Making good theory practical: Five lessons for an Applied Social Identity Approach to challenges of organizational, health, and clinical psychology

Experiences of adults with stroke attending a peer-led peer-support group

PURPOSE

Peer-support groups for stroke survivors are often organized and facilitated by health authorities and disability related organizations within rehabilitation programs. However, the benefits of peer-led, peer-support groups have not yet been evaluated. The purpose of this study was to explore participants' experiences in a community-based, peer-led, peer-support group for stroke survivors.

MATERIALS AND METHODS

Semi-structured interviews were conducted and analyzed following constructivist grounded theory with 11 participants who attended a peer-led, peer-support group for people with stroke. The data were also complemented with one quantitative rating question regarding their experience attending the group.

RESULTS

Three themes were identified. Meeting unmet needs after stroke captured how the group was created by stroke survivors to address life in the community post-stroke. Buddies helping buddies highlighted that stroke recovery is a shared process at the group, where members help and encourage each other to contribute what they can. Creating authentic friendships revealed how people experienced social connection and developed relationships in the peer-led, peer-support group.

CONCLUSIONS

Peer-led, peer-support groups may provide opportunities for stroke survivors to connect with like-minded people in their community to have fun while exploring their abilities.

Shared social identity and media transmission of trauma

When an individual or group trauma becomes a shared public experience through widespread media coverage (e.g., mass violence, being publicly outed), sharing a social identity with a targeted individual or group of victims may amplify feelings of personal vulnerability. This heightened perceived threat may draw people to engage with trauma-related media because of increased vigilance for self-relevant threats, which can, in turn, amplify distress. We studied this possibility among two U.S. national samples following the 2016 Pulse nightclub massacre in Orlando, FL (N = 4675) and the 2018 Dr. Christine Blasey Ford and Judge Brett Kavanaugh Supreme Court Senate hearings (N = 4894). Participants who shared LGBT or Hispanic identities with Pulse massacre victims reported greater exposure to massacre-related media and acute stress. Participants who shared Dr. Blasey Ford's identities as a victim of interpersonal violence and a Democrat reported more hearings-related media exposure and acute stress. Indirect effects of shared single identity on acute stress through self-reported event-related media exposure emerged in both studies. Results for sharing dual identities with victims were mixed. These findings have implications for media use and public health.

The Influence of Family Communication Patterns and Identity Frames on Perceived Collective Psychological Ownership and Intentions to Share Health Information

An experimental study exposed participants (N = 299) to different message frames to investigate whether Family Communication Patterns (FCP) and message characteristics influenced willingness to communicate about Family Health History (FHH). Message frames were either collective (our), individual (mine), or control (no pronouns). Afterward, participants were asked about their perceived collective psychological ownership of health information, attitudes, subjective norms, and FHH communication intentions. Although the message frames had no impact on perceived collective psychological ownership of health information, conversation orientation and conformity orientation (respecting parental authority) were positively associated with perceived collective psychological ownership of health information. Additionally, perceived collective psychological ownership, attitudes, and subjective norms were found to have indirect effects between FCP and FHH communication intentions. These findings provide further support that FCP influences how health message appeals are processed and suggest interventions could be tailored to FCP orientations for effective FHH behaviors.

Situational pathogen avoidance mediates the impact of social connectedness on preventive measures during the COVID-19 pandemic

During the COVID-19 pandemic, physical distancing was one of the more important behaviours for reducing the spread of the virus. The present study investigated the influence on pathogen avoidance of familiarity with other people at private gatherings. Based on the social identity model of risk taking and the theory of the behavioural immune system, we assumed that greater familiarity with others would make people feel more connected with one another and decrease situational pathogen avoidance. This could result in lower perceptions of the risk of contracting COVID-19 and fewer protective behaviours. Two experiments (n₁ = 1022, n₂ = 994) showed that the negative influence of greater familiarity on the perceived risk of infection and protective behaviour is explained by an increased feeling of connectedness and less feeling of situational pathogen avoidance. In an additional survey, the participants (n = 23,023) rated the quality of their past social contacts. The correlational analyses showed that the familiarity of the other person was more important in explaining variance in protective behaviours than attitudes toward those behaviours or the pandemic situation itself. Understanding the process that result in an explosive increase in infection after social gatherings can improve infection control in the future.

The (un)learning of social functions and its significance for mental health

Social interactions are dynamic, context-dependent, and reciprocal events that influence prospective strategies and require constant practice and adaptation. This complexity of social interactions creates several research challenges. We propose a new framework encouraging future research to investigate not only individual differences in capacities relevant for social functioning and their underlying mechanisms, but also the flexibility to adapt or update one's social abilities. We suggest three key capacities relevant for social functioning: (1) social perception, (2) sharing emotions or empathizing, and (3) mentalizing. We elaborate on how adaptations in these capacities may be investigated on behavioral and neural levels. Research on these flexible adaptations of one's social behavior is needed to specify how humans actually "learn to be social". Learning to adapt implies plasticity of the relevant brain networks involved in the underlying social processes, indicating that social abilities are malleable for different contexts. To quantify such measures, researchers need to find ways to investigate learning through dynamic changes in adaptable social paradigms and examine several factors influencing social functioning within the three aformentioned social key capacities. This framework furthers insight concerning individual differences, provides a holistic approach to social functioning, and may improve interventions for ameliorating social abilities in patients.

