Theories of work-related stress

There are many theories of work stress and general stress theories. I have been trying to get my head around just a few, and so I thought I would share them here for future reference on work stress theory. Perhaps these will help you in your job and career?…or perhaps help you as a leader or manager to support your employees. In any case, please share your top workplace tips for working productively…. I would love to see these theories used to make your workplace a happier one ❣

Transactional theories of work-related stress

The most commonly used transactional theory suggests that stress is the direct product of a transaction between an individual and their environment which may tax their resources and thus threaten their wellbeing (Lazarus 1986, Lazarus and Folkman 1987). Yet a more recent version of this theoretical model suggests that it is the appraisal of this transaction that offers a causal pathway that may better express the nature of the underlying psychological and physiological mechanisms which underpin the overall process and experience of stress (Lazarus et al. 2001).

In this sense, any aspect of the work environment can be perceived as a stressor by the appraising individual. Yet the individual appraisal of demands and capabilities can be influenced by a number of factors, including personality, situational demands, coping skills, pervious experiences, time lapse, and any current stress state already experienced (Prem et al. 2017). One multidisciplinary review provides a broad consensus that stressors really only exert their effects through how an individual perceives and evaluates them (Ganster and Rosen 2013).

As such, the experience of workplace stress according to the transactional theory, is associated with exposure to particular workplace scenarios, and a person’s appraisal of a difficulty in coping. This experience is usually accompanied by attempts to cope with the underlying problem and by changes in psychological functioning, behaviour and function (Aspinwall and Taylor 1997, Guppy and Weatherstone 1997). In order to recognise these external and internal elements of workplace stress, Cox (1993) outlined another modified transactional theory. This theory represented the sources of the stressor, the perceptions of those stressors in relation to his/her ability to cope, the psychological and physiological changes associated with the recognition of stress arising, including perceived ability to cope, the consequences of coping, and all general feedback that occurs during this process.

Yet, as with all transactional theories of work-related stress, it is the concept of appraisal that has been criticised for being too simplistic and for not always considering an individuals’ history, future, goals and identities (Harris, Daniels and Briner 2004). Additionally, in his later works, Lazarus stressed that his transactional theories of stress failed to acknowledge the outcomes associated with coping in specific social contexts and during interpersonal interactions (Lazarus 2006a).

Interactional theories of stress

Interactional models emphasise the interaction of the environmental stimulus and the associated individual responses as a foundation of stress (Lazarus and Launier 1978). For instance, the Effort-Reward Imbalance (ERI) theory posits that effort at work is spent as part of a psychological contract, based on the norm of social reciprocity, where effort at work is remunerated with rewards and opportunities (Siegrist 1996). Here, it is the imbalance in this contract that can result in stress or distress. Yet in contrast to transactional theories of stress, this imbalance may not necessarily be subject to any appraisal, as the stressor may be an everyday constant occurrence.

The Person-Environment Fit theory is one of the earliest interactional theories of work-related psychological distress, suggesting that work-related stress arises due to a lack of fit between the individual’s skills, resources and abilities, and the demands of the work environment (Caplan 1987, French, Caplan and Van Harrison 1982). Here, interactions may occur between objective realities and subjective perceptions and between environmental variables and individual variables. In this case, it has been argued that stress can occur when there is a lack of fit between either the degree to which an employee’s attitudes and abilities meet the demands of the job or the extent to which the job environment meets the workers’ needs (French, Rodgers and Cobb 1974).

Yet the Job Demand-Control (JDC) theory supposes that work-related stress can result from the interaction between several psychological job demands relating to workload such as cognitive and emotional demands, interpersonal conflict, job control relating to decision authority (agency to make work-related decisions) and skill discretion (breadth of work-related skills used) (Karasek Jr 1979). The JDC model is concerned with predicting outcomes of psychological strain, and workers who experience high demands paired with low control are more likely to experience work-related psychological distress and strain (Beehr et al. 2001).

However, the original concept of job demand and control was expanded in 1988 to become the Demand Control Support (DCS) theory, describing how social support may also act as a buffer in high demand situations (Johnson and Hall 1988). As social support as a coping mechanism can moderate the negative impacts of job stress, another later version of the JDC theory was developed to suggest that it is those individuals who experience high demands paired with low control and poor support who are most at risk of work-related psychological distress (Van der Doef and Maes 1999). These later versions of the JDC theory were developed, as earlier versions were considered to be too simplistic and ignorant of the moderating effects of social support upon the main variables. However, the perceived job demands and decision autonomy outlined in the JDC theory have been acknowledged as being key factors in determining the effects and outcomes of work on employees’ health (Cox, Griffiths and Rial-González 2000).

Allostatic Load Model of the Stress Process

Early psychological models of stress may be suitable for describing how environmental events generate stressful appraisals for individuals. Yet another theoretical model, devised via a multidisciplinary review of Work Stress and Employee Health identifies the intervening physiological processes that link stress exposure to health outcomes (Ganster and Rosen 2013). This Allostatic load model of the stress process builds on earlier cognitive appraisal models of stress and the work of Seyle (Seyle 1983) to describe the developments of allostasis in the process of stress. Allostasis is the process of adjustment for an individual’s bodily systems that serve to cope with real, illusory, or anticipated challenges to homeostatic (stable) bodily systems. This model proposes that continued overstimulation leads to dysregulation, and then to poor tertiary health outcomes. However, the sequence of this model has proven difficult to validate empirically. Additionally, this research is concerned with the psychological rather than the physical outcomes of work-related stress.

