1
|
Miller CR, Pharris AB, Hellman CM, Swann J. A model of hope as a protective measure to lower burnout and secondary traumatic stress among employees working in developmental and intellectual disabilities services. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13184. [PMID: 38361380 DOI: 10.1111/jar.13184] [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] [Received: 04/04/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Burnout and secondary traumatic stress (STS) are problems for the workforce supporting people with developmental disabilities. This study investigated hope as a potential protective resource for burnout and STS among the developmental disability services workforce. METHOD One hundred and fifty-two non-supervisor caseworkers from a state agency, developmental disabilities division were recruited to participate in an anonymous web-based survey. RESULTS The analyses showed that hope was negatively associated with the three dimensions of STS (intrusion, avoidance, and arousal) and burnout. Controlling for tenure in the workforce and STS, the results of the hierarchical regression analyses showed that hope accounted for a significant incremental variance to burnout. CONCLUSION These findings provide support for emerging literature showing hope as a protective resource to workforce burnout.
Collapse
Affiliation(s)
- Christina R Miller
- Anne & Henry Zarrow School of Social Work, University of Oklahoma, Norman, Oklahoma, USA
| | - Angela B Pharris
- Anne & Henry Zarrow School of Social Work, University of Oklahoma, Norman, Oklahoma, USA
- Hope Research Center, University of Oklahoma, Tulsa, Oklahoma, USA
| | - Chan M Hellman
- Hope Research Center, University of Oklahoma, Tulsa, Oklahoma, USA
- Anne & Henry Zarrow School of Social Work, University of Oklahoma, Tulsa, Oklahoma, USA
| | - Joshua Swann
- Anne & Henry Zarrow School of Social Work, University of Oklahoma, Norman, Oklahoma, USA
| |
Collapse
|
2
|
Boamah DA, Barbee AP. Prevalence of Secondary Traumatic Stress Among Direct Support Professionals in Intellectual and Developmental Disabilities Field. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:273-287. [PMID: 35868303 DOI: 10.1352/1934-9556-60.4.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 11/10/2021] [Indexed: 06/15/2023]
Abstract
Direct support professionals (DSPs) are deemed by existing literature as vital support to persons with intellectual or developmental disabilities (IDD). They may be exposed to the traumatic experiences of people with IDD with potential psychological implications. Secondary traumatic stress (STS) has been studied among related professionals across human services, but little is known among DSPs. The current study examines the prevalence of STS in a sample of DSPs. The results suggested that DSPs are exposed to traumatic experiences, and exposure to a greater number of traumatized clients is significantly correlated with symptoms of STS. At least 12.4% of DSPs in this sample met the diagnostic criteria for experiencing post-traumatic stress disorder (PTSD) symptoms. Also, results suggest STS differences in DSPs based on demographics.
Collapse
|
3
|
Ireland CA, Chu S, Ireland JL, Hartley V, Ozanne R, Lewis M. Extreme Stress Events in a Forensic Hospital Setting: Prevalence, Impact, and Protective Factors in Staff. Issues Ment Health Nurs 2022; 43:418-433. [PMID: 34905419 DOI: 10.1080/01612840.2021.2003492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The current research explored the prevalence of stressful events in a forensic hospital setting, and their impact on staff. A systematic review of the literature on responses following exposure to extreme stress comprised 46 articles. This was followed by a Delphi study of professionals based in a forensic hospital (n = 43) to explore views on the factors that affect responses to extreme stress. This comprised three rounds to build consensus. Finally, a study of forensic hospital staff was conducted (n = 153, 47% male) to capture current trauma symptoms. The systematic review indicated three superordinate themes: outcomes adversely impacting staff and patients; personal characteristics moderating the impact of events; and organisational and interpersonal support moderating the impact of events. The Delphi supported these themes and noted the importance of factors external to the workplace and internal factors, such as self-blame. The final study demonstrated how a fifth of the workforce showed at least some trauma symptomology. Those who experienced less burnout reported lower trauma symptoms, while staff who experienced higher levels of secondary trauma at work reported higher levels of trauma symptoms. A higher level of resilience was related to lower levels of trauma symptomology. Findings are discussed in relation to the importance of recognising trauma in staff and implementing strategies to reduce and/or buffer the impact of stress on wellbeing. In doing so, the research presents a new model for consideration and development, the Impact and Amelioration of extreme stress events Model (IA-Model).