Sports and Social Interaction: Sports Experiences and Attitudes of the Urban Running Community

Social change and development influence the motivational factors of people's sports participation, exposing the need for socialization and interaction. The purpose of this study is to investigate the interaction pattern of the urban running community and the behavior pattern of runners with the help of social interaction theory, and to explore the inner connection between their community movement and social interaction. Ten senior members of marathon urban running societies were selected to conduct two rounds of in-depth interviews which were analyzed using qualitative thematic analysis to understand the sports participation experiences and social interactions of running society members. The study found that the whole interaction process of running groups is accomplished through three aspects: examination of self, adjustment with reference to others, and a sense of group belonging as the core consciousness. On the other hand, the social attributes of running groups can advance the personalization process of runners in society, which is mainly characterized by self-presentation and external constraints, self-requirement and group constraints, intergroup interaction and group identity reorganization. In addition, the unique community culture, standardized group organization and harmonious activity atmosphere will stimulate runners' interest in running, strengthen community communication and establish stable community relations, etc., which in turn will bring about continuous interactive behaviors.

Health literacy among self-help leprosy group members reduces stereotype endorsement and stigma-related harm in rural Nepal

There is increasing appreciation that group memberships can have both beneficial and damaging impacts on health. In collaboration with Nepal Leprosy Trust (NLT), this longitudinal study explores a group-based approach to stigma reduction among people affected by leprosy in rural Nepal (N = 71)-a hard to reach and underrepresented non-WEIRD population. Informed by the 'social cure' literature, and the progressive model of self-stigma, we use a longitudinal design. We found that a sense of belonging to a self-help group can facilitate education in terms of health literacy, and over time these two factors also have impacts on participants stigma. Specifically, self-help group belonging predicted improvements in health literacy, leading to reduced endorsement of negative stereotypes and thus less stigma-related harm among people affected by leprosy. The study offers promising evidence that group-based interventions, which support health education, can reduce the harmful impact of stigma in very challenging contexts.

COVID-19 Adaptive Interventions: Implications for Wellbeing and Quality-of-Life

Social bonds may assist in cultivating a more positive attitude to life through commonly shared meanings about the COVID-19 pandemic. The key challenge, however, is how to foster social bonds meeting the changing demands in a post pandemic world. Yet, it is in the middle of a crisis that the conversation needs to start about how to strategically plan for the recovery. This is important not only in the current pandemic, but also in a post pandemic world. Reinforcing or fostering new social bonds is likely to bring positive experiences. The latter is central to human health and wellbeing, and has potential to contribute greatly in enhancing people's quality of life. In an attempt to foster place social bonding in the COVID-19 pandemic and beyond to subsequently contribute to wellbeing, this paper develops and proposes a new conceptual framework suggesting the need for adaptive social bonding interventions in the SARS-CoV-2 pandemic. This is an essential measure to manage the significant impacts on our global health services due to a decline in people's mental health in addition to COVID-19 physical impacts. The paper discusses how promoting adaptive social bonding interventions (psycho-socio, digital and nature social bonding) can make people more resilient. It further discusses how they can be empowered psychologically, socially, and emotionally in the current challenging times. The conceptual framework posits that social bonding interventions can assist in maintaining better mental, physical, emotional, and spiritual wellbeing and discusses how these wellbeing outcomes may also be experienced post the pandemic. This has important benefits and is of relevance to governments, policy makers and healthcare professionals in delivering better health care and equipping people with coping mechanisms both throughout the pandemic and in the long run.

Continuance Intention of Online Healthcare Communities- The Mediation Mechanism of Social Interaction Ties

The purpose of this research is to evaluate the continuance usage intention on online healthcare community (OHC) platform for patients and examine the "doctor-OHC-patient" relationship. The proposed model attempted to integrate social interaction ties, shared value, trust with the indirect effects on the relationship between the determinants and continuous usage intention of the OHC platform. The empirical results showed that perceived critical mass, social identity, and para-social interaction would strengthen continuance intention via the social interaction ties. In addition, this study found that the shared values and trust increase users' willingness to continue usage of OHC. This study provides OHC platform managers with an in-depth understanding of the "doctor-OHC-patient" online social interaction. The results of this study may also help hospitals, health policy makers, and related healthcare practitioners to improve the way they use the web for advocacy and guidance, and provide insight into the intent of promoting the ongoing use of OHC platforms.

