Coping patterns of in vitro fertilization nurse coordinators: Strategies for combating low outcome effectance

Abstract

Data were gathered concerning coping strategies that nurse coordinators working in the field of in vitro fertilization would use to meet typical work-related stressors. Causality orientation—or tendency to perceive oneself as autonomous, controlled or helpless—was also measured. It was hypothesized that nurses using problem-focused/disengaged strategies, such as thinking about therapeutic successes or trying not to dwell on stressors, and who were high in autonomy, would be most effective in coping with situations where control over outcomes is limited. Statistical analyses revealed a group of nurses following the coping pattern described in the hypothesis. These individuals reported less work-related stress than other nurse coordinators.     

Couple and Family Therapy Within the Current Pan-Canadian Context

Canadians take numerous approaches to couple and family therapy due in part to Canada’s diversity of people and geography, as well as the influence of the health care context, a central facet of our national identity. Tracing back to Nathan Epstein, the founder of family therapy in Canada, there continues to be a strong tradition of couple and family therapy within Canada which has international reach. Formal training in family therapy, as well as couple/marital therapy occurs largely outside of the scope of degree granting programs and university settings. The American Association for Marriage and Family Therapy has a strong presence in Canada, with six divisions across the country. Popular models of practice for Canada’s couple and family therapists include cognitive-behavioral therapy, solution-focused therapy, narrative therapy, emotionally-focused therapy, and Bowenian/intergenerational therapy. A growing number of training opportunities are becoming available across Canada, and the practice of couple and family therapy is becoming institutionalized as one of the core competencies for professions such as psychiatry. In this article, we examine the context of family therapy in Canada by examining its history, the unique accreditation standards, qualifications and organizations associated with family therapy, the relationship between couple and family therapy, and future directions for this field of practice.     

Development of Family Therapy in Ireland

In Ireland family therapy is a small profession, with under 200 registered therapists. The Irish family therapy movement began in the mid-1970s. By 1980 the Family Therapy Network of Ireland in the Republic of Ireland and the Northern Ireland Branch of the UK Association Family therapy had been founded. At present there are three main family therapy training centers in Ireland: two in the south (the Mater University Hospital, affiliated to University College Dublin and Clanwilliam Institute) and one in the north (at Queen’s University Belfast). There is no statutory registration and licensing of family therapists in Ireland. Accredited professional family therapy programs in Ireland are 4-year part-time courses culminating in masters level qualifications. A primary degree in medicine, nursing, psychology, social science or education is a prerequisite for entry. Family therapists in Ireland work in both private practice and the public health service. Most family therapists in the public sector are employed as social workers, psychologists, psychiatrists or nurses, and conduct family therapy as part of their broader professional roles. Couple therapy in Ireland is provided by family therapists, and also by voluntary couple counselors based in networks of local centers, some of which were originally religiously affiliated, without a formal connection to national family therapy associations. The three major future challenges for Irish family therapy are creating a research infrastructure, developing a career structure in the public health service, and introducing statutory registration.     

Psychological impact of remote combat/graphic media exposure among US Air Force intelligence personnel

Since 2001 there has been a significant increase in the use of intelligence, surveillance, and reconnaissance (ISR) analysis for tactical, operational, and strategic decision makers engaged in global operations. To meet this demand, US Air Force intelligence personnel participate in remote combat and graphic media exploitation operations (e.g., review of still imagery, video, and audio), the long-term psychological effects of which are not well understood. Research to date has focused primarily on outcomes related to how intelligence personnel work, versus the specifics of what they do. Military psychologists embedded in ISR units conducted studies to address this gap. Intelligence analysts participated in focus groups and surveys assessing the frequency of exposure, previous exposures to other potentially traumatic events, symptoms of PTSD, moral injury, and other psychosocial experiences. Results showed that exposure levels, albeit virtual, rivaled or exceeded those reported by a sample of special operations forces. Results also showed that specific types of exposures (e.g., witnessing US military casualties, civilian casualties, atrocities committed by the enemy) are related to increased posttraumatic stress and other sequelae that may not adequately be captured by standard posttraumatic stress disorder screening measures. The results contribute to the existing literature on posttraumatic stress, shed new light on the emerging construct of moral injury, and highlight challenges presented by remote combat and graphic media exploitation operations to force health sustainment and performance optimization. The authors provide directions for future research and recommendations for ongoing assessment, monitoring, and selection and training of ISR personnel.     

