Sample records for exile helping distressed

  1. Philosophical and Psychopathological Perspective of Exile: On Time and Space Experiences

    PubMed Central

    Silva Rojas, Matías; Armijo Nuñez, Julio; Nuñez Erices, Gonzalo

    2015-01-01

    This article addresses the experience of exile from an interdisciplinary perspective (philosophy and psychiatry). The main purpose is to try to understand the experience of exile by rehearsing a psychopathological perspective to address it, so it can help with the treatment of disorders that come with this experience. Furthermore, the article tries to explore the experience and reflection of philosophers and thinkers who, being exiled themselves, tried to understand and explain this radical human experience, focusing on the experience of time and space. PMID:26074825

  2. Wittgenstein as Exile: A Philosophical Topography

    ERIC Educational Resources Information Center

    Peters, Michael A.

    2008-01-01

    This paper argues that Wittgenstein considered himself an exile and indeed was a self-imposed exile from his native Vienna; that this condition of exile is important for understanding Wittgenstein the man and his philosophy; and that exile as a condition has become both a central characteristic condition of late modernity (as much as alienation…

  3. Empathy and Helping in a Non-Distress Situation.

    ERIC Educational Resources Information Center

    Gano, Lori

    Theories about helping behavior have branched into two basic areas: egoistic and altruistic. Egoistic theories describe helping as being induced by sadness or distress; the Empathy-Altruism hypothesis contends that people help when they feel empathy for another in need. Fultz, Schaller, and Cialdini (1988) looked at the possibility that three…

  4. Help-Seeking among Male Employees in Japan: Influence of Workplace Climate and Distress

    PubMed Central

    Maekawa, Yumiko; Ramos-Cejudo, Juan; Kanai, Atsuko

    2016-01-01

    Objectives: Although using mental health services is an effective way to cope with work-related stressors and diseases, many employees do not utilize these services despite service improvements in recent years. The present study aimed to investigate the interaction effects of workplace climate and distress on help-seeking attitudes, and elucidate the reasons for mental health service underutilization in Japan. Methods: A questionnaire was distributed to 650 full-time male Japanese employees. Hierarchical multiple regression analysis was used to investigate interaction effects of workplace climate and distress on help-seeking. Results: Results showed that the association between workplace climate and help-seeking attitudes differed depending on employee distress level. For employees experiencing low levels of distress, openness to seeking treatment increased with a higher evaluation of the mental health services available at the workplace. However, the same did not hold true for employees experiencing high levels of distress. Instead, openness to seeking treatment decreased with perceived risk for career disadvantage for high distress employees. Additionally, negative values for seeking treatment in highly distressed employees decreased only when services were perceived as valuable, and the risk to their career was perceived as low. Conclusions: Overall, these findings indicate that distress distorts the perception of social support, which may lead to underutilization of available services. Assessing employees' distress levels and tailoring adequate interventions could facilitate help-seeking in male employees. PMID:27725378

  5. Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey.

    PubMed Central

    Biddle, Lucy; Gunnell, David; Sharp, Debbie; Donovan, Jenny L

    2004-01-01

    BACKGROUND: Young adults, especially men, are among those least likely to consult healthcare professionals when mentally distressed or suicidal. AIMS: To investigate the help-seeking behaviours of mentally distressed young adults. Design of study: Cross-sectional survey. SETTING: Bristol and surrounding areas, including inner-city, suburban and urban locations. METHOD: A questionnaire was sent to a sample of 3004 young adults aged 16-24 years. This assessed probable mental disorder (using the 12-item general health questionnaire [GHQ-12]), suicidal thoughts (GHQ-28 suicide subscale), and help-seeking behaviours. RESULTS: Most responders who were assessed as having probable mental disorders (GHQ "cases") had not sought help. Help seeking was more common in female GHQ cases than male cases (34.8% and 21.8%,respectively; P = 0.003) and women with suicidal thoughts more commonly sought help than men with suicidal thoughts (41.6% and 30.9%, respectively; P = 0.15). Small proportions of male and female GHQ cases (7.5% and 8.9%, respectively; P = 0.6), and less than one in five responders with suicidal thoughts, had consulted a general practitioner. In more female than male cases, help was sought from family and friends (30.7% and 18.4%, respectively; P = 0.004). GHQ score was the strongest predictor of help seeking. Men had a higher threshold of severity at which they would seek help than women. Recent experience of suicidal thoughts appeared to be a stronger predictor of formal help seeking in mentally distressed women than mentally distressed men. CONCLUSION: Distressed young adults are reluctant to seek help. Men are particularly unlikely to do so unless severely distressed and tend not to seek lay support. Sex differences in help seeking may be important in understanding the high suicide rate for men. PMID:15113490

  6. Seeking help for perinatal psychological distress: a meta-synthesis of women's experiences.

    PubMed

    Button, Susan; Thornton, Alexandra; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

    2017-10-01

    Women may not seek help for perinatal psychological distress, despite regular contact with primary care services. Barriers include ignorance of symptoms, inability to disclose distress, others' attitudes, and cultural expectations. Much of the evidence has been obtained from North American populations and may not, therefore, extrapolate to the UK. To understand the factors affecting women's decision to seek help for perinatal distress. Meta-synthesis of the available published qualitative evidence on UK women's experiences of seeking help for perinatal distress. Systematic searches were conducted in accordance with PRISMA guidelines. Databases searched were PubMed, Scopus, PsycINFO, PsycARTICLES, CINAHL, and Academic Search Complete. Searches of grey literature and references were also conducted. Studies were eligible for inclusion if they reported qualitative data on UK women's experiences of perinatal distress and contact with healthcare professionals. The synthesis was conducted using meta-ethnography. In all, 24 studies were eligible for inclusion. Metasynthesis identified three main themes: identifying a problem, the influence of healthcare professionals, and stigma. These themes build on current understanding of help seeking by identifying the need for women to be able to frame their experience, for healthcare professionals to educate women about their roles, the need for continuity of care, and the way that being seen as a 'bad mother' causes women to self-silence. Perinatal care provision needs to allow for continuity of care and for staff training that facilitates awareness of factors that influence women's help seeking. Further research is required, particularly in relation to effective means of identifying perinatal psychological distress. © British Journal of General Practice 2017.

  7. Wittgenstein as Exile: A Philosophical Topography

    ERIC Educational Resources Information Center

    Peters, Michael A.

    2010-01-01

    Exilic thought is a kind of uprooted thought developed away from "home" under conditions of displacement and uncertainty, often in a different mother tongue, language tradition and culture. Exilic thought is sometimes the self-imposed discipline of the "stranger" who develops his or her identity as an "alien" or immigrant against the conventions…

  8. Young adults' perceptions of GPs as a help source for mental distress: a qualitative study

    PubMed Central

    Biddle, Lucy; Donovan, Jenny L; Gunnell, David; Sharp, Debbie

    2006-01-01

    Background Few young adults with mental disorder seek help from a GP. Aim To explore young adults' perceptions of GPs as a source of help for mental distress. Design of study Qualitative interviews. Setting Bristol and surrounding areas, UK. Method Males and females aged 16–24 years screened as ‘cases’ with probable mental disorder (GHQ [General Health Questionnaire]-12 score≥4) or describing past episodes of mental disorder (n = 23) were sampled purposively according to help-seeking behaviour. Semi-structured interviews explored help-seeking choices. Transcripts were analysed using thematic, constant comparison and case study analysis. Results Most young adults did not value or recognise GPs as a source of help for mental disorder or distress. They thought that GPs deal exclusively with physical illness, lack training in mental health, are unable to provide ‘talking’ therapy, and may be dismissive of those consulting with mental distress. A prescription for antidepressants was seen as the most likely outcome of a consultation, but young adults wished to avoid this and so rarely consulted. Encounters with GPs could challenge or reinforce these perceptions. Conclusion Negative perceptions about the value of consulting a GP for mental distress may explain low rates of help-seeking among young adults, including those with severe distress. Young people require a better understanding of GPs' role. It is also necessary to address evidence reported elsewhere that some GPs also experience uncertainties about what they can offer within the constraints of primary care. PMID:17132380

  9. Changing conceptions of mental distress among Somalis in Finland.

    PubMed

    Mölsä, Mulki Elmi; Hjelde, Karin Harsløf; Tiilikainen, Marja

    2010-04-01

    This article examines how the conceptions, expressions and treatment of mental distress are changing among Somalis living in Finland. The data derive from two focus group interviews with Somali seniors and two individual interviews with Islamic healers. Conditions conceptualized by the Finnish biomedical system as mental disorders, are seen by most Somalis as spiritual and/or social problems. Somali migrants face new sources of suffering and new ways of interpreting them. Consequently, traditional conceptions of mental distress both persist and change. Islamic understandings of healing, including notions of jinn spirits and treatment, continue to be important in exile.

  10. Exile as a Means for the Meeting and Construction of Pedagogies: The Exiled Spanish Republican Teachers in Mexico in 1939

    ERIC Educational Resources Information Center

    Civera, Alicia

    2011-01-01

    There has been little study of political exile as a means for transferring pedagogic ideas and models, which has been important in Latin America, especially in the case of the Spaniards exiled in Mexico after the defeat of the Second Republic at the end of the 1930s. The Mexican government's sympathy with the Second Republic allowed many teachers…

  11. Barriers of Chinese primary care attenders to seeking help for psychological distress in Hong Kong.

    PubMed

    Sun, Kai Sing; Lam, Tai Pong; Lam, Kwok Fai; Lo, Tak Lam; Chao, David Vai Kiong; Lam, Edmund Wing Wo

    2016-05-15

    Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. The (n,γ) campaigns at EXILL

    NASA Astrophysics Data System (ADS)

    Jolie, J.; Régis, J.-M.; Wilmsen, D.; Ahmed, S.; Pfeiffer, M.; Saed-Samii, N.; Warr, N.; Blanc, A.; Jentschel, M.; Köster, U.; Mutti, P.; Soldner, T.; Simpson, G.; De France, G.; Urban, W.; Drouet, F.; Vancraeyenest, A.; Baczyk, P.; Czerwinski, M.; Korgul, A.; Mazzocchi, C.; Rzaca-Urban, T.; Bruce, A.; Roberts, O. J.; Fraile, L. M.; Mach, H.; Paziy, V.; Ignatov, A.; Ilieva, S.; Kröll, Th.; Scheck, M.; Thürauf, M.; Ivanova, D.; Kisyov, S.; Lalkovski, S.; Podolyák, Zs.; Regan, P. H.; Korten, W.; Zielinska, M.; Salsac, M. D.; Habs, D.; Thirolf, P. G.; Ur, C. A.; Bernards, C.; Casten, R. F.; Cooper, N.; Werner, V.; Cakirli, R. B.; Leoni, S.; Benzoni, G.; Bocchi, G.; Bottoni, S.; Crespi, F. C. L.; Fornal, B.; Cieplicka, N.; Szpak, B.; Petrache, C. M.; Leguillon, R.; John, R.; Lorenz, C.; Massarczyk, R.; Schwengner, R.; Curien, D.; Lozeva, R.; Sengele, L.; Marginean, N.; Lica, R.

    2015-05-01

    At the PF1B cold neutron beam line at the Institut Laue Langevin, the EXILL array consisting of EXOGAM, GASP and ILL-Clover detectors was used to perform (n,γ) measurements at very high coincidence rates. About ten different reactions were measured in autumn 2012 using a highly collimated cold neutron beam. In spring 2013, the EXOGAM array was combined with 16 LaBr3(Ce) scintillators in the EXILL&FATIMA campaign for the measurement of lifetimes using the generalised centroid difference method. We report on the properties of the set-ups and present first results from both campaigns.

  13. Helping behavior induced by empathic concern attenuates anterior cingulate activation in response to others' distress.

    PubMed

    Kawamichi, Hiroaki; Yoshihara, Kazufumi; Sugawara, Sho K; Matsunaga, Masahiro; Makita, Kai; Hamano, Yuki H; Tanabe, Hiroki C; Sadato, Norihiro

    2016-01-01

    Helping behavior is motivated by empathic concern for others in distress. Although empathic concern is pervasive in daily life, its neural mechanisms remain unclear. Empathic concern involves the suppression of the emotional response to others' distress, which occurs when individuals distance themselves emotionally from the distressed individual. We hypothesized that helping behavior induced by empathic concern, accompanied by perspective-taking, would attenuate the neural activation representing aversive feelings. We also predicted reward system activation due to the positive feeling resulting from helping behavior. Participant underwent functional magnetic resonance imaging while playing a virtual ball-toss game. In some blocks ("concern condition"), one player ("isolated player") did not receive ball-tosses from other players. In this condition, participants increased ball-tosses to the isolated player (helping behavior). Participants then evaluated the improved enjoyment of the isolated player resulting from their helping behavior. Anterior cingulate activation during the concern condition was attenuated by the evaluation of the effect of helping behavior. The right temporoparietal junction, which is involved in perspective-taking and the dorsal striatum, part of the reward system, were also activated during the concern condition. These results suggest that humans can attenuate affective arousal by anticipating the positive outcome of empathic concern through perspective-taking.

  14. Specific attitudes which predict psychology students' intentions to seek help for psychological distress.

    PubMed

    Thomas, Susan J; Caputi, Peter; Wilson, Coralie J

    2014-03-01

    Although many postgraduate psychology programs address students' mental health, there are compelling indications that earlier, undergraduate, interventions may be optimal. We investigated specific attitudes that predict students' intentions to seek treatment for psychological distress to inform targeted interventions. Psychology students (N = 289; mean age = 19.75 years) were surveyed about attitudes and intentions to seek treatment for stress, anxiety, or depression. Less than one quarter of students reported that they would be likely to seek treatment should they develop psychological distress. Attitudes that predicted help-seeking intentions related to recognition of symptoms and the benefits of professional help, and openness to treatment for emotional problems. The current study identified specific attitudes which predict help-seeking intentions in psychology students. These attitudes could be strengthened in undergraduate educational interventions promoting well-being and appropriate treatment uptake among psychology students. © 2013 Wiley Periodicals, Inc.

  15. Late style as exile: De/colonising the life course.

    PubMed

    Hartung, Heike

    2016-12-01

    In the collection of essays On Late Style, Edward Said reflects on the new idiom achieved by great artists in their work near the end of their lives as "late style." Drawing on Adorno's essay on Beethoven's late style, Said also focuses on the aesthetic aspects of lateness. Defining the late works of artists as "a form of exile," however, Said moves beyond Adorno's aesthetic conception of late style. Highlighting the artist's abandonment of communication with the established social order, who achieves a contradictory, alienated relationship with it instead, Said compares artistic lateness with the experience of the subject in exile. Drawing on the analogy provided by Said, this article argues that the relationship between "self" and "other" in the different theoretical contexts of Postcolonial Studies and Age Studies can be usefully combined in the composite concept of "late style as exile." In order to explore how the concept of lateness correlates with that of exile, this contribution turns to theoretical and autobiographical texts by Edward Said. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Cyber-Porn Dependence: Voices of Distress in an Italian Internet Self-Help Community

    ERIC Educational Resources Information Center

    Cavaglion, Gabriel

    2009-01-01

    This study analyzes narratives of cyber-porn users and defines major patterns of distress as self-reported by contributors to a self-help group in the Internet. It applies narrative analysis methodology to 2000 messages sent by 302 members of an Italian self-help Internet community for cyber-porn dependents ("noallapornodipendenza").…

  17. Using health psychology to help patients: common mental health disorders and psychological distress.

    PubMed

    Barley, Elizabeth; Lawson, Victoria

    2016-09-22

    This article provides an overview of how health psychology can be used by nurses to help patients experiencing common mental health problems and psychological distress. Mental health problems are common and are associated with poor outcomes, especially for patients with comorbid physical health conditions. Mental health problems are associated with unhealthy behaviours such as smoking, physical inactivity, overeating and excessive alcohol use, which will result in poorer outcomes for patients. Consideration of a patient's psychological health is therefore important for all nurses providing holistic care. Awareness of the symptoms of psychological distress, good communication skills and simple screening instruments can be used by nurses to assess patients' mental health. The cognitive and behavioural risk factors associated with depression and anxiety are also explored, as an understanding of these can help nurses to provide appropriate care.

  18. Altruism in the wild: when affiliative motives to help positive people overtake empathic motives to help the distressed.

    PubMed

    Hauser, David J; Preston, Stephanie D; Stansfield, R Brent

    2014-06-01

    Psychological theories of human altruism suggest that helping results from an evolved tendency in caregiving mammals to respond to distress or need with empathy and sympathy. However, theories from biology, economics, and social psychology demonstrate that social animals also evolved to affiliate with and help desirable social partners. These models make different predictions about the affect of those we should prefer to help. Empathic models predict a preference to help sad, distressed targets in need, while social affiliative models predict a preference for happy, positive, successful targets. We compared these predictions in 3 field studies that measured the tendency to help sad, happy, and neutral confederates in a real-world, daily context: holding the door for a stranger in public. People consistently held the door more for happy over sad or neutral targets. To allow empathic motivations to compete more strongly against social affiliative ones, a 4th study examined a more consequential form of aid for hypothetical hospital patients in clear need. These conditions enhanced the preference to help a sad over a happy patient, because sadness made the patient appear sicker and in greater need. However, people still preferred the happy patient when the aid required a direct social interaction, attesting to the strength of social affiliation motives, even for sick patients. Theories of prosocial behavior should place greater emphasis on the role of social affiliation in motivating aid, particularly in everyday interpersonal contexts. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PsycINFO Database Record (c) 2014 APA, all rights reserved.

  19. Dreaming woman: Image, place, and the aesthetics of exile.

    PubMed

    Greenspan, Rachel

    2017-08-01

    Looking closely at an Argentine dream interpretation column published in a popular women's magazine from 1948 to 1951, this article examines the role of the dream image in shaping psychoanalytic discourse on femininity and national identity. The column, 'Psychoanalysis Will Help You,' emerged during Juan Domingo Perón's first presidency, featuring verbal interpretations written under the pen name 'Richard Rest,' as well as surreal photomontages by Grete Stern, a German-born, Bauhaus-trained photographer living in exile since 1936. While the column's Jungian text encourages readers' adaptation to the external reality of their social situation, Stern's droll images emphasize the disjuncture between subject and environment, exposing tensions between the experience of exile and the Peronist mission to consolidate an Argentine national identity. Experimenting formally with European avant-garde techniques, Stern presents femininity and nation as conflictive imaginary configurations. This theme resurfaces at the 2013 Venice Biennale, where Nicola Costantino's multimedia installation Eva - Argentina: A Contemporary Metaphor was exhibited alongside Carl Jung's Red Book. Formal contrasts between Stern's use of photomontage, Costantino's projection technique, and Jung's theory of mandala symbolism indicate the divergent ways in which their artwork posits the therapeutic function of the dream image, as well as the role of aesthetic production in psychoanalytic care. Copyright © 2017 Institute of Psychoanalysis.

  20. Language, Identity, and Exile

    ERIC Educational Resources Information Center

    Erdinast-Vulcan, Daphna

    2010-01-01

    The exilic mode of being, a living on boundary-lines, produces a constant relativization of one's home, one's culture, one's language, and one's self, through the acknowledgement of otherness. It is a homesickness without nostalgia, without the desire to return to the same, to be identical to oneself. The encounter with the other which produces a…

  1. Sensitivity and specificity of the Distress Thermometer and a two-item depression screen (Patient Health Questionnaire-2) with a 'help' question for psychological distress and psychiatric morbidity in patients with advanced cancer.

    PubMed

    Ryan, Dermot Anthony; Gallagher, Pamela; Wright, Shelagh; Cassidy, Eugene M

    2012-12-01

    Brief screening tools may help clinicians in busy settings detect patients who are experiencing severe psychological distress. This study examined the performance of the Distress Thermometer (DT) and a two-item depression screen [the Patient Health Questionnaire-2 (PHQ-2)] with a 'help' question in screening for distress and psychiatric morbidity among patients with advanced cancer. Two hundred and five patients with advanced cancer completed the DT, the PHQ-2 and 'help' question and the Hospital Anxiety and Depression Scale and were interviewed using the Structured Clinical Interview for DSM-IV (SCID). The performance of the screening tools was examined against the Hospital Anxiety and Depression Scale and the SCID. Overall, discrimination levels were comparable for the DT [area under the curve (AUC) 0.80-0.81] and the PHQ-2 (AUC 0.73-0.85). The DT performed best in detecting cases of distress and mood, anxiety or adjustment disorders (sensitivity 100%), but it had poor specificity (49-60%). The best performance in terms of combined sensitivity and specificity was the PHQ depression item versus the SCID (sensitivity 88%, specificity 73%). The inclusion of the 'help' question with the PHQ-2 resulted in high levels of specificity (≥89%), but there was a significant drop in sensitivity (≤54%). Ultra-brief screening tools offer an efficient means of identifying patients with advanced cancer with severe distress or psychiatric morbidity but are less effective at identifying non-distressed individuals. Used in conjunction with a 'help' question, these tools can help clinicians identify patients who are both distressed and likely to accept professional support. Copyright © 2011 John Wiley & Sons, Ltd.

  2. Time for a Change: College Students' Preference for Technology-Mediated Versus Face-to-Face Help for Emotional Distress.

    PubMed

    Lungu, Anita; Sun, Michael

    2016-12-01

    Even with recent advances in psychological treatments and mobile technology, online computerized therapy is not yet popular. College students, with ubiquitous access to technology, experiencing high distress, and often nontreatment seekers, could be an important area for online treatment dissemination. Finding ways to reach out to college students by offering psychological interventions through technology, devices, and applications they often use, might increase their engagement in treatment. This study evaluates college students' reported willingness to seek help for emotional distress through novel delivery mediums, to play computer games for learning emotional coping skills, and to disclose personal information online. We also evaluated the role of ethnicity and level of emotional distress in help-seeking patterns. A survey exploring our domains of interest and the Mental Health Inventory ([MHI] as mental health index) were completed by 572 students (mean age 18.7 years, predominantly Asian American, female, and freshmen in college). More participants expressed preference for online versus face-to-face professional help. We found no relationship between MHI and help-seeking preference. A third of participants were likely to disclose at least as much information online as face-to-face. Ownership of mobile technology was pervasive. Asian Americans were more likely to be nontreatment seekers than Caucasians. Most participants were interested in serious games for emotional distress. Our results suggest that college students are very open to creative ways of receiving emotional help such as playing games and seeking emotional help online, suggesting a need for online evidence-based treatments.

  3. Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence.

    PubMed

    Carolan, C M; Smith, A; Davies, G R; Forbat, L

    2018-03-01

    Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality-the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding. © 2017 John Wiley & Sons Ltd.

  4. Between Exile and the Kingdom: Albert Camus and Empowering Classroom Relationships

    ERIC Educational Resources Information Center

    Curzon-Hobson, Aidan

    2003-01-01

    In undertaking an analysis of the work of Camus in the context of the learning environment, this paper examines the breadth of Camus's writing with particular emphasis on the writer's final major work: "Exile and the Kingdom" (1958). It is proposed that "Exile and the Kingdom" could and should be read as an attempt by Camus to explicate in full…

  5. [The members of the exiled Hungarian school, mourning and renewal].

    PubMed

    Brabant, E

    1988-01-01

    A historical survey of the Hungarian psycho-analytical movement, followed by a description of the two successive waves of emigration. After some biographical details about three analysts who emigrated--Alice Balint, Michael Balint and Géza Roheim--exile is considered from the viewpoint of regretting the past and subsequent "renewal". Its effect is traced in the work of Balint and Roheim. Finally exile is seen as an ordeal creative of Freudian thought and as an experience common to all human beings.

  6. The Exilic Classroom: Spaces of Subversion

    ERIC Educational Resources Information Center

    Brogan, Andrew J.

    2017-01-01

    This paper explores the possibility of the classroom as an exilic space of subversion in which we can pursue anarchist notions of personal transformation, relationships and society. Classroom environments in higher education institutions in Britain, particularly following the introduction of the Teaching Excellence Framework in September 2016, are…

  7. Rethinking reproductive "tourism" as reproductive "exile".

    PubMed

    Inhorn, Marcia C; Patrizio, Pasquale

    2009-09-01

    Whereas reproductive "tourism" implies leisure travel, reproductive "exile" bespeaks the numerous difficulties and constraints faced by infertile patients who are "forced" to travel globally for assisted reproduction. Given this reality, it is time to rethink the language of "reproductive tourism," replacing it with more accurate and patient-centered terms.

  8. Exile Has Its Place: A High School Principal Reflects on School Discipline

    ERIC Educational Resources Information Center

    Hawkes, T. Elijah

    2011-01-01

    Exile has its place. As an age-old human response to conflict, its potential value to the healthy maturation of students and the school community should not be discounted. Exile or ostracism goes by various names in school. Students are told: Move your desk. Leave the classroom and wait in the hall. Go to the office. Go to detention. You're…

  9. Distress, need for help, and positive feelings derived from participation in sex research: findings of a population study in The Netherlands.

    PubMed

    Kuyper, Lisette; Wijsen, Ciel; de Wit, John

    2014-01-01

    To inform cost-benefit analyses of potential harms and benefits for participants in sex research, the current study investigated potential effects of completing a self-report sex survey. The data stem from a sexual health study in a population sample in the Netherlands (N = 8,064; 15 to 70 years old). Three measures assessed potential effects of participation: distress, need for help, and positive feelings related to research participation. Analyses showed that levels of experienced distress and need for help resulting from participation in a self-report sex survey were low, while participants reported positive feelings to a considerable extent. Only few participants reported levels of positive experiences that were lower than the levels of distress (4.8%) or need for help (1.7%) they experienced. Although differences were found according to sociodemographic characteristics and sexual experiences, the proportion of variance explained by these variables was generally small. While the findings of this study show that the balance between potential harm and positive outcomes seems disturbed for few participants, researchers should provide participants with the details of care providers in case they experience any distress or need for help.

  10. Between Home and Exile: A Reading of the Exilic Experience of the Iraqi Poet Adnan Al-Sayegh

    ERIC Educational Resources Information Center

    Ghena, Hana Khlaif

    2016-01-01

    This paper aims at exploring the exilic experience of the Iraqi poet, Adnan Al-Sayegh whose involuntarily departure from his homeland, Iraq, in the early 1990s made him suffer a strong sense of estrangement, nostalgia, self-fragmentation and disconnection. The paper is divided into three sections and a conclusion. Section one sheds light on the…

  11. Relationships Among Financial Distress, Emotional Distress, and Overall Distress in Insured Patients With Cancer.

    PubMed

    Meeker, Caitlin R; Geynisman, Daniel M; Egleston, Brian L; Hall, Michael J; Mechanic, Karen Y; Bilusic, Marijo; Plimack, Elizabeth R; Martin, Lainie P; von Mehren, Margaret; Lewis, Bianca; Wong, Yu-Ning

    2016-07-01

    Recent studies have demonstrated increasing rates of financial toxicities and emotional distress related to cancer treatment. This study assessed and characterized the relationships among financial distress, emotional symptoms, and overall distress in patients with cancer. A cross-sectional sample of patients with cancer who visited our outpatient medical oncology and psychiatry clinics completed a pen-and-paper survey. The survey assessed demographics; cost concerns; and financial, emotional, and overall distress. One hundred twenty insured patients completed the survey. Sixty-five percent reported clinically significant overall distress scores, with the same percentage reporting at least one emotional problem (worry, anxiety, depression, etc). Twenty-nine percent scored in the range of high to overwhelming financial distress. By using structural equation modeling, we found that financial distress was associated with overall distress. This association was both direct (accounting for 76% of the effect) and indirect (accounting for 24% of the effect) via mediation by emotional distress. This cohort of patients with cancer reported significant levels of emotional distress, financial distress, and overall distress. These factors were interrelated, with both financial and emotional distress contributing to overall distress. Interventions targeted at alleviating financial distress may help to decrease levels of overall distress. Copyright © 2016 by American Society of Clinical Oncology.

  12. Relationships Among Financial Distress, Emotional Distress, and Overall Distress in Insured Patients With Cancer

    PubMed Central

    Meeker, Caitlin R.; Geynisman, Daniel M.; Egleston, Brian L.; Hall, Michael J.; Mechanic, Karen Y.; Bilusic, Marijo; Plimack, Elizabeth R.; Martin, Lainie P.; von Mehren, Margaret; Lewis, Bianca

    2016-01-01

    Purpose: Recent studies have demonstrated increasing rates of financial toxicities and emotional distress related to cancer treatment. This study assessed and characterized the relationships among financial distress, emotional symptoms, and overall distress in patients with cancer. Methods: A cross-sectional sample of patients with cancer who visited our outpatient medical oncology and psychiatry clinics completed a pen-and-paper survey. The survey assessed demographics; cost concerns; and financial, emotional, and overall distress. Results: One hundred twenty insured patients completed the survey. Sixty-five percent reported clinically significant overall distress scores, with the same percentage reporting at least one emotional problem (worry, anxiety, depression, etc). Twenty-nine percent scored in the range of high to overwhelming financial distress. By using structural equation modeling, we found that financial distress was associated with overall distress. This association was both direct (accounting for 76% of the effect) and indirect (accounting for 24% of the effect) via mediation by emotional distress. Conclusion: This cohort of patients with cancer reported significant levels of emotional distress, financial distress, and overall distress. These factors were interrelated, with both financial and emotional distress contributing to overall distress. Interventions targeted at alleviating financial distress may help to decrease levels of overall distress. PMID:27328795

  13. The psychological effects of political repression on Chilean exiles in the U.S.

    PubMed

    Gonsalves, C J

    1990-01-01

    Interviews with 32 Chilean refugees elicited descriptive findings on the effects of detention and torture and subsequent exile in the U.S. It is suggested that exile for this group constitutes a continuation rather than a cessation of their suffering. Marital problems, economic hardship, and loneliness are recounted by the adults, while teachers and parents report adjustment and behavioral difficulties among the children. The influence of sociopolitical factors on these outcomes is discussed.

  14. Attitudes within the general population towards seeking professional help in cases of mental distress.

    PubMed

    Roskar, Saska; Bracic, Mark Floyd; Kolar, Urska; Lekic, Ksenija; Juricic, Nusa Konec; Grum, Alenka Tancic; Dobnik, Bogdan; Postuvan, Vita; Vatovec, Mojca

    2017-11-01

    Although effective treatment is available for a variety of mental disorders, the treatment and help-seeking gap remains high. One of the main obstacles to help-seeking behaviour is prevailing stigmatizing attitudes. To examine attitudes within the general population towards seeking professional help in times of mental distress. A representative general population survey ( N = 594) was conducted in Slovenia by means of an Internet-based questionnaire, covering data on demographic variables and attitudes towards help-seeking behaviour. More stigmatizing attitudes towards help-seeking behaviour were found in men, single persons, those of a younger age and lower educational achievement and in respondents coming from regions with a high suicide rate. Furthermore, 52.50% of the total sample have had an experience with psychological problems, yet only 41.50% of those have sought professional help. Experience with help-seeking behaviour in the past was associated with less stigmatizing attitudes. Knowledge and understanding of mental health problems are necessary prerequisites to seeking help, but not the only ones. To improve help-seeking behaviour, it is also important to combat stigmatizing attitudes. Additionally, destigmatizing campaigns should also focus on social norms.

  15. Helping Yourself by Offering Help: Mediators of Expressive Helping in Survivors of Hematopoietic Stem Cell Transplant.

    PubMed

    Williamson, Timothy J; Stanton, Annette L; Austin, Jane E; Valdimarsdottir, Heiddis B; Wu, Lisa M; Krull, Jennifer L; Rini, Christine M

    2017-10-01

    A randomized experiment by Rini et al. (Health Psychol. 33(12):1541-1551, 2014) demonstrated that expressive helping, which involves three expressive writing sessions regarding hematopoietic stem cell transplant, followed by one writing session directed toward helping other stem cell transplant recipients, reduced psychological distress and bothersome physical symptoms among stem cell transplant recipients with elevated survivorship problems, relative to a neutral writing control condition. The current study evaluated whether word use reflective of emotional expression, cognitive processing, and change in perspective mediates the effects of expressive helping. The essays of 67 stem cell transplant recipients with high survivorship problems were analyzed with Linguistic Inquiry and Word Count. Multiple mediation modeling was used to test the hypothesized mechanisms of expressive helping on distress and bothersome physical symptoms. Relative to the control condition, expressive helping produced significant reductions in psychological distress and marginal reductions in physical symptom bother in the analyzed subset of participants from the parent study. Results indicated that positive emotion word use significantly mediated effects of expressive helping on reduced distress, but only for participants who used average (compared to above or below average) rates of negative emotion words. Cognitive processing and change in perspective did not significantly mediate benefits of expressive helping. Expressive helping carried its positive effects on distress through participants' higher expression of positive emotions when coupled with moderate rates of negative emotions. Findings highlight the benefit of expressing both positive and negative emotions in stressful situations.

  16. Help-Seeking Intentions among Asian American and White American Students in Psychological Distress: Application of the Health Belief Model

    PubMed Central

    Kim, Jin E.; Zane, Nolan

    2015-01-01

    Objective Underutilization of needed mental health services continues to be the major mental health disparity affecting Asian Americans (Sue, Cheng, Saad, & Chu, 2012). The goal of the study was to apply a social psychological theoretical framework—the Health Belief Model (Rosenstock, 1966)—to understand potential reasons why Asian Americans underutilize mental health services relative to White Americans. Method Using a cross-sectional online questionnaire, this study examined how perceived severity of symptoms, perceived susceptibility to mental health problems, perceived benefits of treatment, and perceived barriers to treatment influenced intentions to seek help among a sample of 395 Asian American and 261 White American students experiencing elevated levels of psychological distress. Results Analyses using structural equation modeling indicated that Asian Americans in distress had relatively lower intentions to seek help compared to White Americans. Perceived benefits partially accounted for differences in help-seeking intentions. Although Asian Americans perceived greater barriers to help-seeking than White Americans, it did not significantly explain racial/ethnic differences in help-seeking intentions. Perceived severity and barriers were related to help-seeking intentions in both groups. Conclusions Outreach efforts that particularly emphasize the benefits of seeking mental health services may be a particularly promising approach to address underutilization. These findings have implications in help-seeking promotion and outreach. PMID:26098454

  17. Correlates and Predictors of Psychological Distress among Afghan Refugees in San Diego County

    PubMed Central

    James, Sigrid; Siddiq, Hafifa; Montgomery, Susanne

    2015-01-01

    The psychological effects of war and resulting displacement continue to negatively impact Afghan refugees. The purpose of this study was to investigate factors that are associated with and predict psychological distress symptoms among Afghan refugees. We analyzed data from a diverse sample of 130 Afghan refugees recruited through non-random sampling in the San Diego area. Participants completed self-report questionnaires consisting of a culturally validated measure of psychological distress, the Afghan Symptom Checklist [ASCL] alongside standardized measures of acculturation, social support, and perceived stress. In bivariate analyses, older age, older age at migration, female gender, being widowed, having lower education, being unemployed, unable to comfortably pay monthly bills, lower acculturation and social support, and higher levels of perceived stress were associated with psychological distress. However, only few variables – female gender, being widowed, unable to comfortably pay monthly bills, and perceived stress – remained significant in multivariate analysis. The findings from this study contribute to understanding the social determinants of distress that affect Afghans in exile even after long-term resettlement in the US. These reported outcomes support the need for continued research with Afghans, alongside the implementation of culturally relevant psychosocial interventions that emphasize prevention of post-resettlement stressors immediately upon resettlement. PMID:26543500

  18. Help-seeking intentions among Asian American and White American students in psychological distress: Application of the health belief model.

    PubMed

    Kim, Jin E; Zane, Nolan

    2016-07-01

    Underutilization of needed mental health services continues to be the major mental health disparity affecting Asian Americans (Sue, Cheng, Saad, & Chu, 2012). The goal of this study was to apply a social psychological theoretical framework-the health belief model (Rosenstock, 1966)-to understand potential reasons why Asian Americans underutilize mental health services relative to White Americans. Using a cross-sectional online questionnaire, this study examined how perceived severity of symptoms, perceived susceptibility to mental health problems, perceived benefits of treatment, and perceived barriers to treatment influenced intentions to seek help among a sample of 395 Asian American and 261 White American students experiencing elevated levels of psychological distress. Analyses using structural equation modeling indicated that Asian Americans in distress had relatively lower intentions to seek help compared with White Americans. Perceived benefits partially accounted for differences in help-seeking intentions. Although Asian Americans perceived greater barriers to help seeking than did White Americans, this did not significantly explain racial/ethnic differences in help-seeking intentions. Perceived severity and barriers were related to help-seeking intentions in both groups. Outreach efforts that particularly emphasize the benefits of seeking mental health services may be a particularly promising approach to address underutilization. The findings have implications in help-seeking promotion and outreach. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.

    PubMed

    Krebber, Anne-Marie H; van Uden-Kraan, Cornelia F; Melissant, Heleen C; Cuijpers, Pim; van Straten, Annemieke; Becker-Commissaris, Annemarie; Leemans, C René; Verdonck-de Leeuw, Irma M

    2017-01-01

    Recent results of a randomized clinical trial showed that a guided self-help intervention (based on problem-solving therapy) targeting psychological distress among head and neck cancer and lung cancer patients is effective. This study qualitatively explored motivation to start, experiences with and perceived outcomes of this intervention. Data were collected from semi-structured interviews of 16 patients. All interviews were audio-recorded and transcribed verbatim. Data were analyzed individually by two coders and coded into key issues and themes. Patients participated in the intervention for intrinsic (e.g. to help oneself) and for extrinsic reasons (e.g. being asked by a care professional or to help improve health care). Participants indicated positive and negative experiences with the intervention. Several participants appreciated participating as being a pleasant way to work on oneself, while others described participating as too confrontational. Some expressed their disappointment as they felt the intervention had brought them nothing or indicated that they felt worse temporarily, but most participants perceived positive outcomes of the intervention (e.g. feeling less distressed and having learned what matters in life). Cancer patients have various reasons to start a guided self-help intervention. Participants appreciated the guided self-help as intervention to address psychological distress, but there were also concerns. Most participants reported the intervention to be beneficial. The results suggest the need to identify patients who might benefit most from guided self-help targeting psychological distress and that interventions should be further tailored to individual cancer patients' requirements.

  20. DOD’s Use of Iraqi Exiles

    DTIC Science & Technology

    2006-12-01

    and Shi’a Islamists turned regional. Before the war Iraqi exiles worked with internal opposition groups against the Ba’th, with little foreign...and confessional diversity.൫ Albright’s speech, although direct, did little to change the meager support the opposition groups received. The neo...January 2, 2000), http://www.proquest.com/ (accessed November 20, 2005). 21 2. Interpreting the ILA While Clinton seemed to have little choice

  1. [Freud in the journals of the German speaking exile].

    PubMed

    May, Ulrike

    2006-01-01

    Freud and psychoanalysis figure frequently in exile journals. This paper documents two letters to the editor written by Alexander Freud who denied that his brother Sigmund had been a zionist, and the recollections of the sculptor Königsberger who had made a bust of Freud in 1920.

  2. Race and Place in the Adaptation of Mariel Exiles.

    ERIC Educational Resources Information Center

    Skop, Emily H.

    2001-01-01

    The influx of lower class Cuban emigres during the 1980 Mariel Boatlift complicates the success story image of previous waves of Cuban exiles. Argues that place of incorporation should be a necessary ingredient in illuminating diverse adjustment experiences among immigrants and refugees to the United States. Concludes by discussing the Cuban…

  3. Psychological Distress and Help Seeking Amongst Higher Education Students: Findings from a Mixed Method Study of Undergraduate Nursing/Midwifery and Teacher Education Students in Ireland

    ERIC Educational Resources Information Center

    Deasy, Christine; Coughlan, Barry; Pironom, Julie; Jourdan, Didier; Mannix-McNamara, Patricia

    2016-01-01

    Psychological distress as experienced by higher education students is of major concern because of its potential to adversely impact academic performance, retention, mental health and lifestyle. This paper reports a mixed method investigation of student self-reported psychological distress and help-seeking behaviour. The sample comprised all…

  4. A Decade of Counseling Services in One College of Veterinary Medicine: Veterinary Medical Students' Psychological Distress and Help-Seeking Trends.

    PubMed

    Drake, Adryanna A S; Hafen, McArthur; Rush, Bonnie R

    Much has been discussed about the high prevalence of psychological distress among veterinary medical students. Studies investigating general samples of veterinary medical students indicate that, on average, depression and anxiety symptoms are present at higher rates than in comparison samples. However, little is known about veterinary medical students who seek counseling. This study intends to expand the literature on veterinary student well-being, as the first to examine a sample of veterinary medical students seeking counseling services. It offers an overview of student distress and help-seeking trends from a decade of counseling services provided in one College of Veterinary Medicine (CVM) in the US. The sample includes data from 279 participants. Results indicate a steady increase in students seeking counseling over the last decade. First-year students sought services at higher rates but second-year students experienced the greatest distress when compared to other cohorts. Students seeking counseling services experienced levels of overall distress, symptoms of anxiety and depression, and social role concerns that were, on average, above cut-off scores. Physical health was significantly associated with student distress, suggesting opportunities for intervention.

  5. Memory, Childhood and Exile: Self-Representation in Post-Colonial Writing.

    ERIC Educational Resources Information Center

    Sharrad, Paul

    1990-01-01

    Using the works of writers like Thomas Wolfe, Christopher Koch, Raja Rao, and Albert Wendt, it is demonstrated that memory is a central element in postcolonial narratives and is associated with two important domains of cognition--recall of childhood and awareness of exile. (57 references) (JL)

  6. Negotiating Gender Norms to Support Men in Psychological Distress.

    PubMed

    Keohane, Aisling; Richardson, Noel

    2018-01-01

    Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers' capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men's help-seeking as well as care givers' behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide. Focus groups ( n = 13) were used with "high-risk suicide" groups of men and community gatekeepers. The principles of grounded theory were used for data analysis. Three themes emerged: "negotiating ways to ask for, offer and accept help without compromising masculinity"; "making and sustaining contact with men in psychological distress"; and "navigating roles responsibilities and boundaries to support men in psychological distress." Approaches to suicide prevention need to take account of how masculine norms shape men's willingness to ask for and accept help during times of psychological distress as well as care givers willingness to offer help. The findings address a gap in the literature by looking beyond men's help-seeking as a passive, one dimensional construct, to a more dynamic triad of help-seeking/giving/taking behaviors that are embedded in the sociocultural context of men's lives.

  7. Impact of ethnicity, violence and acculturation on displaced migrants: psychological distress and psychosomatic complaints among refugees in Sweden.

    PubMed

    Sundquist, J; Bayard-Burfield, L; Johansson, L M; Johansson, S E

    2000-06-01

    This study uses data collected in 1996 by the Swedish National Board of Health and Welfare. By means of interviews with 1980 foreign-born immigrants, an attempt was made to determine the impact of a) migration status (country of birth/ethnicity), b) exposure to violence, c) Antonovsky's sense of coherence, d) acculturation status (knowledge of Swedish), e) sense of control over one's life, f) economic difficulties, and g) education, both on psychological distress (using General Health Questionnaire 12) and psychosomatic complaints (daytime fatigue, sleeping difficulties, and headache/migraine). Iranians and Chileans (age-adjusted) were at great risk for psychological distress as compared with Poles, whereas Turks and Kurds exhibited no such risk. When the independent factors were included in the model, the migration status effect decreased to insignificance (with the exception of Iranian men). A low sense of coherence, poor acculturation (men only), poor sense of control, and economic difficulties were strongly associated with the outcomes, generally accounting for a convincing link between migration status and psychological distress. Furthermore, a low sense of coherence, poor acculturation (men only), poor sense of control, and economic difficulties in exile seemed to be stronger risk factors for psychological distress in this group than exposure to violence before migration.

  8. The effectiveness of bibliotherapy in alleviating tinnitus-related distress.

    PubMed

    Malouff, John M; Noble, William; Schutte, Nicola S; Bhullar, Navjot

    2010-03-01

    The present study examined the efficacy of bibliotherapy in assisting individuals experiencing distress related to tinnitus. One hundred sixty-two tinnitus sufferers from Australia participated in a study designed to examine the effectiveness of a cognitive-behaviorally based self-help book in reducing distress. To maximize the ecological validity of the findings, we excluded no individuals interested in treatment for tinnitus-related distress. The experimental condition lost 35% of participants at postassessment, compared to 10% in the control group. In an analysis of participants who completed postintervention assessment, those assigned to the intervention condition, who received a tinnitus self-help book, showed significantly less tinnitus-related distress and general distress 2 months later compared to those assigned to the waiting list control condition. The intervention group's reduction in tinnitus-related distress and general distress from preintervention to postintervention 2 months later was significant, and these participants maintained a significant reduction in distress on follow-up 4 months after they received the tinnitus self-help book. A long-term follow-up of all participants, who at that time had received the book at least a year previously, showed a significant reduction in tinnitus distress. Although these group differences and pre-post changes were significant, effect sizes were small. Intention-to-treat analyses showed no significant effect for between-groups analyses, but did show a significant effect for the 1-year follow-up pre-post analysis. Information on the effectiveness of using a self-help book, without therapist assistance, in alleviating distress is important, as bibliotherapy can provide inexpensive treatment that is not bound by time or place. Copyright 2010 Elsevier Inc. All rights reserved.

  9. "Once a Soldier, a Soldier Forever": Exiled Zimbabwean Soldiers in South Africa.

    PubMed

    Maringira, Godfrey; Carrasco, Lorena Núñez

    2015-01-01

    Through military training, soldiers' bodies are shaped and prepared for war and military-related duties. In the context these former Zimbabwean soldiers find themselves--that of desertion and 'underground life' in exile in South Africa--their military-trained bodies and military skills are their only resource. In this article, we explore the ways in which former soldiers maintain and 'reuse' their military-trained bodies in South Africa for survival, in a context of high unemployment and a violent, inner-city environment. We look at their social world and practices of soldiering--a term that refers to the specific forms of their social interaction in exile, through which they keep their memories of their military past alive. By attending to their subjectivities and the endurance of their masculine military identities and bodies, we aim to contribute to the discussion on demilitarization, which has largely focused on the failure of models of intervention to assist ex-combatants in postconflict contexts.

  10. Negotiating Gender Norms to Support Men in Psychological Distress

    PubMed Central

    Keohane, Aisling; Richardson, Noel

    2017-01-01

    Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers’ capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men’s help-seeking as well as care givers’ behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide. Focus groups (n = 13) were used with “high-risk suicide” groups of men and community gatekeepers. The principles of grounded theory were used for data analysis. Three themes emerged: “negotiating ways to ask for, offer and accept help without compromising masculinity”; “making and sustaining contact with men in psychological distress”; and “navigating roles responsibilities and boundaries to support men in psychological distress.” Approaches to suicide prevention need to take account of how masculine norms shape men’s willingness to ask for and accept help during times of psychological distress as well as care givers willingness to offer help. The findings address a gap in the literature by looking beyond men’s help-seeking as a passive, one dimensional construct, to a more dynamic triad of help-seeking/giving/taking behaviors that are embedded in the sociocultural context of men’s lives. PMID:29019282

  11. A programme of mental health for political refugees: dealing with the invisible pain of political exile.

    PubMed

    Barudy, J

    1989-01-01

    Political persecution, state terrorism, torture, political assassinations, kidnapping and forced exile have become common occurrences in many parts of the world. Several researchers have tried to determine the impact of these situations on the mental health of those affected. At the same time, different types of aid programmes have been developed to prevent and treat the effects of violence on mental health. In this article we present clinical materials collected for 10 years by the Latin American Collective of Psychosocial Work [Colectivo Latinamericano de Trabajo Psicosocial (Colat)], a medical-psychosocial assistance programme for political refugees. The programme was under the academic supervision of the Catholic Universities of Leuven (KUL, ULC), Belgium. The concept of identity is the central theme of a model which tries to understand and explain the suffering of exiles. We try to identify and expose the mechanisms of political violence that have traumatized an individual's self-esteem and disordered his familial and social bonds. In the second part of this article, the central ideas which support the medical-psychosocial practice of the programme are presented. This programme seeks to heal the damage caused by repression and exile through the active participation of those affected. Only in a context of communal action is it possible to develop a therapy to promote an individual recovery. It is in this sense that the strategic goal of the programme is to permit elaboration of the suffering at an individual, familial and group level, and to facilitate group dynamics which can trigger the potential of the exiles to transform the conditions of violence that originated and maintain their pain.

  12. [Getting old on foreign earth: more suffering from exile].

    PubMed

    Stitou, Rajaa

    2008-03-01

    This paper, which refers to psychoanalysis and anthropology, is devoted to the clinical impact of suffering to get old on foreign earth, at the junction of singularity and culture, on psychic and social sides. It presents some elements on: the discontentment or even the misery of those called foreign workers and who, however, live more and more their retirement and their old age far from the world which contains their language and their culture; the necessity of a redevelopment of settings for listening, when confronted to a suffering whose expressive forms exceed the logic underlying the classical conceptual frames, and disturbs the social and caregiver professionals. This approach leaves place, at first, to the subjective resonance of exile without which one cannot understand what old subjects have to pass through. This exile, which cannot be reduced to emigration, and which sometimes is again actualized with violence during the passage to retirement and aging, reminds to each one his incompleteness and mortality. It disturbs the self-feeling and the relation to others, which require to pass by cultural references to feel being protected and humanized. Listening, to be efficient, should not break or emphasize their difference, but has to be attentive to the peculiar link which connects him to its culture; link which allows him to give sense in every decisive moment of existence.

  13. First results of the (n,γ) EXILL campaigns at the Institut Laue Langevin using EXOGAM and FATIMA

    NASA Astrophysics Data System (ADS)

    Jolie, J.; Régis, J.-M.; Wilmsen, D.; Ahmed, S.; Pfeiffer, M.; Saed-Samii, N.; Warr, N.; Blanc, A.; Jentschel, M.; Köster, U.; Mutti, P.; Soldner, T.; Simpson, G.; de France, G.; Urban, W.; Bruce, A. M.; Roberts, O. J.; Fraile, L. M.; Paziy, V.; Ignatov, A.; Ilieva, S.; Kröll, Th; Scheck, M.; Thürauf, M.; Ivanova, D.; Kisyov, S.; Lalkovski, S.; Podolyak, Zs; Regan, P. H.; Korten, W.; Habs, D.; Thirolf, P. G.; Ur, C. A.

    2014-09-01

    At the PF1B cold neutron beam line at the Institut Laue Langevin the EXILL array consisting of EXOGAM, GASP and LOHENGRIN detectors was used to perform (n,γ) measurements under very high coincidence rates. About ten different reactions were then measured in autumn 2012. In spring 2013 the EXOGAM array was combined with 16 LaBr3(Ce) scintillators in the FATIMA@EXILL campaign for the measurement of lifetimes using the generalised centroid difference method. We report on the properties of both set-ups and present first results on Pt isotopes from both campaigns.

  14. [The long journey of Milton Santos's exile and the formation of his network of cooperation].

    PubMed

    Pedrosa, Breno Viotto

    2018-01-01

    Based on an analysis of letters from the Milton Santos collection, the article revisits his journey through exile and shows how he contributed to solidifying the field of critical geography. It also pinpoints elements that reveal the genesis of his intellectual network, which involved thinkers from France, the United States, and Latin America. Focusing on the contexts of his exile, the article links his experiences outside Brazil to new scientific interests and the formation of an international circle of cooperation. Secondarily, it provides evidence of his concern with planning. It is found that his interest in the group of Pierre George and François Perroux was followed by a critical stance that moved him toward dialogue with Marxist philosophy and structuralism.

  15. Relationships between Adolescents' Preferred Sources of Help and Emotional Distress, Ambivalence over Emotional Expression, and Causal Attribution of Symptoms: A Singapore Study

    ERIC Educational Resources Information Center

    Lee, Boon-Ooi

    2009-01-01

    Past research has shown that many adolescents with depression and anxiety disorders do not consult mental health professionals. This study examines how emotional distress, ambivalence over emotional expression, and causal attribution of depressive and anxious symptoms are related to adolescents' preferred sources of help for these symptoms. 300…

  16. Psychotic-Like Experiences in Nonpsychotic Help-Seekers: Associations With Distress, Depression, and Disability

    PubMed Central

    Yung, Alison R; Buckby, Joe A; Cotton, Sue M; Cosgrave, Elizabeth M; Killackey, Eoin J; Stanford, Carrie; Godfrey, Katherine; McGorry, Patrick D

    2006-01-01

    Psychotic-like experiences (PLEs) increase the risk of schizophrenia and other psychotic disorders yet are common in the community. Some PLEs, such as those associated with depression, distress, and poor functioning, may confer increased risk. The aim of this study is to determine the prevalence of PLEs in a nonpsychotic clinical sample and to investigate whether any subtypes of PLEs are associated with the above factors. Consecutive referrals to a youth psychiatric service (N = 140) were assessed to measure PLEs, depression, and functioning. PLE data were factor analyzed, and the associations of psychotic subtypes and distress, depression, and disability were analyzed. Three subtypes of PLEs were identified: Bizarre Experiences, Persecutory Ideas, and Magical Thinking. Bizarre Experiences and Persecutory Ideas were associated with distress, depression, and poor functioning. Magical Thinking was not, unless accompanied by distress. Bizarre Experiences and Persecutory Ideas may be more malignant forms of psychotic symptoms, as they are associated with current disability, and may confer increased risk of development of full-blown psychotic disorder. PMID:16254060

  17. Idioms of distress among trauma survivors: subtypes and clinical utility.

    PubMed

    Hinton, Devon E; Lewis-Fernández, Roberto

    2010-06-01

    In this introduction to the Special Issue on Trauma and Idioms of Distress, we provide an overview of the concept and typology of "idioms of distress," focusing particularly on their clinical utility. This includes the role of idioms as indicators of trauma exposure, of various types of psychopathology and of levels of distress, risk and functioning. It likewise includes the fact that idioms of distress may profoundly influence the personal meaning of having a trauma-related disorder, may shape the interpersonal course of the disorder and may pattern help-seeking and self-treatment. Finally, it illustrates the fact that idioms may also help clinicians understand sufferers' views of the causes of their distress, constitute key therapeutic targets and help increase therapeutic empathy and treatment adherence. This special issue focuses on the role played by idioms of distress in the local trauma ontology, the associations between the idioms and psychiatric disorders occurring in the context of trauma and the mechanisms by which the idioms profoundly influence the personal and interpersonal course of trauma-related disorders.

  18. Spectroscopy of neutron rich nuclei using cold neutron induced fission of actinide targets at the ILL: The EXILL campaign

    NASA Astrophysics Data System (ADS)

    Blanc, A.; de France, G.; Drouet, F.; Jentschel, M.; Köster, U.; Mancuso, C.; Mutti, P.; Régis, J. M.; Simpson, G.; Soldner, T.; Ur, C. A.; Urban, W.; Vancraeyenest, A.

    2013-12-01

    One way to explore exotic nuclei is to study their structure by performing γ-ray spectroscopy. At the ILL, we exploit a high neutron flux reactor to induce the cold fission of actinide targets. In this process, fission products that cannot be accessed using standard spontaneous fission sources are produced with a yield allowing their detailed study using high resolution γ-ray spectroscopy. This is what was pursued at the ILL with the EXILL (for EXOGAM at the ILL) campaign. In the present work, the EXILL setup and performance will be presented.

  19. The Clinical Ethnographic Interview: A user-friendly guide to the cultural formulation of distress and help seeking

    PubMed Central

    Arnault, Denise Saint; Shimabukuro, Shizuka

    2013-01-01

    Transcultural nursing, psychiatry, and medical anthropology have theorized that practitioners and researchers need more flexible instruments to gather culturally relevant illness experience, meaning, and help seeking. The state of the science is sufficiently developed to allow standardized yet ethnographically sound protocols for assessment. However, vigorous calls for culturally adapted assessment models have yielded little real change in routine practice. This paper describes the conversion of the Diagnostic and Statistical Manual IV, Appendix I Outline for Cultural Formulation into a user-friendly Clinical Ethnographic Interview (CEI), and provides clinical examples of its use in a sample of highly distressed Japanese women. PMID:22194348

  20. Study of fission fragment de-excitation by gamma-ray spectrometry with the EXILL experiment

    NASA Astrophysics Data System (ADS)

    Materna, Thomas; a, Michal Rapał; Letourneau, Alain; Marchix, Anthony; Litaize, Olivier; Sérot, Olivier; Urban, Waldemar; Blanc, Aurélien; Jentschel, Michael; Köster, Ulli; Mutti, Paolo; Soldner, Torsten; Simpson, Gary; Ur, Călin A.; France, Gilles de

    2017-09-01

    A large array of Ge detectors installed at ILL, around a 235U target irradiated with cold neutrons, (EXILL) allowed measurement of prompt gamma-ray cascades occurring in fission fragments with an unambiguous determination of fragments. Here we present preliminary results of a systematic comparison between experimental γ-ray intensities and those obtained from the Monte-Carlo simulation code FIFRELIN, which is dedicated to the de-excitation of fission fragments. Major γ-ray intensities in the 142Ba and 92Kr fission products, extracted from EXILL data, were compared to FIFRELIN, as well as to reported values (when available) obtained with EUROGAM2 in the spontaneous fission of 248Cm. The evolution of γ-ray intensities in 92Kr versus the complementary partner in fission (i.e. versus the total number of evaporated neutrons by the fission pair) was then extracted and compared to FIFRELIN.