Impact of hospitalists' social identities on perceptions of teamwork

Interprofessional teamwork provides unique opportunities for improving patient care. This study used Social Identity Theory as a conceptual framework to characterize the relationships between the social identities of pediatric hospitalists and their perceptions of interprofessional teamwork. We used qualitative methods including free-listing and semi-structured interviews to examine these relationships. We identified five key themes: (a) Pediatric hospitalists' identities fall along a spectrum ranging from profession-centered to team-centered; (b) Familiarity is conducive to formation of team identity; (c) Co-creation of a shared vision and practice of creating shared mental models strengthens sense of team; (d) Institutional culture acts as both a facilitator for and barrier to formation of team identity; (e) High-functioning teams often epitomize the concept of "flexible leadership." We conclude that Social Identity Theory can be a useful theoretical lens for examining interprofessional teamwork in healthcare settings, including among pediatric hospitalists.

'It makes life worthwhile!' Peer mentoring in long-term care-a feasibility study

Objectives: Loneliness and depression are of increasing concern in long-term care homes made more urgent by viral outbreak isolation protocols. An innovative program called Java Mentorship was developed that engaged community volunteers and resident volunteers (mentors) as a team. The team met weekly, received education, and provided visits and guidance in pairs to socially disengaged residents (mentees). The purpose of this study was to assess the feasibility of conducting a larger study.Method: We conducted a mixed-methods pre-post study to evaluate the program. We collected feasibility data associated with the program implementation, including assessment of the sample and ability to recruit; procedures for data collection; retention, program adherence and acceptability; and residents' responses including loneliness, depression, purpose in life, social identity and sense of belonging outcomes. We enrolled community mentors (n = 65), resident mentors (n = 48) staff facilitators (n = 24) and mentees (n = 74) in 10 Canadian sites.Results: Most feasibility objectives were met, and adherence and acceptability were high. Some resource challenges and low retention rates among resident mentors were noted. We found a 29% reduction in depression scores (p = .048; d = .30) and 15% reduction in loneliness scores (p = .014; d = .23). Purpose in life, social identity and sense of belonging were unchanged. Interviews among participants indicated high acceptability and positive perceptions of the program.Conclusion: The study findings reveal a potential role for mentorship as a viable approach to reducing loneliness and depression in long-term care settings and lay the groundwork for future research.

From Identity to Enaction: Identity Behavior Theory

The article deals with the meaning of identity in action regulation. A strengths-based action model, Identity Behavior Theory (IBT), is concerned with the role that identity plays in the prediction of behavioral enaction, and implications for education, science, and clinical practice. With this respect the article explores and discusses how enacted behavior, including intention and action, depends on level of subscription to identity as well as on resilience and attitudes that are related to such a behavior. The article also illustrates fields of application of IBT, use of IBT with underrepresented and marginalized groups, and as an instrument for assessing and testing possible effects of resilience, attitudes, and identity on the enacted behavior. IBT is now used to examine behavior in a variety of educational contexts in the United States, and more studies are needed to satisfactorily validate application of the model empirically.

Emotion and cognition in personal and collective work-identity formation: variable- and person-oriented analyses

The aim of this study was to investigate emotional and cognitive processes involved in the formation of personal and collective work-identity by variable- and person-oriented analyses. A digitized questionnaire was answered by 768 participants. In line with an autobiographical (personal) memory view, we showed that: (1) emotional processes positively predicted cognitive processes (variable-oriented analyses), and (2) emotional profile had an effect on cognitive processes (person-oriented analyses), with regard to personal work-identity formation. Regarding collective work-identity formation, and in line with a social-identity and self-categorization perspective, we showed that: (1) cognitive processes positively predicted emotional processes (variable-oriented analyses), and (2) cognitive profile had an effect on emotional processes (person-oriented analyses). Our results indicate that emotion and cognition play different roles in personal- and collective work-identity formation; additionally, suggesting that the theoretical views of both personal and social psychology as well as analyses at different levels should be involved in order to gain a deeper understanding of the phenomenon of people-work bonding.

The role of the informal and formal organisation in voice about concerns in healthcare: A qualitative interview study

The importance of employee voice-speaking up and out about concerns-is widely recognised as fundamental to patient safety and quality of care. However, failures of voice continue to occur, often with disastrous consequences. In this article, we argue that the enduring sociological concepts of the informal organisation and formal organisation offer analytical purchase in understanding the causes of such problems and how they can be addressed. We report a qualitative study involving 165 interviews across three healthcare organisations in two high-income countries. Our analysis emphasises the interdependence of the formal and informal organisation. The formal organisation describes codified and formalised elements of structures, procedures and processes for the exercise of voice, but participants often found it frustrating, ambiguous, and poorly designed. The informal organisation-the informal practices, social connections, and methods for making decisions that are key to coordinating organisational activity-could facilitate voice through its capacity to help people to understand complex processes, make sense of their concerns, and frame them in ways likely to prompt an appropriate organisational response. Sometimes the informal organisation compensated for gaps, ambiguities and inconsistencies in formal policies and systems. At the same time, the informal organisation had a dark side, potentially subduing voice by creating informal hierarchies, prioritising social cohesion, and providing opportunities for retaliation. The formal and the informal organisation are not exclusive or independent: they interact with and mutually reinforce each other. Our findings have implications for efforts to improve culture and processes in relation to voice in healthcare organisations, pointing to the need to address deficits in the formal organisation, and to the potential of building on strengths in the informal organisation that are crucial in supporting voice.