Allostatic Load Model of the Stress Process

Another model of work stress has been developed in response to the Health and Safety Executive’s (HSE) advice for tackling work-related stress and stress risk assessments (Cousins* et al. 2004, HSE 2001). This model, developed by Cooper and Palmer underpins the theory and practice advocated by the HSE (Palmer, Cooper and Thomas 2003). This model explores the stress-related ‘hazards’ or sources of stress facing employees in the workplace. The acute symptoms of stress are also set out, and these symptoms relate to the organisation, as well as the individual. The negative outcomes are outlined for both an individual’s physical and mental health, however beyond this, outcomes are presented as financial losses for both the individual and the organisation.

Cooper and Palmer’s model of work stress

Another model of work stress developed by Cooper and Marshall sets out the sources of stress at work, factors which determine how an individual may respond to such stressors, go on to experience acute symptoms, and eventually go on to reach the chronic disease phase affecting one’s physical and/or mental health (Cooper and Marshall 1976). This model is concerned with the long-term consequences of work-related stress, as well as the acute symptoms of, sources of, and the individual characteristics associated with work-related stress.

Cooper and Marshall’s model of work-related stress

The Conservation of Resources (COR) Model

The above models all outline potential stressors or hazards relating to the workplace. Yet work-related stressors cannot always remain separate from general life stressors. Illustrating this, the Conservation of Resources (COR) Model, an integrated model of stress looks to encompass several stress theories relating to work, life and family (Hobfoll 1989). According to this theory, stress occurs when there is a loss, or threat of loss of resources. This is because individuals ultimately seek to obtain and maintain their resources, loosely described by the authors as objects, states, conditions, and other things that people value. Some of these stressors may relate to resources such as one’s home, clothing, self-esteem, relationship status, time and/or finances. In this context, work/relationship conflicts may result in stress, because resources such as time and energy are lost in the process of managing both roles effectively (Hobfoll 2001). This may in turn result in job dissatisfaction and anxiety, although other resources such as self-esteem may moderate such conflicts and stress (Hobfoll 2002). Such a model would be useful in the development of resource-focused interventions which aim to make changes in employees’ resources and subsequent outcomes (Halbesleben et al. 2014).

Understanding the Role of Resources in Conservation of Resources Theory

Basic Tenets of Conservation of Resources Theory

Principle 1 Resource loss is more salient than resource gain.

Principle 2 People must invest resources to gain resources and protect themselves from losing resources or to recover from resource loss.

Corollary 1 Individuals with more resources are better positioned for resource gains. Individuals with fewer resources are more likely to experience resource losses.

Corollary 2 Initial resource losses lead to future resource losses.

Corollary 3 Initial resource gains lead to future resource gains.

Corollary 4 Lack of resources leads to defensive attempts to conserve remaining resources.

(Halbesleben et al. 2014)

---

A Sample of Psychological Resources

Objects/ Conditions: Job Security Constructive Rewards, Reinforcement Contingencies, Inducements

Constructive: Autonomy, Decision Authority, Skill Discretion, Control Participation in Decision Making Opportunities for Professional Development Resilience

Social Support: (supervisor, coworker, organization, spousal, customer, etc.)

Energies: Time Away from Work, Recovery Experiences

Key: Self-Esteem, Self-Efficacy, Locus of Control, Core Self-Evaluation Conscientiousness, Emotional Stability

Macro: Family-Friendly Workplace Policies

(Halbesleben et al. 2014)

The Revised Transactional Model of Occupational Stress and Coping

One model combines both Lazarus’ transactional theory of stress and coping (Lazarus 1986) and Karasek’s JDC theory (Karasek Jr 1979) is the revised transactional model of occupational stress and coping presented by Goh and colleagues (Goh, Sawang and Oei 2010). This model demonstrates how individuals appraise, cope with and experience occupational stress. This process involves an individual firstly encountering a potential stressor and appraising their experience of it. Subsequently, this model demonstrates how the individual then goes on to a secondary phase of risk appraisal, where coping strategies are initiated in response to the individuals experience of the initial stressor. The model also outlines how immediate outcomes and outcomes after 2 to 4 weeks are involved throughout this process of stress and coping.

In this case, the model demonstrates a direct link between the primary appraisal of the stressor and primary stress outcomes, and also a direct link between the primary and secondary stress outcomes. This process demonstrates how the appraisals of stressful events can significantly impact on an individual’s experience of stress and its associated outcomes. This model also provides support to the effect of emotions on a person’s choice of coping strategy (Ficková 2002). Notably, this model posits that the experience of stress, coping and the development of negative outcomes can occur at different points in the process of occupational stress and coping, and can be triggered by both psychological and behavioural coping factors.

