When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization. Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the inability to lead a normal life. After an extensive review of the data, no statistically significant common methods of coping strategies were identified between these two professions using prescribed variables. However, the same three strategies used to cope with staffing reduction-related stress were ranked at the top in both professions.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements of the degree of Bachelor of Arts (Masters). / As the past decade has witnessed a growing interest in the nature, causes and management of stress reactions in emergency workers, the present study examined emergency workers' reactions to traumatic work related incidents. Furthermore, although Job Dissatisfaction and Increased levels of Turnover have been identified in literature and research on emergency workers as being behavioural manifestations of the traumatic stress associated with emergency work, the effect of occupational trauma on these variables has not been documented extensively in trauma literature or research. A second aim of the study was therefore to provide further insight into the effects of work related trauma on these constructs. Moreover, although literature on emergency workers has not documented the impact of occasional trauma on Job Involvement, the present study undertook to examine the effects of trauma on tnis construct. The study was considered to be exploratory in this regard. By examining how exposure to occupational trauma impacts on Job Satisfaction, Job involvement and Propensity to Leave, it was hoped that this will lead to a better understanding of the effects of occupational trauma and its implications for employees and organisations alike. One hundred full-time paramedics completed a self-report questionnaire. The questionnaire also included questions to obtain demographic variables as it has been documented that the relationship between exposure to traumatic events and the expression of distress is constructed by personal factors. In addition, qualitative data pertaining to the constructs under investigation was obtained from 30 paramedics. The reported symptoms revealed that 17% of the sample was suffering from rrso. Correlational analyses using a non-experimental, cross-sectional design, revealed a significant relationship between PTSD and Job Satisfaction. A non-significant relationship was found between PTSD and both Job Involvement and Propensity to Leave, Of the demographic variables measured, stepwise regression analysis. revealed that gender and previous exposure to trauma were the most efficient predictors of PTSD Content Analyses performed on the qualitative data indicated that paramedics were subjected to numerous job stressors which seemed to associated to Job Involvement and Propensity to Leave. The results of the study are discussed with respect of the literature reviewed and limitations and implications of these findings are discussed thereafter. Lastly implications of the present study for future research are presented. / Andrew Chakane 2018

This thesis deals with the implementation of the Psychosocial Intervention Service System within the environment of the emergency medical services. The main objective of this thesis is to analyze and identify the problems and causes hindering the implementation of the Psychosocial Intervention Service System. In addition, the thesis analyzes the attitudes, intentions and responsibilities of the parties directly involved in the implementation or affected by this policy, and to identify the applied public policy instruments by which the implementation is realized. The first section focuses on a brief theoretical introduction that deals with the institutional theory, the implementation process and the outlining of the content of the Psychosocial Intervention Service System, which includes stressful situations, their negative effects, psychosocial interventional care and the theory of Critical Incident Stress Management (CISM) as one of the possible methods used to eliminate the negative effects of stress and traumata. The main analytical and research part of this thesis attempts at answering the questions related to the thesis objective, i.e. what factors affect the implementation, what framework applies to the implementation of the project, what interactions take place among the individual parties...

Arbeit ist ein elementarer Bestandteil der menschlichen Lebenswirklichkeit. Sie birgt zahlreiche salutogenetische Potentiale und trägt dazu bei, dass wir gesund bleiben, wachsen und uns weiterentwickeln. Daneben können von Arbeit aber auch pathogene Efekte ausgehen, welche die physische und psychische Gesundheit der Mitarbeiter beeinträchtigen. Die bereits vorherrschende Tendenz hin zu mehr psychischen Beschwerden, wurde durch die pandemische Situation im Zuge von OVID19 noch verstärkt, wie eine aktuelle Meta-Analyse von Salari und Kollegen (2020) zeigt. Es wird deutlich, dass eine Schwerpunktverschiebung der betrieblichen Gesundheitsarbeit hin zur Primärprävention von psychischen Belastungen und Stress und dem sekundärpräventiven Umgang mit Stresssymptomen angezeigt ist. Eine Vielzahl von Studien und Meta-Analysen zeigen hier Zusammenhänge zwischen psychosozialen Belastungsfaktoren wie Arbeitsdruck oder Entgrenzung der Arbeit und stressrelevanten Beanspruchungen und Störungen (van der Molen et al., 2020). Die Vermittlung von Stressmanagementkompetenz stellt somit für Organisationen einen zentralen Stellhebel dar, um die Gesundheit der Beschäftigten zu schützen und die Leistungsfähigkeit des Unternehmens langfristig sicherzustellen (Ford, Cerasoli, iggins, & Decesare, 2011). [Aus: Einleitung]