ASIA: Automated Social Identity Assessment using linguistic style

The various group and category memberships that we hold are at the heart of who we are. They have been shown to affect our thoughts, emotions, behavior, and social relations in a variety of social contexts, and have more recently been linked to our mental and physical well-being. Questions remain, however, over the dynamics between different group memberships and the ways in which we cognitively and emotionally acquire these. In particular, current assessment methods are missing that can be applied to naturally occurring data, such as online interactions, to better understand the dynamics and impact of group memberships in naturalistic settings. To provide researchers with a method for assessing specific group memberships of interest, we have developed ASIA (Automated Social Identity Assessment), an analytical protocol that uses linguistic style indicators in text to infer which group membership is salient in a given moment, accompanied by an in-depth open-source Jupyter Notebook tutorial ( https://github.com/Identity-lab/Tutorial-on-salient-social-Identity-detection-model ). Here, we first discuss the challenges in the study of salient group memberships, and how ASIA can address some of these. We then demonstrate how our analytical protocol can be used to create a method for assessing which of two specific group memberships-parents and feminists-is salient using online forum data, and how the quality (validity) of the measurement and its interpretation can be tested using two further corpora as well as an experimental study. We conclude by discussing future developments in the field.

Managing intergroup silos to improve patient flow

BACKGROUND

Health care managers face the critical challenge of overcoming divisions among the many groups involved in patient care, a problem intensified when patients must flow across multiple settings. Surprisingly, however, the patient flow literature rarely engages with its intergroup dimension.

PURPOSE

This study explored how managers with responsibility for patient flow understand and approach intergroup divisions and "silo-ing" in health care.

METHODOLOGY/APPROACH

We conducted in-depth interviews with 300 purposively sampled senior, middle, and frontline managers across 10 Canadian health jurisdictions. We undertook thematic analysis using sensitizing concepts drawn from the social identity approach.

RESULTS

Silos, at multiple levels, were reported in every jurisdiction. The main strategies for ameliorating silos were provision of formal opportunities for staff collaboration, persuasive messages stressing shared values or responsibilities, and structural reorganization to redraw group boundaries. Participants emphasized the benefits of the first two but described structural change as neither necessary nor sufficient for improved collaboration.

CONCLUSION

Silos, though an unavoidable feature of organizational life, can be managed and mitigated. However, a key challenge in redefining groups is that the easiest place to draw boundaries from a social identity perspective may not be the best place from one of system design. Narrowly defined groups forge strong identities more easily, but broader groups facilitate coordination of care by minimizing the number of boundaries patients must traverse.

PRACTICE IMPLICATIONS

A thoughtfully designed combination of strategies may help to improve intergroup relations and their impact on flow. It may be ideal to foster a "mosaic" identity that affirms group allegiances at multiple levels.

Post-traumatic Growth Dimensions Differently Mediate the Relationship Between National Identity and Interpersonal Trust Among Young Adults: A Study on COVID-19 Crisis in Italy

BACKGROUND

In Italy, the COVID-19 pandemic has caused a collective trauma. Post-traumatic growth (PTG) has been defined as the subjective experience of positive psychological changes as a result of a traumatic event. PTG can involve changes in five psychological main dimensions: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. In the context of national emergencies, those PTG dimensions encompassing changes at the social level (e.g., relating to others) can play a role in coping strategies that involve a renewed sense of self and one's social identities, including national identities, and in turn, foster a stronger sense of trust and connection to others.

AIM

To investigate how each of the five PTG dimensions mediates the association between the salience of national identity and interpersonal trust in a sample of Italian young adults. Trust in national and European institutions were expected to positively predict the strength of the Italian national identity which in turn was expected to be positively associated with interpersonal trust, and the PTG relating to others dimension to mediate this association.

METHOD

This study involves the secondary analysis of data from a representative sample of 2,000 Italian young adults (age range 18-34 years). Participants completed a web survey during the peak of the COVID-19 crisis in Italy with measures of trust in EU and national institutions, national identity, interpersonal trust, and the PTG Inventory. Structural equation modeling procedures were employed for key hypotheses tests.

RESULTS

Trust in national institutions positively predicted national identity, which in turn was positively associated with interpersonal trust. Evidence of a full mediation effect of the PTG relating to others dimension on the association between national identity and interpersonal trust was found.