This model is my personal favourite as it explains the process and experience of stress and appraisal, along with the outcomes of stress. Here, we can also see how each component relates to one another. These are just a few of the stress models out there. Some can be applied to life, and some to areas of the workplace. Are the two ever really separate?…If you have any more you would like me to add then please let me know. I hope these few give us all something to think about in the field of work-related stress research and practice.

Until next time, take care of yourselves, and each other ❤💜💙

References

Aspinwall, L. G. and Taylor, S. E. (1997) ‘A Stitch in Time: Self-Regulation and Proactive Coping.’. Psychological Bulletin 121 (3), 417

Beehr, T. A., Glaser, K. M., Canali, K. G., and Wallwey, D. A. (2001) ‘Back to Basics: Re-Examination of Demand-Control Theory of Occupational Stress’. Work & Stress 15 (2), 115-130

Caplan, R. D. (1987) ‘Person-Environment Fit Theory and Organizations: Commensurate Dimensions, Time Perspectives, and Mechanisms’. Journal of Vocational Behavior 31 (3), 248-267

Cooper, C. L. and Marshall, J. (1976) ‘Occupational Sources of Stress: A Review of the Literature Relating to Coronary Heart Disease and Mental Ill Health’. Journal of Occupational Psychology 49 (1), 11-28

Cousins*, R., Mackay, C. J., Clarke, S. D., Kelly, C., Kelly, P. J., and McCaig, R. H. (2004) ‘‘Management Standards’ Work-Related Stress in the UK: Practical Development’. Work & Stress 18 (2), 113-136

Cox, T., Griffiths, A., and Rial-González, E. (2000) ‘Research on Work-Related Stress: European Agency for Safety and Health at Work’. Luxembourg: Office for Official Publications of the European Communities

Cox, T. (1993) Stress Research and Stress Management: Putting Theory to Work.: HSE Books Sudbury

Ficková, E. (2002) ‘Impact of Negative Emotionality on Coping with Stress in Adolescents.’. Studia Psychologica

French, J. R., Caplan, R. D., and Van Harrison, R. (1982) The Mechanisms of Job Stress and Strain.: Chichester [Sussex]; New York: J. Wiley

French, J. R., Rodgers, W., and Cobb, S. (1974) ‘Adjustment as Person-Environment Fit’. Coping and Adaptation, 316-333

Ganster, D. C. and Rosen, C. C. (2013) ‘Work Stress and Employee Health A Multidisciplinary Review’. Journal of Management, 0149206313475815

Goh, Y. W., Sawang, S., and Oei, T. P. (2010) ‘The Revised Transactional Model (RTM) of Occupational Stress and Coping: An Improved Process Approach’. The Australian and New Zealand Journal of Organisational Psychology 3, 13-20

Guppy, A. and Weatherstone, L. (1997) ‘Coping Strategies, Dysfunctional Attitudes and Psychological Well-being in White Collar Public Sector Employees’. Work & Stress 11 (1), 58-67

Halbesleben, J. R., Neveu, J., Paustian-Underdahl, S. C., and Westman, M. (2014) ‘Getting to the “COR” Understanding the Role of Resources in Conservation of Resources Theory’. Journal of Management 40 (5), 1334-1364

Harris, C., Daniels, K., and Briner, R. B. (2004) ‘How do Work Stress and Coping Work? Toward a Fundamental Theoretical Reappraisal’. British Journal of Guidance & Counselling 32 (2), 223-234

Hobfoll, S. E. (2002) ‘Social and Psychological Resources and Adaptation.’. Review of General Psychology 6 (4), 307

Hobfoll, S. E. (2001) ‘The Influence of Culture, Community, and the Nested‐self in the Stress Process: Advancing Conservation of Resources Theory’. Applied Psychology 50 (3), 337-421

Hobfoll, S. E. (1989) ‘Conservation of Resources: A New Attempt at Conceptualizing Stress.’. American Psychologist 44 (3), 513

HSE (2001) ‘Tackling Work-Related Stress: A Managers’ Guide to Improving and Maintaining Employee Health and Well-Being’

Johnson, J. V. and Hall, E. M. (1988) ‘Job Strain, Work Place Social Support, and Cardiovascular Disease: A Cross-Sectional Study of a Random Sample of the Swedish Working Population’. American Journal of Public Health 78 (10), 1336-1342

Karasek Jr, R. A. (1979) ‘Job Demands, Job Decision Latitude, and Mental Strain: Implications for Job Redesign’. Administrative Science Quarterly, 285-308

Lazarus, R. S. (2006) ‘Emotions and Interpersonal Relationships: Toward a Person‐centered Conceptualization of Emotions and Coping’. Journal of Personality 74 (1), 9-46

Lazarus, R. S., Cohen-Charash, Y., Payne, R., and Cooper, C. (2001) ‘Discrete Emotions in Organizational Life’. Emotions at Work: Theory, Research and Applications for Management 4584

Lazarus, R. S. and Folkman, S. (1987) ‘Transactional Theory and Research on Emotions and Coping’. European Journal of Personality 1 (3), 141-169

