Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

M.A. (Clinical Psychology) / South African paramedics are thought to be exposed to a high number of critical incidents as compared to paramedics elsewhere (Ward, Lombard & Gwebushe, 2006). Therefore, South African paramedics are at particular risk of suffering from negative effects associated from the exposure to critical incidents. This study aimed to gain an in-depth understanding of the meaning which paramedics attach to the experience of “critical incidents” (Mitchell, 1983). This information may be beneficial for those working in Emergency Medical Services in South Africa to further understandings of paramedics’ experience of work related trauma. Five paramedics, sourced from both public and private ambulance service, between the ages of 27 and 36 years old, who have had between 8 to 12 years of working experience were interviewed regarding their lived experiences of critical incidents. The semi-structured interviews were transcribed and analysed based on the Interpretative Phenomenological Analysis (IPA) framework suggested by Smith and Osborn (2008). The analysis of each of the participant’s transcripts provided four master themes, some of which are supported by superordinate themes. The master themes are: 1) Experiencing the trauma of critical incidents, 2) Experiencing in the “World” of EMS, 3) Intrinsic factors and active attempts of coping with stress, and 4)Personal consequence of being a paramedic. For most of the participants, their narratives highlighted that the organisational variables were considered to be more important than the nature of the critical incidents they experienced. Critical incidents were deemed traumatic as there was a disparity between the participant’s expectations of what was expected and what they were confronted with in “reality”. In addition, the participants described forming an emotional bond with their patients or the patient’s family, which added to their distress. The participants’ narratives emphasised the importance of the role of the EMS organisation in influencing their experiences. Despite employing a number of coping strategies to mediate the effects of organisational as well as critical incident stress, the participants reported experiencing longterm negative psychological symptoms that have impacted on their personal and familial lives. These findings support the growing body of knowledge that demonstrates that organisational variables play an important role in either mediating or exacerbating posttrauma outcomes.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Emergency Medicine. Johannesburg, March, 2016 / Objectives: The aim of the current research was to determine the perception and experience of different emergency department occupational groups regarding workplace violence in the past 12 months and to determine the effect that it had on them in two government hospitals in Johannesburg, South Africa. Materials and Methods: The current research was a cross sectional, retrospective qualitative survey. Results: Eighty-six surveys (43%) out of the distributed 200 questionnaires were returned. Five surveys were unfilled leaving 81 surveys (40.5%) that are included in the analysis. Psychological violence was experienced by 73 % (n=51) of the participants while physical violence was experienced by 34.2% (n=27). Patients were the perpetrators of 61% and 67.9% of psychological and physical violence against staff members, respectively. Friends and family members who accompanied patients in the emergency department accounted for 27.4% psychological violence while this same set of people caused 17.3% of physical violence. Ninety-one percent of the participants reported that they did not receive any training courses on how to handle workplace violence incidents. Medical staff (doctors and nurses) were found to be at an increased risk to psychological violence. Conclusions: Workplace violence was commonly experienced by ED staff members. Majority of the incidents were in the form of psychological violence; however, a considerable percentage of the participants experienced physical violent incidents. Most of the violent incidents experienced were perceived to be preventable by majority of participants. This research supports the need for practical training and education of the ED staff members, on how to prevent and deal with issues related to ED WPV. / MT2016

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

Much research has studied cohesiveness within client groups in terms of making therapeutic gains. These studies have defined cohesiveness in terms of a) attraction of the group as perceived by a group member, b) how clearly each member sees his/her role within the group, and c) the effectiveness of one's skills in attaining group goals. Little research has dealt with the role of staff cohesiveness in developing an effective treatment program. Effectiveness, in this study, is defined as the degree to which clients are willing to disclose personal information to the staff. The results show a positive correlation between staff's perceived effectiveness with clients and the clients' willingness to self-disclose. On-hand experience with clients seems important in involving clients in therapy.

Introduction: It was previously established that mental health workers in Rwanda experience secondary traumatic stress when working with trauma survivors. The effects of secondary traumatic stress can be serious and permanent in mental health workers when working with traumatized clients. It interferes with mental health worker’s ability to do their work effectively. Aim: This study aimed to explore STS and to develop an intervention model to manage secondary traumatic stress in mental health workers in Kigali, Rwanda. Methodology: This study was carried out into five cycles using action research approach. In the first cycles of the study a quantitative design was used to explore secondary traumatic stress in mental health workers in Rwanda. For this cycle, the particular aim was to determine the extent of the secondary traumatic stress in mental health workers in Rwanda. A total of 180 participants were selected using convenience sampling to be part of the quantitative study. In the second cycle of the study a qualitative design was used to explore mental health workers’ experiences of secondary traumatic stress. For this cycle 30 unstructured interviews were conducted. The third cycle aimed at developing the model to manage secondary traumatic stress. Action research approach was used in this phase. Experts from mental health services involved in the study were asked to participate in the study based on their availability as research team members. The fourth cycle of the study consisted of implementing the model in one mental health service and the fifth cycle consisted evaluation of the implementation of the model after six weeks period. The main aim of this cycle was an observation of the model implantation. Results: A diagrammatical model to manage secondary traumatic stress was developed by mental health professionals. In the model development cycle of the study, it emerged that there are very strong concurrence between the findings from experts in mental health care system and literature in terms of what needs to be included in the intervention model to manage secondary traumatic stress in mental health workers in Rwanda. The key elements to include in the model were based on preventive, evaluative and curative strategies to manage secondary traumatic stress in mental health workers in Rwanda. During the evaluation of the implementation, it emerged that participant noticed a change in coping strategies when facing the stressful incident in the practice. Recommendations: include an emphasis on more psychological support for mental health professional in their workplace and for more concrete aids such as supervision, guidelines on stress management on workplace, education on secondary traumatic stress management and implementation of counseling service for mental health workers. Conclusion: The model developed in the present study outlined different ways to manage STS at the individual, social and organizational levels. There is a need to translate the interventions to manage STS into active ongoing coping activities to be conducted at the individual, group and organizational levels. Organizational responses, such as creating a supportive organizational culture that acknowledges the potential for secondary traumatic stress, may help mental health workers to deal with workplace related secondary traumatic stress. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2010.