Frontline Healthcare Staffs’ Experience of Organizing Complex Hospital Discharges: An Ethnographic Study

Existing studies show that nurses often experience moral distress when the care they deliver to patients does not meet their professional values. We draw on ethnographic data collected in June 2015 from one acute care trust in England and present how frontline healthcare staff experience organizing complex hospital discharges. Our findings demonstrate how problems with the panel responsible for allocating funding for National Health Service continuing healthcare cases contributed to healthcare staff experiencing moral distress. Our findings offer a basis for further research on how other aspects of the complex hospital discharge-planning process may contribute to nurses’ experiencing moral distress.     

Personality and Preference for Rural Ministry: Replication and Reconsideration

A random sample of 1,057 male stipendiary parochial clergy completed the Eysenck Personality Questionnaire. The data demonstrate that clergy serving in rural ministry tend to be more introverted, more socially conforming and less toughminded. The implications of these findings are discussed in relation to the shape of rural ministry.     

Clergy Work-Related Psychological Health: Listening to the Ministers of Word and Sacrament Within the United Reformed Church in England

Drawing on the classic model of balanced affect proposed by Bradburn (The structure of psychological well-being, Aldine, Chicago, IL, 1969), this study conceptualised poor work-related psychological health in terms of high levels of negative affect in the absence of acceptable levels of positive affect. In order to illuminate self-perceptions of work-related psychological health among a well-defined group of clergy, a random sample of 58 ministers of word and sacrament serving within the west midlands synod of the United Reformed Church in England completed an open-ended questionnaire concerned with the following six guiding questions. Do you enjoy your work? How would you define stress? How would you define burnout? What stresses are there in your ministry? What do you do to keep healthy? What can the church do to enhance the work-related psychological health of ministers? Content analysis highlighted the main themes recurring through these open-ended responses. The conclusion is drawn that ministers of word and sacrament within the United Reformed Church in England are exposed to a number of recurrent recognisable sources of stress. Suggestions are advanced regarding the need for future more detailed research and for the development of more effective pastoral strategies.     

Word shape,orthographic regularity,and contextual interactions in a reading task

In an investigation of the interaction between three sources of information about a printed word, skilled readers performed a simple naming task. The naming latency was observed as a function of case of presentation, orthographic regularity, and the congruency of context supplied in a previously presented sentence. Differences between regular and irregular words were observed for upper case presentations only, suggesting that lexical access can proceed via a direct visual route only when the distinctive features of the global word envelope are available. Incongruent sentences inhibited word naming, and congruent sentences facilitated naming, but this effect was more apparent for upper case than for lower case words. These results suggest an interaction of information during word recognition, with the removal of the word envelope leading to a greater dependence upon other intrinsic and extrinsic information.     

Intervention and sleeper effects: A reply to Victoria Seitz

Victoria Seitz (Developmental Review, 1981, 1, 361–373) has misperceived and misunderstood our position (A. D. B. Clarke & A. M. Clarke, Developmental Review, 1981, 344–360). For example, our argument endorsed a transactional and not a main-effect model, nor was our aim to argue that early intervention has no important later consequences, nor did we dispute Consortium findings (I. Lazar & R. Darlington, Lasting effects after preschool, Washington, D.C.: DHEW Publication No. (OHDS) 79-30178, 1978). In fact, agreements with Seitz greatly exceed disagreements. Our skepticism about whether a behavioral treatment can have long-range effects without also having earlier ones remains. Long-term changes appear to result from ongoing long-term processes.     

Occupational perceptions of academic disciplines

This study investigated the way in which various academic disciplines are viewed by students with respect to their “specificity,” i.e., the degree to which each is related to all occupations after graduation, and their “utility,” i.e., the extent to which each facilitates obtaining employment after graduation. A consensus concerning the specificity and utility of 17 academic disciplines was found for a sample of 485 sixteen- to eighteen-year-olds. This consensus was reliably demonstrated on other independent samples; nevertheless, some differences between individual disciplines were found as a function of sex and type of school attended.     

A comparison of deaf, normal, and brain damaged adults on a tachistoscopic task

Printed words and letters, pictures of signed words, and pictures of finger-spelled letters were presented tachistoscopically to deaf, normal, and brain-damaged adults. The findings suggest that (1) the deaf show no cerebral asymmetry for any of the material but found identification of the stimuli very difficult unless a forced-choice recognition procedure was used or the exposure time was very long; (2) both the normal and the brain-damaged groups show left hemisphere superiority for printed material but no cerebral specialization for signed material; (3) the left-right hemisphere difference is more marked in the brain-damaged group regardless of which hemisphere showed most damage. This may be explained, at least in some cases, by impaired transfer across the corpus callosum.     

Deliberate self-harm,clinical history and extreme scoring on the EPQ

Two hundred consecutive admissions to an inpatient psychiatric unit were assessed on the EPQ following recovery from the disturbance for which they were hospitalized. Case-history data was also checked for these patients and extended by using a clinical-history structured interview, also administered within 1 week of discharge. Results showed that for males, high P and high N was associated with a history of deliberate self-harm (DSH) by mutilation. High N was also associated with parental violence. In females, both low E and high N were associated with a history of self-mutilation. High N scores were also more likely to have appeared in court, and high P females were more likely to have a history of bedwetting and of parental violence.None of the associations between extreme scoring on the EPQ and self-mutilation were found for DSH by overdose.     

Return of fear: The role of inhibition

In a previous study investigating the relationship between subjective, physiological and behavioural changes during treatment of specific phobias, a marked between-session increase was found in subjective fear after high, but not after low intensity phobic stimulation although the groups showed similar fear ratings and heart rates immediately after treatment (Grey et al, 1979). It was hypothesized that the high intensity stimulation led to ‘treatment fatigue’; a state of deactivation, the recovery from which led to a return of fear.In this study high intensity in vivo stimulation was used for the treatment of phobic subjects under conditions of distributed and massed practice. No differences emerged between treatment conditions. A small group of Ss with a conspicuously high heart rate (mean level 120 bpm) when rating zero fear, showed a significant increase in fear after one week's interval, although they had shown similar improvement to the Ss during treatment. Subjects in both treatment conditions showed lower heart rate at all post-treatment assessments than pre-treatment. The high initial heart rate Ss continued to have higher heart rate than other Ss throughout the experiment, although they showed a decrease after treatment. It was only these Ss with desynchronously high heart rate, i.e. high heart rate with zero fear ratings, who suffered a return of fear, whereas high heart rate during high fear did not predict either response to treatment or return of fear. A further finding was a lack of correlation between the behavioural and physiological indices of fear, namely, between distance and heart rate at high levels of fear.