Joanne Cooper

OBJECTIVE: To assess the prevalence and predictors of aggressive behavior among traumatic brain injury (TBI) survivors at 6, 24, and 60 months postdischarge. DESIGN: Mixed cross-sectional and longitudinal data from a 5-year follow-up study of discharged TBI patients analyzed retrospectively. SETTING: A specialized Brain Injury Rehabilitation Service of a tertiary referral hospital. PATIENTS: Two hundred twenty-eight (228) patients with moderate to severe TBI. MAIN OUTCOME MEASURES: The Overt Aggression Scale; injury-related variables (in particular, Glasgow Coma and Outcome scales and posttraumatic amnesia duration); and a battery of postdischarge questionnaires (Beck Depression Inventory, Trauma Complaints List, General Health Questionnaire, etc). RESULTS: At any given follow-up period, 25% of the participants were classified as aggressive. Aggression, where present, was consistently associated with depression, concurrent traumatic complaints, younger age at injury, and low satisfaction with life rather than with injury, demographic, or premorbid characteristics. Depression was the factor that was most significantly associated with aggressive behavior at all times postinjury, followed by a younger age at the time of injury. CONCLUSIONS: Aggression is a common, fluctuating, and long-term problem following TBI. The underlying association between aggression and psychosocial variables lends support to the provision of ongoing outreach services and psychological and behavioral interventions for all affected TBI survivors.

In this conceptual article, we explore the idea of refining the role of the researcher. Using emotional intelligence as a framework, we synthesize methodological writing about the role of the researcher and ways to enhance the connection between humans in qualitative research. Emotional intelligence can strengthen the ability to connect with participants, skillfully listen during the interview process, and more clearly understand the lifeworlds participants articulate.

AIM: To investigate how distributed leadership via the Shared Governance programme influences employee engagement, empowerment, job satisfaction and turnover intentions among direct care nursing staff in a large UK hospital. BACKGROUND: Increasing turnover rates and shortages of health care staff in the UK has called for interventions to improve employee engagement and job satisfaction. METHODS: 116 direct care nursing staff were sampled in a mixed-methods explanatory sequential design. A maximum variance sample of 15 participants were subsequently interviewed to gain a deeper understanding of the motivations and attitudes that influenced employee outcomes through distributed leadership. RESULTS: Higher levels of distributed leadership predicted increased employee engagement and job satisfaction, and lower turnover intentions. Staff also felt more empowered and committed to the organisation despite some challenges experienced in implementing the Shared Governance programme. CONCLUSION: Distributed leadership was found to be beneficial in promoting employee engagement and empowerment, increasing job satisfaction and organisational commitment and reducing turnover intention in the UK health care setting. IMPLICATIONS FOR NURSING MANAGEMENT: By encouraging the practice of distributed leadership at work, health care staff can become more engaged and empowered, leading to higher rates of job retention, job satisfaction and organisational commitment.

Student project groups are a popular teaching tool used by marketing and business instructors. Despite the merits of group projects, trust often breaks down, and a valuable opportunity for learning may deteriorate into disharmony and personal frustration. Using literature on teamwork, student project groups, and trust, as well as qualitative data gathered from 135 undergraduate business school students, the authors develop a model of the determinants and consequences of a climate of trust within student project groups. In particular, they consider the attributes and behaviors students consider when judging the trustworthiness of fellow group members, the perceived consequences of distrust within groups, and facilitating tools or activities that help foser group trust. Findings provide a number of interesting insights for instructors.

Supported Wellbeing Centres have been set up in UK hospital trusts in an effort to mitigate the psychological impact of COVID-19 on healthcare workers, although the extent to which these are utilised and the barriers and facilitators to access are not known. The aim of the study was to determine facility usage and gather insight into employee wellbeing and the views of employees towards this provision. The study included (i) 17-week service use monitoring, (ii) employee online survey with measures of wellbeing, job stressfulness, presenteeism, turnover intentions, job satisfaction, and work engagement, as well as barriers and facilitators to accessing the Wellbeing Centres. Over 17 weeks, 14,934 facility visits were recorded across two sites (peak attendance in single week n = 2605). Facilities were highly valued, but the service model was resource intensive with 134 wellbeing buddies supporting the centres in pairs. 819 hospital employees completed an online survey (88% female; 37.7% working in COVID-19 high risk areas; 52.4% frontline workers; 55.2% had accessed a wellbeing centre). There was moderate-to-high job stress (62.9%), low wellbeing (26.1%), presenteeism (68%), and intentions to leave (31.6%). Wellbeing was higher in those that accessed a wellbeing centre. Work engagement and job satisfaction were high. Healthcare organisations are urged to mobilise access to high-quality rest spaces and psychological first aid, but this should be localised and diversified. Strategies to address presenteeism and staff retention should be prioritised, and the high dedication of healthcare workers should be recognised.