  1. Helping as a Function of Empathic Responses and Sociopathy.

    ERIC Educational Resources Information Center

    Marks, Edward L.; And Others

    1982-01-01

    Investigated helping as a function of empathic anxiety (anxiety in response to modeled distress) and individual differences in sociopathic tendencies. Results indicated modeled distress produces increases in anxiety which are positively associated with helping and sociopathic individuals are less likely to help than are nonsociopathic individuals.…

  2. Women's Exile and Transatlantic Epistolary Ties in the Work of Pilar de Zubiaurre

    ERIC Educational Resources Information Center

    Gonzalez-Allende, Iker

    2012-01-01

    In this essay, I analyze Pilar de Zubiaurre's experience of exile by focusing on the articles she published in the magazine "Euzko Deya" and the letters she wrote and received in Mexico. Among the letters Zubiaurre received, I study those from Maria Martos de Baeza. My main argument is that for Zubiaurre, writing became a fundamental way…

  3. Discharge information needs and symptom distress after abdominal aortic surgery.

    PubMed

    Galloway, S; Rebeyka, D; Saxe-Braithwaite, M; Bubela, N; McKibbon, A

    1997-01-01

    The purpose of this study was to describe the discharge information needs and symptom distress of people after abdominal aortic reconstructive surgery. Interviews (N = 51) were conducted prior to, and 4 weeks after, hospital discharge. People indicated that the most important information to help them manage their care after discharge related to the recognition, prevention and management of complications. Broken sleep and incisional pain were the most distressful of symptoms prior to hospital discharge, whereas fatigue and broken sleep were most distressful once home. These results may assist nurses to understand the discharge information needs and symptom distress of people recovering from aortic reconstructive surgery and the importance of discharge education to help people to manage their care once home.

  4. Leader and Spokesman for a People in Exile: Chief Joseph and the Nez Perce

    ERIC Educational Resources Information Center

    Jain, Samvit

    2009-01-01

    This article discusses Chief Joseph's surrender that marked the beginning of his diplomatic stand for justice in Indian Territory, where his tribe was forcibly exiled in accordance with American Indian policy of the time. Joseph battled for the repatriation of the Nez Perce through protests and other legal means, winning the support of the growing…

  5. Burmese political dissidents in Thailand: trauma and survival among young adults in exile.

    PubMed Central

    Allden, K; Poole, C; Chantavanich, S; Ohmar, K; Aung, N N; Mollica, R F

    1996-01-01

    OBJECTIVES: This study assessed the self-reported mental health, physical health, and social functioning of young adult political exiles and relates their psychiatric symptoms to their trauma and survival strategies. METHODS: A 1992/93 survey of Burmese who fled to Bangkok, Thailand, after participating in a 1988 uprising against Burma's government elicited information on employment, education, disability, trauma, survival strategies, and depressive and posttraumatic stress symptoms. RESULTS: The 104 participants reported a mean of 30 trauma events, including interrogation (89%), imprisonment (78%), threats of deportation (70%), and torture (38%). Many reported poor health and lack of social supports, but few reported substantial social disability. The prevalence of elevated symptom scores was 38% for depressive symptoms and 23% for criterion symptoms of posttraumatic stress disorder. Symptoms of avoidance and of increased arousal were the most strongly related to cumulative trauma. Two survival strategies, camaraderie and a Buddhist concept of self-confidence (weria), were associated with somewhat reduced levels of both classes of symptoms. CONCLUSIONS: Burmese political exiles in Thailand are young adults adversely affected by severe trauma. Their psychosocial well-being may deteriorate further without legal protections to reduce the continuing stress and violence. PMID:8916521

  6. Moral distress and moral conflict in clinical ethics.

    PubMed

    Fourie, Carina

    2015-02-01

    Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. © 2013 John Wiley & Sons Ltd.

  7. Respiratory Distress

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The University of Miami School of Medicine asked the Research Triangle Institute for assistance in improvising the negative pressure technique to relieve respiratory distress in infants. Marshall Space Flight Center and Johnson Space Center engineers adapted this idea to the lower-body negative-pressure system seals used during the Skylab missions. Some 20,000 babies succumb to respiratory distress in the U.S. each year, a condition in which lungs progressively lose their ability to oxygenate blood. Both positive and negative pressure techniques have been used - the first to force air into lungs, the second to keep infant's lungs expanded. Negative pressure around chest helps the baby expand his lungs and maintain proper volume of air. If doctors can keep the infant alive for four days, the missing substance in the lungs will usually form in sufficient quantity to permit normal breathing. The Skylab chamber and its leakproof seals were adapted for medical use.

  8. Exploring the impact of dignity therapy on distressed patients with advanced cancer: three case studies.

    PubMed

    Hall, Sue; Goddard, Cassie; Martin, Pauline; Opio, Diana; Speck, Peter

    2013-08-01

    Dignity therapy (DT) has been developed to help reduce distress experienced by people nearing the end of life; however, evaluations of this novel intervention have largely involved non-distressed samples. The objective of this study was to explore in detail the impact of DT on distressed patients with advanced cancer. We used a case study approach. Three patients with the highest levels of dignity-related distress who received DT were explored in depth. We collected quantitative and qualitative outcomes from patients in face-to-face interviews at baseline and at 1 and 4 weeks after completion of the intervention. We assessed dignity-related distress using the Patient Dignity Inventory. Patients rated the benefits of DT at completion of the intervention and at both follow-ups. We conducted qualitative interviews exploring experiences of DT with patients and with two recipients of generativity documents produced by patients. These patients were experiencing a wide range of major or overwhelming physical and psychosocial problems when they received the intervention, most of which would not be expected to be helped by DT. All felt that DT had helped them and had helped or would help their families; however, patients' concerns about their current situation made delivering the intervention challenging, and DT-relevant problems returned when a patients' condition deteriorated. The extent to which DT can help these patients and their families, either as a stand-alone therapy or as an adjunct to other therapies, needs to be determined in studies focussing on distressed patients, particularly those with problems likely to be helped by the therapy. Copyright © 2012 John Wiley & Sons, Ltd.

  9. Help-seeking behaviors for serious psychological distress among individuals with diabetes mellitus: The California Health Interview Survey, 2011-2012.

    PubMed

    Shin, Jinah K; Poltavskiy, Eduard; Kim, Tae Nyun; Hasan, Abdullah; Bang, Heejung

    2017-02-01

    To investigate patterns of and factors associated with help-seeking behaviors among individuals with diabetes mellitus (DM) and/or serious psychological distress (SPD). The analysis was conducted with the California Health Interview Survey (CHIS) 2011-2012 of 40,803 adults. Logistic regression was used to examine the associations between the multiple facilitating/preventing factors and outcome, guided by the Andersen's Health Care Utilization Model. The prevalence of DM and SPD were 10.9% and 3.4%, respectively, among participants in the survey. The participants with DM were more likely to experience SPD than those without DM (OR 1.46, 95% CI=1.11-1.91, p=0.006). Participants with combined DM and SPD, the most underserved, were less likely to perceive the need for mental health services and less likely to seek help, compared to those with only SPD. Need factors (SPD status and perceived need) were significantly associated with help-seeking behaviors for mental health, along with predisposing factors (age, gender, obesity, race, and employment), and enabling factors (insurance, English proficiency). Perceptions about need for seeking help seem to play an important role in receiving mental health services in addition to other predisposing or enabling factors. Identification of these factors may improve clinical outcomes related to DM and SPD. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  10. Factors associated with psychological distress among young women in Kisumu, Kenya.

    PubMed

    Gust, Deborah A; Gvetadze, Roman; Furtado, Melissa; Makanga, Mumbi; Akelo, Victor; Ondenge, Kenneth; Nyagol, Beatrice; McLellan-Lemal, Eleanor

    2017-01-01

    Attention to mental health issues is growing globally. In many countries, including Kenya, however, assessment of psychological distress, especially in rural areas, is limited. We analyzed data from young women screened for a longitudinal contraceptive ring study in Kisumu, Kenya. Multivariable regression analysis was used to assess factors associated with recent moderate and high psychological distress, as measured by the Kessler (K-6) psychological distress scale. Among the 461 women screened, most (58.4%) were categorized as having moderate psychological distress, 20.8% were categorized as having low or no psychological distress, and 20.8% were categorized as having high psychological distress. Moderate psychological distress (vs low/no) was significantly more likely among women who reported a history of forced sex and were concerned about recent food insecurity. High (vs low/no) psychological distress was significantly more likely among women who reported a history of forced sex, who were concerned about recent food insecurity, and who self-reported a sexually transmitted infection. To reduce psychological distress, a focus on prevention as well as care methods is needed. Girls need a path toward a healthy and productive adulthood with a focus on education, which would help them gain skills to avoid forced sex. Women would benefit from easy access to social services and supports that would help them with basic needs like food security among other things. A holistic or ecological approach to services that would address mental, educational, social, health, and economic issues may have the highest chance of having a long-term positive impact on public health.

  11. Defining and addressing moral distress: tools for critical care nursing leaders.

    PubMed

    Rushton, Cynda Hylton

    2006-01-01

    Nurse clinicians may experience moral distress when they are unable to translate their moral choices into moral action. The costs of unrelieved moral distress are high; ultimately, as with all unresolved professional conflicts, the quality of patient care suffers. As a systematic process for change, this article offers the AACN's Model to Rise Above Moral Distress, describing four A's: ask, affirm, assess, and act. To help critical care nurses working to address moral distress, the article identifies 11 action steps they can take to develop an ethical practice environment.

  12. Use of a self-help book with weekly therapist contact to reduce tinnitus distress: a randomized controlled trial.

    PubMed

    Kaldo, Viktor; Cars, Sofia; Rahnert, Miriam; Larsen, Hans Christian; Andersson, Gerhard

    2007-08-01

    Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT). To compensate for the shortage of CBT therapists, we aimed, in this study, to investigate the effects of a CBT-based self-help book guided by brief telephone support. Seventy-two patients were randomized either to a self-help book and seven weekly phone calls or to a wait-list control condition, later on receiving the self-help book with less therapist support. The dropout rate was 7%. Follow-up data 1 year after completion of treatment were also collected (12% dropout). The Tinnitus Reaction Questionnaire (TRQ) was the main outcome measure, complemented with daily ratings of tinnitus and measures of insomnia, anxiety, and depression. On the TRQ, significant reductions were found in the treatment group both immediately following treatment and at 1-year follow-up. In the treatment group, 32% reached the criteria for clinical significance (at least 50% reduction of the TRQ) compared to 5% in the wait-list group. Directly after treatment, two out of five measures showed significant differences in favor of the treatment with more therapist support compared with the group who, after their waiting period, received little therapist support. The self-help treatment was estimated to be 2.6 (seven phone calls) and 4.8 (one phone call) times as cost-effective as regular CBT group treatment. Guided self-help can serve as an alternative way to administer CBT for tinnitus. Preliminary results cast some doubts on the importance of weekly therapist contact. The effect size was somewhat smaller than for regular CBT, but on the other hand, the self-help seems far more cost-effective. Future studies should compare treatment modalities directly and explore cost-effectiveness more thoroughly.

  13. It could have been me: vicarious victims and disaster-focused distress.

    PubMed

    Wayment, Heidi A

    2004-04-01

    College students who had experienced no personal bereavement in the September 11 terrorist attacks completed questionnaires between 3 and 5 weeks after the attacks and 5 months later. Cross-sectional and longitudinal structural equation model (SEM) analyses revealed that general distress and disaster-focused distress are discernable reactions following a collective loss. Both types of distress were higher among women and by those reporting social strain. General distress was associated with previous stressful events and mental health issues. Perceived similarity to the victims predicted disaster-focused distress and mediated the relationship between attending to media accounts of victims and disaster-focused distress. Only the disaster-focused distress reactions of survivor guilt and grief were associated with collective helping behaviors after the attacks and, for women, these behaviors were associated with greater reductions in these distress reactions over time. Discussion focuses on the importance of examining disaster-focused distress reactions following collective loss.

  14. Moral distress: levels, coping and preferred interventions in critical care and transitional care nurses.

    PubMed

    Wilson, Melissa A; Goettemoeller, Diana M; Bevan, Nancy A; McCord, Jennifer M

    2013-05-01

    To examine the level and frequency of moral distress in staff nurses working in two types of units in an acute care hospital and to gather information for future interventions addressing moral distress. In 2008, the American Association of Critical Care Nurses published a Position Statement on Moral Distress. Nurses working in units where critically ill patients are admitted may encounter distressing situations. Moral distress is the painful feelings and/or psychological disequilibrium that may occur when taking care of patients. An exploratory, descriptive design study was used to identify the type and frequency of moral distress experienced by nurses. The setting was an acute care hospital in which the subjects were sampled from two groups of nurses based on their unit assignment. A descriptive, questionnaire study was used. Nurses completed the 38-item moral distress scale, a coping questionnaire, and indicated their preferred methods for institutional support in managing distressing situations. A convenience sample of staff nurses was approached to complete the moral distress questionnaire. Overall, the nurses reported low levels of moral distress. Situations creating the highest levels of moral distress were those related to futile care. A significance between group differences was found in the physician practice dimension. Specific resources were identified to help guide future interventions to recognise and manage moral distress. Nurses reported lower levels and frequency of moral distress in these units but their open-ended responses appeared to indicate moral distress. Nurses identified specific resources that they would find helpful to alleviate moral distress. There are numerous studies that identify the situations and the impact of moral distress, but not many studies explore treatments and interventions for moral distress. This study attempted to identify nurse preferences for lessening the impact of moral distress. © 2013 Blackwell Publishing Ltd.

  15. Couples with Intimate Partner Violence Seeking Relationship Help: Associations and Implications for Self-Help and Online Interventions.

    PubMed

    Roddy, McKenzie K; Georgia, Emily J; Doss, Brian D

    2017-04-20

    In-person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple-based treatment for couples with IPV, the present study sought to determine whether associations with IPV found in community samples generalized to couples seeking help for their relationship and whether web-based interventions for relationship distressed worked equally well for couples with IPV. In the first aim, in a sample of 2,797 individuals who were seeking online help for their relationship, the levels and correlates of both low-intensity and clinically significant IPV largely matched what is found in community samples. In the second aim, in a sample of 300 couples who were randomly assigned to a web-based intervention or a waitlist control group, low-impact IPV did not moderate the effects of the intervention for relationship distress. Therefore, web-based interventions may be an effective (and easily accessible) intervention for relationship distress for couples with low-intensity IPV. © 2017 Family Process Institute.

  16. The relation between bystanders’ behavioral reactivity to distress and later helping behavior during a violent conflict in virtual reality

    PubMed Central

    Neyret, Solène; Slater, Mel; de Gelder, Beatrice

    2018-01-01

    The occurrence of helping behavior is thought to be automatically triggered by reflexive reactions and promoted by intuitive decisions. Here, we studied whether reflexive reactions to an emergency situation are associated with later helping behavior in a different situation, a violent conflict. First, 29 male supporters of F.C. Barcelona performed a cued-reaction time task with a low and high cognitive load manipulation, to tap into reflexive and reflective processes respectively, during the observation of an emergency. Next, participants entered a bar in Virtual Reality and had a conversation with a virtual fellow supporter. During this conversation, a virtual Real Madrid supporter entered and started an aggressive argument with the fellow supporter that escalated into a physical fight. Verbal and physical interventions of the participant served as measures of helping behavior. Results showed that faster responses to an emergency situation during low, but not during high cognitive load, were associated with more interventions during the violent conflict. However, a tendency to describe the decision to act during the violent conflict as intuitive and reflex-like was related to more interventions. Further analyses revealed that a disposition to experience sympathy, other-oriented feelings during distressful situations, was related to self-reported intuitive decision-making, a reduced distance to the perpetrator, and higher in the intervening participants. Taken together, these results shed new light on helping behavior and are consistent with the notion of a motivational system in which the act of helping is dependent on a complex interplay between intuitive, reflexive and deliberate, reflective processes. PMID:29672638

  17. The relation between bystanders' behavioral reactivity to distress and later helping behavior during a violent conflict in virtual reality.

    PubMed

    Hortensius, Ruud; Neyret, Solène; Slater, Mel; de Gelder, Beatrice

    2018-01-01

    The occurrence of helping behavior is thought to be automatically triggered by reflexive reactions and promoted by intuitive decisions. Here, we studied whether reflexive reactions to an emergency situation are associated with later helping behavior in a different situation, a violent conflict. First, 29 male supporters of F.C. Barcelona performed a cued-reaction time task with a low and high cognitive load manipulation, to tap into reflexive and reflective processes respectively, during the observation of an emergency. Next, participants entered a bar in Virtual Reality and had a conversation with a virtual fellow supporter. During this conversation, a virtual Real Madrid supporter entered and started an aggressive argument with the fellow supporter that escalated into a physical fight. Verbal and physical interventions of the participant served as measures of helping behavior. Results showed that faster responses to an emergency situation during low, but not during high cognitive load, were associated with more interventions during the violent conflict. However, a tendency to describe the decision to act during the violent conflict as intuitive and reflex-like was related to more interventions. Further analyses revealed that a disposition to experience sympathy, other-oriented feelings during distressful situations, was related to self-reported intuitive decision-making, a reduced distance to the perpetrator, and higher in the intervening participants. Taken together, these results shed new light on helping behavior and are consistent with the notion of a motivational system in which the act of helping is dependent on a complex interplay between intuitive, reflexive and deliberate, reflective processes.

  18. Navigating moral distress using the moral distress map.

    PubMed

    Dudzinski, Denise Marie

    2016-05-01

    The plethora of literature on moral distress has substantiated and refined the concept, provided data about clinicians' (especially nurses') experiences, and offered advice for coping. Fewer scholars have explored what makes moral distress moral If we acknowledge that patient care can be distressing in the best of ethical circumstances, then differentiating distress and moral distress may refine the array of actions that are likely to ameliorate it. This article builds upon scholarship exploring the normative and conceptual dimensions of moral distress and introduces a new tool to map moral distress from emotional source to corrective actions. The Moral Distress Map has proven useful in clinical teaching and ethics-related debriefings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation.

    PubMed

    Vincent, Heather K; Horodyski, MaryBeth; Vincent, Kevin R; Brisbane, Sonya T; Sadasivan, Kalia K

    2015-09-01

    Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset the distress. Several options that help trauma patients navigate their short-term recovery include holistic approaches, pastoral care, coping skills, mindfulness, peer visitation, and educational resources. The long-term physical and mental health of the trauma survivor can be enhanced by strategies that connect the survivor to a network of people with similar experiences or injuries, facilitate support groups, and social support networking (The Trauma Survivors Network). Rehabilitation specialists can help optimize patient outcomes and quality of life by participating in and advocating these strategies. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  20. Gender differences in resilience and psychological distress of patients with burns.

    PubMed

    Masood, Afsheen; Masud, Yusra; Mazahir, Shama

    2016-03-01

    This research explored the gender differences in resilience and psychological distress of patients with burns. In Pakistan, psychological states of patients with burns have not been widely studied, women making up as the neglected section of society lag far behind in availing the needful health facilities. It was hypothesized that there would be significant gender differences in resilience and psychological distress of patients with burns. The sample of the study consisted of 50 patients with burns, obtained from four different hospitals of Lahore. In order to investigate resilience and psychological distress, the State Trait Resilience Scales (Hiew, 2007) and Kessler Psychological Distress Scale (Kessler, 2001) were used. In addition to these, self-constructed demographic questionnaire was administered. The data was analyzed using SPSS version 16.0. Independent sample t-test was conducted to find gender differences in resilience and psychological distress. The findings from the current research revealed that there were significant gender differences in resilience and psychological distress of patients with burns. The insightful findings from the current research carry strong implications for the clinicians, psychologists and policy makers who can help to develop and implement the rehabilitation programs for the affected population and can launch resilience promoting programs that would help them in coping with burns in effective manner. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  1. Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial.

    PubMed

    Songprakun, Wallapa; McCann, Terence V

    2012-12-01

    This article reports a study to evaluate the efficacy of a self-help manual in reducing psychological distress in individuals with moderate depression. The prevalence of depression in Thailand is increasing markedly (e.g. from 56-197 per 100,000 population between 1997-2007). We conducted a randomized controlled trial with 54 outpatients with depression in Chiang Mai Province in Thailand. Participants were assigned randomly to an intervention or control group. The intervention group participants were given a self-help manual in addition to standard care and treatment while the control group received standard care and treatment. Psychological distress was measured with the Kessler Psychological Distress Scale. Data were collected between October 2007-April 2008. The findings showed statistically significant differences between both groups in their levels of psychological distress (e.g. tiredness, hopelessness, restlessness). At post-test, the distress scores of the intervention group were lower than those in the control group. Between post-test and 1-month follow-up, distress scores continued to decrease steadily in the intervention group but only decreased slightly in the control group. The findings affirm the benefits of bibliotherapy or self-help therapy in book form in helping to reduce psychological distress in people with moderate depression. The approach is easy to use and can be incorporated as an adjunct to standard care and treatment. Bibliotherapy can be used by community mental health nurses and other clinicians to reduce psychological distress and promote recovery in people with moderate depression. © 2012 Blackwell Publishing Ltd.

  2. Psychological distress and in vitro fertilization outcome

    PubMed Central

    Pasch, Lauri A.; Gregorich, Steven E.; Katz, Patricia K.; Millstein, Susan G.; Nachtigall, Robert D.; Bleil, Maria E.; Adler, Nancy E.

    2016-01-01

    Objective To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Design Prospective cohort study over an 18-month period. Setting Five community and academic fertility practices. Patients Two hundred and two women who initiated their first IVF cycle. Interventions Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months follow-up. Main Outcome Measures IVF cycle outcome and psychological distress. Results Using a binary logistic model including covariates (woman’s age, ethnicity, income, education, parity, duration of infertility, and time interval), pre-treatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. Using linear regression models including covariates (woman’s age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. Conclusions IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. PMID:22698636

  3. Psychological distress and in vitro fertilization outcome.

    PubMed

    Pasch, Lauri A; Gregorich, Steven E; Katz, Patricia K; Millstein, Susan G; Nachtigall, Robert D; Bleil, Maria E; Adler, Nancy E

    2012-08-01

    To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Prospective cohort study over an 18-month period. Five community and academic fertility practices. Two hundred two women who initiated their first IVF cycle. Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up. IVF cycle outcome and psychological distress. In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Diabetes Distress Among Persons With Type 1 Diabetes.

    PubMed

    Powers, Margaret A; Richter, Sara A; Ackard, Diann M; Craft, Cheryl

    2017-02-01

    Purpose The purpose of this study is to evaluate associations between diabetes distress and a range of psychological health behaviors and concerns among persons with type 1 diabetes for the benefit of enhancing early identification and intervention of at-risk individuals. Methods Persons with type 1 diabetes (n = 268; 57.1% female, 91.0% white, 76.8% <18 years of age, average A1C 8.4%) completed the 2-item Diabetes Distress Screening Scale (DDS2) and a battery of psychometrically sound instruments measuring satisfaction with life, self-esteem, self-efficacy, depression, perfectionism, body image satisfaction, dietary restraint and eating, and shape and weight concerns. Each subscale score was compared within age groups (<18 years vs ≥18 years) between groups (diabetes distress level [low, moderate, high]) using analysis of variance (with Bonferroni correction or the Kruskal-Wallis test if the variables were not normally distributed). Results For both age groups, high diabetes distress was independently associated with greater A1C values, higher depression scores and eating, and shape and weight concerns than those with low or moderate distress. For patients <18 years of age, those with high diabetes distress scored lower on measures of satisfaction with life, self-esteem, and self-efficacy and higher on dietary restraint and several areas of perfectionism than those with low or moderate distress. Conclusions Individuals with type 1 diabetes who have high diabetes distress also report higher A1C values and poorer psychological health concerns. A brief diabetes distress questionnaire can help to identify those who need additional screening, education and support, and treatment for overall health and well-being.

  5. Parental Moral Distress and Moral Schism in the Neonatal ICU.

    PubMed

    Foe, Gabriella; Hellmann, Jonathan; Greenberg, Rebecca A

    2018-05-25

    Ethical dilemmas in critical care may cause healthcare practitioners to experience moral distress: incoherence between what one believes to be best and what occurs. Given that paediatric decision-making typically involves parents, we propose that parents can also experience moral distress when faced with making value-laden decisions in the neonatal intensive care unit. We propose a new concept-that parents may experience "moral schism"-a genuine uncertainty regarding a value-based decision that is accompanied by emotional distress. Schism, unlike moral distress, is not caused by barriers to making and executing a decision that is deemed to be best by the decision-makers but rather an encounter of significant internal struggle. We explore factors that appear to contribute to both moral distress and "moral schism" for parents: the degree of available support, a sense of coherence of the situation, and a sense of responsibility. We propose that moral schism is an underappreciated concept that needs to be explicated and may be more prevalent than moral distress when exploring decision-making experiences for parents. We also suggest actions of healthcare providers that may help minimize parental "moral schism" and moral distress.

  6. Distress or no distress, that's the question: A cutoff point for distress in a working population

    PubMed Central

    van Rhenen, Willem; van Dijk, Frank JH; Schaufeli, Wilmar B; Blonk, Roland WB

    2008-01-01

    Background The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Methods Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. Results and conclusion A distress cutoff point of ≥11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations. PMID:18205912

  7. Distress or no distress, that's the question: A cutoff point for distress in a working population.

    PubMed

    van Rhenen, Willem; van Dijk, Frank Jh; Schaufeli, Wilmar B; Blonk, Roland Wb

    2008-01-18

    The objective of the present study is to establish an optimal cutoff point for distress measured with the corresponding scale of the 4DSQ, using the prediction of sickness absence as a criterion. The cutoff point should result in a measure that can be used as a credible selection instrument for sickness absence in occupational health practice and in future studies on distress and mental disorders. Distress is measured using the Four Dimensional Symptom Questionnaire (4DSQ), a 50-item self-report questionnaire, in a working population with and without sickness absence due to distress. Sensitivity and specificity were compared for various potential cutoff points, and a receiver operating characteristics analysis was conducted. A distress cutoff point of >/=11 was defined. The choice was based on a challenging specificity and negative predictive value and indicates a distress level at which an employee is presumably at risk for subsequent sick leave on psychological grounds. The defined distress cutoff point is appropriate for use in occupational health practice and in studies of distress in working populations.

  8. Psychological Distress in Afghan Refugees: A Mixed-Method Systematic Review

    PubMed Central

    Alemi, Qais; James, Sigrid; Cruz, Romalene; Zepeda, Veronica; Racadio, Michael

    2013-01-01

    Mental health problems disproportionately affect Afghan refugees and asylum seekers who continue to seek international protection with prolonged exposure to war. We performed a systematic review aimed at synthesizing peer-reviewed literature pertaining to mental health problems among Afghans resettled in industrialized nations. We used five databases to identify studies published between 1979 and 2013 that provided data on distress levels, and subjective experiences with distress. Seventeen studies met our inclusion criteria consisting of 1 mixed-method, 7 qualitative, and 9 quantitative studies. Themes from our qualitative synthesis described antecedents for distress being rooted in cultural conflicts and loss, and also described unique coping mechanisms. Quantitative findings indicated moderate to high prevalence of depressive and posttraumatic symptomatology. These findings support the need for continued mental health research with Afghans that accounts for: distress among newly resettled groups, professional help-seeking utilization patterns, and also culturally relevant strategies for mitigating distress and engaging Afghans in research. PMID:23784146

  9. Psychological distress, perceived stigma, and coping among caregivers of patients with schizophrenia

    PubMed Central

    Ong, Hui Chien; Ibrahim, Norhayati; Wahab, Suzaily

    2016-01-01

    Nowadays, family members are gradually taking on the role of full-time caregivers for patients suffering from schizophrenia. The increasing burden and tasks of caretaking can cause them psychological distress such as depression or anxiety. The aim of this study was to measure the correlation between perceived stigma and coping, and psychological distress as well as determine the predictors of psychological distress among the caregivers. Results showed that 31.5% of the caregivers experienced psychological distress. “Community rejection” was found to be positively associated with psychological distress. In case of coping subscales, psychological distress had a positive correlation with substance use, use of emotional support, behavioral disengagement, venting, and self-blame, while it was negatively correlated with “positive reframing”. Behavioral disengagement was the best predictor of psychological distress among caregivers of patients with schizophrenia, followed by positive reframing, use of emotional support, self-blame, and venting. Health practitioners can use adaptive coping strategies instead of maladaptive for caregivers to help ease their distress and prevent further deterioration of psychological disorders. PMID:27574475

  10. Distress among young adult cancer survivors: a cohort study.

    PubMed

    Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M

    2013-09-01

    Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p < .05). Young adult cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

  11. Understanding Distress in People with Severe Communication Difficulties: Developing and Assessing the Disability Distress Assessment Tool (DisDAT)

    ERIC Educational Resources Information Center

    Regnard, C.; Reynolds, Joanna; Watson, Bill; Matthews, Dorothy; Gibson, Lynn; Clarke, Charlotte

    2007-01-01

    Background: Meaningful communication with people with profound communication difficulties depends on the ability of carers to recognize and translate many different verbal cues. Carers appear to be intuitively skilled at identifying distress cues, but have little confidence in their observations. To help in this process, a number of pain tools…

  12. Does Self-Help Increase Rates of Help Seeking for Student Mental Health Problems by Minimizing Stigma as a Barrier?

    ERIC Educational Resources Information Center

    Levin, Michael E.; Krafft, Jennifer; Levin, Crissa

    2018-01-01

    Objective: This study examined whether self-help (books, websites, mobile apps) increases help seeking for mental health problems among college students by minimizing stigma as a barrier. Participants and Methods: A survey was conducted with 200 college students reporting elevated distress from February to April 2017. Results: Intentions to use…

  13. Social support, marital adjustment, and psychological distress among women with primary infertility in Pakistan.

    PubMed

    Qadir, Farah; Khalid, Amna; Medhin, Girmay

    2015-01-01

    This study aimed to identify prevalence rates of psychological distress among Pakistani women seeking help for primary infertility. The associations of social support, marital adjustment, and sociodemographic factors with psychological distress were also examined. A total of 177 women with primary infertility were interviewed from one hospital in Islamabad using a Self-Reporting Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Locke-Wallace Marital Adjustment Test. The data were collected between November 2012 and March 2013. The prevalence of psychological distress was 37.3 percent. The results of the logistic regression suggested that marital adjustment and social support were significantly negatively associated with psychological distress in this sample. These associations were not confounded by any of the demographic variables controlled in the multivariable regression models. The role of perceived social support and adjustment in marriage among women experiencing primary infertility are important factors in understanding their psychological distress. The results of this small-scale effort highlight the need for social and familial awareness to help tackle the psychological distress related to infertility. Future research needs to focus on the way the experience of infertility is conditioned by social structural realities. New ways need to be developed to better take into account the process and nature of the infertility experience.

  14. LTPP distress identification manual sets a standard for states

    DOT National Transportation Integrated Search

    2002-01-01

    A brief note about the usefulness of the LTPP program's Distress Identification Manual in helping States with their pavement management and maintenance activities. Accurate reports of pavement conditions are crucial to pavement management and mainten...

  15. Nurse moral distress: A survey identifying predictors and potential interventions.

    PubMed

    Rathert, Cheryl; May, Douglas R; Chung, Hye Sook

    2016-01-01

    Ethical dilemmas and conflicts are inherent in today's health care organizations and may lead to moral distress, which is often associated with physical and psychological symptoms. Although the existence of moral distress has been observed by scholars for decades, most of the research has been descriptive and has examined what types of health care conflicts lead to distress. This study tested a comprehensive model, underpinned by Social Cognitive Theory, that examined work environment and intrapersonal variables that may influence moral distress. We surveyed nursing staff employed in a U.S. acute care hospital (response rate=45%; n=290). More than half of the respondents reported they experience ethical dilemmas and conflicts from several times a month to daily, and nearly half reported they experience moral distress at least several times a month. Structural equation modeling analysis simultaneously examined the effects of five independent variables on moral distress and moral voice: (a) frequency of ethical dilemmas and conflicts; (b) moral efficacy; (c) ethics communication; (d) ethical environment; and (e) organizational ethics support. Results revealed significant independent effects of the frequency of ethics issues and organizational ethics support on moral distress. Bootstrapping analysis indicated that voice fully mediated the relationship between moral efficacy and moral distress, and partially mediated the relationship between organizational ethics support and distress. Supplemental analysis revealed that organizational ethics support moderated the moral efficacy-voice-moral distress relationship such that when organizational support was low, moral efficacy was negatively related to moral distress via voice. Although it may be impossible to eliminate all ethical dilemmas and conflicts, leaders and organizations may wish to help improve nurses' moral efficacy, which appears to give rise to voice, and reduced moral distress. Increasing organizational

  16. Experiences and psychological distress of fertility treatment and employment.

    PubMed

    Payne, Nicola; Seenan, Susan; van den Akker, Olga

    2018-04-16

    This study examined experiences and psychological distress about fertility treatment in people combining work and treatment. Five hundred and sixty-three participants in the UK completed an online survey asking about difficulties in combining work and treatment; workplace disclosure, support, absence and policy; and psychological distress about treatment. Absence from work and perceptions that treatment has an impact on work and career prospects were reported by the majority of participants and this was related to the psychological distress of treatment. Around three quarters of participants disclosed to their employer and colleagues. The key reason for disclosure was needing to ask for absence from work and the main reason for non-disclosure was privacy. Workplace policy relating to managing fertility treatment and support from colleagues and their employer was related to reduced psychological distress but workplace policy was reported by less than one quarter of participants. Difficulties experienced in combining work and treatment suggest that support is needed. Specific workplace policy, guidance for supervisors and flexibility in fertility clinic times should help support employees during treatment and reduce psychological distress, thereby potentially influencing physical health and treatment outcomes.

  17. Prolonged Distress of Parents After Early Preterm Birth.

    PubMed

    Kantrowitz-Gordon, Ira; Altman, Molly R; Vandermause, Roxanne

    2016-01-01

    To examine how parents describe the distress of early preterm birth in the months and years after the infant's hospital discharge. Discourse analysis of in-depth interviews and photo elicitation. Homes or cafés in the Pacific Northwest United States. Parents of premature infants born between 24 and 30 weeks gestation (N = 10) who experienced significant distress in and out of the hospital. Parents participated in the study when their children were between 15 months and 8 years old. Participants described dealing with prematurity, emotional distress, and parenting in individual interviews and returned for second interviews in which they further described their distress using photographs. Data were analyzed using discourse analysis. Parents described preterm birth, hospitalization, and the aftermath as ongoing traumatic events. Discourses of distress included the Perfect Child, the Good Mother, and the Good Father. Parents used these discourses to reconcile the loss of an idealized birth and parenting after the birth of a premature child. Isolation and Medicalized Parenting were used to explain how parents struggled to interact within their social networks and to parent under challenging circumstances. Participants described their trauma and distress in ways not captured by psychiatric diagnoses such as depression and anxiety. Findings may help nurses be aware of the negative effects of preterm birth and respond to parents' emotional needs. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  18. Stigma and psychological distress in suicide survivors.

    PubMed

    Scocco, Paolo; Preti, Antonio; Totaro, Stefano; Ferrari, Alessandro; Toffol, Elena

    2017-03-01

    Suicide bereavement is frequently related to clinically significant psychological distress and affected by stigma. This study was designed to evaluate the relationship between psychological distress by psychopathological domains and stigma, in a sample of individuals bereaved by suicide (suicide survivors). The data were collected between January 2012 and December 2014 and included information on sociodemographic variables (gender, age, marital status and education level) and responses to the Stigma of Suicide Survivor scale (STOSSS) and the Brief Symptom Inventory (BSI). One hundred and fifty-five suicide survivors completed the evaluation and were included in the study. Levels of psychological distress in suicide survivors, as measured by BSI, were positively related to levels of perceived stigma toward suicide survivors, as measured by STOSSS. The association was not affected by age and gender, or by marital status, education level, days from suicide or a personal history of suicide attempt. Participants with higher scores on almost all subscales of the BSI, particularly the interpersonal sensitivity and paranoid ideation subscales, reported the highest levels of perceived stigma toward suicide survivors. Levels of distress in subjects bereaved by the suicide of a relative or friend were positively associated with levels of perceived stigma toward suicide survivors. Specific interventions dedicated to the bereavement of suicide survivors might help to alleviate not only psychological distress but also stigma towards loss by suicide. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Exiling children, creating orphans: when immigration policies hurt citizens.

    PubMed

    Zayas, Luis H; Bradlee, Mollie H

    2014-04-01

    Citizen-children born in the United States to undocumented immigrants have become collateral damage of immigration enforcement. These children suffer the effects of immigration laws designed to deport large numbers of people. In removal proceedings, parents often must decide to either leave their citizen-children behind in the care of others or take them to a country the child may have never known. Accordingly, immigration policy frequently creates two de facto classes of children: exiles and orphans. In discussing these classes, the authors offer a summary of how U.S. citizen-children come into contact with the immigration enforcement system. The article explores the impact of detention and deportation on the health, mental health, and developmental trajectories of citizen-children and argues for reforms in policy and practice that will adhere to the highest standards of child welfare practice. By integrating these children into the immigration discourse, practitioners and policymakers will be better able to understand the effects of immigration enforcement, reduce harm to children, and provide for the protection of their rights.

  20. Idioms of Distress.

    PubMed

    Desai, Geetha; Chaturvedi, Santosh K

    2017-08-01

    The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms.

  1. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction.

    PubMed

    Vannier, Sarah A; Rosen, Natalie O

    2017-03-01

    Sexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction. To identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress. Two-hundred sixty-one pregnant women completed a cross-sectional online survey. Women completed validated measurements of sexual functioning (Female Sexual Function Index; score < 26.55 indicates a sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and relationship satisfaction (Couples Satisfaction Index). Overall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems. Sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy. Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387-395. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  2. Idioms of Distress

    PubMed Central

    Desai, Geetha; Chaturvedi, Santosh K.

    2017-01-01

    The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms. PMID:28936079

  3. Psychological distress and dietary patterns in eight post-Soviet republics.

    PubMed

    Hinote, Brian P; Cockerham, William C; Abbott, Pamela

    2009-08-01

    The purpose of this study is to examine the relationship between psychological distress and dietary consumption patterns in the former Soviet Union. Data are cross-sectional and were collected in 2001 from a large representative sample (n = 18,428) of respondents age 18 years and over in eight former Soviet republics. Sociodemographic covariates and psychological distress predictors were analyzed using ordinal logistic regression models to estimate multivariate correlations with the frequency of meat, fish, vegetable, fruit, and animal fat consumption among men and women in these eight regions. Results show that psychological distress exhibits statistically significant, negative associations with all dietary consumption indicators for both men and women. Social class predictors display consistent positive correlations with food consumption outcomes, emphasizing the potential importance of this concept in the dynamic relationship between diet and psychological distress. Higher reported levels of psychological distress are associated with the less frequent consumption of all types of food products in this analysis. Several possible interpretations are discussed, and we explore the probable multidimensional theoretical mechanisms that can help explain the complex relationships among distress, food insecurity, and dietary patterns in these eight republics of the former USSR. The general and practical significance of these findings is also discussed, along with suggested directions for future research and potential dietary intervention strategies.

  4. Understanding how men experience, express and cope with mental distress: where next?

    PubMed

    Ridge, Damien; Emslie, Carol; White, Alan

    2011-01-01

    In line with the shift towards prioritising lay accounts and narratives of chronic illness in sociology, there is an emerging literature on men, their subjectivities and experiences of mental distress. We argue in this paper that subjectivities and distress among men are an important area for critical sociological research. Very little is known about men's subjectivities or the meanings they give to - and how they cope with or seek help for - distress. At the same time, current theories of gender relations, performativity and wellbeing as they pertain to men are likely to shed further light on subjectivity and distress. However, current theories (and qualitative research involving men and women) are pointing to considerable complexity. In this paper, we outline what is known about distress and men, and consider the utility of gender relations, performativity, subjectivities and wellbeing for a better understanding of distress. We also ask: What other factors influence distress, and how should these be considered in relation to men and masculinities? What are the implications for research and policy? © 2010 The Authors. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  5. A Bowen Family Systems Model of Generalized Anxiety Disorder and Romantic Relationship Distress.

    PubMed

    Priest, Jacob B

    2015-07-01

    Many individuals with generalized anxiety disorder (GAD) do not respond well to currently available treatments. Moreover, treatments are less effective when GAD is accompanied by romantic relationship distress. In order to develop effective treatments for GAD and relationship distress, it is necessary to conduct theory-based research to identify links common to both GAD and romantic relationship distress. Drawing on Bowen's family systems theory, the roles of family abuse/violence and differentiation in GAD and romantic relationship distress were examined using existing data from the National Comorbidity Survey Replication (n = 2,312; 2005). As predicted, family abuse/violence was directly linked to both GAD and romantic relationship distress. Differentiation mediated the relationship between family abuse/violence and GAD, and partially mediated the relationship between family abuse/violence and romantic relationship distress. Findings suggest that current and past relationship processes may help maintain chronic anxiety and that Bowen's theory may be a useful framework for developing couple therapy treatment of GAD and romantic relationship distress. © 2013 American Association for Marriage and Family Therapy.

  6. Psychometric evaluation of the Moral Distress Risk Scale: A methodological study.

    PubMed

    Schaefer, Rafaela; Zoboli, Elma Lcp; Vieira, Margarida M

    2017-01-01

    Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. To psychometrically test the Moral Distress Risk Scale. A methodological study was realized. Data were submitted to exploratory factorial analysis through the SPSS statistical program. Participants and research context: In total, 268 nurses from hospitals and primary healthcare settings participated in this research during the period of March to June of 2016. Ethical considerations: This research has ethics committee approval. The Moral Distress Risk Scale is composed of 7 factors and 30 items; it shows evidence of acceptable reliability and validity with a Cronbach's α = 0.913, a total variance explained of 59%, a Kaiser-Meyer-Olkin = 0.896, and a significant Bartlett <0.001. Concerns about moral distress should be beyond acute care settings, and a tool to help clarify critical points in other healthcare contexts may add value to moral distress speech. Psychometric results reveal that the Moral Distress Risk Scale can be applied in different healthcare contexts.

  7. The mediating effect of psychological distress on functional dependence in stroke patients.

    PubMed

    Huang, Hui-Chuan; Huang, Li-Kai; Hu, Chaur-Jong; Chang, Chien-Hung; Lee, Hsin-Chien; Chi, Nai-Fang; Shyu, Meei-Ling; Chang, Hsiu-Ju

    2014-12-01

    To explore varied forms of psychological distress and to determine the mediating influence of psychological distress on functional outcomes in stroke patients. Previous studies attest to the influence of depression on poststroke functional recovery. While there is evidence for neuropathological deficits that occur after stroke to be associated with psychological distress, few studies have explored the effect of various types of psychological distress on functional recovery. A cross-sectional study was used. Data were collected from 178 first-time stroke patients. Study variables included demographic and disease characteristics (stroke location and stroke syndrome classification), psychological distress (the Chinese language version of the Emotional and Social Dysfunction Questionnaire) and functional outcome (Barthel index). Regression and mediation models were used to evaluate the effect of psychological distress on functional outcome. Results revealed that stroke patients experience various forms of mild psychological distress, including anger, helplessness, emotional dyscontrol, indifference, inertia and euphoria, after stroke. Regression and mediation analyses further confirmed that various forms of psychological distress significantly mediated the effect of severe stroke syndromes on functional dependence. The various forms of psychological distress after stroke might play a mediating role in functional recovery and explain how stroke severity affects functional dependence. By understanding the nature of various forms of psychological distress, healthcare professionals should adopt appropriate assessment instruments and design effective interventions to help improve mental and physical function of stroke patients. © 2014 John Wiley & Sons Ltd.

  8. Toward interventions to address moral distress: navigating structure and agency.

    PubMed

    Musto, Lynn C; Rodney, Patricia A; Vanderheide, Rebecca

    2015-02-01

    The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Some researchers suggest that a closer examination of how socio-political structures influence healthcare delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by-and influence-the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions. © The Author(s) 2014.

  9. Race and Psychological Distress: The South African Stress and Health Study

    PubMed Central

    Jackson, Pamela Braboy; Williams, David R.; Stein, Dan J.; Herman, Allen; Williams, Stacey L.; Redmond, Deidre L.

    2012-01-01

    We analyze data from the South African Stress and Health Study, a nationally representative in-person psychiatric epidemiologic survey of 4,351 adults conducted as part of the World Mental Health Survey Initiative between January 2002 and June 2004. All blacks (Africans, Coloreds, and Indians) initially report higher levels of non-specific distress and anger/hostility than whites. Access to socioeconomic resources helps explain differences in non-specific distress between Coloreds and whites and Indians and whites. However, only when social stressors are considered do we find few differences in psychological distress (i.e., non-specific distress and anger/hostility) between Africans and whites. In addition, self-esteem and mastery have independent effects on non-specific distress and anger/hostility, but differences between Coloreds and whites in feelings of anger/hostility are not completely explained by self-esteem and mastery. The findings contribute to the international body of work on social stress theory, challenge underlying assumptions of the minority status perspective, and raise a series of questions regarding mental health disparities among South Africans. PMID:21131621

  10. Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review

    PubMed Central

    Weber, Samuel R.; Lomax, James W.; Pargament, Kenneth I.

    2017-01-01

    Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients. PMID:28379161

  11. Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review.

    PubMed

    Weber, Samuel R; Lomax, James W; Pargament, Kenneth I

    2017-04-05

    Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients.

  12. Predicting help-seeking behavior: The impact of knowing someone close who has sought help.

    PubMed

    Disabato, David J; Short, Jerome L; Lameira, Diane M; Bagley, Karen D; Wong, Stephanie J

    2018-02-15

    This study sought to replicate and extend research on social facilitators of college student's help seeking for psychological problems. We collected data on 420 ethnically diverse college students at a large public university (September 2008-May 2010). Students completed a cross-sectional online survey. We found that students who were aware of close others' (eg, family, friends) help seeking were two times more likely to have sought formal (eg, psychologist) and informal (eg, clergy) help themselves. Tests of moderation revealed the incremental effect (ie, controlling for help-seeking attitudes, internalizing symptoms, cultural demographics) of close others' formal help seeking was strong and significant for men (R 2 = 0.112), while it was negligible and nonsignificant for women (R 2 = .002). We discuss the importance for students-particularly men-to learn about close others' help seeking for facilitating their own help seeking during times of distress.

  13. Help-Negation and Suicidal Ideation: The Role of Depression, Anxiety and Hopelessness

    ERIC Educational Resources Information Center

    Wilson, Coralie J.; Deane, Frank P.

    2010-01-01

    Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study examined the association between suicidal ideation and intentions to seek help from friends, family and…

  14. Grandparents of children with cancer: a controlled study of distress, support, and barriers to care.

    PubMed

    Wakefield, Claire E; Drew, Donna; Ellis, Sarah J; Doolan, Emma L; McLoone, Jordana K; Cohn, Richard J

    2014-08-01

    For families under stress, positive grandparental relationships provide a valued 'safety net'. However, coping with family stressors can place a heavy burden on older individuals who may be experiencing declining health/energy themselves. This mixed-methods study assessed the prevalence of distress in grandparents of children with, and without, cancer, aiming to identify predictors of grandparental distress and quantify their barriers to care. Two hundred twenty-one grandparents [87 cancer group; 134 controls; mean age 65.47 years (SD = 6.97); 33.5% male] completed self-report questionnaires assessing distress, anxiety, depression, anger, 'need for help', support use, and barriers to psychosocial care. A higher proportion of grandparents in the cancer group reported clinically relevant distress (32.9% vs. 12.7%; p < 0.001), anxiety (48.8% vs. 23.9%; p < 0.001), depression (24.4% vs. 6.0%; p < 0.001), and anger (23.5% vs. 6.8%; p = 0.001). In the cancer group, distress was higher in grandmothers and in families with fewer siblings. Grandparents rarely accessed evidence-based psychosocial support (<5% in both groups), although grandparents of children with cancer were more likely to seek religious/spiritual support. Barriers to help seeking included lack of knowledge and rurality. Grandparents of children with cancer qualitatively described undisclosed feelings of uncertainty and helplessness and provided advice to other grandparents to facilitate their coping. Grandparents of children with cancer were clearly more distressed than controls. Grandparents' capacity to support their families may be limited by their own, untreated, distress. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Distress Intolerance and Prescription Opioid Misuse among Patients with Chronic Pain

    PubMed Central

    McHugh, R. Kathryn; Weiss, Roger D.; Cornelius, Marise; Martel, Marc O.; Jamison, Robert N.; Edwards, Robert R.

    2016-01-01

    The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance--the perceived or actual inability to manage negative emotional and somatic states--was associated with opioid misuse in those with chronic pain. A sample of 51 participants prescribed opioid analgesics for chronic back or neck pain were recruited for a one-time laboratory study. Participants completed measures of distress intolerance and opioid misuse, and a quantitative sensory testing battery. Results suggested that distress intolerance was associated with opioid misuse, even controlling for pain severity and negative affect. Distress intolerance was not associated with pain severity, threshold or tolerance, but was associated with self-reported anxiety and stress following noxious stimuli. This study found robust differences in distress intolerance between adults with chronic pain with and without opioid medication misuse. Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain. PMID:27058161

  16. Demographic and Psychosocial Factors Associated With Psychological Distress and Resilience Among Transgender Individuals

    PubMed Central

    Lyons, Anthony; Leonard, William; Pitts, Marian; Badcock, Paul; Couch, Murray

    2015-01-01

    Objectives. We examined the independent demographic and psychosocial factors associated with psychological distress and resilience among transgender men and women. Methods. Our data came from an online survey involving a national Australian sample of 169 transgender men and women in 2011. Survey questions assessed demographics; sources of support; contact with lesbian, gay, bisexual, and transgender peers; and experiences of victimization. We assessed the outcomes with the Kessler Psychological Distress Scale and the Brief Resilience Scale. Results. In all, 46.0% of the sample reported high or very high levels of psychological distress. Multivariable regression analyses identified considerably different independent factors for psychological distress and resilience. Younger age, feeling unable to turn to family for support, and victimization experiences were associated with greater psychological distress, whereas higher income, identifying as heterosexual, and having frequent contact with lesbian, gay, bisexual, and transgender peers were associated with greater resilience. Conclusions. With different factors identified for psychological distress and resilience, these findings may help inform the development of tailored mental health interventions and resilience-building programs for this vulnerable population. PMID:26270284

  17. A 3-stage model of patient-centered communication for addressing cancer patients' emotional distress.

    PubMed

    Dean, Marleah; Street, Richard L

    2014-02-01

    To describe pathways through which clinicians can more effectively respond to patients' emotions in ways that contribute to betterment of the patient's health and well-being. A representative review of literature on managing emotions in clinical consultations was conducted. A three-stage, conceptual model for assisting clinicians to more effectively address the challenges of recognizing, exploring, and managing cancer patients' emotional distress in the clinical encounter was developed. To enhance and enact recognition of patients' emotions, clinicians can engage in mindfulness, self-situational awareness, active listening, and facilitative communication. To enact exploration, clinicians can acknowledge and validate emotions and provide empathy. Finally, clinicians can provide information empathetically, identify therapeutic resources, and give referrals and interventions as needed to help lessen patients' emotional distress. This model serves as a framework for future research examining pathways that link clinicians' emotional cue recognition to patient-centered responses exploring a patient's emotional distress to therapeutic actions that contribute to improved psychological and emotional health. Specific communicative and cognitive strategies are presented that can help clinicians better recognize a patient's emotional distress and respond in ways that have therapeutic value. Published by Elsevier Ireland Ltd.

  18. Causes and consequences of psychological distress among orphans in eastern Zimbabwe

    PubMed Central

    Nyamukapa, C.A.; Gregson, S.; Wambe, M.; Mushore, P.; Lopman, B.; Mupambireyi, Z.; Nhongo, K.; Jukes, M.C.H.

    2010-01-01

    Substantial resources are invested in psychological support for children orphaned or otherwise made vulnerable in the context of HIV/AIDS (OVC). However, there is still only limited scientific evidence for greater psychological distress amongst orphans and even less evidence for the effectiveness of current support strategies. Furthermore, programmes that address established mechanisms through which orphanhood can lead to greater psychological distress should be more effective. We use quantitative and qualitative data from Eastern Zimbabwe to measure the effects of orphanhood on psychological distress and to test mechanisms for greater distress amongst orphans suggested in a recently published theoretical framework. Orphans were found to suffer greater psychological distress than non-orphans (sex- and age-adjusted co-efficient: 0.15; 95% CI 0.03–0.26; P = 0.013). Effects of orphanhood contributing to their increased levels of distress included trauma, being out-of-school, being cared for by a non-parent, inadequate care, child labour, physical abuse, and stigma and discrimination. Increased mobility and separation from siblings did not contribute to greater psychological distress in this study. Over 40% of orphaned children in the sample lived in households receiving external assistance. However, receipt of assistance was not associated with reduced psychological distress. These findings and the ideas put forward by children and caregivers in the focus group discussions suggest that community-based programmes that aim to improve caregiver selection, increase support for caregivers, and provide training in parenting responsibilities and skills might help to reduce psychological distress. These programmes should be under-pinned by further efforts to reduce poverty, increase school attendance and support out-of-school youth. PMID:20552465

  19. Parent-reported distress in children under 3 years old during preventive medical and dental care.

    PubMed

    Nelson, T M; Huebner, C E; Kim, A; Scott, J M; Pickrell, J E

    2015-06-01

    This study examined factors related to young children's distress during preventive oral health visits. Additionally, associations between parent-reported child behaviour during the dental visit and during previous medical visits were tested. One hundred twenty-two children under 3 years of age enrolled in a government insurance programme for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7 %) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6 % of the children and severe distress was reported for 39.4 %. Intensity of distress during the examination was not associated with the child's age, gender, dental health, or previous experience with dental care. Distress was also unrelated to the caregiver's education level or own dental health. Intensity of distress was associated with the child's pre-dental examination distress and distress during prior medical examinations and injections. Dental professionals can better anticipate child distress by assessing children before a dental examination and enquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit.

  20. Distress Intolerance and Prescription Opioid Misuse Among Patients With Chronic Pain.

    PubMed

    McHugh, R Kathryn; Weiss, Roger D; Cornelius, Marise; Martel, Marc O; Jamison, Robert N; Edwards, Robert R

    2016-07-01

    The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance-the perceived or actual inability to manage negative emotional and somatic states-was associated with opioid misuse in those with chronic pain. A sample of 51 participants prescribed opioid analgesics for chronic back or neck pain were recruited for a 1-time laboratory study. Participants completed measures of distress intolerance and opioid misuse, and a quantitative sensory testing battery. Results suggested that distress intolerance was associated with opioid misuse, even controlling for pain severity and negative affect. Distress intolerance was not associated with pain severity, threshold, or tolerance, but was associated with self-reported anxiety and stress after noxious stimuli. This study found robust differences in distress intolerance between adults with chronic pain with and without opioid medication misuse. Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain. This study demonstrated that distress intolerance was associated with opioid misuse in adults with chronic pain who were prescribed opioids. Distress intolerance can be modified with treatment, and thus may be relevant not only for identification of risk for opioid misuse, but also for mitigation of this risk. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  1. Evaluation of Youth Mental Health First Aid USA: A program to assist young people in psychological distress.

    PubMed

    Aakre, Jennifer M; Lucksted, Alicia; Browning-McNee, Lea Ann

    2016-05-01

    Youth Mental Health First Aid USA (YMHFA) is a manualized training program designed to educate members of the public on common emotional problems and psychological disorders among youth and to provide trainees with tools anyone can use to assist young people in psychological distress. The present study used a pre versus post design to assess the ability of social service employees to generate appropriate strategies to use in hypothetical situations featuring a young person in distress, before versus after participation in the 8-hr YMHFA training. Trainee responses demonstrated significant overall improvement (M = 1.32, SD = 0.80 pretraining vs. M = 1.87, SD = 1.1 posttraining, t = 6.6, p < .001) by including four of the five central YMHFA strategies significantly more often after training. Increased confidence in, likelihood of, and comfort with helping a young person in emotional distress or crisis were also reported posttraining compared to pretraining (all p ≤ .001). Results suggest that individuals participating in YMHFA training are better informed regarding when to assess for risk of suicide, listen nonjudgmentally, encourage appropriate professional help, and encourage self-help strategies with young people in psychological distress. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Neonatal respiratory distress syndrome

    MedlinePlus

    Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs ...

