This article reports on the Adolescent Unresolved Attachment Questionnaire (AUAQ), a brief questionnaire that assesses the caregiving experiences of unresolved adolescents (as recipients of caregiving). The AUAQ was developed and validated in a large normative sample (n = 691) and a sample of 133 adolescents in psychiatric treatment. It is a self-report questionnaire consisting of 3 scales with Likert-type responses ranging from strongly disagree to strongly agree. The Aloneness/Failed Protection Scale assesses the adolescent's perception of the care provided by the attachment figure. The Fear Scale taps the fear generated by the adolescent's appraisal of failed attachment figure care. The Anger/Dysregulation Scale assesses negative affective responses to the perceived lack of care from the attachment figure. All scales demonstrated satisfactory internal reliability and agreement between scores for adolescents (n = 91) from the normative sample who completed the AUAQ twice. Adolescents in the clinical sample also completed the Adult Attachment Interview (AAI; C. George, N. Kaplan, & M. Main, 1984/1985/1996); the AUAQ demonstrated high convergent validity with the AAI.
BACKGROUND: Emotional distress is frequent in patients with acute traumatic hand injury during the first weeks after the accident. Knowledge of coping in relation to emotional distress could help to identify those who need support. OBJECTIVES: To describe the different kinds of coping used by patients in the early stage of recovery following an acute traumatic hand injury and to investigate differences in coping patterns in patients with and without symptoms of emotional distress. DESIGN: Questionnaire survey with a descriptive and comparative design. Setting/participants: A total of 112 patients with acute traumatic hand injury requiring inpatient treatment at the hand surgical clinic. Those with injuries caused by a suicide attempt or with known drug abuse were excluded. Method/main outcome measures: The patients answered a postal questionnaire at home 1-2 weeks after the accident. Emotional distress was assessed with the Hospital Anxiety and Depression scale. Coping was measured with the Jalowiec Coping Scale-40. RESULTS: Coping by "trying to keep the situation under control" and "trying to look at the problems objectively and see all sides" were most frequent. These strategies are typical for the confrontive coping style, which dominated in the actual illness-situation. Symptoms of emotional distress occurred in 32% of the patients. These patients used significantly more kinds of coping strategies and used confrontive and emotive coping strategies more often than the others. Coping by "hoping for improvement", "working tension off with physical activity", "trying to put the problem out of one's mind", "worrying", "getting nervous or angry" and "taking off by one self" were associated with emotional distress. Coping by "accepting the situation as it is" and "thinking that it is nothing to worry about" were more frequent in patients without emotional distress. CONCLUSIONS: Observations of the coping strategies associated with emotional distress in this study could help to identify patients in clinical practice that need nursing support. Coping associated with less emotional distress should be encouraged.
Emotional reactions of parents after the birth of an extremely low birth weight (ELBW) infant were followed during the early period of hospital care. Ten pairs of parents participated. The process concerning feelings of sadness, anger, fear/anxiety and joy was measured by Single Systems Design (SSD). The infants were born in gestation weeks 23-27. The emotional reactions of the mothers and fathers did not differ significantly. There was emotional confusion during the first weeks of parenthood, then the negative feelings decreased and joy increased. But at the end of a long period of care, the negative feelings reappeared. It is important to be aware that the first weeks after birth can be marked by emotional confusion and that negative feelings can return when the infant's medical status has been brought under control. The latter might be explained emotionally as a delayed crisis reaction.
The aim of the study was to identify and describe spouses'/cohabitants' experiences of living with a partner with bipolar affective disorder over time. Qualitative research interviews were conducted with eight spouses/cohabitants. Transcribed interviews were analysed structurally based on Ricoeur's phenomenological hermeneutics as described by Lindseth and Norberg. The participants' shared lives ranged from 6 to 51 years, and the study found three major aspects that characterized their experience along this time-dimension; experience formed part of a cumulative process containing up to 14 experiences. Each experience created a preunderstanding that affected how subsequent experiences were perceived, and mastered. These three major aspects had a reciprocal influence on the following 14 experiences over time: Fear and the incomprehensible. Accusations. Self-doubt and doubt about own powers of judgement. Care and information vs. being overlooked or turned away by health personnel. Stigmatization and loss of social network. Uncertainty, powerlessness and hope. Loneliness. Anger and despair. The persistent threat. Own health problems. Grief over loss. Dawning acceptance. Reconciliation. New hope. A theoretical understanding using gestalt therapy theory suggests that burdensome experience can be seen as an inner imbalance in the spouse/cohabitant when she/he cannot find meaning in their experiences. When only parts of the whole are perceived, an incomplete gestalt is formed in the person's lived-experience that counteracts the equilibrium of the organism. Insight and meaning can protect them against burdensome experiences and nurses can empower them through care, health-promoting education and guidance. Nursing research should develop methods of education and guidance sensitive enough to help each spouse/cohabitant, regardless of where they are in their cumulative process.
