Helen R. Winefield

Social support and recovery after surgery for breast cancer: Frequency and correlates of supportive behaviours by family, friends and surgeon

In a longitudinal study of recovery after surgery for breast cancer, subjects reported the frequency of, and their satisfaction with, various supportive behaviours on the part of family members, close friends and medical professionals. The reliability of the Multi-Dimensional Support Scale (MDSS) devised for this purpose is described. Measures of psychological, social and physical adjustment approached normality by 3 months post-operation. Frequency of support from all sources decreased as time from surgery passed, whilst satisfaction with support varied with the type of support given and the source from which it was received. Quite different patterns emerged in support needs from professional and non-professional sources, with empathic support being required from all sources, whilst informational support was desired from surgeons, rather than from family and friends. Further, subjects were more discriminating in the amounts of support required from family and friends, such that it was more likely for these sources to give unwanted support than it was for professional sources, from whom many subjects reported inadequate support. Satisfaction with social support was matched with measures of adjustment, and it was found that those satisfied with support from family members were significantly less anxious and depressed in hospital than were those who were not satisfied with support from this source. However, at 1 month post-operation, anxiety and depression levels were significantly related to satisfaction with support from surgeons; and at 3 months post-operation, anxiety and depression measures were significantly related to satisfaction with support from both family members and surgeons.(ABSTRACT TRUNCATED AT 250 WORDS)

Psychosocial job strain and productivity in human service workers: A test of the demand-control-support model

The aim of the study was to test the main and interactive effects of the key dimensions of the demand-control-support model in predicting levels of strain (specifically emotional exhaustion, depersonalization and job dissatisfaction) and feelings of productivity and competency (personal accomplishment) in a multi-occupational sample of human service workers (N = 813). Controlling for demographics, negative affectivity (NA), and quadratic terms, structural equation analyses showed some support for the additive iso-strain hypothesis: jobs combining high demands, low control and low support produced the lowest levels of satisfaction in workers. High demands and low supports only were associated with high depersonalization, and high emotional exhaustion. Support was also found for the additive active learning hypotheses: jobs combining high demands and high control produced the highest levels of personal accomplishment. The study supports job redesign interventions for improving worker well-being and productivity.

Psychological impact and cosmetic outcome of surgical breast cancer strategies

Background:  Current surgical treatment modalities for breast cancer include breast conserving surgery, mastectomy alone and mastectomy with breast reconstruction. There are recognized benefits of breast conservation and breast reconstruction over mastectomy but there are few studies assessing this area in Australia. The aim of the present study was to compare the various surgical strategies for breast cancer treatment in terms of quality of life, cosmesis and patient satisfaction.

Evaluating the outcome of communication skill teaching for entry‐level medical students: does knowledge of empathy increase?

While the literature shows the clinical value for medical practitioners of skill in communicating with patients in an empathetic manner, objective evaluations of methods to teach empathy are few.

Breast and Prostate Cancer Online Discussion Boards A Thematic Analysis of Gender Differences and Similarities

Online discussion boards are being used increasingly by cancer survivors, highlighting the need for understanding this potentially supportive communication process. Two online discussion boards, a prostate group and a breast cancer group, were studied using mixed methodology of both Grounded Theory and a quasi-numerative approach. Both mens and womens dialogues fell under two themes, information support and emotional support. Information support accounted for 60 per cent of communications in women and 64 per cent in men and emotional support 40 per cent in women and 36 per cent in men. However, there were gender differences in the language styles of these communications. Further research is recommended to understand adequately the emotional content within womens and mens dialogues in the context of breast and prostate cancer discussion boards.