Collapse
Affiliation(s)
- Carol A Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Simon Chu
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Jane L Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Victoria Hartley
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Rebecca Ozanne
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| | - Michael Lewis
- Ashworth Research Centre, Mersey Care NHS Trust and School of Psychology, University of Central Lancashire, Preston, UK
| |
Collapse
|
4
|
de Almeida Mello J, Luo H, Hirdes A, Heikkilä J, Umubyeyi B, Gishoma D, Saari M, Hirdes JP, Van Audenhove C. An International Pilot Study of Self-Reported Quality of Life in Outpatient and Inpatient Mental Health Settings. Front Psychiatry 2021; 12:719994. [PMID: 34421691 PMCID: PMC8374624 DOI: 10.3389/fpsyt.2021.719994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Measuring quality of life (QoL) is essential to understand how clients perceive their care. In practice, many instruments are in place to identify mental health diagnoses and measure treatment outcomes, but there are fewer standardized instruments to routinely collect information about self-reported QoL, especially across different mental health settings. Moreover, existing tools have been criticized for being built from the perspective of care professionals rather than the users' perspective. The 23-item Self-Reported interRAI-QoL Survey for Mental Health and Addictions (interRAI SQoL-MHA) tackles these issues, as it is based on self-reported measures and has proven validity across settings and countries. Objective: The aim of this study is to assess and compare QoL across settings and explore associations between dimensions of self-reported QoL and some items from the interRAI SQoL-MHA in a multinational sample. Settings: Inpatient and community mental health services. Methods: Data were collected from organizations in Belgium, Finland, Russia, Brazil, Rwanda, Canada and Hong Kong. Logistic regression models were constructed using each domain scale of the interRAI SQoL-MHA (relationship, support, hope, activities and relationship with staff) as dependent variables. Results: A total of 2,474 people (51.2% female, 56.7% of age 45 or older) were included in the study. A benchmark analysis showed the samples that performed above the benchmark line or below. The models yielded significant odds ratios among the domain scales, as well as for the items of the interRAI SQoL-MHA, with positive associations for the items "work and education opportunities" and "satisfied with services", and inverse associations for the items "financial difficulties" and for the inpatient setting. Conclusion: The analysis of associations between the determinants offers relevant information to improve mental health care and clients' perceived quality of life. Information about the determinants can help policymakers to design interventions to improve care outcomes, as well as provide more possibilities for integration into the community. The interRAI SQoL-MHA is innovative, as it can be linked to the third generation interRAI MH and Community MH-instruments, to be used in different mental health care settings, combining the objective and subjective QoL domains.
Collapse
Affiliation(s)
| | - Hao Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Alice Hirdes
- Graduate Program in Health Promotion, Human Development and Society, Lutheran University of Brazil, Canoas, Brazil
| | - Jyrki Heikkilä
- Division of Psychiatry, Turku University Hospital, Turku, Finland
| | - Benoite Umubyeyi
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Darius Gishoma
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Margaret Saari
- SE Research Center, SE Health, Markham, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - John P. Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Chantal Van Audenhove
- LUCAS Center for Care Research and Consultancy, KU Leuven University, Leuven, Belgium
- Academic Center for General Practice in the Department of Public Health and Primary Care, KU Leuven University, Leuven, Belgium
| |
Collapse
|
5
|
Gupta CC, Dorrian J, Coates AM, Zadow A, Dollard M, Banks S. The impact of dayshifts and sleepover nightshifts on the eating and driving behaviours of residential support workers: An exploratory workplace study. Work 2021; 66:827-839. [PMID: 32925142 DOI: 10.3233/wor-203228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Residential support workers (RSWs) provide 24-hour care to clients and many work overnight sleepover nightshifts. Although RSWs perform safety-critical tasks and are at high-risk of work stress and exhaustion, the health and safety of RSWs has not been investigated. OBJECTIVE This explorative workplace case study explored the impact of support work on the eating and driving behaviours of RSWs. METHODS Thirteen RSWs who had worked a dayshift (n = 6) or a sleepover nightshift (n = 7) completed questions on the timing of food intake during their shift, motivations for eating during the shift, subjective work performance, alertness and sleepiness post-shift, and driving performance post-shift. RESULTS RSWs reported snacking during the night on a sleepover nightshift. Time available was the biggest determinant for when RSWs ate during a day and sleepover nightshift. Ratings of subjective alertness and sleepiness after eating were not different between shift types, however participants reported an increase in work performance after eating during a dayshift. Driving events were more frequently reported post-sleepover nightshift, compared to post-dayshift. CONCLUSIONS Findings demonstrate an impact of shift type on eating and driving behaviours of RSWs and highlight the importance of further investigation of this under-researched group to identify appropriate strategies for improving health and safety.
