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Stein M, Perry B, Levit I. Punishing "Privilege": Antisemitic Hate Crime in Canada. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:3876-3903. [PMID: 39119653 DOI: 10.1177/08862605241259996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Both federal government and civil society organization data point to consistently rising incidents of antisemitic narratives and acts across Canada. In spite of this, antisemitic hate crime has not been the focus of any academic research here, some would argue because Jews are not typically thought to be an at-risk community. Rather, the Jewish community is thought to occupy a relatively privileged place in society which shields them from bias motivated attacks. Countering this narrative, our study, based in Ontario and Quebec, reveals that Jewish individuals and institutions are highly vulnerable to discursive, physical, and property violations. Many of those we spoke with felt embattled by the narrative attacks that rendered the community vulnerable to corollary physical attacks. Of particular significance are the enabling images of Jews that equate "Jewish privilege" with excessive power and control. We explore these themes, concluding with calls for strategies intended to counter hateful narratives.
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Affiliation(s)
- Matthew Stein
- Ontario Tech University, Oshawa, ON, Canada
- Centennial College, Toronto, ON, Canada
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2
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Francis A, Le A, Adams-Leask K, Procter N. Utilising co-design to develop a lived experience informed personal safety tool within a mental health community rehabilitation setting. Aust Occup Ther J 2024. [PMID: 39129440 DOI: 10.1111/1440-1630.12988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION Mental health personal safety tools aim to promote a recovery focus and empower an individualised approach to consumer care. These clinical tools are predominantly utilised in acute mental health settings with a person during or straight after a crisis. There is currently a gap in the literature regarding the preparation of personal safety tools in non-acute mental health settings. This descriptive article discusses the learnings and outcomes from a co-designed project that aimed to develop a personal safety tool suitable for a community mental health rehabilitation setting. METHODS Seven people with lived experience engaging within a mental health community-based rehabilitation service were recruited through convenience sampling to participate in the co-design project. A focus group approach was utilised during four group meetings to develop a personal safety tool template. Experiences and ideas about safety planning were transcribed during meetings and thematic analysis extracted key themes. Five steps underpinned the co-design process that included identifying the need, establishing the co-design group, planning, design and development, and review and closure. CONSUMER AND COMMUNITY INVOLVEMENT Consumer involvement commenced at step two of the co-design process. The completed personal safety tool was designed with consumer input and review. FINDINGS The personal safety tool consisted of nine intervention components. Four key themes emerged from focus group meetings that informed the content of the tool: (i) ensuring the personal safety tool is individualised and meaningful, (ii) promoting exploration of personal strengths and interests, (iii) enabling opportunities to learn self-management skills, and (iv) treating the personal safety tool as a dynamic and adaptable tool. CONCLUSION Findings suggest that a personal safety tool targeted to a mental health community-based rehabilitation setting should have an individualised and preventative focus to mental health care. Embedding co-design principles can support opportunities for meaningful consumer engagement and establishing consumer and clinician partnerships.
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Affiliation(s)
- Anna Francis
- SA Health, Central Adelaide Local Health Network, Mental Health Clinical Program, Adelaide, South Australia, Australia
| | - Amily Le
- SA Health, Central Adelaide Local Health Network, Mental Health Clinical Program, Adelaide, South Australia, Australia
| | - Karen Adams-Leask
- SA Health, Central Adelaide Local Health Network, Mental Health Clinical Program, Adelaide, South Australia, Australia
| | - Nicholas Procter
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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3
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Wijayaratnam A, Kozlowska O, Krayem A, Kaur S, Ayres H, Smith R, Paterson J, Moghabghab R, Henshall C. Nurses' experiences of racism in mental health settings through patient and family interactions: A systematic review. Int J Ment Health Nurs 2024; 33:834-858. [PMID: 38519874 DOI: 10.1111/inm.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 02/17/2024] [Accepted: 02/26/2024] [Indexed: 03/25/2024]
Abstract
Nursing staff engage readily with patients and associates in mental health/forensic inpatient settings. These settings are known to have instances of workplace violence directed towards staff and such violence includes racism. Racism is a form of workplace violence that must be better understood and supported within this complex setting. Completing a systematic review to coalesce preexisting research and suggested interventions can be beneficial to supporting nurses. Systematic review following PRISMA guidelines. CINAHL, PsycInfo, Medline, British Nursing Database and Web of Science databases were searched. Reviewers screened the papers for inclusion (29 articles out of 7146 were selected for inclusion) and completed the quality appraisal using the Mixed Methods Appraisal Tool. Subsequently, data extraction was completed, and findings were summarised through narrative synthesis. The way racism was conceptualised impacted how data was collected, reported and interpreted; racism was silenced or exposed depending on how studies were undertaken. If exposed, evidence indicates racism is a problem but is not always acknowledged or acted upon. Some evidence determined racism led to negative work-related outcomes. The literature provided limited examples of interventions. These included changing education/orientation for staff, openly discussing racist events and better planning for patients among colleagues and management. Increasing diversity within the workforce requires more research exploring and addressing issues related to racism towards nurses. Narratives of racism being normalised and embedded in mental health/forensic settings need to be challenged.
