Relationship between job burnout and occupational stress among doctors in China

The purpose of this study was to explore the status of the job burnout of doctors and the variables associated with this in China. The sample consisted of 543 doctors from three provincial hospitals in China. The Maslach Burnout Inventory‐General Survey (MBI‐GS) was used to measure burnout, and the occupational stress inventory revised edition was used to measure the two dimensions of occupational adjustment (including occupational stress and coping resources). After the statistical testing for validity and reliability of MBI‐GS with nurses in China, the participants' scores were evaluated and analysed. The main results were as follows. The scores of job burnout of the surgeon and physician were significantly higher than the others (p < 0.05). The score of exhaustion (EX) was significantly higher in the 30‐ to 40‐year age group than that in any other groups. The score of professional efficacy (PE) decreased with age, while this increased with educational status. Occupational stress was significantly positively related to all burnout dimensions (p < 0.05), while coping resources correlated negatively to all burnout dimensions. Under multilevel regression, the main significant predictors of EX were role overload, responsibility, physical environment and self‐care. The main significant predictors of cynicism were role insufficiency, role overload and responsibility, and of PE were role insufficiency, social support and rational/cognitive coping (p < 0.05). Organizational efforts aimed at reducing occupational stress and strengthening their coping resources among doctors could help prevent job burnout. Copyright © 2007 John Wiley & Sons, Ltd.     

Development of a symptom severity index and a symptom impact index for stress incontinence in women

Stress incontinence is a common problem among women, yet there is no adequately validated instrument for measuring women's views of its severity (disease-specific health status). The only instrument for measuring the impact or bothersomeness of symptoms (disease-specific quality of life) has poor internal consistency. This paper describes the development and psychometric assessment of two new indexes, a Symptom Severity Index and a Symptom Impact Index. Following several qualitative enquiries, a questionnaire was developed and administered to 442 women undergoing stress incontinence surgery. The face and content validity of the items comprising the indexes was good. The Severity Index (0–20) showed good variability (median 14, interquartile range 6) and adequate internal consistency (alpha 0.76). The Impact Index (0–12) also had good variability (median 5, interquartile range 3.5) and internal consistency (alpha 0.80). Convergent and discriminant validity were demonstrated for both indexes. Test-retest reliability was high. While responsiveness is still to be tested, the two indexes are psychometrically strong and can be used to measure the severity and impact of stress incontinence in women. © 1996 Wiley-Liss, Inc.     

Background Stress Inventory: Developing a Measure of Understudied Stress

Background stress is an understudied source of stress that involves both ambient stress and daily hassles upon which new stressors are superimposed. To date, an accurate measure of the background stress construct has not been available. We developed the Background Stress Inventory, a 25‐item self‐report measure that asks respondents to indicate how distressed they have felt over the past month and the majority of the past year across five domains: financial, occupation, environment, health and social. Seven hundred seventy‐two participants completed the paper‐and‐pencil measure; the sample was randomly split into two separate subsamples for analyses. Exploratory factor analysis suggested five factors corresponding to these domains, and confirmatory factor analysis showed acceptable global fit (X²(255) = 456.47, comparative fit index = 0.94, root mean square error of approximation = 0.045). Cronbach's alpha (0.89) indicated good internal reliability. Construct validity analyses showed significant positive relationships with measures of perceived stressfulness (r = 0.62) and daily hassles (0.41), p's < 0.01. Depressive symptoms (0.62) and basal blood pressure (0.21) were both significantly associated with background stress, p's < 0.01. The importance of the proposed measure is reflected in the limited research base on the impact of background stress. Systematic investigation of this measure will provide insight into this understudied form of chronic stress and its potential influence on both psychological and physical endpoints. Copyright © 2013 John Wiley & Sons, Ltd.     

The Acute Stress Checklist for Children (ASC-Kids): development of a child self-report measure

This project aimed to develop and validate a brief, practical self-report measure of acute stress disorder (ASD) reactions (including ASD diagnostic criteria) in children and adolescents. A draft measure was reviewed for content validity by an expert panel, piloted with youth, and revised for clarity and coverage of key constructs. The new 29-item Acute Stress Checklist for Children (ASC-Kids) was administered to 176 youth age 8 to 17 who had a recent injury or intensive care unit admission. The ASC-Kids demonstrated strong test-retest reliability and internal consistency, as well as concurrent and predictive validity with other traumatic stress measures. Results of exploratory factor analyses were consistent with current conceptualizations of acute traumatic stress reactions. The ASC-Kids is a promising measure of child acute stress reactions.     