In many Western countries, the proportion of the population that is White will drop below 50% within the next century. Two experiments examined how anticipation of these future ethnic demographics affects current intergroup processes. In Study 1, White Americans who viewed actual demographic projections for a time when Whites are no longer a numerical majority felt more angry toward and fearful of ethnic minorities than Whites who did not view future projections. Whites who viewed the future projections also felt more sympathy for their ingroup than Whites in the control condition. In Study 2, the authors replicated the effects for intergroup emotions with a sample of White Canadians. White Canadians who thought about a future in which Whites were a numerical minority appraised the ingroup as more threatened, which mediated the effect of condition on intergroup emotions. The authors discuss the implications of these findings for race relations in increasingly diverse societies.
The purpose of this study was to describe the experiences of public health nurses (PHNs) who screen for woman abuse within their clinical practice. Semi-structured, in-depth interviews were conducted with 11 PHNs. There was a great deal of variability in participants' level of experience in working with abused women. The results reveal that nurse readiness is an important factor in screening for woman abuse. The authors describe a number of steps participants appeared to grapple with in order to become comfortable working with abused women, including coming to terms with abuse, asking the question, bearing witness, and "walking with" the client. As the PHN became increasingly comfortable working with abused women, she came to redefine success. Her client's personal growth over time, rather than the single act of leaving an abusive relationship, now defined a successful client interaction. The authors also discuss implications for practice that arise from these accounts.
BACKGROUND: Relatives play an important role in deciding to seek medical care after the onset of symptoms of an acute myocardial infarction (AMI). OBJECTIVE: The aim of this study was to gain deeper understanding of how AMI patients and their relatives think and act during and after onset of symptoms. METHODS: Six focus group interviews were conducted with AMI patients (N=13) and relatives (N=14). Manifest content analysis was used to analyse the transcribed data. RESULTS: The AMI patients experienced a variety of symptoms and both patients and relatives often felt uncertain about the origin of the symptoms, interpreted them as less serious conditions and tried to alleviate the discomfort in various ways. When symptoms continued the patients consulted a relative, who often decided to seek care. Many considered waiting for an ambulance was too long and the relative often drove the patients to the hospital. CONCLUSION: Patients as well as relatives were insecure about AMI symptoms and how to act. All patients contacted a relative, who was more eager than the patient to seek help. Many preferred to go in their own car to the hospital, believing it to be faster than an ambulance. Information about AMI symptoms and recommended action should be given to the public and to AMI patients and their relatives.
This study examined the meaning of cardiac pain for chronic stable angina (CSA) patients who participated in a standardized angina psychoeducation program. The patients documented what angina meant to them at sessions 1 and 6 of a 6-week standardized psychoeducation program aimed at enhancing CSA self-management. At session 1, angina was described as a major negative life change characterized by fear, frustration, limitations, and anger. At session 6, angina signified a broad and ongoing pain problem requiring continual self-management in order to maximize quality of life. The findings suggest that the perceived meaning of angina as a burdensome and debilitating life change shifts, during psychoeducation, to one of angina as a broad pain problem requiring ongoing self-management in order to preserve life goals and functioning. How such perceptual shifts in the meaning of cardiac pain might contribute to the overall effectiveness of psychoedcuation warrants further investigation.
This descriptive study investigated the experience of verbal abuse among a voluntary sample of registered pediatric nurses working in six hospitals in Eastern Ontario (N=35), over a six week period. Roy's Adaptation Model was used as the conceptual framework for this study. A questionnaire was used to ascertain the incidence, source, level of reporting, and personal and professional reactions of verbal abuse in this specific population. Analysis and treatment of data included descriptive statistics and Spearman Correlation tests. Pediatric nurses were the frequent victims of verbal abuse. Patients, parents/visitors, and physicians were equally ranked as the most common perpetrators. There was distinct lack of reporting of verbal abuse. Reasons reported included (a) the incident was not important enough, and (b) the situation was handled/resolved. An increase in stress level and decreased job morale were among the most frequently perceived personal and professional reactions of verbal abuse.