Background: Having a diagnosis of schizophrenia is associated with employment difficulties, high mortality rates, substantial family burden and impoverished quality of life and it costs between 1.5 to 3 per cent of the total expenditure on national health care (Knapp et al 2004). However social functioning and participation can have a protective impact on mental health of people with a diagnosis of psychosis (Stain et al 2013). Method: A systematic and phased approach to complex intervention development was undertaken involving: (1) A systematic review of effectiveness and (2) a feasibility study, designed to explore and test the key uncertainties of an effectiveness study, was conducted in two phases. This involved the development of an occupational therapy intervention specification and a feasibility study for a pragmatic randomised controlled trial (RCT). It utilised the Developing and evaluating complex interventions guidelines (MRC 2008). A task analysis approach was applied to extrapolate occupational therapy theory, practice and outcomes for the intervention specification (Gitlin 2013). The feasibility study was carried out across two centres. It used the intervention specification and included both study and process outcomes. The primary outcome was participation in activities of everyday life and the secondary outcomes were health-related quality of life and self-reported experience of occupational performance and satisfaction with occupational performance. Service user and carer involvement was integrated into the method. Results: The systematic review highlighted that there was no evidence of effectiveness for individualised client-centred occupational therapy interventions on participation in activities of everyday life or quality of life/ health related quality of life. The methodological quality of the effectiveness studies was generally low and details provided regarding interventions made replication difficult. The feasibility study recruited less people (n=20) than planned (n=64). However the outcomes of self-reported experience of occupational performance (p=.002) and satisfaction with occupational performance (p=.001) and self-evaluated transition (SET) (p=.026) improved with occupational therapy and were found to be statistically significant (p < .05). The intervention specification captured 98% of occupational therapy provided and was shown to have good utility for research and practice purposes. Conclusion: An intervention specification that reflects practice and has utility has been developed. Methods of measuring fidelity and adherence of occupational therapy have been designed and tested. Knowledge about how occupational therapy enables participation has advanced. The essential preparatory work to address the previously key uncertainties in a pragmatic RCT has been completed and the foundations for the next stage — a larger pragmatic RCT — have been put in place.

The transition from professional sport marks the beginning of what has been found to be a difficult and stressful experience (Park, Lavallee, & Todd, 2013). Exiting a career serves as a major life change that requires one to adjust to numerous changes (Erpic, Wylleman, & Zupancic, 2004). Research has highlighted a number of personal and contextual factors that affect the quality of the transition experience (Knights, Sherry, & Ruddock-Hudson, 2016; Park et al., 2013); however, no studies to date have examined players who are in the midst of the transition. This qualitative, phenomenological study was undertaken to address the research question: What is the lived experience of NFL free-agent players as they transition from an active NFL player to a retired NFL player? In-depth interviews completed with 12 NFL free-agent players found a three-phase process of transitioning, consisting of the initial reaction, “no-man’s land,” and the final realization. Six themes emerged that described the players’ experience: (1) participants identified a trigger event prior to deselection; (2) being deselected was sudden, leaving participants shocked, isolated, and angry; (3) the subsequent period was dynamic, emotionally, cognitively, and behaviorally; (4) players reached a point of realization about their future; (5) the loss of the NFL community was a significant challenge; and (6) four protective factors helped participants. The study offers recommendations related to theory, practice, and future research.

