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PubMed1989

[Stress and health at work for day care workers : the alleviating role of social support.].

This study, which focuses on the child care work environment, asks four questions : Is the state of stress among child care workers greater than that observed in a normal population? Are there aspects of the work itself that are more associated with the worker's personal state of stress? What link can we establish between the state of stress and the state of health of this group? Finally, can supportive relationships lessen the negative impact of certain work environments? 165 female workers, of which 85% are teachers, took part in the study on a volunteer basis after their child care centre had been selected arbitrarily. Subjects answered five questionnaires to measure the state of their stress, mental health, physical health, the emotional support of their spouse and the importance given to stress-related factors in the workplace. Results show that the state of stress of these workers is, on the average, no higher than that found in a normal population. However, work situations involving child supervision, interpersonal relations among staff, as well as feelings of being overworked are considered the most stressful. These work situations, even the most stress-producing, are not associated to a worker's state of physical or mental stress. It's the stress state itself, in its role as an intermediate variable, that makes the connection between sources of stress and the person's state of health. Finally, emotional support is linked to the state of stress, but has no direct link to the state of physical or mental health. A spouse's support is nonetheless considered as regular and effective protection against increases in the state of stress. A number of methodological implications are also discussed.

English Abstract↗

PubMed1992

Journal keeping as an educational strategy in teaching psychiatric nursing.

Personal attitudes and self-awareness are key issues of which the psychiatric nursing student must be aware when establishing a therapeutic relationship. Facilitating awareness and growth in these areas are fundamental challenges for the nurse educator. One potential teaching strategy with which to address this issue is journal keeping. This paper describes a study evaluating the impact of journal keeping on student nurses' attitudes toward psychiatric clients and self-awareness in relations with others. Third-year nursing students completing a psychiatric rotation kept journals which were used to reflect on thoughts and feelings engendered by their clinical experience. Two student control groups were used: one completing a psychiatric rotation without keeping journals and the second completing a medical-surgical rotation. All students completed the Opinions About Mental Illness, the Fundamental Interpersonal Relations Orientation-Behaviour, and Comfort in Working with Psychiatric Clients Scales prior to and at the end of their clinical experience. Findings support the use of journals to assist students in exploring and changing their attitudes but not necessarily in changing their interpersonal style.

Adult↗

PubMed1991

Self- and object-directedness in adult women.

Separate factor analyses of items anchoring the opposite ends of a narcissism prototype derived from the California Q-set resulted in three narcissism or self-directed factors: Hypersensitivity, Willfulness, and Autonomy; and two factors hypothesized to represent the object-directed line of development: Straightforwardness and Givingness. These five factors were scored in Q-sort descriptions of 103 adult women. Correlates of the factors with the California Psychological Inventory, Adjective Check List, Sentence Completion Test, and life measures supported the usefulness of the distinction between self- and object-directedness. Whereas the narcissistic trajectory related to creativity, norm questioning, undercontrol of impulses, independence, and work orientation, the object-directed line of development was associated with prosocial inclinations, suppressive ego control, readiness to accept life demands, and stress on interpersonal relations.

Adult↗

PubMed2003

The Norelco Sport Fanatics Survey: examining behaviors of sport fans.

The Norelco Sport Fanatics Survey administered by Impulse Research to over 1,400 avid sport fans online assessed their support of and involvement with their teams, emotional responses prior to and subsequent to team performance, and the effect of their fandom on their family and social relations. Analysis yielded results which replicated past research and indicated that sport fandom was extremely important to the respondents, intensified affective reactions, and was perceived as a highly social activity with very few negative consequences for interpersonal relations.

Adult↗

PubMed1978

Organization development: a new modality for community mental health.

Organization development (OD) is discussed as being a valid tool for advancing mental health and for promoting the present goals of community mental health centers, as well as for accomplishing organization development's traditional objectives of increasing organizational effectiveness in business, industry, and government agencies. A comparison is made between the main objectives of the community mental health movement in the United States and the major thrusts of current OD practice, showing how the foci of the two fields are essentially similar. The psychological aspects of OD are presented in their relation to mental health. Organization development is demonstrated to be both a legitimate and an effective modality for the community mental health practitioner to use in reaching large numbers of people in promoting positive mental health, primary prevention, improved interpersonal relations, and personal growth activities in the community.

