Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

The Use of Mental Health Services Among Victims of Partner Violence on College Campuses

The present study investigated the relationship between past victimization of different types of intimate partner violence (IPV; physical, psychological, and sexual) and the likelihood of using mental health services. Results indicate 86% of participants reported experiencing some form of IPV, but only 16% of those victims used mental health services to address emotional problems. The participants reported embarrassment, expense, ineffectiveness, and social stigma as the most prominent barriers to seeking help from a mental health professional. The study also found that participants who experienced physical and psychological IPV, but not sexual IPV, reported using mental health services. Sexual IPV may elicit different barriers in help-seeking behaviors. Implications for college IPV prevention programs and mental health services are discussed.     

Social Workers and Battered Women: The Need to Study Client Violence in the Domestic Violence Field

Domestic violence is a significant issue for the United States and internationally. Although many social workers may desire to work in the domestic violence field, such work is far more difficult and challenging than many social workers would expect. In fact, many domestic violence workers are abused by their clients or their clients' family members in the course of their work. The purpose of this article is to clarify why examining client violence toward workers in the domestic violence field is critically important, describe the current state of the research, and discuss recommendations for future research in this area.     

The prevalence,risk factors and outcomes of workplace bullying among junior doctors: a systematic review

ABSTRACT

Junior doctors’ exposure to bullying may impact their training and compromise quality healthcare, yet little is known in relation to its predictors and effects. The aim of this paper is to assess the prevalence, factors and outcomes of workplace bullying among junior doctors. Literature search was performed to identify all primary studies examining workplace bullying among junior doctors using the following electronic databases: Medline, Scopus, Web of Science, PsycINFO and Cochrane Library. A total of 18 articles were included, reporting on a total of 9,597 junior doctors. The quality of evidence can be rated as moderate according to the Newcastle Ottawa Scale. From the review, a wide range (30–95%) of bullying prevalence, significant differences in bullying rates according to gender, age, height, ethnicity and subspecialty, and significant associations between bullying and mental strain, job dissatisfaction, burnout, and increased accidents at work were observed. Concurrently, heterogeneity in the terms and methodologies used to examine workplace bullying as well as definitional issues in relation to the persistency of negative interactions were noted. Evidence suggests that workplace bullying is a serious occupational hazard for junior doctors, and more research is warranted to better understand this phenomenon and address its definitional and methodological issues.     

Mental health attitudes among Middle Eastern/North African individuals in the United States

ABSTRACT

Middle Eastern/North African (MENA) individuals may have heightened risk for developing mental health problems due to unique cultural stressors. However, traditional cultural and religious practices and beliefs socialised within the family environment may reduce the likelihood of seeking mental health services. This qualitative study aimed to better understand the intersection of cultural, religious, and mental health attitudes among MENA individuals. Semi-structured telephone interviews were conducted with MENA adults who had received therapy services (N?=?13) and were analysed for emergent themes. Respondents reported lack of understanding of mental illness within their communities, and prominent levels of perceived and self-stigma. Families and religious practices/beliefs played an important role in responding to mental illness. Results suggest that incorporating psychoeducation and community awareness campaigns alongside religious services may help to reduce barriers to receiving mental health treatment.     

Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Effects of religious stigma and harm on perceived psychopathology

Prior research suggests that assessment of the pathology of religious beliefs is influenced by conventionality and harm, with less conventional and more harmful beliefs resulting in higher pathology ratings. This study, involving 313 participants, investigated levels of pathology assigned to religious beliefs when the beliefs were either helpful or less severely harmful than those used in prior research, and when the associated religion was either stigmatised (Islam) or non-stigmatised (Christianity). Results indicate that an attenuated form of harm results in elevated pathology ratings. Furthermore, religious stigma impacts these perceptions when beliefs are harmful but not when beliefs are helpful. Ratings in the harm condition were higher for Christianity than for Islam, suggesting that perceived pathology of religious beliefs may depend less on general stigma assumptions and more on perceived consistency between harmful beliefs and assumed religious schemata.     

教师工作压力与职业枯竭的关系：职业承诺的调节效应

应用工作压力、职业枯竭和职业承诺问卷对中小学教师2114人进行调查,主要探讨职业承诺对工作压力与职业枯竭关系的调节效应。结果发现：工作压力与职业枯竭的情绪衰竭、非人性化、认知枯竭具有显著正相关,情感承诺、规范承诺与职业枯竭具有显著负相关;教师职业承诺以及所包括的情感承诺、留职承诺、规范承诺对工作压力与职业枯竭关系具有负向调节效应;不同教龄段教师在职业枯竭不同方面存在差异。     

Social Support, Job Stress, Health, and Job Satisfaction Among Nurses in the United Kingdom

Recruitment and retention of nurses is a major concern in healthcare provision in several countries. This study explored the relationship between perceived social support, job stress, health, and job satisfaction among nurses from 4 organizations in northwest England. A total of 350 usable questionnaires measuring stressors, perceived support, health, and job satisfaction, was obtained from a sample of 1,162 nurses drawn from 4 healthcare organizations. A follow-up study was conducted after 6 months. Results indicate that perceived organizational support is related to nurses' health and job satisfaction. Current interventions to increase support, which typically operate at individual or group level, may be limited in their effectiveness unless nurses' perceptions of organizational support are taken into account.     

工作压力的研究现状与方向

工作压力的研究在西方已经进行了多年,并受到越来越多的注意,但在我国研究还较少。本文从工作压力的定义、对于工作压力的测量、影响工作压力产生的因素、工作压力的后果、以及应对这几个方面介绍这一领域目前的研究现状并提出作者认为这一领域现存的问题和今后的研究方向。