Submitted in partial fulfilment of the requirements for the degree of Master of Arts in the Department of Psychology University of Zululand, 2004. / This report presents the findings of a study conducted in 2003-2004, involving eight members of emergency services in Stanger, KwaZulu Natal, South Africa. The emergency personnel included five firefighters and three paramedics. The aim of the study was to develop and evaluate a mutual aid group programme in order to prevent symptoms of trauma, with special reference to anxiety and depression, and promote psychological well-being in emergency personnel. Emergency personnel are exposed to traumatic events during the line of duty. The study investigated stressors, which were identified as organizational, management style, ineffective communication, stressors relating to patient care (personal loss, traumatic stimuli, high expectations) and low job and high workloads. The study also investigated psychological, physical and social effects of emergency work. Psychological effects that were identified were mental illnesses such as depression and posttraumatic stress disorder. Symptoms included irritability, anger, frustration, hopelessness, helplessness, fear and anxiety. Physical effects included fatigue, difficulty breathing, startle response, nausea, trembling and racing heart. Social problems such as conflicts with family, friends and colleagues were also identified. The study provided group members with the ability to identify symptoms of trauma and accept vulnerability, which served as important preventative measures for mental illness. The group created a safe atmosphere where members were able to share their feelings without the fear of being judged. It also provided members with new coping strategies for dealing with their feelings. Regarding further support systems the group members identified an ongoing need for help via psychologists, psychological debriefing and support from management, family as well as the community. / National Research Foundation

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health. Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on individuals, little is understood about the potential relationship between these immediate and long-term consequences. Exploration of this connection could not only expand the understanding of the relationships between stressors, behavior, and well-being, but also inform intervention strategies. One important domain in which stressors occur is work; certain occupations such as nursing expose individuals to a greater likelihood of experiencing stressors simply by nature of the tasks and/or environment involved. As a nursing shortage continues, stress is in fact one of the most-often cited reasons for nurses to leave the profession (Cangelosi, Markham, & Bounds, 1998). Using a sample drawn from the Oregon Nurse Retention Project and the relatively novel statistical method of slopes-as-predictors, I examined the relationships between work stressors and nurses' health behaviors (alcohol consumption, diet, exercise) and then used those relationships as predictors of follow-up outcomes (depression, life satisfaction, perceived health). Significant variability was found for five combinations of stressors and health behaviors, indicating that varying patterns of health behavior reactivity were indeed present in this sample; moreover four of those five stressor-behavior (reactivity) slopes emerged as significant predictors of later health and well-being. Notably, reactivity in the form of increased days of exercise during weeks of greater demands or negative events was associated with lower depression scores, and reactivity in the form of increased days of exercise during weeks of greater conflicts was associated with greater satisfaction with life. Implications of these findings, including the importance of exercise in maintaining well-being, are discussed.

