Shiri Shinan-Altman

Social workers' and nurses' illness representations about Alzheimer disease: an exploratory study.

Professionals’ perceptions of patients’ diseases (illness representations) are a major factor influencing the quality of treatment they provide. The aim of the study was to examine and compare Alzheimer disease (AD) illness representations among 2 main professional groups involved in the care of Alzheimer patients. A total of 327 nurses and social workers in Israel were asked to report their cognitive representations (dimensions of identity, cause, timeline, consequences, control, coherence, timeline cycle) and emotional representations. Knowledge about AD, demographic, and occupational characteristics were also obtained. Participants perceived AD as a chronic disease associated with severe consequences. Statistically significant differences were found between the groups, as nurses attributed psychological reasons to AD more than the social workers. Nevertheless, social workers perceived AD as more chronic with severe consequences compared with the nurses. Despite some resemblance, there were differences between the social workers and nurses regarding AD illness representations. Therefore, continuing to distribute materials to professionals regarding AD is recommended, with attention to the unique characteristics of each professional group. Furthermore, the findings encourage the development of training and support programs that will not only deal with the organizational and instrumental levels of treating AD patients but also with the assessment and consequences of professionals’ illness representations.

The connection between illness representations of Alzheimer's disease and burnout among social workers and nurses in nursing homes and hospitals: a mixed-methods investigation

Objective: To examine the relationship between Alzheimers disease (AD) illness representations and burnout among social workers and nurses, based on the self-regulatory model. Method: A mixed-methods study was conducted. First, 327 social workers and nurses completed measures of cognitive and emotional representations, burnout (emotional exhaustion, depersonalization, lack of personal accomplishment), role variables, knowledge about AD, emotion-focused coping, problem-focused coping, and demographic and occupational characteristics. Second, interviews were conducted with eight social workers and nurses to uncover their perceptions about AD and their burnout experience. Results: Using structural equation modeling and controlling background variables, findings indicated that emotional representations were associated with burnout while only some of the cognitive illness representations were associated with burnout. While cognitive illness representations were associated directly to burnout, the association between emotional representations and burnout was mediated by emotion-focused coping. The trimmed model showed a good fit of the data and explained 32.2% of the variance in emotion-focused coping, 51% of the variance in emotional exhaustion, 37.7% of the variance in depersonalization, and 22.6% of the variance in lack of personal accomplishment. Interviews demonstrated that AD characteristics were perceived as affecting participants on both personal and professional levels; the participants expressed negative feelings towards AD and stated that these perceptions and feelings had led them to burnout. Conclusions: AD illness representations may be a risk factor for developing burnout. New directions for intervention programs, aiming to reduce burnout, should be examined.

Is Work Beneficial to Good Health

Unemployment and insecurity at work are a source of stress and may create a threat to individual physical and psychological health. The purpose of this study was to examine the connection between personal, functional, and professional variables and reports of how the health of hospital patients is impacted by financial status in Israel. One hundred and forty three hospitalized patients completed demographic, health-functional, and financial status questionnaires. Of the respondents, 32.9% reported a correlation between financial status and health. Significant connections were found between family status, lack of work, a change in partners employment status, job insecurity, and financial commitments and reports of a correlation between financial status and health. The multivariate model predicting reports of a correlation between financial status and health was statistically significant. Discussion and implications focus on the need to create special preparation among health care professionals, in the community and in hospitals, to identify and treat people suffering from financial stress.

Perceptions of Older Residents and Their Adult Children Regarding Continuing Care Retirement Community Staff.

This study examined the perspectives of continuing care retirement community (CCRC) residents and their adult children regarding services provided by staff in the CCRC. The study is based on semistructured qualitative interviews with 49 residents and their 34 adult children from 11 CCRCs. Transcripts were analyzed using qualitative content analysis. Three major themes emerged: (a) “Reliance on the CCRC staff,” (b) “Dissatisfaction with the CCRC staff,” and (c) “Disregard to the CCRC staff.” Findings suggest that staff should maintain constant contact with all residents, including those who are not satisfied with staff’s function and those who do not use staff services, to identify and respond to the residents’ changing needs. Attention should be paid in meeting residents’ physical needs prior to meeting their social and emotional needs, as these tend to be the most urgent.

Medical social workers’ perceptions of obesity:

Summary Professionals’ perceptions of patients’ health conditions are significant factors which influence the quality of treatment they provide. This study aimed to assess medical social workers’ perceptions of their patients’ obesity (“obesity representations”), as well as the relationship between these representations and knowledge about obesity, attitudes toward obesity, and personal exposure to obesity. A convenience sample of 105 medical social workers completed illness representations (dimensions included cause, timeline, consequences, control, coherence, timeline cycle, emotional representation) questionnaires, as well as attitudes toward obese patients, obesity risk knowledge, personal exposure to obesity, and sociodemographic questionnaires. Findings Medical social workers perceived obesity as being associated with severe consequences and as being controlled by one’s own behavior and through treatment. The medical social workers also expressed high negative emotional representations and significantly high percentage of them held negative attitudes toward obese patients. Multiple regression analyses revealed that personal exposure to obesity and attitudes toward obese patients emerged as significant predictors of timeline, emotional representations, and treatment control. Applications The study findings encourage the development of training and support programs, which will deal with the feelings of fear and anger that may accompany the care of obese patients. In addition, the findings can also aid in assessing and evaluating medical social workers’ obesity representations.

