Multiple symptom illness in New Zealand contemporary veterans.

AIMS: To describe patterns of multiple symptom illness (MSI) in New Zealand military veterans, defined as clusters of "medically unexplained" symptoms not fitting within a specific medical diagnosis, and to investigate the relationship with exposure to traumatic events. METHODS: We designed an online cross-sectional survey. The participants of interest were the 3,874 currently serving veterans who had been deployed to a conflict zone, but all veterans were eligible to participate. A modified Centers for Disease Control (CDC) 54-item symptom checklist identified MSI, the post-traumatic checklist-military version (PCL-M) identified symptoms of post-traumatic stress disorder (PTSD) and the brief trauma scale assessed "war zone" service. Factor analysis was used to identify unobserved "latent factors" in the data, factor severity scores and the number of symptoms being calculated for each respondent. RESULTS: The CDC questionnaire was completed by 1,819 veterans, with 1,672 completing the PCL-M. The factor analysis revealed three factors, explaining 86% of the variation in the data. Factor 1 symptoms were of an arthro-neuromuscular nature, Factor 2 cognitive and Factor 3 psycho-physiological. Discriminant function analysis showed that the factors could discriminate between those with and without PTSD but could not discriminate between those who did and did not serve in a war zone. CONCLUSIONS: In veterans, multiple symptoms including pain, sleep disorders, cognitive problems and avoidance, especially when severe, may be worthy of further investigation by health professionals because of the possible association with PTSD.

Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV.

Receiving a diagnosis of HIV can be challenging. People with HIV (PWH) can experience high levels of distress, as well as some positive psychological changes associated with post-traumatic growth. However, the mechanisms which underlying the association of a highly stressful event (i.e., being diagnosed with HIV) and posttraumatic growth (PTG) and posttraumatic stress symptoms (PTSS) are under-explored, and this is the focus of the study. Cross-sectional survey data were provided by 77 PWH living in New Zealand. An analysis examined the roles of deliberate rumination and coping strategies as serial mediators of the associations between event centrality and PTG and PTSSs. The relationships between event centrality and PTG and PTSSs were found to be sequentially mediated by deliberate rumination and avoidance coping, but not by deliberate rumination and active coping. Further analyses explored active coping and deliberate rumination as parallel mediators, with avoidance coping as a subsequent mediator, between event centrality and PTG and PTSSs. However, these analyses were not supported. The findings indicate that the more participants appraised the HIV diagnosis as central, the greater PTG they perceived; however, the more they deliberately ruminated on it, and the more avoidance coping they adopted, the less PTG and greater PTSSs they perceived. Future studies need to explore the relationships of event centrality and coping and their associations with PTG and PTSSs.

Factors associated with self-reported health among New Zealand military veterans: a cross-sectional study.

OBJECTIVE: To identify factors associated with better or poorer self-reported health status in New Zealand military Veterans. DESIGN: A cross-sectional survey. PARTICIPANTS: The participants of interest were the 3874 currently serving Veterans who had been deployed to a conflict zone, but all Veterans were eligible to participate. STUDY VARIABLES: The EQ-5D-5L, asking about problems across five dimensions (mobility, self-care, usual activities, pain or discomfort and anxiety or depression), with five levels of severity (eg, no, slight, moderate, severe or extreme problems), also containing a Visual Analogue Scale (EQ-VAS) to self-assess health state, scaled from 0 (worst) to 100 (best) imagined health.Hypothetical relationships with better health were positive social support, sleep and psychological flexibility; with poorer health, post-traumatic stress, exposure to psychological trauma, distress and hazardous drinking. RESULTS: The EQ5-D-5L was completed by 1767 Veterans, 1009 serving, a response rate of 26% from that group, 1767 completing the EQ5-D, 1458 who had deployed, 288 who had not and the 21 who did not provide deployment data. Of these, 247 were not used in the analysis due to missing values in one or more variables, leaving 1520 for analysis.A significantly higher proportion of Veterans reported 'any problems' rather than 'no problems' with four EQ-5D dimensions: mobility, self-care, usual activities and pain or discomfort, but no difference in anxiety or depression. Age, length of service, deployment, psychological flexibility and better sleep quality were associated with higher EQ-VAS scores; distress with lower EQ-VAS scores. CONCLUSION: In this sample of New Zealand Veterans, psychological flexibility and good sleep are associated with better self-rated health, and distress and poor sleep with diminished health. These factors might be used as sentinel health indicators in assessing Veteran health status, and cognitive-behavioural therapy encompassing these domains may be useful in improving the health of New Zealand Veterans.

Using the critical incident technique to determine veterinary professional competencies important for enhancing the veterinarian-client interaction.

BACKGROUND: While previous research has examined components of professionalism that veterinary employers and clients expect in veterinarians, little attention has been paid to practising clinical veterinarians' opinions on important professional competencies that help to enhance the veterinarian-client relationship. This study used a phenomenological approach and critical incident technique to gather the narratives of practising veterinarians in New Zealand about positive and negative veterinarian-client interactions. The intention was to identify the underlying principles of professionalism that resulted in the positive/negative outcomes of those interactions. METHODS: Twenty-two practising veterinarians were interviewed, and each respondent was asked to recollect and narrate a significant positive and a significant negative critical incident in their career that involved a veterinarian-client interaction within a clinical setting. The professional competencies that the veterinarian believed contributed to a successful or an unsuccessful outcome were elucidated using thematic analysis. RESULTS: Thematic analysis of the critical incident narratives revealed four major themes under the overarching theme of 'building a relationship between the veterinarian and the client': 'accountability and integrity', 'effective communication skills', 'personal wellbeing' and 'quality of care'. CONCLUSION: The description of the important professional competencies that helped to enhance the veterinarian-client relationship provides a reference for the practising profession to help improve the likelihood of veterinarians enjoying satisfied and successful careers.

