Hostname: page-component-6b989bf9dc-cvxtj Total loading time: 0 Render date: 2024-04-14T07:19:17.227Z Has data issue: false hasContentIssue false
  • English
  • Français

Expressed Emotion in Staff Working with the Long-Term Adult Mentally Ill

Published online by Cambridge University Press:  02 January 2018

E. Moore ,
R. A. Ball  and
L. Kuipers
E. Moore
Affiliation:
Institute of Psychiatry, London SE5 8AF
R. A. Ball
Affiliation:
Queen Mary's University Hospital, Roehampton, Maudsley Hospital, London SE5 8AF
L. Kuipers*
Affiliation:
Institute of Psychiatry, and Maudsley Hospital, London SE5 8AF
*
∗Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

Staff-patient relationships in long-term settings were examined in 35 staff and 61 patients. Measures were also taken of the staff's general health, their coping style in relation to work events, and job satisfaction. A range of ratings of EE was evident in staff descriptions of patients under their care. Strain and criticism in the relationship were not associated with identified stressors in the workplace, or the general health of the carer. When patients were grouped according to high-EE and low-EE interviews, there were no significant differences in their symptoms. Criticism was associated with other patient characteristics, including aggressive and attention-seeking behaviour, underactivity, and limited social interaction. The findings have implications for staff training and for the maintenance of optimal staff-patient relationships in services supporting severely disabled patients.