The purpose of this study was to develop and test the effectiveness of one model composite stress management workshop on the perceived stress levels of resident physicians. It was hypothesized that resident physicians would utilize stress management techniques to decrease their perceived stress and would report an increase in work satisfaction and increase their coping skills. The intervention focused on four major areas of stress management: (1) personal management skills; (2) relationship skills; (3) outlook skills; and (4) stamina skills. Sixty-four resident physicians from training programs in Pediatrics, Medical-Pediatrics, and Medicine volunteered to participate in this study. From this group, 43 resident physicians were divided into three sections and were assigned to one of three stress management workshops provided by the researcher. The remaining group of 21 resident physicians became a control group and received no treatment except for the pretest and posttest. To measure the perceived levels of stress, two stress instruments were administered to both groups with the pretest given two weeks before the workshop and the posttest given four weeks after the workshop. The instruments were the Essi Systems Stress Instrument (Orioli, Jaffe, & Scott, 1987) and the Maslach Burnout Inventory (Maslach & Jackson, 1981). The Life Experiences Survey (Sarason, Johnson, & Siegel, 1978) was administered to the treatment group only. Overall, the results supported the effectiveness of this model of stress management workshop for this population. The treatment group reported improvement in half the measures of stress and coping skills. The specific components which showed significant improvement were in areas such as work satisfaction, coping ability, behavioral and emotional symptoms of stress, and emotional exhaustion. The results were determined by an analysis of variance. Conclusions drawn from this study confirmed the high level of stress for resident physicians and indicated a definite place for stress management workshops within residency training programs, and possible for stress management programs in general. Implications were drawn for incorporating stress management training throughout the course of physician training to reduce stress directly by re-designing the work environment in which resident physicians practice.

Mental health professionals are at high risk of experiencing work-related stress and burnout due to the challenging and highly emotive environments in which they work. This may lead to a range of physical and psychological symptomology which may affect them and also the quality of care provided to patients. This thesis presents a systematic review of the literature regarding the effectiveness of workplace interventions designed to reduce or prevent work-related stress and burnout when compared to no intervention or alternative interventions for mental health professionals working in adult mental health settings. The thesis then presents an empirical study, using the Job Demands-Resources model of burnout. Personal resources (styles of coping, self-compassion, cognitive fusion and valued living) were tested as (a) moderators of the relationship between job demands and exhaustion and (b) mediators of the relationship between job resources and disengagement within a sample of mental health nurses. Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs), non-randomised controlled trials (N-RCTs), controlled before and after (CBA) and interrupted time series workplace (ITS) interventions were conducted. Primary outcomes were occupational stress and burnout. An assessment of strength of evidence was made using GRADE criteria. A quantitative cross-sectional survey of 214 mental health nurses was used to examine the role of: self-compassion, cognitive fusion, engaged living and coping in the development of burnout. Results Thirteen eligible studies were identified comprising 11 RCTs and 2 CBA’s. Overall, there was no beneficial effect of organisational and relaxations intervention was found for reducing burnout or work-related stress. There are some promising findings for the effectiveness of staff training and psychosocial interventions in the short and medium-term. Overall, the quality of studies was low due to risk of bias and a lack of precision due to low number of participants in each study. In the empirical paper, the moderating role of personal resources in the development of exhaustion was not supported. By contrast the mediating role of personal resource between job resources and disengagement was supported. Discussion At present, there is limited evidence for the effectiveness of workplace interventions. This is influenced by the low number of intervention studies and the quality of interventions to date for mental health professionals. There is preliminary evidence for the potential for third-wave cognitive behavioural interventions such as acceptance commitment therapy in reducing disengagement in mental health nurses. Interventions to reduce exhaustion need to include strategies to reduce job demands.