Maintaining Balance for Christian Counsellors When Work is a Calling.

This study examined how Christian Counsellors with a calling manage their work-non-work boundaries. A calling offers satisfaction, meaning and purpose but can lead to overwork. Using a qualitative approach with seven experienced counsellors, we identified demands that a calling can create, resources that counsellors use to manage these demands, and strategies for maintaining a balance between work and non-work. Maintaining balance required deliberate attention and giving oneself permission, and strategies were learned over time.

Risk and protective factors for post-traumatic stress among New Zealand military personnel: A cross sectional study.

BACKGROUND: Post-traumatic stress (PTS) is prevalent among military personnel. Knowledge of the risk and protective factors associated with PTS in this population may assist with identifying personnel who would benefit from increased or targeted support. AIMS: To examine factors associated with PTS among New Zealand military personnel. METHODS: For this cross-sectional study, currently serving and retired military personnel were invited to complete a questionnaire. The questionnaire included a measure of PTS (the Military Post-traumatic Stress Disorder Checklist; PCL-M), where scores ≥30 indicate the experience of significant PTS symptoms and scores ≥45 indicate a presumptive clinical diagnosis of post-traumatic stress. Potential risk and protective factors associated with PTS were examined using logistic regression modelling. RESULTS: 1817 military personnel completed the questionnaire. PCL-M scores were ≥30 for 549 (30%) participants and ≥45 for 179 (10%) participants. Factors associated with higher PCL-M scores were trauma exposure, older age, male sex, and Maori ethnicity. Factors associated with lower PCL-M scores were greater length of service, psychological flexibility, and better quality sleep. CONCLUSIONS: PTS was found to be prevalent among New Zealand military personnel. The experience of trauma was strongly associated with PTS. However, factors such as psychological flexibility (the ability to adapt to changes in circumstances) and good sleep were protective, suggesting that these factors could be key targets for interventions designed to reduce PTS among military personnel in New Zealand.

Stressors and Protective Factors among Veterinary Students in New Zealand.

A study was undertaken to investigate the stressors faced by veterinary students and the protective factors against those stressors. The study was conducted as a workshop during which students collaborated with their peers through an iterative process to identify personal and external factors that contributed to or protected against stress as a veterinary student, and then to suggest strategies that would protect their mental health and well-being. Workload and assessment were the most commonly reported stressors. Students reported a variety of effective coping strategies and avoidance behaviors, although most of the suggested solutions revolved around organizational change within the university. Students also recognized that their own perspectives, traits, and behavior could enhance their student experience or increase their perceived levels of stress. While it is important that educators monitor student feedback about the program and make changes when required, students must recognize that stress is an expected component of life and develop effective coping strategies. They should develop a balanced view of the positive and negative aspects of the student experience and, ultimately, of working as a veterinary professional.

Predictors of Workplace Bullying and Cyber-Bullying in New Zealand.

BACKGROUND: The negative effects of in-person workplace bullying (WB) are well established. Less is known about cyber-bullying (CB), in which negative behaviours are mediated by technology. Drawing on the conservation of resources theory, the current research examined how individual and organisational factors were related to WB and CB at two time points three months apart. METHODS: Data were collected by means of an online self-report survey. Eight hundred and twenty-six respondents (58% female, 42% male) provided data at both time points. RESULTS: One hundred and twenty-three (15%) of participants had been bullied and 23 (2.8%) of participants had been cyber-bullied within the last six months. Women reported more WB, but not more CB, than men. Worse physical health, higher strain, more destructive leadership, more team conflict and less effective organisational strategies were associated with more WB. Managerial employees experienced more CB than non-managerial employees. Poor physical health, less organisational support and less effective organisational strategies were associated with more CB. CONCLUSION: Rates of CB were lower than those of WB, and very few participants reported experiencing CB without also experiencing WB. Both forms of bullying were associated with poorer work environments, indicating that, where bullying is occurring, the focus should be on organisational systems and processes.

Optimism, self-esteem, and social support as mediators of the relationships among workload, stress, and well-being in veterinary students.

Optimism, self-esteem, satisfaction with social support, and coping strategies were examined in relation to study-related subjective workload, stress, and life satisfaction. Questionnaires were distributed to students in the second, third, and fourth years of the five-year BVSc program at Massey University. One hundred fifty usable responses were received. Most respondents were female. Students with more optimism and self-esteem were less stressed than those who were more pessimistic or lower in self-esteem. Students who reported having heavy subjective workloads were more stressed, whereas students with higher self-esteem experienced more well-being. Men and women did not differ on any of the study variables, and there were no differences between students in different years of study. Recommendations include retaining initiatives to build well-being that are already in place. Support resources exist within the university, but students are often reluctant to seek help, so staff need to continue to identify students in need of additional help who might benefit from referral to a health practitioner. Where practicable, support service providers may be able to contribute actively to teaching. As well as helping students build effective social and coping strategies, this approach will provide students with additional information about the services that are available. Students may not see workshops on interpersonal skills or stress management as relevant unless they are linked to their immediate concerns.