  3. "I help because I want to, not because you tell me to": empathy increases autonomously motivated helping.

    PubMed

    Pavey, Louisa; Greitemeyer, Tobias; Sparks, Paul

    2012-05-01

    Empathetic arousal has been found to be a strong predictor of helping behavior. However, research has neglected the motivational mechanisms whereby empathetic concern elicits help giving. Three studies examined the extent to which autonomous and controlled motives for helping mediated the relationship between empathy and helping. Study 1 found that state empathy predicted willingness to offer time and money to help a person in need, with this relationship mediated by autonomous motivation for helping. Study 2 demonstrated that dispositional, empathetic concern predicted prosocial intentions and behavior via the mediation of autonomous motivation. Study 3 revealed that participants who focused on the emotions of another person in distress reported greater willingness to help than did participants who remained emotionally detached, with this effect mediated by autonomous motivation to help. Controlled motivation had no positive effects on helping in any of the studies. The results suggest that empathy encourages prosocial behavior by increasing autonomous motivation to help.

  4. A randomized controlled trial of a brief self-help coping intervention designed to reduce distress when awaiting genetic risk information.

    PubMed

    Bennett, Paul; Phelps, Ceri; Brain, Kate; Hood, Kerenza; Gray, Jonathon

    2007-07-01

    The aim of this study was to evaluate the effectiveness of a distraction-based coping leaflet in reducing distress in women undergoing genetic risk assessment for breast/ovarian cancer. One hundred sixty-two women participated in a randomized controlled trial, receiving either the intervention or standard information. Data were collected through a postal questionnaire at entry into a genetic risk assessment programme and 1 month later. Analysis of covariance revealed a nonsignificant reduction in distress in all women, and a significant reduction of distress among those with high baseline stress, who received the intervention. No gains were found among the control group. Measures of emotional response while thinking about cancer genetic assessment suggested these benefits were achieved in the absence of any rebound emotional response. The intervention offers a low-cost effective coping intervention, which could be integrated into existing services with minimal disruption and may also be appropriate for other periods of waiting and uncertainty.

  5. Survivors of childhood cancer and comparison peers: the influence of early family factors on distress in emerging adulthood.

    PubMed

    Robinson, Kristen E; Gerhardt, Cynthia A; Vannatta, Kathryn; Noll, Robert B

    2009-02-01

    This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. Copyright 2009 APA, all rights reserved.

  6. The role of psychological flexibility in a self-help acceptance and commitment therapy intervention for psychological distress in a randomized controlled trial.

    PubMed

    Fledderus, Martine; Bohlmeijer, Ernst T; Fox, Jean-Paul; Schreurs, Karlein M G; Spinhoven, Philip

    2013-03-01

    This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail support (n=250), or to a waiting list control group (n=126). All participants completed measures before and after the intervention to assess depression, anxiety and psychological flexibility. Participants in the experimental condition also completed these measures during the intervention (after three and six weeks) and at a three-month follow-up. With multilevel modelling, it was shown that the effects of the intervention on psychological distress were stronger for participants with higher levels of psychological flexibility. Furthermore, our study showed that improved psychological flexibility mediated the effects of the ACT intervention. With a cross-lagged panel design, it was shown that especially improvements in psychological flexibility in the last three sessions of the intervention were important for further reductions in anxiety. To conclude, our study showed the importance of targeting psychological flexibility during an ACT intervention for a reduction in depressive and anxiety symptoms. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Persistent Distress after Water Contamination.

    PubMed

    Schade, Charles P; Gupta, Rahul; Jha, Ayan; Wright, Nasandra

    2016-01-01

    A chemical spill contaminated the public water supply of Charleston, West Virginia in January 2014 for at least a week. Psychological distress is common after disasters. We surveyed the exposed population to assess psychological distress during and three months after the incident. We inquired about stressors that might predict distress, adequacy of communication from public officials, and use of the water supply and perceptions of its safety three months after the incident. Twenty six percent of interviewees had persistent symptoms of distress. Female sex, negative household experiences during the episode (especially having someone sick), and poor perception of communication increased odds of persistent distress. Households of respondents without persistent distress were significantly more likely to report drinking tap water (RR=1.95) than those with persistent distress. Distress in Charleston area residents persisted and may have resulted in continuing mistrust of the water supply.

  8. Moral sensitivity and moral distress in Iranian critical care nurses.

    PubMed

    Borhani, Fariba; Abbaszadeh, Abbas; Mohamadi, Elham; Ghasemi, Erfan; Hoseinabad-Farahani, Mohammad Javad

    2017-06-01

    Moral sensitivity is the foremost prerequisite to ethical performance; a review of literature shows that nurses are sometimes not sensitive enough for a variety of reasons. Moral distress is a frequent phenomenon in nursing, which may result in paradoxes in care, dealing with patients and rendering high-quality care. This may, in turn, hinder the meeting of care objectives, thus affecting social healthcare standards. The present research was conducted to determine the relationship between moral sensitivity and moral distress of nurses in intensive care units. This study is a descriptive-correlation research. Lutzen's moral sensitivity questionnaire and Corley Moral Distress Questionnaire were used to gather data. Participants and research context: A total of 153 qualified nurses working in the hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected for this study. Subjects were selected by census method. Ethical considerations: After explaining the objectives of the study, all the participants completed and signed the written consent form. To conduct the study, permission was obtained from the selected hospitals. Nurses' average moral sensitivity grade was 68.6 ± 7.8, which shows a moderate level of moral sensitivity. On the other hand, nurses also experienced a moderate level of moral distress (44.8 ± 16.6). Moreover, there was no meaningful statistical relationship between moral sensitivity and moral distress (p = 0.26). Although the nurses' moral sensitivity and moral distress were expected to be high in the intensive care units, it was moderate. This finding is consistent with the results of some studies and contradicts with others. As moral sensitivity is a crucial factor in care, it is suggested that necessary training be provided to develop moral sensitivity in nurses in education and practical environments. Furthermore, removing factors that contribute to moral distress may help decrease it in nurses.

  9. Culture, Context, and the Internalizing Distress of Mexican American Youth

    ERIC Educational Resources Information Center

    Polo, Antonio J.; Lopez, Steven R.

    2009-01-01

    Latino youth appear to be at higher risk for depression relative to youth from other ethnic groups. This study assessed the relationship between nativity and several forms of internalizing distress among Mexican American middle school students as well as sociocultural factors that may help explain this relationship. Immigrant Mexican American…

  10. Student distress in clinical workplace learning: differences in social comparison behaviours.

    PubMed

    Janet Raat, A N; Schönrock-Adema, Johanna; van Hell, E Ally; Kuks, Jan B M; Cohen-Schotanus, Janke

    2015-03-01

    In medical education, student distress is known to hamper learning and professional development. To address this problem, recent studies aimed at helping students cope with stressful situations. Undergraduate students in clinical practice frequently use experiences of surrounding peers to estimate their abilities to master such challenging situations. This use of the experiences of others, known as social comparison, may affect student distress both positively and negatively. To find characteristics of a beneficial use of social comparison, we examined differences in comparison behaviours between students expressing low and high levels of distress. The participants in our study, response rate 93% (N = 301/321), were all medical students in their first year in clinical practice. They completed the General Health Questionnaire (GHQ-12) to measure distress, and three separate questionnaires to measure: (1) orientation to comparison, (2) motive for comparison, and (3) interpretation of comparison. Differences were analysed using multivariate analysis of variance. Although all students were oriented towards social comparison, the analyses showed that this orientation was less apparent among low-distress students. Besides, the low-distress students were less inclined to use motives indicative for comparisons with peers perceived as performing worse and were less negative in the interpretations of their comparisons. As social comparison is frequently used among all students, we recommend to make them aware of their comparison behaviours and inform them about the pros and cons of the distinguished aspects of the comparison process.

  11. Does self-help increase rates of help seeking for student mental health problems by minimizing stigma as a barrier?

    PubMed

    Levin, Michael E; Krafft, Jennifer; Levin, Crissa

    2018-01-01

    This study examined whether self-help (books, websites, mobile apps) increases help seeking for mental health problems among college students by minimizing stigma as a barrier. A survey was conducted with 200 college students reporting elevated distress from February to April 2017. Intentions to use self-help were low, but a significant portion of students unwilling to see mental health professionals intended to use self-help. Greater self-stigma related to lower intentions to seek professional help, but was unrelated to seeking self-help. Similarly, students who only used self-help in the past reported higher self-stigma than those who sought professional treatment in the past. Although stigma was not a barrier for self-help, alternate barriers were identified. Offering self-help may increase rates of students receiving help for mental health problems, possibly by offering an alternative for students unwilling to seek in-person therapy due to stigma concerns.

  12. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

  13. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

  14. Psychological Distress, Acculturation, and Mental Health-Seeking Attitudes among People of African Descent in the United States: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Obasi, Ezemenari M.; Leong, Frederick T. L.

    2009-01-01

    This article investigates the relationship between psychological distress, acculturation, and help-seeking attitudes among people of African descent (N = 130). Psychological distress was measured using the Global Severity Index from the Brief Symptom Inventory (L. R. Derogatis & N. Melisaratos, 1983), acculturation was measured using the…

  15. Student Distress in Clinical Workplace Learning: Differences in Social Comparison Behaviours

    ERIC Educational Resources Information Center

    Raat, A. N. Janet; Schönrock-Adema, Johanna; van Hell, E. Ally; Kuks, Jan B. M.; Cohen-Schotanus, Janke

    2015-01-01

    In medical education, student distress is known to hamper learning and professional development. To address this problem, recent studies aimed at helping students cope with stressful situations. Undergraduate students in clinical practice frequently use experiences of surrounding peers to estimate their abilities to master such challenging…

  16. Peer pressure, psychological distress and the urge to smoke.

    PubMed

    Tsai, Yi-Wen; Wen, Yu-Wen; Tsai, Chia-Rung; Tsai, Tzu-I

    2009-06-01

    Psychology and addiction research have found that cigarette smokers react with subjective and automatic responses to stimuli associated with smoking. This study examines the association between the number of cigarettes smokers consume per month and their response to cues derived from peer and psychological distress. We studied 1,220 adult past and current smokers drawn from a national face-to-face interview survey administered in 2004. We defined two types of cues possibly triggering a smoker to have a cigarette: peer cues and psychological cues. We used ordinary least square linear regressions to analyze smoking amount and response to peer and psychological distress cues. We found a positive association between amount smoked and cue response: peer cues (1.06, 95%CI: 0.74-1.38) and psychological cues (0.44, 95%CI = 0.17-0.70). Response to psychological cues was lower among male smokers (-1.62, 95%CI = -2.26-(-)0.98), but response to psychological cues were higher among those who had senior high school level education (0.96, 95%CI = 0.40-1.53) and who began smoking as a response to their moods (1.25, 95%CI = 0.68-1.82). These results suggest that both peer cues and psychological cues increase the possibility of contingent smoking, and should, therefore, be addressed by anti-smoking policies and anti-smoking programs. More specifically, special attention can be paid to help smokers avoid or counter social pressure to smoke and to help smokers resist the use of cigarettes to relieve distress.

  17. Predicting general and cancer-related distress in women with newly diagnosed breast cancer.

    PubMed

    Gibbons, Andrea; Groarke, AnnMarie; Sweeney, Karl

    2016-12-03

    , more severe consequences, greater illness identity and less illness coherence increases cancer-specific distress (ps < .001) only if women were also more anxiously preoccupied with their diagnosis. Screening women for anxious preoccupation may help identify women with screen-detected breast cancer at risk of experiencing high levels of cancer-related distress; whilst illness perceptions and coping could be targeted for use in future interventions to reduce distress.

  18. Psychosocial and environmental distress resulting from a volcanic eruption: Study protocol.

    PubMed

    Warsini, Sri; Usher, Kim; Buettner, Petra; Mills, Jane; West, Caryn; Methods, Res

    2015-01-01

    To examine the psychosocial and environmental distress resulting from the 2010 eruption of the Merapi volcano and explore the experience of living in an environment damaged by a volcanic eruption. Natural disasters cause psychosocial responses in survivors. While volcanic eruptions are an example of a natural disaster, little is currently known about the psychosocial impact on survivors. Volcanic eruptions also cause degradation of the environment, which is linked to environmental distress. However, little is currently known of this phenomenon. An explanatory mixed method study. The research will be divided into three phases. The first phase will involve instrument modification, translation and testing. The second phase will involve a survey to a larger sample using the modified and tested questionnaire. The third phase will involve the collection of interviews from a sub set of the same participants as the second phase. Quantitative data will be analyzed to determine the extent of psychosocial and environmental distress experienced by the participants. Qualitative data will be analyzed to explain the variation among the participants. The results of the study will be used to develop strategies to support survivors in the future and to help ameliorate distress.

  19. Exploring the Relationship Among Moral Distress, Coping, and the Practice Environment in Emergency Department Nurses.

    PubMed

    Zavotsky, Kathleen Evanovich; Chan, Garrett K

    2016-01-01

    Emergency department (ED) nurses practice in environments that are highly charged and unpredictable in nature and can precipitate conflict between the necessary prescribed actions and the individual's sense of what is morally the right thing to do. As a consequence of multiple moral dilemmas, ED staff nurses are at risk for experiencing distress and how they cope with these challenges may impact their practice. To examine moral distress in ED nurses and its relationship to coping in that specialty group. Using survey methods approach. One hundred ninety-eight ED nurses completed a moral distress, coping, and demographic collection instruments. Advanced statistical analysis was completed to look at relationships between the variables. Data analysis did show that moral distress is present in ED nurses (M = 80.19, SD = 53.27), and when separated into age groups, the greater the age, the less the experience of moral distress. A positive relationship between moral distress and some coping mechanisms and the ED environment was also noted. This study's findings suggest that ED nurses experience moral distress and could receive some benefit from utilization of appropriate coping skills. This study also suggests that the environment in which ED nurses practice has a significant impact on the experience of moral distress. Because health care is continuing to evolve, it is critical that issues such as moral distress and coping be studied in ED nurses to help eliminate human suffering.

  20. Regulating and coping with distress during police interviews of traumatized victims.

    PubMed

    Risan, Patrick; Binder, Per-Einar; Milne, Rebecca

    2016-11-01

    The aim of this study was to qualitatively explore approaches to police interviewing of traumatized victims experiencing distress. Specifically, we examined the research question: What do police investigators regard as useful approaches to regulating distress, maintaining rapport and promoting the well-being of the interviewee? To explore processes relevant to the research objective, 21 semistructured interviews were conducted of police investigators who interviewed survivors following the Utøya massacre on July 22, 2011 in Norway. To examine the relationship between the research question and the material, we used thematic analysis based on a reflexive hermeneutic-phenomenological epistemology. Following the analysis, 3 main themes emerged: (1) becoming aware of the interviewees' capacity to cope with distress by attending to nonverbal cues, (2) interviewers communicating acceptance and modeling how to cope with painful emotions, and, (3) regulating distress by responding to the interviewees' emotional needs, helping them to feel safe and promoting the positive. The findings of the study show the importance of relational processes in investigative interviewing of traumatized interviewees, particularly with regard to coping with emotions. The results suggest that if the police investigator who is conducting an investigative interview can offer a trusting, safe and compassionate relationship, or if he or she steers the relational dynamics toward safety in the present moment when distress arises, he or she may facilitate the regulation of distress. We propose that if the interviewee's emotions are managed in this way during the police interview, it may lead to increased rapport and promote psychological health. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Help-Seeking by Young People with Depressive Disorders

    ERIC Educational Resources Information Center

    Sawyer, Michael G.; Sawyer, Alyssa C. P.; La Greca, Annette M.

    2012-01-01

    Depressive disorders commonly occur for the first time during adolescence and often become a recurring source of distress and impairment. Unfortunately, only a small proportion of adolescents with depressive disorders receive help from professional services, and there is evidence that adolescents with higher levels of depressive symptoms may be…

  2. Moral distress in emergency nurses.

    PubMed

    Fernandez-Parsons, Robin; Rodriguez, Lori; Goyal, Deepika

    2013-11-01

    For nurses, moral distress leads to burnout, attrition, compassion fatigue, and patient avoidance. Using a quantitative, cross-sectional, and descriptive design, we assessed the frequency, intensity, and type of moral distress in 51 emergency nurses in 1 community hospital using a 21-item, self-report, Likert-type questionnaire. Results showed a total mean moral distress level of 3.18, indicative of overall low moral distress. Situations with the highest levels of moral distress were related to the competency of health care providers and following family wishes to continue life support, also known as futile care. Moral distress was the reason given by 6.6% of registered nurses for leaving a previous position, 20% said that they had considered leaving a position but did not, and 13.3% stated that they are currently considering leaving their position because of moral distress. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  3. The relationship between food frequency and menstrual distress in high school females

    PubMed Central

    Mohamadirizi, Soheila; Kordi, Masoumeh

    2015-01-01

    Background: Nutrition pattern is one of the important factors predicting menstrual distress, which varies among different cultures and countries. The purpose of this study is to determine the relationship between food frequency and menstrual distress in high school girls from Mashhad. Materials and Methods: This cross-sectional study was conducted in 2012 using a two-stage sampling method on 407 high school female students from Mashhad who met the inclusion criteria. Subjects completed questionnaires of demographic characteristics, food frequency, and Menstrual Distress Questionnaire (MDQ) during three phases of the menstrual cycle (a week before bleeding, during menstrual bleeding period, and a week after menstruation). The collected data were analyzed by statistical tests such as Pearson correlation coefficient test, independent Student's t-test, and one-way analysis of variance (ANOVA). Results: Results showed that 87.7% of the students were at moderate economic status, 82.2% were exposed to cigarette smoke, 94.8% had mothers without university education, and 9.4% had working mothers. About 71% of the students reported minor pre-menstruation distress, 81% reported minor distress during bleeding, and 39% reported minor post-menstruation distress. In addition, the mean (SD) values for sweet–fatty foods, salty–fatty foods, fast foods, and caffeine were 3.6, 3.3, 1.3, and 10.2 per week, respectively. In addition, Pearson correlation coefficient test showed no significant correlation between total menstruation distress and food frequency (P > 0.05). Conclusions: With regard to the inappropriate food frequency and high intensity of menstrual distress among high school students and as health care and educational efforts for prevention and health promotion in society are among the duties of health workers, the results of this study can help the officials involved in education to emphasize on nutrition and the menstrual health of students. PMID:26793254

  4. Living through pelvic radiotherapy:A mixed method study of self-care activities and distressful symptoms.

    PubMed

    Jakobsson, Sofie; Ekman, Tor; Ahlberg, Karin

    2015-06-01

    To explore patients' experience of their illness when undergoing pelvic radiotherapy by describing the presence and severity of distressful symptoms and to explore initiated self-care activities in response to illness and symptoms. A mixed-method study was performed which included a core qualitative dataset and a supplementary quantitative dataset. Twenty-nine women undergoing five weeks of radiotherapy were prospectively interviewed during five weeks of treatment in order to capture experiences, distressful symptoms and quality of life during treatment. Grounded theory formed collection and analysis of the qualitative dataset and statistics were used to analyze the quantitative dataset. A maintained self-identity was concluded as being central during the trajectory of treatment. Initiated self-care activities served to alleviate physical, emotional, and social suffering; helping the respondents keep their integrity and sense of self. Previous life experiences influenced the process of being able to maintain self-identity. The gastrointestinal symptoms and pain caused most distress. In order to be able to maintain self-identity patients endure treatment by focusing on symptoms, on getting cured and on their self-image. Several distressful symptoms implied social limitations and a sense that the body would not take the strain. The result of this study can help health care professionals to gain a better understanding of the struggle to endure pelvic radiotherapy. Further, health care professionals should be more proactive in alleviating their patients' distressful symptoms. The results imply that previous life experiences should precede initiated interventions because these life experiences affect the patients' self-care activities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Metacognitive self-reflectivity moderates the relationship between distress tolerance and empathy in schizophrenia.

    PubMed

    Bonfils, Kelsey A; Minor, Kyle S; Leonhardt, Bethany L; Lysaker, Paul H

    2018-07-01

    Deficits in empathy seen in schizophrenia are thought to play a major role in the social dysfunction seen in the disorder. However, little work has investigated potential determinants of empathic deficits. This study aimed to fill that gap by examining the effects of two variables on empathy - distress tolerance and metacognitive self-reflectivity. Fifty-four people with schizophrenia-spectrum disorders receiving services at an urban VA or community mental health center were assessed for empathy, metacognition, and distress tolerance. Bivariate correlations and moderation methods were used to ascertain associations amongst these variables and examine interactions. Results revealed that, against hypotheses, empathy was not related at the bivariate level to either distress tolerance or metacognitive self-reflectivity. However, consistent with hypotheses, moderation analyses revealed that participants with higher self-reflectivity showed no relationship between distress tolerance and empathy, while those with lower self-reflectivity showed a relationship such that reduced ability to tolerate distress predicted reduced empathy. Taken together, results of this study suggest that lack of distress tolerance can negatively affect empathy in people with schizophrenia with lesser capacity for metacognitive self-reflection; thus, fostering self-reflectivity may help overcome that negative impact. Future work is needed investigating the impact of metacognitively-tailored interventions on empathy in this population. Copyright © 2018. Published by Elsevier B.V.

  6. Different Sources of Dignity-Related Distress in Women Receiving Chemotherapy for Breast Cancer

    PubMed Central

    Shahhoseini, Somaye; Borhani, Fariba; Shoorideh, Foroozan Atashzadeh; Kavousi, Amir; Bagheri, Hossein; Almasi-Hashiani, Amir

    2017-01-01

    Background: Identification of different sources of dignity-related distress experienced by people nearing the end of life may help nurses to provide better care services. This study was conducted to determine sources of dignity-related distress from the perspective of women with breast cancer undergoing chemotherapy. Materials and Methods: In this cross sectional study, the participants comprised 207 women with breast cancer undergoing chemotherapy in chemotherapy clinics in hospitals of Tehran, Iran. The Cronbach’s coefficient alpha for the PDI was 0.76. Validity of PDI by confirmatory factor analysis shows that the comparative Fit Index of this instrument is 0.96 and so it is appropriate for application in different setting. Data were analyzed by Stata version 13. Results: Patients were mostly concerned about the distress caused by disease symptoms (mean; 2.4061, S.D.; 0.96), followed by existential distress (mean; 1.8784, S.D.; 0.75), peace of mind (mean; 1.871, S.D.; 0.77), dependence (mean; 1.8647, S.D.; 0.98), and social support (mean; 1.4097, S.D.; 0.99), respectively, in order of highest scores. Conclusion: Considering that the patients were mostly concerned about the distress caused by disease symptoms, followed by existential distress, peace of mind, dependency, and social support, it seems necessary to take further measures toward addressing these issues. PMID:29172264

  7. Sexual Assault Disclosure Recipients' Experiences: Emotional Distress and Changes in the Relationship With the Victim.

    PubMed

    Milliken, Jennifer; Paul, Lisa A; Sasson, Sapir; Porter, Abigail; Hasulube, Jemi

    2016-01-01

    Sexual assault victims are more likely to disclose their experience to friends and family than formal support sources (e.g., police, counselors). As such, disclosure receipt is a relatively common occurrence, but little is known about the recipients' disclosure experience. This study examined predictors of recipient emotional distress and positive and negative changes in the victim-recipient relationship postdisclosure among 69 female undergraduates at 3 universities. Predictors of distress included greater self-rated closeness to the victim and greater confusion about how to help. Positive changes were predicted by greater closeness and less responsibility attributed to the victim, and negative changes were predicted by less closeness, greater assigned responsibility, and greater perceived ineffectiveness of one's help. Implications for improving the disclosure experience via psychoeducational interventions are presented.

  8. Social support as a mediator between symptom distress and quality of life in women with breast cancer.

    PubMed

    Manning-Walsh, Juanita

    2005-01-01

    To examine relationships between symptom distress and quality of life when religious support and personal support were introduced as mediating variables. Cross-sectional, correlational. Internet recruitment following university institutional review board approval. Mailed questionnaires from 100 women with breast cancer, mean age 46, length of time since surgery 1 to 24 months, predominantly White. Symptom Distress Scale, Religious Support Scale, FACT-B, and Facit-Sp-12. Personal support was positively related to quality of life and partially mediated the effects of symptom distress. Religious support did not mediate symptom distress and was not directly related to quality of life. Social support from family members and friends helped to decrease the negative effects of symptoms on quality of life. This study underscores the need to continue to assess for symptom distress and adequacy of personal support throughout the cancer trajectory and to facilitate the garnering of support resources when needed.

  9. Public hospitals in financial distress: Is privatization a strategic choice?

    PubMed

    Ramamonjiarivelo, Zo; Weech-Maldonado, Robert; Hearld, Larry; Menachemi, Nir; Epané, Josué Patien; O'Connor, Stephen

    2015-01-01

    As safety net providers, public hospitals operate in more challenging environments than private hospitals. Such environments put public hospitals at greater risk of financial distress, which may result in privatization and deterioration of the safety net. The purpose of this study was to investigate whether financial distress is associated with privatization among public hospitals. We used panel data merged from the American Hospital Association Annual Survey, Medicare Cost Reports, Area Resource File, and Local Area Unemployment Statistics. Our study population consisted of all U.S. nonfederal acute care public hospitals in 1997 tracked through 2009, resulting in 6,426 hospital-year observations. The dependent variable "privatization" was defined as conversion from public status to either private not-for-profit or private for-profit status. The main independent variable, "financial distress," was based on the Altman Z-score methodology. Control variables included market and organizational factors. Two random-effects logistic regression models with state and year fixed-effects were constructed. The independent and control variables were lagged by 1 year and 2 years for Models 1 and 2, respectively. Public hospitals in financial distress had greater odds of being privatized than public hospitals not in financial distress: (OR = 4.53, p < .001) for Model 1 and (OR = 3.05, p = .001) for Model 2. Privatization eases access to resources and may provide financial relief to government entities from the burden of continuously funding a hospital operating at a loss, which in turn may help keep the hospital open and preserve access to care for the community. Privatizing a financially distressed public hospital may be a better strategic alternative than closure. The Altman Z-score could be used as a managerial tool to monitor hospitals' financial condition and take corrective actions.

  10. A framework for understanding moral distress among palliative care clinicians.

    PubMed

    Rushton, Cynda H; Kaszniak, Alfred W; Halifax, Joan S

    2013-09-01

    Palliative care clinicians confront suffering as they care for people living with life-limiting conditions. When the degree of suffering becomes unjustified, moral distress can ensue. Promising work from neuroscience and social psychology has yet to be applied to clinical practice. Our objective was to expand a social psychology model focusing on empathy and compassion in response to suffering to include an ethical dimension and to examine how the interrelationships of its proposed components can assist clinicians in understanding their responses to morally distressing situations. In the clinical context, responses to distressing events are thought to include four dimensions: empathy (emotional attunement), perspective taking (cognitive attunement), memory (personal experience), and moral sensitivity (ethical attunement). These dynamically intertwined dimensions create the preconditions for how clinicians respond to a triggering event instigated by an ethical conflict or dilemma. We postulate that if the four dimensions are highly aligned, the intensity and valence of emotional arousal will influence ethical appraisal and discernment by engaging a robust view of the ethical issues, conflicts, and possible solutions and cultivating compassionate action and resilience. In contrast, if they are not, ethical appraisal and discernment will be deficient, creating emotional disregulation and potentially leading to personal and moral distress, self-focused behaviors, unregulated moral outrage, burnout, and secondary stress. The adaptation and expansion of a conceptual framework offers a promising approach to designing interventions that help clinicians mitigate the detrimental consequences of unregulated moral distress and to build the resilience necessary to sustain themselves in clinical service.

  11. [Burden and capability of damaged parents--how refugee children can grow in exile].

    PubMed

    Adam, Hubertus; Walter, Joachim

    2012-01-01

    In trauma, dialectical tension arises between the inner perspective of the traumatized subject and the outside perspective (objective situation), between environmental stress and the subjective attribution of meaning, as well as between experience and behaviour. The traumatic process--the subject's endeavour to comprehend the overwhelming, often inconceivable experience and integrate it into its concepts of self and world--is understood against the backdrop of these interacting dimensions. The process phases "emerge from each other, run parallel, and permeate each other" (Fischer u. Riedesser, 2003). Problems that arise in the aftermath of trauma are rarely overcome by the victims alone. Attempts to process and self-heal have a social dimension, and family members are affected by war, persecution and flight in individual, varying ways. The impacts of violence experienced by parents from different crisis regions are examined in case studies with regard to the psychological development of indirectly impacted children growing up in exile.

  12. Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors.

    PubMed

    Ghazali, Naseem; Roe, Brenda; Lowe, Derek; Tandon, Sank; Jones, Terry; Shaw, Richard; Risk, Janet; Rogers, Simon N

    2017-10-01

    Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. The rate of significant distress (i.e. DT cut-off score ≥4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p < 0.001). Significant distress was most strongly associated with Physical and Functional well-being (p < 0.001) and Psychological and Emotional well-being domains (p = 0.001). On balance, very little difference was noted between cut-off points of either ≥4 or ≥5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score ≥4 or ≥5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Life after cancer: how does public stigma increase psychological distress of childhood cancer survivors?

    PubMed

    Kim, Min Ah; Yi, Jaehee

    2014-12-01

    Public stigma is a major source of stress for cancer survivors. However, factors that buffer or exacerbate the negative effects of public stigma on psychological distress have not been elucidated. This study examined how perceived public stigma affects psychological distress as mediated by cancer disclosure, internalized reactions to stigma, and social support availability. Cross-sectional study. The study was conducted in South Korea. The study sample was 223 adolescent and young adult survivors of childhood cancer diagnosed before the age of 19 and currently between 15 and 39 years old. Psychological distress was assessed using the Brief Symptom Inventory-18. Structural equation modeling was used with 1000 bootstrap samples. The goodness of model fit was acceptable. Public stigma perceived by cancer survivors influenced psychological distress via cancer disclosure, internalized shame, and social support availability. Higher levels of perceived public stigma predicted higher levels of internalized shame and self-blame and lower levels of social support availability, which subsequently increased psychological distress. Higher levels of perceived public stigma predicted lower levels of disclosure about cancer history and experiences. Cancer disclosure indirectly ameliorated psychological distress by reducing internalized shame. This study offers evidence that cognitive and social factors play important roles in mediating the effects of perceived public stigma on psychological distress in Korean cancer survivors. A greater understanding of factors that influence psychological distress may help psychosocial oncology service providers to identify childhood cancer survivors in need of psychosocial services and provide them with appropriate resources and interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  15. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  16. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  17. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  18. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  19. Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison.

    PubMed

    Bamberger, Simon Grandjean; Larsen, Anelia; Vinding, Anker Lund; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

    2015-01-01

    Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees' assessment of work environment.

  20. Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison

    PubMed Central

    BAMBERGER, Simon Grandjean; LARSEN, Anelia; VINDING, Anker Lund; NIELSEN, Peter; FONAGER, Kirsten; NIELSEN, René Nesgaard; RYOM, Pia; OMLAND, Øyvind

    2015-01-01

    Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees’ assessment of work environment. PMID:25752252

  1. Diabetes-related emotional distress instruments: a systematic review of measurement properties.

    PubMed

    Lee, Jiyeon; Lee, Eun-Hyun; Kim, Chun-Ja; Moon, Seung Hei

    2015-12-01

    The objectives of this study were to identify all available diabetes-related emotional distress instruments and evaluate the evidence regarding their measurement properties to help in the selection of the most appropriate instrument for use in practice and research. A systematic literature search was performed. PubMed, Embase, CINAHL, and PsycINFO were searched systematically for articles on diabetes-related emotional distress instruments. The Consensus-based Standards for the Selection of Health Measurement Instruments checklist was used to evaluate the methodological quality of the identified studies. The quality of results with respect to the measurement properties of each study was evaluated using Terwee's quality criteria. An ancillary meta-analysis was performed. Of the 2345 articles yielded by the search, 19 full-text articles evaluating 6 diabetes-related emotional distress instruments were included in this study. No instrument demonstrated evidence for all measurement properties. The Problem Areas in Diabetes scale (PAID) was the most frequently studied and the best validated of the instruments. Pooled summary estimates of the correlation coefficient between the PAID and serum glycated hemoglobin revealed a positive but weak correlation. No diabetes-related emotional distress instrument demonstrated evidence for all measurement properties. No instrument was better than another, although the PAID was the best validated and is thus recommended for use. Further psychometric studies of the diabetes-related emotional distress instruments with rigorous methodologies are required. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Psychological distress among homeless adults.

    PubMed

    Gelberg, L; Linn, L S

    1989-05-01

    Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

  3. The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care.

    PubMed

    Chochinov, Harvey Max; Hassard, Thomas; McClement, Susan; Hack, Thomas; Kristjanson, Linda J; Harlos, Mike; Sinclair, Shane; Murray, Alison

    2008-12-01

    Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources of dignity-related distress among patients nearing the end of life. Using standard instrument development techniques, this study examined the face validity, internal consistency, test-retest reliability, factor structure and concurrent validity of the PDI. The 25-items of the PDI derive from a model of dignity in the terminally ill. To establish its basic psychometric properties, the PDI was administered to 253 patients receiving palliative care, along with other measures addressing issues identified within the Dignity Model in the Terminally Ill. Cronbach's coefficient alpha for the PDI was 0.93; the test-retest reliability was r = 0.85. Factor analysis resulted in a five-factor solution; factor labels include Symptom Distress, Existential Distress, Dependency, Peace of Mind, and Social Support, accounting for 58% of the overall variance. Evidence for concurrent validity was reported by way of significant associations between PDI factors and concurrent measures of distress. The PDI is a valid and reliable new instrument, which could assist clinicians to routinely detect end-of-life dignity-related distress. Identifying these sources of distress is a critical step toward understanding human suffering and should help clinicians deliver quality, dignity-conserving end-of-life care.

  4. Improving help-seeking for postnatal depression and anxiety: a cluster randomised controlled trial of motivational interviewing.

    PubMed

    Holt, Charlene; Milgrom, Jeannette; Gemmill, Alan W

    2017-12-01

    Low uptake of treatment by women with symptoms of postnatal depression and anxiety is consistently reported. This study examined whether a brief motivational interviewing (MI) intervention delivered by Maternal and Child Health Nurses (MCHNs) during routine emotional health assessments improves help-seeking following childbirth. In this parallel two-group cluster randomised controlled trial, MCHNs delivered a MI intervention ('PRIMER', n = 20) or Routine Care (n = 20) at women's (n = 541) postnatal consultations. The primary outcome was help-seeking over the 12 months post-birth. Other outcomes were emotional distress measured by the Edinburgh Postnatal Depression Scale, Beck Depression Inventory-Revised and Depression Anxiety Stress Scales, and barriers to help-seeking obtained by self-report via a checklist of potential barriers that was presented to women to select from if applicable. 27.4% of the sample experienced emotional distress over the 12 months post-birth. When comparing women who experienced emotional distress with those who did not, odds of seeking help were 4.0 times higher for the MI condition than Routine Care (p = .004). Of the women who sought help from a psychologist, 47.6% in the MI condition attended 6 + sessions versus 20.0% in Routine Care (numbers too small for reliable significance test). There was a non-significant trend of lower depression, anxiety and stress in the MI condition. Three risk factors for postnatal depression predicted help-seeking: antenatal anxiety (OR = 2.8, p = .002), depression history (OR = 2.5, p = .002) and self-esteem (OR = 0.7, p = .04). Common barriers to seeking help were thinking that one would or should be able to manage without help (endorsed by 11.1%). Treatment uptake for postnatal distress can be increased with MI. Training MCHNs in MI was feasible and valued. Given the devastating effects of depression, further research is needed to ascertain whether MI can improve mental health

  5. Who Seeks Help Online for Self-Injury?

    PubMed

    Frost, Mareka; Casey, Leanne

    2016-01-01

    The objective of this study was to identify differences between young people who seek help online for self-injury and those who self-injure but do not seek help online, in order to improve online services for young people at high risk of suicide. Young people reporting a history of self-injury (N = 679) were identified as part of larger study (N = 1,463) exploring help-seeking. One third of young people with a history of self-injury reported online help-seeking for self-injury. Online help-seekers were significantly more distressed, suicidal, and had a greater degree of self-injury compared to those who did not seek help online. The Internet provides an important form of support to the most at risk young people in this population, and may be a proximal step to face-to-face help-seeking. Further research is required to investigate the forms of support currently accessed by young people online, and their effectiveness.

  6. Entering exile: trauma, mental health, and coping among Tibetan refugees arriving in Dharamsala, India.

    PubMed

    Sachs, Emily; Rosenfeld, Barry; Lhewa, Dechen; Rasmussen, Andrew; Keller, Allen

    2008-04-01

    Each year thousands of Tibetans escape Chinese-controlled Tibet. The authors present findings on the experiences, coping strategies, and psychological distress (depression, anxiety, somatization, and posttraumatic stress disorder) of 769 Tibetan refugees arriving in Dharamsala, India (2003-2004). Distress increased significantly with greater trauma exposure. However, despite a high prevalence of potentially traumatizing events, levels of psychological distress were extremely low. Coping activity (primarily religious) and subjective appraisals of trauma severity appeared to mediate the psychological effects of trauma exposure. The potential impact of other variables, including culturally determined attitudes about trauma and timing of assessment, are discussed.

  7. Social relationships and quality of life moderate distress associated with delusional ideation.

    PubMed

    Lim, Michelle H; Gleeson, John F; Jackson, Henry J; Fernandez, Katya C

    2014-01-01

    In a previous study, individuals who followed a particular new religious movement (NRM) reported significantly less distress even though they reported similar levels of delusional ideation when compared with individuals diagnosed with psychotic disorders. Protective factors such as social relationship quality and quality of life (QOL) were hypothesized to explain attenuated distress associated with delusional ideation. NRM individuals (n = 29), individuals diagnosed with psychotic disorders (n = 25), and control individuals (n = 63) were recruited. Psychotic symptoms, delusion-proneness, and facets of social relationships quality and QOL were examined across group. Potential moderators of the relationship between group membership and distress were further examined in multiple regression models. NRM participants reported more social relationships that were of higher quality (as demonstrated by more crisis supports, unique and overlap supports, more helpful supports and more reciprocated supports) than individuals with psychotic disorders. NRM participants also reported significantly higher QOL than individuals with psychotic disorders. Furthermore, NRM participants reported more distinct and less reciprocated supports, and significantly higher psychological, environmental, and total QOL, when compared with control participants. The relationship between group membership, delusional ideation, and distress was moderated by relationship reciprocity as well as by total QOL. Findings highlight the importance of establishing healthy reciprocal social relationships and improving QOL in people diagnosed with psychotic disorders, as these factors may act as a buffer against distress associated with delusional beliefs.

  8. Women's intentions of informal and formal help-seeking for mental health problems during the perinatal period: The role of perceived encouragement from the partner.

    PubMed

    Fonseca, Ana; Canavarro, Maria Cristina

    2017-07-01

    this study aimed to examine the relationship between women's intentions to seek informal help and to seek professional help and to explore the indirect effects of women's perceived encouragement to seek professional help from their male partner. Moreover, this study aimed to examine if these relationships vary as function of the presence of higher levels of perinatal distress. cross-sectional internet survey. participants were recruited through advertisements published in pamphlets and posted on social media websites (e.g., Facebook) and websites and forums that focused on pregnancy and childbirth. 231 women (pregnant/ had a baby during the last 12 months) completed the survey. participants were questioned about sociodemographic and clinical data and were assessed concerning perinatal distress (Edinburgh Postpartum Depression Scale and Hospital Anxiety and Depression Scale), intentions to seek informal and formal help (General Help-Seeking Questionnaire) and perceived encouragement from the partner to seek professional help. the women reported a significantly higher intention to seek help from their partner than to seek professional help (p < .001). Although women with higher perinatal distress levels presented lower intentions to seek informal help from the male partner (p = .001) and perceived less encouragement from the male partner to seek professional help (p < .001), the presence of perinatal distress did not moderate the relationship between those variables. A significant indirect effect on the relationship between women's intention to seek informal and professional help occurred through the women's perceived encouragement from the male partner to seek professional help. the results of this study highlight the important role of the male partner's encouragement in women's professional help-seeking for mental health problems. awareness campaigns about perinatal distress and about professional treatment benefits may be directed universally to all women in the

  9. Charlotte Wolff and lesbian history: reconfiguring liminality in exile.

    PubMed

    Brennan, Toni; Hegarty, Peter

    2010-01-01

    This article considers the "liminality" of the psychologist Charlotte Wolff, MD (1897-1986). Always living openly as a lesbian since her school days in Danzig, Wolff trained as a doctor-also pursuing a parallel interest in poetry and in philosophy. As a Jewish person, she was forced to leave the Berlin Health Service and flee Germany when the Nazi regime came to power. Having moved to Great Britain in 1936 after three years in France, Wolff reconfigured "exile" beyond the literal experience of emigration and immigration, as a form of "marginality" or "liminality" always involved in artistic and scientific endeavors. In her life and work she negotiated several liminal areas-from her gender presentation to her standing in the academic and scientific community (she was a Fellow of the British Psychological Society, to which she bequeathed her papers and the copyright to her work, but at the same time she was not an eminent psychologist), to her membership of sexual minority organizations (she conducted pioneering research on lesbianism and bisexuality, but some resented her connection with the psy-professions). In the spirit of Wolff's "liminality" as a strategy and creative zone, and along the lines indicated by Morawski (1994) as regards the transformative possibilities of feminist psychology as a liminal science, we argue for a reappraisal of Wolff's life and work that, in negotiating the borderlands between lesbian history and history of psychology, could enrich both disciplines.

  10. A qualitative study of help seeking and primary care consultation prior to suicide

    PubMed Central

    Owens, Christabel; Lambert, Helen; Donovan, Jenny; Lloyd, Keith R

    2005-01-01

    Background Many suicides may be preventable through medical intervention, but many people do not seek help from a medical practitioner prior to suicide. Little is known about how consulting decisions are made at this time. Aim To explore how distressed individuals and members of their lay networks had made decisions to seek or not to seek help from a medical practitioner in the period leading up to suicide. Design of study Qualitative analysis of psychological autopsy data. Setting One large English county. Method Semi-structured interviews with close relatives or friends of suicide victims were conducted as part of a psychological autopsy study. Sixty-six interviews were transcribed verbatim and analysed using a thematic approach. Results Relatives and friends often played a key role in determining whether or not suicidal individuals sought medical help. Half the sample had consulted in their final month and many were persuaded to do so by a relative or friend. Of those who did not consult, some were characterised as help-resisters but many others had omitted to do so because no-one around them was aware of the seriousness of their distress or considered it to be medically significant. A range of lay interventions and coping strategies was identified, including seeking non-medical help. Conclusion Greater attention needs to be given to the potential role of lay networks in managing psychological distress and preventing suicide. A balanced approach to suicide prevention is recommended that builds on lay knowledge and combines medical and non-medical strategies. PMID:16004734

  11. Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

    PubMed

    Nichter, M

    1981-12-01

    This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.

  12. Self-Concealment, Avoidance of Psychological Services, and Perceived Likelihood of Seeking Professional Help.

    ERIC Educational Resources Information Center

    Cepeda-Benito, Antonio; Short, Paul

    1998-01-01

    New information about the role of self-concealment in the decision to seek psychological services is investigated. Different types of distress selectively predict students' perceived likelihood of seeking help according to the problems for which help would be sought (N=732). Results are discussed in contrast to previous researchers' findings. (EMK)

  13. Racial and ethnic minority college students' stigma associated with seeking psychological help: Examining psychocultural correlates.

    PubMed

    Cheng, Hsiu-Lan; Kwan, Kwong-Liem Karl; Sevig, Todd

    2013-01-01

    Many college students underuse professional psychological help for mental health difficulties. The stigma associated with seeking such help appears to be one of the reasons for this underuse. Levels of psychological distress and past use of counseling/psychotherapy have been found to be important correlates of stigma associated with seeking psychological help (Obasi & Leong, 2009; Vogel, Wade, & Haake, 2006). For racial and ethnic minorities, the hindering effects of self-stigma and perceived stigmatization by others on treatment seeking may further be compounded by their relationships with their own ethnic groups, with other ethnic groups, and with the dominant society. This study used structural equation modeling (SEM) to test a model that explored the effects of psychological distress and psychocultural variables (i.e., ethnic identity, other-group orientation, perceived discrimination) on perceived stigmatization by others and self-stigma for seeking psychological help, controlling for past use of counseling/psychotherapy. The sample consisted of 260 African American, 166 Asian American, and 183 Latino American students. SEM multigroup analyses indicated measurement invariance, but partial structural invariance, across racial/ethnic groups. Across all 3 groups, higher levels of psychological distress and perceived racial/ethnic discrimination, respectively, predicted higher levels of perceived stigmatization by others for seeking psychological help, which, in turn, predicted greater self-stigma for seeking psychological help. Higher levels of other-group orientation predicted lower levels of self-stigma of seeking psychological help across groups. Higher levels of ethnic identity predicted lower levels of self-stigma of seeking psychological help only for African Americans. Implications for research and practice are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  14. Psychological Distress in Jordanian Parents of Children With Autism Spectrum Disorder: The Role of Trait Mindfulness.

    PubMed

    Rayan, Ahmad; Ahmad, Muayyad

    2018-01-01

    This study examines the role of mindfulness in predicting psychological distress in Arab parents of children with autism spectrum disorder (ASD). In this descriptive study, parents of 104 children with ASD completed measures of psychological distress and mindfulness. The severity of autism in children was measured using the DSM-V criteria. After controlling for parental age and gender and the severity level of ASD, mindfulness was significantly associated with the levels of anxiety, stress, and depression in parents (anxiety: β = 0.49, p < .001; stress: β = 0.55, p < .001; depression: β = 0.53, p < .001). Mindfulness-based intervention may help to reduce psychological distress in Arab parents of children with ASD. © 2016 Wiley Periodicals, Inc.

  15. 46 CFR 28.145 - Distress signals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

  16. 46 CFR 28.145 - Distress signals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

  17. 46 CFR 28.145 - Distress signals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

  18. 46 CFR 28.145 - Distress signals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

  19. Acute respiratory distress syndrome

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000103.htm Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

  20. Distress and Its Effect on Adherence to Antidiabetic Medications Among Type 2 Diabetes Patients in Coastal South India

    PubMed Central

    Kumar, Nithin; Unnikrishnan, Bhaskaran; Thapar, Rekha; Mithra, Prasanna; Kulkarni, Vaman; Holla, Ramesh; Bhagawan, Darshan; Kumar, Avinash; Aithal, Shodhan

    2017-01-01

    Background: Distress can bring about an unfavorable attitude among the patients toward tackling their disease which can affect adherence to medications. The purpose of this study was to assess the effect of distress on adherence to medication among patients with diabetes. Methodology: In this cross-sectional study, 124 type 2 diabetes patients above 18 years, attending the hospitals affiliated to Kasturba Medical College, Mangalore, selected using nonprobability sampling were interviewed to assess the presence of diabetes-related distress (DRD) and their level of adherence to medications. Distress was assessed using diabetes distress scale. Morisky Adherence Questionnaire was used to assess the level of adherence. Approval was obtained from the Institutional Ethics Committee. Multivariate logistic regression was conducted to assess the influence of domains of distress on adherence to antidiabetic medication and P < 0.05 was considered statistically significant. Results: In our study, 41.9% (n = 52) of the participants had high diabetes distress. Exactly 43.5% (n = 54) of the participants had low adherence to antidiabetic medications. On univariate analysis, participants with low regimen distress, low physician distress, and low interpersonal distress were found to have good adherence to antidiabetic medication. However, on multivariate analysis, only low regimen distress was found to be significantly associated with good adherence to medication among the study participants. Conclusion: DRD is a problem in our study participants which affects the adherence to medications. Identifying distress at an early stage can help doctors formulate and implement remedial measures, thereby improving adherence to medications. PMID:28781491

  1. Moral Distress, Workplace Health, and Intrinsic Harm.

    PubMed

    Weber, Elijah

    2016-05-01

    Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

  2. Online Information Searches and Help Seeking for Mental Health Problems in Urban China.

    PubMed

    Chen, Juan; Zhu, Shizhan

    2016-07-01

    In recent years, the Internet has emerged as an alternative information source on mental health problems. Yet, the profile of the typical Internet help seeker is to be determined. Based on data from a household survey of 2558 Beijing residents, the study investigates online information searches and help seeking for mental health problems. Multinomial logistic regressions are estimated for respondents' access to the Internet, and mental-health-related information searches and help seeking on the Internet for the whole community sample and the most psychologically distressed subsample. The study identifies a digital divide in online help seeking for mental health issues based on age, migration and hukou status, and socio-economic factors. Youth and high socio-economic status are significant predictors of Internet access and use. Among the whole community sample, rural-to-urban migrants are less likely to have access to the Internet and search information or seek help online. Among the most psychologically distressed subsample, urban-to-urban migrants are significantly more likely to have access to the Internet and search information or seek help online. Given the shortage of mental health professionals in China, online information dissemination and guided self-help, if properly designed, could offer a means to reach large numbers of individuals in a cost-effective manner.

  3. The Perceived Helpfulness of Rendering Emotional First Aid via Email

    ERIC Educational Resources Information Center

    Gilat, Itzhak; Reshef, Eyal

    2015-01-01

    The present research examined the perceived helpfulness of an increasingly widespread mode of psychological assistance, namely, emotional first aid via email. The sample comprised 62 naturally occurring email interactions between distressful clients and trained volunteers operating within the framework of the Israeli Association for Emotional…

  4. Confronting the unexpected: temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors.

    PubMed

    Rosedale, Mary; Fu, Mei R

    2010-01-01

    To describe women's unexpected and distressing symptom experiences after breast cancer treatment. Qualitative and descriptive. Depending upon their preference, participants were interviewed in their homes or in a private office space in a nearby library. Purposive sample of 13 women 1-18 years after breast cancer treatment. Secondary analysis of phenomenologic data (constant comparative method). Breast cancer symptom distress, ongoing symptoms, and unexpected experiences. Women described experiences of unexpected and distressing symptoms in the years following breast cancer treatment. Symptoms included pain, loss of energy, impaired limb movement, cognitive disturbance, changed sexual experience, and lymphedema. Four central themes were derived: living with lingering symptoms, confronting unexpected situations, losing precancer being, and feeling like a has-been. Distress intensified when women expected symptoms to disappear but symptoms persisted instead. Increased distress also was associated with sudden and unexpected situations or when symptoms elicited feelings of loss about precancer being and feelings of being a has been. Findings suggest that symptom distress has temporal, situational, and attributive dimensions. Breast cancer survivors' perceptions of ongoing and unexpected symptoms have important influences on quality of life. Understanding temporal, situational, and attributive dimensions of symptom distress empowers nurses and healthcare professionals to help breast cancer survivors prepare for subsequent ongoing or unexpected experiences in the years after breast cancer treatment. Follow-up care for breast cancer survivors should foster dialogue about ways that symptoms might emerge and that unexpected situations might occur. Prospective studies are needed to examine symptom distress in terms of temporal, situational, and attributive dimensions and explore the relationship between symptom distress and psychological distress after breast cancer

  5. Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer.

    PubMed

    Hong, Jingfang; Wei, Zengzeng; Wang, Weili

    2015-09-01

    The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. This is a descriptive correlational survey study. The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life. © 2015 John Wiley & Sons Ltd.

  6. Girls in Distress in Israel.

    ERIC Educational Resources Information Center

    Steiner, Yosepha

    The typical girl in distress in Israel comes from a Jewish family of oriental origin. Her distress is partially due to the strains of immigrating to Israel from, in most cases, North Africa. Authority models in distressed girls' families feature either the role of the father as the commanding familial authority figure; the mother as the dominant…

  7. Hypertension Awareness and Psychological Distress

    PubMed Central

    Hamer, Mark; Batty, G. David; Stamatakis, Emmanuel; Kivimaki, Mika

    2011-01-01

    There is conflicting evidence regarding the association of hypertension with psychological distress, such as anxiety and depressive symptoms. The association may be due to a direct effect of the raised blood pressure; side effects of treatment; or the consequences of labelling. In a representative study of 33,105 adults (aged 51.7 ±12.1 yrs, 45.8% men) we measured levels of psychological distress using the 12-item General Health Questionnaire and collected blood pressure, data on history of hypertension diagnosis, and medication usage. Awareness of hypertension was confirmed through a physician’s diagnosis or the use of anti-hypertensive medication and unaware hypertension was defined by elevated clinic blood pressure (systolic/diastolic ≥140/90 mm Hg) without prior treatment or diagnosis. In comparison with normotensive participants, an elevated risk of distress (General Health Questionnaire score ≥4) was observed in aware hypertensive participants (multivariable adjusted odds ratio [OR]=1.57, 95% CI, 1.41 – 1.74), although not in unaware hypertensives (OR = 0.91, 95% CI, 0.78 – 1.07). Anti-hypertensive medication and co-morbidity was also associated with psychological distress although this did not explain the greater risk of distress in aware hypertensives. We observed a weak curvilinear association between systolic blood pressure and distress which suggested that distressed participants were more likely to have low or highly elevated blood pressure. These findings suggest that labelling individuals as hypertensive, rather than elevated blood pressure per se, may partially explain the greater levels of distress in patients treated for hypertension. PMID:20625078

  8. Community perceptions of mental distress in a post-conflict setting: a qualitative study in Burundi.

    PubMed

    Familiar, Itziar; Sharma, Sonali; Ndayisaba, Herman; Munyentwari, Norbert; Sibomana, Seleus; Bass, Judith K

    2013-01-01

    There is scant documentation of the mental health characteristics of low-income communities recovering from armed conflict. To prepare for quantitative health surveys and health service planning in Burundi, we implemented a qualitative study to explore concepts related to mental distress and coping among adults. Mental distress was defined as problems related to feelings, thinking, behaviour and physical stress. Using free listing and key informant interviews with a range of community members, we triangulated data to identify salient issues. Thirty-eight free list respondents and 23 key informants were interviewed in 5 rural communities in Burundi using 2 interview guides from the WHO Toolkit for Mental Health Assessment in Humanitarian Settings. Based on these interviews, we identified four locally defined idioms/terms relating to mental distress: ihahamuka (anxiety spectrum illnesses), ukutiyemera (a mix of depression and anxiety-like syndrome), akabonge (depression/grief-like syndrome) and kwamana ubwoba burengeje (anxiety-like syndrome). Mental distress terms were perceived as important problems impacting community development. Affected individuals sought help from several sources within the community, including community leaders and traditional healers. We discuss how local expressions of distress can be used to tailor health research and service integration from the bottom up.

  9. Understanding Undergraduate Student Perceptions of Mental Health, Mental Well-Being and Help-Seeking Behaviour

    ERIC Educational Resources Information Center

    Laidlaw, Anita; McLellan, Julie; Ozakinci, Gozde

    2016-01-01

    Despite relatively high levels of psychological distress, many students in higher education do not seek help for difficulties. This study explored undergraduate student understanding of the concepts of mental health and mental well-being and where undergraduate students would seek help for mental well-being difficulties. Semi-structured interviews…

  10. Cancer-Related Psychological Distress: A Concept Analysis.

    PubMed

    Gundelach, Amy; Henry, Barb

    2016-12-01

    Cancer-related psychological distress, as a concept, has limited research literature substantiation. Several studies report that patients with cancer suffer from significant psychological distress; however, the description of the concept of cancer-related psychological distress has not been clearly described. Theoretical work based on the concept is also unclear. This article is a report on the concept of cancer-related psychological distress to clarify the concept as separate from non-cancer-related psychological distress and promote the use of the term in nursing practice and research across the cancer trajectory. This article used a content analysis to examine the literature. The literature review for this article used CINAHL®, PsycINFO®, and PubMed to search publications from 1999-2016. Content analysis of the literature revealed that the term psychological distress was used often with regard to distress in patients with cancer, but the concept of cancer-related psychological distress was not clearly defined. Four attributes encompass the concept of cancer-related psychological distress.

  11. Distinguishing Between Spiritual Distress, General Distress, Spiritual Well-Being, and Spiritual Pain Among Cancer Patients During Oncology Treatment.