If I am not for myself, who is for me? The experiences of older migrant home care recipients during their hospitalization

Objective: Hospitalization is a major risk for older adults; therefore, it is crucial to provide the appropriate treatment during hospitalization. This study examined hospitalized older adults’ perceptions regarding three groups of treatment providers: nursing staff, family members, migrant home care workers. Method: Qualitative interviews were conducted with 17 hospitalized older adults. Data were gathered by in-depth interviews. Content analysis included open coding, axial coding and integration of the main findings using constant comparisons. Results: Three themes emerged: (1) ‘What is my worth?’ This theme was focused on the participants’ perceptions of themselves as helpless and dependent on others. (2) ‘What would I do without them?’ This theme referred to the perception of the migrant home care workers and nursing staff as essential. It meant immense gratitude, but also a sense of dependency on paid caregivers. (3) ‘They have their own busy life.’ This theme concerned participants’ low treatment expectations from their family members due to their perception of their family members as having multiple obligations. Conclusion: Hospitalized older adults prefer to turn to paid caregivers rather than to their families. Findings are discussed in light of the tension between formal and informal care in countries that are transitioning from traditional family values to modern values, placing the care of older adults by paid caregivers.

The suffering is similar--is the treatment equal? An intervention with Arab Terror injured.

In the course of the last Intifada and during the Second Lebanon War, all citizens of Israel were exposed to waves of terrorism that claimed many people wounded and killed, unrelated to religious differences, age, gender, or nationality: Jews and Arabs suffered alike. The acts of terror exposed all inhabitants equally to injury, suffering, and the need to adjust. The professional literature attests that minority groups are at a higher risk of experiencing post-traumatic symptoms as a result of exposure to acts of terror. This article describes the treatment with terror injured, Jews and Arabs, in the frame of the project for terror victims at Rambam Medical Center, in cooperation with Operation Embrace. It also covers the project intervention with casualties of the shooting incident in the Arab town of Shefaram, with the cooperation of Shefaram Social Welfare department. The psycho-social work conducted with the injured, Jews and Arabs, emphasized their similarities, their common fate, and the fact that any of us could be injured in a terror act or a war. The suffering, the loss, and the hurt are common to us all. At the same time, the interventions referred to cultural differences and the diverse ways of coping with the aftermath of the events, based on values, faith, and outlook on life arising from cultural background.

Assessing social work and nursing students’ intentions to work with dying patients

Abstract This study assessed social work and nursing students’ intentions to provide end-of-life care, based on the Theory of Planned Behavior. A total of 181 social work and nursing students completed a questionnaire examining intentions to provide end-of-life care, attitudes, subjective norms, perceived control, death anxiety, subjective knowledge, and sociodemographic characteristics. Students manifested a moderate level of intentions to provide end-of-life care, with nursing students indicating higher levels of intentions than social work students. Multiple regression analyses revealed that attitudes, subjective norms, and previous experience were the main predictors of intentions to provide end-of-life care. Recommendations for academic programs are discussed.

Subjective Age and Its Correlates Among Middle-Aged and Older Adults:

The present study evaluates discrepancies in subjective age as reported by middle-age persons (aged 44–64 years) in comparison to older adults (aged 65 years and older), using a multidimensional definition of the concept. A convenience sample of 126 middle-aged and 126 older adults completed subjective age measures (felt age, desired age, and perceived old age), attitudes toward older adults, knowledge about aging, and sociodemographic questionnaires. Overall, participants reported feeling younger than they actually were and wanting to be younger than their chronological age. Perceived mean for old age was about 69 years. Discrepancies in felt age and desired age were significantly larger for the older group compared to the middle-aged group. Regarding perceived old age, compared to the younger group, older adults reported that old age begins at an older age. Findings suggest that middle-aged and older adults’ perceptions regarding themselves and regarding old age in general are independent and need, therefore, separate research and practical attention.

Burnout among psychosocial oncologists in Israel: The direct and indirect effects of job demands and job resources

OBJECTIVE Psychosocial oncologists may be particularly vulnerable to burnout. This study aimed to assess burnout among Israeli psychosocial oncologists in relation to the Job Demands-Resources model and the coping strategies model. METHOD Participants included 85 of 128 listed psychosocial oncologists currently working with cancer patients. They completed a questionnaire assessing emotional exhaustion, depersonalization, job demands, job resources, work engagement, overcommitment, and perceived value of work. RESULTS The mean level of burnout was low, whereas 16.3% experienced high levels of emotional exhaustion and only 2.4% experienced high levels of depersonalization. According to mediation analysis, overcommitment, partially mediated job demands-burnout associations, and work engagement mediated the perceived value-burnout association. Job resources and burnout were not related, either directly or indirectly.Significance of resultsThe study extended the Job Demands-Resources model to include perceived value as an additional resource, and work-engagement and overcommitment as coping strategies. Two distinct patterns of associations were found between work characteristics and burnout: the positive-protective pattern (perceived value and work engagement) and the negative pattern (job demands and overcommitment). These two patterns should be considered for further research and for implementing preventive interventions to reduce burnout in the workplace setting.