Community Mental Health Services↗

PubMed2005

[Difficulties experienced by the patient care team at the intensive care unit].

This interpretative case study aimed to identify the difficulties experienced by the patient care team while working at the Intensive Care Unit. Data were collected through participant observation and semistructured interviews with doctors, nurses and nurse's aides. Two major categories emerged from the data analysis: Care delivery in intensive care-- "it is difficult to deal with death and inform the patient's family" and care delivery in intensive care-- "the lack of material resources and the difficulty to work in a team". The difficulties are related to the contact with family members, dealing with death and the lack of material resources, and particularly with the relation between team members. Therefore, teams need to promote opportunities and discussions to reflect on the technical, scientific and ethic aspects of care for critical patients as well as family members, with a view to better care quality and interpersonal relations.

Critical Care↗

PubMed2004

Mental health status of clients from three HIV/AIDS palliative care projects.

OBJECTIVE: To describe mental health status and its correlates among clients of three palliative care programs targeting underserved populations. METHODS: Mental Health Inventory (MHI-5) scores of clients from programs in Alabama (n = 39), Baltimore (n = 57), and New York City (n = 84) were compared. RESULTS: Mean MHI-5 scores did not differ among sites and were indicative of poor mental health. Significant differences were noted among sites with regard to client sociodemographics, physical functioning, and perceptions of interpersonal relations. Results of multivariate regression models estimated for each site suggest variation in the relative importance of potential predictors among sites. Whereas poorer mental health was primarily associated with history of drug dependence at Baltimore and more physical symptomatology at New York, better mental health was most strongly correlated with more positive perceptions of interpersonal relationships at Baltimore and increasing age and more positive perceptions of meaning and purpose in life at New York. SIGNIFICANCE OF RESULTS: The data presented suggest the importance of assessing clients' history of and current need for mental health services. Evidence of a relationship between positive perceptions of meaning and purpose and better psychological function underscores the importance of existential issues for the overall well-being of those who are seriously ill.

Acquired Immunodeficiency Syndrome↗

PubMed2006

[Parents and nursing staff's expectations regarding the nurse's work in a NICU].

The general purpose of this investigation was to identify parent and nursing staff expectations regarding the nurse's role in Neonatal Intensive Care Units (NICU). A descriptive study was carried out using a qualitative approach and interviews were conducted at a NICU in the interior of the State of São Paulo. Results showed new expectations on the part of parents and professionals regarding the role of NICU nurses. The knowledge identified as necessary were a family-centered approach, interpersonal relations techniques, and differentiation between technology and scientific knowledge. The conclusion is that NICU nurses need to play a more incisive role in the nursing care process, adjusting the use of technological advances to human knowledge, particularly in the area of interpersonal relationships between family members and staff, which includes activities of continuing education, such as specialization courses.

Consumer Behavior↗

PubMed1989

Open assessment of the safety and efficacy of thioridazine in the treatment of patients with borderline personality disorder.

A 12-week open study was conducted to assess the possible efficacy and safety of low-dose thioridazine in 11 outpatients (8 women, 3 men) with borderline personality disorder (BPD) diagnosed according to DSM-III-R (American Psychiatric Association 1987) and the Diagnostic Interview for Borderline Patients (DIB; Gunderson et al. 1981) criteria. Mean thioridazine dose averaged 92 mg per day across the duration of this study. At endpoint, there was a significant reduction in Brief Psychiatric Rating Scale (BPRS; Overall & Gorham 1988) scores, and patients appeared to be less symptomatic on the impulse action patterns, affects, and psychosis subscales of the DIB (modified to assess change). Subjects completing the entire study (n = 6) also showed improvement in interpersonal relations. On self-report measures, significant improvement was noted on most Hopkins Symptom Checklist-90 (SCL-90; Derogatis et al. 1973) subscales, particularly in hostility and additional depressive features. Subjects completing the entire study showed significant improvement in paranoid ideation, interpersonal sensitivity, and anxiety. Three patients, however, developed sustained melancholic depressions that necessitated their discontinuation from the study and the initiation of anti-depressant treatment. These three individuals were more schizotypal, schizoid, and paranoid at baseline according to Personality Disorder Examination (PDE; Loranger et al. 1987) structured interviews. Weight gain was not a significant problem, but sedation and erectile dysfunction were. Overall, these findings suggest that thioridazine may exert prominent effects on patients with BPD and that double-blind, placebo-controlled studies are warranted.