Investigation into factors that promote adherence to a mammography screening programme

The aim of the present research was to investigate the importance of different factors in promoting women's adherence to mammography screening programmes. The research was conducted during a mammography screening programme of the Emilia‐Romagna region addressed to all women aged 50–69 years. The programme was designed to maximize women's participation by increasing their knowledge of the benefits of breast screening (invitation letter and information campaign) and by reducing barriers (e.g. free test). The research was conducted on a sample of 200 women who adhered to the programme, 65 of whom never had a mammogram in the past, and on a sample of 95 women who did not adhere to the programme, 42 of whom never had a mammogram and 53 of whom had mammograms privately. A semi‐structured interview on demographic variables (e.g. age and marital status), an evaluation of mastery and self‐esteem and an evaluation of the influence of the different information channels used during the information campaign were asked to participants. Significant differences among groups were found as regards to age, marital status and education and as regards to objective and subjective vulnerability to breast cancer. Among the information channels, the invitation letter undersigned by the family physician had the most influence. Copyright © 2007 John Wiley & Sons, Ltd.     

Developing the occupational stress indicator (OSI) for use in Brazil: A report on the reliability and validity of the translated OSI

The Occupational Stress Indicator (OSI) was translated into Brazilian Portuguese and administered to a sample of 84 white-collar workers in Brazil. Five of the six scales of the OSI (job satisfaction, mental and physical health, coping, type A behaviour, sources of stress) showed acceptable reliability. The reliability of the sixth scale (locus of control) was disappointing, in keeping with earlier findings that suggest that this scale requires further development. Alternative measures of the stress outcomes — job satisfaction, mental health and physical health — were taken in order to assess the construct validity of these three scales. These measures included translations of the Hackman-Oldham job satisfaction measure and the Crown–Crisp Experiential Index, as well as subjective measures of health-related behaviours. Correlational and multivariate analyses of these data suggested that the job satisfaction, mental health and physical health scales of the OSI had good validity, with the physical health measure probably including a psychosomatic component. These findings are promising for the development of a new version of the OSI designed for use in South America.     

Perceived Changes in Social Relations after Earthquake Trauma among Eastern Anatolian Women: Associated Factors and Mental Health Consequences

In this study, we examined social relations in women exposed to earthquake trauma in Eastern Anatolia, Turkey. We examined women's perceptions regarding the changes in their social relations within their neighbourhood, within their marriage and with their children; analysed the factors that were associated with these relations; and tested the hypothesis that an improvement in social relations will protect women's mental health from the negative impact of earthquake trauma. Participants consisted of a random selection of 1253 women, who were interviewed regarding their psychosocial needs and mental health status 1 year after earthquake. They reported trauma‐related changes in their social relations; their mental health was evaluated using the Post Traumatic Stress Diagnostic Scale and Brief Symptom Inventory. Our study demonstrated severe earthquake trauma was associated with deteriorated social relations, especially neighbourhood and marital relations. Deteriorated marital and child relations were associated with increased levels of psychiatric distress; deteriorated neighbourhood relations were associated with intrusive posttraumatic stress symptoms. Improved neighbourhood relations, but not family relations, were able to protect women's mental health from the negative impact of trauma. The results are discussed regarding their relevance to gender effects and the provision of relation‐specific and symptom‐specific disaster relief. Copyright © 2014 John Wiley & Sons, Ltd.     

