Monica Pedrazza

Nurses’ Comfort with Touch and Workplace Well-Being

Touch is an essential part of caregiving and has been proved to be useful to reduce pain. Nevertheless, little attention has been paid to nurses’ perceptions of touch. The aim of this article was to examine the relationship between nurses’ feelings of comfort with touch and their well-being at work. A sample of 241 nurses attending a pain management training course completed a questionnaire, including the following measures: Comfort with Touch (CT) scale (task-oriented contact, touch promoting physical comfort, touch providing emotional containment), Maslach Burnout Inventory (MBI; emotional exhaustion, cynicism), and Job Satisfaction. Results of structural equation models showed that touch providing emotional containment was the main predictor of emotional exhaustion. Emotional exhaustion, in turn, was positively related to cynicism and negatively related to job satisfaction. In addition, the direct path from touch providing emotional containment to cynicism was significant. Practical implications of the findings are discussed.

Training on attachment styles increases secure adults’ attributions of control

The present study examined whether training on attachment styles may change individual self-perceptions. It was argued that secure individuals are more sensitive and less defensive than insecure ones to new information about the self and, thus, are willing to integrate adaptively and deeply process such information, increasing their perception of environmental control, namely their locus of control. Participants completed the Attachment Style Questionnaire (ASQ) as well as Internal, Powerful Others, and Chance Scales (IPC) both before and after attending classes addressing attachment style in related versus unrelated topics. Results revealed that participants who scored high in secure attachment increased their perception of internality and decreased their perception of externality after training on attachment styles, thus displaying a script-relevant information bias. Conversely, insecure individuals tended to maintain their self-perception and evaluation unchanged.

Development and Initial Validation of the Nurses' Comfort With Touch Scale.

Background and Purpose: The extent to which nurses feel comfortable about the use of touch may affect the frequency and quality of nursing touch-based interventions. No valid instrument exists to assess nurses’ feelings of comfort with touch. In this study, the nurses’ scale was developed and preliminary validated. Methods: Items were generated through semistructured interviews. After testing the content validity with a team of experts, the psychometric properties were tested with a sample of 451 nurses. Results: Explorative factor analysis yielded a five-factor solution, which was supported by confirmatory factor analysis. Examination of concurrent validity revealed that comfort with touch was correlated with positive affective states and emotional self-efficacy. Conclusion: Future directions and implications for nursing research, education, and practice are discussed.

Burnout Disrupts Anxiety Buffer Functioning Among Nurses: A Three-Way Interaction Model

Over the last 40 years, job burnout has attracted a great deal of attention among researchers and practitioners and, after decades of research and interventions, it is still regarded as an important issue. With the aim of extending the Anxiety Buffer Disruption Theory (ABDT), in this paper we argue that high levels of burnout may disrupt the anxiety buffer functioning that protects people from death concerns. ABDT was developed from Terror Management Theory (TMT). According to TMT, reminders of one’s mortality are an essential part of humans’ daily experience and have the potential to awake paralyzing fear and anxiety. In order to cope with death concerns, people typically activate an anxiety-buffering system centered on their cultural worldview and self-esteem. Recent ABDT research shows that individuals with post-traumatic stress disorder are unable to activate such anxiety buffering defenses. In line with these results, we hypothesized that the burnout syndrome may have similar effects, and that individuals with higher levels of burnout will be less likely to activate an anxiety buffering response when their mortality is made salient. Participants were 418 nurses, who completed a questionnaire including: a mortality salience (MS) manipulation, a delay manipulation, and measures of burnout, work-related self-efficacy, and representation of oneself as a valuable caregiver. Nurses are daily exposed both to the risk of burnout and to mortality reminders, and thus constituted an ideal population for this study. In line with an anxiety buffer disruption hypothesis, we found a significant three-way interaction between burnout, MS and delay. Participants with lower levels of burnout reported higher levels of self-efficacy and a more positive representation as caregivers in the MS condition compared to the control condition, when there was a delay between MS manipulation and the assessment of the dependent measures. The difference was non-significant for participants with higher levels of burnout. Theoretical and practical implications of findings are discussed.

Attachment style questionnaire: contributo alla validazione italiana

Nella prima infanzia, gli individui sviluppano stili di attaccamento che possono essere di tipo sicuro versus insicuro, a seconda delle reazioni della figura primaria alle loro richieste di protezione e sicurezza. Il particolare stile di attaccamento sviluppato nella prima infanzia influenza il modello operativo interno, nelle relazioni intime adulte, guidando percezioni, attribuzioni e stile comunicativo tra partner. L’Attachment Style Questionnaire (ASQ, Feeney, Noller e Hanrahan, 1994) si presenta come un ottimo strumento per la misurazione degli stili di attaccamento in eta adulta: e di facile somministrazione e scoring, costa poco, ha ragionevoli proprieta psicometriche e validita di criterio. Lo scopo del presente studio e di contribuire alla validazione dell’ASQ nel contesto italiano: 402 studenti universitari hanno partecipato allo studio. I coefficienti di affidabilita variano da .64 a .71, presentando quindi moderati ma soddisfacenti livelli di affidabilita. La validita di criterio, esaminata tramite correlazioni sia tra le sottoscale dell’ASQ, sia tra queste e le descrizioni proposte da Hazan e Shaver (1987), confermano una buona corrispondenza tra lo strumento ed i profili. La struttura fattoriale e stata indagata attraverso analisi fattoriale confermativa che ha mostrato l’adeguatezza del modello a tre fattori: sicuro, evitante, ansioso. I risultati replicano quelli ottenuti da Feeney e colleghi anche nel contesto italiano. L’ASQ si pone dunque come un ottimo strumento auto-somministrabile per la misurazione delle differenze individuali negli stili di attaccamento anche in eta adulta. Nella discussione sono affrontate alcune questioni metodologiche legate alla misura dell’attaccamento in eta adulta.