Vård- och omsorgspersonal påverkas i dagsläget av hög stressrelaterad ohälsa, samtidigt som få interventioner implementeras för att hantera det. Studiens syfte var att utforska vård- och omsorgspersonals upplevelse av en internetbaserad stresshanteringskurs utifrån compassionfokuserad terapi med fokus på kursens genomförbarhet och hur den påverkat hantering av arbete och vardagligt liv. Flertalet regioner i Sverige representerades av elva deltagare som arbetade med direkt patientkontakt inom vård- och omsorg. Deltagarna besvarade frågeformulären Treatment Credibility Scale och “Utvärdering av stresshanteringskursen”. Sju deltagare deltog även i en semistrukturerad intervju som syftade till att utforska upplevelsen av kursen. Det insamlade materialet analyserades med kvalitativ innehållsanalys samt deskriptiv sammanställning av frågeformulären. Resultatet påvisade att kursen hade hög genomförbarhet som ökade deltagarnas upplevda stresshantering. Alla deltagarna beskrev nya förhållningssätt utifrån bland annat ökade insikter och nya färdigheter. Studiens resultat indikerar att en liknande kurs kan implementeras i större skala för att öka vård- och omsorgspersonals hantering av stress samt öka välmående. / Care and nursing staff are currently affected by high-stress-related health issues, while few interventions are implemented to handle it. The purpose of the study was to explore care and nursing staff´s experiences of an internet-based stress management course based on compassion-focused therapy with a focus on the course's feasibility and how it affected coping of work and everyday life stress. Some regions in Sweden were represented by eleven participants who worked with direct patient contact in healthcare. Participants answered the questionnaires Treatment Credibility Scale and “Evaluation of the stress management course”. Seven participants also participated in a semi-structured interview which aimed to explore the experience of the course. The material was analyzed with qualitative content analysis and a descriptive compilation of the questionnaires. The results showed that the course had high feasibility that increased the participants' stress management. All participants described new approaches based on, for instance, increased insights and new skills. The results of the study indicate that a similar course can be implemented to a greater extent to increase care and nursing staff's coping of stress and well-being. / ICOP

