The effects of patient's frequency of attendance and etiology of symptoms,on the General Practitioners wellbeing

IntroductionThe presence of Medically Unexplained Symptoms and a high Frequency of Attendance negatively affects the General Practitioners’ (GP) wellbeing. Although, overlapping between both phenomena is partial, with a number of frequent attenders reporting medically unexplained symptoms during consultation, there is no evidence on how GP's well-being it is affected by the specific main effects of these factors and their interaction. Evidence is also scant on the psychological processes explaining the negative impact of attendance and the etiology of symptoms on GP's wellbeing.ObjectiveDrawing on the Job Demand-Control and the Conservation of Resource stress models, this paper tests the moderating effects of the GP’ perception of patient's attendance and etiology of symptoms on the relationship between patient's demands and feedback on the GP's wellbeing.MethodA total of 105 volunteer GPs self-reported on the study variables through an experience sampling methodology after 898 patients’ consultation. Patients attendance and etiology of symptoms were categorized according to the physician self-perception and an external criterion (organizational records).ResultsPerception of Patients Frequent Attendance and Medically Unexplained Symptoms were positively related to physician's Emotional Exhaustion. Contrary to expected the test of the moderation effects of patients characteristics on the relation between patient's demands and feedback and the GP's emotional exhaustion were stronger for normal attenders compared with frequent attenders. An ad hoc study shows this unexplained result is related to the GP's expectations on Frequent vs. normal attenders’ behaviors. No significant results were found when the external criterion of classification was used.ConclusionCombined analysis of Frequency of Attendance and Etiology of Symptoms lead to a better understanding of the GP's decreased wellbeing. Also, the perception of the strain level (demands/positive feedback levels) associated to the consultation with different types of patients contribute to explain the consequences for the GP's wellbeing, especially when GP's expectations on patient's behaviors are violated.     

Examining the relationship between hardiness and perceived stress-related growth in a sport injury context

This study examined the relationship between hardiness, coping and perceived stress-related growth (SRG) in a sport injury context. Due to the exploratory nature of the study, a cross-sectional design was employed, whereby 206 previously injured athletes (148 male, 58 female, M_age = 22.23 years) who had recently returned to sport completed three questionnaires: Dispositional Resilience Scale, Stress-Related Growth Scale, and Brief COPE. Pearson product–moment correlations and Preacher's and Hayes's (2008) bootstrapping procedure were used to analyze the data. Findings revealed a significant positive relationship between hardiness and perceived SRG. Two coping strategies were found to mediate this relationship: emotional support and positive reframing. This would suggest that those higher in hardiness may have fostered SRG by mobilising their social support for emotional reasons (e.g., moral support, sympathy or understanding) and having the ability to construe their injury in positive terms; however, more rigorous methodologies are needed to confirm or refute these observations. These findings support some of the central tenets of Joseph and Linley's (2005) organismic valuing theory and provide implications for professional practice. Future researchers should embrace qualitative inquiry to enhance the interpretability and meaningfulness of these findings (e.g., interpretative phenomenological analysis, narrative analysis), and use prospective, longitudinal pre-to-post sport injury designs to further substantiate them.     

Travel and residual emotional well-being

This study addresses the question of how work commutes change positive versus negative and active versus passive mood experienced after the commutes. Analyses are presented for 230 time-sampled morning commutes to work, made by 146 randomly sampled people in three different Swedish cities, asking them to use smartphones to report mood before, directly after, and later in the work place after the commute. The results show that self-reported positive emotional responses evoked by critical incidents are related to mood changes directly after the commute but not later in the day. It is also shown that satisfaction with the commute, measured retrospectively, is related to travel mode, travel time, as well as both positive and negative emotional responses to critical incidents.     