Lazarus, R. S. (1986) ‘Folkman. S.(1984) Stress, Appraisal, and Coping’. New York 1

Lazarus, R. S. and Launier, R. (1978) ‘Stress-Related Transactions between Person and Environment’. in Perspectives in Interactional Psychology. ed. by Anon: Springer, 287-327

Palmer, S., Cooper, C., and Thomas, K. (2003) ‘Revised Model of Organisational Stress for use within Stress Prevention/Management and Wellbeing programmes—Brief Update’. International Journal of Health Promotion and Education 41 (2), 57-58

Prem, R., Ohly, S., Kubicek, B., and Korunka, C. (2017) ‘Thriving on Challenge Stressors? Exploring Time Pressure and Learning Demands as Antecedents of Thriving at Work’. Journal of Organizational Behavior 38 (1), 108-123

Seyle, H. (1983) ‘The Stress Concept: Past, Present and Future’. Cooper, CL, 1-20

Siegrist, J. (1996) ‘Adverse Health Effects of High-Effort/Low-Reward Conditions.’. Journal of Occupational Health Psychology 1 (1), 27

Van der Doef, M. and Maes, S. (1999) ‘The Job Demand-Control (-Support) Model and Psychological Well-being: A Review of 20 Years of Empirical Research’. Work & Stress 13 (2), 87-114

Advertisements

Being Examined: Tips for your viva

This wisdom comes from the 10th annual ‘Life beyond the PhD’ conference (#CLPhD) hosted at Cumberland Lodge. I was lucky enough to win a scholarship to attend and gather a multitude of hints and tips for my academic career…Now I plan to share them here for those who wish to read them…I have also experienced a viva voce examination…so these viva tips also come from me too.

What is a viva voce?

In a nutshell it is the oral assessment of your PhD Thesis.

So your first viva tip would be….know how a PhD/doctorate/thesis is defined!…Here is a sample of some of the key phrases and expressions relating to ‘doctorateness’:

• worthy of publication either in full or abridged form;

• presents a thesis embodying the results of the research;

• original work which forms an addition to knowledge;

• makes a distinct contribution to the knowledge of the subject and offers evidence of originality shown by the discovery of new facts and/or the exercise of independent critical power;

• shows evidence of systematic study and the ability to relate the results of such study to the general body of knowledge in the subject;

• the thesis should be a demonstrably coherent body of work;

• shows evidence of adequate industry and application;

• understands the relationship of the special theme of the thesis to a wider field of knowledge;

• represents a significant contribution to learning, for example, through the discovery of new knowledge, the connection of previously unrelated facts, the development of new theory or the revision of older views;

• provides originality and independent critical ability and must contain matter suitable for publication;

• adequate knowledge of the field of study;

• competence in appropriate methods of performance and recording of research;

• ability in style and presentation;

• the dissertation is clearly written;

• takes account of previously published work on the subject.

Source: Searching for ‘Doctorateness’.

The problem is…..that a range of literature has pointed out the variability in examination processes across universities, individual examiners, disciplines. Yup, this can be a fairly subjective process. So it is your job within your thesis and within your viva to make your case and convince your examiners that your work is indeed doctoral work.

Within Wellington’s (2013) framework for assessing ‘Doctorateness’, there are seven categories listed for which doctorates may contribute original knowledge. Therefore, in order for ‘Doctorateness’ to be unequivocally established for your thesis, it is important to apply the categories of this framework to each component of your research. The table below was added to my own thesis in order to prove how and why my work was indeed doctoral work.

Category number	Category description	Evidence
1	Building new knowledge, e.g. by extending previous work or ‘putting a new brick in the wall’.	The Delphi method has been used previously to assess the workplace needs of midwifery populations (Hauck, Bayes and Robertson 2012). Yet the views and opinions of an expert panel about the design and development of an online intervention designed to support midwives in work-related psychological distress have been gathered and presented for the first time within this thesis.
2	Using original processes or approaches, e.g. applying new methods or techniques to an existing area of study.	As the Delphi study presented within this thesis was a modified one, where the identity of experts remained unknown to the researcher, and free text response options accompanied each statement, it has also applied somewhat original processes and approaches to an existing area of study.
3	Creating new syntheses, e.g. connecting previous studies or linking existing theories or previous thinkers.	Chapter one presents the first narrative review to integrate studies of midwives in work-related psychological distress (Pezaro et al. 2015). This original knowledge demonstrates how midwives working in rural, poorly resourced areas who experience neonatal and maternal death more frequently can experience death anxieties, where midwives working in urban and well-resourced areas do not. This creation of new syntheses connects previous studies and existing theories together to form new knowledge.   The mixed-methods systematic review presented within chapter three is the first of its kind to collate and present the current and available evidence in relation to existing interventions targeted to support midwives in work-related psychological distress (Pezaro, Clyne and Fulton 2017).
4	Exploring new implications, for either practitioners, policy makers, or theory and theorists.	Chapter two makes an original contribution to ethical decision making, and may be extrapolated and applied to other healthcare professions who may also now consider the provision of confidential support online.
5	Revisiting a recurrent issue or debate, e.g. by offering new evidence, new thinking, or new theory.	The original research presented in chapter two contributes to an ongoing academic dialogue in relation to ethical decision making.
6	Replicating or reproducing earlier work, e.g. from a different place or time, or with a different sample.	The mixed-methods systematic review, presented in chapter three somewhat replicates earlier work from a different place, time, and with a different inclusion sample (Shaw, Downe and Kingdon 2015).
7	Presenting research in a novel way, e.g. new ways of writing, presenting, disseminating.	The results of this research have been disseminated via popular media publications throughout. A further summary of this research is planned for publication. Furthermore, this research has also informed new guidance, published by the Royal College of Midwives, who also present the findings of this research in a new way. This new guidance is intended to guide heads of midwifery to support midwives experiencing work-related stress. Evidence of this can be found in Appendix 15.