Predictors of pain 1 year post-spinal cord injury

OBJECTIVE: To determine the predictive validity of demographic and medical characteristics to the subsequent development of pain 1 year post-spinal cord injury (SCI). DESIGN: Prospective longitudinal design using data from 18 Model Spinal Cord Injury Systems of Care. PARTICIPANTS: Adults 18 years or older with traumatic-onset SCI (n = 540) evaluated at 1 year postinjury. OUTCOME MEASURES: A single item from the Short Form-12 that assessed pain interference in day-to-day activities using a 5-point Likert scale. PREDICTOR VARIABLES: Demographic and medical characteristics, individual and total medical complications during rehabilitation, and insurance provider. RESULTS: Univariate analyses showed age, education, marital status, primary occupation at the time of injury, American Spinal Injury Association motor score, and sponsor of care to be related to pain interference 1 year post-SCI. Polychotomous logistic regression indicated that age and occupational status at the time of injury were the only significant unique predictors of pain interference. The youngest (aged 18-29 years) and oldest (aged 60 years and older) age groups reported the least amount of pain interference, whereas individuals unemployed at the time of injury were significantly more likely to report pain interference. None of the other predictor variables was significant. CONCLUSION: Age and occupational status appear to be important predictors of pain interference 1 year post-SCI. Future directions of study and limitations are discussed.     

Gender differences in experiencing occupational stress: the role of age,education and marital status

Studies investigating gender differences over the past two decades have produced contradictory results, with some to indicate no differences, and some suggesting that either men or women experience more psychological stress. In this study, we examine gender differences in occupational stress, taking into consideration the role of marital status, age and education. Results from a sample of 2775 professionals suggest that women experience higher levels of occupational stress than men. Nevertheless, when marital status, age and education were introduced in the equation, no significant gender differences were identified. Implications and future research directions are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

CANADIAN CROSS-CULTURAL COMPARISON OF THE HIGH-RISK PREGNANCY STRESS SCALE

The purpose of this article is to present the French and English versions of the High-Risk Pregnancy Stress Scale (HRPSS) and the reliability and validity analyses. This instrument contains 16 items representing psychological and environmental stressors of the at-risk pregnancy situation with or without hospitalization. The HRPSS was developed specifically to measure the degree of stress as experienced by women with high-risk pregnancy. The results of the principal component analyses with Varimax rotation (N=105) reveal that the HRPSS has two components. The first component represents physical restriction, while the second represents concerns related to pregnancy. These two components have been identified as forming the basis of the concept of antenatal-related stress. The HRPSS demonstrates internal consistency, equivalence and stability reliability. The psychometric analyses reveal that both the French and English versions have similar qualities.     

The risks of partner violence following HIV status disclosure,and health service responses: narratives of women attending reproductive health services in Kenya

Introduction

For many women living with HIV (WLWH), the disclosure of positive status can lead to either an extension of former violence or new conflict specifically associated with HIV status disclosure. This study aims to explore the following about WLWH: 1. the women''s experiences of intimate partner violence (IPV) risks following disclosure to their partners; 2. an analysis of the women''s views on the role of health providers in preventing and addressing IPV, especially following HIV disclosure.

Methods

Thirty qualitative interviews were conducted with purposively selected WLWH attending clinics in Kenya. Data were coded using NVivo 9 and analyzed thematically.

Results

Nearly one third of the respondents reported experiencing physical and/or emotional violence inflicted by their partners following the sero-disclosure, suggesting that HIV status disclosure can be a period of heightened risk for partner stigma and abuse, and financial withdrawal, and thus should be handled with caution. Sero-concordance was protective for emotional and verbal abuse once the partner knew his positive status, or knew the woman knew his status. Our results show acceptance of the role of the health services in helping prevent and reduce anticipated fear of partner stigma and violence as barriers to HIV disclosure. Some of the approaches suggested by our respondents included couple counselling, separate counselling sessions for men, and facilitated disclosure. The women''s narratives illustrate the importance of integrating discussions on risks for partner violence and fear of disclosure into HIV counselling and testing, helping women develop communication skills in how to disclose their status, and reducing fear about marital separation and break-up. Women in our study also confirmed the key role of preventive health services in reducing blame for HIV transmission and raising awareness on HIV as a chronic disease. However, several women reported receiving no counselling on safe disclosure of HIV status.

Conclusion

Integration of partner violence identification and care into sexual, reproductive and HIV services for WLWH could be a way forward. The health sector can play a preventive role by sensitizing providers to the potential risks for partner violence following disclosure and ensuring that the women''s decision to disclose is fully informed and voluntary.     