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Affiliation(s)
| | | | | | - Satinder Kaur
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Helen Ayres
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Jane Paterson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rola Moghabghab
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Cathy Henshall
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Oxford Brookes University, Oxford, UK
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4
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Diab JL, Al-Azzeh D. Inclusive inquiry: a compassionate journey in trauma-informed qualitative research with GBV survivors from displaced communities. Front Psychol 2024; 15:1399115. [PMID: 39118846 PMCID: PMC11307779 DOI: 10.3389/fpsyg.2024.1399115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/01/2024] [Indexed: 08/10/2024] Open
Abstract
The integration of trauma-informed and ethical frameworks in qualitative research concerning survivors of gender-based violence (GBV) within displaced communities is critical. These individuals often bear the weight of traumatic experiences compounded by displacement and associated hardships. Adopting a trauma-informed approach establishes a safe environment, prioritizing survivors' well-being and respecting their agency and narratives, thereby fostering trust and reducing re-traumatization risks. Ethical considerations ensure the dignity, rights, and cultural sensitivities of participants are upheld, contributing to rigorous and humane research. This integration amplifies survivors' voices and experiences, enhancing understanding and empathy. Trauma-informed approaches acknowledge the likelihood of trauma in individuals' lives and prioritize safety without aiming to treat symptoms. Proficient interviewing skills aim to improve comfort, safety, and recall without avoiding challenging questions. Integration of trauma-informed principles across all interview phases is crucial, particularly for individuals experiencing various traumas simultaneously, such as displacement, violence, and ongoing conflict. Drawing from the authors' experiences and existing literature, this paper advocates for a compassionate and empowering shift in qualitative research methodologies to better engage with survivors of trauma and GBV within displaced communities.
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Affiliation(s)
- Jasmin Lilian Diab
- School of Arts and Sciences, Institute for Migration Studies, Lebanese American University, Beirut, Lebanon
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Dana Al-Azzeh
- School of Arts and Sciences, Institute for Migration Studies, Lebanese American University, Beirut, Lebanon
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Berring LL, Holm T, Hansen JP, Delcomyn CL, Søndergaard R, Hvidhjelm J. Implementing Trauma-Informed Care-Settings, Definitions, Interventions, Measures, and Implementation across Settings: A Scoping Review. Healthcare (Basel) 2024; 12:908. [PMID: 38727465 PMCID: PMC11083630 DOI: 10.3390/healthcare12090908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/16/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Traumatic experiences can have long-lasting negative effects on individuals, organizations, and societies. If trauma is not addressed, it can create unsafe cultures with constant arousal, untrusting relationships, and the use of coercive measures. Trauma-informed care (TIC) can play a central role in mitigating these negative consequences, but it is unknown how and in which way(s) TIC should be implemented. Our objective was to conduct a scoping review that systematically explored and mapped research conducted in this area and to identify existing knowledge about the implementation of TIC. The search was conducted on the CINAHL, Cochrane, Embase, ERIC, Medline, PsycINFO, and Web of Science databases, and more than 3000 empirical papers, published between 2000 and 2022, were identified. Following further screening, we included 157 papers in our review, which were mainly from the USA, Australia, New Zealand, and Canada, focusing on study settings, methodologies, and definitions of TIC, as well as the types of interventions and measures used. This review shows that TIC is a complex and multifaceted framework, with no overarching structure or clear theoretical underpinnings that can guide practical implementations. TIC has been defined and adapted in varied ways across different settings and populations, making it difficult to synthesize knowledge. A higher level of agreement on how to operationalize and implement TIC in international research could be important in order to better examine its impact and broaden the approach.