USAF Special Tactics Operator Combat Exposure and Psychological Stress

Given the length of combat in Afghanistan, Iraq, Syria, and elsewhere, and the role special operations forces will continue to play, we believe it is imperative to gain understanding of the psychological “wear and tear” associated with sustained combat operations on these highly specialized, highly utilized personnel. This study focused on a seldom-studied group, Air Force Special Tactics (ST) operators, to assess combat exposure, current psychological stress, and preferences for support when needed. This study assessed symptoms of posttraumatic stress, depression, anxiety, sleep, anger, and perceptions of help seeking in 5 ST units. Data revealed that the majority of study participants report distress levels below clinical thresholds; however, 26% struggle with generalized stress/agitation and, at smaller percentages, other distress symptoms that have negative impact on work performance. Combat experiences were comparable or higher than Army and Marine maneuver forces, and greater amounts of exposure related to positive screening for a possible mental health disorder, generalized agitation, and posttraumatic symptoms; combat involving direct fighting and being in high-threat situations were also related to posttraumatic stress. Distress rates for Special Operations Weather personnel were higher. Attitudes toward mental health support were positive however, embedded assets were preferred over base clinic providers. We review these and other findings and offer suggestions for future research in this area.     

Forgiveness as a mediator of the relationship between PTSD and hostility in survivors of childhood abuse

This paper argues that emotional inferences about characters in a text are not as specific as previously assumed (DeVega, Diaz, & Leon, 1997; DeVega, Leon, & Diaz 1996; Gernsbacher, Goldsmith, & Robertson, 1992; Gernsbacher, Hollada, & Robertson, 1998; Gernsbacher & Robertson, 1992). The emotional information inferred by readers does not differentiate between emotions that are similar, though not identical. In both Experiments 1 and 2, participants read the stories used by Gernsbacher et al. (1992). Results from Experiment 1 (off-line) show that participants judged several emotions consistent with the same story. In Experiment 2 (on-line), participants took longer to read target sentences containing emotions mismatching the stories, but there was no difference between target sentences containing different matching emotions as determined by Experiment 1. Results from Experiments 1 and 2 suggest that the emotional information readers infer from the stories is too broad to determine a specific emotion. The results are consistent with the idea that a general emotional response is evoked, which is compatible with one or more specific emotions.     

Phonological and semantic strategies in immediate serial recall

It has been suggested that certain theoretically important anomalous results in the area of verbal short-term memory could be attributable to differences in strategy. However there are relatively few studies that investigate strategy directly. We describe four experiments, each involving the immediate serial recall of word sequences under baseline control conditions, or preceded by instruction to use a phonological or semantic strategy. Two experiments varied phonological similarity at a presentation rate of one item every 1 or 2 seconds. Both the control and the phonologically instructed group showed clear effects of similarity at both presentation rates, whereas these were largely absent under semantic encoding conditions. Two further experiments manipulated word length at the same two rates. The phonologically instructed groups showed clear effects at both rates, the control group showed a clear effect at the rapid rate which diminished with the slower presentation, while the semantically instructed group showed a relatively weak effect at the rate of one item per second, and a significant reverse effect with slower presentation. The latter finding is interpreted in terms of fortuitous differences in inter-item rated associability between the two otherwise matched word pools, reinforcing our conclusion that the semantically instructed group were indeed encoding semantically. Implications for controlling strategy by instruction are discussed.     

Directed remembering: Subliminal cues alter nonconscious memory strategies

Much research on memory function has focused on changes in recognition performance brought about by differences in the processes engaged during encoding. In most of this work, participants either receive explicit instructions to remember particular items or they perform orienting (i.e., encoding) tasks that support different levels of memory performance. In daily life, however, the retention or dismissal of information often occurs without conscious intent, thereby suggesting an alternative, nonconscious route through which purposive remembering and forgetting can occur. Based on this line of reasoning, we speculated that recognition performance in a standard item-based forgetting paradigm may be moderated by subliminal cues that trigger the automatic activation of different mnemonic strategies. We report the results of two experiments that supported this prediction. In each experiment, the basic item-based forgetting effect was replicated, but via the subliminal presentation of “remember” and “forget” cues. In addition, cue-dependent differences in memory performance were traced to the operation of a covert rehearsal mechanism during encoding. We consider the implications of these findings for the non-conscious operation of memory processes in everyday life.     

Age-related differences in metacognition for memory capacity and selectivity

ABSTRACT

Background: We compared two types of metacognitive monitoring in younger and older adults: metacognitive accuracy for their overall memory performance and their ability to selectively remember high-value information. Method: Participants studied words paired with point values and were asked to maximise their point score. In Experiment 1, they predicted how many words they would remember while in Experiment 2, they predicted how many points they would earn. Results: In Experiment 1, while younger adults were accurate in their predictions, older adults were overconfident in the number of words they would recall throughout the task. In Experiment 2, however, both younger and older adults were equally accurate when predicting the amount of points they would earn after some task experience. Conclusions: While younger adults may have higher metacognitive accuracy for their capacity, older adults can accurately assess their ability to selectively remember information, suggesting potentially separate metacognitive mechanisms that are differentially affected by aging.