Cheryl Regehr

Factors contributing to posttraumatic growth: A proposed structural equation model

With the current shift to include positive outcomes of trauma, this research was designed to explore factors that allow growth to occur. Structural equation modeling was used to test a model for understanding posttraumatic growth. A sample (N = 174) of bereaved HIV/AIDS caregivers completed questionnaires. Spirituality, social support, and stressors were found to have a positive relationship with growth. Facilitation of posttraumatic growth is crucial to all helping professions.

Interventions to reduce stress in university students: A review and meta-analysis

BACKGROUND Recent research has revealed concerning rates of anxiety and depression among university students. Nevertheless, only a small percentage of these students receive treatment from university health services. Universities are thus challenged with instituting preventative programs that address student stress and reduce resultant anxiety and depression. METHOD A systematic review of the literature and meta-analysis was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design. RESULTS Retrieved studies represented a variety of intervention approaches with students in a broad range of programs and disciplines. Twenty-four studies, involving 1431 students were included in the meta-analysis. Cognitive, behavioral and mindfulness interventions were associated with decreased symptoms of anxiety. Secondary outcomes included lower levels of depression and cortisol. LIMITATIONS Included studies were limited to those published in peer reviewed journals. These studies over-represent interventions with female students in Western countries. Studies on some types of interventions such as psycho-educational and arts based interventions did not have sufficient data for inclusion in the meta-analysis. CONCLUSION This review provides evidence that cognitive, behavioral, and mindfulness interventions are effective in reducing stress in university students. Universities are encouraged to make such programs widely available to students. In addition however, future work should focus on developing stress reduction programs that attract male students and address their needs.

Exposure to Human Tragedy, Empathy, and Trauma in Ambulance Paramedics

Paramedics are exposed to events involving human pain and suffering on a daily basis, many of which are the result of violence perpetrated by 1 individual on another. For the most part, these emergency workers have learned to deal with such events and take them in stride. At times, however, certain circumstances lead workers to develop an emotional connection with the victim or his or her family. When this occurs, paramedics report increased symptoms of traumatic stress. Aspects that can trigger this connection include the victims alienation from others, profound loss, or the abuse of an innocent child. One of the coping strategies described in these circumstances is to manage the events on a cognitive and technical level while maintaining an emotional distance. Although such a strategy may be protective, it may also have long-term negative effects in terms of interpersonal relationships. This mixed-methods study attempts to better understand factors that lead to higher levels of distress among paramedics within the theoretical framework of emotional and cognitive empathy.

Individual predictors of traumatic reactions in firefighters

Increasingly, theorists and researchers in the area of trauma are pointing to the importance of individual differences in resilience and vulnerability as key determinants of the intensity and duration of trauma-related symptoms. Determining the relative influence of individual predictors is important for the further development of theoretical models for understanding trauma responses and for the subsequent development of intervention strategies that are sensitive to individual differences. This study explores the influence of individual factors and social support on traumatic reactions in firefighters exposed to tragic events in the line of duty. A total of 164 Australian firefighters completed questionnaires targeting locus of control, self-efficacy, patterns of interpersonal relating, social support and level of emotional distress. Results indicate that individuals with feelings of insecurity, lack of personal control, and alienation from others were more likely to experience higher levels of depression and posttraumatic stress symptoms subsequent to exposure to traumatic events on the job.

Tapping the Perspectives of Children: Emerging Ethical Issues in Qualitative Research

The unique ethical issues related to conducting research with children are insufficiently distinguished from issues in working with vulnerable groups, despite a shift to recognizing children as active in the research process. Qualitative researchers are challenged to consider complex ethical issues related to children and are obligated to protect their rights, freedoms, safety, and dignity. While some issues are similar to those in any research context, the nature of the researcher-participant relationship, and the unstructured nature of qualitative research methods, add a dimension of risk. This article examines ethical issues in qualitative research with children: (1) consent and assent; (2) the obligation to protect children from harm while respecting

Evaluating a Measure of Student Field Performance in Direct Service: Testing Reliability and Validity of Explicit Criteria.