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Affiliation(s)
- Lene Lauge Berring
- Psychiatric Research Unit, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark; (C.L.D.); (R.S.)
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
| | - Tine Holm
- Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus, Denmark;
| | - Jens Peter Hansen
- Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
- Retspsykiatrisk Forskningsenhed, Østre Hougvej 70, 5500 Middelfart, Denmark
| | - Christian Lie Delcomyn
- Psychiatric Research Unit, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark; (C.L.D.); (R.S.)
- Department for Forensic Psychiatry, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark
| | - Rikke Søndergaard
- Psychiatric Research Unit, Region Zealand Psychiatry, Faelledvej 6, 4200 Slagelse, Denmark; (C.L.D.); (R.S.)
| | - Jacob Hvidhjelm
- Clinical Mental Health and Nursing Research Unit, Mental Health Center Sct Hans, Copenhagen University Hospital—Mental Health Services CPH, 2400 Copenhagen, Denmark;
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Tuakli-Wosornu YA, Galea NR, Forsdike K, MacLeod JG. Methodological and ethical limitations of interpersonal violence research in Sports and Exercise Medicine: advancing an athlete-centred approach. Br J Sports Med 2023; 57:1537-1538. [PMID: 37286309 DOI: 10.1136/bjsports-2023-106754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Yetsa A Tuakli-Wosornu
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Natalie R Galea
- Faculty of Architecture, Building and Planning, University of Melbourne (AUS), Melbourne, Victoria, Australia
| | - Kirsty Forsdike
- La Trobe Business School, La Trobe University (AUS), Melbourne, Victoria, Australia
| | - Jelena G MacLeod
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
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Camacho D, Bhattacharya A, Moore K, Aranda MP, Lukens EP. Employment of trauma informed principles in the Palabras Fuertes project: Implications for narrative research with older Latinx communities. METHODOLOGICAL INNOVATIONS 2023; 16:359-373. [PMID: 38469125 PMCID: PMC10927001 DOI: 10.1177/20597991231202866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
In the US, there is a growing number of older Latinx communities. Qualitative approaches such as narrative inquiry may be fruitful endeavors to elucidate their lived experiences. However, older Latinx communities, including sexual minorities, are disproportionately exposed to social, health, and historical challenges that may result in exposure to potentially traumatic events (e.g. discrimination, illness, grief, etc.). The recognition of high rates of exposure to potentially traumatic events among participants has led to the recommended adoption of Trauma Informed (TI) principles for use in non-trauma specific research. At present, there are limited examples and discussions about the implementation of TI principles in qualitative research and our literature review yielded no discussion of the use of TI principles in narrative inquiry or with older Latinx communities. In this manuscript, we advocate for the adoption of TI principles when engaging in narrative inquiry with older Latinx adults. Second, we discuss examples of TI guided practices we employed while conducting the Palabras Fuertes study of life history narratives with older Latino immigrant gay men living in New York City. Finally, based on these experiences, we provide recommendations for incorporating TI into future narrative research with older Latinx communities.