Brief report Low positive affect and less extreme emotional encoding

Current theories suggest low positive affect (PA) should be associated with negative encoding of ambiguous information. However, recent findings (Lawson & MacLeod, 1999) paradoxically suggest that low positive affect may lead to less negative encoding. One possibility is that low positive affect is associated with less emotionally extreme encoding rather than less negative encoding. Undergraduates (22 Low PA, 23 High PA) read potentially negative and potentially positive ambiguous sentences followed by a word related to an emotional or a non‐emotional interpretation of the sentence, or by an unrelated word. Low PA participants demonstrated greater priming for neural interpretations, while High PA participations showed the opposite pattern. There was no interaction with valence, suggesting low positive affect may be related to encoding ambiguity as less emotionally extreme.     

The Welch Emotional Connection Screen: Adapting observational methods to pediatric primary care via resident training

The Welch Emotional Connection Screen (WECS) is a novel instrument that is a brief, practicable, evidenced-based observational screening tool for assessing relationship health between parent and child. The WECS requires observing 2−3 min of face-to-face interactions between parent and child, without toys, prompts, paradigms or technology. Here, we describe a translational project from the coding lab to the primary care provider via a residency training program conducted with 50 residents during a 30-day developmental and behavioral pediatrics medical resident education rotation. The aims of this study were to evaluate the efficacy of WECS pediatric resident training: 1) to improve residents' accuracy in recognizing the dyadic behaviors of emotional connection (EC) via WECS training; and 2) to improve residents' attitudes, self-efficacy, and perceived professional norms (ASPPN) pertaining to Early Relational Health in Pediatrics. Results indicate that using a rapid prototyping approach to training, residents improved in their identification of dyads showing low to midrange levels of emotional connection. As well, resident attitudes about the importance of relationship health in pediatrics and their self-efficacy in identifying emotional connection improved significantly after this brief resident training.     

Brief Report The coherence of emotion systems: Comparing “on‐line” measures of appraisal and facial expressions,and self‐report

Recently, investigators have challenged long‐standing assumptions that facial expressions of emotion follow specific emotion‐eliciting events and relate to other emotion‐specific responses. We address these challenges by comparing spontaneous facial expressions of anger, sadness, laughter, and smiling with concurrent, “on‐line” appraisal themes from narrative data, and by examining whether coherence between facial and appraisal components were associated with increased experience of emotion. Consistent with claims that emotion systems are loosely coupled, facial expressions of anger and sadness co‐occurred to a moderate degree with the expected appraisal themes, and when this happened, the experience of emotion was stronger. The results for the positive emotions were more complex, but lend credence to the hypothesis that laughter and smiling are distinct. Smiling co‐occurred with appraisals of pride, but never occurred with appraisals of anger. In contrast, laughter occurred more often with appraisals of anger, a finding consistent with recent evidence linking laughter to the dissociation or undoing of negative emotion.     

Distraction and reappraisal efficiency on immediate negative emotional responses: role of trait anxiety

Background and Objectives: Emotion regulation involves attempts to influence emotion unfolding and may target experiential, expressive and physiological responses. Several strategies can be used, such as reappraisal (re-evaluating the emotional situation to reduce its emotional meaning) or distraction (turning the attention toward non-emotional aspects of the situation). Previous research on these regulation strategies produced contrasting results regarding their efficiency and we hypothesize that this could be due to individual differences such as trait anxiety.

Design and Methods: Participants (N?=?77) were confronted with negative pictures and we examined the differential emotional reactivity according to trait anxiety, followed by a comparison of the efficiency of reappraisal and distraction in reducing emotional responses.

Results: Results show that trait anxiety has no impact on reactivity at the experiential and expressive levels, but has an impact at the physiological level, where high anxiety individuals show increased cardiac orienting effect, as well as higher skin conductance and respiratory rate. Regarding regulation, reappraisal and distraction successfully reduce emotional experience and expressivity, but not physiological arousal.

Conclusions: Such contrasting results involve that high trait anxiety individuals might benefit from the use of other kinds of strategies than reappraisal and distraction, some that may successfully target physiological responses.