Determinants of adherence in adults with cystic fibrosis

Cystic fibrosis (CF) is now as much a disease of adults as of children and adolescents. An important focus of recent research has been the impact of the complex, expensive, and time consuming routine of self-care and medical treatment that is required by adults with CF to maintain health. A growing concern for medical and allied health teams is the issue of patient adherence to prescribed health management plans. A summary of the particular medical and treatment context of CF is followed by a review of adherence measurement issues and the determinants of adherence to treatment regimens in people with CF, primarily adults. Evidence for factors which influence adherence decisions of people with CF is examined. The medical and psychological aspects of this complex problem have not been adequately addressed because of difficulties with definition and measurement. Only a small proportion of the variance in adherence has been accounted for in the literature. New measurement technologies and new theoretical directions offer promise for a better understanding of this complex and important issue and may result in more effective intervention strategies to improve adherence.

Growing Up with Unemployment: A Longitudinal Study of Its Psychological Impact

The transition from school to work is recognized by developmental psychologist as a significant phase in the maturation of young people. The likelihood that the transition might be delayed by a period of prolonged unemployment is now greater than at any time since the 1930s. The psychological consequences of such a delay need to be understood because they may be damaging both to the individual and to society, particularly if they are long-lasting. Such an understanding is essential for the devleopment of sound policy in relation to youth unemployment. Growing up with Unemployment is a major longitudinal study of a large group of young people through the 1980s. It describes the scale and context of the problem and reviews the methods and theories that have been developed to study the psychological impact of unemployment. It also looks at those factors which may contribute towards helping young people cope with it, such as social support and being involved in constructive activities with other people. The authors also examine how we might be able to predict future unemployment and understand the relationship between it and alcohol consumption, smoking and drug use. Growing up with Unemployment is a major study with important implications for employment policy, as well as future theory and research. It will be valuable reading for students in social policy and psychology, policy makers, and all those who deal with young people.

The role of depression and anxiety symptoms in hospital readmissions after cardiac surgery

The objective of this study was to determine the association between depression, anxiety and general stress symptoms with hospital readmissions after coronary artery bypass graft surgery. Two hundred and twenty six coronary artery bypass graft patients completed baseline self-report measures of depression, anxiety and stress and 222 patients completed these measures after surgery on the hospital ward. The hospital readmission outcomes at six months were analyzed using multivariable proportional hazard models. When analyzed as continuous variables in multivariable analyses, preoperative anxiety and postoperative depression predicted readmissions independent of medical covariates. In multivariable analyses with dichotomized anxiety, depression and stress, more than two-fold increase in readmission risk was attributable to preoperative anxiety and postoperative depression, independent of covariates. These results lend further support to previous research that has shown the symptoms of depression and anxiety are associated with morbidity following coronary artery bypass graft surgery. The findings highlight the need to develop suitable interventions for anxiety and depression among coronary artery bypass graft surgery patients.

The General Health Questionnaire: reliability and validity for Australian youth.

General Health Questionnaire (GHQ) results are given for a large (N = 1013) sample of South Australian young people (average age 19.6 years), to compare the usefulness of the 12-, 28-, and 30-item forms of the GHQ. Internal reliabilities are generally adequate and the Likert scoring method produces significant correlations with psychological measures such as self-esteem. the case-prevalence rate using the binary scoring method was comparable with other studies, but misclassification rates were unacceptably high when DSM-Ill Axis I diagnosis was used as the criterion for the presence of any psychiatric disorder.

Unique aspects of stress in human service work

Two unique stressors associated with human service work are emotional dissonance, particularly the need to hide negative emotions (emotion work), and client/customer-related social stressors. The latter may involve disproportionate or ambiguous client/customer expectations and/or verbally aggressive customers. These stressors affect all human service workers, even though they may vary in the extent to which their work involves lasting relationships with clients/customers, and in the amount of training they have received to deal with client/customer-related social stressors. For example, health professionals typically develop long-lasting relationships with their clients whereas call centre workers may have only a single brief interaction. In accordance with contemporary theories of work stress (conservation of resources, effort-reward imbalance, demand-control-support), we argue that social support and training designed to develop “role separation” are crucial resources needed to help human service worker...