Adult marijuana users seeking treatment (N = 291) were randomly assigned to 3 treatment conditions: 1) a cognitive-behavioral relapse prevention support group (RPSG), 2) individualized assessment and advice group, and 3) delayed treatment control group. The purpose of this study was to examine the relationship between psychological distress, self-efficacy, and marijuana use. Measures of marijuana use, psychological distress, situational self-efficacy, coping self-efficacy, temptation to use, and frequency of encountering situations were used. Only a portion of the hypotheses were supported. Psychologically distressed individuals had lower self-efficacy for psychologically distressing (PD) situations as opposed to non-psychologically distressing (NPD) situations. Participants had lower self-efficacy for NPD situations than PD situations. The RPSG condition did not have the hypothesized effect on self-efficacy for PD situations. / Master of Science

Although relationships between identity status and agentic personality have been found (Cote & Schwartz, 2002), it is hypothesized in this paper that identity distress better accounts for variation in agentic personality score than identity status alone. In other words, this paper tests the incremental validity of identity distress in predicting agentic personality. Marcia (1966) operationalized Erikson's (1963) concept of identity formation in terms of four identity statuses: diffusion, foreclosure, moratorium, and achievement. Each status has been empirically associated with certain personality characteristics and differing levels of adjustment. James Cote found a link between identity status and agentic personality. A person is considered to have an agentic personality when they have the ability to be thoughtful of relationships, plan ahead, have confidence in making major life changing choices, accept oneself fully and overcome adversity (Cote &Schwarz, 2002). Although identity status has been shown to be linked to agentic personality, identity status is probably not the only, nor perhaps even the best, predictor of agentic personality. Berman et al. (2004) noted that the distress that some adolescents experience during the identity formation process may result in a delay or obstruction in achieved identity in some individuals, resulting in psychological symptoms. They suggested that identity distress variables should be considered when studying identity formation and its effects on mental health. Veronica Petkus (2005) found identity status mediated the relationship between psychological symptoms and status. This study looks at positive qualities (i.e. agentic personality) to see if that too is predicted albeit negatively by identity distress. To test the hypothesis that identity distress would account for a greater percentage of the variance in agentic personality than identity status alone, a multiple regression analysis was calculated. Although identity distress significantly increased the predictive power of the regression equation the identity status still remained highly predictive. Thus, it seems that identity distress is an important contributing factor to the prediction of agentic personality but not necessarily a better one than status. The strongest predictive equation includes both.

The present study examined the relationship between coping and psychological and psychosomatic distress of 25 individuals who experienced the same severe, acute traumatic event: the violent shooting that killed 23 people and severely injured 20 more in Luby's Cafeteria in Killeen, Texas, on October 16, 1991. Distress was assessed by one-month pre-event and post-event scores on the SCL-90R, Psychosomatic Questionnaire, and by a Life Event Questionnaire score for the year before the incident. Coping was measured by a modified version of the Ways of Coping Scale (Folkman et al., 1986) and Response Style Questionnaire (Nolen-Hoeksema & Morrow, 1991). All post-event distress scores, except the Psychosomatic score, significantly increased over their corresponding pre-event scores regardless of gender. Although female distress scores were consistently higher than male scores, gender was predictive of post-event distress only for the SCL-90R Anxiety, Somatization, and Global Severity Index scales. The only pre-event score found to be predictive of post-event distress was the Psychosomatic scale. Regression analysis, with demographic and pre-event variables controlled, found a significant positive relationship between Escape/Avoidance coping and one-month post-event levels of Anxiety and Psychosomatic distress. Findings were discussed in the context of the process-oriented stress-illness model and were compared to current disaster and crime victimization literature. Implications for helping professionals, methodological issues, and implications for future research were explored.

Mutations in BRCA1 and BRCA2, the first two breast cancer susceptibility genes identified, carry as much as an 85% lifetime risk of developing breast, ovarian or other cancers. Genetic testing for mutations in these two genes has recently become commercially available. There have been varying amounts of psychological distress noted among women with a family history of breast cancer. Distress has been observed to impact psychological functioning, activities of daily living, and the practice of breast cancer surveillance behaviors. Within the genetic screening process, psychological distress has been shown to impact the decision to undergo genetic screening, the comprehension and retention of risk assessment information, as well as affecting the subject following the receipt of the genetic test results. Little work has been done to examine predictors of distress within at risk subjects. This study examines psychological distress among 52 community women presenting for BRCA1 and BRCA2 genetic mutation testing. Predictors of distress included family cancer history, education, age, Ashkenazi ethnicity, and Internality and Powerful Others Health Locus of Control. Vulnerable sub-groups of patients include younger women, women with higher levels of education and women of Ashkenazi ethnicity.