Type
Papers
Information
The British Journal of Psychiatry , Volume 161 , Issue 6 , December 1992 , pp. 802 - 808
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bennett, D. & Morris, I. (1983) Support and rehabilitation. In Theory and Practice of Psychiatric Rehabilitation (eds F. N. Watts & D. H. Bennett). Chichester: Wiley.Google Scholar
Berkowitz, R. & Heinl, P. (1984) The management of schizophrenic patients: the nurses' view. Journal of Advanced Nursing, 9, 23–33.CrossRefGoogle Scholar
Billings, A. G. & Moos, R. H. (1981) The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioural Medicine, 4, 139–157.CrossRefGoogle ScholarPubMed
Birchwood, M. & Preston, M. (1991) Schizophrenia. In Adult Clinical Problems: A Cognitive–Behavioural Approach (eds W. Dryden & R. Rentoul). London: Routledge.Google Scholar
Bledin, K. D., MacCarthy, B., Kuipers, L., et al (1990) Daughters of people with dementia: expressed emotion, strain and coping. British Journal of Psychiatry, 157, 221–227.CrossRefGoogle ScholarPubMed
Brewin, C. R., Veltro, F., Wing, J. K., et al (1990) The assessment of psychiatric disability in the community. A comparison of clinical, staff and family interviews. British Journal of Psychiatry, 157, 671–674.CrossRefGoogle ScholarPubMed
Cherniss, C. (1980) Staff Burnout: Job Stress in the Human Services. London: Sage.Google Scholar
Creer, C., Sturt, E. & Wykes, T. (1982) The role of relatives. In Long Term Community Care. Psychological Medicine, Monograph Supplement 2 (ed. Wing, J. K.), pp. 29–39. Cambridge: Cambridge University Press.Google Scholar
Fadden, G., Bebbington, P. & Kuipers, L. (1987) The burden of care: the impact of functional psychiatric illness on the patient's family. British Journal of Psychiatry, 150, 285–292.CrossRefGoogle ScholarPubMed
Finlay-Jones, R. A. & Burvill, P. W. (1977) The prevalence of minor psychiatric morbidity in the community. Psychological Medicine, 7, 475–489.CrossRefGoogle ScholarPubMed
Firth, J. (1986) Levels and sources of stress in medical students. British Medical Journal, 292, 1177–1180.CrossRefGoogle ScholarPubMed
Garety, P. A. & Morris, I. (1984) A new unit for long-stay psychiatric patients: organisation, attitudes and quality of care. Psychological Medicine, 14, 183–192.CrossRefGoogle ScholarPubMed
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. Oxford: Oxford University Press.Google Scholar
Goldberg, D. P. (1978) Manual of the General Health Questionnaire. Windsor: NFER-Nelson.Google Scholar
Hall, J. N. (1989) Chronic psychiatric handicaps. In Cognitive Behaviour Therapy for Psychiatric Problems (eds K. E. Hawton et at). Oxford: Oxford University Press.Google Scholar
Hall, J. N. (1990) Towards a psychology of caring. British Journal of Clinical Psychology, 29, 129–144.CrossRefGoogle ScholarPubMed
Hahlweg, K., Goldstein, M. J., Nuechterlein, K. H., et al (1989) Expressed emotion and patient-relative interaction in families of recent onset schizophrenics. Journal of Consulting and Clinical Psychology, 57, 11–18.CrossRefGoogle ScholarPubMed
Handy, J. (1991) Stress and contradiction in psychiatric nursing. Human Relations, 44, 39–53.CrossRefGoogle Scholar
Herzog, T. (1992) Nurses, patients and relatives: a study of family patterns on psychiatric wards. In Family Intervention in Schizophrenia: Experiences and Orientations in Europe (eds C. L. Cazzullo & G. Invernizzi). Milan: ARS (in press).Google Scholar
Hooley, J. M. (1987) The nature and origins of expressed emotion. In Understanding Major Mental Disorder: The Contribution of Family Interaction Research (eds K. Hahlweg & M. J. Goldstein). New York: Family Process Press.Google Scholar
Isaacs, A. D. & Bebbington, P. E. (1991) Strategies for the management of severe psychiatric illness in the community. International Review of Psychiatry, 3, 71–82.CrossRefGoogle Scholar
Jackson, H. J., Smith, N. & McGorry, P. (1990) Relationship between expressed emotion and family burden in psychiatric disorders: an exploratory study. Acta Psychiatrica Scandinavica, 82, 243–249.CrossRefGoogle ScholarPubMed
Jackson, S. E., Schwab, R. L. & Schuler, R. S. (1986) Toward an understanding of the burnout phenomenon. Journal of Applied Psychology, 71, 630–640.CrossRefGoogle ScholarPubMed
James, D. V., Finberg, N. A., Shah, A. K., et al (1990) An increase in violence on an acute psychiatric ward. British Journal of Psychiatry, 156, 846–852.CrossRefGoogle Scholar
Kuipers, L. & Bebbington, P. (1988) Expressed emotion research in schizophrenia: theoretical and clinical implications. Psychological Medicine, 18, 893–909.CrossRefGoogle ScholarPubMed
Kuipers, L. & Bebbington, P. (1990) Working in Partnership: Clinicians and Carers in the Management of Longstanding Mental Illness. London: Heinemann Medical Books.Google Scholar
Lavender, A. (1985) Quality of care and staff practices in long-stay settings. In New Developments in Clinical Psychology (ed. Watts, F. N.). British Psychological Society, Leicester. Chichester: Wiley.Google Scholar
Leff, J. P., Kuipers, L., Berkowitz, R., et al (1985) A controlled trial of social intervention in the families of schizophrenic patients: 2 year follow up. British Journal of Psychiatry, 146, 594–600.CrossRefGoogle Scholar
Leff, J. P. & Vaughn, C. (1985) Expressed Emotion in Families. London: Guilford Press.Google Scholar
Mann, S. A. & Cree, W. (1976) New long-stay psychiatric patients: a national sample survey of fifteen mental hospitals in England and Wales, 1972–1973. Psychological Medicine, 6, 603–616.CrossRefGoogle Scholar
Miklowitz, D. J., Goldstein, M. J., Doane, J. A., et al (1989) Is expressed emotion an index of a transactional process? I. Parent's affective style. Family Process, 28, 153–167.CrossRefGoogle ScholarPubMed
Morris, I. (1991) Residential care. In Community Psychiatry: The Principles (eds D. H. Bennett & H. L. Freeman). London: Churchill Livingstone.Google Scholar
Nichols, K. A. (1985) Psychological care by nurses, paramedical and medical staff: essential developments for the general hospitals. British Journal of Medical Psychology, 58, 231–240.CrossRefGoogle ScholarPubMed
O'Driscoll, C., Marshall, J. & Reed, J. (1990) Chronically ill patients in a district general hospital unit. A survey and two-year follow-up in an inner-London health district. British Journal of Psychiatry, 157, 694–702.CrossRefGoogle Scholar
Pines, A. & Maslach, C. (1978) Characteristics of staff burnout in mental health settings. Hospital and Community Psychiatry, 29, 233–237.Google ScholarPubMed
Salokanoas, R. K. R., Der, G. & Wing, J. K. (1985) Community psychiatric services in England and Finland. Social Psychiatry, 20, 23–29.CrossRefGoogle Scholar
Smith, J. & Birchwood, M. (1990) Relatives and patients as partners in the management of schizophrenia: the development of a service model. British Journal of Psychiatry, 156, 654–600.CrossRefGoogle ScholarPubMed
SPSS/PC (1990) Statistics Version 4.0. Chicago: SPSS Inc.Google Scholar
Sutton, G. (1981) The role of the nurse. The organisation and administration of nursing services for long stay patients. In Handbook of Psychiatric Rehabilitation Practice (eds J. K. Wing & B. Morris). Oxford: Oxford University Press.Google Scholar
Thornicroft, G. (1991) The concept of case management for long-term mental illness. International Review of Psychiatry, 3, 125–132.CrossRefGoogle Scholar
Vaughn, C. & Leff, J. (1976) The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165.CrossRefGoogle ScholarPubMed
Watts, S. (1988) A descriptive investigation of the incidence of high expressed emotion in staff working with schizophrenic patients in a hospital setting. Unpublished dissertation for the Diploma in Clinical Psychology, the British Psychological Society, Leicester.Google Scholar
Wing, J. K. (1989) The concept of negative symptoms. British Journal of Psychiatry, 155 (suppl. 7): 10–14.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., Mann, S. A., Leff, J. P., et al (1978) The concept of a ‘case’ in psychiatric population surveys. Psychological Medicine, 8, 203–217.CrossRefGoogle ScholarPubMed
Woods, P. A. & Cullen, C. (1983) Determinants of staff behaviour in long-term care. Behavioural Psychotherapy, 11, 4–17.CrossRefGoogle Scholar
Wykes, T. & Sturt, E. (1986) The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS. British Journal of Psychiatry, 148, 1–11.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.