中文版气管切开术后患者生活质量量表的言效度检验

目的 引进气管切开术后长期置管患者生活质量量表(TQOL),并检验信效度.方法 按照Brislin跨文化翻译原则对TQOL进行汉化及文化调适,使用中文版TQOL量袁调查153例气管切开术后患者的生活质量,分析其信效和效度.结果 中文版TQOL保留22个条目,因子分析共提取生理状况、躯体功能状况、社会/家庭状况、满意程度4个公因子,累计贡献率达68.45％.量表内容效度指数为0.920,Cronbach's α系数为0.907,各因子Cronbach' s α系数为0.824～0.912,Guttmann折半系数为0.925(均P＜0.01).结论 中文版TQOL具有良好的信效度,适合中国文化背景下气管切开术后长期置管患者生活质量的测量.     

Predictors of Pain 1 Year Post-Spinal Cord Injury

Abstract

Objective: To determine the predictive validity of demographic and medical characteristics to the subsequent development of pain 1 year post-spinal cord injury (SCI).

Design: Prospective longitudinal design using data from 18 Model Spinal Cord Injury Systems of Care.

Participants: Adults 18 years or older with traumatic-onset SCI (n = 540) evaluated at 1 year postinjury.

Outcome Measures: A single item from the Short Form-12 that assessed pain interference in day-to-day activities using a 5-point Likert scale.Predictor Variables: Demographic and medical characteristics, individual and total medical complications during rehabilitation, and insurance provider.

Results:Univariate analyses showed age, education, marital status, primary occupation at the time of injury, American Spinal Injury Association motor score, and sponsor of care to be related to pain interference 1 year post-SCI. Polychotomous logistic regression indicated that age and occupational status at the time of injury were the only significant unique predictors of pain interference. The youngest (aged 18-29 years) and oldest (aged 60 years and older) age groups reported the least amount of pain interference,whereas individuals unemployed at the time of injury were significantly more likely to report pain interference. None of the other predictor variables was significant.

Conclusion: Age and occupational status appear to be important predictors of pain interference 1 year post-SCI. Future directions of study and limitations are discussed.     

Impact of demographic and medical factors on satisfaction with life after spinal cord injury: a normative study

OBJECTIVE: The aim of this study was (1) to examine demographic and medical predictors of the Satisfaction With Life Scale (SWLS) among individuals with spinal cord injury (SCI) and (2) to provide a normative table for the SWLS that includes appropriate adjustments for the most important predictors of life satisfaction. STUDY DESIGN: We examined predictors of the SWLS including age, education, sex, race, injury duration, number of rehospitalizations, marital status, employment status, SCI etiology, and level of neurological impairment. PARTICIPANTS: Individuals in the National Spinal Cord Injury Statistical Center database [from 18 SCI model systems (1995-1999)] undergoing follow-up assessment were included for study. OUTCOME MEASURE: Satisfaction With Life Scale. RESULTS: Univariate analyses indicated that marital and employment status, race, sex, education, and injury duration were significant factors associated with scores on the SWLS. In general, individuals who were female, white, married, and currently employed and had a higher education and longer injury duration reported significantly higher scores on the SWLS (P < .01). Effect-size estimates for these factors ranged from 0.16 to 0.41. Regression analyses showed that education, employment status, and injury duration were the strongest unique predictors of satisfaction with life but accounted for only 10% of the variance. CONCLUSION: The SWLS is a global measure of life satisfaction and is relatively unrelated to demographic and medical characteristics. Normative tables are provided for epidemiologic comparison.     

Posttraumatic Stress Disorder Symptom Clusters,Alcohol Misuse,and Women's Use of Intimate Partner Violence

Exploring how PTSD and alcohol misuse relate to women's use of intimate partner violence (IPV) is vital to develop our understanding of why some women may engage in IPV, which can serve to maximize intervention efforts for women. This study examined the extent to which posttraumatic stress disorder (PTSD) symptom clusters are directly and indirectly related to women's use of IPV through pathways involving alcohol misuse while controlling for severity of women's IPV victimization. The sample was comprised of substance‐using, low socioeconomic status community women (N = 143) currently experiencing IPV victimization. The majority of the sample was African American (n = 115, 80.42%). This sample had an average annual household income of $14,368.68 (SD = $12,800.68) and the equivalent of a high school education (11.94 years, SD = 1.32). Path analyses indicated that the strongest statistical relationship emerged between women's use of IPV and women's IPV victimization. PTSD reexperiencing and numbing symptom severity was related to women's use of psychological, minor physical, and severe physical IPV; however, these relationships were indirect through alcohol misuse. Findings lend preliminary support for the application of the self‐medication hypothesis to the study of PTSD, alcohol misuse, and IPV among women.     