The emotional impact of serious illness in families is recognised. To enhance well-being in families living we must understand how distress is experienced within families; from this, evidenced-based systemic distress interventions can be derived. However, the success of systemic intervention programmes is reliant on whether families will seek help (or not) for distress. This PhD by publication explores emotional distress and help-seeking in families living with advanced cancer. Papers one and two used systematic review techniques. Paper one evidenced distress as a systemic construct and proposes the tiered model of distress to convey current understandings. Paper two offers the attaining normality model to convey why some people seek help for distress to achieve a new normality whereas some choose not to seek help to maintain normality. Together, these papers evidence gaps in systemic understandings of distress and help-seeking; from this an exploratory cross-sectional multiple case study of families was proposed. Papers three and four provided methodological underpinning to this research through the development of the DESCARTE model: The Design of Case Study Research in Healthcare (paper three) used in the case study design; paper four reflects on multi-perspective interviewing methods used. Distress and help-seeking are conceived as systemic relational phenomena, occurring within the family system and arising from relational interaction with healthcare. Distress is conveyed through four themes: interdependent distress, living in uncertainty, unnecessary distress and oscillatory distress; from this, possible systemic intervention designs are offered (paper five). Non-help-seeking for distress was the predominant response in families. The mutuality model of help-seeking is proposed to synthesise current understandings (paper six). Families describe how healthcare interactions cause unnecessary distress and shapes families’ help-seeking behaviours. Findings indicate significant gaps between the rhetoric of palliative care policy and families’ experience. To improve families’ wellbeing, relational care must be embedded in policy and practice.

<p>Background: During the year 2002 approximately 27 000 people lost their jobs because of companies filing for bancruptcy. In 2002 the number of companies filing for bancruptcy in Sweden were 6740. This is approximately twice as many as in the year of 1974 when the first major study concerning bancruptcies in Sweden was carried out. The accumulated amount of unpaid bancruptcy claims for the period 1991 – 1997 was 51 billion SEK. Several swedish banks estimates that approximately one third of these bancruptcies could be avoided. </p><p>Purpose: Create a checklist for issuing- and evaluation of company loans. </p><p>Execution: Only financial information available in annual reports have been used in this study. A targetpopulation with companies filing for bancruptcy in the year 2001 has been derived. The targetpopulation has been evaluated in comparison with a controlpopulation for the same period of time. </p><p>Outcome: Two variables, high long term liabilities to total assets and a low degree of equity to total assets, showed high predictability five years prior to bancruptcy. According to our study there are four variables useful for prediction of financial distress two to three years prior to bancruptcy. (1) An increased degree of long term liabilities to total assets, (2) a decrease in untaxed reserves, (3) decreasing profitability more than two years in a row from a already low level and (4) an increase in assets financed with long term liabilities.</p>

<p>The aim of the present literature study was to describe the significant factors contributing to the development of moral distress and the consequences of moral distress can lead to in the nurse profession. A literature search was performed in the databases Medline through PubMed and Academic Search Elite on the basis of in advanced defined criterions. A total of 19 articles was reviewed and included in the study. The main result revealed that nurses experience moral distress and that it is frequent within the nurse profession. The findings revealed that there seem to be several significant factors in the development of moral distress, such as providing life-sustaining care, competing loyalties, conflicts with the physician, communication barriers, emotional barriers, cultural barriers, regulation and rules and working environment that gives the nurse difficult or unsolved ethical dilemmas. The consequences of moral distress can contribute to health problems both physical symptoms and mentally, such as headache, neck and muscle pain, stomach problems, depression, anger and guilt. Moral distress affects the nurse professionally, and contributes to distancing from patients, relatives and colleagues, a resistance against going to work and to perform work tasks. The conclusion is that the consequences of moral distress don’t just affect nurses but undeniably also patients, relatives and other instances in within the healthcare system.</p> / <p>Syftet med denna litteraturstudie var att beskriva de faktorer som har betydelse för utvecklingen av moral distress, och vilka konsekvenser moral distress kan leda till i sjuksköterskans yrkesutövning. En litteratursökning genomfördes i databaserna Medline via PubMed och Academic Search Elite utifrån i förväg uppsatta kriterier. Totalt 19 artiklar granskades och inkluderades i studien. Huvudresultatet visade att moral distress existerar och är frekvent inom vården och sjuksköterskeyrket. Av författarnas resultat framkommer att det tycks finnas flera faktorer av betydelse för utvecklingen av moral distress, som livsuppehållande vård, konkurrerande lojaliteter, konflikt med läkaren, kommunikationshinder, emotionella hinder, kulturella hinder, föreskrifter och regler och arbetsmiljöfaktorer ger sjuksköterskan svårlösta eller olösta etiska och moraliska dilemman. Konsekvenserna av detta kan bidra till långvariga stressrelaterade hälsoproblem, så som huvudvärk, smärta i nacke, muskler och mage, nedstämdhet, ilska, skuld och depression. Moral distress får även konsekvenser för professionen så som avståndstagande till patienter, anhöriga och arbetskamrater, motstånd att gå till jobbet och att utföra sina arbetsuppgifter. Författarna drar slutsatsen att följderna av moral distress inte bara drabbar sjuksköterskan utan onekligen även patienter, anhöriga och övriga i vårdkedjan.</p>

