A 1 and 6 month follow-up of prenatal diagnosis patients who lost pregnancies

This paper reports results of an exploratory study of prenatal diagnosis patients who experienced voluntary terminations of pregnancy following the detection of an abnormality or spontaneous miscarriages. The 121 participants were part of the national collaborative Chorionic Villus Sampling and Amniocentesis Study. They completed semi-structured telephone interviews and mailed questionnaires at 1 month and 6 months after the pregnancy losses. Scores on the Profile of Mood States showed that mood levels improved significantly over time. However, there were some declines in loss-related support from partners and others. The persisting distress and difficulties of a minority highlight the variability in women's responses to pregnancy losses. Women who lost pregnancies later in gestation, showed the greatest mood disturbances at initial assessments, used professional mental health assistance after the loss, or reported less satisfactory loss-related support from significant others showed the greatest levels of mood disturbance at the six-month assessment. Follow-up contacts with patients who lose pregnancies should be used to inform women about the variation in possible grief reactions, to assess the extent of support the women are receiving from their partners and significant others, and to provide additional follow-up or referral of those experiencing the greatest distress.     

Communication openness with friends,relatives and children of couples having amniocentesis

In a study of couples having amniocentesis for prenatal diagnosis of genetic defects, it was found that couples were open in telling friends and relatives about the procedure. Couples were more conservative, however, in telling their children about amniocentesis and the implications of a positive diagnosis.     

The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality

A retrospective study to investigate the psychosocial sequelae of a second-trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described. After appropriate consent was obtained, 84 women and 68 spouses were visited 2 years after the event and asked to complete an extensive questionnaire. Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP. In the same period, there was increased marital disharmony in which 12 per cent of the couples separated for a while and one couple obtained a divorce. These problems could be attributed to a lack of synchrony in the grieving process. Confusing and conflicting feelings led to social isolation and lack of communication. Difficulties in coming to terms with the fetal loss were not found to be linked to the type of fetal abnormality or religious beliefs but were related to parental immaturity, inability to communicate needs, a deep-rooted lack of self-esteem before the pregnancy, lack of supporting relationships, and secondary infertility. Suggestions for improved management are given.     

Women's opinions on the offer and use of maternal serum screening

We studied the opinions and experiences concerning maternal serum screening of two groups of women: (A) women who were not eligible for prenatal diagnosis; and (B) women for whom prenatal diagnosis was available because of advanced maternal age, and who either underwent chorionic villus sampling or amniocentesis. Many of the women were in favour of the availability of serum screening and would apply for this test in a future pregnancy. This applied also to many respondents who had previously undergone prenatal diagnosis. Most of these women, however, did not intend to decline diagnostic amniocentesis if the screening results did not indicate an increased risk. The majority of the group of respondents of 36 years and over did not consider it acceptable if age indication was dropped altogether. A system based on serum screening will have other implications than a policy based on age indication, since specific individual risk assessment is perceived as being of more significance than a risk statistically derived from age alone. Serum screening is often seen as a means of reassurance and many women are not aware of the possible drawbacks. As technology becomes increasingly complicated, counselling has to be adjusted correspondingly. Further research is needed to establish whether and how distress can be minimized and well-considered individual choice can be achieved.     

Social and hospital costs of patients admitted to a university hospital in Brazil due to motorcycle crashes

Objective: This study aimed to investigate the social and hospital costs of patients treated at a public hospital who were motorcycle crash victims.

Method: This prospective study was on 68 motorcycle riders (drivers or passengers), who were followed up from hospital admission to 6 months after the crash. A questionnaire covering quantitative and qualitative questions was administered.

Results: Motorcycle crash victims were responsible for 12% of the institution's hospital admissions; 54.4% were young (18–28 years of age); 92.6% were the drivers; 91.2% were male; and 50% used their motorcycles as daily means of transportation. Six months afterward, 94.1% needed help from someone; 83.8% had changed their family dynamics; and 73.5% had not returned to their professional activities. Among the injuries, 94.7% had some type of fracture, of which 53.5% were exposed fractures; 35.3% presented temporary sequelae; and 32.4% presented permanent sequelae. They used the surgical center 2.53 times on average, with a mean hospital stay of 18 days. The per capita hospital cost of these victims’ treatment was US$17,481.50.

Conclusion: The social and hospital costs were high, relative to the characteristics of a public institution. Temporary or permanent disability caused changes to family dynamics, as shown by the high numbers of patients who were still away from their professional activities more than 6 months afterward.     

A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses

INTRODUCTION: Although Musculoskeletal Disorders (MSD) represent a common occupational problem, few epidemiological studies have investigated MSD risk factors among Asian nurses, particularly those in Japan. METHOD: We administered a modified Japanese-language version of the Standardized Nordic Questionnaire to 1,162 nurses from a large teaching hospital. MSD categories focused on the neck, shoulder, upper back, and lower back regions. RESULTS: A total of 844 completed questionnaires were analyzed (response rate: 72.6%). The 12-month period-prevalence of MSD at any body site was 85.5%. MSD was most commonly reported at the shoulder (71.9%), followed by the lower back (71.3%), neck (54.7%), and upper back (33.9%). Alcohol consumption, tobacco smoking, and having children were shown to be significant risk factors, with adjusted Odds Ratios of 1.87 (95%CI: 1.17-2.96), 2.45 (95%CI: 1.43-4.35), and 2.53 (95%CI: 1.32-4.91), respectively. Workplace risk factors included manually handling patients (OR: 2.07 to 11.97) and undertaking physically laborious work (OR: 2.09 to 2.76). Nurses reporting pre-menstrual tension were 1.66 and 1.94 times more likely to suffer from lower back and upper back MSD, respectively. High mental pressure was also identified as a significant risk factor for MSD of the neck (OR: 1.53) and shoulder (OR: 2.07). IMPACT ON INDUSTRY: The complex nature of MSD risk factors identified during this study suggests that remediation strategies which focus only on manual handling tasks would probably be suboptimal in reducing MSD among nurses. Therefore, to help alleviate their considerable MSD burden, a greater emphasis will need to be placed on job satisfaction, work organization, and occupational stress, as well as the more traditional hazard reduction strategies such as manual handling, work tasks, and other occupational factors.     