Adult↗

PubMed1993

The immediate role of psychiatric staff in the resistance.

The psychiatric staff of the University Department of Psychiatry in Osijek University Hospital played an active and important role during the 1991/92 war. This grew out of the analytical approach to psycho-social relations in the undirectional spiritual state of mind under the communist system of Yugoslavia. The role of psychiatric staff in the resistance against the aggressor was determined by a spontaneous freedom of choice, an aspiration for permanent harmony of moral and legal system, mature interpersonal relations and an awareness of their place in the national community. Psychiatric staff investigate the psychology of a nation, its desires, anxieties and defense and they recognize their role. War makes therapeutical relationships more complex and demands almost daily supervision of the counter-transfer reactions towards the wounded, refugees and other patients who ask for or need psychiatric help. This study comments on the experiences of a group of staff members of the University Department of Psychiatry. In addition, the therapeutical phenomena in their relations with patients are also recognized.

Adaptation, Psychological↗

PubMed1981

Inpatient male alcoholics: predicting program completion time in days and characteristics of fast and slow completers.

This study relates the origin and validation of an hypothesis-based scale that predicted program completion time (PCT) of inpatient male alcoholics within 8.6 days. It comprises 10 statements from an emotional state and demographic questionnaire's 46 items. The new scale is the ratio of interpersonal relations (IR) items to "recovery facilitating" (RF) items: IR/RF. Cross-validation on two groups of 28 male alcoholic completers yielded validities from 0.49 to 0.52. Combining the scale with other data selected by computer from the same questionnaire raised validity to 0.73 (adjusted) and reduced prediction error 19.8% to 6.9 days. The scale's rationale involves relationship dynamics between "internal strength" (RF) and "external behavior" (IR). It is consistent with: pre/post changes in IR/RF; RF; IR; data and interpretations from Edwards Personal Preference Schedule (EPPS) and California Psychological Inventory (CPI) scores; comparisons of contrasting groups. Profiles of high and low scale score groups show both major differences and similarities. Treatment personnel reactions to high score profile content suggest the scale's potential value for planning patient improvement and for reducing non-completer incidence. The nature of the scale's pre/post changes indicates an additional utility: assessing treatment effectiveness.

Adolescent↗

PubMed1999

The need for psychiatric nursing: towards a multidimensional theory of caring.

Contemporary developments in health care have encouraged a review of the professional status of psychiatric nursing. Although research has documented psychiatric nursing activity, little study has been made of the 'need' for psychiatric nursing within a multidisciplinary service. Employing adapted grounded theory methodology, substantive theory was developed concerning the expressed need for psychiatric nursing, by patients, their carers and mental health professionals. The study was based on six sites from England, Eire and Northern Ireland. The study found some consensus across both recipients and providers of mental health care, that the essential feature of nursing (the core category) involved a complex of relationships: 'knowing you, knowing me'. Within that complex, nurses either elected, or were required, to move--or 'toggle'--between three discrete domains of relating: the Ordinary Me (OM); the Pseudo-ordinary or Engineered Me (POEM); and the Professional Me (PM). Four internal dimensions involving the nurses' depth of knowing, power, use of time and use of translation distinguished these domains. The emergent theory extends current awareness of the importance of interpersonal relations in nursing. To what extent current health care policy, which emphasizes the promotion of alternative roles for nurses, will challenge this essential focus remains unclear.

Attitude of Health Personnel↗

PubMed2006

Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996-2001).

BACKGROUND: Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes. AIMS: To estimate the incidence of work-related stress and mental illness reported 1996-2001 by occupational physicians and 1999-2001 by psychiatrists. METHODS: Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events. RESULTS: An estimated annual average of 3,624 new cases were reported by psychiatrists, and 2,718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for approximately 10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall. CONCLUSIONS: The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.

Confidence Intervals↗

PubMed2002

The relational self: an interpersonal social-cognitive theory.