Adapting this table to fit your own work should assist you in realizing how your own research can be argued to be doctoral work, both in your thesis and in your viva. Once this argument is clear in your own mind, your confidence should rise and enable you to direct your thoughts towards a really positive goal. Getting your PhD!…and not just because you want it, but because you are worthy of it! You have worked really hard for this opportunity, and seeing your work match up to this framework can really help you to visualize your successes. But now there are other things you can do to help you prepare…

Viva tips

Just because you have submitted your thesis, this does not mean you can sit back a relax until your viva day. Following a short break, and with fresh eyes, you should be revisiting your thesis and getting to know it really well. Also, be sure to keep up to date with any new research arising in your field, it may well be discussed in your viva!

Get to know your university’s policies and procedures. This will help you to prepare for how the viva voce may play out on the day. As your examiners will be drawing upon their own expertise, make sure that you also have a broad knowledge of their work!

Pick your battles. Fighting every point can be really jarring for everyone in the room, and your examiners need to see that you can accept constructive criticism and reflect. Decide what you will really defend, and what you are willing to let go of. This means that you will need to anticipate what your examiners may ask you. Here, it is a good idea to mock up some practice questions. Try defending the questions you fear most. This will help you to face your demons and formulate your arguments….constructively. An extra tip here would be to record yourself arguing your points. How do you sound? are you believable? How do you come across?

Having your supervisor with you can be very reassuring and comforting, although they may well not be allowed to speak during your viva voce. However, try to have them sit next to you or behind you, as eye contact or some other gestures, however well meaning may put you off your game.

Once you get to the viva, be prepared to break the ice. Your examiners are not ogres. They want you to pass! Starting your viva with a warm greeting can set the tone for the session, so don’t start with your defensive wall up too high! You can also set the scene with a short presentation to cover some broad points you anticipate coming up. Use this time to also show your knowledge and demonstrate your own unique way of thinking and working.

If there has been a long gap between your thesis submission and your viva, you may now have moved on to new ways of thinking or changed your original work to move on to a new project. Remember that this new work does not count in your viva. You must remain focused on what you submitted.

If the discussion moves to really complex debates, it is important to keep your cool, remain professional and don’t turn into a robot who has learnt their responses off by heart. Also, don’t be overly humble or point out your own weaknesses directly…if they are raised by the examiners, then you can show respectful considerations to other methods, but it is still important not to shoot yourself in the foot.

Your viva can last a good few hours…it is basically a brain marathon! So you will need to prepare both mentally and physically. This means de-stressing, eating and sleeping well…and generally giving time to your own self care regime. If you need a break during the session, don’t be afraid to ask for one. If you feel overwhelmed at any time, take a constructive pause to write or read and deliberate. It can’t be an extremely emotional and draining experience.

However, some people can enjoy their viva. After all, you will be speaking about your own work with experts in the field for some time. This is a chance to show off, be proud of what you have achieved and even learn more! Thinking in this positive way may make the viva experience not seem so daunting.

I personally found my own viva experience very daunting, emotional and stressful. However, my examiners were not ogres…they too wanted me to pass and to help me make the best of my work… Following the submission of my revised thesis, I realized how much better my thesis now is because of this viva process and the input of my examiners. Having now gone beyond the viva process, I believe that I have truly earned my PhD. I worked hard for it. It didn’t come easy. It was a brain marathon. But would a PhD really be worth having if it was easy to achieve?

I can also now reflect on this process and learn from it. It is an experience that will certainly stay with me and enrich my future work. I hope it will also enable me to improve my own examination and supervisory skills in future.

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

 

Highlights from the Third Annual #BirthTrauma conference #birthtrauma18

The first week back in January and I am invited by the wonderful becca moore @dr_bjm to share some research thoughts and ideas at the 3rd annual birth trauma study day in London = #birthtrauma18.

First of all..thank you for arranging and facilitating this day. It really is growing in strength and popularity year on year as this topic gathers momentum. You are a true #maternityleader for making this happen. Thank you also to those who participated in such important debates and discussion…and to those supported me to present my work as a new mum (baby Loveday is now 6 weeks old and as you can see….she was able to join her mum on stage 🙂

The discussions that followed on Twitter were also pretty awesome and continue to thrive online. I can see may collaborations being born out of this day…what change may come I wonder? – #BirthTrauma19 will be even bigger and better…that’s for sure!

