The resilience seen in firefighters may be related to their career selection, their preparedness and experience, the fewer injuries they suffered, and postdisaster mental health interventions. However, alcohol disorders were endemic before the disaster, indicating a need for ongoing programs targeting this problem.
Studies have not previously considered postdisaster adjustment in the context of psychiatric disorders. After the Oklahoma City bombing, a volunteer sample of 181 firefighters who served as rescue and recovery workers was assessed with a structured diagnostic interview. The firefighters had relatively low rates of posttraumatic stress disorder (PTSD) and described little functional impairment, positive social adjustment, and high job satisfaction. PTSD was associated with reduced job satisfaction and functional impairment, providing diagnostic validity. Turning to social supports, seeking mental health treatment, and taking medication were not widely prevalent coping responses. Postdisaster alcohol use disorders and drinking to cope were significantly associated with indicators of poorer functioning. Surveillance for problem drinking after disaster exposure may identify useful directions for intervention.
This follow-up study confirmed the immediacy of onset of PTSD and its persistence over time, pointing to the need for early interventions that continue over the long term. Group C avoidance and numbing symptoms may aid in early recognition of PTSD and in predicting long-term functioning.
Introduction
Effectively discussing palliative care with patients and families requires knowledge and skill. The purpose of this study was to determine perceived needs of inpatient nurses for communicating with patients and families about palliative and end of life care.
Method
A non-experimental design was utilized. Sixty inpatient nurses completed the End of Life Professional Caregiver survey.
Results
Effects for years of experience and unit were found [F(9,131.57)=2.22, p=0.0246; Wilk's Λ=0.709 and F(6,110)=2.49, p=0.0269]. For all three domains (Patient and Family-Centered Communication, Cultural and Ethical Values, and Effective Care Delivery) years of nursing experience was positively associated with comfort in communicating about end of life care. Oncology nurses reported were most comfortable with regard to patient and family-centered communication.
Discussion
The success and sustainability of this service is dependent on education for healthcare providers. Studies are needed to determine best ways to meet this educational challenge.
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