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-06-28T18:52:41Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Polyana Felipe - Mestrado em Saúde Coletiva (PPGISC).pdf: 54230265 bytes, checksum: 42616aa26e49ad7e2dc0904afeaf5628 (MD5) / Made available in DSpace on 2016-06-28T18:52:41Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Polyana Felipe - Mestrado em Saúde Coletiva (PPGISC).pdf: 54230265 bytes, checksum: 42616aa26e49ad7e2dc0904afeaf5628 (MD5) Previous issue date: 2015-04-06 / CAPES / O agronegócio canavieiro no Brasil vem se destacando no cenário econômico nacional e internacional como um modelo de desenvolvimento gerador de energia limpa e renovável. Entretanto, o seu desenvolvimento é contraditório. Pois, ao mesmo tempo em que permite a introdução de novas tecnologias, escamoteia condições e relações de trabalho precárias, bem como a destruição ambiental. A proposta desta dissertação é desvelar os mitos construídos em torno do “desenvolvimento” do agronegócio canavieiro, bem como os reflexos da mecanização na saúde mental dos trabalhadores-migrantes. Foi realizada uma análise criteriosa da literatura, aplicação do questionário Self-Reporting Questionnaire (SRQ-20), observação participante e entrevistas semi-estruturadas com trabalhadores-migrantes do sertão paraibano e pernambucano que laboram na colheita manual da cana-de-açúcar, na Usina Santa Isabel, localizada na região de São José do Rio Preto, interior do Estado de São Paulo. Os resultados mostram a (in) sustentabilidade do agronegócio canavieiro, uma vez que tal produção é fortemente marcada por condições perversas de degradação ambiental e descaso com a vida humana. Constatou-se também a alta prevalência (40%) de Transtornos Mentais Comuns e sua associação com o baixo nível de escolaridade dos trabalhadores-migrantes, a positividade do teste CAGE indicando casos suspeitos de bebedores-problemas, o adoecimento relacionado ao trabalho e o absenteísmo. Por outro lado, o sofrimento psíquico ficou evidente no relato dos trabalhadores que denunciam novos padrões de riscos, divisão do espaço de trabalho com moderníssimos maquinários e rigorosos mecanismos de controle, como as punições, advertências e demissões que amedrontam e ameaçam o futuro destes trabalhadores. Por fim, acredita-se que o desafio essencial passa pela construção de políticas públicas inovadoras para o meio rural nordestino; políticas que dêem acesso ao trabalho, renda, educação e outros serviços básicos, inclusive, já garantidos na legislação brasileira. / The sugarcane agribusiness in Brazil has been increasing in national and international economic scenery as a generator model of development of clean and renewable energy. However, its development is contradictory. Because at the same time allowing the introduction of new technologies, sidesteps conditions and poor working relations and environmental destruction. The purpose of this work is to unveil the myths built around the "development" of the sugarcane agribusiness, as well as the reflections of mechanization in the mental health of workers-migrants. A careful review of the literature was carried out, the questionnaire Self-Reporting Questionnaire (SRQ-20), participant observation and semistructured interviews with backwoods of workers-migrants Paraiba and Pernambuco that operate on manual harvesting of sugarcane in Usina Santa Isabel, located in the region of São José do Rio Preto, in the state of São Paulo. The results show the (un) sustainability of the sugarcane agribusiness, since this production is strongly marked by perverse conditions of environmental degradation and disregard for human life. It was also found a high prevalence (40%) of Common Mental Disorders and its association with the low educational level of workers-migrants, test positive CAGE indicating suspected cases of drinkers problems, workrelated illness and absenteeism. On the other hand, the psychological distress was evident in the story of workers who report new standards risks, division of work space with ultramodern machinery and strict control mechanisms, as punishment, warnings and layoffs that frighten and threaten the future of these workers. Finally, it is believed that the essential challenge is to build innovative public policies for the northeastern countryside; policies that give access to work, income, education and other basic services, including, as guaranteed by Brazilian law.