    PubMed

    Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

    2017-07-01

    Spiritual distress is present in approximately 25% of oncology patients. We examined the extent to which this measure is identical to a variety of other measures, such as spiritual well-being, spiritual injury, spiritual pain, and general distress. Structured interview of oncology outpatients over 12 months, approached nonselectively. The presence or absence of spiritual distress was compared against spiritual pain and two spiritual well-being tools: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) and the Spiritual Injury Scale (SIS). We also examined whether a general distress visual analogue scale sufficed to identify spiritual distress. Other questions concerned demographic and clinical data. Of 416 patients approached, 202 completed the interview, of whom 23% reported spiritual distress. All measures showed significant correlation (receiver operating characteristic, area under the curve: SIS 0.79; distress thermometer [DT] 0.68; FACIT-Sp-12 0.67), yet none were identical with spiritual distress (sensitivity/specificity: SIS 64%/79%; spiritual pain 72%/76%; DT 41%/76%; FACIT-Sp-12 57%/72%). Of the FACIT-Sp-12 subscales, only peace correlated with spiritual distress. A significant predictor of spiritual distress was patients' self-evaluation of grave clinical condition (odds ratio 3.3; 95% CI 1.1-9.5). Multivariable analysis of individual measure items suggests an alternative three-parameter model for spiritual distress: not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one's illness. The DT is not sufficient to identify spiritual distress. The peace subscale of FACIT-Sp-12 is a better match than the measure as a whole. The SIS is the best match for spiritual distress, although an imperfect one. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  12. Distress | Springboard Beyond Cancer

    Cancer.gov

    Distress may affect your ability to cope with a cancer diagnosis or treatment. It may cause you to miss check-ups or delay treatment. Even mild distress can affect the quality of life for you and your caregivers.

  13. The Effect of Social Support on Psychological Flourishing and Distress Among Migrants in Australia.

    PubMed

    du Plooy, Daniel R; Lyons, Anthony; Kashima, Emiko S

    2018-05-04

    We examine the access that culturally diverse migrant groups in Australia have to different sources of social support and how this access, or lack thereof, is associated with psychological flourishing and distress. A national online survey was conducted with 1334 migrants in Australia, examining 11 different sources of social support, including family, friends, relationship partner, acquaintances, work colleagues, health professionals, government agencies, community organisations, religious groups, social groups and online groups. We also examined migrants from different cultural groups. All sources of support were significantly associated with mental health, but somewhat differently for the dimensions of distress and flourishing. Flourishing was linked to higher support from all 11 sources, though not for all cultural groups. High psychological distress was linked to lower support only from family, friends, a partner, acquaintances, work colleagues and social groups, and only for some cultural groups. In particular, for distress, there was no link between migrants from Southern Asia and family support, as well as Confucian Asia groups and friend support. Understanding where migrants from different cultural origins draw their support from could help policymakers and support workers improve health and well-being in migrant populations, especially by focusing on sources of support that are linked to lower distress and greater flourishing, as indicated in this study.

  14. Fecal incontinence knowledge, attitudes, and help-seeking behaviors among community-dwelling adults in Korea.

    PubMed

    Joh, Hee-Kyung; Seong, Moo-Kyung; Ahn, Hyun-Jun

    2018-04-01

    Fecal incontinence (FI) is a common debilitating disorder that tends to be underreported. Although low health literacy likely contributes to the underreporting, studies on FI knowledge among the general population remain scarce. We investigated how FI knowledge is associated with attitudes and help-seeking behaviors. We conducted a cross-sectional survey among community-dwelling adults undergoing national health screening in Korea. A structured, self-administered questionnaire was used to assess FI knowledge, attitudes, and help-seeking behaviors. Odds ratios (ORs; 95% confidence intervals, CIs) were estimated using logistic regression with adjustment for covariables. Of the 601 participants completing the survey, only 29.8% were aware of the term FI, and their knowledge levels were insufficient. As for FI-related attitudes, 24.6% considered FI to be very rare, and 22.3% considered it to be moderately or less distressing. Individuals who knew the term FI tended to consider FI more common (OR: 2.45; 95%CI: 1.49-4.02) and distressing (OR: 1.68; 95%CI: 1.07-2.63) than those without knowledge. Assuming future FI occurrence, those considering FI to be distressing were less willing to ignore or self-manage the condition (OR: 0.25; 95%CI: 0.11-0.58). Among patients with FI (n = 83), only 30.1% had sought help and 8.4% had consulted doctors. Knowing the term FI was significantly associated with overall help-seeking behavior (OR: 9.23; 95%CI: 2.09-40.77). FI knowledge levels and help-seeking rates were low among community-dwelling adults. FI knowledge was significantly associated with attitudes and help-seeking behaviors. Future public education programs are warranted to improve FI knowledge, attitudes, and help-seeking behaviors. © 2018 Wiley Periodicals, Inc.

  15. [Counselling versus a self-help manual for tinnitus outpatients: a comparison of effectiveness].

    PubMed

    Konzag, T A; Rübler, D; Bloching, M; Bandemer-Greulich, U; Fikentscher, E; Frommer, J

    2006-08-01

    Counselling is a basic psychological intervention for chronic tinnitus the effectiveness of which has not yet been evaluated. The therapeutic effect of counselling was compared to that of a self-help manual. Outcome was analysed for tinnitus disability, tendency to become chronic, and accompanying psychiatric disorders. A total of 75 tinnitus outpatients were randomly assigned to group counselling (n=35) and self-help (n=40). Tinnitus disability, general psychological disturbances, depression, anxiety, coping and illness beliefs were measured using questionnaires (TQ, SCL-90-R, BDI, BAI, FKV, KKG) administered before and after treatment and at a 6-month follow-up. Psychiatric disorders (DSM-IV) were assessed using the CIDI. Counselling and the self-help manual had a significant effect on tinnitus disability, showing most profit for participants with a high level of tinnitus distress. The significant reduction in tinnitus distress was maintained at the 6-month follow-up. There was, however, no difference between the two treatment-groups. Effect-sizes for patients with DSM-IV-diagnoses were smaller. For tinnitus outpatients without psychiatric comorbidity, self-help manuals can be an effective first treatment.

  16. The dynamic financial distress prediction method of EBW-VSTW-SVM

    NASA Astrophysics Data System (ADS)

    Sun, Jie; Li, Hui; Chang, Pei-Chann; He, Kai-Yu

    2016-07-01

    Financial distress prediction (FDP) takes important role in corporate financial risk management. Most of former researches in this field tried to construct effective static FDP (SFDP) models that are difficult to be embedded into enterprise information systems, because they are based on horizontal data-sets collected outside the modelling enterprise by defining the financial distress as the absolute conditions such as bankruptcy or insolvency. This paper attempts to propose an approach for dynamic evaluation and prediction of financial distress based on the entropy-based weighting (EBW), the support vector machine (SVM) and an enterprise's vertical sliding time window (VSTW). The dynamic FDP (DFDP) method is named EBW-VSTW-SVM, which keeps updating the FDP model dynamically with time goes on and only needs the historic financial data of the modelling enterprise itself and thus is easier to be embedded into enterprise information systems. The DFDP method of EBW-VSTW-SVM consists of four steps, namely evaluation of vertical relative financial distress (VRFD) based on EBW, construction of training data-set for DFDP modelling according to VSTW, training of DFDP model based on SVM and DFDP for the future time point. We carry out case studies for two listed pharmaceutical companies and experimental analysis for some other companies to simulate the sliding of enterprise vertical time window. The results indicated that the proposed approach was feasible and efficient to help managers improve corporate financial management.

  17. 47 CFR 80.314 - Distress communications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... radiotelephone distress call consists of: (1) The distress signal MAYDAY spoken three times; (2) The words THIS IS; (3) The call sign (or name, if no call sign assigned) of the mobile station in distress, spoken...

  18. The Exile of Hansen's Disease Patients to Moloka'i: A Diffusion of Innovations Perspective.

    PubMed

    Pitman Harris, Adrea; Matusitz, Jonathan

    2016-07-01

    This article analyzes the exile of patients with Hansen's disease (leprosy) to Moloka'i (Hawaii) by applying the diffusion of innovations (DoI) theory. Developed by Rogers, DoI posits that an innovation (i.e., idea, movement, or trend) is initiated within a culture. Then, it is diffused via particular channels across diverse cultures. Instead of evolving independently, innovations diffuse from one culture to another through various forms of contact and communication. In the context of this analysis, the objective is to examine how the diffusion of certain ideas, namely, abolishing the stigma associated with leprosy, could have improved the lives of Hawaiians. An important premise of this article is that the Hawaiian government barely applied the tenets of DoI, which is the reason why many people lost their lives. So, this article seeks to explore what could have been done to improve their situation and what pitfalls should be avoided in the future.

  19. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Transmission of a distress alert by a station not itself in distress. 80.1115 Section 80.1115 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and...

  20. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Transmission of a distress alert by a station not itself in distress. 80.1115 Section 80.1115 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and...

  1. Who's distressed? A comparison of diabetes-related distress by type of diabetes and medication.

    PubMed

    Wardian, Jana L; Tate, Joshua; Folaron, Irene; Graybill, Sky; True, Mark; Sauerwein, Tom

    2018-03-07

    We hypothesized that diabetes-related distress would vary by type of diabetes and medication regimen [Type 1 diabetes (T1DM), Type 2 diabetes with insulin use (T2DM-i), Type 2 diabetes without insulin use (T2DM)]. Thus, the aim of this study was to identify groups with elevated diabetes-related distress. We administered the 17-item Diabetes-related Distress Scale (DDS-17) to 585 patients. We collected demographics, medications, and lab results from patient records. Patients were categorized by type of diabetes and medication: T1DM (n = 149); T2DM-i (n = 333); and T2DM (n = 103). ANOVA revealed significant differences in sample characteristics. ANCOVA were conducted on all four DDS-17 domains [Emotional Burden (EB); Physician-related Distress (PD); Regimen-related Distress (RD); and Interpersonal Distress (ID)]; covariates included in the models were sex, age, duration of diabetes, BMI, and HbA1c. EB was significantly lower in T1DM than T2DM-i, p < 0.05. In addition, RD was significantly lower in T1DM than either T2DM-i, p < 0.05 and T2DM, p < 0.05. EB and RD are higher for those with type 2 diabetes. Thus, interventions to reduce EB and RD need to be considered for patients with type 2 diabetes. DDS-17 is useful in identifying diabetes-related distress in patients with diabetes. Efforts need to be made to reduce EB and RD. Published by Elsevier B.V.

  2. Psychosocial distress in patients with thyroid cancer.

    PubMed

    Buchmann, Luke; Ashby, Shaelene; Cannon, Richard B; Hunt, Jason P

    2015-04-01

    The purpose of this study is to evaluate levels of psychosocial distress in thyroid cancer patients. An analysis of factors contributing to levels of distress is included. Individual retrospective cohort study. Head and neck cancer clinic at the Huntsman Cancer Institute. A total of 118 newly diagnosed thyroid cancer patients were included in the study. Univariate and multivariate analyses evaluated levels of and factors contributing to distress. Almost half (43.3%) of patients had significant distress. Those with self-reported psychiatric history, use of antidepressant medication, and history of radiation treatment had higher levels of distress. On multivariate analysis, patient endorsement of emotional issues predicted a higher distress level. Thyroid cancer patients have high distress levels. Identification of thyroid cancer patients with high distress levels is important to offer additional support during cancer therapy. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  3. Guided self-help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial.

    PubMed

    Hazell, Cassie M; Hayward, Mark; Cavanagh, Kate; Jones, Anna-Marie; Strauss, Clara

    2016-07-26

    Cognitive behavior therapy for psychosis (CBTp) is an effective intervention for people who hear distressing voices (auditory hallucinations). However, there continues to be a problem of poor access to CBTp. Constraints on health care funding require this problem to be addressed without a substantial increase in funding. One solution is to develop guided self-help forms of CBTp to improve access, and a symptom-specific focus on, for example, distressing voices (auditory verbal hallucinations) has the potential to enhance effectiveness. We term this cognitive behavior therapy for distressing voices (CBTv). This trial is an external pilot randomized controlled trial comparing the effects of 12-week guided self-help CBTv (with eight therapist support sessions) with a wait list control condition. Informed consent will be obtained from each participant. Half of the 30 participants will be randomized to receive guided self-help CBTv immediately; the remaining half will receive the intervention after a 12-week delay. All participants will continue with their usual treatment throughout the study. Outcomes will be assessed using questionnaires completed at baseline and 12 weeks postrandomization. Interviews will be offered to all those who receive therapy immediately to explore their experiences with the intervention. The outcomes of this trial, both quantitative and qualitative, will inform the design of a definitive randomized controlled trial of guided self-help CBTv. If this intervention is effective, it could help to increase access to CBT for those who hear distressing voices. ISRCTN registration number  ISRCTN77762753 . Registered on 23 July 2015.

  4. The relationship between help-seeking attitudes and masculine norms among monozygotic male twins discordant for sexual orientation.

    PubMed

    Sánchez, Francisco J; Bocklandt, Sven; Vilain, Eric

    2013-01-01

    In general, heterosexual men are less favorable to asking for help compared to women and gay men. This can be problematic if a man avoids professional help when he is experiencing significant psychological distress. Yet, it is unclear to what degree such attitudes among men are due to innate differences or social environments. Studying twins provides one avenue for teasing apart these relationships. We recruited 38 pairs of monozygotic male twins (Mage = 35.87 years, SD = 9.52) raised together and who were discordant for sexual orientation. They completed measures of psychological distress (Symptom Checklist-90-Revised), positive attitudes toward psychological help-seeking behavior, and emphasis with fulfilling traditional masculine norms. Contrary to predictions, the heterosexual twins expressed more symptoms of specific distress-hostility (r = .30), paranoid ideation (r = .26), and psychoticism (r = .24)-than their gay cotwins. As predicted, heterosexual men were less favorable to seeking help (r = .25) and expressed greater emphasis on masculine norms (r = .26) than their cotwins. Within each group of men, unique aspects of masculine norms were significantly related to attitudes toward psychological help-seeking behavior. The findings lend credence to the hypothesis that social environments influence attitudes and behaviors that are stereotypically masculine and potentially detrimental to men's health. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Analysis of the barriers of mental distress disclosure in medical inpatients in Taiwan.

    PubMed

    Han, Der-Yan; Lin, Yi-Yin; Liao, Shih-Cheng; Lee, Ming-Been; Thornicroft, Graham; Wu, Chia-Yi

    2015-08-01

    Disclosure of mental distress to physicians is important for mental illness identification, early referrals and proper treatment to prevent suicide. Little is known about what affects mental health communication in the clinical settings in the Chinese societies. The study aimed to identify the demographic, psychosocial and medical factors related to people with non-disclosure of their mental distress. We interviewed a series of consecutive inpatients from two medical wards of a general hospital in northern Taiwan. We collected depressive symptoms (the Patient Health Questionnaire, PHQ-9), living arrangement, threatening life events, suicide risks (i.e. past self-harm history, lifetime suicide ideas and hopelessness) and recent experience of mental distress disclosure. Furthermore, we explored the reasons of non-disclosure. A total of 230 medical inpatients agreed to participate (53.5% males). The results indicated that only 5.7% actually communicated their mental health concerns, and that 12.3% were willing to talk about their mental health problems. Among the 69 (30%) depressed participants (PHQ-9 score ≥ 10 points), the disclosure rate was low (8.7%) and the wish to talk about mental distress was also low (10.3%). After adjustment, living alone (OR = 7.58, 95% CI =  1.56-36.91) and having stressful life events (OR = 3.68, 95% CI = 1.09-12.46) remained significant in predicting disclosure of mental distress. The 109 participants attributed their refusal of communicating mental distress as medical-related attributes, subjective perceptions or sociocultural factors. Communication of mental distress in medical settings was uncommon due to medical or psychosocial barriers in Taiwan. Skill training to facilitate disclosure in medical education and public campaigns to improve knowledge of depression and enhance help-seeking deserve more attention, particularly under the influence of stigma in the Chinese societies. © The Author(s) 2014.

  6. Moral distress in Iranian pediatric nurses.

    PubMed

    Ghasemi, Elham; Negarandeh, Reza; Janani, Leila

    2017-01-01

    Moral distress is a very common experience in the nursing profession, and it is one of the main reasons for job dissatisfaction, burnout, and quitting among nurses. For instance, morally difficult situations in taking care of child patients who are severely ill may lead to moral distress for nurses. However, most of the studies about moral distress have been conducted on nurses of special wards and adult medical centers with much focus on developed countries. Subsequently, little has been researched on this topic among nurses in other nations such as Iran, and most certainly, there has been hardly any such research involving Iranian pediatric nurses. Aim/objectives: This study was conducted to evaluate moral distress among nurses in selected pediatric hospitals in Tehran, Iran. This cross-sectional study was conducted on eligible nurses who were selected through proportional stratified sampling and who completed demographic characteristics and the pediatric version of Moral Distress Scale-Revised questionnaires. Data were analyzed using descriptive statistics, t test, one-way analysis of variance, and Pearson correlation coefficient. Participants and research context: In total, 195 pediatric nurses working at three selected children's specialized university hospitals in Tehran participated in this study. Ethical considerations: This study was evaluated and approved by the institutional review board of Tehran University of Medical Sciences. The mean and standard deviation of total score of moral distress was 106.41 ± 61.64 within a range of 10-257. Also, the difference between the mean score of moral distress of the group who had not quitted their position and those who have quit in the past was statistically significant (p = 0.043). The situation that was associated with the highest moral distress was "observing medical students performing painful procedures on patients just to gain some skill." Total score of moral distress was significantly higher among male

  7. Adopting a family approach to theory and practice: measuring distress in cancer patient-partner dyads with the distress thermometer.

    PubMed

    Zwahlen, Diana; Hagenbuch, Niels; Jenewein, Josef; Carley, Margaret I; Buchi, Stefan

    2011-04-01

    Significant others are central to patients' experience and management of their cancer illness. Building on our validation of the Distress Thermometer (DT) for family members, this investigation examines individual and collective distress in a sample of cancer patients and their matched partners, accounting for the aspects of gender and role. Questionnaires including the DT were completed by a heterogeneous sample of 224 couples taking part in a multisite study. Our investigation showed that male patients (34.2%), female patients (31.9%), and male partners (29.1%) exhibited very similar levels of distress, while female partners (50.5%) exhibited much higher levels of distress according to the DT. At the dyad level just over half the total sample contained at least one individual reporting significant levels of distress. Among dyads with at least one distressed person, the proportion of dyads where both individuals reported distress was greatest (23.6%). Gender and role analyses revealed that males and females were not equally distributed among the four categories of dyads (i.e. dyads with no distress; dyads where solely the patient or dyads where solely the partner is distressed; dyads where both are distressed). A remarkable number of dyads reported distress in one or both partners. Diverse patterns of distress within dyads suggest varying risks of psychosocial strain. Screening patients' partners in addition to patients themselves may enable earlier identification of risk settings. The support offered to either member of such dyads should account for their role- and gender-specific needs. Copyright © 2010 John Wiley & Sons, Ltd.

  8. Parent and child distress after war exposure.

    PubMed

    Lai, Betty S; Hadi, Fawzyiah; Llabre, Maria M

    2014-09-01

    The purpose of this study was to examine multiple distress symptoms (i.e., post-traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990-1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined. Parents and children were assessed at one time point. Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female). Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety. Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed. Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure. Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events. This study was cross-sectional. Thus, we are not able to infer direction or causality. The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures. © 2014 The British Psychological Society.

  9. The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management.

    PubMed

    Wassersug, Richard J; Oliffe, John L

    2009-04-01

    Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise. Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT. We draw on academic literature, media accounts, and web-based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues. By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress. The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy. Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of

  10. Moving from conceptual ambiguity to knowledgeable action: using a critical realist approach to studying moral distress.

    PubMed

    Musto, Lynn C; Rodney, Patricia A

    2016-04-01

    Moral distress is a phenomenon that has been receiving increasing attention in nursing and other health care disciplines. Moral distress is a concept that entered the nursing literature - and subsequently the health care ethics lexicon - in 1984 as a result of the work done by American philosopher and bioethicist Andrew Jameton. Over the past decade, research into moral distress has extended beyond the profession of nursing as other health care disciplines have come to question the impact of moral constraint on individual practitioners, professional practice, and patient outcomes. Along with increased interest in the phenomenon of moral distress have come increasing critiques - critiques that in their essence point to a serious lack of conceptual clarity in the definition, study, and application of the concept. Foundational to gaining conceptual clarity in moral distress in order to develop strategies to prevent and ameliorate the experience is a careful revisiting of the epistemological assumptions underpinning our knowledge and use of the concept of moral distress. It is our contention that the conceptual challenges reveal flaws in the original understanding of moral distress that are based on an epistemological stance that holds a linear conception of cause and effect coupled with a simplistic perspective of 'constraint' and 'agency'. We need a more nuanced approach to our study of moral distress such that our ontological and epistemological stances help us to better appreciate the complexity of moral agents acting in organizational contexts. We believe that critical realism offers such a nuanced approach. © 2015 John Wiley & Sons Ltd.

  11. Self systems, cultural idioms of distress, and the psycho-bodily consequences of childhood suffering.

    PubMed

    Hollan, Douglas

    2004-03-01

    In this article, I examine the effects of childhood suffering in two cases--one from my anthropological fieldwork in the central highlands of Sulawesi in Indonesia and one from my psychotherapeutic practice in Los Angeles. I argue that although people will always carry with them the psycho-bodily signature of their past social experience, these signatures are affected by the cultural idioms of distress into which they are woven and from which psycho-bodily attention is channeled and given meaning (or not). However, I also suggest that past social experiences are related to life trajectories in very complicated ways. For example, while the enactment of a cultural idiom of distress may help to resolve or give meaning to a form of illness or distress, it also may cause or exacerbate other forms of suffering--depending on how it is used and articulated by any given individual.

  12. A qualitative study of Filipina immigrants' stress, distress and coping: the impact of their multiple, transnational roles as women.

    PubMed

    Straiton, Melanie L; Ledesma, Heloise Marie L; Donnelly, Tam T

    2017-09-05

    Migration is associated with a number of stress factors which can affect mental health. Ethnicity, gender and socioeconomic status can intertwine with and influence the process of migration and mental health. Philippine migration to Europe has increased in recent years and has become more feminised. Knowing more about the factors that influence immigrants' mental health and coping can help aid health care delivery and policy planning. The purpose of this qualitative study was to explore the contextual factors that influence the mental health of Filipinas living in Norway and their coping strategies. Individual in-depth interviews were conducted with fourteen Filipinas 24-49 years, living in Norway. The analysis was informed by the post-colonial feminist perspective in order to examine the process by which gender, ethnicity and socioeconomic status interact with contextual factors in these women's lives and influence their wellbeing. Data analysis revealed that all informants experienced some level of stress or distress. Two main factors: Sense of belonging and Securing a future contributed to the women's level of distress associated with living abroad as an immigrant woman. Distress was heighted by the women's multiple, transnational roles they occupied; roles as workers, breadwinners, daughters, wives and mothers. None of the women had sought professional help for their distress. Religion and informal support from friends and family appear to help these women cope with many of the challenges they face as immigrant women living and working abroad. Filipinas face a number of challenges related to their status as immigrant women and the juggling of their transnational lives. Understanding the context of these women's lives may aid the identification of mental health problems. Although the women show resilience and appear to cope successfully, some may benefit from professional help.

  13. The contribution of self-esteem and self-concept in psychological distress in women at risk of hereditary breast cancer.

    PubMed

    den Heijer, Mariska; Seynaeve, Caroline; Vanheusden, Kathleen; Duivenvoorden, Hugo J; Vos, Joël; Bartels, Carina C M; Menke-Pluymers, Marian B E; Tibben, Aad

    2011-11-01

    Clarification of the role of several aspects of self-concept regarding psychological distress in women at risk of hereditary breast cancer will help to target counselling and psychosocial interventions more appropriately. In this study, we aimed (1) to examine the role of general self-esteem and specific aspects of self-concept (i.e. stigma, vulnerability, and mastery) in psychological distress in women at risk of hereditary breast cancer and (2) to compare the relative importance of these self-concept aspects in psychological distress in women with low versus high self-esteem. General and breast-cancer-specific distress, self-esteem, self-concept, and demographics were assessed in 246 women being at risk of hereditary breast cancer, who opted either for regular breast surveillance or prophylactic surgery. In the total study group, self-esteem was negatively associated with general distress. Furthermore, feeling stigmatized was strongly associated with more breast-cancer-specific distress, and to a lesser degree with general distress. In women with low-self esteem, feelings of stigmatization were strongly associated with higher levels of both breast-cancer-specific and general distress, while a sense of mastery was associated with less general distress. For women with high self-esteem, feelings of both stigmatization and vulnerability were associated with more breast-cancer-specific distress, whereas there were no significant associations with general distress. Psychosocial interventions or support groups for women at risk of hereditary breast cancer should focus on self-esteem and feelings of stigmatization and isolation, and consequently tailor the interventions on specific items for respective women. Copyright © 2010 John Wiley & Sons, Ltd.

  14. War and Bereavement: Consequences for Mental and Physical Distress

    PubMed Central

    Morina, Nexhmedin; von Lersner, Ulrike; Prigerson, Holly G.

    2011-01-01

    Background Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence. Methods 179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE), anxiety, and substance use disorders, and current suicide risk were assessed using the Mini–International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD) was assessed with the Prolonged Grief Disorder Interview (PG-13). Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire. Findings Bereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%). Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD. Conclusion War-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction. PMID:21765944

  15. War and bereavement: consequences for mental and physical distress.

    PubMed

    Morina, Nexhmedin; von Lersner, Ulrike; Prigerson, Holly G

    2011-01-01

    Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence. 179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE), anxiety, and substance use disorders, and current suicide risk were assessed using the Mini-International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD) was assessed with the Prolonged Grief Disorder Interview (PG-13). Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire. Bereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%). Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD. War-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction.

  16. Setting the stage for universal financial distress screening in routine cancer care.

    PubMed

    Khera, Nandita; Holland, Jimmie C; Griffin, Joan M

    2017-11-01

    Financial burden from cancer treatment is increasingly being recognized as a threat to optimal access, quality, and outcomes of cancer care for patients. Although research in the area is moving at a fast pace, multiple questions remain unanswered, such as how to practically integrate the assessment and management of financial burden into routine health care delivery for patients with cancer. Although psychological distress screening for patients undergoing cancer treatment now is commonplace, the authors raise the provocative idea of universal screening for financial distress to identify and assist vulnerable groups of patients. Herein, the authors outline the arguments to support screening for financial burden in addition to psychological distress, examining it as an independent patient-reported outcome for all patients with cancer at various time points during their treatment. The authors describe the proximal and downstream impact of such a strategy and reflect on some challenges and potential solutions to help integrate this concept into routine cancer care delivery. Cancer 2017;123:4092-4096. © 2017 American Cancer Society. © 2017 American Cancer Society.

  17. 47 CFR 80.325 - Control of distress traffic.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Control of distress traffic. 80.325 Section 80... Safety Procedures § 80.325 Control of distress traffic. (a) Distress traffic consists of all messages relating to the immediate assistance required by the mobile station in distress. In distress traffic, the...

  18. Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised.

    PubMed

    Lamiani, Giulia; Setti, Ilaria; Barlascini, Luca; Vegni, Elena; Argentero, Piergiorgio

    2017-03-01

    Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. Validation study using a survey design. Eight medical-surgical ICUs in the north of Italy. A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (α = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was

  19. Psychological Distress in Jordanian Parents of Children with Autism Spectrum Disorder: The Role of Positive Reappraisal Coping.

    PubMed

    Rayan, Ahmad; Ahmad, Muayyad

    2017-02-01

    Parents of children with autism spectrum disorder (ASD) frequently report poor psychological well-being. Positive reappraisal coping (PRC) is a coping strategy which offers a protective effect from anxiety and depression. However, the association between PRC and the psychological distress in parents of children with ASD has yet to be established. This study examines the association between PRC and the psychological distress in parents of children with ASD. In this descriptive correlational study, 104 parents of children with ASD completed measures of psychological distress and PRC. Hierarchical multiple regression analysis was used to examine the association between PRC and the psychological distress in parents after controlling the influence of parental age and gender. The PRC was associated with the psychological distress in parents above and beyond the variance accounted for by parental age and gender. After controlling for parental age and gender, PRC had significant negative correlation with the levels of anxiety, stress, and depression in parents (Anxiety: β=-0.36, p<0.001; Stress: β=-0.21, p=0.03; Depression: β=- 0.37, p<0.001). Using positive reappraisal coping strategy may help to reduce psychological distress in parents of children with ASD. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Racial and Ethnic Minority College Students' Stigma Associated with Seeking Psychological Help: Examining Psychocultural Correlates

    ERIC Educational Resources Information Center

    Cheng, Hsiu-Lan; Kwan, Kwong-Liem Karl; Sevig, Todd

    2013-01-01

    Many college students underuse professional psychological help for mental health difficulties. The stigma associated with seeking such help appears to be one of the reasons for this underuse. Levels of psychological distress and past use of counseling/psychotherapy have been found to be important correlates of stigma associated with seeking…

  1. Moral distress in Turkish intensive care nurses.

    PubMed

    Karagozoglu, Serife; Yildirim, Gulay; Ozden, Dilek; Çınar, Ziynet

    2017-03-01

    Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue. The study aims to (a) validate the Turkish version of the Moral Distress Scale-Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses' moral distress level. The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale-Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. In parallel with the original scale, Turkish version of Moral Distress Scale-Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Turkish version of Moral Distress Scale-Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress

  2. Politics, economic distress mark Rmoga sessions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    This paper reports that election year energy politics clashed with economic distress at Rocky Mountain Oil and Gas Association's annual meeting in Denver early this month. Energy Sec. James D Watkins used the occasion to hail omnibus energy legislation passed by a House-Senate conference committee just hours before he spoke. But not all producers and refiners in the audience shared his enthusiasm for the energy bill, a hard-won Bush administration goal that many Rmoga members doubt will help this industry much. Several of them privately expressed dismay over Watkins' praise, delivered to a beleaguered oil and gas group, of Departmentmore » of Energy research programs boosting clean coal technology and battery powered vehicles.« less

  3. Psychological Factors Associated with Emotional Distress among Palestinian Arabs from East Jerusalem Accessing Psychiatric Care in Israel.

    PubMed

    Nakash, Ora; Nagar, Maayan; Levav, Itzhak; Danilovich, Eli; Abu-Tair, Mamoun; Podolsky, Grigory

    2016-01-01

    The Palestinian population residing in East Jerusalem is characterized by high rates of poverty and unemployment and is subject to discrimination in various forms, including infrastructure of mental health services. Little is known about the help seeking needs and practices of East Jerusalem residents. We examined socio-demographic and clinical characteristics of a consecutive sample Palestinian residents from East Jerusalem (N=50) who accessed a specially assigned psychiatric clinic in Israel. In addition, we examined the psychological factors associated with emotional distress among these service-users upon entry to care. Participants completed a survey in Arabic that included a socio-demographic questionnaire and measures assessing emotional distress, perceived exposure to discrimination and social support, and mental health stigma. Participants reported high levels of emotional distress. Female gender, low socioeconomic status, higher perceived exposure to discrimination and higher perceived social support were associated with increased emotional distress. Findings add to the scarce body of knowledge on specific mental health characteristics of East Jerusalem Palestinian residents.

  4. Examining behavioural coping strategies as mediators between work-family conflict and psychological distress.

    PubMed

    Aazami, Sanaz; Shamsuddin, Khadijah; Akmal, Syaqirah

    2015-01-01

    We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict.

  5. Examining Behavioural Coping Strategies as Mediators between Work-Family Conflict and Psychological Distress

    PubMed Central

    Shamsuddin, Khadijah

    2015-01-01

    We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict. PMID:25695097

  6. Neglect and perceived stigmatization impact psychological distress of orphans in Tanzania

    PubMed Central

    Hermenau, Katharin; Eggert, Ina; Landolt, Markus A.; Hecker, Tobias

    2015-01-01

    Background Research has shown that orphans in sub-Saharan Africa are at increased risk for mental health problems. Exposure to maltreatment and HIV/AIDS-related stigmatization are related to orphans’ psychological distress. Yet, researchers stress the need for more research in low-income countries to identify which factors of being an orphan may lead to psychological distress. Objectives The present study aims to systematically investigate orphans’ experiences of maltreatment and stigmatization to identify factors that relate to their psychological distress. Methods In total, 89 Tanzanian children who had lost at least one parent were compared to 89 matched non-orphans (mean age: 11 years; 51% boys). We measured exposure to maltreatment and perceived stigmatization as an orphan. Mental health was assessed using the Strengths and Difficulties Questionnaire, the Children's Depression Inventory, the UCLA PTSD Index for Children, and the Reactive–Proactive Questionnaire. Results Orphans reported significantly more experiences of neglect, but not of abuse. A group comparison revealed more depressive symptoms, posttraumatic stress symptoms, and aggressive behavior among orphans. Neglect, abuse, and stigmatization correlated with orphans’ internalizing and externalizing problems, yet only neglect and stigmatization were related to orphans’ depression severity. Perceived stigmatization moderated the relationship between neglect and depression. Conclusions Our findings suggest that orphans in Tanzania are at increased risk of experiencing neglect. Maltreatment and perceived stigmatization may play a role in orphans’ psychological distress. Culturally appropriate and evidence-based interventions may help to prevent maltreatment and stigmatization of orphans. PMID:26589257

  7. Neglect and perceived stigmatization impact psychological distress of orphans in Tanzania.

    PubMed

    Hermenau, Katharin; Eggert, Ina; Landolt, Markus A; Hecker, Tobias

    2015-01-01

    Research has shown that orphans in sub-Saharan Africa are at increased risk for mental health problems. Exposure to maltreatment and HIV/AIDS-related stigmatization are related to orphans' psychological distress. Yet, researchers stress the need for more research in low-income countries to identify which factors of being an orphan may lead to psychological distress. The present study aims to systematically investigate orphans' experiences of maltreatment and stigmatization to identify factors that relate to their psychological distress. In total, 89 Tanzanian children who had lost at least one parent were compared to 89 matched non-orphans (mean age: 11 years; 51% boys). We measured exposure to maltreatment and perceived stigmatization as an orphan. Mental health was assessed using the Strengths and Difficulties Questionnaire, the Children's Depression Inventory, the UCLA PTSD Index for Children, and the Reactive-Proactive Questionnaire. Orphans reported significantly more experiences of neglect, but not of abuse. A group comparison revealed more depressive symptoms, posttraumatic stress symptoms, and aggressive behavior among orphans. Neglect, abuse, and stigmatization correlated with orphans' internalizing and externalizing problems, yet only neglect and stigmatization were related to orphans' depression severity. Perceived stigmatization moderated the relationship between neglect and depression. Our findings suggest that orphans in Tanzania are at increased risk of experiencing neglect. Maltreatment and perceived stigmatization may play a role in orphans' psychological distress. Culturally appropriate and evidence-based interventions may help to prevent maltreatment and stigmatization of orphans.

  8. Communication, support and psychosocial work environment affecting psychological distress among working women aged 20 to 39 years in Japan

    PubMed Central

    HONDA, Ayumi; DATE, Yutaka; ABE, Yasuyo; AOYAGI, Kiyoshi; HONDA, Sumihisa

    2015-01-01

    When compared with their older counterparts, younger women are more likely to have depressive symptoms because they more often experience interrupted work history and a heavy childrearing burden. The purposes of the present study were 1) to investigate the possible association of psychosocial work environment with psychological distress and 2) to examine the way by which communication and support in the workplace affect to psychological distress among young women. We studied 198 women aged 20 to 39 yr in a cross-sectional study. The Kessler Scale-10 (K10 Scale) was used to examine psychological distress. In employees who experienced interpersonal conflict, those who had little or no conversations with their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 4.2), and those who received little or no support from their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 3.8) compared to those who had more frequent communication and received more support. Harmonious communication in the workplace can help prevent psychological distress among employees, which in turn may enable them to be satisfied with their work. PMID:26320729

  9. Communication, support and psychosocial work environment affecting psychological distress among working women aged 20 to 39 years in Japan.

    PubMed

    Honda, Ayumi; Date, Yutaka; Abe, Yasuyo; Aoyagi, Kiyoshi; Honda, Sumihisa

    2016-01-01

    When compared with their older counterparts, younger women are more likely to have depressive symptoms because they more often experience interrupted work history and a heavy childrearing burden. The purposes of the present study were 1) to investigate the possible association of psychosocial work environment with psychological distress and 2) to examine the way by which communication and support in the workplace affect to psychological distress among young women. We studied 198 women aged 20 to 39 yr in a cross-sectional study. The Kessler Scale-10 (K10 Scale) was used to examine psychological distress. In employees who experienced interpersonal conflict, those who had little or no conversations with their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 4.2), and those who received little or no support from their supervisor and/or co-workers had a significantly increased risk of psychological distress (OR, 3.8) compared to those who had more frequent communication and received more support. Harmonious communication in the workplace can help prevent psychological distress among employees, which in turn may enable them to be satisfied with their work.

  10. Reducing psychological distress in patients undergoing chemotherapy.

    PubMed

    Milanti, Ariesta; Metsälä, Eija; Hannula, Leena

    Psychological distress is a common problem among patients with cancer, yet it mostly goes unreported and untreated. This study examined the association of a psycho-educational intervention with the psychological distress levels of breast cancer and cervical cancer patients undergoing chemotherapy. The design of the study was quasi-experimental, pretest-posttest design with a comparison group. One hundred patients at a cancer hospital in Jakarta, Indonesia, completed Distress Thermometer screening before and after chemotherapy. Fifty patients in the intervention group were given a psycho-educational video with positive reappraisal, education and relaxation contents, while receiving chemotherapy. Patients who received the psycho-educational intervention had significantly lower distress levels compared with those in the control group. Routine distress screening, followed by distress management and outcome assessment, is needed to improve the wellbeing of cancer patients.

  11. Mind-Body Skills Training to Improve Distress Tolerance in Medical Students: A Pilot Study.

    PubMed

    Kraemer, Kristen M; Luberto, Christina M; O'Bryan, Emily M; Mysinger, Erica; Cotton, Sian

    2016-01-01

    improvements in distress tolerance in the mind-body group but not in the control group. These preliminary findings provide support for the notion that improving distress tolerance through mind-body skills training might serve to protect medical students from becoming functionally impaired by psychological distress. Thus, implementing mind-body skills training into medical school education may help to improve the psychological well-being of medical students. Future studies utilizing more methodologically rigorous designs are warranted.

  12. Framing the issues: moral distress in health care.

    PubMed

    Pauly, Bernadette M; Varcoe, Colleen; Storch, Jan

    2012-03-01

    Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight

  13. Secondary distress in violence researchers: a randomised trial of the effectiveness of group debriefings.

    PubMed

    Grundlingh, Heidi; Knight, Louise; Naker, Dipak; Devries, Karen

    2017-06-02

    Secondary distress including emotional distress, vicarious trauma (VT) and secondary traumatic stress (STS) due to exposure to primary trauma victims have been described in helping professionals and in violence researchers. To our knowledge, there are few prevalence studies, and no tailored interventions have been tested to reduce secondary distress in violence researchers. The study aims to (1) describe the epidemiology of secondary distress experienced by violence researchers; to (2) assess the effectiveness of group debriefings in mitigating secondary distress; to (3) assess risk and protective factors. We conducted an un-blinded, individually randomised trial with parallel assignment. Eligible participants were 59 Ugandan researchers employed by the Good Schools Study to interview children who experienced violence in a district of Uganda. Fifty-three researchers agreed to participate and were randomly allocated. The intervention group (n = 26) participated in three group debriefings and the control group (n = 27) in three leisure sessions (film viewings). The primary outcome was change in levels of emotional distress (SRQ-20); secondary outcomes were levels of VT and STS at end-line. A paired t-test assessed the difference in mean baseline and end-line emotional distress. Un-paired t-tests compared the change in mean emotional distress (baseline vs. end-line), and compared levels of VT and STS at end-line. Separate logistic regression models tested the association between end-line emotional distress and a-priori risk or protective factors. Baseline and end-line levels of emotional distress were similar in control (p = 0.47) and intervention (p = 0.59) groups. The superiority of group debriefing over leisure activities in lowering levels of emotional distress in the intervention group (n = 26; difference in SRQ-20 = 0.23 [SD = 2.18]) compared to the control group (n = 26; difference in SRQ-20 = 0.23 [SD = 1.63]) could not be detected (p = 1

  14. Cross-cultural study of idioms of distress among Spanish nationals and Hispanic American migrants: susto, nervios and ataque de nervios.

    PubMed

    Durà-Vilà, Glòria; Hodes, Matthew

    2012-10-01

    Susto (fright), nervios (nerves) and ataque de nervios (attack of nerves) are idioms of distress widely experienced amongst Hispanic Americans, often associated with psychiatric disorders. This study explores understanding of these idioms of distress and attitudes to help seeking amongst indigenous Spanish and Hispanic American residents in Spain. A population survey was undertaken in four adult education centres in Spain. Hypothetical case vignettes of individuals suffering from the idioms of distress were used to investigate understanding and help seeking by a Spanish sample compared with Hispanic American migrants to Spain. 350 questionnaires were obtained (94.6% response rate). The idioms ataque de nervios and nervios were recognised by the majority of the Spanish group but by significantly more of the Hispanic American migrants. However, susto was infrequently recognised by the Spanish group but it was recognised by half of the Hispanic Americans. Hispanic Americans were also more likely to recommend consultation with a psychiatrist/psychologist than Spanish respondents for ataque de nervios and nervios. The Spanish group were more likely to recommend non-medical sources of support such as relatives and priest than Hispanic Americans. Hispanic Americans, more recently arrived, did not show greater recognition of the three idioms than those who have been in Spain longer. Regression analysis showed that being Hispanic American and having lower educational attainment was associated with greater use of susto. The study suggests that people hold multiple models of distress and disorder. This may influence clinical presentations and help seeking behaviour in Spanish as well as Hispanic American populations.

  15. The cultural expression of spiritual distress in Israel.

    PubMed

    Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

    2018-03-30

    Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel. We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care. Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress. Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.

  16. Maternal psychological distress and child decision-making.

    PubMed

    Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

    2017-08-15

    There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

  17. Making punishment palatable: Belief in free will alleviates punitive distress.

    PubMed

    Clark, Cory J; Baumeister, Roy F; Ditto, Peter H

    2017-05-01

    Punishing wrongdoers is beneficial for group functioning, but can harm individual well-being. Building on research demonstrating that punitive motives underlie free will beliefs, we propose that free will beliefs help justify punitive impulses, thus alleviating the associated distress. In Study 1, trait-level punitiveness predicted heightened levels of anxiety only for free will skeptics. Study 2 found that higher state-level incarceration rates predicted higher mental health issue rates, only in states with citizens relatively skeptical about free will. In Study 3, participants who punished an unfair partner experienced greater distress than non-punishers, only when their partner did not have free choice. Studies 4 and 5 confirmed experimentally that punitive desires led to greater anxiety only when free will beliefs were undermined by an anti-free will argument. These results suggest that believing in free will permits holding immoral actors morally responsible, thus justifying punishment with diminished negative psychological consequences for punishers. Published by Elsevier Inc.

  18. Psychological distress and work and home roles: a focus on socio-economic differences in distress.

    PubMed

    Matthews, S; Power, C; Stansfeld, S A

    2001-05-01

    Home and work factors have been linked to psychological status, but less is known about their contribution to social inequalities in psychological status. We examine whether social inequalities in psychological distress can be explained by work-home factors and whether the impact of these potential explanatory factors is similar for men and women. Data are from the 1958 British birth cohort study. We sought to explain social class differences in psychological distress at age 33. Explanatory factors were classified as work-home roles: i.e. employment, marital status, domestic responsibility, children and elderly care; and work-home characteristics: i.e. job-strain, insecurity, unsocial working hours, youngest child's age, number of children and level of involvement in childcare. A social gradient in psychological distress was found: odds ratios for classes IV and V v. I and II were 2.65 (men) and 3.02 (women). Work factors had consistently stronger associations with psychological distress and with social class among men than women. Work factors had a greater impact on class differences in psychological distress in men. Associations for home roles and characteristics were less consistent and their combined effect on class differences in distress was negligible for both sexes. Explanations for the social gradient differ for men and women. Work may be more important for men than women, but the impact of home factors was not strong during the early adulthood of this cohort.

  19. Distress Associated with Dementia-Related Psychosis and Agitation in Relation to Healthcare Utilization and Costs.

    PubMed

    Maust, Donovan T; Kales, Helen C; McCammon, Ryan J; Blow, Frederic C; Leggett, Amanda; Langa, Kenneth M

    2017-10-01

    Explore the relationship between behavioral and psychological symptoms of dementia (BPSD; specifically, delusions, hallucinations, and agitation/aggression) and associated caregiver distress with emergency department (ED) utilization, inpatient hospitalization, and expenditures for direct medical care. Retrospective cross-sectional cohort of participants with dementia (N = 332) and informants from the Aging, Demographics, and Memory Study, a nationally representative survey of U.S. adults >70 years old. BPSD of interest and associated informant distress (trichotomized as none/low/high) were assessed using the Neuropsychiatric Inventory (NPI). Outcomes were determined from one year of Medicare claims and examined according to presence of BPSD and associated informant distress, adjusting for participant demographics, dementia severity, and comorbidity. Fifty-eight (15%) participants with dementia had clinically significant delusions, hallucinations, or agitation/aggression. ED visits, inpatient admissions, and costs were not significantly higher among the group with significant BPSD. In fully adjusted models, a high level of informant distress was associated with all outcomes: ED visit incident rate ratio (IRR) 3.03 (95% CI: 1.98-4.63; p < 0.001), hospitalization IRR 2.78 (95% CI: 1.73-4.46; p < 0.001), and relative cost ratio 2.00 (95% CI: 1.12-3.59; p = 0.02). A high level of informant distress related to participant BPSD, rather than the symptoms themselves, was associated with increased healthcare utilization and costs. Effectively identifying, educating, and supporting distressed caregivers may help reduce excess healthcare utilization for the growing number of older adults with dementia. Copyright © 2017 American Association for Geriatric Psychiatry. All rights reserved.

  20. Who Is Experiencing What Kind of Moral Distress? Distinctions for Moving from a Narrow to a Broad Definition of Moral Distress.

    PubMed

    Fourie, Carina

    2017-06-01

    Moral distress, according to Andrew Jameton's highly influential definition, occurs when a nurse knows the morally correct action to take but is constrained in some way from taking this action. The definition of moral distress has been broadened, first, to include morally challenging situations that give rise to distress but which are not necessarily linked to nurses feeling constrained, such as those associated with moral uncertainty. Second, moral distress has been broadened so that it is not confined to the experiences of nurses. However, such a broadening of the concept does not mean that the kind of moral distress being experienced, or the role of the person experiencing it, is morally irrelevant. I argue that differentiating between categories of distress-e.g., constraint and uncertainty-and between groups of health professionals who might experience moral distress is potentially morally relevant and should influence the analysis, measurement, and amelioration of moral distress in the clinic. © 2017 American Medical Association. All Rights Reserved.

  1. Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies.

    PubMed

    Berry, Emma; Lockhart, Sam; Davies, Mark; Lindsay, John R; Dempster, Martin

    2015-05-01

    Diabetes distress is a rational emotional response to the threat of a life-changing illness. Distinct from depression, it is conceptually rooted in the demands of diabetes management and is a product of emotional adjustment. Diabetes distress has been found to be significantly associated with glycated haemoglobin (HbA1c) level and the likelihood of an individual adopting self-care behaviours. The lack of perceived support from family, friends and healthcare professionals significantly contributes to elevated diabetes distress, and this issue tends to be overlooked when designing interventions. Pioneering large-scale research, DAWN2, gives voices to the families of those with diabetes and reaffirms the need to consider psychosocial factors in routine diabetes care. Structured diabetes education programmes are the most widely used in helping individuals cope with diabetes, but they tend not to include the psychological or interpersonal aspects of diabetes management in their curricula. The need for health practitioners, irrespective of background, to demonstrate an understanding of diabetes distress and to actively engage in discussion with individuals struggling to cope with diabetes is emphasised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Germanium-gated γ-γ fast timing of excited states in fission fragments using the EXILL&FATIMA spectrometer

    NASA Astrophysics Data System (ADS)

    Régis, J.-M.; Simpson, G. S.; Blanc, A.; de France, G.; Jentschel, M.; Köster, U.; Mutti, P.; Paziy, V.; Saed-Samii, N.; Soldner, T.; Ur, C. A.; Urban, W.; Bruce, A. M.; Drouet, F.; Fraile, L. M.; Ilieva, S.; Jolie, J.; Korten, W.; Kröll, T.; Lalkovski, S.; Mach, H.; Mărginean, N.; Pascovici, G.; Podolyak, Zs.; Regan, P. H.; Roberts, O. J.; Smith, J. F.; Townsley, C.; Vancraeyenest, A.; Warr, N.

    2014-11-01

    A high-granularity mixed spectrometer consisting of high-resolution Ge and very fast LaBr3(Ce)-scintillator detectors has been installed around a fission target at the cold-neutron guide PF1B of the high-flux reactor of the Institut Laue-Langevin. Lifetimes of excited states in the range of 10 ps to 10 ns can be measured in around 100 exotic neutron-rich fission fragments using Ge-gated LaBr3(Ce)-LaBr3(Ce) or Ge-Ge-LaBr3(Ce)-LaBr3(Ce) coincidences. We report on various characteristics of the EXILL&FATIMA spectrometer for the energy range of 40 keV up to 6.8 MeV and present results of ps-lifetime test measurements in a fission fragment. The results are discussed with respect to possible systematic errors induced by background contributions.

  3. Do adolescents know when they need help in the aftermath of war?

    PubMed

    Schiff, Miriam; Pat-Horenczyk, Ruth; Benbenishty, Rami; Brom, Danny; Baum, Naomi; Astor, Ron Avi

    2010-10-01

    This study examined Israeli Arab and Jewish students' reports on needing help, a year after the Second Lebanon War and whether students' requests for support were associated with posttraumatic distress. The representative sample included 1,800 Jewish and 2,351 Arab students, grades 7-11. The questionnaires included items regarding (a) exposure to wartime events and other negative life events, (b) measures of posttraumatic stress disorder, and (c) needing help. The results showed that about 30% of the students reported needing help from any source (e.g., parents, peers) in the aftermath of the war. Arab students were more likely to report needing help than Jewish students. The students who reported needing help experienced higher levels of posttraumatic symptoms.

  4. 47 CFR 80.1114 - False distress alerts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false False distress alerts. 80.1114 Section 80.1114 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and...

  5. 47 CFR 80.1114 - False distress alerts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false False distress alerts. 80.1114 Section 80.1114 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and...

  6. 13 CFR 301.3 - Economic distress levels.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

  7. 13 CFR 301.3 - Economic distress levels.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

  8. 13 CFR 301.3 - Economic distress levels.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

  9. 13 CFR 301.3 - Economic distress levels.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3 Economic distress...

  10. Piracetam for fetal distress in labour.

    PubMed

    Hofmeyr, G Justus; Kulier, Regina

    2012-06-13

    Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

  11. [Distress, Main Burdens, Engagement Motivators and Needs of Fulltime and Volunteer Refugee Aid Workers].

    PubMed

    Grimm, Theresa; Georgiadou, Ekaterini; Silbermann, Andrea; Junker, Katharina; Nisslbeck, Winfried; Erim, Yesim

    2017-08-01

    In the psychosomatic department of the University Hospital of Erlangen trainings were conducted for active refugee aid workers with start in January, 2016. Meanwhile 49 helpers participated in the training and 45 of them filled out a survey questionnaire. Perceived distress when providing care for refugees, as well as engagement motivation and further training needs were explored. Furthermore, depressive symptoms as well as the prevalence of traumatic experiences were investigated. The main burden was experienced through lacking freedom of action on the background of legal regulations. Furthermore dissociative symptoms (15.4%) and aggressive behavior (26.9%) of refugees were reported as distress factors. To help others proved to be the highest motivator for their work with refugees. Only 2 workers (4.4%) showed elevated depressive symptom manifestations. In contrast, 93.3% of refugee helpers had experienced a traumatic event personally or as a witness. For the helpers the greatest training needs were the recognition of mental health problems and to learn concrete intervention strategies to help those affected. © Georg Thieme Verlag KG Stuttgart · New York.

  12. The association of metacognitive beliefs with emotional distress after diagnosis of cancer.

    PubMed

    Cook, Sharon A; Salmon, Peter; Dunn, Graham; Holcombe, Chris; Cornford, Philip; Fisher, Peter

    2015-03-01

    Emotional distress after a diagnosis of cancer is normal and, for most people, will diminish over time. However, a significant minority of patients with cancer experience persistent or recurrent symptoms of emotional distress for which they need help. A model developed in mental health, the self-regulatory executive function model (S-REF), specifies that maladaptive metacognitive beliefs and processes, including persistent worry, are key to understanding why such emotional problems persist. This cross-sectional study explored, for the first, time whether metacognitive beliefs were associated with emotional distress in a cancer population, and whether this relationship was mediated by worry, as predicted by the S-REF model. Two hundred twenty-nine participants within 3 months of diagnosis of, and before treatment for, primary breast or prostate cancer completed self-report questionnaires measuring anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, metacognitive beliefs, worry, and illness perceptions. Regression analysis showed that metacognitive beliefs were associated with symptoms of anxiety, depression, and PTSD, and explained additional variance in these outcomes after controlling for age, gender, and illness perceptions. Structural equation modeling was consistent with cross-sectional hypotheses derived from the theory that metacognitive beliefs cause and maintain distress both directly and indirectly by driving worry. The findings provide promising first evidence that the S-REF model may be usefully applied in cancer. Further study is required to establish the predictive and clinical utility of these findings. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  13. Perfectionism, procrastination, and psychological distress.

    PubMed

    Rice, Kenneth G; Richardson, Clarissa M E; Clark, Dustin

    2012-04-01

    Using a cross-panel design and data from 2 successive cohorts of college students (N = 357), we examined the stability of maladaptive perfectionism, procrastination, and psychological distress across 3 time points within a college semester. Each construct was substantially stable over time, with procrastination being especially stable. We also tested, but failed to support, a mediational model with Time 2 (mid-semester) procrastination as a hypothesized mechanism through which Time 1 (early-semester) perfectionism would affect Time 3 (end-semester) psychological distress. An alternative model with Time 2 perfectionism as a mediator of the procrastination-distress association also was not supported. Within-time analyses revealed generally consistent strength of effects in the correlations between the 3 constructs over the course of the semester. A significant interaction effect also emerged. Time 1 procrastination had no effect on otherwise high levels of psychological distress at the end of the semester for highly perfectionistic students, but at low levels of Time 1 perfectionism, the most distressed students by the end of the term were those who were more likely to have procrastinated earlier in the semester. Implications of the stability of the constructs and their association over time, as well as the moderating effects of procrastination, are discussed in the context of maladaptive perfectionism and problematic procrastination.

  14. High level of distress in long-term survivors of thyroid carcinoma: results of rapid screening using the distress thermometer.

    PubMed

    Roerink, Sean H P P; de Ridder, Mischa; Prins, Judith; Huijbers, Angelique; de Wilt, Hans J H; Marres, Henri; Repping-Wuts, Han; Stikkelbroeck, Nike M M L; Timmers, Henri J; Hermus, Ad R M M; Netea-Maier, Romana T

    2013-01-01

    Cancer patients are at increased risk for distress. The Distress Thermometer (DT) and problem list (PL) are short-tools validated and recommended for distress screening in cancer patients. To investigate the level of distress and problems experienced by survivors of differentiated non-medullary thyroid carcinoma (DTC), using the DT and PL and whether this correlates with clinical and demographical variables. All 205 DTC patients, under follow-up at the outpatient clinic of our university hospital, were asked to fill in the DT and PL, hospital anxiety and depression scale (HADS), illness cognition questionnaire (ICQ) and an ad hoc questionnaire. Receiver Operator Characteristic analysis (ROC) was used to establish the optimal DT cut-off score according to HADS. Correlations of questionnaires scores with data on diagnosis, treatment and follow-up collected from medical records were analyzed. Of the 159 respondents, 145 agreed to participate [118 in remission, median follow-up 7.2 years (range 3 months-41 years)]. Of these, 34.3% rated their distress score ≥5, indicating clinically relevant distress according to ROC analysis. Patients reported physical (86%) over emotional problems (76%) as sources of distress. DT scores correlated with HADS scores and ICQ subscales. No significant correlations were found between DT scores and clinical or demographical characteristics except for employment status. Prevalence of distress is high among patients with DTC even after long-term remission and cannot be predicted by clinical and demographical characteristics. DT and PL are useful screening instruments for distress in DTC patients and could easily be incorporated into daily practice.

  15. Dynamics of H II regions around exiled O stars

    NASA Astrophysics Data System (ADS)

    Mackey, Jonathan; Langer, Norbert; Gvaramadze, Vasilii V.

    2013-11-01

    At least 25 per cent of massive stars are ejected from their parent cluster, becoming runaways or exiles, travelling with often-supersonic space velocities through the interstellar medium (ISM). Their overpressurized H II regions impart kinetic energy and momentum to the ISM, compress and/or evaporate dense clouds, and can constrain properties of both the star and the ISM. Here, we present one-, two- and (the first) three-dimensional simulations of the H II region around a massive star moving supersonically through a uniform, magnetized ISM, with properties appropriate for the nearby O star ζ Oph. The H II region leaves an expanding overdense shell behind the star and, inside this, an underdense wake that should be filled with hot gas from the shocked stellar wind. The gas column density in the shell is strongly influenced by the ISM magnetic field strength and orientation. Hα emission maps show that H II region remains roughly circular, although the star is displaced somewhat from the centre of emission. For our model parameters, the kinetic energy feedback from the H II region is comparable to the mechanical luminosity of the stellar wind, and the momentum feedback rate is >100 times larger than that from the wind and ≈10 times larger than the total momentum input rate available from radiation pressure. Compared to the star's eventual supernova explosion, the kinetic energy feedback from the H II region over the star's main-sequence lifetime is >100 times less, but the momentum feedback is up to 4 times larger. H II region dynamics are found to have only a small effect on the ISM conditions that a bow shock close to the star would encounter.