Users’ acceptance of private automated vehicles: A systematic review and meta-analysis

Introduction: This research systematically reviewed relevant studies on users’ acceptance of conditional (Level 3) to full (Level 5) automated vehicles when such vehicles are to be used privately (herein referred to as ‘private automated vehicles or private AVs). Method: The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and was undertaken in three databases: APA PsycINFO, Transport Research International Documentation, and Web of Science. Articles were required to focus on individuals’ acceptance of private SAE Level 3–5 AVs. Acceptance was defined as individuals’ attitudes towards or intentions and/or willingness to use AVs in the future. A total of 2,354 articles were identified in the database search. Thirty-five articles were included in the review, six of which included multiple studies and/or comparison groups. Results: Most studies (n = 31) applied self-reported measures to assess user acceptance together with a range of psychosocial factors predicting such acceptance. The meta-analytic correlations revealed that perceived behavioral control, perceived benefits/usefulness, perceived ease of use, and subjective/social norms had significant positive pooled relationships with attitudes and intentions. Trust and sensation seeking also had significant positive pooled correlations with intentions, while knowledge of AVs had a significant and negative pooled correlation with intentions. Age did not show any significant pooled relationship with attitudes, intentions, or willingness. Conclusions: The findings obtained from the systematic review and meta-analysis provide support for psychosocial models to aid understanding of users’ acceptance of private AVs. Practical applications: Examining acceptance of AVs after participants have experienced these vehicles on closed tracks or open roads would advance contemporary knowledge of users’ intentions to use these vehicles in the future. Further, experiencing these vehicles firsthand may also help with addressing any perceived barriers reducing acceptance of future use of private AVs.     

Environmental problem-solving: Psychosocial factors

This is a study of individual differences in environmental problem-solving, the probable roots of these differences, and their implications for the education of resource professionals. A group of student Resource Managers were required to elaborate their conception of a complex resource issue (Spruce Budworm management) and to generate some ideas on management policy. Of particular interest was the way in which subjects dealt with the psychosocial aspects of the problem. A structural and content analysis of responses indicated a predominance of relatively compartmentalized styles, a technological orientation, and a tendency to ignore psychosocial issues. A relationship between problem-solving behavior and personal (psychosocial) style was established which, in the context of other evidence, suggests that problem-solving behavior is influenced by more deep seated personality factors. The educational implication drawn was that problem-solving cannot be viewed simply as an intellectual-technical activity but one that involves, and requires the education of, the whole person.     

Psychosocial safety climate: Conceptual distinctiveness and effect on job demands and worker psychological health

Psychosocial safety climate is an emerging construct that refers to shared perceptions regarding policies, practices, and procedures for the protection of worker psychological health and safety. The purpose of the research was to: (1) demonstrate that psychosocial safety climate is a construct distinct from related climate measures (i.e., physical safety climate, team psychological safety, and perceived organizational support); and (2) test the proposition that organizational psychosocial safety climate determines work conditions (i.e., job demands) and subsequently worker psychological health. We used samples from two different cultures; an Australian sample (N = 126 workers in 16 teams within a primary health care organization) and a Malaysian sample (N = 180 workers in 31 teams from different organizations and diverse industries). In both samples confirmatory factor analysis verified that psychosocial safety climate is a construct distinct from related climate measures. Using hierarchical linear modeling, psychosocial safety climate was superior to other team level climate measures in its negative relationship to both job demands and psychological health problems. Results supported a mediation process, psychosocial safety climate → job demands → psychological health problems, corroborating psychosocial safety climate as a preeminent stress risk factor, and an efficient target for intervention. We found both physical and psychosocial safety climates were stronger in the Australian, compared with the Malaysian work context. Levels of psychosocial safety climate were significantly lower than those of physical safety climate in both countries indicating a ‘universal’ lack of attention to workplace psychological health.     

Parental reaction and adaptability to the prenatal diagnosis of fetal defect or genetic disease leading to pregnancy interruption

The objective of the study was to evaluate the psychological reaction of two groups of parents to a pregnancy termination after they had undergone a prenatal diagnostic procedure. The analysis involved interviews with a study group of 76 patients who were at risk of giving birth to a child with a genetic disease or defect and a comparison group of 124 who had a pregnancy termination after a major anomaly had been detected by routine ultrasound and who were not at known risk for a genetic disease. Only patients in the study group had received counselling before the prenatal diagnosis and were aware that the fetus could be affected. The overall reaction of the comparison group was one of shock, denial of fetal abnormality, and guilt over ‘abandoning the fetus’. A feeling of guilt was expressed by patients in the comparison group (73 per cent versus 29 per cent) in the period immediately following the interruption. One-third of patients in both groups felt obliged to undergo a therapeutic abortion. More patients in the study group than in the comparison group expressed the need to see a psychiatrist at the time of the study (19 per cent versus 7 per cent) and viewed future pregnancies as a replacement for the lost pregnancy (63 per cent versus 19 per cent). The recommendations of the study focus on information sessions to personnel, nursing support, analgesia during the expulsion period, an atmosphere of respect that should be present at the time that the fetus is viewed, the anticipation of mourning, and the long-term follow-up of the couple to ensure that counselling for future pregnancies and psychological support are provided when needed.