion and alterations in arousal and reactivity. The same multiple regression analysis indicated that social connectedness made a significant contribution to the model predicting PTSD symptom severity, greater than that of exhaustion. It was also found that increased symptoms of exhaustion significantly predicted increased general distress, whereas disengagement (a further aspect of burnout) and social connectedness did not. Lastly, it was found that none of the predictor variables made a significant contribution to the model predicting sickness absence. These findings are discussed in terms of their theoretical and clinical implications

Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review

Background: Tailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes. Aims: To understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered. Method: A systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012. Results: We identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in ‘feeling bereft’; and perceptions of transgressions against social norms associated with ‘misunderstandings about behaviour’ in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging. Conclusions: Family carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their ‘personhood’. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers

The experience of family carers attending a joint reminiscence group with people with dementia: A thematic analysis

Reminiscence therapy has the potential to improve quality of life for people with dementia. In recent years reminiscence groups have extended to include family members, but carers' experience of attending joint sessions is undocumented. This qualitative study explored the experience of 18 family carers attending 'Remembering Yesterday Caring Today' groups. Semi-structured interviews were transcribed and subjected to thematic analysis. Five themes were identified: experiencing carer support; shared experience; expectations (met and unmet), carer perspectives of the person with dementia's experience; and learning and comparing. Family carers' experiences varied, with some experiencing the intervention as entirely positive whereas others had more mixed feelings. Negative aspects included the lack of respite from their relative, the lack of emphasis on their own needs, and experiencing additional stress and guilt through not being able to implement newly acquired skills. These findings may explain the failure of a recent trial of joint reminiscence groups to replicate previous findings of positive benefit. More targeted research within subgroups of carers is required to justify the continued use of joint reminiscence groups in dementia care

Using meta-ethnography to synthesize relevant studies: capturing the bigger picture in dementia with challenging behavior within families

In understanding the range and depth of people’s experiences, it is important to include the wide range of approaches which capture the richness within a given knowledge base. However, systematic reviews using quantitative data alone risk missing findings that can contribute to a better understanding of a research question. In response, meta-ethnography has emerged as a potentially useful method to synthesize and integrate both qualitative and quantitative data from different perspectives using qualitative methodology. In this case study, we describe how we have used meta-ethnography to better understand how families experience dementia. We address a particular issue of selecting the highest quality evidence across a range of epistemologies