Caroline Kamau

Prevalence of oncologists in distress: Systematic review and meta-analysis

High mortality from cancer and rising patient numbers can trigger distress among oncologists because of a heavy and emotionally demanding workload. This systematic review and meta‐analysis assesses the prevalence of high levels of distress among oncologists.

Cross‐cultural impression management: a cultural knowledge audit model

Purpose – Many people moving into a new culture for work or study do so without prior cross‐cultural training, yet successful cultural adaptation has important ramifications. The purpose of this paper is to focus on cross‐cultural impression management as an element of cultural adaptation. Does cultural adaptation begin by paying strong attention to nonverbal cues in a host culture? How is that attention converted into knowledge, and how do people use such knowledge management during impression management within the new culture?Design/methodology/approach – The method was qualitative. In total, ten international students at an English university were recruited. All originated outside the European Union and each took part in a one‐hour structured interview. The transcripts were analysed through thematic analysis.Findings – International students adopted cross‐cultural impression management strategies in order to enhance successful adaptation to the new host culture. Students consciously processed knowledge...

Inductions Buffer Nurses’ Job Stress, Health, and Organizational Commitment

Nurses suffer disproportionate levels of stress and are at risk of sickness-absence and turnover intentions, but there is a lack of research clarifying preventions. This study investigated the impact of inductions (job preparation courses) about mental health for nurses’ job stress, general health, and organizational commitment. Data from 6,656 nurses were analyzed using structural equation modeling (SEM), showing that mental health inductions increase nurses’ job satisfaction, which reduces their occupational stress and improves their health. SEM showed that these occupational health benefits increase the nurses’ commitment to the organization. Job satisfaction (feeling valued, rewarded) also had a direct effect on nurses’ intentions to continue working for the organization. Mental health inductions are therefore beneficial beyond job performance: they increase occupational health in the nursing profession.

Preparing patients with cancer who work and treatment responsiveness

Background Many patients with life-limiting illnesses continue to work because of financial reasons and because work provides good psychosocial support. A lack of appropriate advice/support through patient education could, however, make having a job detrimental to well-being (eg, symptom worsening). Aim This study investigated the frequency with which patients received information that empowers their understanding of their condition, treatment, side effects of treatment and the likely impact on occupational functioning. Design A cross-sectional study. Setting/participants An analysis of survey data from 3457 patients with cancer in employment. Results Logistic regression showed that patients who received information about the impact of cancer on work life or education are 1.72 times more likely to have a positive treatment outcome. Patients who receive written information about the type of cancer are 1.99 times more likely to have a positive treatment outcome. Also, patients who receive written information before a cancer-related operation are 1.90 times more likely to have a positive treatment outcome. Information about the side effects of cancer treatment produces worse odds of a positive treatment outcome (0.65–1). A stepwise logistic regression analysing the effects irrespective of current employment status in 6710 patients showed that preparing them produces nearly twice better odds of cancer treatment responsiveness. Conclusions Palliative care teams should consider ways of actively advising patients who work. Whereas the results showed evidence of good practice in cancer care, there is a need to ensure that all working patients with potentially life-limiting illnesses receive similar support.

Orientations can avert psychosocial risks to palliative staff

Key points 1. Personnel in palliative care wards and hospices are at risk of chronic stress, burnout, anxiety, depression and substance/alcohol abuse because working in end-of-life care involves frequent grief, death anxiety and feelings of professional helplessness. 2. This commentary discusses the reported labour shortage in palliative care, and why some occupations are particularly at risk of quitting (e.g., care workers). 3. Most healthcare organizations are not providing palliative staff with training or orientations (inductions) about how to cope with the psychosocial risks of the profession. 4. This commentary discusses evidence that training interventions trialled on palliative staff are effective solutions. 5. The conclusion is a call on healthcare organizations to implement orientation or training programmes that help palliative personnel cope. Keywords: cancer; oncology; psychosocial risks; staff inductions; workplace coping.

Effects of shadowing and supervised on‐the‐job inductions on mental health nurses

Supervised on-the-job inductions or inductions through shadowing can help new nurses gain realistic information about the job role, the organization and procedures within it. This study investigated whether the induction of new mental health nurses is a key predictor of job performance, attitudes towards the organization and work-related stress. Data from 5337 mental health nurses who took part in the NHS Staff Survey of 2011 were analysed. Results showed that the more the work-related stress, the worse the nurses’ job performance, and the less positive the attitude towards the organization; in addition, the better the job performance, the more positive the attitude towards the organization. Multivariate analysis of variance showed significant multivariate and between-group main effects of each induction method (supervised on-the-job inductions and inductions via shadowing). In both cases, inducted nurses rated the organization more positively, had lower work-related stress and better job performance than non-inducted nurses. There were no significant interactions between the two induction methods, showing that their impact is orthogonal. Inductions help mental health nurses gain realistic views of the job, and this benefits the quality of their work, their attitudes towards the organization and experiences of stress. Lay summary 1. Inductions help mental health nurses gain realistic information about how to do the job, as well as helping them learn about the organization. 2. There are different induction methods; this study focused on investigating the impact of supervised on-the-job training, and also inductions which use job shadowing methods. 3. The results showed that the higher the nurse’s work-related stress, the worse their job performance and the less positive the nurse’s attitude towards the organization. 4. Inducted nurses rate the organization more positively, experience lower levels of work-related stress and present better job performance than non-inducted nurses. This applies to both induction methods.