  16. Medical student depression, anxiety and distress outside North America: a systematic review.

    PubMed

    Hope, Valerie; Henderson, Max

    2014-10-01

    North American medical students are more depressed and anxious than their peers. In the UK, the regulator now has responsibility for medical students, which may potentially increase scrutiny of their health. This may either help or hinder medical students in accessing appropriate care. The prevalences of anxiety, depression and psychological distress in medical students outside North America are not clear. A better understanding of the prevalence of, risk factors for and results of psychological distress will guide the configuration of support services, increasingly available for doctors, for medical students too. The aim of this study was to examine the prevalences of depression, anxiety and psychological distress in students in medical schools in the UK, Europe and elsewhere in the English-speaking world outside North America. A systematic review was conducted using search terms encompassing psychological distress amongst medical students. OvidSP was used to search the following databases: Ovid MEDLINE (R) from 1948 to October 2013; PsycINFO from 1806 to October 2013, and EMBASE from 1980 to October 2013. Results were restricted to medical schools in Europe and the English-speaking world outside North America, and were evaluated against a set of inclusion criteria including the use of validated assessment tools. The searches identified 29 eligible studies. Prevalences of 7.7-65.5% for anxiety, 6.0-66.5% for depression and 12.2-96.7% for psychological distress were recorded. The wide range of results reflects the variable quality of the studies. Almost all were cross-sectional and many did not mention ethical approval. Better-quality studies found lower prevalences. There was little information on the causes or consequences of depression or anxiety. Prevalences of psychological distress amongst medical students outside North America are substantial. Future research should move on from simple cross-sectional studies to better-quality longitudinal work which can

  17. Internet-based guided self-help for university students with anxiety, depression and stress: a randomized controlled clinical trial.

    PubMed

    Day, Victor; McGrath, Patrick J; Wojtowicz, Magdalena

    2013-07-01

    Anxiety, depression and stress, often co-occurring, are the psychological problems for which university students most often seek help. Moreover there are many distressed students who cannot, or choose not to, access professional help. The present study evaluated the efficacy of an internet-based guided self-help program for moderate anxiety, depression and stress. The program was based on standard cognitive behavior therapy principles and included 5 core modules, some of which involved options for focusing on anxiety and/or depression and/or stress. Trained student coaches provided encouragement and advice about using the program via e-mail or brief weekly phone calls. Sixty-six distressed university students were randomly assigned to either Immediate Access or a 6-week Delayed Access condition. Sixty-one percent of Immediate Access participants completed all 5 core modules, and 80% of all participants completed the second assessment. On the Depression, Anxiety and Stress Scales-21, Immediate Access participants reported significantly greater reductions in depression (ηp(2)=. 07), anxiety (ηp(2)=. 08) and stress (ηp(2)=. 12) in comparison to participants waiting to do the program, and these improvements were maintained at a six month follow-up. The results suggest that the provision of individually-adaptable, internet-based, self-help programs can reduce psychological distress in university students. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer.

    PubMed

    Yee, Melissa K; Sereika, Susan M; Bender, Catherine M; Brufsky, Adam M; Connolly, Mary C; Rosenzweig, Margaret Q

    2017-06-01

    There is a persistent racial survival disparity between African American (AA) and white women with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer-related distress may be unexplored, important contributing factors. The purpose of the current study was to: 1) describe and compare the number of chemotherapy-related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and 2) to describe the relationship between the number of chemotherapy-related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe. Descriptive, comparative, and correlational analyses of symptom incidence, symptom distress, cancer-related distress, and prescribed chemotherapy dose received among a cohort of AA women receiving chemotherapy for breast cancer were performed. AA women (121 women) experienced worsening symptoms from baseline to midpoint in chemotherapy and then stabilized for the duration of therapy. The inability to receive 85% of the prescribed chemotherapy within a prescribed time point was found to be significantly correlated with midpoint symptom distress. The main findings of the current study were that AA women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of physical and emotional symptoms, as measured through a multidimensional symptom measurement tool, may be contributing to breast cancer dose disparity and should be explored further. Cancer 2017;123:2061-2069. © 2017 American Cancer Society. © 2017 American Cancer Society.

  19. Perceived organizational support and moral distress among nurses.

    PubMed

    Robaee, Navideh; Atashzadeh-Shoorideh, Foroozan; Ashktorab, Tahereh; Baghestani, Ahmadreza; Barkhordari-Sharifabad, Maasoumeh

    2018-01-01

    Moral distress is prevalent in the health care environment at different levels. Nurses in all roles and positions are exposed to ethically challenging conditions. Development of supportive climates in organizations may drive nurses towards coping moral distress and other related factors. This study aimed at determining the level of perceived organizational support and moral distress among nurses and investigating the relationship between the two variables. This was a correlational-descriptive study. A total of 120 nurses were selected using random quota sampling method. A demographic questionnaire, Survey of Perceived Organizational Support, and Moral Distress Scale were used to collect the data which were analyzed using descriptive and analytical tests in SPSS20. The mean perceived organizational support was low (2.63 ± 0.79). The mean moral distress was 2.19 ± 0.58, which shows a high level of moral distress. Moreover, Statistical analysis showed no significant relationship between perceived organizational support and moral distress ( r  = 0.01, p  = 0.86). Given the low level of perceived organizational support and high moral distress among nurses in this study, it is necessary to provide a supportive environment in hospitals and to consider strategies for diminishing moral distress.

  20. The Montessori Model in Puebla, Mexico: How One Nonprofit Is Helping Children

    ERIC Educational Resources Information Center

    Harger, Jeni

    2008-01-01

    In this article, the author discusses how the JUCONI Foundation in Puebla, Mexico is helping children. (JUCONI is an acronym for "Junto con los Ninos", or "Together with the Children)." This Mexican nongovernmental organization (NGO) has been successfully working with distressed families and children in Puebla since 1989. For…

  1. 46 CFR 169.553 - Pyrotechnic distress signals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

  2. 46 CFR 169.553 - Pyrotechnic distress signals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

  3. 46 CFR 169.553 - Pyrotechnic distress signals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

  4. 46 CFR 169.553 - Pyrotechnic distress signals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

  5. 46 CFR 169.553 - Pyrotechnic distress signals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

  6. Self-injury in young people and the help-negation effect.

    PubMed

    Frost, Mareka; Casey, Leanne M; O'Gorman, John G

    2017-04-01

    This study examined the relationship between self-injurious behavior and intentions to seek help from professionals, family and friends, technology based support and from no-one. Participants were 679 young people aged 14-25 years drawn from a larger internet survey (N =1463) on the basis of their reported self-injury. A help-negation effect was found only in relation to intentions to seek help from family and friends. That is, a higher extent or severity of self-injury was independently associated with lower intentions to seek help from family and friends. This effect remained after controlling for psychological distress and suicidal ideation. Establishing avenues for early intervention and providing access to a range of potential avenues for help-seeking may assist young people to seek support in relation to self-injury. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

    PubMed

    Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

    2017-02-01

    Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Descriptive figures for differences in parenting and infant night-time distress in the first three months of age.

    PubMed

    St James-Roberts, Ian; Roberts, Marion; Hovish, Kimberly; Owen, Charlie

    2016-11-01

    Aim To provide descriptive figures for infant distress and associated parenting at night in normal London home environments during the first three months of age. Most western infants develop long night-time sleep periods by four months of age. However, 30% of infants in many countries sleep for short periods and cry out on waking in the night: the most common type of infant sleep behaviour problem. Preventive interventions may help families and improve services. There is evidence that 'limit-setting' parenting, which is common in western cultures, supports the development of settled infant night-time behaviour. However, a recent review has challenged this and argued that this form of parenting risks distressing infants. This study describes limit-setting parenting as practiced in London, compares it with 'infant-cued' parenting and measures the associated infant distress. Longitudinal infrared video, diary and questionnaire observations comparing a General-Community (n=101) group and subgroups with a Bed-Sharing (n=19) group on measures of infant and parenting behaviours at night. Findings General-Community parents took longer to detect and respond to infant waking and signalling, and to begin feeding, compared with the highly infant-cued care provided by Bed-Sharing parents. The average latency in General-Community parents' responding to infant night-time waking was 3.5 min, during which infants fuss/cried for around 1 min. Compared with Bed-Sharing parenting, General-Community parenting was associated with increased infant distress of around 30 min/night at two weeks, reducing to 12 min/night by three months of age. However, differences in infant distress between General-Community subgroups adopting limit-setting versus infant-cued parenting were not large or statistically significant at any age. The figures provide descriptive evidence about limit-setting parenting which may counter some doubts about this form of parenting and help parents and professionals to

  9. Psychological distress of adolescents exposed to Hurricane Hugo.

    PubMed

    Hardin, S B; Weinrich, M; Weinrich, S; Hardin, T L; Garrison, C

    1994-07-01

    To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

  10. Using Moral Distress for Organizational Improvement.

    PubMed

    Sabin, James E

    2017-01-01

    Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvement-oriented manner. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

  11. Prevalence and related factors of psychological distress among cancer inpatients using routine Distress Thermometer and Chinese Health Questionnaire screening

    PubMed Central

    Chiou, Yu-Jie; Chiu, Nien-Mu; Wang, Liang-Jen; Li, Shau-Hsuan; Lee, Chun-Yi; Wu, Ming-Kung; Chen, Chien-Chih; Wu, Yi-Shan; Lee, Yu

    2016-01-01

    Background Clinical practice guidelines suggest routine screening for distress among cancer patients for immediate early psychiatric care. However, previous studies focusing on routine screening for psychological distress among cancer inpatients in Taiwan are scant. Thus, the aim of this study was to evaluate the prevalence and related factors of psychological distress and mental illness among cancer inpatients in Taiwan. Patients and methods This study was conducted as a retrospective chart review in a general hospital in southern Taiwan. Cancer inpatients were regularly screened by nursing staff using the Distress Thermometer and the 12-item Chinese Health Questionnaire. Positive screening results on either instrument were followed by a non-commanded referral to psychiatrists for clinical psychiatric diagnosis and treatment. Results Of the 810 participants in this study, 179 (22.1%) were recognized as having psychological distress. Younger age (odds ratio [OR] =1.82), having head and neck cancer (OR =2.43), and having not received chemotherapy (OR =1.58) were significantly related to psychological distress. Among the 56 patients (31.3%) with psychological distress who were referred to psychiatrists, the most common mental illness was adjustment disorder (n=22, 39.2%), followed by major depressive disorder (n=13, 23.2%), depressive disorder not otherwise specified (n=6, 10.7%), and anxiety disorder not otherwise specified (n=4, 7.1%). Conclusion Our study indicated that cancer inpatients with psychological distress were more likely to be younger in age, have head and neck cancer, and have not received chemotherapy. The most common psychiatric disorder was adjustment disorder. Early detection of psychological distress and prompt psychiatric consultation and management are very important for cancer inpatients. PMID:27822049

  12. Distress and Burnout among Genetic Service Providers

    PubMed Central

    Bernhardt, Barbara A.; Rushton, Cynda H.; Carrese, Joseph; Pyeritz, Reed E.; Kolodner, Ken; Geller, Gail

    2009-01-01

    Purpose To determine the nature, sources, prevalence and consequences of distress and burnout among genetics professionals. Methods Mailed survey of randomly selected clinical geneticists (MDs), genetic counselors (GCs) and genetic nurses. Results 214 providers completed the survey (55% response rate). Eight discrete sources of distress were identified forming a valid 28-item scale (alpha=.89). The greatest sources of distress were compassion stress, the burden of professional responsibility, negative patient regard and concerns about informational bias. GCs were significantly more likely to experience personal values conflicts, burden of professional responsibility, and concerns about informational bias than MDs or nurses. Burnout scores were lower among those practicing more than 20 years and nurses. Distress scores were positively correlated with burnout and professional dissatisfaction (p<.0001). 18% of respondents think about leaving patient care, and burnout was the most significant predictor. Predictors of burnout included greater distress, fewer years in practice, working in university-based settings, being a GC or an MD, and deriving less meaning from patient care. Conclusions Genetic service providers experience various types of distress that may be risk factors for burnout and professional dissatisfaction. Interventions to reduce distress and burnout are needed for both trainees and practitioners. PMID:19444128

  13. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  14. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  15. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  16. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  17. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  18. The outcomes of children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

    PubMed

    Quasney, Michael W; López-Fernández, Yolanda M; Santschi, Miriam; Watson, R Scott

    2015-06-01

    To provide additional details and evidence behind the recommendations for outcomes assessment of patients with pediatric acute respiratory distress syndrome from the Pediatric Acute Lung Injury Consensus Conference. Consensus conference of experts in pediatric acute lung injury. A panel of 27 experts met over the course of 2 years to develop a taxonomy to define pediatric acute respiratory distress syndrome and to make recommendations regarding treatment and research priorities. The outcomes subgroup comprised four experts. When published data were lacking, a modified Delphi approach emphasizing strong professional agreement was used. The Pediatric Acute Lung Injury Consensus Conference experts developed and voted on a total of 151 recommendations addressing the topics related to pediatric acute respiratory distress syndrome, seven of which related to outcomes after pediatric acute respiratory distress syndrome. All seven recommendations had strong agreement. Children with acute respiratory distress syndrome continue to have a high mortality, specifically, in relation to certain comorbidities and etiologies related to pediatric acute respiratory distress syndrome. Comorbid conditions, such as an immunocompromised state, increase the risk of mortality even further. Likewise, certain etiologies, such as non-pulmonary sepsis, also place children at a higher risk of mortality. Significant long-term effects were reported in adult survivors of acute respiratory distress syndrome: diminished lung function and exercise tolerance, reduced quality of life, and diminished neurocognitive function. Little knowledge of long-term outcomes exists in children who survive pediatric acute respiratory distress syndrome. Characterization of the longer term consequences of pediatric acute respiratory distress syndrome in children is vital to help identify opportunities for improved therapeutic and rehabilitative strategies that will lessen the long-term burden of pediatric acute

  19. Distressed Couples and Marriage Education

    ERIC Educational Resources Information Center

    DeMaria, Rita M.

    2005-01-01

    Professionals generally believe that couples who choose to attend marriage education programs are not as distressed as are clinical couples and that distressed couples are not good candidates for marriage education. We examined these assumptions in 129 married couples who enrolled in a PAIRS, Practical Application of Intimate Relationship Skills…

  20. BABY EMPATHY: INFANT DISTRESS AND PEER PROSOCIAL RESPONSES.

    PubMed

    Liddle, Mitzi-Jane E; Bradley, Ben S; Mcgrath, Andrew

    2015-01-01

    Empathy is an important competence in our social world, a motivator of prosocial behavior, and thought to develop throughout the second year of life. The current study examined infants' responses to naturalistic peer distress to explore markers of empathy and prosocial behavior in young babies. Seventeen 8-month-old infants participated in a repeated measures design using the "babies-in-groups" paradigm, with maternal presence as the independent variable. Significant differences were found between response types: Gaze was the standard response to infant distress, followed by socially directed behaviors and affect, with self-distress rarely occurring. Maternal presence was not found to impact the nature or frequency of babies' responses to peer distress. During distress episodes, babies looked preferentially at the distressed peer, then other mothers, and least to their own mother. Data revealed that infant responses to peer distress resulted in a successful cessation of that distress episode over one third of the time. Case studies are provided to illustrate the quantitative data. The results provided evidence of empathic concern and prosocial behavior in the first year of life, and provoke a challenge to developmental theories of empathy. © 2015 Michigan Association for Infant Mental Health.

  1. Symptom distress in older adults following cancer surgery.

    PubMed

    Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

    2013-01-01

    Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P < .001, 6 months: P = .002) than at baseline while controlling for demographic, biologic, psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P < .05). Participants 75 years or older reported increased symptom distress over time compared with those aged 65 to 69 years (P < .05). Age, type of cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

  2. A philosophical taxonomy of ethically significant moral distress.

    PubMed

    Thomas, Tessy A; McCullough, Laurence B

    2015-02-01

    Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one's moral knowledge about what one ought to do. We begin by unpacking the philosophical components of Andrew Jameton's original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Do Ravens Show Consolation? Responses to Distressed Others

    PubMed Central

    Fraser, Orlaith N.; Bugnyar, Thomas

    2010-01-01

    Background Bystander affiliation (post-conflict affiliation from an uninvolved bystander to the conflict victim) may represent an expression of empathy in which the bystander consoles the victim to alleviate the victim's distress (“consolation”). However, alternative hypotheses for the function of bystander affiliation also exist. Determining whether ravens spontaneously offer consolation to distressed partners may not only help us to understand how animals deal with the costs of aggressive conflict, but may also play an important role in the empathy debate. Methodology/Principal findings This study investigates the post-conflict behavior of ravens, applying the predictive framework for the function of bystander affiliation for the first time in a non-ape species. We found weak evidence for reconciliation (post-conflict affiliation between former opponents), but strong evidence for both bystander affiliation and solicited bystander affiliation (post-conflict affiliation from the victim to a bystander). Bystanders involved in both interactions were likely to share a valuable relationship with the victim. Bystander affiliation offered to the victim was more likely to occur after intense conflicts. Renewed aggression was less likely to occur after the victim solicited affiliation from a bystander. Conclusions/Significance Our findings suggest that in ravens, bystanders may console victims with whom they share a valuable relationship, thus alleviating the victims' post-conflict distress. Conversely victims may affiliate with bystanders after a conflict in order to reduce the likelihood of renewed aggression. These results stress the importance of relationship quality in determining the occurrence and function of post-conflict interactions, and show that ravens may be sensitive to the emotions of others. PMID:20485685

  4. [The Life Impacts and Symptom Distress in Women With Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery].

    PubMed

    Ko, I-Chen; Lo, Tsia-Shu; Lu, Yu-Ying; Tsao, Lee-Ing

    2017-02-01

    The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery. To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women. A cross-sectional and correlational research design was used and a total of 110 women with pelvic organ prolapse who had not yet undergone pelvic reconstruction surgery were recruited in the gynecological clinics of one medical center in Taiwan. Daytime urination frequency was the most prevalent urinary tract symptom noted by the participants; vaginal protrusion was the most prevalent pelvis-related symptom noted; and depression and anxiety were the most prevalent life impacts noted. Moreover, greater lower-urinary-tract symptom distress was associated with greater pelvic-symptom distress. Furthermore, greater lower urinary tract and pelvic symptom distresses were associated with a greater negative impact on life. Education background and pelvis-related symptoms were the explained variances in pre-surgery life impacts. Women with pelvic organ prolapse should pay particular attention to symptoms that include: daytime urinary frequency, vaginal protrusion, and emotional problems including depression and anxiety. Education background and level of symptom distress should be taken into consideration when caring for the life impacts of this vulnerable group of women.

  5. Music to reduce pain and distress in the pediatric emergency department: a randomized clinical trial.

    PubMed

    Hartling, Lisa; Newton, Amanda S; Liang, Yuanyuan; Jou, Hsing; Hewson, Krista; Klassen, Terry P; Curtis, Sarah

    2013-09-01

    Many medical procedures aimed at helping children cause them pain and distress, which can have long-lasting negative effects. Music is a form of distraction that may alleviate some of the pain and distress experienced by children while undergoing medical procedures. To compare music with standard care to manage pain and distress. Randomized clinical trial conducted in a pediatric emergency department with appropriate sequence generation and adequate allocation concealment from January 1, 2009, to March 31, 2010. Individuals assessing the primary outcome were blind to treatment allocation. A total of 42 children aged 3 to 11 years undergoing intravenous placement were included. Music (recordings selected by a music therapist via ambient speakers) vs standard care. The primary outcome was behavioral distress assessed blinded using the Observational Scale of Behavioral Distress-Revised. The secondary outcomes included child-reported pain, heart rate, parent and health care provider satisfaction, ease of performing the procedure, and parental anxiety. With or without controlling for potential confounders, we found no significant difference in the change in behavioral distress from before the procedure to immediately after the procedure. When children who had no distress during the procedure were removed from the analysis, there was a significantly less increase in distress for the music group (standard care group = 2.2 vs music group = 1.1, P < .05). Pain scores among children in the standard care group increased by 2 points, while they remained the same in the music group (P = .04); the difference was considered clinically important. The pattern of parent satisfaction with the management of children's pain was different between groups, although not statistically significant (P = .07). Health care providers reported that it was easier to perform the procedure for children in the music group (76% very easy) vs the standard care group (38% very easy

  6. Distress in significant others of patients with chronic fatigue syndrome: A systematic review of the literature.

    PubMed

    Harris, Kamelia; Band, Rebecca J; Cooper, Hazel; Macintyre, Vanessa G; Mejia, Anilena; Wearden, Alison J

    2016-11-01

    The objective of this study was to systematically review existing empirical research assessing levels and correlates of distress in significant others of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Systematic searches in CINAHL, Web of Science and PsycINFO were conducted in August 2014. The search was repeated in January 2015 to check for newly published articles. Studies published in English with quantitative, qualitative, or mixed designs exploring distress, poor subjective health, poor mental health, reduced quality of life and well-being, and symptoms of depression and anxiety in significant others (>18 years) of children and adults with CFS/ME were included. Quality appraisal of included studies was carried out. Quantitative and qualitative studies were summarized separately. Six articles met eligibility criteria. Two quantitative studies with significant others of adult patients, and one quantitative and two mixed-methods studies with significant others of child patients showed moderate to high levels of distress. One qualitative study (adult patients) found minimal evidence of distress and that acceptance of CFS/ME was related to better adjustment. In the quantitative and mixed-methods studies, significant others who attributed some level of responsibility for symptoms to the patient, or who were female, or whose partners had poorer mental health, had higher levels of distress. The small number of studies to date, the contrary evidence from a qualitative study, and the limited data available on levels of distress in significant others of patients with CFS/ME mean that our conclusion that distress levels are elevated is provisional. We recommend that future qualitative studies focus on this particular topic. Further longitudinal studies exploring correlates of distress within the context of a predictive theoretical model would be helpful. Statement of contribution What is already known on this subject? Chronic fatigue syndrome

  7. Psychological distress associated with cancer screening: A systematic review.

    PubMed

    Chad-Friedman, Emma; Coleman, Sarah; Traeger, Lara N; Pirl, William F; Goldman, Roberta; Atlas, Steven J; Park, Elyse R

    2017-10-15

    Current national cancer screening recommendations include the potential risk of psychological harm related to screening. However, data on the relation of psychological distress to cancer screening is limited. The authors conducted a systematic review to assess psychological distress associated with cancer screening procedures. Studies that administered measures of psychological distress between 2 weeks before and 1 month after the screening procedure were included. In total, 22 eligible studies met criteria for review, including 13 observational trials and 9 randomized controlled trials. Eligible studies used a broad range of validated and unvalidated measures. Anxiety was the most commonly assessed construct and was measured using the State Trait Anxiety Inventory. Studies included breast, colorectal, prostate, lung, and cervical screening procedures. Distress was low across procedures, with the exception of colorectal screening. Distress did not vary according to the time at which distress was measured. None of the studies were conducted exclusively with the intention of assessing distress at the time of screening. Evidence of low distress during the time of cancer screening suggests that distress might not be a widespread barrier to screening among adults who undergo screening. However, more studies are needed using validated measures of distress to further understand the extent to which screening may elicit psychological distress and impede adherence to national screening recommendations. Cancer 2017;123:3882-94. © 2017 American Cancer Society. © 2017 American Cancer Society.

  8. 47 CFR 2.402 - Control of distress traffic.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... distress traffic. The control of distress traffic is the responsibility of the mobile station in distress or of the mobile station which, by the application of the provisions of § 2.403, has sent the...

  9. Providing care to relatives with mental illness: reactions and distress among primary informal caregivers.

    PubMed

    Chang, Sherilyn; Zhang, Yunjue; Jeyagurunathan, Anitha; Lau, Ying Wen; Sagayadevan, Vathsala; Chong, Siow Ann; Subramaniam, Mythily

    2016-03-25

    of these domains was found to be significantly associated with caregiver distress. Higher distress was associated with stronger impact on the negative domains and a lower impact in the positive domain of caregiving reaction. Interventions such as educational programs at the caregiver level, and also promoting wider social care support in these domains may help to address caregiver distress.

  10. Recent insight into potential acute respiratory distress syndrome.

    PubMed

    Amin, Zulkifli; Rahmawati, Fitriana N

    2017-04-01

    Acute respiratory distress syndrome (ARDS) is an acute inflammatory lung injury, characterized by increased pulmonary capillary endothelial cells and alveolar epithelial cells permeability leading to respiratory failure in the absence of cardiac failure. Despite recent advances in treatments, the overall mortality because of ARDS remains high. Biomarkers may help to diagnose, predict the severity, development, and outcome of ARDS in order to improve patient care and decrease morbidity and mortality. This review will focus on soluble receptor for advanced glycation end-products, soluble tumor necrosis factor-receptor 1, Interluken-6 (IL-6), IL-8, and plasminogen activator inhibitor-1, which have a greater potential based on recent studies.

  11. Recent insight into potential acute respiratory distress syndrome

    PubMed Central

    Amin, Zulkifli; Rahmawati, Fitriana N.

    2017-01-01

    Acute respiratory distress syndrome (ARDS) is an acute inflammatory lung injury, characterized by increased pulmonary capillary endothelial cells and alveolar epithelial cells permeability leading to respiratory failure in the absence of cardiac failure. Despite recent advances in treatments, the overall mortality because of ARDS remains high. Biomarkers may help to diagnose, predict the severity, development, and outcome of ARDS in order to improve patient care and decrease morbidity and mortality. This review will focus on soluble receptor for advanced glycation end-products, soluble tumor necrosis factor-receptor 1, Interluken-6 (IL-6), IL-8, and plasminogen activator inhibitor-1, which have a greater potential based on recent studies. PMID:28397939

  12. The ethics of distress: toward a framework for determining the ethical acceptability of distressing health promotion advertising.

    PubMed

    Brown, Stephen L; Whiting, Demian

    2014-04-01

    Distressing health promotion advertising involves the elicitation of negative emotion to increase the likelihood that health messages will stimulate audience members to adopt healthier behaviors. Irrespective of its effectiveness, distressing advertising risks harming audience members who do not consent to the intervention and are unable to withdraw from it. Further, the use of these approaches may increase the potential for unfairness or stigmatization toward those targeted, or be considered unacceptable by some sections of the public. We acknowledge and discuss these concerns, but, using the public health ethics literature as a guide, argue that distressing advertising can be ethically defensible if conditions of effectiveness, proportionality necessity, least infringement, and public accountability are satisfied. We do not take a broad view as to whether distressing advertising is ethical or unethical, because we see the evidence for both the effectiveness of distressing approaches and their potential to generate iatrogenic effects to be inconclusive. However, we believe it possible to use the current evidence base to make informed estimates of the likely consequences of specific message presentations. Messages can be pre-tested and monitored to identify and deal with potential problems. We discuss how advertisers can approach the problems of deciding on the appropriate intensity of ethical review, and evaluating prospective distressing advertising campaigns against the conditions outlined. © 2013 International Union of Psychological Science.

  13. The Distress Disclosure Index: a research review and multitrait-multimethod examination.

    PubMed

    Kahn, Jeffrey H; Hucke, Brandy E; Bradley, Allyson M; Glinski, Austin J; Malak, Brittany L

    2012-01-01

    The Distress Disclosure Index (DDI; J. H. Kahn & R. M. Hessling, 2001) is a brief self-report measure of one's tendency to disclose personally distressing information. The purpose of this article was to summarize what is known about the DDI, present new validity evidence, and make recommendations for use of the DDI. This article reviews research on the DDI from the past decade that indicates that distress disclosure is associated with well-being, professional help-seeking attitudes and intentions, and success in brief psychotherapy. On the basis of the reviewed literature, the authors report a reliability generalization study of DDI scores that strongly supports the internal consistency and test-retest reliability of DDI scores, and they review criterion-related and construct validity evidence. Next, the authors present a new multitrait-multimethod validity study of the DDI. Participants (N = 153) and peer informants (N = 153)--one per participant--completed paper-and-pencil questionnaire packets. Convergent validity of self-reported DDI scores was supported by a strong association with self-reports of emotional self-disclosure in response to a specific, unpleasant event, and self- and peer reports on the DDI were moderately correlated. DDI scores were not strongly associated with cognitive reappraisal and ambivalence over emotional expression, thus supporting discriminant validity. DDI scores were strongly associated with expressive suppression, and correlations between DDI scores and affect, depression symptoms, coping, and emotional expressivity were similar to those found with expressive suppression. The authors offer possible hypotheses explaining the overlap between distress disclosure and expressive suppression and present recommendations for future use of the DDI. (c) 2012 APA, all rights reserved.

  14. Intimate partner violence and help-seeking – a cross-sectional study of women in Sweden

    PubMed Central

    2013-01-01

    Background Intimate partner violence (IPV) is a global public health concern with possible detrimental consequences for its victims. Studies have found prevalence rates of 15 to 71% for IPV. There is evidence that IPV exposed women perceive barriers to help-seeking and many remain undetected by care givers and authorities. This cross-sectional study aimed to examine IPV exposed women in relation to help-seeking versus non help-seeking from the social services or women’s shelters with regard to social and psychological characteristics as well as relationship with the perpetrator and type of violence exposure. Methods Two groups of Swedish IPV exposed women were included: non help-seekers (n = 128) were recruited through ads in newspapers, while help-seekers (n = 347) were recruited from four social service sites and twenty women’s shelters around Sweden. Participants were assessed with questionnaires regarding age, education, occupation and relation to the perpetrator as well as validated instruments measuring psychological distress, psychosocial functioning alcohol use and violence. Analyses were made using Chi2 and multivariate logistic regression. Results Help-seekers had significantly more often children together with the perpetrator than non help-seekers (64% and 29% respectively) and a high association was found in the fully adjusted model (Adj. OR = 5.46 95% CI 2.99-9.97). Many women in both groups reported a poor social situation and high levels of psychological distress, although more psychological distress was associated with elevated odds for help-seeking (Adj. OR = 2.83 95% CI 1.84-4.34). No differences were found between the groups regarding violence exposure and most women in both groups had experienced severe violence from an intimate partner (95% to 98%). Conclusions Results indicate a high problem load among women who had not contacted the social services or women’s shelters due to IPV, and that non help-seekers had similar

  15. Organ sales and moral distress.

    PubMed

    Rivera-Lopez, Eduardo

    2006-01-01

    The possibility that organ sales by living adults might be made legal is morally distressing to many of us. However, powerful arguments have been provided recently supporting legalisation (I consider two of those arguments: the Consequentialist Argument and the Autonomy Argument). Is our instinctive reaction against a market of organs irrational then? The aim of this paper is not to prove that legalization would be immoral, all things considered, but rather to show, first, that there are some kinds of arguments, offered in favour of legalisation, that are, in an important sense, illegitimate, and second, that even if legalisation might not be wrong all things considered, there are good reasons for our negative moral intuitions. Moreover, identifying these reasons will help highlight some features of moral decisions in non-ideal situations, which in turn might be relevant to some other moral or policy choices.

  16. The effect of mode of detection of breast cancer on stress and distress.

    PubMed

    Gibbons, Andrea; Groarke, AnnMarie; Curtis, Ruth; Groarke, Jenny

    2017-06-01

    The number of women with screen-detected breast cancer is increasing, but it is not clear if these women experience the same levels of distress as women with symptomatic breast cancer. The current study compared stress and distress in women with screen-detected or symptomatic breast cancer at diagnosis and 12 months post-diagnosis. Ninety-two women with screen-detected breast cancer and 129 women with symptomatic breast cancer completed measures of perceived stress, anxiety, and depression at diagnosis and 12 months post-diagnosis. Women also completed a measure of cancer-related stress 12 months post-diagnosis. Both groups reported similar levels of perceived stress, anxiety, and depression at diagnosis. A third of women in both groups reported clinical levels of anxiety at diagnosis, which decreased over time. There were no differences in depression. Analyses revealed that at 12 months post-diagnosis, the symptomatic group reported a significant reduction in anxiety, but the screen-detected group reported a nonsignificant trend for a reduction over time. The screen-detected group reported significantly higher cancer-related stress at 12 months than the symptomatic group. Screen-detected women report similar distress at diagnosis but may be more at risk for greater distress requiring further psychological support 1 year after diagnosis. Future interventions that focus on preparation for screening may help to reduce ongoing levels of anxiety and cancer-related stress for this group. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Effects of Poly-Victimization on Adolescent Social Support, Self-Concept, and Psychological Distress.

    PubMed

    Turner, Heather A; Shattuck, Anne; Finkelhor, David; Hamby, Sherry

    2015-06-01

    Past research has demonstrated the particularly damaging effects of exposure to multiple forms of victimization, or "poly-victimization," on youth mental health. The primary objective of the present study is to begin to identify the mechanisms that help explain its powerful impact. Analyses are based on two waves of longitudinal data from the National Survey of Children's Exposure to Violence (NatSCEV), conducted in 2008 and 2010, that comprised a telephone sample of 1,186 youth ages 10 to 17. Using structural equation modeling, we examine direct and indirect effects on distress symptoms of increased, decreased, and stable high poly-victimization between Waves 1 and 2 compared to no or low victimization in both waves. Specifically, we consider the extent to which reductions in core psychosocial resources, including family support, peer support, self-esteem, and mastery, mediate the relationship between these poly-victimization conditions and distress. Relative to stable low victimization, both increased poly-victimization and stable high poly-victimization were associated with declines in all four resources. However, only self-esteem and mastery significantly mediated the association between poly-victimization and distress, with mastery showing the strongest effect. Although significant indirect effects were evident, poly-victimization still had a strong direct effect on distress with resource factors controlled. Findings support the hypothesis that the potent effect of poly-victimization on youth mental health is, in part, due to its damaging influence on core psychosocial resources. © The Author(s) 2015.

  18. Capital management helps hospitals face hard times.

    PubMed

    Harris, J; Pitts, K

    1989-03-01

    Financial officers of healthcare organizations in severe financial distress must map out an effective capital management strategy to help their institutions avoid disaster. An executive's plan of action should include streamlining and restructuring the organization, studying long- and short-term assets to improve cash flow, and investigating ways to refinance debt. Healthcare organizations must develop warning signals for impending financial difficulties and contingency plans that address operating and capital responses to such a crisis. Learning to guide an organization through financial difficulties may be an executive's most important financial skill in the decade to come.

  19. Social-cognitive determinants of help-seeking for mental health problems among prison inmates.

    PubMed

    Skogstad, Philip; Deane, Frank P; Spicer, John

    2006-01-01

    Prisoners experience high rates of mental health problems and suicidal behaviours. Failure to seek help may exacerbate these problems and limit opportunities to participate in offending-related programmes. To assess whether prisoners'; intentions to seek help for a personal-emotional problem, including suicidal feelings, can be predicted using variables from the Theory of Planned Behaviour (TPB). These TPB variables were supplemented by measures of emotional distress, prior contact with a psychologist and demographic variables. Male inmates from six New Zealand prisons were asked to participate, with approximately 50% (n = 527) of those who initially expressed an interest in the study completing the self-report questionnaire. Most participants completed the questionnaire in small-group meetings in the prison units and returned them to the researchers immediately after completion.Results On average, participants reported higher levels of current emotional distress than comparison student samples. TPB variables predicted help-seeking intentions for suicidality and personal-emotional problems. Those with prior contact with prison psychologists had lower intentions to seek help for suicidal feelings than prisoners without such contact. Older prisoners, those with more years of education, and those who had previous contact with a psychologist outside prison tended to have higher intentions to seek psychological help. Social-cognitive factors predicted intentions to seek help among New Zealand prisoners but prison-specific issues, such as relative reluctance to seek help when suicidal and reluctance to seek help from prison psychologists, were also identified. Implications for practice Prisoners'; access to services could be improved, for example, through directly working on attitudinal barriers. Strategies to ensure access to specialized forensic mental health in-reach services could also be an alternative or additional route to ensure that this disadvantaged group

  20. Does education buffer the impact of disability on psychological distress?

    PubMed

    Mandemakers, Jornt J; Monden, Christiaan W S

    2010-07-01

    This paper investigates whether education buffers the impact of physical disability on psychological distress. It further investigates what makes education helpful, by examining whether cognitive ability and occupational class can explain the buffering effect of education. Two waves of the 1958 British National Child Development Study are used to test the hypothesis that the onset of a physical disability in early adulthood (age 23 to 33) has a smaller effect on psychological distress among higher educated people. In total 423 respondents (4.6%) experienced the onset of a physical disability between the ages of 23 and 33. We find that a higher educational level cushions the psychology impact of disability. Cognitive ability and occupational class protect against the effect of a disability too. The education buffer arises in part because individuals with a higher level of education have more cognitive abilities, but the better social position of those with higher levels of education appears to be of greater importance. Implications of these findings for the social gradient in health are discussed. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Management of respiratory distress syndrome: an update.

    PubMed

    Rodriguez, Ricardo J

    2003-03-01

    Respiratory distress syndrome is the most common respiratory disorder in preterm infants. Over the last decade, because of improvements in neonatal care and increased use of antenatal steroids and surfactant replacement therapy, mortality from respiratory distress syndrome has dropped substantially. However, respiratory morbidity, primarily bronchopulmonary dysplasia, remains unacceptably high. The management of respiratory distress syndrome in preterm infants is based on various modalities of respiratory support and the application of fundamental principles of neonatal care. To obtain best results, a multidisciplinary approach is crucial. This review discusses surfactant replacement therapy and some of the current strategies in ventilatory management of preterm infants with respiratory distress syndrome. Copyright 2003 Daedalus Enterprises

  2. Influences of face, stigma, and psychological symptoms on help-seeking attitudes in Macao.

    PubMed

    Cheang, Sut Ieng; Davis, J Mark

    2014-09-01

    The purpose of this study was to examine the relationships between concerns about loss of face, stigma, psychological symptoms, and attitudes toward seeking mental health services such as counseling in Macao. Participants included 391 students attending the largest public university in Macao: 277 were from Macao and 114 were from Mainland China. Participants completed questionnaires measuring attitudes toward seeking professional psychological help, concerns about loss of face, self-stigma, public-stigma, and psychological symptoms. Results showed that positive attitudes toward help-seeking were significantly negatively correlated with self-stigma, public-stigma, and concerns about loss of face but there was no significant correlation with psychological symptoms. Psychological symptoms were positively correlated with face concerns, self-stigma, and public-stigma. Stigma (self and public) was found to be significantly positively associated with face concerns, but the correlations were weak. Findings also showed that Macao students had higher levels of distress, and endorsed greater self- and public-stigma than Mainland Chinese students; however, the groups did not differ in face concerns or attitudes toward help-seeking. Regression analysis indicated that group membership was not a significant predictor of help-seeking. Self-stigma was the strongest predictor of professional help-seeking. Age and sex were also found to be significant predictors. Results suggested that younger students were more likely to seek help and that female students reported greater levels of distress and tended to have more positive attitudes toward seeking psychological services than male students. © 2014 The Institute of Psychology, Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

  3. Predictors of Psychological Distress among Infertility Clinic Patients.

    ERIC Educational Resources Information Center

    Morrow, Kelly A.; And Others

    1995-01-01

    Investigated predictors of psychological distress among infertility clinic patients. Analyses indicated that infertile men and women reported greater psychological distress than the general population. Self-blame and avoidance coping significantly predicted psychological distress among men and women. Increased age and childlessness added to…

  4. Early Childhood Adversity and its Associations With Anxiety, Depression, and Distress in Women With Breast Cancer.

    PubMed

    McFarland, Daniel C; Andreotti, Charissa; Harris, Kirk; Mandeli, John; Tiersten, Amy; Holland, Jimmie

    2016-01-01

    Certain vulnerability factors have been found to place patients at risk for depression and anxiety, especially within the context of medical illness. We sought to describe the relationships among early childhood adversity (ECA) and anxiety, depression and distress in patients with breast cancer. Patients with breast cancer (stages 0-IV) were assessed for ECA (i.e., the Risky Families Questionnaire subscales include Abuse/Neglect/Chaotic Home Environment), distress (i.e., Distress Thermometer and Problem List), anxiety (Hospital Anxiety and Depression Scale-Anxiety), depression (Hospital Anxiety and Depression Scale-Depression), meeting standardized cut-off thresholds for distress (Distress Thermometer and Problem List ≥4 or ≥7)/anxiety (Hospital Anxiety and Depression Scale-Anxiety ≥8)/depression (Hospital Anxiety and Depression Scale-Depression ≥8) and demographic factors. A total of 125 participants completed the study (78% response rate). ECA was associated with depression (p <0.001), anxiety (p = 0.001), and distress (p = 0.006), meeting cut-off threshold criteria for distress (p = 0.024), anxiety (p = 0.048), and depression (p = 0.001). On multivariate analysis, only depression (p = 0.04) and emotional issues (i.e., component of Distress Thermometer and Problem List) (p = 0.001) were associated with ECA. Neglect, but not Abuse and Chaotic Home Environment, was associated with depression (β = 0.442, p < 0.001), anxiety (β = 0.342, p = 0.002), and self-identified problems with family (β = 0.288, p = 0.022), emotion (β = 0.345, p = 0.004), and physical issues (β = 0.408, p < 0.001). ECA and neglect are associated with multiple psychologic symptoms, but most specifically depression in the setting of breast cancer. ECA contributes to psychologic burden as a vulnerability factor. ECA may help to explain individual patient trajectories and influence the provision of patient-centered care for psychologic symptoms in patients with breast cancer. Copyright

  5. Longitudinal relationships between workplace bullying and psychological distress.

    PubMed

    Nielsen, Morten Birkeland; Hetland, Jørn; Matthiesen, Stig Berge; Einarsen, Ståle

    2012-01-01

    The aims of this study were to examine reciprocal longitudinal associations between exposure to workplace bullying and symptoms of psychological distress and to investigate how self-labeled victimization from bullying explains the effects of bullying on health. Logistic regression analysis was employed to examine the longitudinal relationships between workplace bullying and psychological distress in a representative cohort sample of 1775 Norwegian employees. The time-lag between baseline and follow-up was two years. Exposure to bullying behavior was measured with the revised version of the Negative Acts Questionnaire. Perceived victimization from bullying was measured by a single self-labeling question. Psychological distress was measured with the 25-item Hopkins Symptom Checklist. All variables were measured at both baseline and follow-up. After adjustment for psychological distress at baseline, exposure to bullying behavior [odds ratio (OR) 1.68, 95% confidence interval (95% CI) 1.07-2.62) was found to predict subsequent psychological distress. This effect of bullying behaviors disappeared when victimization from bullying (OR 2.47, 95% CI 1.17-5.22) was entered into the regression. Both psychological distress (OR 2.49, 95% CI 1.64-3.80) and victimization (OR 2.61, 95% CI 1.42-4.81) at baseline were associated with increased risks of being a target of bullying behaviors at follow-up. Psychological distress (OR 2.51, 95% CI 1.39-4.52) and bullying behaviors (OR 2.95, 95% CI 1.39-4.52) at follow-up were associated with victimization. The mutual relationship between bullying and psychological distress indicates a vicious circle where bullying and distress reinforce their own negative effects. This highlights the importance of early interventions to stop workplace bullying and provide treatment options to employees with psychological distress.

  6. Spiritual well-being and moral distress among Iranian nurses.

    PubMed

    Soleimani, Mohammad Ali; Sharif, Saeed Pahlevan; Yaghoobzadeh, Ameneh; Sheikhi, Mohammad Reza; Panarello, Bianca; Win, Ma Thin Mar

    2016-06-16

    Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and

  7. A longitudinal study of psychological distress and exposure to trauma reminders after terrorism.

    PubMed

    Glad, Kristin A; Hafstad, Gertrud S; Jensen, Tine K; Dyb, Grete

    2017-08-01

    The aim of this study was threefold: (1) to examine the type and frequency of trauma reminders reported by survivors 2.5 years after a terrorist attack; (2) to examine whether frequency of exposure to trauma reminders is associated with psychological distress and level of functioning; and (3) to compare the worst trauma reminders reported by the same survivors at 2 different time points. Participants were 261 survivors (52.1% male; Mage = 22.1 years, SD = 4.76) of the 2011 massacre on Utøya Island, Norway, who were interviewed face-to-face 14-15 and 30-32 months postterror. Participants were asked how often they had experienced various trauma reminders in the past month, which reminder was the worst, and how distressing it was. Current posttraumatic reactions were measured using the University of California at Los Angeles PTSD Reaction Index and an 8-item version of the Hopkins Symptom Checklist-25. Auditory reminders were most frequently encountered and the most distressing. Frequency of exposure to trauma reminders was positively correlated with symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, as well as negatively correlated with level of functioning, over time. Almost 20% of the survivors reported being very distressed by their worst reminder 2.5 years postterror. Less than half reported the same worst reminder at both time points. Trauma reminders, especially auditory reminders, are prevalent and distressing for years after a terrorist attack. Exposure to reminders may be important not only in the development and maintenance of PTSD but also in a broader conceptualization of posttraumatic reactions and functioning. Which reminder survivors appraise as the worst may fluctuate over time. It is important to help survivors identify and cope with reminders. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Psychological distress screening in cancer patients: psychometric properties of tools available in Italy.

    PubMed

    Muzzatti, Barbara; Annunziata, Maria Antonietta

    2012-01-01

    The main national and international organisms recommend continuous monitoring of psychological distress in cancer patients throughout the disease trajectory. The reasons for this concern are the high prevalence of psychological distress in cancer patients and its association with a worse quality of life, poor adherence to treatment, and stronger assistance needs. Most screening tools for psychological distress were developed in English-speaking countries. To be fit for use in different cultural contexts (like the Italian), they need to undergo accurate translation and specific validation. In the present work we summarized the validation studies for psychological distress screening tools available in Italian that are most widely employed internationally, with the aim of helping clinicians choose the adequate instrument. With knowledge of the properties of the corresponding Italian versions, researchers would be better able to identify the instruments that deserve further investigation. We carried out a systematic review of the literature. Results. Twenty-nine studies of eight different instruments (five relating to psychological distress, three to its depressive component) were identified. Ten of these studies involved cancer patients and 19 referred to the general population or to non-cancer, non-psychiatric subjects. For seven of the eight tools, data on concurrent and discriminant validity were available. For five instruments data on criterion validity were available, for four there were data on construct validity, and for one tool divergent and cross-cultural validity data were provided. For six of the eight tools the literature provided data on reliability (mostly about internal consistency). Since none of the eight instruments for which we found validation studies relative to the Italian context had undergone a complete and organic validation process, their use in the clinical context must be cautious. Italian researchers should be proactive and make a valid

  9. Aerophagia in a toddler with gastric pull-up: an unusual combination precipitating severe respiratory distress.

    PubMed

    Gyanesh, Prakhar; Rastogi, Amit

    2012-12-01

    Aerophagia is a common disorder in adults as well as children, which often goes unnoticed. In toddlers, it may lead to acute gastric dilatation, which, if severe enough, may lead to respiratory distress. We hereby report case of a child who had successfully undergone gastric pull-up approximately 18 months before and presented with gradually progressing dyspnea due to aerophagia from excessive crying. Expedient diagnosis from history, examination and x-ray study, and simple treatment by passage of feeding tube and gastric decompression relieved the distress and helped us overcome the acute crisis. Literature search revealed few cases of aerophagia after dissociative anesthesia. Management of aerophagia in children is discussed, and the importance of proper clinical diagnosis to prevent unnecessary interventions in an emergency scenario is highlighted.

  10. Using a personality inventory to identify risk of distress and burnout among early stage medical students.

    PubMed

    Bughi, Stephanie A; Lie, Desiree A; Zia, Stephanie K; Rosenthal, Jane

    2017-01-01

    Distress and burnout are common among medical students and negatively impact students' physical, mental, and emotional health. Personality inventories such as the Myers-Briggs Type Indicator (MBTI), used in medical education, may have a role in identifying burnout risk early. The authors conducted a cross-sectional survey study among 185 1st year medical students with the MBTI, the general well-being schedule (GWB), and Maslach Burnout Inventory-Student Survey (MBI-SS). Descriptive statistics and one-way MANOVAs were used to identify the prevalence and differences in MBTI preferences and distress/burnout risk. Response rate was 185/185 (100%). Distress (GWB) was reported by 84/185 (45.4%). High scores on exhaustion were reported by 118/182 (64.8%), cynicism by 76/182 (41.8%), and decreased professional efficacy by 38/182 (20.9%) for the three dimensions of the MBI-SS. Only 21/182 (11.5%) of respondents had high scores on all three dimensions of burnout. Students with MBTI preferences for extraversion reported greater positive well-being (P < 0.05), self-control (P < 0.05), professional efficacy (P < 0.01), and lower levels of depression (P < 0.01) compared with those with introversion preference. Distress and burnout are prevalent early in medical training. The significant difference between extraversion and introversion in relation to distress and burnout deserves further study. Use of a personality inventory may help identify students at risk of burnout and allow appropriate early stress management.

  11. Perceptions of friendship among youth with distressed friends.

    PubMed

    Hill, Erin N; Swenson, Lance P

    2014-02-01

    This cross-sectional study examined the relationship between a friend's level of internalizing distress and the focal child's perceptions of friendship amongst 5th, 8th, and 11th grade youth. Participants completed the Youth Self-Report to assess internalizing distress and measures assessing perceptions of friendship quality, social support, and self-disclosure within reciprocal, same-sex friendship dyads. Results indicated that youth with friends experiencing low levels of internalizing distress reported poorer friendship quality and decreased levels of social support and self-disclosure within the friendship compared to youth with friends experiencing average or high internalizing distress. In a second set of analyses controlling for the focal child's own internalizing symptoms, gender, and age, friend's level of internalizing distress remained a significant, unique predictor of target participants' self-disclosure about their own problems within the friendship. The findings suggest that a mild degree of internalizing distress may enhance, rather than harm, friendships amongst youth.

  12. Factors associated with financial distress of nonprofit hospitals.

    PubMed

    Kim, Tae Hyun

    2010-01-01

    Financial distress can have a detrimental influence on the performance of hospitals. Hospital management needs to monitor potential financial distress effectively and know how it will respond depending on the severity of the circumstances. This study examined the multiple factors that may explain the financial distress of nonprofit hospitals during 1998 to 2001 and discussed their importance. To obtain more robust results, financial distress was assessed in 2 ways: first, financial strength index was used to incorporate 4 financial dimensions including profitability, liquidity, leverage, and physical facilities; second, cash flow (CF) was used to address the issues of accrual-based accounting in hospitals. This study finds that decrease in occupancy rate and increase in Medicaid payer mix, health maintenance organization penetration, market competition, physician supply, and percentage of the elderly are associated with increased likelihood of financial distress of urban hospitals. Increases in both Medicare and Medicaid payer mix, however, are related to higher likelihood of financial distress of rural hospitals.

  13. Analysis and evaluation of the moral distress theory.

    PubMed

    Wilson, Melissa A

    2018-04-01

    Moral distress is a pervasive problem in nursing resulting in a detriment to patient care, providers, and organizations. Over a decade ago, the moral distress theory (MDT) was proposed and utilized in multiple research studies. This middle range theory explains and predicts the distress that occurs in a nurse because of moral conflict. The research findings born from this theory have been substantial. Since inception of this theory, moral distress has been extensively examined which has further elaborated its understanding. This paper provides an analysis and evaluation of the MDT according to applicable guidelines. Current understanding of the phenomenon indicates that a new theory may be warranted to better predict, treat, and manage moral distress. © 2017 Wiley Periodicals, Inc.

  14. A longitudinal examination of dyadic distress patterns following a skills intervention for carers of adolescents with anorexia nervosa.

    PubMed

    Salerno, Laura; Rhind, Charlotte; Hibbs, Rebecca; Micali, Nadia; Schmidt, Ulrike; Gowers, Simon; Macdonald, Pamela; Goddard, Elizabeth; Todd, Gillian; Tchanturia, Kate; Lo Coco, Gianluca; Treasure, Janet

    2016-12-01

    Family interventions in anorexia nervosa (AN) have been developed to ameliorate maladaptive patterns of patient-carer interaction that can play a role in illness maintenance. The primary aim of this study is to examine the inter-relationship between baseline and post-treatment distress in dyads of carers and patients with AN to examine the interdependence between carers and patients. The secondary aim is to examine whether a carer skills intervention [Experienced Carer Helping Others (ECHO)] impacts on this inter-relationship. Dyads consisting of treatment-seeking adolescents with AN and their primary carer (n = 149; mostly mothers) were randomised to receive a carer skills intervention (ECHO) in addition to treatment as usual (TAU), or TAU alone, as part of a larger clinical trial. Carers and patients completed a standardised measure of psychological distress (The Depression, Anxiety, and Stress Scale) at baseline and 12 months post-treatment. The Actor Partner Interdependence Model was used to examine longitudinal changes in interdependence by treatment group. As expected, post-treatment levels of distress were related to baseline levels in both groups (actor effects). Moreover, carer distress at 12 months was related to patient distress at baseline for the TAU (partner effects), but not for the ECHO group. Finally, carers' distress change was not a significant predictor of patients' body mass index (BMI) change in the two treatment conditions. These findings are limited to predominantly mother-offspring dyads and may not generalise to other relationships. The ECHO intervention which is designed to teach carers skills in illness management and emotion regulation may be an effective addition to TAU for ameliorating interdependence of distress in patients and their primary carers over time.

  15. 33 CFR 175.130 - Visual distress signals accepted.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

  16. 33 CFR 175.130 - Visual distress signals accepted.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

  17. 33 CFR 175.130 - Visual distress signals accepted.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

  18. Conflict in Maritally Distressed Military Couples.

    ERIC Educational Resources Information Center

    Griffin, William A.; Morgan, Allison R.

    1988-01-01

    Investigated whether 30 maritally distressed military couples differed from 30 distressed civilian couples using marital satisfaction questionnaires. Found same-sex differences across groups, and cross-sex differences within groups. Found military wives were more likely to be physically abused than were civilian wives, and more often requested…

  19. 33 CFR 175.110 - Visual distress signals required.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

  20. 46 CFR 25.25-19 - Visual distress signals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

  1. 46 CFR 25.25-19 - Visual distress signals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

  2. 46 CFR 25.25-19 - Visual distress signals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

  3. 46 CFR 25.25-19 - Visual distress signals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. [USCG-1999...

  4. 33 CFR 175.110 - Visual distress signals required.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

  5. 33 CFR 175.110 - Visual distress signals required.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

  6. 33 CFR 175.110 - Visual distress signals required.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

  7. Psychological distress in the active duty military spine patient.

    PubMed

    Brooks, D Ethan; Agochukwu, Uzondu F; Arrington, Edward D; Mok, James M

    2013-10-01

    Disorders of the spine are a substantial burden to the military health care system that degrades readiness in the overall force. Because treatment outcomes are affected by psychosocial factors, assessment of psychological distress is important for patients with spine complaints. The incidence of psychological distress in the unique military population is not well described. The purpose of this retrospective case-control study was to determine the rate of psychological distress and identify associated patient characteristics among many variables collected in the military health system. A consecutive cohort of active duty service members presenting to a spine specialty clinic was assessed as Normal, At Risk, or Distressed using the Distress and Risk Assessment Method. Of 74 active duty patients (63 male, 11 female), 43 (58%) had some level of psychological distress: 29 (39%) At Risk, 12 (16%) Distressed-Depressive, and 2 (3%) Distressed-Somatic. Multivariate regression analysis identified female gender (odds ratio [OR] 7.90), higher disability as measured by Oswestry Disability Index/Neck Disability Index (OR 8.0 per 13.8 point increase), and assignment to a Warrior Transition Unit or Medical Evaluation Board (OR 7.35) as statistically significant variables. The results indicate that active duty patients are subject to similarly high levels of psychological distress as their civilian counterparts. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  8. Public involvement in suicide prevention: understanding and strengthening lay responses to distress.

