Traumatic stress symptoms following a lower limb amputation in diabetic patients: a longitudinal study

Objective: Limited research has focussed on the development of traumatic stress symptoms following an amputation due to a chronic disease such as Diabetes. This study analysed whether coping strategies, anxiety and depression symptoms, sociodemographic and clinical variables were related to traumatic stress symptoms in a sample of patients who had undergone a lower limb amputation.

Design: A longitudinal design with three assessments, one month (T1), six (T2) and ten months after an amputation surgery (T3), included 144 patients.

Main outcome measures: IES-R, WOC and HADS.

Results: Traumatic stress symptoms were prevalent at T1 (M?=?15.65, SD?=?15.40) and probable PTSD was observed in 13.9% patients. Presence of pain, high level of anxiety symptoms and emotion-focused strategies contributed to traumatic stress symptoms, and the period between T1 and T2, was critical. Six to ten months (Λ?=?0.871, F (2,84) =6.245, p=. 003), after surgery, symptoms tended to decrease 0.122 units (SE?=?0.032, p?=?0.002) per assessment.

Conclusions: Findings raise awareness to the need of urgent identification of traumatic stress symptoms in medically ill patients who underwent a lower limb amputation, given the prevalence of traumatic stress symptoms right after surgery and in the following six months.     

Team adaptability and task cohesion as resources to the non-linear dynamics of workload and sickness absenteeism in firefighter teams

ABSTRACT

The current study builds on the non-linear Dynamic Systems (NDS) perspective to test the assumption that change in sickness absenteeism is non-linear, and that such change is due to workload, team adaptability and task cohesion. Participants were 37 firefighter teams (n = 250 individuals) from a main European capital city. The research hypotheses were tested using SPSS and the “cusp” package, in the statistical software R. The results suggest that change in sickness absenteeism behaviours over time is non-linear, with the cusp catastrophe model predicting such behaviours better than the linear and logistic models. In our model, task cohesion functions as an asymmetry factor (i.e., the independent variable that determines the strength and discrepancy between the two stable states of the dependent variable) leading to a linear change in sickness absenteeism. Interestingly, both workload and team adaptability function as bifurcation (i.e., the independent variable that determines the change between the two stable states of the order parameter) and asymmetry factors leading to non-linear and linear change in sickness absenteeism over time. This study contributes to the growing evidence that incorporating the NDS perspective enables a better understanding of action teams, namely those working in extreme environments.