Sinking,swimming and sailing: experiences of job satisfaction and emotional exhaustion in child welfare employees

The authors conducted a mixed‐method study after a previous study of child welfare employees revealed a subgroup exhibiting surprisingly high levels of both emotional exhaustion (EE) and job satisfaction (JS). This subgroup included direct service workers, supervisors and managers. As these findings appeared to conflict with previous studies, we re‐reviewed the literature and undertook the current study to account for the co‐existence of EE and JS. We explored and compared this subgroup with two others: workers who found their work satisfying without experiencing high levels of EE and those whose high levels of EE were associated with low JS. Using a survey that included several standardized measures with 226 employees and semi‐structured interviews with a criteria‐based subsample of 25, we explored the role that personality, career expectations, coping styles, stage of life, education, gender and social networks play in outcomes for individual employees. Analyses of quantitative and qualitative data yielded a profile for each subgroup, offering insights into the subjective experiences of workers within individual, social and organizational contexts. These findings have implications for recruitment, training and support of child welfare workers.     

Integrated physical and mental health care at a nurse-managed clinic: report from the trenches

The Health and Wellness Center (HWC), located in Joliet, Illinois, is a nurse-managed universally accessible primary health care center funded by a grant from the Health Resources and Services Administration. The goals of the HWC are to improve access to quality primary health care services for all patients, including those who are uninsured and underserved, and to develop and implement a model of nurse-managed primary health care that integrates both physical and mental health assessment and treatment. After 5 years of developing and using this model, it is clear that integration requires strategic supports from the financial, political, and professional sectors to be considered a cost-effective model of health care delivery. Recommendations for policy and practice change are offered based on the author's experiences of providing integrated health care at the HWC and the health care industry's responses to uninsured or underinsured patients' needs.     

Child welfare workers who are exhausted yet satisfied with their jobs: how do they do it?

In response to a study of Canadian child welfare workers that unexpectedly found participants scoring high on a measure of emotional exhaustion (burnout) and, at the same time, high on overall job satisfaction, this paper reviews research that has investigated these constructs in the social work literature as well as in selected studies from sociology, social psychology, management and women’s studies. The review reveals that some previous studies also report the coexistence of high levels of emotional exhaustion and strong job satisfaction in child welfare and social worker samples. Several studies have suggested that individual characteristics, including finding reward in helping others, having a commitment to the mandate of child welfare and believing that one’s labour is ‘making a difference’, contribute to satisfaction with child welfare work in spite of work overload and emotional exhaustion. Attributions regarding causes of exhaustion, coping strategies and goal orientation may also attenuate the expected negative effects of emotional exhaustion. Considerable evidence supports the positive influence of variables organizational managers can control, including job autonomy, supportive supervisors, workload, promotional opportunities and perception of personal safety. The degree to which this phenomenon is associated with female socialization and the ‘ethic of care’ underlying social work is discussed. Implications for child welfare research, practice and policy are offered.     

Factors effecting the model performance measures area under the ROC curve,net reclassification improvement and integrated discrimination improvement

ABSTRACT

The aim of this study is to investigate the impact of correlation structure, prevalence and effect size on the risk prediction model by using the change in the area under the receiver operating characteristic curve (ΔAUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). In simulation study, the dataset is generated under different correlation structures, prevalences and effect sizes. We verify the simulation results with the real-data application. In conclusion, the correlation structure between the variables should be taken into account while composing a multivariable model. Negative correlation structure between independent variables is more beneficial while constructing a model.     

Community need for university-based mental health services: identifying the top 5

The purpose of this study was to determine the community need for mental health and health promotion services provided by advanced practice nursing faculty at a small university in the midwestern United States. Fifty participants from a three-county service area were selected to complete a needs assessment survey. Survey results indicated strong community need for primary mental health services for low-income residents, older adults, pregnant women, and families with children. Mental health services (particularly for depression), health promotion, wellness information, and primary mental health care were among the leading areas of need. In addition, low-cost mental health services were identified as the most significant need, which was magnified in the underserved, Hispanic population.     

Potential effects of antidepressant agents on the growth and development of children and adolescents

The regulatory bodies of both the United States and United Kingdom have issued cautionary statements about prescribing antidepressant medications to treat major depressive disorder (MDD) in children younger than age 18. Despite these cautions, antidepressant agents, particularly SSRIs and serotonin activators, are regularly used to treat MDD in this age group, and increasingly so in very young children. This article considers the possible effects of antidepressant agents on the growth and development of children younger than age 18 and provides recommendations for the use and careful monitoring of these medications, including screening for physiological effects, selfinjurious behavior, and suicidal ideation. Guidelines for use of antidepressant agents with these populations include incorporating medications into comprehensive, holistic treatment, assessing for onset of severe akathesia as a marker of increased risk for self-harm, and advocating for more clinical trials of these medications in different childhood age groupings.