Understanding students’ motivation towards proactive career behaviours through goal-setting theory and the job demands–resources model

ABSTRACT The graduate labour market is highly competitive but little is known about why students vary in their development of employability. This study contributes to the literature by applying goal-setting theory and the job demands–resources model to investigate how motivational processes influence students’ proactive career behaviours. We tested four hypotheses using structural equation modelling and moderation/mediation analysis using a nested model approach; 432 undergraduates from 21 UK universities participated in this cross-sectional study. The results showed that students higher in mastery approach had greater perceived employability mediated by two proactive career behaviours (skill development and network building). Students’ career goal commitment was associated with all four proactive career behaviours (career planning, skill development, career consultation and network building). Students’ academic and employment workloads did not negatively impact their proactive career behaviours. University tutors and career services should therefore encourage students to set challenging career goals that reflect mastery approach.

Is the NHS Mental Health Service Preparing Clients to Resume Employment

Objectives: The care program approach in the NHS mental health service emphasizes a holistic approach to treatment, including understanding how employment and mental health relate. Mental disorders account for 47% of UK long-term sickness-absence from the workplace therefore support for clients finding or keeping employment should be integrated with NHS mental healthcare. This study examined the extent to which this philosophy is put into practice. Methods: This study examined cross-sectional survey data from 3329 clients of the NHS mental health service. All expressed an interested in getting employment support. Results: Only 56% of the clients received this support. Univariate analysis of variance showed that clients who take psychiatric medication are significantly more likely to receive the support even controlling for the recency or duration of their use of the service, P<0.001. Conclusions: Care program approach training in NHS mental health services should increase staff awareness about clients’ employment support needs.

Postpartum depression or psychosis and return to work

“Psychosis” “Depression” “Occupational health” “Health and safety” “Employment law” “Occupational psychiatry” “Organisational psychology” “Organizational psychology” “Occupational psychology” “Delusions” “Hallucinations” “Disorganized speech” “Catatonia” “Fatigue” “Mood” “Mood disorders” “Psychotic disorders” “Rehabilitation” “Psychiatric treatment” “Psychiatric rehabilitation” “Workplace” “Work” “Employment” “Working” “Maternity leave” “Women and work” “Gender and employment” “Preparing for work” “Induction” “Orientation” “Management” “Inpatient” “Female” “Pregnancy” “Childbirth” “Risk” “Mental disorders” “Motherhood” “Early motherhood” “NHS” “Mental healthcare” “Mental health care” “NHS mental health service” “Occupational impairment” “Occupational therapy” “GP” “Birkbeck” “Returning to work after pregnancy” “Returning to work after maternity leave” “Returning to work after childbirth” “Coping with mental illness” “Work and mental health” “Work and mental illness” “Caroline Kamau” “The Lancet Psychiatry”

Guiding trainee pediatricians about how to cope with grief

To the Editor: In pediatrics, there is a strong culture of maintaining close relationships with dying patients and their families. Most pediatricians keep in touch with grieving families: 71.9% have attended a patient’s funeral,1 61% telephone the family, and 68% initiate face-to-face consultations.2 Parents and relatives play a very important role in the care of a child patient. Therefore, 47% of experienced pediatricians find it helpful to maintain followup with a patient’s family.1 Bereaved parents also welcome a pediatrician who attends their child’s funeral because it gives them the opportunity to talk to someone who was near their loved ones during their last days.3 However, there are pragmatic reasons why some pediatricians prefer not to attend a patient’s funeral, e.g., being under time pressure, facing logistic difficulties, feeling too emotional or uncomfortable, or fearing that it will seem inappropriate to attend.1,4 In addition, communication with a patient’s relatives can be very stressful: more than half of pediatricians (55%) are afraid to hurt the bereaved family and 77% of pediatricians admit that they lack bereavement care knowledge.2 Discovering what works best when coping with grief from patient death in pediatrics comes with experience; therefore, pediatric trainees especially feel uncertain about how best to cope with grief.5 Pediatric trainees caring for terminally ill children experience sadness, guilt, and vulnerability2,4,5 and report feeling left alone in the experience.5 Some trainees find funeral attendance useful in getting a sense of closure4; however, 42% fear attending a child’s funeral because it serves as a reminder of the cause of death, the family’s mourning induces troublesome feelings, and the death seems to represent professional failure.4 It is important for pediatric trainees to feel comfortable with their decision about how to cope: maintaining a psychological distance or engage in close contact with a patient’s family if they want to. Guidance may take 3 forms (1) debriefing sessions after the death of a patient; (2) structural changes in pediatric teams; (3) training sessions about bereavement coping. Debriefing sessions would provide trainees with an opportunity to talk openly about their emotions and to learn from a senior about the different methods of coping. This will help a trainee feel empowered to choose a coping method that they feel is the best for them and the patient’s family. Second, we recommend that pediatric teams make some structural changes, so that trainees are not disconnected from news about a patient’s death. Being disconnected can make it more difficult for a trainee to cope with grief when the patient dies and to feel a sense of psychological closure.4,5 Where possible, trainees should be included in plans about family followup. Third, pediatric residency and fellowship programs should present trainee pediatricians with the opportunity to attend bereavement training sessions facilitated by a palliative care specialist. These sessions should encourage trainees to talk about grief experience, to learn about different coping strategies, and to recognize the effects of patient loss on families and themselves. In short, institutions can create an environment where trainees can grieve in a psychologically healthy way.