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Affiliation(s)
- David Camacho
- Department of Disability and Human Development, University of Illinois Chicago, Chicago, IL, USA
| | - Anindita Bhattacharya
- School of Social Work & Criminal Justice, University of Washington Tacoma, Tacoma, WA, USA
| | - Kiara Moore
- Silver School of Social Work, New York University, New York, NY, USA
| | - Maria P Aranda
- USC Suzanne Dworak-Peck School of Social Work, Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
| | - Ellen P Lukens
- School of Social Work, Columbia University, New York, NY, USA
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Lamarche L, Scallan E, Mak O, Howden J, Bodkin C, Nussey L, Wolf K, Ans J, Delottinville D, O'Shea T, Lennox R. "They forgot about us": experiences of the COVID-19 pandemic among people deprived of housing in an urban centre in Ontario, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:796-805. [PMID: 37526915 PMCID: PMC10485215 DOI: 10.17269/s41997-023-00793-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/29/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES People deprived of housing have been disproportionately affected by the COVID-19 pandemic and the public health mitigation measures implemented in response. Emerging evidence has shown the adverse health outcomes experienced by these communities due to SARS-CoV-2 infection; however, the voices of community members themselves have not been widely amplified in the published literature. METHODS We conducted an interpretive qualitative study. People deprived of housing were involved in study development, recruitment, and data analysis. People deprived of housing or precariously housed were recruited during street outreach from June to July 2020. Participants completed one-on-one semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically. RESULTS Twenty-one participants were interviewed. Central to participants' experiences of the COVID-19 pandemic were descriptions of access to services, in terms of both changes in service availability and the reality of how accessible existing services were to the community, represented by the theme access. Four other themes were generated from our analysis and include feeling and being unheard, stripped of dignity, I've been broken, and strength and survival (with a subtheme, community care). CONCLUSION Future emergency response efforts must meaningfully engage people deprived of housing in planning and decision-making in order to minimize adverse impacts of health emergencies and the associated public health responses. There needs to be more careful consideration of the unintended harmful impacts of public health measures implemented in response to pandemics.
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Affiliation(s)
- Larkin Lamarche
- Department of Family Medicine, David Braley Health Sciences Centre, Hamilton, ON, Canada.
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - Eilish Scallan
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Orianna Mak
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jillian Howden
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Claire Bodkin
- Department of Family Medicine, David Braley Health Sciences Centre, Hamilton, ON, Canada
- Hamilton Social Medicine Response Team (HAMSMaRT), Hamilton, ON, Canada
| | - Lisa Nussey
- Hamilton Social Medicine Response Team (HAMSMaRT), Hamilton, ON, Canada
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada
| | | | - Jody Ans
- Keeping Six, Hamilton, ON, Canada
| | | | - Tim O'Shea
- Hamilton Social Medicine Response Team (HAMSMaRT), Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Robin Lennox
- Department of Family Medicine, David Braley Health Sciences Centre, Hamilton, ON, Canada
- Hamilton Social Medicine Response Team (HAMSMaRT), Hamilton, ON, Canada
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Ford JL, Slesnick N, Kelleher K, Brakenhoff B, Chavez L, Feng X, Mallory A, Moore L, O'Connor R, Pinkus L, Sullenbarger B, Yilmazer T, Zavarella H. Hair Collection for Cortisol Among Youth Experiencing Homelessness. Nurs Res 2023; 72:371-376. [PMID: 37625179 PMCID: PMC10662939 DOI: 10.1097/nnr.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Investigations of chronic physiological stress measured by hair cortisol are rapidly expanding among community samples of adolescents and adults. However, research examining physiological stress among youth experiencing homelessness is nascent despite the youth's increased risk for adverse exposures and subsequent impaired mental health. OBJECTIVE This article aimed to examine the feasibility of collecting hair for measuring cortisol among diverse youth experiencing homelessness and gain an understanding of variation in participation. METHODS Analysis of survey and hair participation data from three pilot studies among youth experiencing homelessness was conducted. Survey measures included sociodemographic characteristics (age, race and ethnicity, sex assigned at birth, and sexual orientation) and reasons for nonparticipation. Descriptive analysis examined participation rates in hair collection for cortisol measurement, including sociodemographic differences in participation. RESULTS Participation in the hair sampling for cortisol was high for the combined sample (88.4%), with some variation across the three pilot studies. Insufficient hair for cutting was the most common reason for not participating; Black and multiracial youth, as well as male youth, had a higher prevalence of nonparticipation. DISCUSSION The collection of hair for cortisol research among youth experiencing homelessness is feasible, and integration of physiological measures of stress into research with this vulnerable population should be considered, given their high risk for adversity and death by suicide and drug overdose. Methodological considerations and avenues for potential research are discussed.