Background. Caregivers of individuals with Autism Spectrum Disorder (ASD) are a highly stressed group and their parenting stress has been linked to increased depression, anxiety, and reduced parenting self-efficacy (Osborne & Reed, 2008; Rezendes & Scarpa, 2011; Weiss & Lunsky, 2011). Given these areas of concern that parents of children with autism experience, there is a need to look more closely at modifiable factors that improve parental well-being. As such, health habit behaviors, including sleep, diet, exercise, and substance use are modifiable factors demonstrated to be causally related to well-being in adults. The present dissertation consists of two studies that explored how parents’ engagement in health habits (sleep, diet, exercise, and substance use) related to their well-being (stress and depression) and explored the possible determinants of health habit engagement. Specifically, how parental characteristics (both psychological and demographic), social support (both relationship-based and resource-related), and child factors (child behavior and demographic variables), relate to parents’ engagement in these habits. And, in study two, these exploratory analyses went further by examining how parent’s engagement in healthy habits relates to the observed parenting quality. Methods and Results: Study 1. Study one was a needs assessment completed by mothers and fathers (n=68) of children in an Applied Behavior Analysis (ABA) early intervention program in the northeastern United States, all at-risk for a developmental disability, many of whom were at risk for developing ASD. Parents completed questionnaires that included questions about their healthy habit engagement adapted from the Promise Neighborhoods RFA Indicators and the Promise Neighborhoods Research Consortium [PNRC] Measurement System (Promise Neighborhoods Research Consortium: Measures, 2001) as well as those related to parent, social support, and child characteristics. Parental characteristics included demographic characteristics of caregiver age and education level along with questionnaires on the parent’s psychological functioning; a measure of well-being (WHO-5; Topp, Østergaard, Søndergaard, & Bech, 2015), parental stress (PSI-4; Abidin, 2012), and caregiver depressive symptoms (PHQ-9; Kroenke, Spitzer, & Williams, 2001). Questionnaires covering the second domain of social support included a measure of perceived social support (Interpersonal Support Evaluation List (ISEL-12); Cohen & Hoberman, 1983), marital satisfaction (Kansas Marital Satisfaction Scale; Schumm et al., 1986a), household income, and caregiver nativity. Questionnaires covering the third domain of child factors included a measure of child sleep problems (Children’s Sleep Habits Questionnaire; Owens, Spirito, & McGuinn, 2000), the ratio of children to adults in the home, child age, and child gender. Overall, about half of the caregivers reported an insufficient amount of sleep (less than 7 hours on average). A third of caregivers reported they did not exercise at all. Only a third reported eating breakfast every day, half ate only one serving of fruit most days and one serving of vegetables a day, half ate family meals prepared at home almost every day, a third ate fast food regularly, about half were told to lose weight. Most did not smoke or drink alcohol regularly. Additionally, about 30% reported elevated levels of depressive symptoms and elevated levels of parental stress. Significant relationships were found between parental characteristics, social support, child factors, and healthy habit engagement. Of note, caregiver stress, depression, and well-being were related adversely to mother’s sleep, diet, and substance use. Perceived social support was positively related to sleep, marital satisfaction negatively to smoking, household income negatively to diet and alcohol consumption, and nativity positively to sleep, diet, and alcohol consumption. No correlations were found with child factors and healthy habits. Examining a regression model of the facilitators and barriers to healthy habit engagement, caregiver well-being positively related (t=4.015, p<.001) while child sleep disruptions negatively related to healthy habit engagement (t=-2.344, p=.026). Additionally, depression was found tomediate the relationship between healthy habit engagement and parental stress using PROCESS (CI= (-1.811, -.324), R2=.274). Methods and Results: Study 2. Study two aimed to narrow in on a specific population of mothers of preschool-aged children with autism. Participants were 46 mother-child dyads, with children ages 2-6 to 5-6 recruited from a preschool utilizing an Applied Behavior Analysis (ABA) approach to schooling. Children had a classification of ASD, verified by the Autism Diagnostic Observation System – Two (ADOS-2) (Lord, Rutter, DiLavore, Risi, Gotham, & Bishop, 2012). Parenting behaviors, categorized as positive and harsh parenting, were observed across three tasks and coded using the Psychological Multifactor Care Scale — ASD Adapted Preschool Version (Brassard, Donnelly, Hart, & Johnson, 2016). Mothers completed the same questionnaires as study one for measures of healthy habit engagement, parental characteristics (excluding the WHO-5), and social support, There were additional child factor measures; however, including the child sleep problems and child externalizing behavior subscales from the CBCL (Achenbach & Rescorla, 2000), child language functioning (Vineland-III Communication subscale; Sparrow, Cicchetti, & Saulnier, 2016), ASD severity (ADOS-2), along with ratio of children to adults in the home, child age, and child gender. Overall, more than half of the mothers reported an insufficient amount of sleep (less than 7 hours on average). Almost half of mothers reported they did not exercise at all. Almost half reported eating breakfast every day, a third ate only one serving of fruit most days, and half ate one serving of vegetables a day, a third ate family meals prepared at home almost every day, a third ate fast food regularly, and a third were told to lose weight. Most did not smoke. Additionally, 11% of the sample had elevated depressives symptoms and 20% had elevated levels of parental stress. Similar significant relationships were found between parental characteristics, social support, child factors, and healthy habit engagement in study two. Of note, caregiver stress and depression were related negatively to caregiver’s sleep, diet, exercise, and being overweight. More perceived social support was related to better diet, household income to not being overweight, and nativity to smoking. Correlations were also found with child factors and healthy habits; child sleep with mother’s sleep, externalizing behavior problems withsmoking, and high child to adult ratio with mother’s sleep. Examining a regression model of the facilitators and barriers to healthy habit engagement, caregiver depressive symptoms related negatively to healthy habit engagement (t=-.380, p=.049). ASD severity (t=-.511, p=.045) and child age (t=-.523, p=.014) came out as negatively related to mother’s diet in a similar model analysis. Additionally, mothers sleep directly related to both positive (R2=.213) and harsh (R2=.165) observed parenting quality. Conclusion. The results from study one and study two suggest that sleep, diet, exercise and substance use are important for parent’s well-being in both parents of children in early intervention and mothers of preschool-aged children with autism. Furthermore, parental wellbeing was the most predictive of engagement in healthy habits when examining possible facilitators and barriers. Child sleep was an important potential barrier in parents of children in early intervention and autism severity and child age were important potential barriers to mother’s diet in mothers of preschool-aged children with ASD. Furthermore, in study two, mothers sleep was an important factor not only for well-being but also for an objective measure of parentingquality, further strengthening the importance and value of sleep for a highly stressed population.

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