Collapse
Affiliation(s)
- Charlotte C Gupta
- Sleep and Chronobiology Laboratory, Behaviour Brain Body Research Centre, University of South Australia, Adelaide, Australia
| | - Jill Dorrian
- Sleep and Chronobiology Laboratory, Behaviour Brain Body Research Centre, University of South Australia, Adelaide, Australia
| | - Alison M Coates
- Sleep and Chronobiology Laboratory, Behaviour Brain Body Research Centre, University of South Australia, Adelaide, Australia.,Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Amy Zadow
- Asia Pacific Centre for Work Health and Safety, University of South Australia, Adelaide, Australia
| | - Maureen Dollard
- Asia Pacific Centre for Work Health and Safety, University of South Australia, Adelaide, Australia
| | - Siobhan Banks
- Sleep and Chronobiology Laboratory, Behaviour Brain Body Research Centre, University of South Australia, Adelaide, Australia
| |
Collapse
|
6
|
Hammarström L, Häggström M, Devik SA, Hellzen O. Controlling emotions-nurses' lived experiences caring for patients in forensic psychiatry. Int J Qual Stud Health Well-being 2019; 14:1682911. [PMID: 31645227 PMCID: PMC6818121 DOI: 10.1080/17482631.2019.1682911] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 01/20/2023] Open
Abstract
Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses' daily work. This study was conducted to illuminate the meaning of nurses' lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: "Being frustrated" (subthemes included "Fighting resignation" and "Being disappointed"), "Protecting oneself" (subthemes included "To shy away," "Being on your guard," and "Being disclosed"), "Being open-minded" (subthemes included "Being confirmed," "Developing trust," and "Developing compassion"), and "Striving for control" (subthemes included "Sensing mutual vulnerability" and "Regulating oneself"). Further, working in forensic psychiatry challenged nurses' identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses' professional identity. Nurses must attempt to empathize with patients' experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients' needs.
Collapse
Affiliation(s)
| | - Marie Häggström
- Department of Nursing, Mid-Sweden University, Sundsvall, Sweden
| | | | - Ove Hellzen
- Department of Nursing, Mid-Sweden University, Sundsvall, Sweden
| |
Collapse
|
7
|
Useche SA, Montoro LV, Ruiz JI, Vanegas C, Sanmartin J, Alfaro E. Workplace burnout and health issues among Colombian correctional officers. PLoS One 2019; 14:e0211447. [PMID: 30753198 PMCID: PMC6372146 DOI: 10.1371/journal.pone.0211447] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/15/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction Correctional employees typically work under adverse conditions that may enhance the occurrence of different negative psychological states. Burnout constitutes a high-risk phenomenon that may affect people’s physical/mental health and welfare, especially in vulnerable occupational groups. Objectives The aim of this study was to characterize the burnout profile of correctional officers, and to associate their burnout profile with health issues and lifestyle factors. Methods The full sample was composed of 219 Colombian correctional officers with a mean age of 30.18 years. A questionnaire composed of three sections was employed: demographic data, burnout, and health information. Results A high proportion of participants reported burnout indicators, also significantly correlated to their health indicators and lifestyle factors. Cluster analyses were used in order to characterize the burnout/age (model A) and burnout/age/psychological disturbance (model B) profiles of correctional officers. Furthermore, significant differences were found when comparing frequencies of alcohol consumption and physical exercise (lifestyle indicators) and perceived social support of officers depending on their profile. Conclusions the discussion focused on the negative impact of burnout on health, and on the importance of strengthening occupational programs aimed at reducing the impact of hazardous working conditions that contribute to the development of burnout, and to the arise different mid and long-term health complains among correctional workers.