    PubMed

    Owens, Christabel; Owen, Gareth; Lambert, Helen; Donovan, Jenny; Belam, Judith; Rapport, Frances; Lloyd, Keith

    2009-08-23

    The slogan "Suicide prevention is everyone's business" has been used in a number of campaigns worldwide in recent years, but most research into suicide prevention has focused on the role of medical professionals in identifying and managing risk. Little consideration has been given to the role that lay people can play in suicide prevention, or to the resources they need in order to do so.The majority of people who take their own lives are not under the care of specialist mental health services, and around half have not had recent contact with their general practitioner. These individuals are not known to be 'at risk' and there is little or no opportunity for clinical intervention. Family members and friends may be the only ones to know that a person is troubled or distressed, and their capacity to recognise, assess and respond to that distress is therefore vitally important. This study aims to discover what the suicidal process looks like from the point of view of relatives and friends and to gain insight into the complex and difficult judgements that people have to make when trying to support a distressed individual. The study uses qualitative methods to build up a detailed picture of 15-20 completed suicides, aged 18-34. Data are gathered by means of in-depth interviews with relatives, friends and others who knew the deceased well. In each case, as many informants as possible are sought using a purposive snowballing technique. Interviews focus on the family and social network of the deceased, the ways in which relatives and friends interpreted and responded to his/her distress, the potential for intervention that may have existed within the lay network and the knowledge, skills and other resources that would have helped members to support the distressed individual more effectively. The study will inform interventions to promote public mental health awareness and will provide a basis on which to develop community-focussed suicide prevention strategies.

  9. Distress in patients with cancer: definition, assessment, and suggested interventions.

    PubMed

    Vitek, Leesa; Rosenzweig, Margaret Quinn; Stollings, Susan

    2007-06-01

    Distress in patients with cancer impacts their quality of life. The National Comprehensive Cancer Network (NCCN) created a distress thermometer and a problem checklist to aid in recognizing distress. The thermometer measures distress on a 0-10 scale, and the problem checklist identifies more specific etiologies of distress, such as practical, spiritual, physical, emotional, and family problems. Oncology nurses play a key role in the success of the distress-screening tool because they have the most patient contact. The NCCN guidelines suggest that patients complete the screening tools at each visit and clinicians review the outcome. NCCN has provided clinical pathways for treating the etiologies of distress using a multidisciplinary approach, including members from social work, pastoral services, mental health, and oncology.

  10. 33 CFR 83.37 - Distress signals (Rule 37).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

  11. 33 CFR 83.37 - Distress signals (Rule 37).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

  12. 33 CFR 83.37 - Distress signals (Rule 37).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

  13. 33 CFR 83.37 - Distress signals (Rule 37).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

  14. 33 CFR 83.37 - Distress signals (Rule 37).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

  15. Psychological distress in an incarcerated juvenile population.

    PubMed

    Lyu, Shu-Yu; Chi, Ying-Chen; Farabee, David; Tsai, Liang-Ting; Lee, Ming-Been; Lo, Feng-En; Morisky, Donald E

    2015-11-01

    This study sought to examine the prevalence and correlates of psychological distress among incarcerated youth in Taiwan using the 5-item Brief Symptom Rating Scale (BSRS-5). This cross-sectional census survey study was conducted in 2007 among all the juveniles incarcerated in 23 correctional institutions (n = 1505) in Taiwan using a self-administered anonymous questionnaire. Of the total 1505 participants, 1363 completed the questionnaire (91% response rate). We excluded 494 participants as they were aged either over 17 years or under 12 years. Psychological distress was measured among the final 869 participants using the BSRS-5. Psychological distress was defined as a total score of at least 6 out of 20. Those identified as having psychological distress were then pooled into a case group and compared with control participants without psychological distress. The prevalence of psychological distress was 44.1%. Among the case group, sleep disturbance (36.8%) had the highest prevalence of severe or very severe symptoms, followed by depression (34.7%), and hostility (27.9%). Multivariate logistic regression analysis revealed that correlates of psychological distress included the following: being female; having a poor self-rated health status; having joined a gang; having experienced life disturbances prior to the current imprisonment; and having ever had a smoking habit. Significant sex differences were found for both the overall BSRS-5, as well as for each individual item of the BSRS-5. Treatment programs and interventions should be carefully tailored to address the mental health needs of juvenile inmates in a sex-specific manner using a multifaceted approach. Copyright © 2014. Published by Elsevier B.V.

  16. Psychological distress through immigration: the two-phase temporal pattern?

    PubMed

    Ritsner, M; Ponizovsky, A

    1999-01-01

    A large community sample, cross-sectional and in part longitudinal design, and comparison groups was used to determine the timing of psychological distress among immigrants. A total of 2,378 adult immigrants from the former Soviet Union to Israel completed the self-administered questionnaire Talbieh Brief Distress Inventory. The aggregate levels of distress and six psychological symptoms--obsessiveness, hostility, interpersonal sensitivity, depression, anxiety, and paranoid ideation--were compared at 20 intervals covering 1 to 60 months after resettlement. The level of psychological distress was significantly higher in the immigrants than that of Israeli natives but not in the potential immigrant controls. A two-phase temporal pattern of development of psychological distress was revealed consisting of escalation and reduction phases. The escalation phase was characterized by an increase in distress levels until the 27th month after arrival (a peak) and the reduction phase led to a decline returning to normal levels. The 1-month prevalence rate was 15.6% for the total sample, and for highly distressed subjects it reached 24% at the 27th month after arrival, and it declined to 4% at the 44th month. The time pattern of distress shared males and females, married and divorced/widowed (but not singles), as well as subjects of all age groups (except for immigrants in their forties). The two-phase pattern of distress obtained according to cross-sectional data was indirectly confirmed through a longitudinal way. Claims of early euphoric or distress-free period followed by mental health crisis frequently referred to in the literature on migration was not supported by this study.

  17. Psychological distress in women who have experienced intrauterine insemination.

    PubMed

    Lin, Jia-Ling; Lin, Ya-Hui; Chueh, Ke-Hsin

    2012-12-01

    Despite evidence that psychological distress manifests itself in underreported and atypical ways, few studies have assessed these symptoms in women who have experienced intrauterine insemination (IUI). The aim of this study was to examine the prevalence of psychological distress and explore the relationships among psychological distress, various demographic characteristics, and somatic symptoms in women who had received IUI treatment in Taiwan. A cross-sectional study design was used in this study. The 117 participants were recruited from a teaching hospital in northern Taiwan. The brief symptom rating scale (BSRS-5) was used as the measurement instrument, and scores of more than 5 on the BSRS-5 were used to mark the boundary between milder and more severe psychological distress. Demographic characteristics and somatic symptoms of IUI that contributed most significantly to psychological distress were identified from the data. Thirty-eight (32.5%) participants experienced psychological distress. Psychological distress was most common in participants (a) with husbands who were an only son, (b) who had taken medication during the previous week, (c) with an education level below college or university, and (d) who reported feeling faint. The factors studied are important to understand psychological distress in women who have undergone IUI treatment.

  18. Hearts and minds: Agency and discourse on distress.

    PubMed

    Kemp, Martin

    2003-01-01

    This paper is based on ethnographic fieldwork in south Bristol, United Kingdom, and on the south Atlantic island of St Helena. It addresses the relationship between the experience of psychosocial distress, the language used to express such distress and the socio-cultural constraints on both language and experience. Accounts of emotional distress were obtained from interviews with 36 informants in south Bristol and with 40 informants on St Helena. Informants in both settings shared a Euro-American discourse on the self in which emotional distress is conceived as a breakdown in human agency. This discourse is linked to narrative as a way of depicting and re-affirming individual agency. A prototypical concept of narrative is used in this paper to interpret accounts of emotional distress. This interpretation demonstrates the usefulness of the idea of narrative for understanding such experiences.

  19. Emotional Distress, Bullying Victimization, and Protective Factors Among Transgender and Gender Diverse Adolescents in City, Suburban, Town, and Rural Locations.

    PubMed

    Eisenberg, Marla E; Gower, Amy L; McMorris, Barbara J; Rider, G Nicole; Coleman, Eli

    2018-06-25

    Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protective factors among TGD high school students in city, suburban, town, and rural locations. Data come from a statewide school-based survey conducted in Minnesota in 2016 (n = 2,168 TGD youth). Analysis of covariance models were used to predict the prevalence of multiple indicators of emotional distress, bullying victimization, and protective factors across the 4 location categories, with multiple adjustments. Significant linear trends were observed for 2 emotional distress outcomes and 2 bullying victimization outcomes, with urban TGD students having the lowest rates and rural having the highest prevalences. Additional significant differences in emotional distress were noted, with unexpectedly high rates of depressive symptoms and suicidal ideation among suburban students. Helping TGD adolescents in all types of locations identify resources and supportive professionals is critical to supporting this population. © 2018 National Rural Health Association.

  20. A pavement Moisture Accelerated Distress (MAD) identification system, volume 2

    NASA Astrophysics Data System (ADS)

    Carpenter, S. H.; Darter, M. I.; Dempsey, B. J.

    1981-09-01

    A users manual is designed which provides the engineer with a rational method of examining a pavement and determining rehabilitation needs that are related to the causes of the existing distress, particularly moisture related distress. The key elements in this procedure are the MAD Index developed in Volume 1, the Pavement Condition Index (PCI) and the Moisture Distress Index (MDI). Step by step procedures are presented for calculating each parameter. Complete distress identification manuals are included for asphalt surfaced highways and jointed reinforced concrete highways with pictures and descriptions of all major distress types. Descriptions of the role moisture plays in the development of each distress type are included.

  1. Reducing children's pain and distress towards flu vaccinations: a novel and effective application of humanoid robotics.

    PubMed

    Beran, Tanya N; Ramirez-Serrano, Alex; Vanderkooi, Otto G; Kuhn, Susan

    2013-06-07

    Millions of children in North America receive an annual flu vaccination, many of whom are at risk of experiencing severe distress. Millions of children also use technologically advanced devices such as computers and cell phones. Based on this familiarity, we introduced another sophisticated device - a humanoid robot - to interact with children during their vaccination. We hypothesized that these children would experience less pain and distress than children who did not have this interaction. This was a randomized controlled study in which 57 children (30 male; age, mean±SD: 6.87±1.34 years) were randomly assigned to a vaccination session with a nurse who used standard administration procedures, or with a robot who was programmed to use cognitive-behavioral strategies with them while a nurse administered the vaccination. Measures of pain and distress were completed by children, parents, nurses, and researchers. Multivariate analyses of variance indicated that interaction with a robot during flu vaccination resulted in significantly less pain and distress in children according to parent, child, nurse, and researcher ratings with effect sizes in the moderate to high range (Cohen's d=0.49-0.90). This is the first study to examine the effectiveness of child-robot interaction for reducing children's pain and distress during a medical procedure. All measures of reduction were significant. These findings suggest that further research on robotics at the bedside is warranted to determine how they can effectively help children manage painful medical procedures. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  2. 46 CFR 28.145 - Distress signals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... day and night requirement. [CGD 88-079, 56 FR 40393, Aug. 14, 1991, as amended at 60 FR 48048, Sept... Great Lakes; or within 3 miles of the coastline on the Great Lakes Night visual distress signals consisting of one electric distress light, approval series 161.013 or 3 approved flares; plus Day visual...

  3. Predicting Financial Distress and Closure in Rural Hospitals.

    PubMed

    Holmes, George M; Kaufman, Brystana G; Pink, George H

    2017-06-01

    Annual rates of rural hospital closure have been increasing since 2010, and hospitals that close have poor financial performance relative to those that remain open. This study develops and validates a latent index of financial distress to forecast the probability of financial distress and closure within 2 years for rural hospitals. Hospital and community characteristics are used to predict the risk of financial distress 2 years in the future. Financial and community data were drawn for 2,466 rural hospitals from 2000 through 2013. We tested and validated a model predicting a latent index of financial distress (FDI), measured by unprofitability, equity decline, insolvency, and closure. Using the predicted FDI score, hospitals are assigned to high, medium-high, medium-low, and low risk of financial distress for use by practitioners. The FDI forecasts 8.01% of rural hospitals to be at high risk of financial distress in 2015, 16.3% as mid-high, 46.8% as mid-low, and 28.9% as low risk. The rate of closure for hospitals in the high-risk category is 4 times the rate in the mid-high category and 28 times that in the mid-low category. The ability of the FDI to discriminate hospitals experiencing financial distress is supported by a c-statistic of .74 in a validation sample. This methodology offers improved specificity and predictive power relative to existing measures of financial distress applied to rural hospitals. This risk assessment tool may inform programs at the federal, state, and local levels that provide funding or support to rural hospitals. © 2016 National Rural Health Association.

  4. 'I know they are distressed. What do I do now?'.

    PubMed

    Moorey, Stirling

    2013-09-01

    Significant advances have been made in our understanding of psychological adjustment to cancer over the last 40 years. Most clinicians now recognise the importance of psychosocial factors and the need for skills in emotional support. In the first phase of psycho-oncology, pioneering work in the 1970s and 1980s mapped the extent of psychological morbidity in cancer. This has been followed by a second phase where clinical trials have demonstrated that psychological treatments are effective. But although clinicians may feel more confident in identifying distress and listening to the patient, they rarely feel confident that they possess the skills to help. This paper will review the progress through the first two phases and argue that we are now in the third phase where we can begin to examine methods for delivering cost-effective psychological care. One of these methods is to equip staff with basic skills to understand and manage psychological distress. This paper will also describe a programme over the last 10 years to evaluate the effectiveness and clinical impact of such training for palliative care professionals. Copyright © 2013 John Wiley & Sons, Ltd.

  5. Telephone Crisis Support Workers' Psychological Distress and Impairment.

    PubMed

    Kitchingman, Taneile A; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

    2018-01-01

    In order to respond to crises with appropriate intervention, crisis workers are required to manage their own needs as well as the needs of those they respond to. A systematic review of the literature was conducted to examine whether telephone crisis support workers experience elevated symptoms of psychological distress and are impaired by elevated symptoms. Studies were identified in April 2015 by searching three databases, conducting a gray literature search, and forward and backward citation chaining. Of 113 identified studies, seven were included in the review. Results suggest that that telephone crisis support workers experience symptoms of vicarious traumatization, stress, burnout, and psychiatric disorders, and that they may not respond optimally to callers when experiencing elevated symptoms of distress. However, definitive conclusions cannot be drawn due to the paucity and methodological limitations of available data. While the most comprehensive search strategy possible was adopted, resource constraints meant that conference abstracts were not searched and authors were not contacted for additional unpublished information. There is an urgent need to identify the impact of telephone crisis support workers' role on their well-being, the determinants of worker well-being in the telephone crisis support context, and the extent to which well-being impacts their performance and caller outcomes. This will help inform strategies to optimize telephone crisis support workers' well-being and their delivery of support to callers.

  6. Resilience, loneliness, and psychological distress among homeless youth.

    PubMed

    Perron, Jeff L; Cleverley, Kristin; Kidd, Sean A

    2014-08-01

    Extant quantitative research on loneliness among homeless youth has grouped loneliness with other elements of psychological distress. The current study seeks to determine if loneliness has a different relationship with resilience than does psychological distress among street youth. Using data from 47 participants, linear regression was conducted. Results indicate that homeless youth experiencing higher psychological distress reported lower resilience scores. However, levels of resilience are not significantly associated with feelings of loneliness when psychological distress was accounted for. This study has implications for how researchers and clinicians conceptualize and address feelings of loneliness among homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Association between weight perception and psychological distress.

    PubMed

    Atlantis, E; Ball, K

    2008-04-01

    Obesity is a well-known cause of cardiovascular disease burden and premature death, but effects on depressive symptoms remain equivocal. Depressive symptoms may be more common among the obese individuals who perceive themselves as overweight, rather than those who perceive themselves as having an acceptable weight. Our aim was to determine whether weight status and weight perceptions are independently associated with psychological distress. We conducted a cross-sectional study using data from the Australian National Health Survey 2004-2005 (N=17 253). All variables were collected by self-report. Adjusted multinomial logistic regression analysis was conducted to generate prevalence odds ratios with 95% confidence intervals (95% CI) for medium (Kessler Psychological Distress Scale (K10) scores of 20-29) and high (K10 scores of 30-50) psychological distress (compared with K10 scores of 10-19 as the reference) associated with weight status (standard body mass index (BMI) cutoffs for underweight, overweight and obesity vs normal weight), weight perception (perceived underweight and overweight vs acceptable weight) and weight misperception (incorrect with BMI vs correct with BMI) adjusting for numerous important covariates. Overweight and underweight perception increased the odds of medium (40 and 50%) and high (50 and 120%) psychological distress, whereas weight status and weight misperception were not associated with psychological distress in adjusted analysis. Gender, alcohol consumed per week and post-school education were not significant covariates (at P<0.10 level). Overweight and underweight perception rather than weight status or weight misperception are significant risk factors associated with medium and high psychological distress prevalence and effects appear to be uniform for men and women. Well-designed prospective studies are still needed to determine whether weight perceptions cause psychological distress, and if so, whether symptoms are significantly

  8. Distress and Coping Self-Efficacy in Inpatient Oncology Nurses.

    PubMed

    Wahlberg, Lara; Nirenberg, Anita; Capezuti, Elizabeth

    2016-11-01

    To examine distress and coping self-efficacy in inpatient oncology nurses. 
. Cross-sectional survey design.
. Oncology Nursing Society (ONS) chapter meetings and Hunter-Bellevue School of Nursing, both in New York, New York, as well as social media.
. 163 oncology nurses who work with an inpatient adult population.
. Participants were recruited through the ONS New York, New York, area chapter meetings, Hunter College, and ONS Facebook pages. An adapted Nurse Distress Thermometer (NDT) measured distress levels. The Occupational Coping Self-Efficacy Questionnaire for Nurses (OCSE-N) used a Likert-type scale to measure coping self-efficacy. Open-ended questions elicited additional perceptions of nurse respondents. 
. Descriptive statistics summarized sample demographics. A Pearson correlation between distress levels and coping self-efficacy scores was calculated. Low, normal, and high coping scores were compared to mean distress levels. 
. Survey participants showed high levels of distress, with a mean NDT score of 8.06. Those with higher coping self-efficacy scores reported less distress. A moderate, negative correlation was shown, with a statistically significant Pearson coefficient of -0.371. Responses to the open-ended questions revealed common stressors and pointed to solutions that institutions might implement to support nurses.
. Because coping self-efficacy related to lower distress levels in inpatient oncology nurses, institutional-level support for oncology nurses should be provided. 
. Interventions aimed at coping self-efficacy may prepare oncology nurses to cope better with their professional demands. Future research should explore how nurse distress affects patients.

  9. Moral distress and professional freedom of speech among doctors.

    PubMed

    Førde, Reidun; Aasland, Olaf Gjerløw

    2013-06-25

    Previous studies indicate that Norwegian doctors experience distress in their encounter with differing and partly contradictory ideals, such as the obligation to criticise unethical and inappropriate practices. The objective of this study was to investigate the perception of moral distress and professional freedom of speech among Norwegian doctors as of today, as well as identify changes that have occurred since the previous study undertaken in 2004. A total of 1,522 economically active doctors received a questionnaire listing various statements describing the perception of moral distress and professional freedom of speech. The responses were compared to responses to the 2004 study. Altogether 67% of the doctors responded to the questionnaire. The proportion who reported «fairly strong» or «strong» moral distress varied from 24% to 70% among the different statements. On the whole, the «rank and file» hospital doctors reported the highest degree of moral distress. Nevertheless, a decrease in the scores for moral distress could be observed from 2004 to 2010. During the same period, the perception of professional freedom of speech increased slightly. A reduced level of distress associated with ethical conflicts in working life may be due to improved methods for handling distressing situations, or because the consequences of the health services reorganisations are perceived as less threatening now than in 2004, immediately after the introduction of the hospital reform. However, the perceived lower distress level may also be due to professional and ethical resignation. These findings should be followed up by a qualitative study.

  10. Mental distress predicts divorce over 16 years: the HUNT study.

    PubMed

    Idstad, Mariann; Torvik, Fartein Ask; Borren, Ingrid; Rognmo, Kamilla; Røysamb, Espen; Tambs, Kristian

    2015-04-01

    The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce.

  11. Young Children Sympathize Less in Response to Unjustified Emotional Distress

    ERIC Educational Resources Information Center

    Hepach, Robert; Vaish, Amrisha; Tomasello, Michael

    2013-01-01

    Three-year-old children saw an adult displaying the exact same distress in 3 different conditions: (a) the adult's distress was appropriate to a genuine harm, (b) the adult's distress was an overreaction to a minor inconvenience, and (c) there was no apparent cause for the adult's distress. Children who witnessed the adult being appropriately…

  12. Mental Disorder, Psychological Distress, and Functional Status in Canadian Military Personnel.

    PubMed

    Sampasa-Kanyinga, Hugues; Zamorski, Mark A; Colman, Ian

    2018-01-01

    We examined the overlap between mood and anxiety disorders and psychological distress and their associations with functional status in Canadian Armed Forces (CAF) personnel. Data on Regular Forces personnel ( N = 6700) were derived from the 2013 Canadian Forces Mental Health Survey, a nationally representative survey of the CAF personnel. Current psychological distress was assessed using the Kessler K10 scale. Past-month mood and anxiety disorders were assessed using the World Health Organization World Mental Health Composite Diagnostic Interview. The prevalence of psychological distress was the same as that of any past-month mood or anxiety disorder (7.1% for each). A total of 3.8% had both distress and past-month mood or anxiety disorder, 3.3% had past-month disorder without psychological distress, while another 3.3% had psychological distress in the absence of a past-month mood or anxiety disorder. After adjusting for age, sex, marital, education, income, language, element, rank, and alcohol use disorder, individuals with both psychological distress and past-month mood and anxiety disorders exhibited the highest levels of disability, days out of role, and work absenteeism relative to those with neither mental disorders nor psychological distress. Relative to individuals with both disorder and distress, those who endured distress in the absence of mental disorder exhibited lower, but meaningful, levels of disability compared with those with neither disorder nor distress. Disability is most severe among CAF personnel with both distress and past-month mood and anxiety disorders. Nevertheless, distress in the absence of disorder is prevalent and is associated with meaningful levels of disability.

  13. Distress Intolerance during Smoking Cessation Treatment

    PubMed Central

    Farris, Samantha G.; Leyro, Teresa M.; Allan, Nicholas P.; Øverup, Camilla S.; Schmidt, Norman B.; Zvolensky, Michael J.

    2016-01-01

    Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N = 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence. PMID:27565398

  14. Caring for persons with schizophrenia at home:examining the link between family caregivers’ role distress and quality of life.

    PubMed

    Quah, Stella

    2014-05-01

    This article re-examines the link between role distress and quality of life of family caregivers of a loved one with schizophrenia by exploring the impact of role overload (defined as spending 7 or more hours daily looking after the care recipient). Role theory and symbolic interactionism provide the conceptual background to this study. The research question is: under what conditions does role distress reduce quality of life? The answer helps us identify circumstances under which caregivers may be able to carry out their stressful caregiving role while minimising a decline in their quality of life. The data are from a purposive sample of 47 family caregivers in Singapore who were interviewed in person using a semi-structured questionnaire. The data analysis includes non-parametric tests,exploratory factor analysis and relative risks estimates. The findings show that the inverse association between role distress and quality of life found in most studies of family caregivers changes when hours of care are taken into consideration.While role distress is found among all family caregivers it only reduces the family caregiver’s quality of life in situations of role overload. The implications for the situation of family caregivers are discussed.

  15. Resilience and Psychological Distress in Psychology and Medical Students.

    PubMed

    Bacchi, Stephen; Licinio, Julio

    2017-04-01

    The authors investigated levels of resilience and psychological distress in medical and psychology students, factors that may affect these levels, the relationship between resilience and psychological distress, and student opinion on causes of stress and possible interventions. A voluntary anonymous online survey was distributed to University of Adelaide medical and psychology students. Medical and psychology students (n = 560; response rate = 24.7%) had similar mean resilience and psychological distress scores, and 47.9% of medical students and 55.1% of psychology students were psychologically distressed. Higher levels of resilience were associated with lower levels of distress (p < 0.001). Students supported resilience-based interventions, greater financial support, clearer learning objectives and more continuous assessment as potential means to reduce the effects of stress. Higher levels of resilience were associated with lower levels of psychological distress. Further studies are required to determine the efficacy of resilience-based interventions in these groups.

  16. Ethical conflicts and moral distress experienced by paediatric residents during their training

    PubMed Central

    Hilliard, RI; Harrison, C; Madden, S

    2007-01-01

    significant ethical conflicts and moral distress. Understanding these ethical issues will help those responsible for postgraduate medical education to review or revise the ethics curriculum in keeping with the current moral distress experienced by residents, and help to mentor and guide trainees. PMID:19030336

  17. Secondary Traumatic Stress and Burnout in Child Welfare Workers: A Comparative Analysis of Occupational Distress across Professional Groups

    ERIC Educational Resources Information Center

    Sprang, Ginny; Craig, Carlton; Clark, James

    2011-01-01

    This study describes predictors of secondary traumatic stress and burnout in a national sample of helping professionals, with a specific focus on the unique responses of child welfare (CW) workers. Specific worker and exposure characteristics are examined as possible predictors of these forms of occupational distress in a sample of 669…

  18. The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement.

    PubMed

    Deno, Minako; Tashiro, Mie; Miyashita, Mitsunori; Asakage, Takahiro; Takahashi, Koji; Saito, Kenich; Busujima, Yasunobu; Mori, Yoshiyuki; Saito, Hiroto; Ichikawa, Yuji

    2012-02-01

    Although social support has been recognized as an important factor in the quality of life of head and neck cancer patients, there has been little investigation of the buffering effect of social support on these patients' social distress or of the coping skill of self-efficacy. The aim of this study was to examine how social support and self-efficacy mediate the relationship between social distress and emotional distress in head and neck cancer patients. Two hundred twenty-five head and neck cancer patients completed our questionnaire (effective response rate, 92.2%). Of these, 129 (57.3%) had facial disfigurement. These participants responded to questions about perception of social distress, social support, self-efficacy, and emotional distress (depression and anxiety). We used structural equation modeling for statistical analysis. The fit indices of this model were excellent (χ2 (7) = 9.147, p = 0.242, goodness of fit index (GFI) = 0.981, adjusted goodness of fit index (AGFI) = 0.922, comparative fit index (CFI) = 0.993, root mean square error of approximation (RMSEA) = 0.049). Self-efficacy strongly buffered the negative influence of social distress on emotional distress. Social support from family members did not have a direct or indirect influence on emotional distress. Social support from friends was related to lower social distress and higher emotional distress. Our findings suggest that self-efficacy might confound the relationship between social support and emotional distress, and that different sources of social support might play different roles in the mediation of social distress on emotional distress. Copyright © 2010 John Wiley & Sons, Ltd.

  19. Exploring Sources of Emotional Distress among People Living with Scleroderma: A Focus Group Study

    PubMed Central

    Gumuchian, Stephanie T.; Peláez, Sandra; Delisle, Vanessa C.; Carrier, Marie-Eve; Jewett, Lisa R.; El-Baalbaki, Ghassan; Fortune, Catherine; Hudson, Marie; Impens, Ann; Körner, Annett; Persmann, Jennifer; Kwakkenbos, Linda; Bartlett, Susan J.; Thombs, Brett D.

    2016-01-01

    Background Systemic sclerosis, or scleroderma, is a chronic and rare connective tissue disease with negative physical and psychological implications. Sources of emotional distress and the impact they have on the lives of people with scleroderma are not well understood. Objectives To gain an in-depth understanding of the emotional experiences and sources of emotional distress for women and men living with scleroderma through focus group discussions. Methods Three semi-structured focus group discussions were conducted (two in English, one in French) with a total of 22 people with scleroderma recruited through the Scleroderma Society of Ontario in Hamilton, Ontario and a scleroderma clinic in Montreal, Canada. Interviews were recorded, transcribed, and then coded for emerging themes using thematic inductive analysis. Results Core themes representing sources of emotional distress were identified, including: (a) facing a new reality; (b) the daily struggle of living with scleroderma; (c) handling work, employment and general financial burden; (d) changing family roles; (e) social interactions; and (f) navigating the health care system. Collectively, these themes refer to the stressful journey of living with scleroderma including the obstacles faced and the emotional experiences beginning prior to receiving a diagnosis and continuing throughout the participants’ lives. Conclusion Scleroderma was portrayed as being an unpredictable and overwhelming disease, resulting in many individuals experiencing multiple sources of emotional distress. Interventions and supportive resources need to be developed to help individuals with scleroderma and people close to them manage and cope with the emotional aspects of the disease. PMID:27008209

  20. Disaster Distress Helpline

    MedlinePlus

    ... Tips Anniversaries and Trigger Events Types of Disasters Social Media and Disasters Español Contact Us Disaster Distress Helpline ... information if you wish to receive a reply. Social media inquiries . Email us with questions about the Disaster ...

  1. Does Tinnitus Distress Depend on Age of Onset?

    PubMed Central

    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

    2011-01-01

    Objectives Tinnitus is the perception of a sound in the absence of any physical source of it. About 5–15% of the population report hearing such a tinnitus and about 1–2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Methods Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Results Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. Conclusion We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation. PMID:22125612

  2. Does tinnitus distress depend on age of onset?

    PubMed

    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

    2011-01-01

    Tinnitus is the perception of a sound in the absence of any physical source of it. About 5-15% of the population report hearing such a tinnitus and about 1-2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

  3. Negative Emotions and Behaviors are Markers of Breakup Distress

    ERIC Educational Resources Information Center

    Field, Tiffany; Diego, Miguel; Pelaez, Martha; Deeds, Osvelia; Delgado, Jeanette

    2013-01-01

    Method: University students who experienced a recent romantic breakup were given several self-report measures and were then divided into high versus low breakup distress groups. Results: The high breakup distress versus the low breakup distress groups had higher scores on negative emotions scales including depression, anxiety and anger and…

  4. 46 CFR 117.68 - Distress flares and smoke signals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Distress flares and smoke signals. 117.68 Section 117.68... AND ARRANGEMENTS Emergency Communications § 117.68 Distress flares and smoke signals. (a) Oceans... hand orange smoke distress signals approved in accordance with § 160.037 in subchapter Q of this...

  5. Understanding the Areas and Correlates of Diabetes-Related Distress in Parents of Teens With Type 1 Diabetes.

    PubMed

    Hessler, Danielle; Fisher, Lawrence; Polonsky, William; Johnson, Nicole

    2016-08-01

    To identify the unique areas of diabetes-related distress (DD) for parents of teens with type 1 diabetes and parent and teen characteristics associated with DD. Areas of DD were developed from structured interviews and translated into 46 survey items. Items were analyzed with exploratory factor analysis (EFA). An EFA with 332 parents (88% mothers) reduced items to four Parent Diabetes Distress Scale (PDDS) factors (20 items, α = .94): Personal, Teen Management, Parent/Teen Relationship, and Healthcare Team Distress. Parent DD was higher among fathers, younger or single parents, parents of teens with higher hemoglobin A1c or severe low blood glucose levels, authoritarian parenting, depressive symptoms, and low emotional support. 4 areas of parent DD were identified using a newly developed measure, the PDDS. DD was associated with family demographic, teen diabetes status, and parent contextual factors, and can help identify parents who may be more vulnerable to DD. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Correlates of psychological distress, burnout, and resilience among Chinese female nurses

    PubMed Central

    ZOU, Guiyuan; SHEN, Xiuying; TIAN, Xiaohong; LIU, Chunqin; LI, Guopeng; KONG, Linghua; LI, Ping

    2016-01-01

    The present survey investigated the association between resilience, burnout and psychological distress among Chinese female nurses. A total of 366 female nurses were enrolled in our study. A series of self-reported questionnaires that dispose of the following constructs: psychological distress, burnout, and resilience were estimated. The hierarchical linear regression models were used to evaluate the mediating effect of resilience on the relationship between burnout and psychological distress. Results of the survey showed 85.5% nurses experienced psychological distress. Resilience was negatively related to psychological distress and burnout whereas burnout was positively associated with psychological distress. Mediation analysis revealed that resilience could partially mediate the relationship between the dimensions of emotional exhaustion, depersonalization, and psychological distress. This study highlights the mediator of resilience between burnout and psychological distress of female nurses. As such, interventions that attend to resilience training may be the focus for future clinical and research endeavors. PMID:27021058

  7. 13 CFR 301.3 - Economic distress levels.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Economic distress levels. 301.3 Section 301.3 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ELIGIBILITY, INVESTMENT RATE AND PROPOSAL AND APPLICATION REQUIREMENTS Economic Distress Criteria § 301.3...

  8. Distress and job satisfaction after robbery assaults: a longitudinal study.

    PubMed

    Giorgi, G; Leon Perez, J M; Montani, F; Courcy, F; Arcangeli, G

    2015-06-01

    External/intrusive violence at work can result in psychological distress and can be an important risk to employee health and safety. However, the vast majority of workplace violence studies have employed cross-sectional and correlational research, designed to examine immediate reactions after being assaulted at work. To explore whether exposure to robbery as a traumatic event may contribute to the onset of typical symptoms of psychological distress (anxiety depression, dysphoria and loss of confidence) and job dissatisfaction over time. We collected data by using a two-wave panel design, in which employees working the days of bank robberies, in an Italian bank, filled in a questionnaire between 48h and 1 week after the robbery (T1) and 2 months after the robbery (T2). We performed structural equation models to evaluate the fit of different models to our data. There were 513 participants at T1 (58% women) and 175 (34%) participants at T2 (62% women). There was a simultaneous association in which psychological distress leads to job dissatisfaction both following robbery and 2 months later. Our findings support a synchronous effects model and suggest that interventions after suffering physical assaults, apart from helping employees to recover their health, should consider restoring their trust and confidence in the organization. This study contributes to understanding the dynamic relationships between a robbery at work and its outcomes over time, by addressing several methodological deficiencies in previous longitudinal studies. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Indicators of distress in newly diagnosed breast cancer patients

    PubMed Central

    Lucidi, Fabio; Mallia, Luca; D’Aiuto, Massimiliano; Merluzzi, Thomas V.

    2015-01-01

    Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life. Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment. Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress. Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68). Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress. PMID:26244115

  10. Partner relationship, social support and perinatal distress among pregnant Icelandic women.

    PubMed

    Jonsdottir, Sigridur Sia; Thome, Marga; Steingrimsdottir, Thora; Lydsdottir, Linda Bara; Sigurdsson, Jon Fridrik; Olafsdottir, Halldora; Swahnberg, Katarina

    2017-02-01

    It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress. The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress. A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress. Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale. Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Medical student psychological distress and academic performance.

    PubMed

    Dendle, Claire; Baulch, Julie; Pellicano, Rebecca; Hay, Margaret; Lichtwark, Irene; Ayoub, Sally; Clarke, David M; Morand, Eric F; Kumar, Arunaz; Leech, Michelle; Horne, Kylie

    2018-01-21

    The impact of medical student psychological distress on academic performance has not been systematically examined. This study provided an opportunity to closely examine the potential impacts of workplace and study related stress factors on student's psychological distress and their academic performance during their first clinical year. This one-year prospective cohort study was performed at a tertiary hospital based medical school in Melbourne, Australia. Students completed a questionnaire at three time points during the year. The questionnaire included the validated Kessler psychological distress scale (K10) and the General Health Questionnaire-28 (GHQ-28), as well as items about sources of workplace stress. Academic outcome scores were aggregated and correlated with questionnaire results. One hundred and twenty six students participated; 126 (94.7%), 102 (76.7%), and 99 (74.4%) at time points one, two, and three, respectively. 33.1% reported psychological distress at time point one, increasing to 47.4% at time point three. There was no correlation between the K10 scores and academic performance. There was weak negative correlation between the GHQ-28 at time point three and academic performance. Keeping up to date with knowledge, need to do well and fear of negative feedback were the most common workplace stress factors. Poor correlation was noted between psychological distress and academic performance.

  12. It’s Not What You Think, It’s How You Relate to It: Dispositional Mindfulness Moderates the Relationship Between Psychological Distress and the Cortisol Awakening Response

    PubMed Central

    Daubenmier, Jennifer; Hayden, Dara; Chang, Vickie; Epel, Elissa

    2014-01-01

    Objective The cortisol awakening response (CAR) is a natural metabolic response that can be potentiated by negative cognitive-emotional processes, including stress appraisals, negative affect, and rumination. Psychological distress and the CAR are not consistently related, however. Individual differences in aspects of dispositional mindfulness which reflect how people relate to negative thoughts and emotions may help explain such inconsistencies. We tested whether the tendency to 1) label and describe inner experiences and 2) accept negative thoughts and feelings without judgment moderated the association between psychological distress and the CAR. Methods Self-reported dispositional mindfulness, perceived stress, anxiety, negative affect, and rumination, and the CAR were assessed among overweight/obese women. Regression analyses were conducted to examine whether dispositional mindfulness moderated the relationship between indicators of psychological distress and the CAR. Results While psychological distress was consistently positively related to the CAR, these associations were qualified by significant interactions with both components of dispositional mindfulness. Psychological distress was associated with the CAR at lower levels of dispositional mindfulness but not at higher levels. Conclusion These findings support the idea that the tendency to describe and accept distressing experiences may buffer the impact of psychological distress on physiological arousal. These metacognitive processes may be important moderators in unraveling the complex relationship between psychological distress and physiological stress reactivity. Further research is recommended to replicate this approach in other populations. PMID:24971591

  13. Moral distress among nurses in medical, surgical and intensive-care units.

    PubMed

    Lusignani, Maura; Giannì, Maria Lorella; Re, Luca Giuseppe; Buffon, Maria Luisa

    2017-09-01

    To assess the frequency, intensity and level of moral distress perceived by nurses working in medical, surgical and intensive care units. Moral distress among nurses compromises their ability to provide optimal patient care and may cause them to leave their job. A cross-sectional questionnaire survey of 283 registered nurses was conducted to evaluate the frequency, intensity and levels of moral distress. A revised version of the Moral Distress Scale (MDS-R) was used. The highest level of moral distress was associated with the provision of treatments and aggressive care that were not expected to benefit the patients and the competency of the health-care providers. Multivariate regression showed that nurses working in medical settings, nurses with lower levels of experience working in medical, surgical or intensive care settings, and nurses who intend to leave their job experienced the highest levels of moral distress. The present study indicates that nurses experience an overall moderate level of moral distress. Gaining further insight into the issue of moral distress among nurses and the clinical situations that most frequently cause this distress will enable development of strategies to reduce moral distress and to improve nurse satisfaction and, consequently, patient care. © 2016 John Wiley & Sons Ltd.

  14. Diabetes-Related Distress Assessment among Type 2 Diabetes Patients.

    PubMed

    Aljuaid, Majed O; Almutairi, Abdulmajeed M; Assiri, Mohammed A; Almalki, Dhifallah M; Alswat, Khaled

    2018-01-01

    Diabetes is one of the most common chronic diseases; it is a debilitating and hard to live with. Diabetes-related distress (DRD) refers to the emotional and behavioral changes caused by diabetes. Our study aims to assess the prevalence of DRD among type 2 diabetes (T2D) patients using Diabetes Distress Scale-17 items (DDS-17) and its relation to complications and treatment modalities. A cross-sectional study of adult T2D patients with follow-up visits at the Diabetes and Endocrinology Center in Taif, Saudi Arabia, between January and July 2017. We excluded patients with other forms of diabetes, untreated hypothyroidism, and psychiatric illness. The total score of DDS-17 was calculated by summing the 17 items' results and then dividing the total by 17. If the total score was >2, then it was considered as clinically significant results (moderate distress), but if it is ≥3, then it is classified as a high distress. A total of 509 T2D patients with a mean age of 58 ± 14 years were included. The majority of participants were male, married, not college educated, and reported a sedentary lifestyle. We found 25% of the screened T2D patients have moderate to high DRD. Regarding the DRD components, emotional distress was the most prevalent followed by physician-related distress. HabA1c was significantly higher in those with high combined distress and high emotional distress compared to those with mild/moderate distress ( p = 0.015 and 0.030, resp.). Our study shows that DRD is a medically relevant issue that clinicians need to address. Despite observing a low prevalence of DRD compared to other studies, we found significant correlations between DRD scores and HabA1c, triglyceride levels, BMI, T2D duration, and interval between visits.

  15. 7 CFR 762.143 - Servicing distressed accounts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Servicing distressed accounts. 762.143 Section 762.143 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.143 Servicing distressed accounts. (a) A borrower is...

  16. Prospective relationships between workplace sexual harassment and psychological distress.

    PubMed

    Nielsen, M B; Einarsen, S

    2012-04-01

    Exposure to workplace sexual harassment (SH) has been associated with impaired mental health, but longitudinal studies confirming the relationship are lacking. To examine gender differences in prospective associations between SH and psychological distress. Baseline questionnaire survey data were collected in 2005 in a representative sample of Norwegian employees. Follow-up data were collected in 2007. SH was measured with the Bergen Sexual Harassment Scale. Psychological distress was measured with the 25 item Hopkins Symptom Checklist (HSCL-25) with cases of psychological distress defined as having a mean score of <1.75. Variables were measured at both baseline and follow-up. Logistic regression analysis was used to analyse data. Response rates were 57% in 2005 and 75% in 2007 when the final cohort comprised 1775 respondents. After adjusting for baseline distress and age, exposure to SH at baseline was associated with psychological distress at follow-up among women [odds ratio (OR): 2.03; 95% confidence interval (CI): 1.2-3.39] but not men (OR: 1.32; 95% CI: 0.72-2.43). Baseline distress was significantly related to SH at follow-up among men (OR: 3.03; 95% CI: 1.74-5.26) but not women (OR: 1.15; 95% CI: 0.69-1.92). The study found that SH contributed to subsequent psychological distress among women. Workplace measures against SH would be expected to lead to a reduction in mental disorders. The finding that psychological distress predicts SH among men may indicate either a vulnerability factor or a negative perception mechanism.

  17. Does intergenerational mobility shape psychological distress? Sorokin revisited

    PubMed Central

    Houle, Jason N.; Martin, Molly A.

    2014-01-01

    Drawing from Sorokin's hypothesis that socially mobile individuals are at greater risk of experiencing psychological distress than their non-mobile counterparts, we investigate whether intergenerational occupational mobility influences psychological distress, as measured by the Center for Epidemiologic Studies Depression (CES-D) scale. Using data for men from the Wisconsin Longitudinal Study (WLS) and Sobel's Diagonal Mobility Models, we find little evidence for Sorokin's hypothesis; mobile individuals are no more likely to be psychologically distressed than their non-mobile counterparts. In fact, one group of mobile men – those who left their farming origins – are actually less distressed than the sons who remain as farmers and non-mobile men in higher-ranked social classes. We speculate that this reflects the fact that farming became very arduous during the late 20th century and these mobile sons of farmers appreciate their improved life chances. Our findings suggest that the association between mobility and psychological distress varies across specific class backgrounds and is contingent upon the broader social and economic context. PMID:25152556

  18. Psychological distress among students from five universities in Sri Lanka.

    PubMed

    Kuruppuarachchi, K A L A; Kuruppuarachchi, K A J M; Wijerathne, S; Williams, S S

    2002-03-01

    To determine the proportion of university students that are psychologically distressed when compared to an age and sex matched population sample and to describe the factors that may contribute to their distress. A cross-sectional comparison study. The general health questionnaire (GHQ 30), previously validated in Sinhala, was administered as a screening test to random samples of undergraduates in 5 universities. Age and sex matched controls from the respective communities were also administered the screening test. The undergraduates also filled in a pre-tested questionnaire with personal details. Chi-square tests were used to determine statistical significance between groups. Among the undergraduates, 104 (39.8%) had scores for psychological distress whereas only 67 (25.7%) from the community sample had scores for similar distress. This difference was significant (p = 0.0007). A significantly greater proportion (p = 0.009) of those entering from rural schools were psychologically distressed than those from suburban and urban schools, and a greater proportion living in rented rooms and hostels were (p = 0.001) distressed than those travelling from their homes. The psychological distress among undergraduates was significantly greater than among the general population. More students who enter from rural schools seem to be distressed than those who enter from suburban and urban schools.

  19. Distress tolerance is linked to unhealthy eating through pain catastrophizing.

    PubMed

    Emami, Ashley S; Woodcock, Anna; Swanson, Heidi E; Kapphahn, Teresa; Pulvers, Kim

    2016-12-01

    Low distress tolerance, an important component of emotion regulation, is a risk factor for unhealthy eating. Identifying factors which explain the link between distress tolerance and unhealthy eating can advance the understanding of problematic eating and inform prevention and treatment of obesity and eating disorders. The present study examines pain catastrophizing as a mediator between distress tolerance and unhealthy eating in a nonclinical population, which has received little attention despite being a risk factor for unhealthy eating behaviors. The Distress Tolerance Scale (DTS), Pain Catastrophizing Scale (PCS), and the Dutch Eating Behavior Questionnaire (DEBQ), were administered to 171 college students (62.6% female, 38.6% White, 28.1% Hispanic). There was no evidence of a significant direct effect of distress tolerance on unhealthy eating. However, as hypothesized, there was a significant indirect or mediated effect of pain catastrophizing on the relationship between distress tolerance and unhealthy eating. Individuals low in distress tolerance reported higher pain catastrophizing, and a result, these individuals also reported higher levels of unhealthy eating. These findings introduce pain catastrophizing as an influential variable in the link between distress tolerance and unhealthy eating. Findings suggest that reducing catastrophic thinking about pain may be a worthy target of intervention in reducing unhealthy eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Psychological Distress following Injury in a Large Cohort of Thai Adults

    PubMed Central

    Yiengprugsawan, Vasoontara; Seubsman, Sam-Ang; Sleigh, Adrian

    2016-01-01

    Introduction Injury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress. Methods Study participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide. We analysed 2009 and 2013 data. Injury questions included injury prevalence, causes and levels of severity. Distress was measured using the standard Kessler-6. To assess the risk for post-injury distress, we used multinomial logistic regression investigating psychological distress in 2013 as an outcome including injury categories in both 2009 and 2013 as predictors, adjusted for sociodemographic factors. Results Overall injury was predictive of psychological distress. Both types of injury (traffic and non- traffic) associated with increasing psychological distress. Those that had experienced both types of injuries in the previous year had higher odds of developing psychological distress compared to those who experienced just one type. In 2013, adjusted psychological distress odds ratios were 1.46 [95% Confidence Interval 1.14–1.87] for traffic injury only; 1.26 [1.13–1.40] for non-traffic injury only; and 2.71 [2.19–3.35] for both traffic and non-traffic injuries. Increasing frequency of injury and increasing injury severity were also linked to elevated psychological distress among our Thai cohort members. Conclusions Our results revealed a significantly high risk of psychological distress following injury. With increasing occurrence of injury, especially traffic injuries in low and middle income countries such as Thailand, future policies should not only focus on physical care but also address psychological distress as an important consequence of injury. PMID:27776133

  1. Women with breast cancer: self-reported distress in early survivorship.

    PubMed

    Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L

    2015-01-01

    To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Descriptive, cross-sectional. A National Cancer Institute-designated comprehensive cancer center. 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Distress scores, problem reports, and time groups. Participants scored in range of the cutoff of more than 4 (range = 4.1-5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Interventions to reduce or prevent distress may improve outcomes in early survivorship.

  2. Care and caring in the intensive care unit: Family members' distress and perceptions about staff skills, communication, and emotional support.

    PubMed

    Carlson, Eve B; Spain, David A; Muhtadie, Luma; McDade-Montez, Liz; Macia, Kathryn S

    2015-06-01

    Family members of intensive care unit (ICU) patients are sometimes highly distressed and report lower satisfaction with communication and emotional support from staff. Within a study of emotional responses to traumatic stress, associations between family distress and satisfaction with aspects of ICU care were investigated. In 29 family members of trauma patients who stayed in an ICU, we assessed symptoms of depression and posttraumatic stress disorder (PTSD) during ICU care. Later, family members rated staff communication, support, and skills and their overall satisfaction with ICU care. Ratings of staff competence and skills were significantly higher than ratings of frequency of communication, information needs being met, and support. Frequency of communication and information needs being met were strongly related to ratings of support (rs = .75-.77) and staff skills (rs = .77-.85), and aspects of satisfaction and communication showed negative relationships with symptoms of depression (rs = -.31 to -.55) and PTSD (rs = -.17 to -.43). Although satisfaction was fairly high, family member distress was negatively associated with several satisfaction variables. Increased understanding of the effects of traumatic stress on family members may help staff improve communication and increase satisfaction of highly distressed family members. Published by Elsevier Inc.

  3. Recurrent headache and interpersonal violence in adolescence: the roles of psychological distress, loneliness and family cohesion: the HUNT study.

    PubMed

    Stensland, Synne Oien; Thoresen, Siri; Wentzel-Larsen, Tore; Zwart, John-Anker; Dyb, Grete

    2014-06-10

    Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache. The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006-2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes. In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex. Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate coping and recovery, it may be helpful to

  4. Suicide literacy predicts the provision of more appropriate support to people experiencing psychological distress.

    PubMed

    Cruwys, Tegan; An, Soontae; Chang, Melissa Xue-Ling; Lee, Hannah

    2018-06-01

    Mental health literacy has been hailed as a public health priority to reduce stigma and increase help seeking. We examined the effect of suicide literacy on the type of help provided to those experiencing suicidal ideation. A community sample of 363 Australians were randomly assigned to read one of three messages from a member of their social network (the target). The target reported symptoms consistent with either (1) subclinical distress, (2) clinical depression, or (3) suicidal ideation. Participants were most likely to recommend social support and least likely to recommend professional help. Suicide literacy interacted with the target's presentation, such that participants with higher suicide literacy who considered a suicidal target were less likely to recommend self-help or no action, and more likely to recommend professional help. Suicide literacy was also associated with lower suicide stigma, and unexpectedly, this indirectly predicted more reluctance to recommend professional help. Overall, results indicated that the relationship between mental health literacy, stigma, and provision of help is not straightforward. While suicide literacy was associated with greater sensitivity to a person's risk of suicide, it also predicted fewer recommendations for professional help overall, partly due to the stigma associated with seeking professional help. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Investigation of early distress in Wisconsin rubblized pavements.

    DOT National Transportation Integrated Search

    2011-07-01

    This study investigated premature distress formation in Wisconsin HMA overlays of rubblized concrete pavement. The premature : distress was tented transverse cracking, which formed during the winter season and significantly affected pavement ride. Th...

  6. Physical Activity Mode and Mental Distress in Adulthood.

    PubMed

    Sciamanna, Christopher N; Smyth, Joshua M; Doerksen, Shawna E; Richard, Barrett R; Kraschnewski, Jennifer L; Mowen, Andrew J; Hickerson, Benjamin D; Rovniak, Liza S; Lehman, Erik B; Yang, Chengwu

    2017-01-01

    Nearly one fifth of American adults suffer from mental health issues, yet many treatments have side effects and stigma attached. Physical activity can be an effective treatment for mental health disorders, but most promotion efforts fail. One understudied aspect of physical activity is the specific mode, including if it engages others, and how this may relate to mental health. This study examined the potential relationship between different modes of physical activity and the frequency of mental distress. Data from the 2000 Behavioral Risk Factor Surveillance System were analyzed in 2015 to determine the relationship between participation in different modes of physical activity and frequent mental distress. Data were obtained on physical activity and frequent mental distress from 183,341 adults (aged 18-99 years, 51.9% female, 57.4% overweight/obese, 9.5% frequent mental distress). Prevalence of mental distress for those reporting activities was contrasted against walking alone. People who participated in tennis had 46% lower odds (95% CI=0.35, 0.84) of frequent mental distress. Approaching significance, non-team play sports were associated with 18% lower odds (95% CI=0.66, 1.01) of frequent mental distress, compared with walking alone. Activity modes are associated with mental health outcomes above and beyond the frequency and duration of activity. Given the social and play nature of the activities, this may reflect the relational aspect, enjoyment, or a combination of both. These results suggest that adding social or affective components to physical activity may enhance engagement and retention in activity promotion efforts and their benefits on mental health. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Psychosocial distress and stroke risk in older adults.

    PubMed

    Henderson, Kimberly M; Clark, Cari J; Lewis, Tené T; Aggarwal, Neelum T; Beck, Todd; Guo, Hongfei; Lunos, Scott; Brearley, Ann; Mendes de Leon, Carlos F; Evans, Denis A; Everson-Rose, Susan A

    2013-02-01

    To investigate the association of psychosocial distress with risk of stroke mortality and incident stroke in older adults. Data were from the Chicago Health and Aging Project, a longitudinal population-based study conducted in 3 contiguous neighborhoods on the south side of Chicago, IL. Participants were community-dwelling black and non-Hispanic white adults, aged 65 years and older (n=4120 for stroke mortality; n=2649 for incident stroke). Psychosocial distress was an analytically derived composite measure of depressive symptoms, perceived stress, neuroticism, and life dissatisfaction. Cox proportional hazards models examined the association of distress with stroke mortality and incident stroke over 6 years of follow-up. Stroke deaths (151) and 452 incident strokes were identified. Adjusting for age, race, and sex, the hazard ratio (HR) for each 1-SD increase in distress was 1.47 (95% confidence interval [CI]=1.28-1.70) for stroke mortality and 1.18 (95% CI=1.07-1.30) for incident stroke. Associations were reduced after adjustment for stroke risk factors and remained significant for stroke mortality (HR=1.29; 95% CI=1.10-1.52) but not for incident stroke (HR=1.09; 95% CI=0.98-1.21). Secondary analyses of stroke subtypes showed that distress was strongly related to incident hemorrhagic strokes (HR=1.70; 95% CI=1.28-2.25) but not ischemic strokes (HR=1.02; 95% CI=0.91-1.15) in fully adjusted models. Increasing levels of psychosocial distress are related to excess risk of both fatal and nonfatal stroke in older black and white adults. Additional research is needed to examine pathways linking psychosocial distress to cerebrovascular disease risk.

  8. Impact of parental emotional support and coercive control on adolescents' self-esteem and psychological distress: results of a four-year longitudinal study.

    PubMed

    Boudreault-Bouchard, Anne-Marie; Dion, Jacinthe; Hains, Jennifer; Vandermeerschen, Jill; Laberge, Luc; Perron, Michel

    2013-08-01

    This study aims at investigating the impact of parental practices on youths' adjustment. In all, 605 adolescents completed questionnaires at ages 14, 16 and 18. Self-esteem, psychological distress as well as parental emotional support and coercive control were measured. Analyses based on individual growth models revealed that self-esteem increased with age, but psychological distress remained stable over time. Boys reported higher levels of self-esteem and lower levels of psychological distress than girls. Maternal and paternal emotional support reinforced self-esteem over time. Maternal coercive control undermined self-esteem, but only at ages 16 and 18. Psychological distress decreased with parental emotional support but increased with parental coercive control at ages 14, 16 and 18. Overall, these results indicate that positive parental practices are related to youths' well-being. These findings support the importance of establishing intervention strategies designed to promote best practices among parents of teenagers to help them develop into well-adjusted adults. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. Review of a Parent's Influence on Pediatric Procedural Distress and Recovery.

    PubMed

    Brown, Erin A; De Young, Alexandra; Kimble, Roy; Kenardy, Justin

    2018-06-01

    Understanding how parents influence their child's medical procedures can inform future work to reduce pediatric procedural distress and improve recovery outcomes. Following a pediatric injury or illness diagnosis, the associated medical procedures can be potentially traumatic events that are often painful and distressing and can lead to the child experiencing long-term physical and psychological problems. Children under 6 years old are particularly at risk of illness or injury, yet their pain-related distress during medical procedures is often difficult to manage because of their young developmental level. Parents can also experience ongoing psychological distress following a child's injury or illness diagnosis. The parent and parenting behavior is one of many risk factors for increased pediatric procedural distress. The impact of parents on pediatric procedural distress is an important yet not well-understood phenomenon. There is some evidence to indicate parents influence their child through their own psychological distress and through parenting behavior. This paper has three purposes: (1) review current empirical research on parent-related risk factors for distressing pediatric medical procedures, and longer-term recovery outcomes; (2) consider and develop existing theories to present a new model for understanding the parent-child distress relationship during medical procedures; and (3) review and make recommendations regarding current assessment tools and developing parenting behavior interventions for reducing pediatric procedural distress.

