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Empirical Advances in Studying Relational NetworksThe relating of relations is a key feature of the development of complex relational networks. Despite this, thus far there has been little empirical study of this phenomenon, outside of analogy. The latter, which involves coordination of relational networks, is indeed an important example of the relating of relations but there are other examples that can also be involved in complex relational framing. Experiment 1 extended previous research by exploring non-coordinate relating of relations in adult participants. First, Crel functions of YES, NO, SAME, DIFFERENT, and OPPOSITE were established in arbitrary stimuli using a multi-stage Relational Evaluation Procedure (REP). Then participants were tested for the evaluation of various forms of relating of relations including deriving coordination, distinction and opposition relations between relations. Three out of four participants showed predicted patterns of behavior. In Experiment 2, these same three participants showed transformation of contextual control functions via the relating of relational networks. Implications and future research directions are discussed.
Perceived stress and professional quality of life in nursing staff: how important is psychological flexibility?Objectives: Nurses are at high risk of chronic stress. Tailored, evidence-based stress-management interventions may minimise absenteeism and staff turnover, whilst at the same time promoting good quality patient care. Current literature for nurse-focused stress-management interventions is varied in quality, with little focus on data-driven intervention development. This study explores how process measures related to Acceptance and Commitment Training (ACT) are associated with perceived stress and professional quality of life in nurses, in order to guide intervention development. Design: A cross-sectional, online psychometric survey was implemented using LimeSurvey software. Methods: One-hundred and forty-two nurses were recruited from various specialties across four English National Health Service (NHS) Trusts. Questionnaires assessed demographic and work-related sample characteristics, ACT processes (mindfulness, acceptance, cognitive defusion, self-as-context, values and committed action), and four work-related wellbeing outcomes (perceived stress, burnout, compassion fatigue and compassion satisfaction). Correlation and regression models were used to analyse data. Results: All six ACT processes negatively correlated with perceived stress, burnout and compassion fatigue, and positively correlated with compassion satisfaction (all p<.05). In regression models, these same processes explained significant variance for all outcomes (R2 range=.36-.61), above and beyond that explained by socio-demographic and work-related factors. Acceptance (β range: -.25 to -.55), mindfulness (β range: -.25 to -.39), and values-based processes (β range: -.21 to -.36) were frequent independent contributors to work-related wellbeing. Conclusions: This study demonstrates that the ACT framework provides a promising platform from which to develop nurse-focused stress-management interventions. Interventions focusing on acceptance, mindfulness, and values-linked processes may be most effective.
Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility.Background The period immediately after the end of cancer treatment is a time when supportive care for the cancer patient decreases; this is known to increase risk of psychological distress and poor wellbeing. While there is broad recognition that unmet psychological and supportive care needs correlate with psychological wellbeing, little is understood about the factors that influence this relationship. This study explores the role of psychological flexibility, with a particular focus on its potential moderating role between unmet needs and psychological distress in haematological cancer survivors. Materials and Method Haematological cancer survivors were recruited for this cross-sectional study through two major UK blood cancer charities. Participants (n=91) were all over the age of 16 and had been diagnosed with any sub-type of haematological cancer more than 18 months previously. Participants completed self-report questionnaires assessing unmet psychological and supportive care needs (SCNS SF34), anxiety and depression (HADS), quality of life (EORTC QLQ-C30) and psychological flexibility (AAQ II). Results High levels of both unmet need and distress were present in the sample, indicating on-going care needs for these cancer survivors. Statistically significant correlations between unmet needs, psychological flexibility and all outcome variables (anxiety, depression, quality of life) were found. Using regression analysis based on Hayes’ methodology (Hayes, 2013), psychological flexibility was found to act as a moderator between unmet need and distress in four out of 15 models; specifically, the statistical relationship between need and distress emerged only when levels of psychological flexibility were at average level or above. Discussion Haematological cancer survivors have on-going supportive care needs that persist well beyond the end of active treatment. Unmet needs can, in turn, increase levels of anxiety and depression, and reduce quality of life in this patient group. The understanding offered by our data that psychological flexibility plays a moderating relationship between need and psychological distress creates opportunities for the development of theoretically-informed interventions to reduce both unmet need and distress in cancer patients. As such, these findings support the growing emphasis on Acceptance and Commitment based interventions for cancer patients.