Coaches' perceptions of athletes' stress-related growth following sport injury

ObjectiveThe objective of this study was to examine coaches' perceptions of athletes' stress-related growth following sport injury.DesignQualitative inquiry, grounded in a post-positivism paradigm was used to gain an in-depth understanding of the study's objective.MethodA purposeful sample of eight coaches (M age = 45.7; SD = 11.2) were interviewed across different sports and competitive standards. The semi-structured life world interviews were analysed using content analysis, and two trustworthiness procedures were employed to bolster the rigour of the findings (i.e., peer-debriefing and member checking).ResultsFindings revealed four general dimensions of stress-related growth: personal growth (e.g., beliefs), psychological growth (e.g., sporting qualities), social growth (e.g., social support), and physical growth (e.g., strength). The coaches also reported a number of behavioural indicators that reflected the four general dimensions (e.g., health and performance).ConclusionsFindings ‘validate’ or provide coherence with athletes' self-reports of stress-related growth in previous research and also extend the literature by identifying a number of novel types of growth and perceived behavioural correlates. Future avenues of research include the need to conduct prospective studies and explore related concepts (e.g., vicarious stress-related growth).     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.     

The Achievement of Therapeutic Objectives Scale: interrater reliability and sensitivity to change in short-term dynamic psychotherapy and cognitive therapy

This study examined interrater reliability and sensitivity to change of the Achievement of Therapeutic Objectives Scale (ATOS; McCullough, Larsen, et al., 2003) in short-term dynamic psychotherapy (STDP) and cognitive therapy (CT). The ATOS is a process scale originally developed to assess patients' achievements of treatment objectives in STDP, but further operational definitions have led to a theoretically neutral assessment device, making it applicable to other treatment modalities as well. Videotapes from a randomized controlled trial comparing the effectiveness of STDP and CT for patients with Cluster C personality disorders were rated by independent raters, typically at Sessions 6 and 36. The results indicated good to excellent interrater reliability, as well as adequate sensitivity to change in theoretically expected ways, in both STDP and CT. The results lend further support to the psychometric soundness of the ATOS and show promise for its use when comparing STDP and CT.     

An ethical framework for the responsible management of pregnant patients in a medical disaster

The ethics of managing obstetric patients in medical disasters poses ethical challenges that are unique in comparison to other disaster patients, because the medical needs of two patients--the pregnant patient and the fetal patient--must be considered. We provide an ethical framework for doing so. We base the framework on the justice-based prevention of exploitation of populations of patients, both obstetric and non-obstetric, in medical disasters. We use the concept of exploitation to identify a spectrum from ethically acceptable, to ethically challenging, to ethically unacceptable, management of obstetric patients in medical disasters. We also address the ethics of the care of obstetric and neonatal patients when the resources of a hospital are completely overwhelmed in a large-scale medical disaster.