Rocío Rodríguez-Rey

Posttraumatic growth in pediatric intensive care personnel: Dependence on resilience and coping strategies.

Objective: Staff in pediatric intensive care units (PICU) are inherently exposed to potentially traumatic events. Posttraumatic growth (PTG) is the occurrence of positive changes after experiencing a traumatic event. This study aims (a) to evaluate the prevalence of PTG in PICU staff, and whether their scores are different from those reported by professionals working in other pediatric units, (b) to explore the role of resilience and coping strategies in predicting PTG, and (c) to explore the relation of demographic and work-related variables with PTG. Method: Participants of this multicentric, cross sectional study were 298 PICU workers and 189 professionals working in noncritical pediatric units. They completed the Brief Resilience Scale, a Coping Strategies Questionnaire, the Posttraumatic Growth Inventory (PTGI), and provided demographic and work-related information. Results: Of PICU staff, 68.8% experienced growth to a “great” or “very great” degree in at least one of the PTGI’s dimensions. Higher PTG was reported following the death of a child or after a recent conflict with a work colleague. PICU workers and noncritical pediatric staff showed equivalent PTG levels. Multigroup path analysis with latent variables showed that emotion-focused coping was related to PTG only in PICU staff, whereas problem-focused coping was related to PTG in both groups. The relation between resilience and PTG was not significant. Conclusions: Work-related trauma can act as a catalyst for positive posttrauma changes. Modifying coping strategies may be a way to foster PTG in health care providers.

Personal factors underlying resilience: development and validation of the Resiliency Questionnaire for Adults

Abstract Resilience outcomes following significant adverse events are related to certain personal attributes, termed resiliency factors. This study aimed to adapt the Prince-Embury resiliency model, developed with children and adolescents, to adult populations. To that end, the Resiliency Questionnaire for Adults (RQA) was developed, consisting of nine characteristics organised around three factors: Sense of Mastery, Sense of Relatedness and Emotional Reactivity. The questionnaire adequacy was tested in adults from both general and health-distressed populations (N = 430) through reliability, confirmatory factor, cross-validation and multiple-group analyses. Criterion validity was assessed via path analysis with latent variables to predict resilience outcomes. The RQA scores were reliable and the three-factor model fitted the data well. The three resiliency factors predicted two-thirds of the variance in resilience. This questionnaire constitutes a reliable and valid assessment of personal factors underlying resilience.

Posttraumatic growth inventory: factor structure in Spanish-speaking people living with HIV

ABSTRACT This cross-sectional study analyzed the factorial structure of the Posttraumatic Growth Inventory (PTGI) in a sample of 304 Spanish-speaking HIV-positive adults. Participants completed the PTGI and a socio-demographic questionnaire. Exploratory factor analysis (EFA) was carried out through structural equations modeling, with a Varimax rotation. Factors with eigenvalues greater than 1 were extracted, and items with loadings higher than .5 on a factor and lower than .4 on the rest were retained. Two confirmatory factor analyses (CFA) were performed to test a hierarchical model and a bifactor model. Reliability analyses were conducted. EFA suggested a three-factor model keeping 11 of the original 21 items. The three factors that emerged were changes in philosophy of life, in the self and in interpersonal relationships. CFAs suggested that only the bifactor model fitted the data. The three factors as well as the global scale showed good reliability. The factor structure of PTGI’s scores in our data is consistent with the three dimensions theorized by Tedeschi and Calhoun, which speaks in favor of the construct validity of this measure.

Development of a screening measure of stress for parents of children hospitalised in a Paediatric Intensive Care Unit

BACKGROUND Having a child admitted to intensive care is a highly stressful experience for parents; however there is a lack of screening instruments of parental stress in that context, which would be useful for both, research and clinical purposes. OBJECTIVES (1) To validate a brief measure of parental stress based on the Parental Stressor Scale: Paediatric Intensive Care Unit (PSS:PICU), (2) to study which environmental factors of the PICU are more stressful in a sample of Spanish parents, and (3) to study which variables are related to higher levels of stress among this group. METHOD 196 Spanish parents completed the Abbreviated PSS: PICU (A-PSS:PICU) and a general stress scale (the Perceived Stress Scale) upon their childs discharge to test the convergent validity of the tool. Three months later, they were assessed anxiety and depression using the Hospital Anxiety and Depression Scale, and posttraumatic stress with the Davidson Trauma Scale in order to test the predictive validity of the A-PSS:PICU. RESULTS Two factors emerged from Confirmatory Factor Analyses, (1) stress due to childs condition and (2) stress related to PICUs staff. The A-PSS:PICU showed adequate reliability and convergent and predictive validity. The most stressful aspects were the behaviours and emotional responses of their child and the loss of their parental role. Age, gender, childs condition, length of admission, spiritual beliefs, and mechanical ventilation were associated to parental stress scores. CONCLUSION The A-PSS:PICU is a reliable and valid measure. Parental stress should be screened during a childs PICU admission to identify parents at risk of post-discharge distress.