What struck me most about the speakers involved in this conference, is that every one of us was drawing from some kind of personal experience. Our past traumas had been turned into passion…fire and fury to make a change in the world…to make is better for the next person in some way.

“We had turned our wounds into wisdom.” – Me

Thank you to those who engaged in my presentation. I was thrilled to share some of my PhD work and the findings of other research studies to raise awareness of psychological distress in midwifery populations. The beautiful images below capture some of the key messages from my slides.

Further statistics around midwives at work can be found here.

I also really enjoyed the ethical debates around providing online anonymity and confidentiality for midwives in psychological distress who wish to seek help. You can read the wider arguments for this here. Do you have any further thoughts on this? I would love to hear them!

Once again…Thank you so much to everyone for making this event so amazing. The quote that I believe summed up the vibe in the room was this…shared by @millihill .

 

“If we can find ways of harvesting the energy in women’s oceanic grief we shall move mountains.” –Germaine Greer

🎓🌟😀

Overall take home messages…

• Tailored care is needed for every family
• A healthy baby is not ALL that matters
• Good outcomes include good psychological outcomes
• Kindness and compassion cost nothing yet can really make a difference
• Appropriate use of language can make or break the birthing experience
• The power of listening can never be underestimated
• We must remember that fathers and wider family members may also be affected by trauma in the birth room.
• A traumatic experience is always subjective. What is traumatic for some, may be unremarkable for others.
• Mothers can have a positive experience of a clinically complicated birth, or a traumatic experience of a seemingly straightforward birth.
• Any past trauma can always be re-awoken
• The best care is delivered by a workforce that is healthy and cared for.

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

5 career tips for a successful academic application

This wisdom comes from the 10th annual ‘Life beyond the PhD’ conference (#CLPhD) hosted at Cumberland Lodge. I was lucky enough to win a scholarship to attend and gather a multitude of hints and tips for my academic career…Now I plan to share them here for those who wish to read them…

Tip One: Potential employers will want to know how they will benefit from having you work with them as much as, if not more than, how you will benefit from working with them. Why should they invest their money in you? Will they be able to tolerate you on a daily basis? This means that you will need to come across as unselfish, and avoid saying the same thing as everyone else…be different!

Tip Two: Avoid jargon, and make sure you back up your claims with lived examples! For instance..It is no use saying that your I.T skills are fabulous if you don’t back this up with a real lived example of how you have used your I.T skills to do something of real value.

Tip Three: A potential employer will only take a few seconds to scan your CV. Therefore, you need to cut out the gimmicks, reduce it to no more than a couple of pages and make sure that you have used clear and easy to read formatting. Everything on your CV should be in reverse chronological order, and tailored to the job you are applying for. Your cover letter should never be a replication of your CV, yet it should hold lived examples of the skills you have presented.

Tip four: Within your interview,  it will not necessarily matter what answer you give to any awkward interview questions, as long as your answers are void of generic jargon and backed up with a sound rationale for your choice. Also, it is important not to pretend that either you or your research is impervious to failure…what matters is how you handle things and learn.

Tip five: Be yourself, and be honest about any career gaps…being evasive over these issues will only arouse suspicions…the truth is always far more welcome….It’s often not as big a deal as you think, and a good employer will appreciate what you are planning to do to get back on track.

For further hints and tips see this early career researcher blog.

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

The #QualWorld2017 Virtual international conference, hosted by the International Institute for Qualitative Methodology (@theIIQM)

The #QualWorld2017 virtual international conference, hosted by the International Institute for Qualitative Methodology (IIQM) @theIIQM is the first online conference focused on the subject of qualitative research. I gravitated towards this as something new, exciting and inclusive. Plus, as my new daughter has just been born….a virtual online conference seemed to be the perfect way to share my latest work and breastfeed at the same time.

The poster I presented was:

Exploring the perceptions of new mother’s in relation to psychological distress and workplace support in midwifery. A Patient and Public Involvement study

I was representing The Centre for Innovative Research Across the Life Course at Coventry University. This work was formed in partnership with Dr. Gemma Pearce and Dr. Elizabeth Bailey, also from Coventry University.

The conference theme was: Qualitative Research Across Boundaries

Keynote Speakers:

Prof. Amanda Kenny, La Trobe University, Australia
Prof. Trish Greenhalgh, University of Oxford, UK
Prof. Martyn Hammersley, The Open University, UK
Prof. Babette Babich, Fordham University, The Jesuit University of New York City

Here are a few snapshots of the keynote speeches…

As an early career researcher (post-doc) I really appreciated the insights shared in relation to progressing an academic career and thriving in a research centre. The idea that collaborations and publications can be planned to achieve maximum impact really appeals to me…. a few hints and tips in the right direction were very welcome.

I have yet to use or explore storytelling and narratives in my research career thus far in any great depth. As such, it was really inspiring to see how these have been used in other qualitative work. Ethnography is also an area fairly new to me, and so being introduced to new topics in this way really helped me to digest and think about new directions for my own research.