This study examines the reliability and validity of a measure to evaluate student field performance. Results demonstrated a consistent factor structure with excellent internal consistency, however, there was inadequate consistency between ratings of individual students in their first and second field education experiences. The measure had some predictive validity in that it could differentiate between students identified as having difficulty in Year 1 of the program, but not in Year 2. Scores were significantly associated with academic grades. Implications for future instrument development and the process of evaluation are considered.

Interventions to reduce the consequences of stress in physicians: a review and meta-analysis.

Abstract A significant proportion of physicians and medical trainees experience stress-related anxiety and burnout resulting in increased absenteeism and disability, decreased patient satisfaction, and increased rates of medical errors. A review and meta-analysis was conducted to examine the effectiveness of interventions aimed at addressing stress, anxiety, and burnout in physicians and medical trainees. Twelve studies involving 1034 participants were included in three meta-analyses. Cognitive, behavioral, and mindfulness interventions were associated with decreased symptoms of anxiety in physicians (standard differences in means [SDM], −1.07; 95% confidence interval [CI], −1.39 to −0.74) and medical students (SDM, −0.55; 95% CI, −0.74 to −0.36). Interventions incorporating psychoeducation, interpersonal communication, and mindfulness meditation were associated with decreased burnout in physicians (SDM, −0.38; 95% CI, −0.49 to −0.26). Results from this review and meta-analysis provide support that cognitive, behavioral, and mindfulness-based approaches are effective in reducing stress in medical students and practicing physicians. There is emerging evidence that these models may also contribute to lower levels of burnout in physicians.

Operationalizing Evidence-Based Practice: The Development of an Institute for Evidence-Based Social Work

Although evidence-based practice (EBP) has received increasing attention in social work in the past few years, there has been limited success in moving from academic discussion to engaging social workers in the process of implementing EBP in practice. This article describes the challenges, successes, and future aims in the process of developing a university-based institute for evidence-based social work. Aspects of the development include attempting to address concerns and critiques through developing an inclusive model of EBP; engaging community agency partners as active participants in the process; developing collaborative research projects with community partners to further the research evidence available for practice; conducting systematic reviews; finding means of disseminating review and research findings broadly in order to effect social policy revisions and lead to the development of effective programs and practices; and training agency personnel and social work students in the process of EBP and conducting practice evaluation research.

Posttraumatic Symptoms and Disability in Paramedics

Objective: The concern that secondary gain may result in an overreporting of trauma symptoms in those seeking compensation or taking stress leave from work has raised questions about the relation between posttraumatic stress and disability. This study attempts to examines the relation between traumatic stress symptoms and the use of work leave in an anonymous sample of emergency-service workers who are not currently seeking compensation. Method: A total of 86 paramedics completed questionnaires that addressed exposure to traumatic events, use of mental health stress leave, social support, current level of distress, and personality patterns. Comparisons were made between groups who had used mental health stress (MHS) leave and those who had not. Logistic regression was used to determine the best predictors of using leaves. Results: Current levels of social support were associated with previous use of mental health stress leave. In addition, significantly more individuals who had taken MHS leave in the past reported posttraumatic stress symptoms in the high or severe range. People with personality patterns characterized by suspiciousness, hostility, and isolation and having a tendency toward demanding, controlling, and manipulative behaviour in relationships were also more likely to have taken an MHS leave. Conclusion: Although social support and trauma symptoms were associated with the use of MHS leave, in this study, personality style was the strongest factor differentiating those individuals who took MHS leave from those who did not.

Toward New Approaches for Evaluating Student Field Performance: Tapping the Implicit Criteria Used by Experienced Field Instructors

Abstract This study determined the reliability of ratings and consistency of descriptions generated by experienced field instructors using only their acquired practice wisdom as a framework to evaluate students. Ten field instructors independently divided 20 student vignettes into as many categories as necessary to reflect various levels of student performance, described their categories, and ranked the individual vignettes within each category. The independently generated categories and their descriptions were very similar across instructors, and the inter-rater reliability was very high both for the placement of vignettes into categories (0.77) and the rankings (0.83).