Collapse
Affiliation(s)
- Sergio A. Useche
- INTRAS—Faculty of Psychology, University of Valencia, Valencia, Spain
- * E-mail: ,
| | - Luis V. Montoro
- INTRAS—Faculty of Psychology, University of Valencia, Valencia, Spain
| | - José I. Ruiz
- Laboratory of Psychology and Law, National University of Colombia, Bogotá, Colombia
| | - César Vanegas
- National Penitentiary School, National Penitentiary and Prison Institute, Funza, Colombia
| | - Jaime Sanmartin
- INTRAS—Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Elisa Alfaro
- Faculty of Medicine, University of Valencia, Valencia, Spain
| |
Collapse
|
8
|
de Looff P, Nijman H, Didden R, Embregts P. Burnout symptoms in forensic psychiatric nurses and their associations with personality, emotional intelligence and client aggression: A cross-sectional study. J Psychiatr Ment Health Nurs 2018; 25:506-516. [PMID: 30199590 DOI: 10.1111/jpm.12496] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/21/2018] [Accepted: 09/06/2018] [Indexed: 12/25/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Client aggression in forensic psychiatry is associated with burnout symptoms in nursing staff. It is unclear what mechanisms contribute to this relationship. The type and severity of aggression might be of importance in the association between client aggression and burnout symptoms, but also the personality characteristics and emotional intelligence of nursing staff. It is unknown whether wearable devices that measure arousal can be used to detect chronic stress and burnout symptoms. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Especially, physical aggression as experienced by nursing staff is associated with staff's burnout symptoms (e.g., emotional exhaustion and depersonalization). Further research on the aggression questionnaire is necessary. The stress management skill of nursing staff is an important factor to consider in the association between burnout symptoms and client aggression. The wearable device was not useful for detecting burnout symptoms. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing staff who experience (physical) aggression should be carefully monitored and should receive social support from their management to aid their well-being. Contrary to intuition, nurses who reported a higher number of stress management skills might have to be monitored more closely if necessary. ABSTRACT Introduction Aggressive behaviour of forensic clients is associated with burnout symptoms in nursing staff. The role of staff characteristics as moderators is unclear. Aim We explored the association between type and severity of aggressive behaviour as experienced by nursing staff and staff's burnout symptoms. In addition, the moderating roles of personality characteristics and emotional intelligence (EI) were studied. Moreover, the usefulness of ambulatory skin conductance assessments in detecting arousal related to burnout symptoms was studied. Method A total of 114 forensic nursing staff members filled out questionnaires and wore an ambulatory device. Results Experiencing physical aggression was positively associated with staff's burnout symptoms. Stress management skills, a subscale of EI, but not personality, moderated this relationship. Skin conductance was not associated with burnout symptoms. Remarkably, the association between aggression and burnout symptoms was highest for staff reporting a higher number of stress management skills. Discussion Longitudinal research is necessary to establish causality between client aggression and staff burnout symptoms. In addition, further research is necessary on the validity of the aggression measure used in the current study. Implication for practice Nursing staff who experience physical aggression frequently should receive social support for this, and staff who report high stress management skills should be monitored more carefully after having been confronted with aggression.