DISCUSSION

Findings contribute to clarify the psychological responses to collective traumas. In the context of Italy's COVID-19 crisis, trust in national institutions reinforced Italian national identity, which was in turn associated with greater interpersonal trust, but only when psychological responses to the trauma involved changes in how individuals perceived and related to others, and not merely a focus on the self. Theoretical and practical implications are discussed.

Predicting GP visits: A multinomial logistic regression investigating GP visits amongst a cohort of UK patients living with Myalgic encephalomyelitis

Background

Myalgic Encephalomyelitis (ME) is a chronic condition whose status within medicine is the subject of on-going debate. Some medical professionals regard it as a contentious illness. Others report a lack of confidence with diagnosis and management of the condition. The genesis of this paper was a complaint, made by an ME patient, about their treatment by a general practitioner. In response to the complaint, Healthwatch Trafford ran a patient experience-gathering project.

Method

Data was collected from 476 participants (411 women and 65 men), living with ME from across the UK. Multinomial logistic regression investigated the predictive utility of length of time with ME; geographic location (i.e. Manchester vs. rest of UK); trust in GP; whether the patient had received a formal diagnosis; time taken to diagnosis; and gender. The outcome variable was number of GP visits per year.

Results

All variables, with the exception of whether the patient had received a formal diagnosis, were significant predictors.

Conclusions

Relationships between ME patients and their GPs are discussed and argued to be key to the effective delivery of care to this patient cohort. Identifying potential barriers to doctor patient interactions in the context of ME is crucial.

Application of the Roy Adaptation Theory to a care program for nurses

Theory-guided nursing practice is foundational in providing the framework for the development of excellent nursing care. There is a need for effective care programs for nurses, whereby they are adequately supported within their workplace infrastructures as a professional group whose work is essential to the provision of healthcare worldwide. Likewise, there is a need for care programs for nurses to be theory-guided. In the current global pandemic climate, the well-being of nurses continues to become compromised evidenced by increasing moral distress, compassion fatigue, and burnout. Theory-based supportive programs are vital to the overall wellbeing, morale, and retention of nurses. The Roy Adaptation Theory may serve as a guide in the development and evaluation of a hospital-based program designed to support the needs of the healthcare team. This discussion will explore the application of the Roy Adaptation Theory-Group Identity Mode to the Tea for the Soul Care Model for nurses.

Group Membership and Social and Personal Identities as Psychosocial Coping Resources to Psychological Consequences of the COVID-19 Confinement

The confinement imposed by measures to deal with the COVID-19 pandemic may in the short and medium term have psychological and psychosocial consequences affecting the well-being and mental health of individuals. This study aims to explore the role played by group membership and social and personal identities as coping resources to face the experience of the COVID-19 confinement and radical disruption of social, work, family and personal life in a sample of 421 people who have experienced a month of strict confinement in the Region of Madrid. Our results show that identity-resources (membership continuity/new group memberships, and personal identity strength) are positively related to process-resources (social support and perceived personal control), and that both are related to better perceived mental health, lower levels of anxiety and depression, and higher well-being (life satisfaction and resilience) during confinement. These results, in addition to providing relevant information about the psychological consequences of this experience, constitute a solid basis for the design of psychosocial interventions based on group memberships and social identity as coping resources.

Risk-Taking That Signals Trust Increases Social Identification

Abstract. Social identification predicts many important phenomena; however, its determinants have received comparably little research attention. We argue that people are more likely to socially identify with others who engage in risky behavior that implies trust than with those who act cautiously, and test this in four experiments with over 900 participants. The experiments found support for the hypotheses across diverse risk contexts – specifically, risk of physical injury, disease risk, and financial risk. These findings indicate that others’ risk taking can strengthen shared psychological group membership.

Teachers' Personal and Collective Work-Identity Predicts Exhaustion and Work Motivation: Mediating Roles of Psychological Job Demands and Resources

The aim of this study was to investigate the mediating roles of teachers' psychological job demands and resources regarding personal and collective work-identity, respectively, and exhaustion and self-determined work motivation, respectively. A total of 2,905 members of a Swedish teacher's trade union received an online questionnaire by e-mail; 768 individuals answered the questionnaire and so participated in this study. The data were obtained by self-reported measures (e.g., emotional and cognitive components of work-identity, psychological job demands and resources, exhaustion and work motivation) and analyzed by mediation regression analyses. The results showed that teachers' psychological job demands (prosocial extra-role performance) mediated relationships between cognitive personal work-identity and emotional collective work-identity, respectively, and exhaustion. Teachers' psychological job resources (educational inspiration) mediated relationships between emotional personal work-identity and cognitive collective work-identity, respectively, and self-determined work motivation. Thus, teachers might be disadvantaged by stronger personal work-related thinking and collective work-related feeling when related to exhaustion, to some extent accounted for by psychological job demands, and they might find advantage in stronger personal work-related feeling and collective work-related thinking when related to work motivation, to some extent accounted for by psychological job resources.