Then, to  fall in love with philosophy again was wonderful…looking at what makes science….science….within the terminology of the postmodern? Lot’s to think about here. And certainly lot’s to discuss. The online chat room was on the go throughout the conference, and on Twitter. The conversations really made me think about my own future directions in research and how it may be grounded.

Yet the best thing about this conference for me was the fact that it has been so accessible for me. Having just had a new baby girl, this conference gave me the chance to share new findings from our PPI study from the comfort of home. This meant that I could care for my baby and breastfeed whilst not missing out on the career I love. Thank you to the conference organizers for making this possible. …and thank you to the Centre for Innovative Research Across the Life Course for funding my place.

Best thing about sharing #research at the #QualWorld2017 virtual international conference today? I get to breastfeed my newborn daughter whilst engaging with @trishgreenhalgh & @AJKennylrhs et al. #brelfie #academia #WomenInAcademia pic.twitter.com/wxNCarORLF

— Dr. Sally Pezaro (@SallyPezaro) November 29, 2017

As you can see, this tweet of my experience was the most popular one of the conference… I think that these accessible conferences are really making history and showing the way for future conferences of this type.

History was made today. This could be the future of [some] conferences.#qualworld2017 https://t.co/UdkWKjGs4E

— Trisha Greenhalgh (@trishgreenhalgh) 29 November 2017

History was made today. This could be the future of [some] conferences.#qualworld2017 https://t.co/UdkWKjGs4E

— Trisha Greenhalgh (@trishgreenhalgh) November 29, 2017

In conclusion…I would like to reiterate the following tweet:

Congratulations @theIIQM you really do like to push the boundaries #qualworld2017 an amazing online world conference. Great to think that delegates could attend from home with brand new babies, no travel budget etc. Great stuff !

— Mandy Kenny (@AJKennylrhs) November 29, 2017

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

Public engagement: What it is, why it matters and how to do it…

This wisdom comes from the 10th annual ‘Life beyond the PhD’ conference (#CLPhD) hosted at Cumberland Lodge. I was lucky enough to win a scholarship to attend and gather a multitude of hints and tips for my academic career…Now I plan to share them here for those who wish to read them…In this case, much of what I have learnt here comes from Steve Cross (@steve_x)….Thank you 🙂

“Public engagement describes the myriad of ways in which the activity and benefits of higher education and research can be shared with the public. Engagement is by definition a two-way process, involving interaction and listening, with the goal of generating mutual benefit.” – National Co-ordinating Centre for Public Engagement (NCCPE)

First….think about why you want to engage the public?..

• inform people and make your research more accessible?
• consult people and explore the ethical and social implications of your research?
• collaborate with people and share expertise?

Why does it matter?

Having a conversation with the public about research means that your research is more likely to have an impact….yes there are the pressures to publish, publish, publish…but what about sustaining rigor in your research through PPI research activities?…these could be enhanced via public engagement surely?

Try to coordinate public engagement efforts within your university via other departments. This will not only ensure that your work has a wider reach, but it will also save you time and energy.

Public engagement isn’t the same as self promotion, however, you will no doubt improve your research reputation and career by engaging the public. Why not share your successes with other researchers?

Try to look at what is happening around you. Does your local community share some of your research problems? public health issues?…these are the populations who may well be interested to join in your particular research conversation.

Don’t just rush into public engagement activities or try to force it…make sure it is well planned…who are you wanting to engage? How why?…How might they be engaged?? Following public engagement, it is also important to measure impact and evaluate the success of your activities.

“If the public had a better idea of what universities do and how we can influence and observe the world we live in, there would be a far greater understanding of issues such as public funding for research and teaching.” (@ddubdrahcir)

So how might you engage the public in your research?

I personally like to engage the public via this blog, media publications and The Academic Midwife Facebook page. This enables my alter ego to take on a character of her own to engage in a wider conversation. Others choose to host specialist events, deliver comedy shows via @ScienceShowoff, engage in FameLab or create public engagement magic via larger institutions such as @Ri_Science. There is no one way to engage the public in your research, so be creative…seek constructive feedback, and touch base with the experts within your own university.

More information

• A step-by-step guide to planning public engagement activities [PDF 40KB]
• The National Co-ordinating Centre for Public Engagement’s information on planning, managing and evaluating public engagement activities(opens in a new tab)
• The British Science Association’s Collective Memory(opens in a new tab), a database of evaluations of science communication initiatives.

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤

Developing your literature search strategy in 5 easy steps

OK, so you have a research problem that you want to solve or answer using evidence based in the literature. You need to find the right literature and capture it by spreading your net wide, and in the right places. You need a strategy for searching the literature….a search strategy if you will. I hope that these 5 steps will get you to where you want to be.

What is a search strategy?

1.A structured organisation of terms used to search a database

2.A document that shows how terms combine to retrieve the best results

3.Something that must be adapted for each database you use

4.Something which is tailored to the question you are trying to answer

5.A good search strategy is something that takes time to refine

Different ways to search the literature

1.Electronically

2.Manually

3.Snowballing of the literature (going from reference list to reference list to find what you  need.