Collapse
Affiliation(s)
- Peter de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Wier, Specialized and Forensic Care, Fivoor, Den Dolder, The Netherlands
| | - Henk Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Wier, Specialized and Forensic Care, Fivoor, Den Dolder, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Specialized and Forensic Care, Zwolle, The Netherlands
| | - Petri Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
9
|
Abstract
SummaryOver the past decade attention to the provision of healthcare for individuals with personality disorder, particularly those who pose a risk to others, has substantially increased. Keeping pace with such developments with a suitably trained, consistent and motivated workforce, interfacing health and criminal justice systems where necessary, presents an enormous challenge. Staff must be experts in managing conflict at every level, while sustaining an optimistic and therapeutic orientation. Boundaried relationships provide the context for recovery for patients. Key principles and practices likely to promote resilience in personality disorder services, with a focus on the role of supervision, are outlined in order to support staff in keeping themselves afloat, their patients safe, and their services on target.
Collapse
|
10
|
Volpe U, Luciano M, Palumbo C, Sampogna G, Del Vecchio V, Fiorillo A. Risk of burnout among early career mental health professionals. J Psychiatr Ment Health Nurs 2014; 21:774-81. [PMID: 25757038 DOI: 10.1111/jpm.12137] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2013] [Indexed: 11/29/2022]
Abstract
Burnout is a stress-related syndrome that often affects mental health professionals (MHPs) and may have serious consequences on personal well-being as well as on the quality of provided psychiatric care. Established literature shows a high risk to develop burnout among MHPs. Few data are available on the incidence and on the clinical implications of the burnout syndrome in the early phases of MHP professional career. We confirmed the presence of burnout among early career MHPs: early career psychiatrists showed a lower sense of personal accomplishment, while non-medical MHPs tended to have more depersonalization and suffered from higher levels of depression. Specific programmes to identify the presence of the burnout syndrome and to cope with it should be taught within mental health training curricula. Burnout is a stress-related syndrome that often affects professionals working in emotionally loaded and highly interpersonal environments. Mental health professionals (MHPs) are long known to be at high risk to develop the burnout syndrome, but this has rarely been investigated in professionals in an early phase of career. The aim of the present study was to evaluate the presence of the burnout syndrome and of depressive symptoms among early career psychiatrists and 'non-medical' MHPs. One hundred MHPs (including 50 psychiatrists and 50 non-medical MHPs) were screened for the presence of burnout and depression, with the Maslach Burnout Inventory and the Beck Depression Inventory - revised, respectively. The relationships of burnout with socio-demographical and professional characteristics were also explored. We confirmed the presence of burnout among both groups of early career MHPs, but psychiatrists had a significantly higher degree of emotional exhaustion and a lower sense of personal accomplishment, while non-medical MHPs adopted more frequently depersonalization as a coping strategy and had higher scores for depression, which is associated with higher level of burnout. The risk of developing burnout should be properly addressed in training curricula and strategies to overcome it should be systematically taught, in order to promote personal well-being and efficient team work in mental health settings.
Collapse
Affiliation(s)
- U Volpe
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | | | | | | | | | | |
Collapse
|
11
|
Vassos M, Nankervis K, Skerry T, Lante K. Work engagement and job burnout within the disability support worker population. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3884-3895. [PMID: 24029805 DOI: 10.1016/j.ridd.2013.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 08/02/2013] [Accepted: 08/05/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to explore work engagement and job burnout within the disability support worker (DSW) population, using the job demands-resources (JD-R) model as a guiding theory. The research measured a set of work-related demands and resources related to working within the disability sector in order to assess which demands/resources account for a significant portion of unique variance when used to model DSW engagement and burnout. This study sampled 258 DSWs from across Australia who completed an online or paper questionnaire that included measures of engagement, burnout and the demands/resources of interest. With regard to demands, role ambiguity was significantly associated with the three engagement scores and the three burnout scores. It also accounted for the most unique variance in the three engagement scores (vigour [VI], dedication [DE] and absorption [AB]), and the personal accomplishment (PA) burnout score. With regard to resources, job feedback was significantly associated with two of the engagement scores (VI and DE) and all three burnout scores. It accounted for the most unique variance in VI and DE, and PA. In conclusion, this research adds to the existing disability workforce literature as it represents one of the first comprehensive investigations of work engagement within this population. Improved job descriptions, on-the-job feedback and the creation of specialist support workers are offered as recommendations to improve the psychosocial health of DSWs.