Made available in DSpace on 2014-12-17T15:43:49Z (GMT). No. of bitstreams: 1 GlaudeniaAM_DISSERT.pdf: 2134728 bytes, checksum: f418d9786b3ab74e5c06ca33dab9e66a (MD5) Previous issue date: 2012-12-19 / The Psychiatric Reform has brought profound changes in assistance to people affected by mental disorders and behavior. In this context, mental health workers have played decisive roles of great impact, acting driving the process. Objective: To evaluate the impact felt by working professionals, because of the daily work with people who have psychiatric disorders. Methodology: This is a search field, a quantitative approach, sectional, descriptive and applied. Data collection occurred through the Assessment Scale Impact of Working in Mental Health Services (IMPACT-BR) applied to mental health researchers city Mossor? - RN. Results: Participants in this study 87 professionals, mostly female married, which took charge of higher education, working on a single service, working in the area for more than six years, aged between 25 and 64 years. There were a low effect of overloading the professionals surveyed. Discussion: Our results corroborate findings in other surveys conducted previously, not identifying large impact load at work among professionals of mental health teams studied. Subscales studied the highest score was observed in measuring the impact of work on team functioning. It was observed that the greater age and duration of action, reduced the emotional impact at work, suggesting that the experience enhances safety in decisions made and the possibility of greater control over the demands of work. Final Thoughts: The work presented showed that the interactive relationships between professionals and users are not the causes of greatest impact in the workplace, although it revealed overload in relation to specific aspects such as: fear of being assaulted by a patient and the feeling of physical exhaustion the end of the workday. Further investigations should be conducted on this topic in order to contribute to the implementation of psychiatric reform proposed by advances both in terms of assistance to individuals and the quality of life in the work of the professionals involved / A Reforma Psiqui?trica trouxe profundas modifica??es na assist?ncia ?s pessoas acometidas por transtornos mentais e de comportamento. Nesse contexto, os trabalhadores de sa?de mental desempenharam pap?is decisivos de grande repercuss?o, atuando de forma impulsionadora do processo. Objetivo: Avaliar o impacto laboral sentido pelos profissionais de sa?de, em virtude do trabalho di?rio com pessoas que apresentam dist?rbios psiqui?tricos. Metodologia: Trata-se de uma pesquisa de campo, numa abordagem quantitativa, seccional, descritiva e aplicada. A coleta de dados ocorreu por meio da Escala de Avalia??o do Impacto do Trabalho em Servi?os de Sa?de Mental (IMPACTO-BR), aplicada aos profissionais de Sa?de Mental da cidade de Mossor? - RN. Resultados: Participaram desse estudo 87 profissionais, em sua maioria do sexo feminino casados, que assumiam cargo de n?vel superior, trabalhando em um ?nico servi?o, atuando na ?rea h? mais de seis anos, com idade entre 25 e 64 anos. Foi observado um baixo efeito de sobrecarga nos profissionais pesquisados. Discuss?o: Os resultados encontrados corroboram com resultados encontrados em outras pesquisas realizadas anteriormente, n?o identificando grande carga de impacto no trabalho entre os profissionais das equipes de sa?de mental estudadas. Das subescalas estudadas a maior pontua??o foi observada na que mede o impacto do trabalho no funcionamento da equipe. Observou-se que quanto maiores a idade e o tempo de atua??o, menor o impacto emocional no trabalho, o que sugere que a experi?ncia aumenta a seguran?a nas decis?es tomadas e a possibilidade de um maior controle sobre as demandas de trabalho. Considera??es finais: O trabalho apresentado demonstrou que as rela??es interativas entre os profissionais e os usu?rios n?o s?o as causas de maior impacto no trabalho, embora tenha revelado sobrecarga em rela??o a aspectos pontuais como: receio de ser agredido por um paciente e a sensa??o de cansa?o f?sico ao fim do expediente. Novas investiga??es nessa tem?tica devem ser realizadas a fim de colaborar para a efetiva??o dos avan?os propostos pela Reforma Psiqui?trica tanto no que se refere ? assist?ncia aos sujeitos quanto na qualidade de vida no trabalho dos profissionais envolvidos

