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Emotional Issues (emotional + issues)

Distribution by Scientific Domains

Medical Sciences	66%

Selected Abstracts

Emotional issues after kidney transplantation: a prospective psychotherapeutic study

CLINICAL TRANSPLANTATION, Issue 6 2002
Lyndsay S Baines
Abstract:,Background:, Negative emotional states are the single most influential factor in determining quality of life after a successful kidney transplant. We designed a prospective study using psychotherapeutic principles to understand and intervene in emotional issues in adult recipients of first cadaver kidney transplants. Methods:, Forty-nine recipients of first cadaver kidney transplants were subjected to 12 sessions (at weekly intervals) of psychotherapy within 3 months of receiving their transplant. The Beck Depression Inventory (BDI) was utilized as a measure of change in emotional state, pretherapy, at 3, 6, 9 and 12 months. A higher score on BDI was suggestive of psychological dysfunction. In the first instance, data was analysed within a quantitative framework, by virtue of the BDI. In the second instance, data was considered in terms of recurring themes described by patients during psychotherapy and was analysed qualitatively. In the third instance, both qualitative and quantitative data was considered in terms of individual patient's ability to achieve some feeling of having implemented some social, relational and vocational equilibrium into their everyday life. Recipients of live kidneys, paediatric transplants and patients who received more than one transplant were excluded, as emotional issues are different in this cohort of patients. All patients have completed 1 yr of follow up. None of the patients were on antidepressant medication before or after therapy. Results:, This is an ongoing study in which we are comparing individual vs. group therapy vs. controls (who receive no therapy). The total number of patients recruited will be 120 and the final report will be available in 2003,04. The results reported in this paper form the 49 patients in the individual arm of the study. All the patients in our study happened to be white people. There was significant improvement in the BDI scores following therapy. The mean score was 26.3 ± 7.9 before and 20.5 ± 8.8 after therapy (p = 0.001); the lowering of the scores remained sustained at 12 months. Multivariate analysis of age, gender, employment status, duration of dialysis (if in dialysis for more than 3 yrs) and psychotherapy given before transplantation did not affect the results of our study. For the qualitative aspect of the study, we grouped the emotional problems as expressed by the patients into three recurring themes (i) fear of rejection, (ii) feelings of paradoxical loss post-transplant despite having received a successful transplant and (iii) the psychological integration of the newly acquired kidney. Conclusions:, Psychotherapeutic intervention was an effective means of addressing emotional problems in recipients of kidney transplants. The recurring themes as identified above provided a baseline for psychotherapeutic exploration and resolution of these issues. Successful resolution of these issues was associated with lower BDI scores and the redefinition of normality in daily living post-transplant. [source]

Debriefing critical incidents in the paediatric emergency department: Current practice and perceived needs in Australia and New Zealand

EMERGENCY MEDICINE AUSTRALASIA, Issue 6 2009
Theane Theophilos
Abstract Anecdotally critical incident debriefing (CID) is an important topic for staff in paediatric ED. The present study aimed to determine current baseline CID practices and perceived needs of ED staff. A questionnaire regarding CID practice was circulated to all 13 Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites in Australia and New Zealand (including all tertiary paediatric ED), and completed by 1 senior doctor and 1 senior nurse. All PREDICT sites participated (13 nurses, 13 doctors). Seventy per cent did not currently have a hospital protocol on debriefing and 90% did not have ED-specific guidelines. The most commonly debriefed topics were death of a patient, multi-trauma and sudden infant death syndrome, also ranked highest in importance for debriefing. The median reported debriefs per department were 4 per year (range 0,12), all conducted within a week of the CI with half within 24 h. ED workers most likely to be invited to the CID session were doctors, nurses and social workers (96%). Debriefing was mostly conducted internally (62%) and most likely facilitated by a doctor (81%) or nurse (54%). Debriefing addressed both clinical and emotional issues (89%) within the same session (69%). Debriefing was rated as very important, median of 8/10 by doctors and 10/10 by nurses. Almost 90% of those surveyed indicated that they would like a CID programme and guidelines for their department. Debriefing is perceived as important by senior ED clinicians, yet few ED have formalized guidelines or programmes. Best-practice guidelines should be developed. [source]

,In the Company of Men': A Reflexive Tale of Cultural Organizing in a Small Organization

GENDER, WORK & ORGANISATION, Issue 4 2002
Denise Fletcher
A tale of fieldwork in a small organization is discussed in this article with a view to highlighting how social processes, cultural understandings and expressions of gender are produced during fieldwork interaction. The tale is told reflexively and retrospectively, recording an ongoing conversation about fieldwork experience. Central to the tale is discussion of how the researcher is drawn into ,culture,making' within the organization and the ways in which fieldwork interaction creates a ,space' through which organizational members engage with, work through and realize work,place values. In this article there are multiple levels of reflection. At one level it is examined how the organizational,researcher role of ,emotional nurturer' was constructed during fieldwork. At the same time some cultural insights drawn from ethnographic inquiry and intensive interviewing within the small organization are presented. The analysis is also shaped by a further layer of post,fieldwork reflection and interpretation which draws in emotional issues and expressions of gender. It is argued that a close scrutiny of fieldwork roles is important to organizational research in that it makes explicit how the researcher,,native' interaction is central to the theorizing process and how the researcher can become a participant in organizational culture,making. [source]

We've never done it this way before: Prompting organizational change through stories

GLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 2 2008
North McKinnon
Organizations have discovered that storytelling is a powerful change management tool for addressing the emotional issues that have torpedoed many an initiative. Leaders from five businesses discuss how stories finally enabled employees and other stakeholders to get on board with major change efforts. The cases include organizations that used metaphors to create a common team vision, a road map for new business strategy, and the future vision for a massive high tech merger, as well as leaders who used personal stories to convey the essence of a difficult business issue for a skeptical audience. This article is reprinted from the book, Wake Me Up When the Data Is Over: How Organizations Use Stories to Drive Results, by Lori L. Silverman (Jossey-Bass, 2006) © 2006 John Wiley & Sons. [source]

Quality of life in adult enteral tube feeding patients

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2007
A. M. Brotherton
Abstract Background, Enteral tube feeding may impact significantly on patients' quality of life (QoL). The aim of this paper is to review studies that have measured QoL in adult patients receiving enteral tube feeding to determine the factors that are associated with feeding that impact on the patients' QoL. Methods, An electronic search of CINAHL, MEDLINE and EMBASE was undertaken to identify articles that had measured QoL in adults receiving enteral tube feeding. Results, Ten studies were included in the review. Quality of life in patients receiving enteral tube feeding generally appeared poor compared with control groups. Factors that were found to impact on patients' quality of life included symptoms such as nausea, vomiting, diarrhoea and fatigue. Issues around body image, inability to go out and discomfort while carrying out activities of daily living also impacted on QoL. Conclusions, Although the presence of underlying disease and the use of different QoL measures made comparison of the results difficult, issues requiring further consideration in clinical practice include effective symptom management, assessment of psychological and emotional issues and support for patients to enable them to cope with the resulting social isolation. [source]