The authors propose an interpersonal social-cognitive theory of the self and personality, the relational self, in which knowledge about the self is linked with knowledge about significant others, and each linkage embodies a self-other relationship. Mental representations of significant others are activated and used in interpersonal encounters in the social-cognitive phenomenon of transference (S. M. Andersen & N. S. Glassman, 1996), and this evokes the relational self. Variability in relational selves depends on interpersonal contextual cues, whereas stability derives from the chronic accessibility of significant-other representations. Relational selves function in if-then terms (W. Mischel & Y. Shoda, 1995), in which ifs are situations triggering transference, and thens are relational selves. An individual's repertoire of relational selves is a source of interpersonal patterns involving affect, motivation, self-evaluation, and self-regulation.

Humans↗

PubMed2001

Health Workers for Change: developing the initiative.

This paper describes an intervention developed in South Africa for health workers at the health facility level, and designed to explore interpersonal relations among health workers and between health workers and female clients. Several participatory methods to explore the provider-client relationship were tested with health workers. Health workers identified many constraints to the provision of adequate health services and that these constraints affected their work in general and their relationship with women clients in particular. Constraints included inadequacies and inefficiencies in management and the lack of gender sensitivity training. The participatory approach was found to be acceptable to the participants and effective in exploring interpersonal relationships.

Female↗

PubMed1998

Erikson's concept of ego identity reconsidered.

This paper explores and attempts to explain the paradox that Erik Erikson--after Freud, undoubtedly the psychoanalyst best known, most deeply esteemed, and most widely influential in the sociohistorical surround of world culture--has at the same time never been properly integrated into the psychoanalytic mainstream, but has instead been marginalized, consigned to a persisting psychoanalytic limbo. Two successive contexts within the historical unfolding of psychoanalysis in America, the milieu in which Erikson worked, would seem to account for this neglect. First, Erikson's monumental contributions to our understanding of the psychosocial developmental process, of the epigenesis of the ego, of the phase-specific developmental tasks across the eight postulated stages of the life cycle, and of the intergenerational cogwheeling of the life cycles were made during the 1950s and 1960s and could not easily be integrated into the ego psychology metapsychological paradigm then monolithically regnant within American psychoanalysis. And, second, as a major paradigm shift took place in America, beginning in the 1970s, toward a more relational, interpersonal, and intersubjective framework, Erikson's contributions, couched as they were in the structural language of the ego psychology of his time, were overlooked and went unremarked as seminal precursors of the newly emerging emphases. The clear relationship of Erikson's concepts of (ego) identity to emerging conceptions of self in relation to objects was simply not noticed, and his work continues to this day to be neglected and unintegrated within psychoanalysis.

Adult↗

PubMed1992

The Rationality/Emotional Defensiveness Scale--II. Convergent and discriminant correlational analysis in males and females with and without cancer.

The psychological correlates of the Rationality/Emotional Defensiveness Scale and its two subscales were examined in 1236 males and 863 females from the Western Collaborative Group Study. An additional 157 males and 164 females with some form of cancer other than of the skin were also included in this analysis. Characteristics measured included self-reported emotional control, anger expression, trait personality, depressive and neurotic symptomatology, Type A behavior, hostility, and social desirability. Results indicate that the Rationality/Emotional Defensiveness Scale is most strongly related to the suppression and control of emotions, especially anger. Scores on this scale also tend to be associated with less Type A behavior and hostility and with more social conformity. Analysis of the component subscale suggests that Antiemotionality, i.e. the extent to which an individual uses reason and logic to avoid interpersonally related emotions, is most strongly marked by the control of anger, while Rationality, i.e. the extent to which an individual uses reason and logic as a general approach to coping with the environment, is related to the control of anxiety and a higher level of trait curiosity. The psychological interpretation of the scale appears to be largely invariant across gender, unaffected by residualization of the total scale score for its association with Social Desirability, and, except for a few minor instances, unrelated to the diagnosis of cancer.

Aged↗

PubMed1990

Children's evaluations of morality in the context of peer, teacher-child, and familial relations.

The purpose of this study was to investigate how children evaluate moral transgressions (rule violations that do not involve conflicts) and conflicts (stories involving peer, teacher-child, and familial relations) and how children weigh different issues and re-evaluate their decisions after hearing new information about the conflict. Results showed that children at all ages supported decisions by authorities (peer and adult) to ignore social order violations to prevent harm or a failure to share. Decisions to give preference to interpersonal relations were made for issues about harm but not about sharing resources. The findings demonstrate that children give priority to the prevention of harm and a failure to share for some, but not all types of moral conflicts, and that the salience of moral consequences influences their overall evaluation.

Attitude↗