psychological skills for the advanced practice nurse · psychological skills training • pst is a...
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Psychological Skills for the Advanced Practice Nurse
Elaine Ford
August 2012
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• Briefly look at Australian Health
demographics
• Understand Psychological Skills
Training processes
• Focus on Attentional Quadrant grid
• Highlight importance of
psychologically preparing nurses to
provide optimal care and minimize
risks
Aims of Session
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Australian Health Statistics
• Australia’s life expectancy at birth continues to rise and is among the
highest in the world—almost 84 years for females and 79 years for
males.
• Death rates are falling for many of our major health problems such
as cancer, cardiovascular disease, chronic obstructive pulmonary
disease, asthma and injuries.
• Coronary heart disease causes the largest number of ‘lost years’
through death among males aged under 75 years, and breast cancer
causes the most among females.
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Diseases
• Cancer is Australia’s leading broad cause of disease burden (19% of the
total), followed by cardiovascular disease (16%) and mental disorders
(13%).
• Around 1 in 5 Australians aged 16–85 years has a mental disorder at
some time in a 12-month period, including 1 in 4 of those aged 16–24
years.
• The burden of Type 2 diabetes is increasing and it is expected to become
the leading cause of disease burden by 2023.
• The incidence of treated end-stage kidney disease is increasing, with
diabetes as the main cause.
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Westmead Hospital
• 4th busiest in Australia
• Opened in 1978
• 975 bed specialised referral hospital
• Population 1.5 million
• Has dental school and a unit for emotionally disturbed children
• 29% speak language other than English
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Psychological Skills Training
• PST is a systematic and consistent practice of mental skills used to
enhance performance.
• Common characteristics in athletes:
• their sport is important to them and they are committed to being the best
that they can be within the scope of their limitations – other life
commitments, finances, time, and their natural ability.
• They set high, realistic goals for themselves and train and play hard.
• Their sport participation enriches their lives and they believe that what
they get back is worth what they put into their sport.
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Peak Performance
StressDistressAnxietyPanic
Under stimulated
BoredomApathyAmotivationAnergy
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Over stimulated
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9 Skills over Three Phases of Development
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Focusing attention
• Breadth of focus (width) is the amount of information that you
attend to any one time. This is divided into either broad or narrow.
• Direction of focus (direction) is the location of what you are
concentrating on: whether it is external (outside you) or internal
(inside you).
• Different situations require different concentration skills.
Psychologically-skilled people learn to switch to whatever
concentration style is required for specific tasks.
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Attentional Quadrant
EXTERNAL
NARROW
BROAD
INTERNAL
Broad-External Narrow-External
Broad – Internal Narrow- Internal
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Broad External
• Needed for looking at the whole situation
• attend well to rapidly changing situations
• taking in a lot of information.
• susceptible to information overload affecting decision making efficacy.
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Broad Internal
• Thinkers
• Needed to ensure they have prepared themselves well to perform
• quick to make tactical adjustment
• can get caught up in analyzing, especially when things are not going well.
• May doubt their own skills and not challenge themselves
• Tend to outguess themselves and miss important cues.
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Narrow External
• Needed when focusing on patient and not on distractions of noise, interruptions, own feelings
• People who perform any task, in which the focus must be pinpointed, perform better with this type of attentional style.
• Problems occur when the environment changes and decisions need to be made about how to respond to the changes.
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Narrow Internal
• Needed to ensure own homeostatic requirements are met
• This style is conclusive for diagnosing performance or strategy errors, but such diagnostic tendencies carry the risk of becoming highly critical self-analysis
• People with this style perform better in roles which change takes place slowly and in obvious ways.
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Improving Concentration
• Concentration is affected by fatigue. The higher level of fitness and
health you maintain, the less mistakes you will make
• Use specific attentional cues to trigger you to concentrate
o Listening cues
o Visual cues
o Physical cues
• Task-oriented goal-setting
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Conclusion
• Higher expectations on effective and efficient delivery of service
• PST is an essential component in developing advanced practice
nursing that will impact on performance, recruitment and retention
• There are 9 Psychological skills that enhance performance, over 3
phases of development
• 4 quadrants of attention for concentration skills
• It is important to prepare ourselves psychologically if we are going
to use our crafts and skills to optimise performance
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References
• Australian College of Applied Psychology. (200-2004). Manuals from subjects in
Athletic Counselling, Stress and performance and applied sport psychology
• AIHW 2010. Australia's health 2010. Cat. no. AUS 122. Canberra: AIHW.
• Clarkson, M. (1999). Competitive Fire. Chicago: Human Kinetics
• Hanin, Y.L. (2000). Emotions in Sport. Illinois: Human Kinetics
• Jackson, S., & Csikszentmihalyi. (1999). Flow in sports. Chicago: Human
Kinetics
• Nideffer, R (1992). Psyched to win. Chicago: Human Kinetics
• Orlick, T. (2000). In pursuit of excellence. Chicago: Human Kinetics
• Sarafino, E.P. (1998). Health psychology: Biopsychological interactions. New
York: John Wiley and sons
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Questions and Discussion
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