A social identity perspective on COVID-19: Health risk is affected by shared group membership

In the face of a novel infectious disease, changing our collective behaviour is critical to saving lives. One determinant of risk perception and risk behaviour that is often overlooked is the degree to which we share psychological group membership with others. We outline, and summarize supporting evidence for, a theoretical model that articulates the role of shared group membership in attenuating health risk perception and increasing health risk behaviour. We emphasize the importance of attending to these processes in the context of the ongoing response to COVID‐19 and conclude with three recommendations for how group processes can be harnessed to improve this response.

Variation in academic preparation and progression of nurses across the continuum of care

BACKGROUND

Changing health care needs are driving new models of care that emphasize care coordination, health promotion, and disease management by registered nurses (RNs). A skill-mix favoring professional (baccalaureate or above) over technical (less than baccalaureate) education is promoted by national initiatives.

PURPOSE

To examine the academic preparation and progression of general practice RNs in practice settings across the care continuum.

METHOD

Secondary analyses of data from the Texas Board of Nurses RN Licensure databases in 2008 and 2014.

FINDINGS

Overall the professional skill-mix for general practice RNs improved from 47.1% to 50.2%. Disparities were identified in home health (31.6%), long-term care (27.8%) and nonmetropolitan areas (31.7%). Role change was the strongest correlate of academic progression.

DISCUSSION

Non-hospital and rural practice settings may be vulnerable to the effects of an undereducated RN workforce. More effective reimbursement policies and employer incentives are needed to drive academic progression and address disparities across practice settings.

Social psychological research on prejudice as collective action supporting emergent ingroup members

Why does social psychological research on prejudice change across time? We argue that scientific change is not simply a result of empirical evidence, technological developments, or social controversies, but rather emerges out of social change-driven shifts in how researchers categorize themselves and others within their larger societies. As mainstream researchers increasingly recategorize former outgroup members as part of a novel ingroup, prejudice research shifts in support of emergent ingroup members against their emergent outgroup opponents. Although social change-driven science results in valuable opportunities for researchers, it also results in significant risks for research - collective, scientific biases in the inclusion and exclusion of social groups in prejudice research that are not readily detected or managed by traditional controls. We present the Emergent Ingroup Model (EIM) to encourage reflection on shared biases, as well as to spark a broader conversation on how to strengthen our field for a rapidly changing and increasingly global world.

Team-level identification predicts perceived and actual team performance: Longitudinal multilevel analyses with sports teams

Social identification and team performance literatures typically focus on the relationship between individual differences in identification and individual-level performance. By using a longitudinal multilevel approach, involving 369 members of 45 sports teams across England and Italy, we compared how team-level and individual-level variance in social identification together predicted team and individual performance outcomes. As hypothesized, team-level variance in identification significantly predicted subsequent levels of both perceived and actual team performance in cross-lagged analyses. Conversely, individual-level variance in identification did not significantly predict subsequent levels of perceived individual performance. These findings support recent calls for social identity to be considered a multilevel construct and highlight the influence of group-level social identification on group-level processes and outcomes, over and above its individual-level effects.

Predicting general mental health and exhaustion: the role of emotion and cognition components of personal and collective work-identity

The aim of this study was to investigate relationships between emotion and cognition components of personal and collective work-identity and self-reported general mental health and exhaustion, in Swedish teachers (N = 768). In line with our predictions, we showed that the emotion component of personal work-identity and the cognition component of collective work-identity associated positively with general mental health and negatively with exhaustion. The reverse result was found, however, for the cognition component of personal work-identity and emotion component of collective work-identity. In general, all this indicates that person-work bonding might, to some degree, account for general mental health and exhaustion in employees. In particular, the findings suggest that general mental health and exhaustion may vary symmetrically across the: (1) Type of person-work bonding (personal vs. collective work-identity); and (2) Type of psychological component (emotion vs. cognition) involved in personal- and collective work-identity.

Am I Cut Out for This? Transitioning From Surgical Trainee to Attending

OBJECTIVE

Progressing from trainee to attending surgeon is arguably one of the most significant transitions in a surgeon's career. Despite this, little is known about this critical period. The purpose of this study was to develop a framework for understanding the phenomenon of the transition from trainee to attending surgeon.

DESIGN

A constructivist grounded theory methodology was used to explore the experience of new attending surgeons as they transition into practice. A purposeful sampling strategy was used to conduct 13 semistructured interviews with surgeons from various specialties. Data collection and analysis were performed simultaneously as part of the iterative process. Themes were identified and informed the development of the conceptual framework.

SETTING

The setting included 4 separate Canadian urban, academic health centers.

PARTICIPANTS

A total of 13 surgeons in their first 5 years of practice from 6 separate departments were included.

RESULTS

Participants described 4 phases that marked their transition from trainee to attending surgeon. In the initial phase (getting undressed), participants shared vivid moments where they realized they no longer fit their trainee identity, but did not yet belong to the attending group. An intense phase of vulnerability and self-doubt (exposed and vulnerable), which was associated with building a new reputation and identity, followed. In the next phase (suiting up), surgeons began to project the image associated with their new role to others. With the passage of time and accumulation of successful cases, participants began to internalize their new identity in the final phase (tailoring the fit).