Psychometric evaluation of an adapted version of the perceived stress scale for ecological momentary assessment research

Ecological momentary assessment (EMA) methodologies are commonly used to illuminate the predictors and impacts of experiencing subjective stress in the course of daily life. The validity of inferences from this research is contingent on the availability of measures of perceived momentary stress that can provide valid and reliable momentary stress scores. However, studies of the development and validation of such measures have been lacking. In this study, we use an EMA data collection design to examine the within- and between- person reliability and criterion validity and between-person gender measurement invariance of a brief EMA-adapted measure of a widely used trait measure of stress: the Perceived Stress Scale (PSS). Scores showed high internal consistency reliability and significant correlations with a range of criterion validity measures at both the within- and between-person level. Gender measurement invariance up to the scalar level also held for scores. Findings support the use of the EMA-adapted PSS presented in the current study for use in community-ascertained samples to address research questions relating to the influences on and effects of momentary stress and their gender differences.     

STRESS IN MARITAL INTERACTION AND DIET BEHAVIOR

The research examines the effects of stress in the marital relationship on dietary behavior. The theoretical model predicted that the marital stress of inequality and role disagreement would lead to an unfavorable reflected appraisal and low self-efficacy. The latter two variables are predicted to be related to the dietary indicator of fat consumption. One hundred and fifty-five married couples were selected by a random area sample from the state of Iowa. Husbands and wives were interviewed separately in the home. The results supported the stress model. Marital interaction stress had an effect on diet as mediated by the reflected self (how one imagines they are perceived by significant others) self-efficacy (perceived control over one's outcomes). Also, interesting gender differences were found. For husbands, reflected appraisal was related to per cent calories from fat in the diet whereas for wives, self-efficacy was related to per cent calories from fat. The differences in part reflect the changing role of women.©1997 John Wiley &Sons, Ltd.     

Stress,Cognitive Appraisal and Psychological Health: Testing Instruments for Health Professionals

The job of health professionals, including nurses, is considered inherently stressful, and thus, it is important to improve and develop specific measures that are sensitive to the demands that health professionals face. This study analysed the psychometric properties of three instruments that focus on the professional experiences of nurses in aspects related to occupational stress, cognitive appraisal and mental health issues. The evaluation protocol included the Stress Questionnaire for Health Professionals (SQHP), the Cognitive Appraisal Scale (CAS) and the General Health Questionnaire‐12 (GHQ‐12). Validity and reliability issues were considered with statistical analysis (i.e. confirmatory factor analysis, convergent validity and composite reliability) that revealed adequate values for all of the instruments, namely a six‐factor structure for the SQHP, a five‐factor structure for the CAS and a two‐factor structure for the GHQ‐12. In conclusion, this study proposes three consistent instruments that may be useful for analysing nurses' adaptation to work contexts. Copyright © 2014 John Wiley & Sons, Ltd.     

Musculoskeletal function assessment instrument: Criterion and construct validity

The Musculoskeletal Function Assessment (MFA) instrument, a health status instrument with 100 self-reported health items; was designed for use with the broad range of patients with musculoskeletal disorders of the extremities commonly seen in clinical practice. In this paper, we report on its criterion and construct validity. Criterion validity was tested against physicians' ratings of patient functioning (e.g., upper functioning, lower functioning, daily activities, recreational functioning, emotional adjustment, and overall functioning) and standard clinical measures (e.g., grip strength, walking speed, fine motor skills, knee and elbow strength, and range of motion). Significant correlations (p ? 0.05) between its scores, physicians' ratings, and clinical measures support the MFA's criterion validity. Construct validity was demonstrated against existing measures of health status (e.g., measures of lower and upper mobility, activity level and satisfaction, health status, social support, pain, emotional status, and quality of life), in accordance with clinical hypotheses about the effect of musculokeletal disorders on functioning (e.g., type and number of problems, severity of illness or injury, and comorbidites) and by an analysis of demographic characteristics (e.g., sex, education, income, health insurance, and employment) against the MFA scores. Discriminant construct validity was supported in an analysis of MFA scores by patient disease groups (p ? 0.01).