Collapse
Affiliation(s)
- Maria Vassos
- Centre of Excellence for Behaviour Support, University of Queensland, Ipswich, Queensland, Australia; Discipline of Disability Studies, RMIT University, Bundoora, Victoria, Australia.
| | | | | | | |
Collapse
|
12
|
Dodevska GA, Vassos MV. What qualities are valued in residential direct care workers from the perspective of people with an intellectual disability and managers of accommodation services? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:601-615. [PMID: 22563721 DOI: 10.1111/j.1365-2788.2012.01565.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a 'good' direct care worker differently from service users with an intellectual disability (ID), with professionals placing an emphasis on describing workers with a range of practical skills and knowledge and service users placing an emphasis on describing workers with interpersonal skills. The aim of this research was to replicate this finding using a methodological approach that rectifies some of the weaknesses of previous research in this field. METHOD Semi-structured interviews were conducted to explore the qualities that are valued in residential direct care workers (RDCWs) from the perspective of seven residents with ID and seven managers of accommodation services located in metropolitan Melbourne, Australia. RESULTS Thematic and chi-squared analysis confirmed the findings of previous research with residents with an ID placing more of an emphasis on the interpersonal behaviours of RDCWs in their descriptions compared to the managers. CONCLUSIONS The interpersonal skills of a potential worker along with their practical skills and knowledge must be considered when recruiting RDCWs. It is also implied that given the different conceptualisation of a 'good' direct care worker across service users and professionals, increased service user participation in the organisation of appropriate supports is warranted.
Collapse
Affiliation(s)
- G A Dodevska
- Discipline of Disability Studies, RMIT University, Bundoora, Victoria, Australia.
| | | |
Collapse
|
13
|
Cechnicki A, Bielańska A, Hanuszkiewicz I, Daren A. The predictive validity of expressed emotions (EE) in schizophrenia. A 20-year prospective study. J Psychiatr Res 2013; 47:208-14. [PMID: 23158233 DOI: 10.1016/j.jpsychires.2012.10.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 10/10/2012] [Accepted: 10/12/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND The level of expressed emotions in the family (EE) and components thereof (emotional over-involvement EOI, and critical comments CC) have been found to be related to treatment outcomes in psychotic patients. One point of interest is the dynamic of various outcomes in relation to initial EE, CC and EOI levels. METHOD 43 individuals with diagnosis of schizophrenia were assessed at 1, 3, 7, 12 and 20-year follow-ups. The EE indicator was evaluated during the index hospitalization. Outcome indicators included: number of relapses, number and duration of in-patient rehospitalizations, and severity of psychopathological symptoms. RESULTS 1) A high EE indicator was associated with a higher number of relapses in every follow-up and differences between the groups with low and high EE indicators proved significant after 3, 7, 12 and 20 years of the illness. 2) A high EE indicator was associated with a higher number of rehospitalizations after 3 and 7 years, and showed as a clear trend after 12 and 20 years. 3) A high level of CC was associated with a higher number of relapses. 4) The severity of positive symptoms increased only in the group with high CC. 5) The negative syndrome was not associated with EE, EOI or CC. CONCLUSIONS The EE indicator may be considered a valid prolonged predictor of relapses and rehospitalizations. A high level of CC was associated with a higher number of relapses and intensification of the positive syndrome in both the short-term and long-term course of the illness.