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Henderson Z, Kia-Keating M, Woods-Jaeger B. Reimagining traumatic stress studies as a participatory science grounded in critical self-reflection: A call to action. J Trauma Stress 2023; 36:665-667. [PMID: 37428643 DOI: 10.1002/jts.22952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/29/2023] [Accepted: 04/17/2023] [Indexed: 07/12/2023]
Abstract
Recognizing the need for a transformative shift to advance scholarship and practice focused on traumatic stress, this paper emerged from a special invited panel at the 38th Annual Meeting of the International Society for Traumatic Stress Studies (ISTSS). The panel brought together scholars from interdisciplinary backgrounds, including psychology, public health, and social work, to share their unique perspectives and experiences harnessing a collaborative, critical, and strengths-based lens in research. This piece invites the field to consider the importance of cultural humility as a foundational, nonnegotiable practice in traumatic stress studies. Details about participatory science and healing-centered practice are presented along with key questions to support the application of these frameworks in studies of traumatic stress.
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Affiliation(s)
- Zuleka Henderson
- Center for Black WellBEing, LLC, New York, New York, United States
| | - Maryam Kia-Keating
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, Santa Barbara, California, USA
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Thompson HG, Askelson NM, Bucklin R, Gauthreaux N, Faber E, Ball C, Yang S, Steere E. Organization-Level Factors Associated With Burnout: Guided Discussions With Micropolitan Public Health Workers During COVID-19. J Occup Environ Med 2023; 65:580-583. [PMID: 36893056 PMCID: PMC10329979 DOI: 10.1097/jom.0000000000002837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVE To understand how micropolitan public health workers (PHWs) experienced burnout antecedents during the COVID-19 pandemic. METHODS We conducted in-depth guided discussions with 34 representatives from 16 micropolitan public health departments using semistructured, open-ended questions about departments' experiences during the COVID-19 pandemic. We coded discussion transcripts to develop themes according to the Six Areas of Worklife model. RESULTS PHWs described antecedents of burnout that stemmed from organizational and external forces, most notably within the workload, control, reward, and values dimensions of the Six Areas of Worklife model, as well as instances of workplace violence. CONCLUSIONS Our findings support organization-level approaches to reducing and preventing burnout in the micropolitan public health workforce. We discuss addressing specific dimensions of the Six Areas of Worklife model when designing burnout solutions for this essential workforce.
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Winterstein TB, Avieli H, Gichaz M. Recovering the Lost Soul: Older Women's Reflections on Past Intrafamilial Child Sexual Abuse. QUALITATIVE HEALTH RESEARCH 2023; 33:426-439. [PMID: 36882288 DOI: 10.1177/10497323231159802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.
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Affiliation(s)
| | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
| | - Mili Gichaz
- Department of Gerontogy, University of Haifa, Ariel, Israel
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13
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Carra K, Curtin M, Fortune T, Gordon B. Rural former service members participate in meaningful occupations to 'fill the void' after military service. Aust Occup Ther J 2023. [PMID: 36682383 DOI: 10.1111/1440-1630.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Over 50% of former service members report debilitating health conditions and difficulty adjusting to civilian life. Former service members living in rural areas are even more likely to experience poor health outcomes and have decreased access to specialist health-care services. Participation in meaningful occupations can support health and adjustment after military service. However, little is known about rural former service members' perspectives and experiences of participating in occupations after separating from military service. This study explored rural former service members' experiences of participating in occupations during their transition and their perceptions of how these experiences influenced their health and adjustment. METHODS Purposive sampling was used to recruit 10 rural former Australian Defence Force members discharged from service between 1 July 2013 and 1 July 2018. Former service members participated in a series of semi-structured interviews. Interpretative phenomenological analysis was used to determine themes for individual participants and then overarching themes that characterised the experiences of the group. FINDINGS A single overarching theme, 'It can't all be for nothing': Searching for ways to fill 'the void' through meaningful occupational participation, reflected rural former service members' experiences. The different ways that participants sought to fill 'the void' after military service were interpreted through two sub-themes: (1) 'You can't heal if you're still in a battlefield': Participating in occupations to re-establish safety and wellbeing, and (2) 'I was in a uniform and I could still do well': Participating in occupations to reconnect with self and continue the mission to serve. CONCLUSION Rural former service members participated in various occupations to establish safety, wellbeing, and reconnection after transitioning from military service. The findings point to the need for further research to inform the development of consumer-led occupation-based interventions that are sensitive to individuals' service history, environmental context, and trauma recovery needs.
