Self-awareness and quality of relationships after acquired brain injury: Systematic review without meta-analysis (SWiM).

BACKGROUND: Relational aspects of self-awareness following Acquired Brain Injury (ABI) are increasingly being recognized. However, research underpinning the nature of the association between self-awareness and quality of relationships has yet to be synthesized. METHOD: Searches, which were completed between February 2022 and February 2023, consisted of combining terms related to ABI, self-awareness, and quality of relationships. Data were analyzed using the Synthesis Without Meta-Analysis (SWiM) approach. RESULTS: Associations between self-awareness and relationship quality across eight studies identified for this review differed in direction and significance. A more consistent pattern emerged, however, when studies assessing the quality of specific types of relationships i.e., spousal (N = 1) and therapeutic (N = 3), were compared to studies assessing the quality of a person's broader network of relationships (N = 4). In particular, good awareness was positively associated with the quality of specific relationships (r = 0.66) whereas it was negatively associated with the quality of a person's broader network of relationships (r = -0.35). CONCLUSION: Results are discussed with consideration given to measures assessing the quality of specific relationships. In particular, such measures may tap into important patterns of interaction between two individuals, such as those related to attunement or communication, which may be valuable preconditions for improving awareness.

Consultant psychiatrists' perspectives on occupational stress in child and adolescent mental health services (CAMHS).

BACKGROUND: Occupational stress is increasingly recognised as key factor contributing to service quality, safety, and worker wellbeing, with clinician providers most at high risk. OBJECTIVES: To explore work-related stressors among consultant child and adolescent psychiatrists working in CAMHS. METHODS: Fifty-two consultants completed an online questionnaire with free-text entries describing factors contributing to occupational stress in CAMHS in Ireland. RESULTS: Content analysis indicated that consultants' perception of working conditions revolved around six factors: organisational factors, human resources, adequacy of services, professional relationships, socio-political factors, and public perception. Both adequate skilled staff and funding, identified by 54% and 34% of respondents, were viewed as essential factors associated with occupational wellbeing, the most often cited concern (raised by 56% consultants) which contributed to occupational stress was of widespread public misunderstanding of CAMHS' remit. CONCLUSIONS: Given decades of under-resourcing, ensuring adequate levels and expertise of staffing in the post-COVID-19 era must become a reality. However, less obvious and equally important is that of correcting any public misperceptions regarding CAMHS "core" business to ensure that available scarce resources are utilised most effectively, and that staff stress levels are minimised. To achieve this, active engagement between service users, providers and planners must be undertaken.