4.We can do a rapid review of the literature or an exhaustive one

5.We can see what other published literature reviews have done and how they have found their literature for ideas.

6.Ask! (Librarians, authors etc.)… authors of great papers often know of other papers you may be looking for…why not ask them?

Step one: Define your research question or ‘problem’.

First…we will use this as an example: Does hand washing among midwives reduce postnatal infections? 

	Example:
P (Problem or Patient or Population)	postnatal infections
I (intervention/indicator)	hand washing
C (comparison)	no hand washing; other solution; masks
O (outcome of interest)	reduced infection

 

Whilst PICO can sometimes be seen as the go to tool for formulating your question..don’t be limited by it. Here are a few other tools to help your formulate your perfect research question…

Methodology  e.g. questionnaires

Issues e.g. ethical decision-making

Participants e.g. midwives or patients

—————————————————

Setting – Where? What is the context?

Perspective – For who?

Intervention (Subject of Interest)– What?

Comparison – What else?

Evaluation – What results?

————————————————————

Sample

P I Phenomenon of Interest

Design

Evaluation

Research type

————————————————————

Client – who is the service aimed at?

Location – where?

Improvement – what do you want to find out?

Professional – who is involved in providing/improving the service?

——————————————–

Context

Intervention

Mechanism

Outcome

———————————————-

Expectation—What do you want the information for?

Client Group.

Location.

Impact— What change are you looking for? How is this being measured?

Professionals.

Service—For example, community services, birth centres or accident and emergency.

Step two: choose which databases you will search

Different search databases should be searched separately as they each have their own dictionaries of terms and keywords. Each database is tailored toward a particular topic of interest. The following set of databases relate to healthcare topics.

1.Web of Science (strong coverage which goes back to 1990 and most of its journals written in English)

2.Scopus (Covers a superior number of journals but with lower impact and limited to recent articles)

3.CINHAL (Prime source of nursing and allied health literature)

4.Pubmed & MEDLINE (Great starting point for any health or medical literature search.)

5.Cochrane (The source of systematic reviews)

6.NHS Evidence & The TRIP database (Search a limited number of high quality sources)

7.PsychINFO (Prime source for psychology and psychiatry literature.)

8.AMED (Allied and Complementary Medicine Database)

9.HMIC (Health Information Management Consortium – great information from DoH and Kings Fund)

There are no strict rules as to how many databases you should search. That would depend on how thorough you are trying to be. Also, many databases will pick up duplicates for you…which you will later need to delete.

Step three: Identify and map your key concepts

A concept map is a visual representation of concepts within your research question or ‘problem’ and their relationships to each other.

To create a concept map:

• Write down the main concepts which relate to your research question and circle them on a blank page.
• Write down other words/concepts and ideas which relate to each of your concepts in groups. Draw lines between concepts to show how they are related.

Step four: Identify your key words

Some of these you may already have found in your concept mapping work, however, you really need to grab every keyword you can to get the best results…sometimes your databases will already have predefined keywords for you to use….helpful 🙂

To identify your own keywords, you will need to break down your own research question. I will go back to using our example.

Does	Hand washing	among	midwives	reduce	Postnatal infections
	‘OR’	‘AND’	‘OR’	‘AND’	‘OR’
	Hand hygiene		Midwifery staff		Postpartum infections
	‘OR’ Clean hands		‘OR’ Midwif*		‘OR’ After birth
	‘OR’ Washed hands

 

 

Step five: Build your concepts and keywords into a search strategy

Sounds easy right? Well let me show you how to do this using an example from one of my published systematic literature reviews.

The questions relating to this review were…

1) What interventions have been developed to support midwives and/or student midwives in work-related psychological distress? and 2) What are the outcomes and experiences associated with the use of these interventions?

Key concepts have been underlined.

Below is a search strategy I built to answer these research questions. This was used to search one database only.

As you can see, the search starts right from the bottom with the first concept ‘midwives’… the ‘population’. Each concept moving forward is grouped together with keywords combined with the boolean operator ‘OR’. When I need to combine concepts nearer the top, I combine them using the boolean operator ‘AND’. See below…

This search strategy also uses truncations, where I have entered the root of the word and then a (*) at the end. When you do this, the database will then return any ending of the root word. Another example of this would be ….child* = child, childs, children, childrens, childhood.

If a word you want to find is spelled in different ways, wildcards can also be used to substitute a symbol for one letter of a word. Examples of how you might use this may be

wom!n = woman, women
colo?r = color, colour

(Credits to https://libraries.mit.edu/experts/)

Click this link for a great example paper, where the authors have mapped their key concepts and search terms to their research questions and databases.

If you are looking to publish a paper and would like me to join your team, I am always happy to be a co-author on your article in exchange for guidance and insight..Not sure how to do this?…see my post…’Why Midwifery and Nursing Students Should Publish their Work and How’ for further info.

I hope you find this ‘How to’ guide useful. I now look forward to you all going forth to develop and share your own search strategies with me. I can’t wait to see what problems you will solve 🙂

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaro; The Academic Midwife; This blog

Until next time…Look after yourselves and each other 💚💙💜❤