  10. Moral Distress in PICU and Neonatal ICU Practitioners: A Cross-Sectional Evaluation.

    PubMed

    Larson, Charles Philip; Dryden-Palmer, Karen D; Gibbons, Cathy; Parshuram, Christopher S

    2017-08-01

    To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. Cross-sectional survey. A large pediatric tertiary care center. Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. A 41-item questionnaire examining moral distress, burnout, and uncertainty. The main outcome was moral distress measured with the Revised Moral Distress Scale. Secondary outcomes were frequency and intensity Revised Moral Distress Scale subscores, burnout measured with the Maslach Burnout Inventory depersonalization subscale, and uncertainty measured with questions adapted from Mishel's Parent Perception of Uncertainty Scale. Linear regression models were used to examine associations between participant characteristics and the measures of moral distress, burnout, and uncertainty. Two-hundred six analyzable surveys were returned. The median Revised Moral Distress Scale score was 96.5 (interquartile range, 69-133), and 58% of respondents reported significant work-related moral distress. Revised Moral Distress Scale items involving end-of-life care and communication scored highest. Moral distress was positively associated with burnout (r = 0.27; p < 0.001) and uncertainty (r = 0.04; p = 0.008) and inversely associated with perceived hospital supportiveness (r = 0.18; p < 0.001). Nurses reported higher moral distress intensity than physicians (Revised Moral Distress Scale intensity subscores: 57.3 vs 44.7; p = 0.002). In nurses only, moral distress was positively associated with increasing years of ICU experience (p = 0.02) and uncertainty about whether their care was of benefit (r = 0.11; p < 0.001) and inversely associated with uncertainty about a child's prognosis (r = 0.03; p = 0.03). In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated

  11. Disentangling Depression and Distress Networks in the Tinnitus Brain

    PubMed Central

    Joos, Kathleen; Vanneste, Sven; De Ridder, Dirk

    2012-01-01

    Tinnitus is the continuous perception of an internal auditory stimulus. This permanent sound often affects a person's emotional state inducing distress and depressive feelings changes in 6–25% of the affected population. Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person's ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state. Based on previous observations in chronic pain, posttraumatic stress disorder and depression, we assume that both states are related to separate neural circuits. We used the Dutch version of the Tinnitus Questionnaire to assess the global index of distress together with the Beck Depression Inventory to evaluate the depressive symptoms accompanying tinnitus. Furthermore sLORETA analysis was performed to correlate current density distribution with distress and depression scores, revealing a lateralization effect of depression versus distress. Distress is mainly correlated with alpha 2, beta 1 and beta 2 activity of the right frontopolar cortex and orbitofrontal cortex in combination with beta 2 activation of the anterior cingulate cortex. In contrast, the more permanent depressive alterations induced by tinnitus are associated with activity of alpha 2 activity in the left frontopolar and orbitofrontal cortex. These specific neural circuits are embedded in a greater neural network, with the parahippocampal region functioning as a crucial linkage between both tinnitus related pathways. PMID:22808188

  12. Sharing, liking, commenting, and distressed? The pathway between Facebook interaction and psychological distress.

    PubMed

    Chen, Wenhong; Lee, Kye-Hyoung

    2013-10-01

    Studies on the mental health implications of social media have generated mixed results. Drawing on a survey of college students (N=513), this research uses structural equation modeling to assess the relationship between Facebook interaction and psychological distress and two underlying mechanisms: communication overload and self-esteem. It is the first study, to our knowledge, that examines how communication overload mediates the mental health implications of social media. Frequent Facebook interaction is associated with greater distress directly and indirectly via a two-step pathway that increases communication overload and reduces self-esteem. The research sheds light on new directions for understanding psychological well-being in an increasingly mediated social world as users share, like, and comment more and more.

  13. Gender and the experience of moral distress in critical care nurses.

    PubMed

    O'Connell, Christopher B

    2015-02-01

    Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether. Do significant gender differences exist in the moral distress scores of critical care nurses? This study utilized a quantitative, descriptive methodology to explore moral distress levels in a sample of critical care nurses to determine whether gender differences exist in their mean moral distress scores. Participants (n = 31) were critical care nurses from an American Internet nursing community who completed the Moral Distress Scale-Revised online over a 5-day period in July 2013. Institutional review board review approved the study, and accessing and completing the survey implied informed consent. The results revealed a statistically significant gender difference in the mean moral distress scores of participants. Females reported statistically significantly higher moral distress scores than did males. Overall, the moral distress scores for both groups were relatively low. The findings of a gender difference have not previously been reported in the literature. However, other findings are consistent with previous studies on moral distress. Although the results of this study are not generalizable, they do suggest the need for continuing research on moral distress in underrepresented groups in nursing, including cultural and ethnic groups. © The Author(s) 2014.

  14. Diabetes Distress and Depression in South Asian Canadians with Type 2 Diabetes.

    PubMed

    Sidhu, Rawel; Tang, Tricia S

    2017-02-01

    South Asians are disproportionately affected by diabetes compared to some other ethnic groups in Canada. Although depression and diabetes distress are psychological issues well studied in the general population of those with diabetes, they have not been investigated in South Asian Canadians with type 2 diabetes. We sought to identify the rates of depression and diabetes distress in South Asian adults with type 2 diabetes and to explore the relationship among glycemic control, depression and diabetes distress. We recruited 41 South Asian adults with type 2 diabetes for this study. Glycated hemoglobin (A1C) levels were collected via venous puncture. We utilized the Diabetes Distress Scale to assess total diabetes distress and its subscales (emotional distress, interpersonal distress, regimen-related distress and physician distress) and the Personal Health Questionnaire-9 to assess depressive symptoms. The rate of depression was 15%, and the rate of total diabetes distress was 52.5%. Although neither measure was found to be correlated with A1C levels, depression had a moderate positive correlation with total diabetes distress (r=0.696; p<0.001); subscales of regimen distress and emotional burden emerged as the strongest correlates. This is the first study to report that diabetes distress is a serious concern for South Asian Canadians with type 2 diabetes. Given that depression and diabetes distress are linked, studies recruiting a larger and more diverse sample of South Asian Canadians should be conducted to better understand the psychological issues that may impact diabetes self-management in this community. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  15. Bisexual-Specific Minority Stressors, Psychological Distress, and Suicidality in Bisexual Individuals: the Mediating Role of Loneliness.

    PubMed

    Mereish, Ethan H; Katz-Wise, Sabra L; Woulfe, Julie

    2017-08-01

    Bisexual individuals are at higher risk for poor mental health outcomes compared to heterosexual as well as lesbian and gay individuals and experience minority stressors, such as discrimination, from both heterosexual and sexual minority communities. However, there is little research examining the negative effects of bisexual-specific minority stressors on bisexual individuals' mental health as well as psychological factors that might help explain minority stressors' deleterious effects. This research examined the effects of distal minority stressors (i.e., anti-bisexual experiences from both heterosexual as well as lesbian and gay people) and proximal stressors (i.e., internalized heterosexism and sexual orientation concealment) on psychological distress and suicidality among bisexual adults (N = 503). Building on the relational framing of the minority stress model, we also tested one relational factor (i.e., loneliness) as a mediator of the associations between distal and proximal minority stressors and poor mental health (i.e., psychological distress and suicidality). Structural equation modeling analyses were used to test the mediating effects of loneliness on the associations between minority stressors and psychological distress and suicidality. Although distal and proximal minority stressors were not associated with each other, loneliness mediated the effects of distal and proximal minority stressors on psychological distress and suicidality. The results of this study underscore the importance of targeting bisexual-specific minority stressors as well as loneliness in preventive interventions to improve the mental health of bisexual individuals.

  16. [Are members of fibromyalgia syndrome self-help groups "different"? Demographic and clinical characteristics of members and non-members of fibromyalgia syndrome self-help groups].

    PubMed

    Jung, E; Erbslöh-Möller, B; Gesmann, M; Kühn-Becker, H; Petermann, F; Langhorst, J; Weiss, T; Thoma, R; Winkelmann, A; Häuser, W

    2013-06-01

    No data were available on demographic and clinical characteristics of members of fibromyalgia syndrome (FMS) self-help groups in Germany. The study was carried out from November 2010 to April 2011. A set of questionnaires was distributed by the German League Against Rheumatism and the German Fibromyalgia Association to members and to all consecutive FMS patients at nine clinical centres of different levels of care. The set included a self-developed questionnaire on demographic and medical data and on previously and currently used therapies, the patient health questionnaire (PHQ 4) and the fibromyalgia survey questionnaire. Members of FMS self-help groups (N = 1,014) were older and reported a longer duration of chronic widespread pain, less anxiety and depression and a more frequent current use of aerobic exercise, relaxation training and complementary alternative medication than participants not affiliated with FMS self-help groups (N = 630). Membership in FMS self-help groups was associated with less psychological distress and a more frequent use of active self-management strategies.

  17. Teaching school teachers to recognize respiratory distress in asthmatic children.

    PubMed

    Sapien, Robert E; Fullerton-Gleason, L; Allen, N

    2004-10-01

    To demonstrate that school teachers can be taught to recognize respiratory distress in asthmatic children. Forty-five school teachers received a one-hour educational session on childhood asthma. Each education session consisted of two portions, video footage of asthmatic children exhibiting respiratory distress and didactic. Pre- and posttests on general asthma knowledge, signs of respiratory distress on video footage and comfort level with asthma knowledge and medications were administered. General asthma knowledge median scores increased significantly, pre = 60% correct, post = 70% (p < 0.0001). The ability to visually recognize respiratory distress also significantly improved (pre-median = 66.7% correct, post = 88.9% [p < 0.0001]). Teachers' comfort level with asthma knowledge and medications improved. Using video footage, school teachers can be taught to visually recognize respiratory distress in asthmatic children. Improvement in visual recognition of respiratory distress was greater than improvement in didactic asthma information.

  18. Impact of ethical climate on moral distress revisited: multidimensional view.

    PubMed

    Atabay, Gülem; Çangarli, Burcu Güneri; Penbek, Şebnem

    2015-02-01

    Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and Cullen's framework, and moral distress intensity among nurses in Turkish healthcare settings. An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Factor analyses showed that moral distress had three dimensions, namely, organizational constraints, misinformed and over-treated patients, and lack of time and resources, while ethical climate had four types, namely, rules, well-being of stakeholders, individualism, and organizational interests. Positive correlations were identified between certain types of ethical climate (rules, individualism, or organizational interests) and moral distress intensity. Factor distribution of the scales shows some commonalities with the findings of previous research. However, context-specific dimensions and types were also detected. No particular ethical climate type was found to have a negative correlation with moral distress. Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical

  19. Child Affected by Parental Relationship Distress.

    PubMed

    Bernet, William; Wamboldt, Marianne Z; Narrow, William E

    2016-07-01

    A new condition, "child affected by parental relationship distress" (CAPRD), was introduced in the DSM-5. A relational problem, CAPRD is defined in the chapter of the DSM-5 under "Other Conditions That May Be a Focus of Clinical Attention." The purpose of this article is to explain the usefulness of this new terminology. A brief review of the literature establishing that children are affected by parental relationship distress is presented. To elaborate on the clinical presentations of CAPRD, four common scenarios are described in more detail: children may react to parental intimate partner distress; to parental intimate partner violence; to acrimonious divorce; and to unfair disparagement of one parent by another. Reactions of the child may include the onset or exacerbation of psychological symptoms, somatic complaints, an internal loyalty conflict, and, in the extreme, parental alienation, leading to loss of a parent-child relationship. Since the definition of CAPRD in the DSM-5 consists of only one sentence, the authors propose an expanded explanation, clarifying that children may develop behavioral, cognitive, affective, and physical symptoms when they experience varying degrees of parental relationship distress, that is, intimate partner distress and intimate partner violence, which are defined with more specificity and reliability in the DSM-5. CAPRD, like other relational problems, provides a way to define key relationship patterns that appear to lead to or exacerbate adverse mental health outcomes. It deserves the attention of clinicians who work with youth, as well as researchers assessing environmental inputs to common mental health problems. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Gendered experiences of conflict and co-operation in heterosexual relations of Somalis in exile in Gothenburg, Sweden.

    PubMed

    Aden, A S; Dahlgren, L; Tarsitani, G

    2004-01-01

    Political upheaval and poverty at home has been forcing many Somalis to immigrate. These immigrants do not only leave their physical house, families, relatives, loved ones, friends, but also familiarities, culture, customs, and often they do end up in no man's land being between their own and new home culture. Available reports suggest that there are about 15,000 Somalis in Sweden and their majority came here from late 1989 to 1996. About one third these immigrants live in and around the city of Gothenburg. This paper explores and describes gendered experiences of conflict and co-operation in heterosexual relations of Somalis in exile in Gothenburg, Sweden. A qualitative sociological in-depth interviews with 6 women and 7 men was performed during May 1999 to January 2000. A follow up focus group interviews with 10 people (2 women and 8 men) was also carried on. The results show that both the Somali culture and Muslim religion do not support the children being taught sex education in schools or the names of the sex organs being pronounced other than to be used as metaphors. The girls, unlike their age group males, experience a very painful and terrifying process during childhood in which their self-esteem is downgraded by means of serious degrading traditional active violence such as female genital mutilation and visible virginity control. The narratives tell stories in which Somali women are degraded and expected to obey in situations characterised by their man's arbitrariness. They are subject to a very extensive form of social control, which is especially pronounced on issues regarding sexuality. Their integrity as women is, consequently set aside. When Somali refugees came to Sweden some of them came to adopt much of the modern lifestyle and cultural norm systems, preferable young people and some of the females. Relating to a new culture with its new expectations on the norm obedience also created changes in self-esteem. Exile situation tends to generate

  1. Psychological distress in Ghana: associations with employment and lost productivity.

    PubMed

    Canavan, Maureen E; Sipsma, Heather L; Adhvaryu, Achyuta; Ofori-Atta, Angela; Jack, Helen; Udry, Christopher; Osei-Akoto, Isaac; Bradley, Elizabeth H

    2013-03-07

    Mental health disorders account for 13% of the global burden of disease, a burden that low-income countries are generally ill-equipped to handle. Research evaluating the association between mental health and employment in low-income countries, particularly in sub-Saharan Africa, is limited. We address this gap by examining the association between employment and psychological distress. We analyzed data from the Ghana Socioeconomic Panel Survey using logistic regression (N = 5,391 adults). In multivariable analysis, we estimated the association between employment status and psychological distress, adjusted for covariates. We calculated lost productivity from unemployment and from excess absence from work that respondents reported was because of their feelings of psychological distress. Approximately 21% of adults surveyed had moderate or severe psychological distress. Increased psychological distress was associated with increased odds of being unemployed. Men and women with moderate versus mild or no psychological distress had more than twice the odds of being unemployed. The association of severe versus mild or no distress with unemployment differed significantly by sex (P-value for interaction 0.004). Among men, the adjusted OR was 12.4 (95% CI: 7.2, 21.3), whereas the association was much smaller for women (adjusted OR = 3.8, 95% CI: 2.5, 6.0). Extrapolating these figures to the country, the lost productivity associated with moderate or severe distress translates to approximately 7% of the gross domestic product of Ghana. Psychological distress is strongly associated with unemployment in Ghana. The findings underscore the importance of addressing mental health issues, particularly in low-income countries.

  2. Violence and psychological distress among police officers and security guards.

    PubMed

    Leino, T M; Selin, R; Summala, H; Virtanen, M

    2011-09-01

    Police officers and security guards are more exposed to violence during their work duties than the general workforce and it can damage their psychological health. Still research on specific forms of violence and a potential pathway through which violence may affect distress is scarce. The aim of this study was to investigate the association of two forms of violence with distress among police officers and security guards and whether personal worry about future violence mediates this association. Violence was specified as physically violent acts and threats or assaults with a deadly weapon. Symptoms of psychological distress were measured using the General Health Questionnaire-12 scale. Analyses of 1993 completed responses (response rate 58%) showed that the odds ratio of distress for 'physically violent acts was' 1.67 (95% CI = 1.11-2.51) and for 'threats or assaults with a deadly weapon' 1.62 (95% CI = 1.20-2.17). When personal worry about future violence was taken into account, the association between exposure to physically violent acts and distress was completely broken. Instead, with the same adjustment, the association between exposure to threats or assaults with a deadly weapon and distress held. The results indicate that the association between physically violent acts and distress is mediated by personal worry about future violence, while threats or assaults with a deadly weapon had a stronger and independent association with distress. It is concluded that there is association between violence and distress. Personal worry about future violence mediates this association.

  3. Discrimination and distress among Afghan refugees in northern California: The moderating role of pre- and post-migration factors

    PubMed Central

    2018-01-01

    This study investigates the effect of perceived discrimination on the mental health of Afghan refugees, and secondly, tests the distress moderating effects of pre-migration traumatic experiences and post-resettlement adjustment factors. In a cross-sectional design, 259 Afghans completed surveys assessing perceived discrimination and a number of other factors using scales developed through inductive techniques. Multivariable analyses consisted of a series of hierarchical regressions testing the effect of perceived discrimination on distress, followed by a sequential analysis of moderator variables. Perceived discrimination was significantly associated with higher distress, and this relationship was stronger among those with a strong intra-ethnic identity and high pre-resettlement traumatic experiences. The expected buffering effects of civic engagement, ethnic orientation (e.g. integration), and social support were not significant. Discrimination is a significant source of stress for Afghan refugees, which may exacerbate stresses associated with other pre- and post-migration stressors. Future research is needed to tailor interventions that can help mitigate the stress associated with discrimination among this highly vulnerable group. PMID:29782531

  4. A Health System-wide Moral Distress Consultation Service: Development and Evaluation.

    PubMed

    Hamric, Ann B; Epstein, Elizabeth G

    2017-06-01

    Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the "presenting problem" may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution's ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral distress.

  5. Distress, anxiety, and depression in cancer patients undergoing chemotherapy

    PubMed Central

    Pandey, Manoj; Sarita, Gangadharan P; Devi, Nandkumar; Thomas, Bejoy C; Hussain, Badridien M; Krishnan, Rita

    2006-01-01

    Background Chemotherapy for cancer is an intense and cyclic treatment associated with number of side-effects. The present study evaluated the effect of chemotherapy on distress, anxiety and depression. Patients and methods A total of 117 patients were evaluated by using distress inventory for cancer (DIC2) and hospital anxiety and depression scale (HADS). Majority of the patients were taking chemotherapy for solid tumors (52; 44.4%). Results The mean distress score was 24, 18 (15.38%) were found to have anxiety while 19 (16.23%) had depression. High social status was the only factor found to influence distress while female gender was the only factor found to influence depression in the present study. Conclusion The study highlights high psychological morbidity of cancer patients and influence of gender on depression. Construct of distress as evaluated by DIC 2 may have a possible overlap with anxiety. PMID:17002797

  6. Distress Responses in a Routine Vaccination Context: Relationships to Early Childhood Mental Health

    PubMed Central

    Racine, Nicole M.; Gennis, Hannah G.; Pillai Riddell, Rebecca; Greenberg, Saul; Garfield, Hartley

    2018-01-01

    Social and emotional competencies, such as distress regulation, are established in early childhood and are critical for the development of children’s mental health and wellbeing. Routine vaccinations in primary care provide a unique opportunity to relate responses to a universal, relatively standardized, distress regulation paradigm (i.e., pain-related distress) to key developmental outcomes. The current study sought to examine distress regulation during routine vaccination in infancy and preschool as predictors of outcomes related to socioemotional competence in preschool. It was hypothesized that children with poorer distress regulation abilities post-vaccination would have lower socioemotional development. Furthermore, it was hypothesized that insensitive parenting would exacerbate this relationship for children with poor distress regulation abilities. As part of an ongoing longitudinal cohort, 172 parent–child dyads were videotaped during vaccinations in infancy and preschool, and subsequently participated in a full-day psychological assessment in a university lab. Videotapes were coded for child pre-needle distress (baseline distress), immediate post-needle pain-related distress reactivity (immediate distress reactivity), and pain-related distress regulation (distress regulation). Parent sensitivity during the preschool vaccination was also coded. Baseline distress prior to vaccination predicted greater externalizing problems and behavioral symptoms. Parent sensitivity did not moderate the association between any child distress behaviors and socioemotional development indicators. Child distress behaviors prior to injection, regardless of parent behavior, during the vaccination context may provide valuable information to health care professionals about child socioemotional functioning in the behavioral and emotional domains. PMID:29466307

  7. Relatives' expressed emotion, distress and attributions in clinical high-risk and recent onset of psychosis.

    PubMed

    Domínguez-Martínez, Tecelli; Medina-Pradas, Cristina; Kwapil, Thomas R; Barrantes-Vidal, Neus

    2017-01-01

    It has been well-demonstrated that Expressed Emotion (EE) in caregivers of schizophrenia patients is related to their illness attributions, but little is known about relatives' cognitive and emotional appraisals at early stages of psychosis. This study examined differences on the relationships of EE with distress and illness attributions in 78 relatives of At-Risk Mental States (ARMS) and First-Episode of Psychosis (FEP) patients, and which of those variables better predicted EE. Criticism and Emotional Over-Involvement (EOI) were associated with distress and with several illness attributions in both groups. Anxiety was more strongly associated with criticism in ARMS than in FEP-relatives, and it was associated with EOI in the ARMS but not in the FEP-group. No differences on the relationships of EE with depression or attributions were found. Furthermore, distress and attributions of blame toward the patients predicted criticism. Attributions of control by the patient and emotional negative representation about the disorder predicted EOI. Findings highlight the need to focus on early family interventions that provide proper information and psychological support in accordance with the illness stage, to help relatives improve their understanding of the disorder, handle difficult thoughts and emotions, reduce negative appraisals, and prevent high-EE over the psychotic process. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Association between serious psychological distress and health care use and expenditures by cancer history.

    PubMed

    Han, Xuesong; Lin, Chun Chieh; Li, Chunyu; de Moor, Janet S; Rodriguez, Juan L; Kent, Erin E; Forsythe, Laura P

    2015-02-15

    Serious psychological distress (SPD) is associated with adverse health outcomes such as poor quality of life and shorter survival in cancer survivors, but to the authors' knowledge, the relationship between SPD and health care use and medical expenditures is not clear. A total of 4326 cancer survivors and 57,109 noncancer participants were identified from the 2008 through 2010 Medical Expenditure Panel Survey, a nationwide population-based survey, and their psychological distress was assessed with the 6-item Kessler Psychological Distress Scale (SPD defined by a score ≥13). The association between SPD and use and medical expenditures of various types of health care (office-based, outpatient, hospital inpatient, emergency department, dental, and prescriptions) was examined using a 2-part modeling approach that adjusted for demographic, personal, and comorbidity factors. The marginal effects of SPD on health care use and expenditures were calculated for cancer survivors and were compared with those of noncancer participants. The weighted prevalence of SPD in cancer survivors was 8.2% compared with 4.8% in the noncancer participants. SPD was significantly associated with higher use of all care types except dental care in cancer survivors. Cancer survivors with SPD spent $4431 (95% confidence interval, $3419-$5443) more than survivors without SPD on medical services each year, whereas this extra expenditure associated with SPD for participants without cancer was $2685 (95% confidence interval, $2099-$3271). In a national representative sample of cancer survivors, SPD was found to be associated with higher health care use and medical expenditures. Distress screening and psychosocial care in cancer survivors may help reduce the economic burden of cancer in the United States. © 2014 American Cancer Society.

  9. Associations between psychological distress, workplace accidents, workplace failures and workplace successes.

    PubMed

    Hilton, Michael F; Whiteford, Harvey A

    2010-12-01

    This study investigates associations between psychological distress and workplace accidents, workplace failures and workplace successes. The Health and Work Performance Questionnaire (HPQ) was distributed to employees of 58 large employers. A total of 60,556 full-time employees were eligible for analysis. The HPQ probed whether the respondent had, in the past 30-days, a workplace accident, success or failure ("yes" or "no"). Psychological distress was quantified using the Kessler 6 (K6) scale and categorised into low, moderate and high psychological distress. Three binomial logistic regressions were performed with the dependent variables being workplace accident, success or failure. Covariates in the models were K6 category, gender, age, marital status, education level, job category, physical health and employment sector. Accounting for all other variables, moderate and high psychological distress significantly (P < 0.0001) increased the odds ratio (OR) for a workplace accident to 1.4 for both levels of distress. Moderate and high psychological distress significantly (P < 0.0001) increased the OR (OR = 2.3 and 2.6, respectively) for a workplace failure and significantly (P < 0.0001) decreased the OR for a workplace success (OR = 0.8 and 0.7, respectively). Moderate and high psychological distress increase the OR's for workplace accidents work failures and decrease the OR of workplace successes at similar levels. As the prevalence of moderate psychological distress is approximately double that of high psychological distress moderate distress consequentially has a greater workplace impact.

  10. Structural neighbourhood conditions, social cohesion and psychological distress in the Netherlands.

    PubMed

    Erdem, Özcan; Prins, Richard G; Voorham, Toon A J J; van Lenthe, Frank J; Burdorf, Alex

    2015-12-01

    Neighbourhood inequalities in psychological distress are well reported, but underlying mechanisms remain poorly understood. The main purposes of this study were to investigate associations between structural neighbourhood conditions and psychological distress, and to explore the potential mediating role of neighbourhood social cohesion. Cross-sectional questionnaire study on a random sample of 18,173 residents aged ≥ 16 years (response 49%) from the four largest cities in the Netherlands. Psychological distress was measured with the Kessler Psychological Distress Scale (K10). Structural environmental factors under study were neighbourhood socio-economic status (SES), neighbourhood green, urbanity and home maintenance. Neighbourhood social cohesion was measured by five statements and aggregated to the neighbourhood level by using ecometrics methodology. Multilevel linear regression analysis was used to investigate associations of neighbourhoods characteristics with psychological distress, adjusted for individual level characteristics. High neighbourhood SES and neighbourhood social cohesion were associated with decreased psychological distress. Adjusted for individual level characteristics and neighbourhood SES, only neighbourhood social cohesion remained significantly associated with psychological distress. Neighbourhood social cohesion accounted for 38% of the differences in the association between neighbourhood SES and psychological distress. High neighbourhood social cohesion is significantly associated with decreased psychological distress among residents of the four largest cities in the Netherlands. Reducing neighbourhood inequalities in psychological distress may require increasing social interactions among neighbourhood residents. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  11. Women With Breast Cancer: Self-Reported Distress in Early Survivorship

    PubMed Central

    Lester, Joanne; Crosthwaite, Kara; Stout, Robin; Jones, Rachel N.; Holloman, Christopher; Shapiro, Charles; Andersen, Barbara L.

    2015-01-01

    Purpose/Objectives To identify and compare levels of distress and sources of problems among patients with breast cancer in early survivorship. Design Descriptive, cross-sectional. Setting A National Cancer Institute–designated comprehensive cancer center. Sample 100 breast cancer survivors were selected to represent four time points in the cancer trajectory. Methods Distress was self-reported using the Distress Thermometer and its 38-item problem list. Analysis of variance and chi-square analyses were performed as appropriate. Main Research Variables Distress scores, problem reports, and time groups. Findings Participants scored in range of the cutoff of more than 4 (range = 4.1–5.1) from treatment through three months post-treatment. At six months post-treatment, distress levels were significantly lower. Significant differences were found between groups on the total problem list score (p = 0.007) and emotional (p = 0.01) and physical subscale scores (p = 0.003). Conclusions Comparison of groups at different points in the cancer trajectory found similar elevated levels from diagnosis through three months. Distress remained elevated in early survivorship but significantly decreased at six months post-treatment. Implications for Nursing Interventions to reduce or prevent distress may improve outcomes in early survivorship. PMID:25542330

  12. Terrorism, distress, and drinking: vulnerability and protective factors.

    PubMed

    Richman, Judith A; Rospenda, Kathleen M; Cloninger, Lea

    2009-12-01

    Research has demonstrated effects of 9/11 on distress and drinking outcomes in individuals directly affected and indirectly affected across the United States. Fewer studies have addressed vulnerability and protective factors shown to moderate the effects of stress exposure. We report findings from a Midwestern workplace cohort study. Respondents to a 6 wave longitudinal mail survey completed questionnaires prior to September 11, 2001 and again in 2003 and 2005. Regression analyses encompassed measures of terrorism-related beliefs and fears, workplace stressors (sexual harassment, generalized abuse and low decision latitude), marital and parental status, and perceived social support in 2003, and distress and deleterious drinking outcomes in 2005. Analyses showed that terrorism-related fears significantly interacted with workplace stressors and interpersonal social relationships in predicting distress, drinking or both, controlling for pre-9/11 distress and drinking. Gender differences were also found. This article suggests that certain individuals may be at heightened risk for distressful reactions to and/or deleterious drinking resulting from terrorism-related issues and fears due to additional risk factors involving workplace stressors and inadequate interpersonal bonds. However, limitations of the study were noted and future research was recommended.

  13. Early Childhood Adversity and Its Associations with Anxiety, Depression, and Distress in Women with Breast Cancer

    PubMed Central

    McFarland, Daniel C; Andreotti, Charissa; Harris, Kirk; Mandeli, John; Tiersten, Amy; Holland, Jimmie

    2016-01-01

    Introduction Certain vulnerability factors have been found to place patients at risk for depression and anxiety, especially within the context of medical illness. Early childhood adversity (ECA) primes adults to become more vulnerable to depression by enhancing their reactivity to stress; this relationship is not adequately described in patients with breast cancer. Methods Breast cancer patients (Stage 0-IV) were assessed for ECA (i.e., the Risky Families Questionnaire [RFQ]-subscales include Abuse/Neglect/Chaotic Home Environment), distress (i.e., Distress Thermometer and Problem List [DT&PL]), anxiety (Hospital Anxiety and Depression Scale-Anxiety [HADS-A]), depression (Hospital Anxiety and Depression Scale-Depression [HADS-D]), meeting standardized cut-off thresholds for distress (DT&PL ≥4 or ≥7)/anxiety (HADS-A ≥8)/depression (HADS-D ≥8), and demographic factors. Results One hundred twenty-five participants completed the study (78% response rate). ECA was associated with depression (p<.001), anxiety (p=.001), and distress (p=.006) and with meeting cut-off threshold criteria for distress (p=.024), anxiety (p=.048), and depression (p=.001). On Multivariate analysis, only depression (p=.04) and emotional issues (i.e, component of DT&PL)(p=.001) were associated with ECA. Neglect, but not Abuse and Chaotic Home Environment, was associated with depression (β=.442, p<.001), anxiety (β=.342, p=.002), and self-identified problems with family (β−.288, p=.022), emotion (β=.345, p=.004), and physical issues (β=.408, p<.001). Conclusion ECA and neglect are associated with multiple psychological symptoms but most specifically depression in the setting of breast cancer. ECA contributes to psychological burden as a vulnerability factor. ECA may help to explain individual patient trajectories and influence the provision of patient centered care for psychological symptoms in patients with breast cancer. PMID:26876888

  14. Trauma and Psychological Distress among Ethnically Diverse Community College Students

    ERIC Educational Resources Information Center

    Edman, Jeanne L.; Watson, Susan B.; Patron, David J.

    2016-01-01

    An association has been found between traumatic experiences and psychological distress; however, the impact of ethnicity on psychological distress is less clear. The present study examined the relationship between traumatic experiences and measures of psychological distress among a multiethnic sample of community college students. A total of 389…

  15. The Impact of Financial Hardship on Single Parents: An Exploration of the Journey From Social Distress to Seeking Help.

    PubMed

    Stack, Rebecca Jayne; Meredith, Alex

    2018-01-01

    Single parent families are at high risk of financial hardship which may impact on psychological wellbeing. This study explored the impact of financial hardship on wellbeing on 15 single parents. Semi-structured interviews were conducted and analysed using constructivist thematic analysis. Participants described food and fuel poverty, and the need to make sacrifices to ensure that children's basic needs were met. In some cases, participants went without food and struggled to pay bills. Isolation, anxiety, depression, paranoia, and suicidal thoughts were described. However, participants reported that psychological services not able to take the needs of single parents in to account. Support for single parents must acknowledge the impact of social circumstances and give more consideration economic drivers of distress.

  16. Emotional Distress and Cognitive Functioning of Older Couples: A Dyadic Analysis

    PubMed Central

    Lee, Jinkook; Paddock, Susan M.; Feeney, Kevin

    2017-01-01

    This paper examines the relationship between cognitive functioning and emotional distress in a sample of 2,684 married couples from the 2006 and 2008 Korean Longitudinal Study of Aging surveys. Using the Center for Epidemiologic Studies Depression (CESD) scale and the Mini-Mental State Exam (MMSE), we examine longitudinal interrelation between emotional and cognitive health for individuals and spouses. We test how emotional distress and cognitive impairment affect each other for individuals and how these for one spouse may affect the other. We find emotional distress contributes to cognitive impairment for wives, but not for husbands. We also find emotional distress and cognitive impairment in one spouse affects that in the other, although the emotional distress of wives affects husbands’ more than that of husbands affects wives’. We find no evidence indicating that emotional distress of one’s spouse affects one’s own cognitive impairment or that the cognitive ability of one’s spouse leads to one’s own emotional distress. PMID:21990580

  17. Adolescent identity development and distress in a clinical sample.

    PubMed

    Wiley, Rachel E; Berman, Steven L

    2013-12-01

    The purpose of this study was to examine the relationships of identity development and identity distress to psychological adjustment within adolescents affected by psychological problems. Participants included 88 adolescents (43.2% female) ranging from 11 to 20 years of age who were receiving services from a community mental health center. A high proportion of the participants (22.7%) met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision criteria for Identity Problem. Regression analyses found psychopathology symptom score was associated with identity distress, identity exploration, and identity commitment, while identity distress was only related to psychopathology symptom score and not the other two identity variables. Adolescents with a clinical diagnosis may report significant levels of identity distress. Given that the relationship between psychopathology and identity distress may be reciprocal, assessing for identity issues might be prudent when conducting clinical diagnostic interviews and useful in treatment planning. © 2013 Wiley Periodicals, Inc.

  18. Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine.

    PubMed

    Cockerham, William C; Hinote, Brian P; Abbott, Pamela

    2006-11-01

    This paper examines the relationship between psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine. These countries have been subjected to highly stressful and extensive social change associated with the transition out of communism. Data were collected by face-to-face interviews (n = 10,406) in November 2001. Distress was measured by 12 psychological distress symptoms. Health lifestyles focused on measures of alcohol consumption, smoking and diet. We found that females carried a much heavier burden of psychological distress than males, but this distress did not translate into greater alcohol consumption and smoking for these women or for men. The greatest influence of distress on health lifestyle practices was on daily diets in that both less distressed females and males consumed a more balanced diet than more distressed persons. Our findings suggest that it is the normative demands of a particular lifestyle, rather than distress, that principally shapes the pattern of heavy male drinking. This is an important finding as some sources indicate heavy drinking is largely responsible for the health crisis in the former socialist states.

  19. Predicting parental distress among children newly diagnosed with craniopharyngioma.

    PubMed

    Peterson, Rachel K; Ashford, Jason M; Scott, Sarah M; Wang, Fang; Zhang, Hui; Bradley, Julie A; Merchant, Thomas E; Conklin, Heather M

    2018-06-22

    Childhood brain tumor diagnoses are stressful for families. Children diagnosed with craniopharyngioma (Cp) present with particularly challenging medical and cognitive problems due to tumor location and associated biophysiologic comorbidities. This study examined parental distress in a sample of families of patients with Cp treated with proton beam therapy to identify factors for targeting psychological intervention. Prior to (n = 96) and 1 year after (n = 73) proton therapy, parents of children diagnosed with Cp (9.81 ± 4.42 years at baseline; 49% male) completed a self-report measure of distress, the Brief Symptom Inventory (BSI). Children completed cognitive assessment measures at baseline; medical variables were extracted from the study database. At baseline, t-tests revealed parents reported higher levels of distress than normative expectations on Anxiety, Depression, Global Severity, and Positive Symptom Distress BSI scales (P < 0.05). Linear mixed effects models revealed parent report measures of child executive dysfunction and behavioral issues were more predictive of parental distress than patients' cognitive performance or medical status (P < 0.05). Models also revealed a significant reduction only in Anxiety over time (t = -2.19, P < 0.05). Extensive hypothalamic involvement at baseline predicted this reduction (P < 0.05). Parents experience significant distress before their child begins adjuvant therapy for Cp, though parental distress appears largely unrelated to medical complications and more related to parent perceptions of child cognitive difficulties (vs. child performance). Importantly, this may be explained by a negative parent reporting style among distressed parents. Knowledge of socio-emotional functioning in parents related to patient characteristics is important for optimization of psychological intervention. © 2018 Wiley Periodicals, Inc.

  20. Medical students' experiences of moral distress: development of a web-based survey.

    PubMed

    Wiggleton, Catherine; Petrusa, Emil; Loomis, Kim; Tarpley, John; Tarpley, Margaret; O'Gorman, Mary Lou; Miller, Bonnie

    2010-01-01

    To develop an instrument for measuring moral distress in medical students, measuring the prevalence of moral distress in a cohort of students, and identifying the situations most likely to cause it. Moral distress, defined as the negative feelings that arise when one knows the morally correct thing to do but cannot act because of constraints or hierarchies, has been documented in nurses but has not been measured in medical students. The authors constructed a survey consisting of 55 items describing potentially distressing situations. Responders rated the frequency of these situations and the intensity of distress that they caused. The survey was administered to 106 fourth-year medical students during a three-week period in 2007; the response rate was 60%. Each of the situations was experienced by at least some of the 64 respondents, and each created some degree of moral distress. On average, students witnessed almost one-half of the situations at least once, and more than one-third of the situations caused mild-to-moderate distress. The survey measured individual distress (Cronbach alpha = 0.95), which varied among the students. Whereas women witnessed potentially distressing situations significantly more frequently than did men (P = .04), men tended to become more distressed by each event witnessed (P = .057). Medical students frequently experience moral distress. Our survey can be used to measure aspects of the learning environment as well as individual responses to the environment. The variation found among student responses warrants further investigation to determine whether students at either extreme of moral distress are at risk of burnout or erosion of professionalism.

  1. The Impact of Multiple Roles on Psychological Distress among Japanese Workers

    PubMed Central

    Honda, Ayumi; Abe, Yasuyo; Date, Yutaka; Honda, Sumihisa

    2015-01-01

    Background There has been considerable interest in Japanese society in the problem of work-related stress leading to depressive symptoms, and an increasing number of primary houseworkers maintain paid employment. The purpose of this study was to examine the differential impact of multiple roles associated with psychological distress among Japanese workers. Methods We studied 722 men and women aged 18–83 years in a cross-sectional study. The K10 questionnaire was used to examine psychological distress. Results The proportion of participants with psychological distress was higher in women (17.8%) compared with men (11.5%). Having three roles significantly decreased the risk of psychological distress [women: odds ratio (OR), 0.37-fold; men: OR, 0.41] compared with only one role. In working married women, there was significantly less psychological distress (OR, 0.27), and those with childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.38) than those with only an employment role. Similarly, working married men who had childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.41) than those who had only an employment role. Conclusion The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress. PMID:26106510

  2. The Impact of Multiple Roles on Psychological Distress among Japanese Workers.

    PubMed

    Honda, Ayumi; Abe, Yasuyo; Date, Yutaka; Honda, Sumihisa

    2015-06-01

    There has been considerable interest in Japanese society in the problem of work-related stress leading to depressive symptoms, and an increasing number of primary houseworkers maintain paid employment. The purpose of this study was to examine the differential impact of multiple roles associated with psychological distress among Japanese workers. We studied 722 men and women aged 18-83 years in a cross-sectional study. The K10 questionnaire was used to examine psychological distress. The proportion of participants with psychological distress was higher in women (17.8%) compared with men (11.5%). Having three roles significantly decreased the risk of psychological distress [women: odds ratio (OR), 0.37-fold; men: OR, 0.41] compared with only one role. In working married women, there was significantly less psychological distress (OR, 0.27), and those with childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.38) than those with only an employment role. Similarly, working married men who had childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.41) than those who had only an employment role. The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress.

  3. Non-pharmacological approaches to alleviate distress in dementia care.

    PubMed

    Mitchell, Gary; Agnelli, Joanne

    2015-11-25

    Distress is one of the most common clinical manifestations associated with dementia. Pharmacological intervention may be appropriate in managing distress in some people. However, best practice guidelines advocate non-pharmacological interventions as the preferred first-line treatment. The use of non-pharmacological interventions encourages healthcare professionals to be more person-centred in their approach, while considering the causes of distress. This article provides healthcare professionals with an overview of some of the non-pharmacological approaches that can assist in alleviating distress for people living with dementia including: reminiscence therapy, reality orientation, validation therapy, music therapy, horticultural therapy, doll therapy and pet therapy. It provides a summary of their use in clinical practice and links to the relevant literature.

  4. Distress vocalization sequences broadcasted by bats carry redundant information.

    PubMed

    Hechavarría, Julio C; Beetz, M Jerome; Macias, Silvio; Kössl, Manfred

    2016-07-01

    Distress vocalizations (also known as alarm or screams) are an important component of the vocal repertoire of a number of animal species, including bats, humans, monkeys and birds, among others. Although the behavioral relevance of distress vocalizations is undeniable, at present, little is known about the rules that govern vocalization production when in alarmful situations. In this article, we show that when distressed, bats of the species Carollia perspicillata produce repetitive vocalization sequences in which consecutive syllables are likely to be similar to one another regarding their physical attributes. The uttered distress syllables are broadband (12-73 kHz) with most of their energy focussing at 23 kHz. Distress syllables are short (~4 ms), their average sound pressure level is close to 70 dB SPL, and they are produced at high repetition rates (every 14 ms). We discuss that, because of their physical attributes, bat distress vocalizations could serve a dual purpose: (1) advertising threatful situations to conspecifics, and (2) informing the threatener that the bats are ready to defend themselves. We also discuss possible advantages of advertising danger/discomfort using repetitive utterances, a calling strategy that appears to be ubiquitous across the animal kingdom.

  5. Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study.

    PubMed

    O'Connor, Mairead; Waller, Jo; Gallagher, Pamela; Martin, Cara M; O'Leary, John J; D'Arcy, Tom; Prendiville, Walter; Flannelly, Grainne; Sharp, Linda

    2015-01-01

    Women who have an abnormal cervical cytology test may be referred for a colposcopy. Accumulating evidence suggests some women may experience distress after colposcopy. This exploratory study examined women's differing experiences of post-colposcopy distress with the aim of identifying factors that are predictive of, or protective against, distress. We carried out semistructured, qualitative interviews with 23 women who had undergone colposcopies. Interviews were transcribed verbatim, coded, and analyzed thematically. The Framework Approach was used to summarize and organize the data and identify emerging higher order themes. Two forms of post-colposcopy distress emerged: 1) short term and 2) long term. Short-term distress was experienced immediately after the colposcopy and in the days afterward, and was usually related to the physical experience of the colposcopy. Long-term distress typically persisted over time and was related to concerns about fertility, cervical cancer, and sexual intercourse. The drivers of short-term and long-term distress differed. Factors related to short-term distress were feeling unprepared for the procedure, having a negative experience of the procedure, and attending the clinic alone. Factors related to long-term distress were future intentions to have (more) children, having physical after-effects of the procedure that impacted on the woman's life, and being under on-going clinic surveillance. Absence of these factors (e.g., being accompanied to the clinic) was protective against short- and long-term distress. Colposcopy can lead to short- and long-term post-procedural distress for some women. We identified a range of factors, some potentially modifiable, that seem to influence the chances of experiencing distress. These results may inform the development of strategies or interventions aimed at preventing or minimizing distress after colposcopy and related procedures. Copyright © 2015 Jacobs Institute of Women's Health. Published by

  6. Nurse middle manager ethical dilemmas and moral distress.

    PubMed

    Ganz, Freda D; Wagner, Nurit; Toren, Orly

    2015-02-01

    Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.

  7. Specific conditions of distress in the dental situation.

    PubMed

    Hentschel, U; Allander, L; Winholt, A S

    1977-01-01

    The general feeling of distress in the dental situation has been studied in 60 female dental patients and correlated to the following variables: Experimentally evaluated sensitivity to pain, self-rating and the dentist's rating of sensitivity to pain, the pain-threshold value in the teeth, the need of local anesthesia, extraversion-introversion, neuroticism, and some percept-genetic psychological measures of adaptive behavior. The subjects have also answered a questionnaire for grading their distress in regard to different aspects of the treatment-situation, which were combined into eight groups using factor analysis and then correlated to the general distress. The variables having a significant relation to distress in the dental situation were: the dentist's rating of the patient's sensitivity, the need of anesthesia, four groups of treatment-components and two of the percept-genetic measures. There was also a certain relation to the pain threshold in the teeth.

  8. A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations.

    PubMed

    Caron, J; Liu, A

    2010-06-01

    This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Data were collected through the Canadian Community Health Survey - Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.

  9. Psychological distress and coping in military cadre candidates

    PubMed Central

    Nakkas, Can; Annen, Hubert; Brand, Serge

    2016-01-01

    Background Soldiers must cope with stressors during both military operations and training if they are to accomplish their missions successfully and stay mentally stable. This holds true particularly for military superiors, as they bear greater responsibilities and must meet greater demands during both deployment and training. Accordingly, in the present study, we investigated whether recruits chosen for further promotion at the end of basic training differed with regard to psychological distress and coping strategies from those not chosen for promotion, and whether recruits’ coping styles and distress levels were associated. Methods A total of 675 Swiss recruits took part in the study. At the beginning of basic training, recruits filled out self-rating questionnaires covering demographic data, psychological distress (depression, somatization, anxiety, interpersonal sensitivity, and hostility), and coping styles. Results were compared between those recruits who received a recommendation for further promotion at the end of basic training and those who did not. Results Recruits selected for promotion had lower scores for depressive symptoms and hostility, engaged more in active coping, and considered their coping to be more effective. Dysfunctional and functional coping were associated with higher and lower distress levels, respectively. Conclusion Recruits recommended for promotion exhibited less psychological distress during basic training and exhibited a socially more conducive profile of distress. They also endorsed more efficient and more prosocial coping strategies than those recruits not recommended for promotion. These cognitive–emotional features not only contribute to resilience but are also consistent with leadership research, indicating the importance of emotional stability and prosocial behavior in successful leaders. PMID:27621634

  10. Non-professional-help-seeking among young people with depression: a qualitative study

    PubMed Central

    2014-01-01

    Background Adolescents and young adults often suffer from depression, but tend to avoid seeking professional help. The aim of this study was to explore the reasons for non-professional-help-seeking in a sample of young adults resident in Catalonia with depressive symptoms through a qualitative study. In addition, the subjects were invited to offer their recommendations for making mental health care services more accessible. Methods We recruited 105 young persons (17–21 years of age) who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants were interviewed in depth about their reasons for avoiding professional mental health care services, and the interview results were analyzed using both qualitative and cultural domain techniques and corroborated through comparison with the results of three focus groups. Results Participants’ reasons for avoidance varied both by gender and according to prior experience with health services. Male study participants and female controls mainly understood depressive symptoms as normal and therefore not requiring treatment. Female participants with self-perceived distress were more likely to cite problems of access to treatment and fear of speaking to an unknown person about their problems. Females with a diagnosis expressed lack of trust in the benefits of treatment and fear of the social consequences of help-seeking. In their recommendations for best practices, the study participants suggested educational initiatives, as well as changes in the organization of mental health care services. Conclusions A better understanding of the views of young people and a greater effort to involve them as active participants is important for facilitating help-seeking in this age group, and for adapting mental health care services to adolescent users and their social context. PMID

  11. Resources, stressors and psychological distress among older adults in Chennai, India.

    PubMed

    Chokkanathan, Srinivasan

    2009-01-01

    Scant information exists on the complex interaction between resources and stressors and their subsequent influence on the psychological distress of older adults in India. Within the framework of resource theory, the present study examined the various pathways through which resources and stressors influence psychological distress by testing four models - the independence model, the stress-suppression model, the counteractive model and the resource-deterioration model. The independence model posits that resources and stressors have a direct relationship with psychological distress. The stress-suppression model hypothesizes that stressors mediate the influence of resources on psychological distress. The counteractive model postulates that stressors mobilize resources, which in turn influence psychological distress. The resource-deterioration model states that stressors deplete resources and subsequently exacerbate distress. In the present study, resources include social support, religiosity and mastery; stressors include life events, abuse and health problems. Psychological distress was measured using the Center for Epidemiological Studies Depression scale and Geriatric Depression Scale. Interviews were conducted among 400 adults aged 65 years and above, randomly selected from the electoral list of urban Chennai, India. The battery of instruments was translated into Tamil (local language) by back-translation. Structural Equation Modeling was conducted to test the three models. The results supported the stress-suppressor model. Resources had an indirect, negative relationship with psychological distress, and stressors had a direct, positive effect on distress. As such there is a need to identify and strengthen the resources available to older adults in India.

  12. Does financial hardship account for elevated psychological distress in lone mothers?

    PubMed

    Hope, S; Power, C; Rodgers, B

    1999-12-01

    Lone mothers have been shown to have higher levels of psychological distress than married mothers, but it is not clear how this difference arises. Using data from the 1958 British birth cohort followed to age 33, we investigated alternative explanations for the excess distress of lone mothers. Logistic regression models were used to estimate odds ratios for distress (measured using the Malaise Inventory) in lone vs married mothers. Odds ratios were adjusted to assess the contribution of explanatory factors. At age 33, psychological distress was greater among lone than married mothers (OR 2.59, 95% CI 1.97, 3.41). The odds ratio decreased to 1.43 (95% CI 1.02, 2.01) after adjustment for all explanatory factors (prior psychological distress, age of youngest child and number of children in the household, and contemporary measures of financial hardship, employment, and social support). Attenuation of the odds ratio was most marked after taking account of financial hardship. Psychological distress was greater among divorced mothers than never married mothers, though not significantly (OR = 1.70, 95% CI 0.88, 3.28). This difference was not explained by the factors examined, and was not due to the immediate distress associated with a recent divorce. Elevated psychological distress of lone mothers appears to be related to financial hardship, while other explanations, including social support and selection, have a more modest impact. Not all of the elevated psychological distress among lone mothers was accounted for, particularly among divorced lone mothers.

  13. Are Mindfulness and Self-Compassion Related to Psychological Distress and Communication in Couples Facing Lung Cancer? A Dyadic Approach.

    PubMed

    Schellekens, Melanie P J; Karremans, Johan C; van der Drift, Miep A; Molema, Johan; van den Hurk, Desiree G M; Prins, Judith B; Speckens, Anne E M

    2017-01-01

    Lung cancer patients and their spouses report high rates of distress. Due to the increasing popularity of and evidence for mindfulness-based interventions in cancer, mindfulness and self-compassion have been identified as potentially helpful skills when coping with cancer. This dyadic study examined how mindfulness and self-compassion are related to psychological distress and communication about cancer in couples facing lung cancer. Using the actor-partner interdependence model, self-reported mindfulness, self-compassion, psychological distress and communication about cancer were analyzed in a cross-sectional sample of 88 couples facing lung cancer. Regarding psychological distress, no difference was found between patients and spouses. In both partners, own levels of mindfulness ( B  = -0.19, p  = .002) and self-compassion ( B  = -0.45, p  < .001) were negatively related to own distress levels. At a dyadic level, own self-compassion was less strongly associated with distress if the partner reported high self-compassion ( B  = 0.03, p  = .049). Regarding communication about cancer, patients reported to communicate more openly with their partner than with spouses. However, after controlling for gender, this difference was no longer significant. In both partners, own self-compassion ( B  = 0.03, p  = .010) was significantly associated with own communication while mindfulness was not. A trend showed that mindfulness of the partner was related to more open communication in the individual ( B  = 0.01, p  = .080). These findings give a first indication that mindfulness and self-compassion skills may go beyond the individual and could impact couple functioning. Future research should examine whether couples facing (lung) cancer may benefit from programs in which mindfulness and self-compassion are cultivated.

  14. Testing a mediation model of psychotherapy process and outcome in psychodynamic psychotherapy: Previous client distress, psychodynamic techniques, dyadic working alliance, and current client distress.

    PubMed

    Kivlighan, Dennis M; Hill, Clara E; Ross, Katherine; Kline, Kathryn; Furhmann, Amy; Sauber, Elizabeth

    2018-01-05

    To test a sequential model of psychotherapy process and outcome, we included previous client distress, therapist psychodynamic techniques, dyadic working alliance, and current client distress. For 114 sets of eight-session segments in 40 cases of psychodynamic psychotherapy, clients completed the Outcome Questionnaire-45 and Inventory of Interpersonal Problems-32 after the first and final session, judges reliably coded one middle sessions on the Psychodynamic subscale of the Multitheoretical List of Therapeutic Interventions, and clients and therapists completed the Working Alliance Inventory after every session. Results indicated that higher use of psychodynamic techniques was associated with higher levels of the working alliance, which in turn was associated decreased client distress; and working alliance was higher later in psychotherapy. There was a significant indirect effect of psychodynamic techniques on decreases in distress mediated by the working alliance. Implications for theory, practice, and research are provided. Clinical or methodological significance of this article: Conducted a longitudinal, latent variable examination of the relationships of psychodynamic techniques and working alliance on client distress. Psychodynamic techniques have an indirect effect on decreases in client distress through the dyadic working alliance.

  15. Assessment of sexually related personal distress accompanying premenopausal sexual dysfunction with an Arabic version of the Female Sexual Distress Scale.

    PubMed

    Ahmed, Magdy R; Shaaban, Mohamed M; Meky, Heba K

    2017-10-01

    To assess sexually related personal distress among premenopausal women with female sexual dysfunction (FSD) via a validated Arabic version of the Female Sexual Distress Scale (FSDS). A cross-sectional study was conducted among women attending Suez Canal University Hospital, Egypt, between May 2015 and July 2016. In a pilot study to evaluate test-retest reliability and internal consistency, 42 sexually active premenopausal women (aged ≥20 years) completed the Arabic FSDS at recruitment and 2 weeks later. Subsequently, premenopausal sexually active women (aged 20-45 years) were asked to complete the female sexual function index (FSFI) questionnaire; those with FSD (FSFI score ≤26.55) were invited to return to complete the validated version of the Arabic FSDS. The Arabic FSDS showed good test-retest reliability (Pearson correlation coefficient 0.93-0.98) and internal consistency (Cronbach α 0.83-0.92). Overall, 140 (58.1%) of 241 women who completed the FSFI had sexual dysfunction, of whom 51 (36.4%) had sexually related personal distress. Marriage duration was significantly increased among women with FSD (P<0.001). All FSFI sexual domains except lubrication were negatively correlated with FSDS. FSD and sexually related personal distress were highly interrelated and prevalent. An Arabic version of the FSDS was found to be valid and reliable for evaluation of sexually related personal distress. © 2017 International Federation of Gynecology and Obstetrics.

  16. 19 CFR 4.32 - Vessels in distress; landing of cargo.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Vessels in distress; landing of cargo. 4.32...; DEPARTMENT OF THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Landing and Delivery of Cargo § 4.32 Vessels in distress; landing of cargo. (a) When a vessel from a foreign port arrives in distress at a port...

  17. Shift work, mental distress and job satisfaction among Palestinian nurses.

    PubMed

    Jaradat, Y M; Nielsen, M B; Kristensen, P; Bast-Pettersen, R

    2017-01-01

    Associations between shift work (SW) schedules, mental distress and job satisfaction have never been completely described. To examine gender-specific associations of SW with mental distress and job satisfaction in nurses in Hebron District, Palestine, in 2012. Detailed information on work schedules (day versus shift), socio-demographic status, mental distress (General Health Questionnaire, GHQ-30) and job satisfaction (Generic Job Satisfaction Scale) in nurses employed in Hebron District, Palestine, was obtained through a questionnaire survey. Associations of SW and outcomes were examined by linear regression analysis. Of 372 nurses eligible for the study, 309 and 338 completed surveys regarding mental distress and job satisfaction, respectively. The sample comprised 62% women and 38% men. After adjusting for covariates, women working shifts reported significantly higher levels of mean mental distress [β coefficient 3.6; 95% confidence interval (CI) 0.3-7.0] compared with women working regular day shifts. Men working shifts reported significantly lower levels of job satisfaction (-3.3; 95% CI -6.2 to -0.5) than men working regular day shifts. Women reported higher levels of mental distress than men, but this was unrelated to work schedule. In this study, nurses working shifts reported higher levels of mental distress and lower levels of job satisfaction, although these associations were weaker when adjusted for potential covariates. There was no evidence of a gender differential in the association between SW and mental distress and job satisfaction. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

  18. Maternal distress and intended breastfeeding duration.

    PubMed

    Rondó, Patricia H C; Souza, Márcia R

    2007-03-01

    To evaluate the associations between maternal psychological status and intended breastfeeding duration. A total of 852 pregnant women who attended antenatal care between September 1997 and August 2000 in 12 health units and five hospitals in Jundiaí city, Brazil, were included in the study. Psychological measures (stress and distress) were obtained at a gestational age from 30 to 36 weeks, using standardized scales, questionnaires and inventories. Psychological factors specifically related to breastfeeding assessed their worries, concerns, and support when breastfeeding. Multiple linear regression analysis identified the associations between the outcome "intended duration of breastfeeding" and psychological status of the mothers, controlling for toxic exposure, socioeconomic, demographic, obstetric and nutritional factors. There were negative associations between the outcome and distress, "concerned about body's changes", and work outside home, and a positive association between the outcome and marital status (p < or = 0.03). Early identification of distress in pregnant women and a more attentive encouragement to breastfeed is probably one of the steps to improve intended breastfeeding duration.