Background: During the year 2002 approximately 27 000 people lost their jobs because of companies filing for bancruptcy. In 2002 the number of companies filing for bancruptcy in Sweden were 6740. This is approximately twice as many as in the year of 1974 when the first major study concerning bancruptcies in Sweden was carried out. The accumulated amount of unpaid bancruptcy claims for the period 1991 – 1997 was 51 billion SEK. Several swedish banks estimates that approximately one third of these bancruptcies could be avoided. Purpose: Create a checklist for issuing- and evaluation of company loans. Execution: Only financial information available in annual reports have been used in this study. A targetpopulation with companies filing for bancruptcy in the year 2001 has been derived. The targetpopulation has been evaluated in comparison with a controlpopulation for the same period of time. Outcome: Two variables, high long term liabilities to total assets and a low degree of equity to total assets, showed high predictability five years prior to bancruptcy. According to our study there are four variables useful for prediction of financial distress two to three years prior to bancruptcy. (1) An increased degree of long term liabilities to total assets, (2) a decrease in untaxed reserves, (3) decreasing profitability more than two years in a row from a already low level and (4) an increase in assets financed with long term liabilities.

The aim of the present literature study was to describe the significant factors contributing to the development of moral distress and the consequences of moral distress can lead to in the nurse profession. A literature search was performed in the databases Medline through PubMed and Academic Search Elite on the basis of in advanced defined criterions. A total of 19 articles was reviewed and included in the study. The main result revealed that nurses experience moral distress and that it is frequent within the nurse profession. The findings revealed that there seem to be several significant factors in the development of moral distress, such as providing life-sustaining care, competing loyalties, conflicts with the physician, communication barriers, emotional barriers, cultural barriers, regulation and rules and working environment that gives the nurse difficult or unsolved ethical dilemmas. The consequences of moral distress can contribute to health problems both physical symptoms and mentally, such as headache, neck and muscle pain, stomach problems, depression, anger and guilt. Moral distress affects the nurse professionally, and contributes to distancing from patients, relatives and colleagues, a resistance against going to work and to perform work tasks. The conclusion is that the consequences of moral distress don’t just affect nurses but undeniably also patients, relatives and other instances in within the healthcare system. / Syftet med denna litteraturstudie var att beskriva de faktorer som har betydelse för utvecklingen av moral distress, och vilka konsekvenser moral distress kan leda till i sjuksköterskans yrkesutövning. En litteratursökning genomfördes i databaserna Medline via PubMed och Academic Search Elite utifrån i förväg uppsatta kriterier. Totalt 19 artiklar granskades och inkluderades i studien. Huvudresultatet visade att moral distress existerar och är frekvent inom vården och sjuksköterskeyrket. Av författarnas resultat framkommer att det tycks finnas flera faktorer av betydelse för utvecklingen av moral distress, som livsuppehållande vård, konkurrerande lojaliteter, konflikt med läkaren, kommunikationshinder, emotionella hinder, kulturella hinder, föreskrifter och regler och arbetsmiljöfaktorer ger sjuksköterskan svårlösta eller olösta etiska och moraliska dilemman. Konsekvenserna av detta kan bidra till långvariga stressrelaterade hälsoproblem, så som huvudvärk, smärta i nacke, muskler och mage, nedstämdhet, ilska, skuld och depression. Moral distress får även konsekvenser för professionen så som avståndstagande till patienter, anhöriga och arbetskamrater, motstånd att gå till jobbet och att utföra sina arbetsuppgifter. Författarna drar slutsatsen att följderna av moral distress inte bara drabbar sjuksköterskan utan onekligen även patienter, anhöriga och övriga i vårdkedjan.

A growing interest in evaluating quality of healthcare services has led to several initiatives geared towards quality improvement and increased efficiency by focusing on patient needs and collected evidence. Efforts designed to standardize quality healthcare delivery are difficult because of variation in perspectives and disagreement as to what actually indicates quality healthcare. To help bring more clarity to the topic of quality care this study performed a secondary analysis on data gathered from the ‘provider morale’ section of the ‘Managing Quality in Canadian Hospitals’ project. The purpose of this study was to address how nurses’ perceptions of distress, work place recognition and satisfaction influenced their assessment of quality care in Saskatoon hospitals. The conservation of resources (COR) theory was used as a theoretical framework to guide the development of an understanding of nurses’ perceptions through a focus on occupational distress, recognition, and job satisfaction as a potential means of observing environmental effects on quality of care. This research established that there were significant positive relationships between recognition-quality, satisfaction-quality and recognition-satisfaction; suggesting that recognition and satisfaction can be viewed as work related resources and indicators of nurses’ perceptions of quality care delivery. Significant negative relationships were found between distress-recognition and distress-satisfaction; suggesting that distress levels have an effect on perceptions of nursing work resources. The research findings also indicated that there was a significant difference in how nursing units perceived quality and distress, but no significant difference in perceptions of recognition or satisfaction; suggesting that work place resources have different effects, that there are other resources in play on units which affect perceptions, and that the impact of recognition and satisfaction on quality and distress perceptions differs between nursing units. The results of this study provide nurses, nursing managers, and healthcare organizations with a deeper understanding of how resources and stress processes in work environments effect the perception of quality care delivery.