Collapse
Affiliation(s)
- Andrzej Cechnicki
- Community Psychiatry Unit, Chair of Psychiatry, Collegium Medicum, Jagiellonian University, 2/8 Sikorskiego sq., 31-115 Cracow, Poland.
| | | | | | | |
Collapse
|
14
|
Vassos MV, Nankervis KL. Investigating the importance of various individual, interpersonal, organisational and demographic variables when predicting job burnout in disability support workers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1780-1791. [PMID: 22699251 DOI: 10.1016/j.ridd.2012.04.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 04/26/2012] [Accepted: 04/26/2012] [Indexed: 06/01/2023]
Abstract
Previous research has highlighted that factors such as large workload, role ambiguity, lack of support from colleagues, and challenging behaviour are associated with higher levels of burnout within the disability support worker (DSW) population. The aim of this research was to investigate which factors contribute the most to the prediction of the three facets of burnout--feeling exhausted and overextended by one's work (emotional exhaustion), detached and callous responses towards work (depersonalisation) and a lack of achievement and productivity within one's role (personal accomplishment). The factors chosen for analysis within this research were analysed within four categories linked to theories of burnout development (individual, interpersonal, organisational and demographic). A sample of 108 DSWs completed a questionnaire booklet that contained standardised measures of burnout and job stressors related to disability work. Results highlighted the importance of predictors such as challenging behaviour (interpersonal), workload (individual), supervisor support (individual), work-home conflict (individual), job feedback (individual), role ambiguity (organisational), low job status (organisational), role conflict (organisational), gender (demographic) and work hours (demographic) when predicting one or more of the facets of burnout. In conclusion, disability services and organisations may benefit from focusing on remodelling their staff-related organisational practices in order to prevent the development of burnout in their DSWs (e.g., increase supervision and support practices).
Collapse
Affiliation(s)
- Maria V Vassos
- Centre of Excellence for Behaviour Support, University of Queensland, Ipswich, Queensland, Australia.
| | | |
Collapse
|
15
|
Berry K, Barrowclough C, Haddock G. The role of expressed emotion in relationships between psychiatric staff and people with a diagnosis of psychosis: a review of the literature. Schizophr Bull 2011; 37:958-72. [PMID: 20056685 PMCID: PMC3160217 DOI: 10.1093/schbul/sbp162] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The concept of expressed emotion (EE) has been extended to the study of staff-patient relationships in schizophrenia. A comprehensive review of the literature identified a total of 27 studies investigating EE in this group published between 1990 and 2008. The article aims to assess whether the concept of EE is a useful and valid measure of the quality of professional caregiver and patient relationships, given that staff may be less emotionally invested in relationships than relatives. In doing so, it summarizes methods of measuring EE, the nature of professional EE compared with familial EE, associations between high EE and patient outcomes, associations between EE and both patient and staff variables, and intervention studies to reduce staff high EE. The available evidence suggests that the Camberwell Family Interview is an acceptable measure of EE in staff-patient relationships, although the Five Minute Speech Sample may provide a less resource intensive alternative. However, in contrast to familial research, neither the EE status on the Camberwell Family Interview nor the Five Minute Speech Sample show a robust relationship with outcomes. The presence or absence of a positive staff-patient relationship may have more predictive validity in this group. There is relatively consistent evidence of associations between staff criticism and poorer patient social functioning. Consistent with findings in familial research, staff attributions may play a key role in driving critical responses, and it may be possible to reduce staff high EE by modifying negative appraisals.
Collapse
Affiliation(s)
- Katherine Berry
- School of Psychological Sciences, University of Manchester, Manchester, M13 9PL, UK.