CONCLUSIONS

The transition from trainee to attending surgeon is a critical time during which new surgeons experience an identity shift. The conceptual framework presented contributes to a deeper understanding of the experience of this transition in order to help new surgeons transition successfully into independent practice.

Social connectedness improves public mental health: Investigating bidirectional relationships in the New Zealand attitudes and values survey

BACKGROUND

The importance of social connectedness in supporting public mental health is well established. However, the reverse causal pathway (that psychological ill-health leads to reduced social connectedness) remains a dominant perspective among mental health practitioners. Our analysis aimed to provide a rigorous test of the directionality of this relationship.

METHOD

A cross-lagged panel analysis of a large longitudinal national probability sample ( N ≈ 21,227), the New Zealand Attitudes and Values Survey, was used to assess the bidirectional longitudinal relationship between social connectedness and mental health, controlling for baseline levels of both variables and demographics.

RESULTS

Social connectedness was found to be a stronger and more consistent predictor of mental health year-on-year than mental health was of social connectedness.

CONCLUSION

These results further demonstrate how the psychological resources conferred by social connectedness can act as a 'social cure' for psychological ill-health, and provide the strongest evidence to date for the direction of this relationship in the general community.

An intervention for pulmonary rehabilitators to develop a social identity for patients attending exercise rehabilitation: a feasibility and pilot randomised control trial protocol

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a degenerative condition that can impair health-related quality of life (HRQoL). A number of self-management interventions, employing a variety of behavioural change techniques (BCTs), have been adopted to improve HRQoL for COPD patients. However, a lack of attention has been given to group management interventions with an emphasis on incorporating BCTs into rehabilitators' practice. This study aims to pilot and feasibly explore a social identity group management intervention, delivered by COPD rehabilitation staff to patients attending exercise pulmonary rehabilitation. Doing so will help inform the plausibility of the intervention before conducting a full trial to evaluate its effectiveness to improve HRQoL.

METHODS

This is a two-centre, randomised cross-over controlled trial. Two pulmonary rehabilitation centres based in the UK will be randomly allocated to two treatment arms (standard care and intervention). Outcome measurements relating to HRQoL and social identity will be completed pre- and post-exercise rehabilitation. Focus group interviews will be conducted at the end of exercise rehabilitation to capture participants' contextualised experiences of the intervention. COPD rehabilitators will undertake semi-structured interviews at the end of the trial to garner their holistic perspectives of intervention fidelity and implementation.

DISCUSSION

This is the first study to adopt a social identity approach to develop a rehabilitator-led, group management intervention for COPD patients attending exercise pulmonary rehabilitation. The results of this study will provide evidence for the feasibility and sample size requirements to inform a larger study, which can ascertain the intervention's effectiveness for improving HRQoL for COPD patients.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02288039. Date 31 October 2014.

Post-traumatic Stress Disorder Symptoms Among People Living with HIV/AIDS in Rural China

Among people living with HIV/AIDS (PLHA), the occurrence of post-traumatic stress disorder (PTSD) symptoms associated with HIV diagnosis is a common problem. This study examined HIV diagnosis-related PTSD symptoms and its associated factors among PLHA in rural China. We used baseline data from a randomized controlled trial conducted in Anhui Province, China. Surveys of 522 PLHA were conducted via computer-assisted personal interview method. PTSD symptoms were measured based on re-experiencing, avoidance and arousal of the day of HIV diagnosis. Association between PTSD symptoms and demographic characteristics, physical and social functioning were assessed by multiple regression analysis and structural equation modeling. Social functioning exhibited a direct association with HIV diagnosis-related PTSD symptoms, and also mediated the association between PTSD symptoms and age, family income, and physical functioning. The study findings underscore the importance of developing interventions that alleviate PTSD symptoms and improve social functioning among PLHA in rural China.

A Social Identity Approach to Leadership Development

Abstract. Social identity research shows that leadership is a process of group identity development but has not examined how leaders can manage group identities in the workplace. The 5R leadership development program addresses this issue. This takes leaders through a five-stage process of (1) Readying: explaining the importance of social identity processes for leadership; (2) Reflecting: identifying important workplace social identities; (3) Representing: clarifying goals and aspirations associated with different subgroup identities; (4) Realizing: identifying superordinate goals and developing strategies to achieve both them and subgroup goals; and (5) Reporting: assessing progress toward goals. Results of a longitudinal study indicate that 5R is a useful framework for leadership development that translates insights from social identity theorizing into structured intervention.