Text in Afrikaans / Die doel met hierdie navorsing is om vanuit 'n geestesgesondheidsperspektief ondersoek in te stel na die rolkonflik van die werkende moeder. Die literatuurdoelstellings behels dat rolgedrag verduidelik word. Veranderlikes binne die organisasie- en werksfeer asook farniliesfeer wat tot rolkonflik by die werkende moeder aanleiding gee is beskryf. Die groeisielkunde is vanuit die analitiese, humanistiese en eksistensiele paradigmas aangebied, ten einde 'n geestesgesonde persoonlikheidsprofiel te ontwikkel. Wat die operasionele doelstellings betref, is die veranderlikes wat tot rolkonflik aanleiding gee en die persoonlikheidsfunksionering van tien werkende moeders met hulle eerste kind, deur middel van 'n ongestruktureerde onderhoud, ondersoek. Die verband tussen rolkonflik en 'n geestesgesonde persoonlikheid is vasgestel, om te bepaal hoe geestesgesondheid die hantering van rolkonflik beinvloed. Die resultate dui daarop dat die werkende moeder, met die ervaring van haar rol as moeder, groei in haar persoonlikheidsfunksionering getoon het. Uit die resultate blyk dit dat dit 'n positiewe gesindheid teenoor loopbaan, min werksekuriteit vir die moeder wat in haar eie praktyk werksaam is, onbuigsame werksomstandighede, ondersteuning deur betekenisvolle ander, rolbeperking en hoë deurdringbaarheid tussen die moeder se moeder- en werkrol, temas is wat die rolkonflik wat die werkende moeder ervaar, en gevolglik haar geestesgesondheid, bei:nvloed. Die resultate dui daarop dat die werkende moeder konflik tussen haar moeder- en werkrol, rol as eggenote en eie tyd ervaar. Unieke veranderlikes wat tot rolkonflik lei in die Suid-Afrikaanse konteks, wat in die navorsing geidentifiseer is, is rolbeperking en gebrek aan werksekuriteit vir die moeder wat haar eie praktyk bedryf. Die geestesgesonde persoonlikheidsfunksionering van die werkende moeder is met die ontwikkelde persoonlikheidsprofiel vergelyk. Dit blyk dat akkurate en realistiese waarnemings van ervarings, vryheid om emosies te beleef, geloof, toekomsgerigtheid en innige interpersoonlike verhoudings die werkende moeder se geestesgesondheid positief kan beinvloed, en tot makliker hantering van rolkonflik lei. Hierteenoor blyk dit dat gebrek aan seltkennis, gebrek aan vryheid van keuse, min emosionele beheer asook onaanvaarbaarheid en onverdraagsaamheid teenoor ander, eienskappe is waar sy heelwat in haar persoonlikheidsfunksionering kan groei. Aanbevelings vir die hantering van rolkonflik deur die werkende moeder is vir die bedryfsielkundige praktyk en die werkende moeder self geformuleer, asook aanbevelings vir verdere navorsingsgeleenthede. / The aim of this research was to study the role conflict experienced by the working mother from the mental health perspective. The literature study includes a description of role behaviour as well as variables within the organisational, work and family spheres that influence role conflict. Growth psychology is presented from analytical, humanistic and existential perspectives, culminating in a profile of the mentally healthy personality. The operational aims involved an investigation of variables that influence role conflict and the personality functioning of ten working mothers who are bringing up their first child. This was conducted through unstructured interviews. This involved determining the relationship between role conflict and a mentally healthy personality, to determine how mental health facilitates coping with role conflict. The results indicate that the working mother showed growth in her personality functioning as a result of the experience of her role as mother. However, the results also indicate that a positive orientation to career, minimal job security for the mother working in her own business, inflexible working conditions, support from significant others, role restriction and high penetrability between the roles of mother and worker, are themes that influence the conflict that the working mother experiences which, in turn, influences her mental health. The working mother experiences conflict between her roles as mother, worker, spouse and individuaL Unique variables that influence role conflict in the South African context were identified, namely, role restriction and minimal job security for the mother who operates her own business. The mental personality functioning of the working mother was compared with the developed personality profile. It seems that accurate and realistic observation of experiences, freedom to express feelings, religion, future orientation and close interpersonal relationships, influence the working mother's mental health positively and lead to better coping with role conflict. In contrast she could grow in terms of the following characteristics: lack of self-knowledge, little freedom of choice, little control over emotions as well as unacceptance and intolerance of others. Recommendations were made to the industrial psychology practice and the working mother herself, on how to handle role conflict, and also regarding future research possibilities. / Industrial and Organisational Psychology / D. Comm. (Bedryfsielkunde)