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Affiliation(s)
- Kylie Carra
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Michael Curtin
- School of Community Health, Charles Sturt University, Albury, New South Wales, Australia
| | - Tracy Fortune
- Occupational Therapy, Social Work and Social Policy, La Trobe University, Bundoora, Victoria, Australia
| | - Brett Gordon
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Edelman NL. Trauma and resilience informed research principles and practice: A framework to improve the inclusion and experience of disadvantaged populations in health and social care research. J Health Serv Res Policy 2023; 28:66-75. [PMID: 36326603 PMCID: PMC9850377 DOI: 10.1177/13558196221124740] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Trauma, socio-economic, cultural and structural issues are associated with poor outcomes for most health conditions and may also make research participation difficult and onerous, perpetuating intervention-generated inequalities by generating evidence from those least in need. Trauma-informed and resilience-informed approaches to care may help address these concerns across health and social care research. These approaches take an empowerment-based response to adversity, and are suitable for integration and extension as Trauma and Resilience Informed Research Principles and Practice (TRIRPP) for studies beyond the topics of resilience and trauma. Four TRIRPP aims were identified: addressing the adversity context that may underpin the lives of research participants and the phenomenon under study; improving study accessibility and acceptability for individuals and populations facing adversity; recognising and addressing traumatisation in potential participants; and recognising and promoting resilience. Recommendations include interview participant control of recording devices, over-sampling of under-represented populations in population surveys, and actively seeking to engage disenfranchised individuals in patient and public involvement from design to dissemination. The practice of research has the power to address adversity and trauma or to perpetuate it at both an individual and a societal level. It is feasible and worthwhile to integrate trauma-informed and resilience-informed approaches across research topics and designs. Further work should extend the TRIRPP recommendations and evaluate their use.
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Affiliation(s)
- Natalie L Edelman
- Principal Research Fellow in
Applied Sexual & Reproductive Health, School of Sport & Health Sciences,
University
of Brighton, UK,Honorary Research Fellow,
Department of Primary Care & Public Health, Brighton & Sussex Medical
School, UK,Natalie L Edelman, University of Brighton,
Westlain House, Village Way, Brighton BN2 4AT, UK.
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Bradfield O, Jenkins K, Spittal M, Bismark M. Australian and New Zealand doctors' experiences of disciplinary notifications, investigations, proceedings and interventions relating to alleged mental health impairment: a qualitative analysis of interviews. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 86:101857. [PMID: 36571923 DOI: 10.1016/j.ijlp.2022.101857] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
When poor mental health impairs a doctor's ability to safely practise medicine, poor patient outcomes can result. Medical regulators play a critical role in protecting the public from impaired doctors, by requiring monitoring and treatment. However, regulatory processes may paradoxically harm doctors, with potential adverse implications for the community. There is little prior research examining the experiences of doctors with prior mental health or substance use challenges who are subject to regulatory notifications and processes relating to their health. Therefore, we explored this issue through the thematic analysis of semi-structured qualitative interviews. Participants reported that mandated treatment improved aspects of their health, but that fear of regulatory processes delayed them seeking treatment. Participants recognised being significantly unwell at the time of regulatory notification. Participants told us that regulatory processes triggered psychological distress, symptom relapse, and adverse financial and vocational implications. They also told us that these processes eroded their trust in regulators and regulatory processes. To improve health outcomes for unwell doctors and to create safer healthcare for the community, we propose: 1) greater awareness and education of the medical profession about the thresholds and requirements for mandatory reporting of health impairment; 2) better integrating specialised doctors' health services into existing regulatory pathways; and 3) adoption of a more therapeutic approach to regulation by medical regulators.
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Affiliation(s)
- Owen Bradfield
- Law and Public Health Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, VIC 3010, Australia.
| | - Kym Jenkins
- Consultant Psychiatrist Cabrini Hospital Melbourne, Past President of the Royal Australian and New Zealand College of Psychiatrists, Past Medical Director Victorian Doctors' Health Program, Australia
| | - Matthew Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Marie Bismark
- Law and Public Health Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Australia
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