  19. Distress tolerance and physiological reactivity to stress predict women's problematic alcohol use.

    PubMed

    Holzhauer, Cathryn Glanton; Wemm, Stephanie; Wulfert, Edelgard

    2017-06-01

    Research has shown that measures of reactivity to distress-including distress tolerance and physiological reactivity to stress-are dysregulated in women who misuse alcohol. These variables may interact and create a risk profile for young adult women, reflecting patterns of stress reactivity that confer a risk for alcohol misuse. The current study tested this hypothesis by examining the independent and interactive associations of subjective distress tolerance, behavioral distress tolerance, and physiological stress reactivity with women's alcohol misuse. The study was conducted with a sample of 91 college women recruited on a large northeastern university campus. Results showed that subjective levels of distress tolerance and physiological reactivity to stress (skin conductance reactivity, SCR), but not behavioral distress tolerance, were independently associated with alcohol misuse. In addition, subjective distress tolerance moderated the relationship between SCR and negative alcohol-related consequences. Specifically, women with low physiological reactivity (SCR) to a stressful task and greater urge to quickly rid themselves of distress (low subjective distress tolerance) endorsed a significantly greater number of adverse consequences from their alcohol use. These results extend prior findings by showing that, even among a nonclinical sample of women, lower stress reactivity in combination with low subjective distress tolerance is associated with increased risk for various drinking-related negative consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Psychological Distress and Emotional Expression on Facebook.

    PubMed

    Bazarova, Natalya N; Choi, Yoon Hyung; Whitlock, Janis; Cosley, Dan; Sosik, Victoria

    2017-03-01

    Social network sites (SNS) are a novel social environment for college students with psychological distress to connect with their peers, but the nature and effects of these interactions are not well understood. This study reports findings from a Facebook study among 238 college students reporting nonspecific psychological distress using the K-6 scale. Behavioral data included Facebook status updates containing affect words written by participants within the past 60 days and the number of responses (comments and likes) each update received. The updates were also coded for depression symptoms. Self-report data included participants' self-presentational concerns, the affective valence of each post, effects of responses on mood, and satisfaction with the responses to and outcome of each status update. Higher psychological distress was associated with displaying depression language on Facebook, with higher self-presentational concerns, and with less satisfaction with audiences' responses and less overall satisfaction with the outcome of the interaction. These results offer a unique glimpse into the social world of college students with psychological distress through their everyday use of Facebook, and how the interplay of this novel environment and students' mental health impacts their social behaviors and interaction meaning-making on Facebook.

  1. Frustrated Fertility: Infertility and Psychological Distress among Women.

    ERIC Educational Resources Information Center

    McQuillan, Julia; Greil, Arthur L.; White, Lynn; Jacob, Mary Casey

    2003-01-01

    Tests the hypothesis that women who have experienced infertility report higher psychological distress. Examines whether roles or resources condition the effects of infertility or whether its effects are limited to childless women. Infertility combined with involuntary childlessness is associated with significantly greater distress. For women in…

  2. Brief coping strategy enhancement for distressing voices: Predictors of engagement and outcome in routine clinical practice.

    PubMed

    Paulik, Georgie; Jones, Anna-Marie; Hayward, Mark

    2018-05-24

    Cognitive behaviour therapy is recommended internationally as a treatment for psychosis (targeting symptoms such as auditory hallucinations, or "voices"). Yet mental health services are commonly unable to offer such resource-intensive psychological interventions. Brief, symptom-specific and less resource-intensive therapies are being developed as one initiative to increase access. However, as access increases, so might the risk of offering therapy to clients who are not optimally disposed to engage with and benefit from therapy. Thus, it is important to identify who is most/least likely to engage with and benefit from therapy, and when. In the current study, 225 clients were assessed for suitability for a brief, 4-session, manualized, cognitive behaviour therapy-based intervention for voices (named coping strategy enhancement therapy) and 144 commenced therapy, at a transdiagnostic voices clinic based in Sussex, UK. This article reports on the value of depression, anxiety, stress, insight into the origin of voices, length of voice hearing, and demographics in the prediction of engagement and outcomes. The study found that higher levels of baseline depression, anxiety, and stress were significantly associated with poorer outcomes, especially if clients also had high levels of voice-related distress. The engagement analyses showed that levels of voice-related distress at baseline predicted dropout. These findings highlight the importance of assessing negative affect and voice-related distress prior to commencing therapy for distressing voices, to help determine if the client is suitable or ready for brief-coping strategy enhancement. Copyright © 2018 John Wiley & Sons, Ltd.

  3. Distinguishing fear versus distress symptomatology in pediatric OCD

    PubMed Central

    Rozenman, Michelle; Peris, Tara; Bergman, R. Lindsey; Chang, Susanna; O’Neill, Joseph; McCracken, James T.; Piacentini, John

    2018-01-01

    Prior research has identified OCD subtypes or “clusters” of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7 to 17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment. PMID:27225633

  4. Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD.

    PubMed

    Rozenman, Michelle; Peris, Tara; Bergman, R Lindsey; Chang, Susanna; O'Neill, Joseph; McCracken, James T; Piacentini, John

    2017-02-01

    Prior research has identified OCD subtypes or "clusters" of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7-17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment.

  5. Effects of Screening for Psychological Distress on Patient Outcomes in Cancer: a Systematic Review

    PubMed Central

    Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

    2013-01-01

    Objective Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes. Methods CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT. Results There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement. Conclusion Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening. PMID:23751231

  6. Distressing situations in the intensive care unit: a descriptive study of nurses' responses.

    PubMed

    McClendon, Heather; Buckner, Ellen B

    2007-01-01

    Moral distress is a significant stressor for nurses in critical care. Feeling that they are doing the "right thing" is important to nurses, and situations of moral distress can make them question their work. The purpose of this study was to describe critical care nurses' levels of moral distress, the effects of that distress on their personal and professional lives, and nurses' coping strategies. The study consisted of open-ended questions to elicit qualitatively the nurses' feelings about moral distress and a quantitative measure of the degree of distress caused by certain types of situations. The questionnaires were then analyzed to assess the nurses' opinions regarding moral distress, how their self-perceived job performance is affected, and what coping methods they use to deal with moral distress. The most frequently encountered moral distress situations involved critically ill patients whose families wished to continue aggressive treatment when it probably would not benefit the patient in the end.

  7. Accuracy and Bias in Perception of Distress Level and Distress Change Among Same-Sex College Student Roommate Dyads.

    PubMed

    Xu, Qi; Shrout, Patrick E

    2018-06-01

    University students often experience high levels of stress and, in some cases, the stress leads to tragic outcomes. An important question is whether roommates can perceive the level and change in distress in their peers. We examined self- and other-reports of 187 same-sex undergraduate dyads at two times in a spring semester. Using the truth and bias model, we found that roommates tended to underestimate their partner's distress at both time points, and that ratings were equally influenced by truth and self-focus bias forces. For change, however, there was no evidence of directional (average) bias, and perceived change was only significantly related to the truth force. There were no consistent moderation effects by closeness or gender. These findings are interpreted in the context of person perception theory and the practical need for early warning about extreme distress in college students.

  8. Psychological Distress and Coping amongst Higher Education Students: A Mixed Method Enquiry

    PubMed Central

    Deasy, Christine; Coughlan, Barry; Pironom, Julie; Jourdan, Didier; Mannix-McNamara, Patricia

    2014-01-01

    Background Psychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students. Methods This mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping. Results A significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between “escape-avoidance” and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity. Conclusion The paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and

  9. Understanding psychological distress among pediatric cancer caregivers.

    PubMed

    Nam, Gina E; Warner, Echo L; Morreall, Deborah K; Kirchhoff, Anne C; Kinney, Anita Y; Fluchel, Mark

    2016-07-01

    Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic, and patient clinical factors on caregivers' self-reported psychological distress associated with having a child with cancer. N = 366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010 to July 2012. The Impact of Event Scale (IES), along with two subscales "intrusion" and "avoidance" measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95 % confidence intervals (95 % CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (standard deviation (SD) = 16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes <$40,000 reported higher mean distress scores than those with incomes ranging from $40,000 to $79,999 (β = 4.45, 95 % CI 0.04-8.87, p = 0.05). Infrequently or never attending religious services, younger child age, and a diagnosis of AML were associated with higher intrusion (all p < 0.05). Caregivers with a child currently receiving therapy reported higher overall IES (β = 5.9, 95 % CI 2.15-9.7, p < 0.01) and intrusion (β = 4.1, 95 % CI 1.9-6.3, p < 0.001) scores compared to those off therapy (β = 3.13, 95 % CI 0.93-5.33, p < 0.01). Our findings identify socioeconomic and clinical factors that influence psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.

  10. Moral distress: a review of the argument-based nursing ethics literature.

    PubMed

    McCarthy, Joan; Gastmans, Chris

    2015-02-01

    The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers' Index and Socindex. A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. We found that like the empirical literature, most authors in this review draw on Jameton's original definition and describe moral distress in psychological-emotional-physiological terms. They also agree that moral distress is linked to the presence of some kind of constraint on nurses' moral agency, and that it is best understood as a two-staged process that can intensify over time. There is also consensus that moral distress has an important normative meaning, although different views concerning the normative meaning of moral distress are expressed. Finally, the authors generally agree that moral distress arises from a number of different sources and that it (mostly) affects negatively on nurses' personal and professional lives and, ultimately, harms patients. However, despite this consensus, many authors take issue with the way in which moral distress is conceptualized and operationalized. Moreover, while some worry that identifying nurses as a group of health professionals whose voices are ignored or marginalized might disempower nurses and encourage them to avoid their moral responsibilities, others take situations involving moral distress as indicative of more fundamental, structural inequities at the heart of contemporary healthcare provision. We conclude that research on moral distress in nursing is timely and important because it highlights the specifically moral labour of nurses. However, we suggest that significant concerns about the conceptual fuzziness and

  11. Pain complaints and psychological distress among soldiers in specialty military medical clinics.

    PubMed

    Feldman, D; Rabinowitz, J

    1995-05-01

    This paper explores: (1) the relationship of pain complaints and psychological distress among orthopedic, dermatology, ophthalmology, and neurology outpatients, (2) the ability of patients with pain complaints and their physicians to detect patients' psychological distress, and (3) the connection between type of pain, prognosis as rated by physician, and patient's use of military primary health care and mental health treatment. Five hundred fifty-six soldiers in compulsory service in the Israel Defence Forces, ages 18 to 21, responded to the PERI-D (Psychiatric Epidemiological Research Interview Demoralization Scale), a measure of psychological distress, and questions about presenting medical complaint and use of mental health and primary health services. Military specialist physicians, who were blind to patients' responses, were asked the extent to which they thought that the cause of the patients' complaints were physical or psychological and to prognosticate. Almost 47% of soldiers attended clinics due to pain. In descending order were limb pain (42.5%), headache (29.1%), lower-back pain (24.5%), and right arm pain (3.8%). Right arm complainers were the most distressed and the heaviest users of primary health care and got the lowest prognosis, yet the physicians did not detect any psychological distress in this group. The least distressed and lowest users of medical services were patients with limb pain. There was a positive linear relationship between psychological distress and use of primary health care. There was a negative linear relationship between distress and prognosis. The patients' ability to detect psychological distress was better than that of the physicians. Physicians tended to find more cases of psychological distress than did the PERI-D in lower-back pain and limb pain patients. Psychologically distressed headache and limb pain patients reported using significantly more primary health care than non-distressed patients with similar pain complaints

  12. Pathways to help-seeking in bulimia nervosa and binge eating problems: a concept mapping approach.

    PubMed

    Hepworth, Natasha; Paxton, Susan J

    2007-09-01

    To conduct an in-depth study, using concept mapping, of three factors related to help-seeking for bulimia nervosa and binge eating: problem recognition, barriers to help-seeking, and prompts to help-seeking. Semistructured interviews were conducted to elicit information about help-seeking with 63 women (18-62 years) with past or present bulimic behaviors. Using Leximancer software, factors identified as associated with problem recognition were Changes in Behavior, Interference with Life Roles, Comments about Changes and Psychological Problems. Salient barriers to help-seeking were Fear of Stigma, Low Mental Health Literacy/Perception of Need, Shame, Fear of Change and Cost. Prompts to help-seeking were increased Symptom Severity, Psychological Distress, Interference with Life Roles, Health Problems, and Desire to Get Better. Results highlighted the need for awareness campaigns to reduce both self and perceived stigma by others towards bulimic behaviors, and the need to enhance awareness of available interventions for people ready to engage in treatment, to increase help-seeking. (c) 2007 by Wiley Periodicals, Inc.

  13. Adolescent adjustment and well-being: effects of parental divorce and distress.

    PubMed

    Størksen, Ingunn; Røysamb, Espen; Holmen, Turid L; Tambs, Kristian

    2006-02-01

    This study investigates the long-term effects of parental divorce on adolescent psychological adjustment and well-being, and to what extent the effects are accounted for by parental psychological distress. Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents. Outcome variables were symptoms of anxiety and depression, subjective well-being, and three areas of school problems. Parental divorce was found to be associated with both higher mean levels and larger variances in adolescent problems. Divorce and parental distress contributed independently to adolescent distress, supporting the notion of "double exposure" effects. The prevalence of adolescents with substantial distress symptoms was 14% among those with non-distressed non-divorced parents and 30% among those with divorced and distressed parents. In general effects remained when controlling for demographic factors. Long-term effects of divorce on symptoms of anxiety and depression were stronger among girls than among boys.

  14. Relationship between ICU nurses' moral distress with burnout and anticipated turnover.

    PubMed

    Shoorideh, Foroozan Atashzadeh; Ashktorab, Tahereh; Yaghmaei, Farideh; Alavi Majd, Hamid

    2015-02-01

    Moral distress is one of intensive care unit nurses' major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses' personal and professional practice, recognizing moral distress is very important. The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses. This study is a descriptive-correlation research. A total of 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included "demographic questionnaire," "ICU Nurses' Moral Distress Scale," "Copenhagen Burnout Inventory" and "Hinshaw and Atwood Turnover Scale." Data analysis was done by using SPSS19. Informed consent from samples and research approval was obtained from Shahid Beheshti Medical Sciences University Research Ethics Board in Tehran. The findings showed intensive care unit nurses' moral distress and anticipated turnover was high, but burnout was moderate. The results revealed that there was a positive statistical correlation between intensive care unit nurses' age, their work experience and the fraction of nurses' number to number of intensive care unit beds with their moral distress and burnout. However, there were no correlation between gender, marriage status, educational degree and work shift and moral distress. Some of the findings of this research are consistent with other studies and some of them are inconsistent. Similarly, moral distress with burnout and anticipated turnover did not have statistical correlation. However, a positive correlation was found between burnout and anticipated turnover. The results showed that increase in the recruitment of young nurses, and nursing personnel, and diminishing intensive care unit nurses' moral distress, burnout and their turnover intention are essential. © The Author(s) 2014.

  15. Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey?

    PubMed

    Belek, I

    2000-02-01

    The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. Psychological distress was assessed by means of the GHQ 12. The study covered 1,092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health.

  16. What are the sources of stress and distress for general practitioners working in England? A qualitative study

    PubMed Central

    Spiers, Johanna; Buszewicz, Marta; Taylor, Anna Kathryn; Thornton, Gail; Chew-Graham, Carolyn Anne

    2018-01-01

    Objectives This paper reports the sources of stress and distress experienced by general practitioners (GP) as part of a wider study exploring the barriers and facilitators to help-seeking for mental illness and burnout among this medical population. Design Qualitative study using in-depth interviews with 47 GP participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. Setting England. Participants A purposive sample of GP participants who self-identified as: (1) currently living with mental distress, (2) returning to work following treatment, (3) off sick or retired early as a result of mental distress or (4) without experience of mental distress. Interviews were conducted face-to-face or over the telephone. Results The key sources of stress/distress related to: (1) emotion work—the work invested and required in managing and responding to the psychosocial component of GPs’ work, and dealing with abusive or confrontational patients; (2) practice culture—practice dynamics and collegial conflict, bullying, isolation and lack of support; (3) work role and demands—fear of making mistakes, complaints and inquests, revalidation, appraisal, inspections and financial worries. Conclusion In addition to addressing escalating workloads through the provision of increased resources, addressing unhealthy practice cultures is paramount. Collegial support, a willingness to talk about vulnerability and illness, and having open channels of communication enable GPs to feel less isolated and better able to cope with the emotional and clinical demands of their work. Doctors, including GPs, are not invulnerable to the clinical and emotional demands of their work nor the effects of divisive work cultures—culture change and access to informal and formal support is therefore crucial in enabling GPs to do their job

  17. Distress among young adults from divorced families.

    PubMed

    Laumann-Billings, L; Emery, R E

    2000-12-01

    Researchers find that most children from divorced families function normally, but some clinicians assert that young people are disturbed even many years after a divorce. These accounts may be less discrepant than they appear, because research typically focuses on notably problematic behavior (disorder), whereas case studies emphasize more subtle inner turmoil (distress). In Study 1 college students reported painful feelings, beliefs, and memories about their parents divorce on a reliable new measure, but they also reported accepting the divorce and having few psychological symptoms. Distress about family life was greater among students from divorced than from married families. Study 2 replicated these findings in a community sample of young people from low-income divorced families. In both studies, greater distress was associated with children's residence, frequency of contact with fathers, interparental conflict, and psychological symptoms.

  18. The influence of social stigma and discriminatory experience on psychological distress and quality of life among rural-to-urban migrants in China.

    PubMed

    Wang, Bo; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi

    2010-07-01

    The global literature has revealed a potential negative impact of social stigma on both physical and mental health among stigmatized individuals; however, the mechanisms through which social stigma affects the individual's quality of life and mental health are not well understood. This research simultaneously examines the relationships of several determinants and mediating factors of psychological distress and quality of life. Data were collected through a cross-sectional survey among 1006 adult (predominantly male) rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported on their perceived social stigma, discriminatory experiences in daily life, preparation for migration, discrepancy between expectation and reality, coping with stigma-related stress, psychological distress, and quality of life. Structural equation modeling was performed. We found that perceived social stigma and discriminatory experiences had direct negative effects on psychological distress and quality of life among rural-to-urban migrants. Expectation-reality discrepancy mediated the effects of perceived social stigma and discriminatory experiences on psychological distress and quality of life; coping mediated the effect of social stigma on quality of life. Psychological distress was associated with quality of life. Preparation prior to migration was positively related to coping skills, which were positively related to quality of life. We conclude that perceived social stigma and daily discriminatory experiences have a significant influence on psychological distress and quality of life among rural-to-urban migrants. Pre-migration training with a focus on establishment of effective coping skills and preparation of migration may be helpful to improve their quality of life and mental health.

  19. Financial strain and birth weight: the mediating role of psychological distress.

    PubMed

    Mitchell, Amanda M; Christian, Lisa M

    2017-02-01

    The effects of financial strain during pregnancy have received limited attention. In addition, data examining the pathways by which SES indicators contribute to birth weight are lacking. The objective of the current study was to examine the potential pathway of psychological distress in the relationship between financial strain and birth weight. Participants consisted of 138 pregnant women who completed measures assessing financial strain, depressive symptoms, pregnancy-specific distress, perceived stress, and general anxiety during pregnancy (mean gestational age = 18.5, SD = 7.2). Birth outcome data were obtained via medical record review. Simple and parallel mediation models were conducted using PROCESS. Simple mediation models showed that depressive symptoms (95% CI -24.65, -0.90) and pregnancy-specific distress (95% CI -37.31, -5.91), but not perceived stress (95% CI -31.17, 4.69) or anxiety (95% CI -25.84, 5.57), served as mediators in the relationship between financial strain and birth weight. When depressive symptoms and pregnancy-specific distress were included in the same mediation model, only pregnancy-specific distress remained significant. Financial strain was positively associated with all facets of psychological distress and negatively associated with birth weight during pregnancy. The current study demonstrated the mechanistic role of pregnancy-specific distress in the link between financial strain and birth weight in a racially diverse sample. Interventions targeting pregnancy-specific distress may mitigate the effects of financial strain on birth weight. Studies examining whether pregnancy-specific distress accounts for the relationship between other types of stressor exposures and birth weight would be informative.

  20. "It Just Doesn't Feel Right": A Mixed Methods Study of Help-Seeking in Irish Schools

    ERIC Educational Resources Information Center

    Doyle, Louise; Treacy, Margaret P.; Sheridan, Ann

    2017-01-01

    Schools are a key setting for mental health promotion and the provision of emotional support to students. As teachers and school counsellors are adults with whom adolescents have regular contact, it is likely they would be used as a help source by distressed students however there are few studies on this from an Irish context. A mixed methods…

  1. Distress in spouses of service members with symptoms of combat-related PTSD: secondary traumatic stress or general psychological distress?

    PubMed

    Renshaw, Keith D; Allen, Elizabeth S; Rhoades, Galena K; Blais, Rebecca K; Markman, Howard J; Stanley, Scott M

    2011-08-01

    Combat-related posttraumatic stress disorder (PTSD) is linked with elevated psychological distress in service members'/veterans' spouses. Researchers use a variety of terms to describe this distress, and recently, secondary traumatic stress and secondary traumatic stress disorder (STS/STSD) have become increasingly commonly used. Although STS/STSD connotes a specific set of symptoms that are linked to service members'/veterans' symptoms, researchers often use general measures of distress or generically worded measures of PTSD symptoms to assess STS/STSD. To determine how often scores on such measures appear to be an accurate reflection of STS/STSD, we examined responses to a measure of PTSD symptoms in 190 wives of male service members with elevated levels of PTSD symptoms. Wives rated their own PTSD symptoms, and then answered questions about their attributions for the symptoms they endorsed. Fewer than 20% of wives who endorsed symptoms on the PTSD measure attributed these symptoms completely to their husbands' military experiences. Moreover, compared with wives who attributed symptoms only to events in their own lives, wives who attributed symptoms completely or partially to their husbands' military experiences had a greater overlap between some of their responses on the PTSD measure and their responses to a measure of general psychological distress. These results suggest that most wives of service members/veterans with PTSD experience generic psychological distress that is not conceptually consistent with STS/STSD, although a subset does appear to endorse a reaction consistent with this construct. Implications of these findings for intervention and research with this vulnerable population are discussed.

  2. Distress in Spouses of Service Members with Symptoms of Combat-Related PTSD: Secondary Traumatic Stress or General Psychological Distress?

    PubMed Central

    Renshaw, Keith D.; Allen, Elizabeth S.; Rhoades, Galena K.; Blais, Rebecca K.; Markman, Howard J.; Stanley, Scott M.

    2011-01-01

    Combat-related posttraumatic stress disorder (PTSD) is linked with elevated psychological distress in service members’/veterans’ spouses. Researchers use a variety of terms to describe this distress, and recently, secondary traumatic stress and secondary traumatic stress disorder (STS/STSD) have become increasingly commonly used. Although STS/STSD connotes a specific set of symptoms that are linked to service members’/veterans’ symptoms, researchers often use general measures of distress or generically worded measures of PTSD symptoms to assess STS/STSD. To determine how often scores on such measures appear to be an accurate reflection of STS/STSD, we examined responses to a measure of PTSD symptoms in 190 wives of male service members with elevated levels of PTSD symptoms. Wives rated their own PTSD symptoms, and then answered questions about their attributions for the symptoms they endorsed. Fewer than 20% of wives who endorsed symptoms on the PTSD measure attributed these symptoms completely to their husbands’ military experiences. Moreover, compared with wives who attributed symptoms only to events in their own lives, wives who attributed symptoms completely or partially to their husbands’ military experiences had a greater overlap between some of their responses on the PTSD measure and their responses to a measure of general psychological distress. These results suggest that most wives of service members/veterans with PTSD experience generic psychological distress that is not conceptually consistent with STS/STSD, although a subset does appear to endorse a reaction consistent with this construct. Implications of these findings for intervention and research with this vulnerable population are discussed. PMID:21639635

  3. Negative Affect Mediates the Relation Between Trait Urgency and Behavioral Distress Tolerance

    PubMed Central

    Borges, Allison M.; Dahne, Jennifer; Lim, Aaron C.; MacPherson, Laura

    2017-01-01

    Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. PMID:28080084

  4. Negative affect mediates the relation between trait urgency and behavioral distress tolerance.

    PubMed

    Borges, Allison M; Dahne, Jennifer; Lim, Aaron C; MacPherson, Laura

    2017-06-01

    Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Impact of Multiple Factors on the Degree of Tinnitus Distress.

    PubMed

    Brüggemann, Petra; Szczepek, Agnieszka J; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

    2016-01-01

    The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.

  6. Impact of Multiple Factors on the Degree of Tinnitus Distress

    PubMed Central

    Brüggemann, Petra; Szczepek, Agnieszka J.; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

    2016-01-01

    Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress. PMID:27445776

  7. Marital Distress and Mental Health Care Service Utilization

    ERIC Educational Resources Information Center

    Schonbrun, Yael Chatav; Whisman, Mark A.

    2010-01-01

    Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…

  8. 'Sharing things with people that I don't even know': help-seeking for psychological symptoms in injured Black men in Philadelphia.

    PubMed

    Jacoby, Sara F; Rich, John A; Webster, Jessica L; Richmond, Therese S

    2018-04-01

    Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.

  9. Assessing the utility of the willingness/prototype model in predicting help-seeking decisions.

    PubMed

    Hammer, Joseph H; Vogel, David L

    2013-01-01

    Prior research on professional psychological help-seeking behavior has operated on the assumption that the decision to seek help is based on intentional and reasoned processes. However, research on the dual-process prototype/willingness model (PWM; Gerrard, Gibbons, Houlihan, Stock, & Pomery, 2008) suggests health-related decisions may also involve social reaction processes that influence one's spontaneous willingness (rather than planned intention) to seek help, given conducive circumstances. The present study used structural equation modeling to evaluate the ability of these 2 information-processing pathways (i.e., the reasoned pathway and the social reaction pathway) to predict help-seeking decisions among 182 college students currently experiencing clinical levels of psychological distress. Results indicated that when both pathways were modeled simultaneously, only the social reaction pathway independently accounted for significant variance in help-seeking decisions. These findings argue for the utility of the PWM framework in the context of professional psychological help seeking and hold implications for future counseling psychology research, prevention, and practice. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  10. Transportations of space, time and self: the role of reading groups in managing mental distress in the community.

    PubMed

    Shipman, Judith; McGrath, Laura

    2016-10-01

    The practice of reading and discussing literature in groups is long established, stretching back into classical antiquity. Although benefits of therapeutic reading groups have been highlighted, research into participants' perceptions of these groups has been limited. To explore the experiences of those attending therapeutic reading groups, considering the role of both the group, and the literature itself, in participants' ongoing experiences of distress. Eleven participants were recruited from two reading groups in the South-East of England. One focus group was run, and eight individuals self-selected for individual interviews. The data were analysed together using a thematic analysis drawing on dialogical theories. Participants described the group as an anchor, which enabled them to use fiction to facilitate the discussion of difficult emotional topics, without referring directly to personal experience. Two aspects of this process are explored in detail: the use of narratives as transportation, helping to mitigate the intensity of distress; and using fiction to explore possibilities, alternative selves and lives. For those who are interested and able, reading groups offer a relatively de-stigmatised route to exploring and mediating experiences of distress. Implications in the present UK funding environment are discussed.

  11. Healing war wounds and perfuming exile: the use of vegetal, animal, and mineral products for perfumes, cosmetics, and skin healing among Sahrawi refugees of Western Sahara.

    PubMed

    Volpato, Gabriele; Kourková, Pavlína; Zelený, Václav

    2012-12-27

    Over the past decade, there has been growing interest within ethnobiology in the knowledge and practices of migrating people. Within this, scholars have given relatively less attention to displaced people and refugees: to the loss, maintenance, and adaptation of refugees' ethnobiological knowledge, and to its significance for refugees' wellbeing. This study focuses on cosmetics and remedies used to heal skin afflictions that are traditionally used by Sahrawi refugees displaced in South Western Algerian refugee camps. The research methods included a structured survey carried out with 37 refugee households, semi-structured interviews with 77 refugees, 24 retrospective interviews with refugees and other knowledgeable informants, and a voucher specimen collection of the plants and products cited. We recorded the use of 55 plant species, nine animal species, and six mineral products used within the three main use categories discussed in this paper: 1) Remedies for health issues that are typical of the desert environment where the Sahrawi once lived as nomads and now live as refugees (e.g. eye afflictions); 2) Remedies for wounds that are influenced by the Sahrawi's recent history of guerrilla warfare; and 3) Cosmetics and products used for body care, decoration and perfuming (e.g. hair care, teeth cleansing, henna use) and for aromatizing the air inside of tents and which are widely used in everyday life and social practices. We discuss the changes that have occurred in the patterns of use and procurement of these products with exile and sedentarization in refugee camps, and conclude that refugees are not simply passive recipients of national and international aid, but rather struggle to maintain and recover their traditional ethnobiological practices in exile. Finally, we suggest further research into the ethnobiological practices and knowledge of displaced populations.

  12. 47 CFR 80.320 - Radiotelephone distress call and message transmission procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... by its call sign or name, to permit direction-finding stations to determine its position. This... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radiotelephone distress call and message... Procedures Distress, Alarm, Urgency and Safety Procedures § 80.320 Radiotelephone distress call and message...

  13. Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors.

    PubMed

    Hong, J S; Tian, J

    2013-12-01

    The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt might not be a valid scale for

  14. Sensitivity and specificity of the Distress Thermometer in screening for distress in long-term nasopharyngeal cancer survivors

    PubMed Central

    Hong, J.S.; Tian, J.

    2013-01-01

    Background The Distress Thermometer (dt) is a screening tool recommended to quickly identify cancer patients with distress. Our study aimed to examine the sensitivity and specificity of the dt in detecting psychological distress in long-term Chinese nasopharyngeal cancer (npc) survivors. Methods Data for the 442 participating npc survivors were collected through a self-administered questionnaire based on the dt and the Hospital Anxiety and Depression Scale (hads). The hads was used to define cases of psychological distress. Positive and negative groups were defined based on 4 hads criteria (Anxiety, Depression, Anxiety or Depression, and overall score). Receiver operating characteristic (roc) curves were used to examine the ability of all possible cut-off values of the dt to detect positive and negative cases. For each roc curve, the area under the curve (auc) was used as an indicator of the overall accuracy of the dt to identify positive cases of distress. Results The positive auc values [with 95% confidence intervals (ci)] for the 4 hads criteria were 0.715 (95% ci: 0.667 to 0.764), 0.714 (95% ci: 0.661 to 0.768), 0.724 (95% ci: 0.677 to 0.771), and 0.724 (95% ci: 0.664 to 0.775) respectively. At a cut-off score of 4, the sensitivity of the dt to the four hads criteria was, respectively, 0.366 (95% ci: 0.296 to 0.436), 0.448 (95% ci: 0.364 to 0.532), 0.362 (95% ci: 0.299 to 0.425), and 0.421 (95% ci: 0.339 to 0.502), and the specificity of the dt to the 4 hads criteria was, respectively, 0.860 (95% ci: 0.818 to 0.902), 0.860 (95% ci: 0.821 to 0.899), 0.854 (95% ci: 0.814 to 0.894), and 0.854 (95% ci: 0.814 to 0.894). At a cut-off score of 5, the corresponding sensitivities were lower than those at the cut-off score of 4. All potential cut-off scores showed poor sensitivity (<0.90). Conclusions The roc analysis showed poor discrimination. No potential dt cut-off score had an acceptable sensitivity. The dt showed poor sensitivity in npc survivors. Thus, the dt

  15. Help-seeking Following Termination of Pregnancy after Diagnosis of Fetal Anomaly: Women's Intentions and Experiences 1 to 7 Years after the Event.

    PubMed

    Hanschmidt, Franz; Hoffmann, Rahel; Klingner, Johanna; Kersting, Anette; Stepan, Holger

    2018-02-01

    Diagnosis of fetal anomaly and the difficult circumstances involved in the decision to terminate an affected pregnancy can go along with severe psychological distress. However, little is known about women's help-seeking for emotional problems following an abortion after diagnosis of fetal anomaly. 148 women who had been treated for abortion after diagnosis of fetal anomaly at the University Hospital Leipzig responded to self-report questionnaires 1 to 7 years after the event. Main outcomes were help-seeking intentions and actual help-seeking behavior. Logistic regression was used to explore the associations between participants' sociodemographic characteristics and help-seeking intentions. Most women reported that they would seek help from their partner (91.7%), friends/family (82.8%) or the internet (62.2%). With regard to health services, 50.0% of women would seek help from gynecologists and between 43.8 and 47.9% from counseling services and mental health professionals. Intentions to seek help from support groups were lowest (21.7%). Age, income, region, and religion were associated with help-seeking intentions. Among participants with elevated levels of current psychological distress, 23.8% indicated that they had not discussed their emotional problems with a health service ever. Gynecologists are among the most preferred health professionals for women to discuss psychological problems in the aftermath of an abortion after diagnosis of fetal anomaly. They should be actively involved in screening, diagnostic assessment, and referral of affected women.

  16. Empathy and distress: two distinct but related emotions in response to infant crying.

    PubMed

    Lin, Hung-Chu; McFatter, Robert

    2012-12-01

    This study examined a largely overlooked, yet potentially important, association between empathy and distress in cry responding. The cry stimulus included a 1-min-long video clip of a 4-week-old, crying, male infant. Participants reported their dispositional empathy and distress, perceived aversiveness of the cry stimulus, response emotions, and intention to intervene with the crying infant. Empathy and distress covaried positively both in disposition and in cry responding. Response empathy and distress were related to their corresponding dispositional emotions, but response empathy was also related to dispositional distress. Perceived aversiveness interacted with response distress in predicting response empathy. Both response empathy and distress appeared to be important determinants of intention to intervene. Overall, empathy and distress in response to infant crying appeared more closely related than previously thought. Implications concerning the regulation of emotions in cry responding are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Psychopathic Traits, Victim Distress and Aggression in Children

    ERIC Educational Resources Information Center

    van Baardewijk, Yoast; Stegge, Hedy; Bushman, Brad J.; Vermeiren, Robert

    2009-01-01

    Background: The relationship between psychopathic traits and aggression in children may be explained by their reduced sensitivity to signs of distress in others. Emotional cues such as fear and sadness function to make the perpetrator aware of the victim's distress and supposedly inhibit aggression. As children high in psychopathic traits show a…

  18. Cancer-Related Distress in Young Adults Compared to Middle-Aged and Senior Adults.

    PubMed

    Burgoyne, Mary Jo; Bingen, Kristin; Leuck, Julianne; Dasgupta, Mahua; Ryan, Polly; Hoffmann, Raymond G

    2015-06-01

    Little is known about cancer-related distress during young adulthood. Results from the few studies that have directly assessed this age group have indicated that young adults (YAs) may be at greater risk of developing psychosocial difficulties due to their unique challenges of coping with cancer. This study's objective was to investigate cancer-related distress in YAs compared to older adults. This retrospective cross-sectional study compared the distress level of YAs (18-39 years old) with that of middle-aged (40-64 years old) and senior adults (65-90 years old) using the Distress Thermometer (DT) and associated Problem List (PL). Factors that may be associated with distress by age group were examined, including demographics, cancer type, and PL items endorsed. YAs had higher cancer-related distress than senior adults but similar distress levels to middle-aged adults. Findings from distress comparisons across demographics, cancer types, and PL items endorsed suggest that YAs and middle-aged adults had similar distress patterns when compared to senior adults, who had the lowest DT scores. Multivariable analyses indicated age-related risk factors for high distress, including gynecologic cancers for YAs; divorced, single, or unemployed statuses for middle-aged adults; and being of Hispanic ethnicity for senior adults. Female gender and practical, emotional, and physical problems were associated with distress for all age groups. There is a differential impact of cancer by age. It is important to screen for cancer-related distress, paying attention to risk factors by age to determine age-appropriate supportive care needs.

  19. Partner relationship satisfaction and maternal emotional distress in early pregnancy

    PubMed Central

    2011-01-01

    Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558) completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25). Other predictors were dissatisfaction at work (β = 0.11), somatic disease (β = 0.11), work related stress (β = 0.10) and maternal alcohol problems in the preceding year (β = 0.09). Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P < 0.05). Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors. PMID:21401914

  20. Lifestyle and Mental Health Correlates of Psychological Distress in College Students

    ERIC Educational Resources Information Center

    Knowlden, Adam P.; Hackman, Christine L.; Sharma, Manoj

    2016-01-01

    Objective: College students are at an increased risk of mental distress. The purpose of this study was to determine whether mental and lifestyle factors differed according to self-reported levels of psychological distress. Design and setting: A self-report questionnaire comprising the Kessler-6 Psychological Distress Scale, Revised Life…

  1. Recurrent headache and interpersonal violence in adolescence: the roles of psychological distress, loneliness and family cohesion: the HUNT study

    PubMed Central

    2014-01-01

    Background Recurrent headache is the most common and disabling pain condition in adolescence. Co-occurrence of psychosocial adversity is associated with increased risk of chronification and functional impairment. Exposure to interpersonal violence seems to constitute an important etiological factor. Thus, knowledge of the multiple pathways linking interpersonal violence to recurrent headache could help guide preventive and clinical interventions. In the present study we explored a hypothetical causal model where the link between exposure to interpersonal violence and recurrent headache is mediated in parallel through loneliness and psychological distress. Higher level of family cohesion and male sex is hypothesized to buffer the adverse effect of exposure to interpersonal violence on headache. Methods The model was assessed using data from the cross-sectional, population-based Young-HUNT 3 study of Norwegian adolescents, conducted from 2006–2008. A cohort of 10 464 adolescents were invited. The response rate was 73% (7620), age ranged from 12 and 20 years, and 50% (3832) were girls. The study comprised self-report measures of exposure to interpersonal violence, loneliness, psychological distress and family cohesion, in addition to a validated interview on headache, meeting the International Classification of Headache Disorders criteria. Recurrent headache was defined as headache recurring at least monthly during the past year, and sub-classified into monthly and weekly headache, which served as separate outcomes. Results In Conditional Process Analysis, loneliness and psychological distress consistently posed as parallel mediating mechanisms, indirectly linking exposure to interpersonal violence to recurrent headache. We found no substantial moderating effect of family cohesion or sex. Conclusions Loneliness and psychological distress seem to play crucial roles in the relationship between exposure to interpersonal violence and recurrent headache. To facilitate

  2. Culture, context, and the internalizing distress of Mexican American youth.

    PubMed

    Polo, Antonio J; López, Steven R

    2009-03-01

    Latino youth appear to be at higher risk for depression relative to youth from other ethnic groups. This study assessed the relationship between nativity and several forms of internalizing distress among Mexican American middle school students as well as sociocultural factors that may help explain this relationship. Immigrant Mexican American youth (n = 78) reported significantly higher social anxiety and loneliness than U.S.-born Mexican American youth (n = 83). Acculturation stress and English proficiency were identified as significant mediators of these nativity differences. Although internalizing problems and depression symptoms did not vary across nativity groups, both were related to lower affiliative obedience. The findings point to cultural socialization values and contextual influences as important variables in the mental health of youth in immigrant families.

  3. Moral distress in undergraduate nursing students: A systematic review.

    PubMed

    Sasso, Loredana; Bagnasco, Annamaria; Bianchi, Monica; Bressan, Valentina; Carnevale, Franco

    2016-08-01

    Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety. The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute to moral distress in undergraduate student nurses during their clinical experience and professional education. The research design was a systematic literature review. The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check. Since this was a systematic review, no ethical approval was required. From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students' individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses. Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students.

  4. Hypnosis decreases presurgical distress in excisional breast biopsy patients.

    PubMed

    Schnur, Julie B; Bovbjerg, Dana H; David, Daniel; Tatrow, Kristin; Goldfarb, Alisan B; Silverstein, Jeffrey H; Weltz, Christina R; Montgomery, Guy H

    2008-02-01

    Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures. Groups did not differ in terms of the following: demographics (age, education, ethnicity, marital status, all P's > 0.28); medical variables (presurgery diagnosis, previous excisional biopsy, previous breast cancer, all P's > 0.11); or preintervention distress (SV-POMS P > 0.74) assessed on the day of surgery. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

  5. Relationships between compulsive exercise, quality of life, psychological distress and motivation to change in adults with anorexia nervosa.

    PubMed

    Young, Sarah; Touyz, Stephen; Meyer, Caroline; Arcelus, Jon; Rhodes, Paul; Madden, Sloane; Pike, Kathleen; Attia, Evelyn; Crosby, Ross D; Hay, Phillipa

    2018-01-01

    For people with anorexia nervosa (AN), compulsive exercise is characterized by extreme concerns about the perceived negative consequences of stopping/reducing exercise, dysregulation of affect, and inflexible exercise routines. It is associated with increased eating disorder psychopathology and poor clinical outcome. However, its relationships with two important clinical issues, quality of life (QoL) and motivation to change, are currently unknown. This study aimed to assess the cross-sectional relationships between compulsive exercise, QoL, psychological distress (anxiety and depressive symptoms, and obsessive-compulsive traits) and motivation to change in patients with AN. A total of 78 adults with AN participated in this study, which was nested within a randomized controlled trial of psychological treatments for AN. At baseline (pre-treatment), participants completed questionnaires assessing compulsive exercise, eating disorder (ED) psychopathology, QoL, psychological distress and motivation to change. Baseline correlational analyses demonstrated a moderate positive relationship between compulsive exercise and ED psychopathology, and a weak positive relationship between compulsive exercise and psychological distress. There was a moderate negative relationship between compulsive exercise and eating disorder QoL. These results indicate compulsive exercise is moderately associated with poorer QoL and weakly associated with higher distress. Targeting compulsive exercise in the treatment of anorexia nervosa may help reduce the burden of illness and improve patients' engagement in treatment. ACTRN12610000585022. Taking a LEAP forward in the treatment of anorexia nervosa: a randomized controlled trial. NHMRC grant: 634922.

  6. Distress among women receiving uninformative BRCA1/2 results: 12-month outcomes.

    PubMed

    O'Neill, Suzanne C; Rini, Christine; Goldsmith, Rachel E; Valdimarsdottir, Heiddis; Cohen, Lawrence H; Schwartz, Marc D

    2009-10-01

    Few data are available regarding the long-term psychological impact of uninformative BRCA1/2 test results. This study examines change in distress from pretesting to 12-months post-disclosure, with medical, family history, and psychological variables, such as pretesting perceived risk of carrying a deleterious mutation prior to testing and primary and secondary appraisals, as predictors. Two hundred and nine women with uninformative BRCA1/2 test results completed questionnaires at pretesting and 1-, 6-, and 12-month post-disclosure, including measures of anxiety and depression, cancer-specific and genetic testing distress. We used a mixed models approach to predict change in post-disclosure distress. Distress declined from pretesting to 1-month post-disclosure, but remained stable thereafter. Primary appraisals predicted all types of distress at 1-month post-disclosure. Primary and secondary appraisals predicted genetic testing distress at 1-month as well as change over time. Receiving a variant of uncertain clinical significance and entering testing with a high expectation for carrying a deleterious mutation predicted genetic testing distress that persisted through the year after testing. As a whole, women receiving uninformative BRCA1/2 test results are a resilient group. For some women, distress experienced in the month after testing does not dissipate. Variables, such as heightened pretesting perceived risk and cognitive appraisals, predict greater likelihood for sustained distress in this group and could be amenable to intervention.

  7. Moral distress and its influencing factors: A cross-sectional study in China.

    PubMed

    Wenwen, Zhang; Xiaoyan, Wu; Yufang, Zhan; Lifeng, Ci; Congcong, Sun

    2018-06-01

    The purpose of this study was to describe the current situation of moral distress and to explore its influencing factors among Chinese nurses. This is an exploratory, descriptive design study. A total of 465 clinical nurses from different departments in three Grade-III, Level-A hospitals in Jinan, Shandong Province, completed the questionnaires, including demographics questionnaire, Chinese version of Moral Distress Scale-Revised, and Job Diagnostic Survey. Ethical considerations: The study was approved by the university ethics board and the local health service director. The total score of Moral Distress Scale-Revised was 36.01 ± 24.02 points. The mean frequency and intensity scores of moral distress were 1.13 ± 0.49 and 1.09 ± 0.58, respectively. The level of moral distress among Chinese clinical nurses was low, and the frequency and intensity of moral distress were on low to moderate level. The level of moral distress experienced by clinical nurses is associated with demographics features and job characteristics, including age, education degree, department, task significance, autonomy, and dealing with others. Our conclusion suggests that hospital and organizational administrations should attach much importance to the moral distress experienced by clinical nurses in China. Further studies should focus on interventions about how to reduce the levels of the frequency and intensity of moral distress among clinical nurses.

  8. Psychological distress and prejudice following terror attacks in France.

    PubMed

    Goodwin, Robin; Kaniasty, Krzysztof; Sun, Shaojing; Ben-Ezra, Menachem

    2017-08-01

    Terrorist attacks have the capacity to threaten our beliefs about the world, cause distress across populations and promote discrimination towards particular groups. We examined the impact of two different types of attacks in the same city and same year on psychological distress and probable posttraumatic stress symptoms, and the moderating effects of religion or media use on distress/posttraumatic symptoms and inter-group relations. Two panel surveys four weeks after the January 2015 Charlie Hebdo attack (N = 1981) and the November 2015 Bataclan concert hall/restaurant attacks (N = 1878), measured intrinsic religiosity, social and traditional media use, psychological distress (K6), probable posttraumatic stress symptoms (proposed ICD-11), symbolic racism and willingness to interact with Muslims by non-Muslims. Prevalence of serious mental illness (K6 score > 18) was higher after November 2015 attacks (7.0% after the first attack, 10.2% the second, χ2 (1) = 5.67, p < 0.02), as were probable posttraumatic stress symptoms (11.9% vs. 14.1%; χ2 (1) = 4.15, p < 0.04). In structural equation analyses, sex, age, geographic proximity, media use and religiosity were associated with distress, as was the interaction between event and religiosity. Distress was then associated with racism symbolism and willingness to interact with Muslims. Implications are considered for managing psychological trauma across populations, and protecting inter-group harmony. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Workplace bullying and mental distress - a prospective study of Norwegian employees.

    PubMed

    Finne, Live Bakke; Knardahl, Stein; Lau, Bjørn

    2011-07-01

    Using a prospective design, the objective of this study was to determine the relationship between workplace bullying and mental distress. Altogether, 1971 Norwegian employees, recruited from 20 organizations, answered questions regarding workplace bullying and mental distress at both baseline and follow-up. Baseline data were gathered between 2004-2006, and follow-up data were gathered between 2006-2009. The time-lag between baseline and follow-up was approximately two years for all the respondents in all the organizations. The factors measured in the study were individual characteristics, mental distress measured with the Hopkins Symptom Checklist (HSCL-10), self-reported workplace bullying measured with a single item from the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic) and job demands and job control assessed by QPSNordic. A multiple linear regression analysis adjusted for mental distress, sex, age, job demands and job control at baseline [β=0.05, 95% confidence interval (95% CI) 0.03-0.17] and a repeated measures ANOVA adjusted for sex and age [F(3,1965)=38.37; partial η (2)=0.06] showed that workplace bullying predicted mental distress. Furthermore, a multiple binary logistic regression analysis adjusted for bullying, sex, age, job demands and job control at baseline [odds ratio (OR) 2.30, 95% CI 1.43-3.69] showed that mental distress was a predictor of bullying. We found support for the notion that self-reported workplace bullying is a predictor of mental distress two years later. Bullying had an independent effect on mental distress after adjusting for job demands and job control. Mental distress was also found to be a predictor of bullying, indicating that the reverse relationship is also important.

  10. 'Moral distress'--time to abandon a flawed nursing construct?

    PubMed

    Johnstone, Megan-Jane; Hutchinson, Alison

    2015-02-01

    Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. © The Author(s) 2013.

  11. Floating on Air: Fulfillment and Self-in-Context for Distressed Japanese Women

    PubMed Central

    Arnault, Denise Saint; Shimabukuro, Shizuka

    2017-01-01

    This research was part of a larger mixed-methods study examining culture, distress, and help seeking. We surveyed 209 Japanese women living in the United States recruited from clinic and community-based sites, and carried out semi-structured ethnographic interviews with a highly distressed subsample of 25 Japanese. Analytic Ethnography revealed that women described themselves as a “self-in-context,” negotiating situations using protective resources or experiencing risk exposure. Women experienced quality of life (QOL) when they were successful. However, a related goal of achieving Ikigai (or purpose in life) was differentiated from QOL, and was defined as an ongoing process of searching for balance between achieving social and individual fulfillment. Our resulting hypothetical model suggested that symptom level would be related to risk and protective factors (tested for the full sample) and to specific risk and protective phenomenon (tested in the distressed subsample). The t tests in the full sample found that women who were above threshold for depressive symptoms (n = 26) had higher social stressor and lower social support means. Women who were above the threshold for physical symptoms (n = 99) had higher social stressor means. Analysis of the interviewed subsample found that low self-validation and excessive responsibilities were related to high physical symptoms. We conclude that perceived lack of balance between culturally defined, and potentially opposing, markers of success can create a stressful dilemma for first-generation immigrant Japanese women, requiring new skills to achieve balance. Perceptions of health, as well as illness, are part of complex culturally based interpretations that have implications for intervention for immigrant Japanese women living in the United States. PMID:26896391

  12. Floating on Air: Fulfillment and Self-in-Context for Distressed Japanese Women.

    PubMed

    Saint Arnault, Denise; Shimabukuro, Shizuka

    2016-05-01

    This research was part of a larger mixed-methods study examining culture, distress, and help seeking. We surveyed 209 Japanese women living in the United States recruited from clinic and community-based sites, and carried out semi-structured ethnographic interviews with a highly distressed subsample of 25 Japanese. Analytic Ethnography revealed that women described themselves as a "self-in-context," negotiating situations using protective resources or experiencing risk exposure. Women experienced quality of life (QOL) when they were successful. However, a related goal of achievingIkigai(or purpose in life) was differentiated from QOL, and was defined as an ongoing process of searching for balance between achieving social and individual fulfillment. Our resulting hypothetical model suggested that symptom level would be related to risk and protective factors (tested for the full sample) and to specific risk and protective phenomenon (tested in the distressed subsample). Thettests in the full sample found that women who were above threshold for depressive symptoms (n= 26) had higher social stressor and lower social support means. Women who were above the threshold for physical symptoms (n= 99) had higher social stressor means. Analysis of the interviewed subsample found that low self-validation and excessive responsibilities were related to high physical symptoms. We conclude that perceived lack of balance between culturally defined, and potentially opposing, markers of success can create a stressful dilemma for first-generation immigrant Japanese women, requiring new skills to achieve balance. Perceptions of health, as well as illness, are part of complex culturally based interpretations that have implications for intervention for immigrant Japanese women living in the United States. © The Author(s) 2016.

  13. Bullying victimization and emotional distress: is there strength in numbers for vulnerable youth?

    PubMed

    Eisenberg, Marla E; McMorris, Barbara J; Gower, Amy L; Chatterjee, Debanjana

    2016-07-01

    The present study examines whether the prevalence of vulnerable peers in school protects the emotional health of youth who are lesbian, gay, bisexual or questioning (LGBQ), overweight, or have a disability, and if the adverse emotional effects of bullying victimization are mitigated by the presence of these peers. Survey data come from a large school-based sample of adolescents attending 505 schools. The primary independent variable was the percent of students in school with each vulnerability characteristic. Multilevel logistic regression models estimated the odds of internalizing problems, self-harm, suicidal ideation and suicide attempts among students who were LGBQ, overweight or had a disability. Cross-level interaction terms were added to determine if the association between being victimized and emotional distress was moderated by the presence of vulnerable peers. Greater presence of similar students was, on average, protective against emotional distress for LGBQ girls and overweight boys. In contrast, greater presence of students with a disability was, on average, a risk factor among girls with a disability. Several tests of effect modification indicated that odds of emotional distress for those who had been victimized were lower in schools with a higher proportion of vulnerable youth. The presence of a similar peer group may increase the likelihood that a bystander or witness to bullying will react in a helpful way. School personnel, health care providers and other youth service professionals should inquire about social relationships at school, including experiences of harassment and perceptions of peer support, to buffer negative experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. 33 CFR 175.130 - Visual distress signals accepted.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... red flare (160.024 or 160.036) meets both day and night requirements. Three hand held orange smoke (160.037) with one electric distress light (161.013) meet both day and night requirements. Table 175... Number required 160.021 Hand Held Red Flare Distress Signals 3 Day and Night 3 160.022 Floating Orange...

  15. Psychological Distress and Mortality: Are Women More Vulnerable?

    ERIC Educational Resources Information Center

    Ferraro, Kenneth F.; Nuriddin, Tariqah A.

    2006-01-01

    Does psychological distress increase mortality risk? If it does, are women more vulnerable than men to the effect of distress on mortality? Drawing from cumulative disadvantage theory, these questions are addressed with data from a 20-year follow-up of a national sample of adults ages 25-74. Event history analyses were performed to examine…

  16. Differences in Psychological Distress and Esteem Based on Sexual Identity Development

    ERIC Educational Resources Information Center

    Shepler, Dustin; Perrone-McGovern, Kristin

    2016-01-01

    A sample of 791 college students between the ages of 18 and 25 years were administered a series of measures to determine their sexual identity development status, global self-esteem, global psychological distress, sexual-esteem and sexual distress. As hypothesized, results indicated no significant difference in terms of psychological distress,…

  17. Researching moral distress among New Zealand nurses: a national survey.

    PubMed

    Woods, Martin; Rodgers, Vivien; Towers, Andy; La Grow, Steven

    2015-02-01

    Moral distress has been described as a major problem for the nursing profession, and in recent years, a considerable amount of research has been undertaken to examine its causes and effects. However, few research projects have been performed that examined the moral distress of an entire nation's nurses, as this particular study does. The purpose of this study was to determine the frequency and intensity of moral distress experienced by registered nurses in New Zealand. The research involved the use of a mainly quantitative approach supported by a slightly modified version of a survey based on the Moral Distress Scale-Revised. In total, 1500 questionnaires were sent out at random to nurses working in general areas around New Zealand and 412 were returned, giving an adequate response rate of 27%. The project was evaluated and judged to be low risk and recorded as such on 22 February 2011 via the auspices of the Massey University Human Ethics Committee. Results indicate that the most frequent situations to cause nursing distress were (a) having to provide less than optimal care due to management decisions, (b) seeing patient care suffer due to lack of provider continuity and (c) working with others who are less than competent. The most distressing experiences resulted from (a) working with others who are unsafe or incompetent, (b) witnessing diminished care due to poor communication and (c) watching patients suffer due to a lack of provider continuity. Of the respondents, 48% reported having considered leaving their position due to the moral distress. The results imply that moral distress in nursing remains a highly significant and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators. © The Author(s) 2014.

  18. Emotional distress in junior house officers.

    PubMed Central

    Firth-Cozens, J

    1987-01-01

    In a study of 170 junior house officers who were followed up from their fourth year in medical school mean levels of stress were higher than in other reported occupational groups, and the estimated prevalence of emotional disturbance was 50%, with 28% of the subjects showing evidence of depression. Nearly a fifth of the subjects reported occasional or frequent bouts of heavy drinking, a quarter took drugs for physical illness, and a few took drugs for recreation. Those who were emotionally distressed at the initial study and the follow up were more empathetic and more self critical than those who had low levels of stress on both occasions. Overwork was the most stressful aspect of their jobs, though the number of hours worked was not related to stress levels, unlike diet and sleep. The more stressed they were the more unfavourably they viewed aspects of their jobs. The incidence of distress is unacceptably high in junior house officers, and both they and the hospitals need to deal with the causes of the distress. PMID:3117213

  19. Ordered LOGIT Model approach for the determination of financial distress.

    PubMed

    Kinay, B

    2010-01-01

    Nowadays, as a result of the global competition encountered, numerous companies come up against financial distresses. To predict and take proactive approaches for those problems is quite important. Thus, the prediction of crisis and financial distress is essential in terms of revealing the financial condition of companies. In this study, financial ratios relating to 156 industrial firms that are quoted in the Istanbul Stock Exchange are used and probabilities of financial distress are predicted by means of an ordered logit regression model. By means of Altman's Z Score, the dependent variable is composed by scaling the level of risk. Thus, a model that can compose an early warning system and predict financial distress is proposed.

  20. Psychological distress among tsunami refugees from the Great East Japan earthquake

    PubMed Central

    Takahashi, Masahito; Sun, Shaojing; Ben-Ezra, Menachem

    2015-01-01

    Background The 2011 Great Japan tsunami and nuclear leaks displaced 300 000 people, but there are no large studies of psychological distress suffered by these refugees. Aims To provide a first assessment of major factors associated with distress and dysfunctional behaviour following the disasters. Method All refugee families living in Miyagi were sent a questionnaire 10–12 months after the disasters. 21 981 participants (73%) returned questionnaires. Questions assessed psychological distress (Kessler Psychological Distress Scale, K6), dysfunctional behaviours, demographics, event exposure, change in physical activity, household visitors and emotional support. Results Nine percent scored 13+ on the K6 indicating risk of severe mental illness. Psychological distress was greater among Fukushima refugees. Demographic variables, family loss, illness history and change in physical activity were associated with psychological distress and dysfunctional behaviours. Associations between psychological distress and dysfunction and visitors/supporters depended on relation to supporter. Conclusions Practitioners need to recognise existing disease burden, community histories and family roles when intervening following disasters. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703729