Variables of Individual Difference and the Experience of Touch in Nursing

We aim to investigate nurses’ feelings of comfort or discomfort with three different types of touch: task-oriented contact, touch promoting physical comfort, and touch providing emotional containment. A questionnaire was administered to a sample of 198 nurses. We present results of multiple regression analysis identifying some antecedents of nurses’ feelings of comfort with touch, namely, attachment style, worry, gender, and length of service. Worry is negatively associated with task-oriented contact and touch promoting physical comfort. Attachment security and length of service are associated with comfort with touch aimed at emotional containment; female nurses feel more comfortable than male nurses in performing this type of touch. Practical implications of findings are discussed in relation to the promotion of focused training courses for practitioners who are willing to improve the quality of care services.

Practice-Based ‘Inside-Out’ Innovation in Public Service: A Regional Child Welfare Agency

The aim of this chapter is to describe an inside-out, practice-based innovation process in the public sector. The innovation is concerned with the improvement of the quality of the internal vs. external and cross-disciplinary information/data transfer on foster youth in a regional child welfare agency in Italy. The process is an open one; it occurs at the third sector level of the public service agency. Different professional groupings are involved in the inter-institutional decision-making process on children; thus, local and role-specific knowledge is needed to resolve problems that arise at a more complex inter-institutional level, such as the joint evaluation of children’s behaviours. The practitioners’ need to reduce intra-team conflict rates turned out to be the activating influential factor of this innovation. The employee-driven innovation process developed through three steps: (1) in-service training led by psychologist, (2) staff assessment, and (3) development of a new tool for the systematic observation by residential youth workers of children’s behaviour. They can be referred to as ‘educators’, ‘front-line community educators’, ‘practitioners’ or youth workers. The new tool adopted reduced interpersonal and team conflicts at intra-service level, according equal dignity to both beginners and to experienced workers when reporting on children’s behaviour. Unintended and positive outcome of the development of the new tool emerged at the adoption/diffusion stage: the large number of observations of each child, available in real time, allowed youth workers to be effective both in intra-service and interservice information transfer. Comparative studies should be carried out in order to identify commonalities between social, health and educational services’ innovation influential factors and outcomes. According to De Vries et al. (2014), innovation’s outcomes are seldom analysed; we’ve contributed to fill this research gap.

The Tension between Empathy and Assertiveness and its Correletion with Self-Efficacity

The tension between empathy and assertiveness and its correlation with self-efficacy - It has been argued that empathy and assertiveness are not two mutually exclusive traits but rather two skills working together to enhance individuals’ outcomes in negotiations: empathy and assertiveness are two universally recognized emotional skills that must be included in the repertoire of any successful social actor. To investigate this issue, aid relationships, a field where it is particularly important to perform efficient negotiations with the client, were considered: in pilot study , nurses completed a paper and pencil questionnaire including measures of empathy, assertiveness and perception of self-efficacy; in Study 1, educators compiled a questionnaire that included also measures of social efficacy, social identification and deficit in emotions identification. In both studies, a positive correlation between both empathy and assertiveness with self-efficacy was found; additionally, in Study 2, social efficacy was found to correlate positively with in-group identification and deficit in emotions management, namely alexitymia, moderated main results. It is important, mostly for activities that require efficient daily negotiations, such as caring professions, to increase the knowledge and management of empathy and assertiveness through guided training.

Inter-professional Collaboration: An Evaluation Study

Both conventional wisdom and some of the literature in this area tell us that public organizations and services find it hard to innovate. We present a case study on the impact of a third sector intra-service innovation on the interservices’ network of a regional child welfare agency. The innovation was implemented in 2010 and the follow-up presented in this chapter was completed in 2014. The innovation consisted of the introduction of a new tool for the direct, systematic observation of children’s behaviour and attitudes. Residential youth workers, an important part of the child welfare agency’s workforce, introduced the new tool in order to improve the quality of their contribution to the information flow on young people in residential care. The follow-up research allowed us to recognize that the introduction of a new tool, while improving team work performance and reducing interpersonal and team conflicts at the intra-service’s educative service level, highlighted an important asymmetry between service providers in the child welfare agency network with regard to the provision of information.