A Longitudinal Study of Relationships between Identity Continuity and Anxiety Following Brain Injury

Objective: Anxiety is of particular importance following acquired brain injury (ABI), because anxiety has been identified as a significant predictor of functional outcomes. Continuity of self has been linked to post ABI adjustment and research has linked self-discrepancy to anxiety. This longitudinal study investigates the impact of affiliative and ‘self as doer’ self-categorisations anxiety.

Materials and Methods: Data was collected at two time points. Fifty-three adult ABI survivors participating in post-acute community neuro-rehabilitation participated at time one and 32 of these participated at time two. Participants completed a 28-item identity questionnaire based on Leach et al.’s (2008) multicomponent model of ingroup identification which measured the strength of affiliative and self as doer identities. Anxiety was measured using the Hospital Anxiety and Depression Scale.

Results: Analysis indicates a significant mediated relationship between affiliative identification and anxiety via self as doer identification. Contrary to initial prediction, this relationship was significant for those with consistency in affiliative self-categorisation and inconsistency in ‘self as doer’ self-categorisation.

Conclusion: These findings can be interpreted as evidencing the importance of identity continuity and multiplicity following ABI and contribute to the understanding of these through the use of a social identity approach.

GPs, nurses and pharmacists as prescribers in primary care: an exploration using the social identity approach / Hausärzte/-innen, Diplomierte Pflegefachpersonen und Apotheker/-innen als Arzneimittelverschreiber/-innen: eine Exploration mit dem Ansatz der Sozialen Identität

The social identity approach was used to explore the inter-professional relations between nurse prescribers, pharmacist prescribers and general practitioners (GPs) in primary care in the United Kingdom. We investigated their social identities as prescribers, the influence of social structure in practice settings and the implications for further development of nurse and pharmacist prescribing. Interviews were conducted with 21 GPs, nurse prescribers and pharmacist prescribers in primary care from the south of England. Five themes emerged, including the ambiguous social identity of some nurse and pharmacist prescribers (‘a no man’s land’), constraining social structures (‘the doctor is king’), the content of GPs’ social identity (‘subtle prescribing’), the content of nurse and pharmacists’ social identity (‘more than just competent’) and context (‘engaging with each other’s identities’). At some GP practices, there was a willingness to engage with the different social identities and reframe them within the organisational context of a GP surgery. At these sites, where social identities were respected and supported, the social identity approach offered insight into how the resulting teamwork could lead to a shared practice identity focused on multi-disciplinary working. This research provides evidence of how professional and organisational identities can be enhanced and supported. Further, there is the potential for an intervention using the social identity approach to improve patient care.

Social Identity Mapping: A procedure for visual representation and assessment of subjective multiple group memberships

In this research, we introduce Social Identity Mapping (SIM) as a method for visually representing and assessing a person's subjective network of group memberships. To provide evidence of its utility, we report validating data from three studies (two longitudinal), involving student, community, and clinical samples, together comprising over 400 participants. Results indicate that SIM is easy to use, internally consistent, with good convergent and discriminant validity. Each study also illustrates the ways that SIM can be used to address a range of novel research questions. Study 1 shows that multiple positive group memberships are a particularly powerful predictor of well-being. Study 2 shows that social support is primarily given and received within social groups and that only in-group support is beneficial for well-being. Study 3 shows that improved mental health following a social group intervention is attributable to an increase in group compatibility. In this way, the studies demonstrate the capacity for SIM to make a contribution both to the development of social-psychological theory and to its practical application.

A Meta-Analytic Review of Social Identification and Health in Organizational Contexts

We provide a meta-analytical review examining two decades of work on the relationship between individuals’ social identifications and health in organizations (102 effect sizes, k = 58, N = 19,799). Results reveal a mean-weighted positive association between organizational identification and health ( r = .21, T = .14). Analysis identified a positive relationship for both workgroup ( r = .21) and organizational identification ( r = .21), and in studies using longitudinal/experimental ( r = .13) and cross-sectional designs ( r = .22). The relationship is stronger (a) for indicators of the presence of well-being ( r = .27) than absence of stress ( r = .18), (b) for psychological ( r = .23) than physical health ( r = .16), (c) to the extent that identification is shared among group members, and (d) as the proportion of female participants in a sample decreases. Overall, results indicate that social identifications in organizations are positively associated with health but that there is also substantial variation in effect size strength. We discuss implications for theory and practice and outline a roadmap for future research.

Spaces That Signal Identity Improve Workplace Productivity

Abstract. The physical spaces we inhabit have a profound impact on psychological functioning. People generally experience positive outcomes in spaces that support important identities and negative outcomes in spaces that threaten those identities. We investigated the effects of working in an ingroup or outgroup space on organizational performance. Participants completed exercises in a simulated work environment as a member of a research education development (RED) work team. The office space was designed to be identity affirming (decorated by a RED team), identity threatening (decorated by a rival business legacy usability and engineering [BLUE] team), or undecorated. Work teams performed better in both ingroup spaces and outgroup spaces than in undecorated spaces. The findings highlight the importance of considering the impact of physical space on psychological functioning in the workplace and beyond.