Text in Afrikaans / Die doel met hierdie navorsing is om vanuit 'n geestesgesondheidsperspektief ondersoek in te stel na die rolkonflik van die werkende moeder. Die literatuurdoelstellings behels dat rolgedrag verduidelik word. Veranderlikes binne die organisasie- en werksfeer asook farniliesfeer wat tot rolkonflik by die werkende moeder aanleiding gee is beskryf. Die groeisielkunde is vanuit die analitiese, humanistiese en eksistensiele paradigmas aangebied, ten einde 'n geestesgesonde persoonlikheidsprofiel te ontwikkel. Wat die operasionele doelstellings betref, is die veranderlikes wat tot rolkonflik aanleiding gee en die persoonlikheidsfunksionering van tien werkende moeders met hulle eerste kind, deur middel van 'n ongestruktureerde onderhoud, ondersoek. Die verband tussen rolkonflik en 'n geestesgesonde persoonlikheid is vasgestel, om te bepaal hoe geestesgesondheid die hantering van rolkonflik beinvloed. Die resultate dui daarop dat die werkende moeder, met die ervaring van haar rol as moeder, groei in haar persoonlikheidsfunksionering getoon het. Uit die resultate blyk dit dat dit 'n positiewe gesindheid teenoor loopbaan, min werksekuriteit vir die moeder wat in haar eie praktyk werksaam is, onbuigsame werksomstandighede, ondersteuning deur betekenisvolle ander, rolbeperking en hoë deurdringbaarheid tussen die moeder se moeder- en werkrol, temas is wat die rolkonflik wat die werkende moeder ervaar, en gevolglik haar geestesgesondheid, bei:nvloed. Die resultate dui daarop dat die werkende moeder konflik tussen haar moeder- en werkrol, rol as eggenote en eie tyd ervaar. Unieke veranderlikes wat tot rolkonflik lei in die Suid-Afrikaanse konteks, wat in die navorsing geidentifiseer is, is rolbeperking en gebrek aan werksekuriteit vir die moeder wat haar eie praktyk bedryf. Die geestesgesonde persoonlikheidsfunksionering van die werkende moeder is met die ontwikkelde persoonlikheidsprofiel vergelyk. Dit blyk dat akkurate en realistiese waarnemings van ervarings, vryheid om emosies te beleef, geloof, toekomsgerigtheid en innige interpersoonlike verhoudings die werkende moeder se geestesgesondheid positief kan beinvloed, en tot makliker hantering van rolkonflik lei. Hierteenoor blyk dit dat gebrek aan seltkennis, gebrek aan vryheid van keuse, min emosionele beheer asook onaanvaarbaarheid en onverdraagsaamheid teenoor ander, eienskappe is waar sy heelwat in haar persoonlikheidsfunksionering kan groei. Aanbevelings vir die hantering van rolkonflik deur die werkende moeder is vir die bedryfsielkundige praktyk en die werkende moeder self geformuleer, asook aanbevelings vir verdere navorsingsgeleenthede. / The aim of this research was to study the role conflict experienced by the working mother from the mental health perspective. The literature study includes a description of role behaviour as well as variables within the organisational, work and family spheres that influence role conflict. Growth psychology is presented from analytical, humanistic and existential perspectives, culminating in a profile of the mentally healthy personality. The operational aims involved an investigation of variables that influence role conflict and the personality functioning of ten working mothers who are bringing up their first child. This was conducted through unstructured interviews. This involved determining the relationship between role conflict and a mentally healthy personality, to determine how mental health facilitates coping with role conflict. The results indicate that the working mother showed growth in her personality functioning as a result of the experience of her role as mother. However, the results also indicate that a positive orientation to career, minimal job security for the mother working in her own business, inflexible working conditions, support from significant others, role restriction and high penetrability between the roles of mother and worker, are themes that influence the conflict that the working mother experiences which, in turn, influences her mental health. The working mother experiences conflict between her roles as mother, worker, spouse and individuaL Unique variables that influence role conflict in the South African context were identified, namely, role restriction and minimal job security for the mother who operates her own business. The mental personality functioning of the working mother was compared with the developed personality profile. It seems that accurate and realistic observation of experiences, freedom to express feelings, religion, future orientation and close interpersonal relationships, influence the working mother's mental health positively and lead to better coping with role conflict. In contrast she could grow in terms of the following characteristics: lack of self-knowledge, little freedom of choice, little control over emotions as well as unacceptance and intolerance of others. Recommendations were made to the industrial psychology practice and the working mother herself, on how to handle role conflict, and also regarding future research possibilities. / Industrial and Organisational Psychology / D. Comm. (Bedryfsielkunde)