| | | | - Gillian Haddock
- School of Psychological Sciences, University of Manchester, Manchester, M13 9PL, UK
| |
Collapse
|
16
|
Moore E, Andargachew S, Taylor PJ. Working with women prisoners who seriously harm themselves: ratings of staff expressed emotion (EE). CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2011; 21:63-74. [PMID: 21259370 DOI: 10.1002/cbm.795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Prison staff are repeatedly exposed to prisoners' suicidal behaviours; this may impair their capacity to care. Expressed emotion (EE), as a descriptor of the 'emotional climate' between people, has been associated with challenging behaviour in closed environments, but not previously applied to working alliances in a prison. AIMS To investigate the feasibility of rating EE between staff and suicidal women in prison; to test the hypothesis that most such staff-inmate alliances would be rated high EE. METHODS All regular staff on two small UK prison units with high suicidal behaviour rates were invited to participate. An audiotaped five-minute speech sample (FMSS) about work with one nominated suicidal prisoner was embedded in a longer research interview, then rated by two trained raters, independent of the interview process and the prison. RESULTS Seven prison officers and 8 clinically qualified staff completed interviews; 3 refused, but 17 others were not interviewed, reasons including not having worked long enough with any one such prisoner. Participants and non-participants had similar relevant backgrounds. Contrary to our hypothesis, EE ratings were generally 'low'. As predicted, critical comments were directed at high frequency oppositional behaviour. CONCLUSIONS EE assessments with prison staff are feasible, but our sample was small and turnover of prisoners high, so the study needs replication. Attributions about problem behaviour to illness, and/or traumatic life experience, tend to confirm generally supportive working relationships in this sample.
Collapse
Affiliation(s)
- Estelle Moore
- Centralised Groupwork Service, Newbury Therapy Unit, Broadmoor Hospital, Crowthorne, Berkshire, UK
| | | | | |
Collapse
|
17
|
Solomon P, Alexander L, Uhl S. The relationship of case managers' expressed emotion to clients' outcomes. Soc Psychiatry Psychiatr Epidemiol 2010; 45:165-74. [PMID: 19370297 DOI: 10.1007/s00127-009-0051-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 03/27/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND Expressed emotion (EE) has been studied in families of a relative with schizophrenia as well as other psychiatric disorders; and high EE (hostile, critical, and overinvolved) families have been found to be strongly related to relapse among their relatives. EE has been assessed on a limited basis among non-familial care providers and determined that providers can also have high EE which results in poor quality of life and negative consequences for their clients. METHODS The present study assessed 42 case managers serving clients with schizophrenia spectrum disorder regarding their EE for specific clients enrolled in a larger study examining the reliability and validity of two alliance measures. Case managers and clients were personally interviewed at baseline, 3, 6, 6 plus 2 weeks, and 9 months post-client entry into case management. The EE measure was inserted into the 6 months plus 2 week case manager interview. Generalized Estimating Equation analysis was employed to examine predicted outcomes of EE. RESULTS High EE was found to be related to client attitudes toward medication compliance and social contact. CONCLUSIONS Family psychoeducation interventions, an evidence-based practice, have been demonstrated to be effective in reducing relapse of relatives with serious mental illness. Given the clinical evidence that EE is modifiable, it is expected that such educational training for non-familial caregivers will have the same potential as for family caregivers. Providers dealing with challenging clients may also need support and skills to better handle difficult situations, especially direct support providers like case managers who are not clinically trained.
Collapse
Affiliation(s)
- Phyllis Solomon
- School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA.
| | | | | |
Collapse
|
18
|
Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Oliva D, Campodonico F, Groeneweg J. Assisting persons with multiple disabilities to move through simple occupational activities with automatic prompting. RESEARCH IN DEVELOPMENTAL DISABILITIES 2008; 29:439-46. [PMID: 17890053 DOI: 10.1016/j.ridd.2007.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 08/06/2007] [Indexed: 05/17/2023]
Abstract
The present study assessed the possibility of assisting four persons with multiple disabilities to move through and perform simple occupational activities arranged within a room with the help of automatic prompting. The study involved two multiple probe designs across participants. The first multiple probe concerned the two participants with blindness or minimal vision and deafness, who received air blowing as a prompt. The second multiple probe concerned the two participants with blindness and typical hearing who received a voice calling as a prompt. Initially, all participants had baseline sessions. Then intervention started with the first participant of each dyad. When their performance was consolidated, new baseline and intervention occurred with the second participant of each dyad. Finally, all four participants were exposed to a second intervention phase, in which the number of activities per session doubled (i.e., from 8 to 16). Data showed that all four participants: (a) learned to move across and perform the activities available with the help of automatic prompting and (b) remained highly successful through the second intervention phase when the sessions were extended. Implications of the findings are discussed.
Collapse
|