PSYCHOLOGICAL of 12 months. Due to the

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PSYCHOLOGICAL REPORT Student ID #: 22923629 Client Name: Sandra Johnson Date of Report: 09/23/10 REFERRAL QUESTION/ REASON FOR TESTING Sandra Johnson was referred the Chief of Staff of Greenrun Medical Center for evaluation after her work performance and interpersonal relations substantially decreased after being assigned to a nursing missionary stationed in Rwanda. As the head nurse for the missionary Sandra will be stationed in Rwanda with 20 subordinates for a period of 12 months.Due to the recent change in her work performance and behavior her employer questions whether Sandra would still prove to be an asset in such a challenging environment. ASSESTMENT METHODS Examinee Biography Perceived Stress Scale (PSS) Willingness to Care Scale (WTC) Duke Health Profile (DUKE) International Personality Item Pool (IPIP-NEO) Index of Job Satisfaction (IJS) BACKGROUND INFORMATION Sandra Johnson is a 32 year old biracial (African American and Hispanic) female.She is married and resides with her husband and three children.

Mrs. Johnson is employed as the lead LPN at Greenrun Medical Center, supervising a staff of at least 30. Mrs. Johnson is approximately 5 foot 3 with an athletic build weighing between 130 and 140 pounds.

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She is neat in her appearance and appears at least 8 years younger than her years. Mrs. Johnson describes herself as a fun-loving, caring, family orientated individual, whom takes extreme pride in all of her endeavors. Mrs.Johnson articulates well and demonstrates intelligences slightly above average. While her mood is consistently euthymic and she presents a cooperative demeanor, she admits that she has become counterproductive in her job duties and performance, withdrawn from fellow colleagues, and becoming aggressively rude in relation to interpersonal relations.

She also admits that marital disagreements are becoming more frequent sometimes even physically violent. Mrs. Johnson states the lack of adequate rest contributes to such behaviors. Though Mrs.Johnson expresses deep contentment and pride with her promotion to lead LPN, she also recognizes that the supervisory role has tripled her work load and subsequently increased her stress level.

She reports experiencing what she labels as “occasional overload burnout” however, she has no suicidal or homicidal thoughts. Mrs. Johnson admits to having being forced into anger-management therapy during her teen years however, the sessions were terminated due to her being uncooperative. Besides the occasional knee pain associated with a high school injury, Mrs.Johnson seems to be in good physical health. She reports that she occasional takes over the counter pain pills, and nightly she takes over the counter sleep aids.

Other than her chosen birth control method, Mrs. Johnson is not prescribed any other medications. SUMMARY OF TEST RESULTS Perceived Stress Scale(PSS): The PSS is designed to measure the degree of which an individual views one’s own life situations as stressful and provides information of how stressful events influence pathology. It has internal consistency with an alpha of . 8 and presents a small but significant correlation between higher PSS scores and some self reports of health behavior and significant correlation with the Life Satisfaction Scale.

PSS is a 10-item instrument with scales assessing the respondent’s thoughts and feelings (i. e. anger, irritability, confidence, anxiousness, nervousness, etc) and the frequency of such (i. e. never, almost never, sometimes, fairly often, and very often) based on the past months experiences.

PSS scores are reported as raw scores with an overall mean of 13. 02 and standard deviation of 6. 35.

Greater levels of perceived stress are represented by higher scores.Mrs. Johnson’s scores 27 on the PSS. Her score (27-13. 02= 13.

98) is more than double the standard deviation of 6. 35 of the overall all mean of 13. 02 for all respondents. Willingness to Care Scale (WTC): The WTC is 30-item instrument used to measure attitudes in relation to providing emotional, instrumental, and nursing support. It is a global scale with three subscales (i.

e. emotional, instrumental, and nursing) which reflect the two components of caregiving ability and willingness. The scales are scored by summing the item responses and then dividing by the number of items which were summed to produce the mean.The mean scores for each scale are as follows: global WTC was 4.

64, emotional subscale was 4. 68, instrumental subscale was 4. 60 and nursing subscale was 4. 61. Mrs. Johnson’s Scores are as follows: Scale1, Emotional: 5.

0 (50). Scale 2, Instrumental: 4. 5 (45) Scale 3, Nursing: 4. 6 (46) Global Scale: 4.

7 (141) Duke Health Profile (DUKE): The DUKE is designed to measure the health quality of life. It is a 17-item scale with scores ranging from 0 to 3. The Duke can be used as a separate items, a total scale or 11subscales.

The norm composed of 1,997 medical policy holders, with 1,335 being females.Norm mean scores for the 11 subscales are as follows: Physical Health=62. 8 (SD=25. 8); Mental Health=80.

7 (SD=19. 5); Social Health=73. 7 (SD=19. 0); General Health=72. 7 (SD=16. 6); Perceived Health=75.

2 (SD=31. 7); Self-Esteem=82. 5 (SD=18. 1); Anxiety=25. 4 (SD=19.

6); Depression=26. 2 (SD=21. 4); DUKE-AD=24. 1 (SD=19.

6) Pain=46. 1 (SD=34. 4); and Disability=12. 5(SD=28. 3).

The first six listed scales are those of Positive Functioning, the higher scores are healthier. The last four subscales are classified as Dysfunction, lower scores are healthier. Mrs.Johnson’s IPIP-NEO scores are recorded in the following chart: Extraversion |28 |Agreeableness |34 |Conscientiousness |98 |Neuroticism |39 |Openness to experience |30 | |Friendliness |17 |Trust |38 |Self-Efficacy |80 |Anxiety |69 |Imagination |0 | |Assertiveness |93 |Morality |52 |Orderliness |96 |Anger |70 |Artistic Interests |3 | |Activity Level |49 |Altruism |14 |Dutifulness |72 |Depression |29 |Emotionality |59 | |Excitement-Seeking |17 |Cooperation |10 |Achievement-Striving |95 |Self-Consciousness |30 |Adventurousness |71 | |Cheerfulness |10 |Modesty |65 |Self-Discipline |97 |Immoderation |3 |Intellect |75 | |Gregariousness |23 |Sympathy |55 |Cautiousness |90 |Vulnerability |62 |Liberalism |43 | | PSYCHOLOGICAL IMPRESSIONS IPIP-NEO self-efficacy subdomain (80) and DUKE self-esteem sub-scale (80) indicate that Mrs. Johnson is confident in her personal attributes and physical appearance. Results also indicate she is confident in her abilities to achieve success.

IPIP-NEO conscientiousness domain (98) suggest that Mrs. Johnson is able to set clear goals, actively pursue those goals with strong determination, and achieve them with excellence. Dutifulness subdomain (72) reveal that Mrs. Johnson is also motivated by moral obligation.Combined these scores indicate that Mrs.

Johnson is motivated by both external and internal factors and is confident in her abilities to accomplish her goals and fulfill obligatory duties. In regards to Mrs. Johnson’s overall mental and emotional health, IPIP-NEO neuroticism domain (39) and the DUKE mental health subscale (70) suggest that Mrs. Johnson is of average mental and emotional health. Specifically, the scores indicate that Mrs. Johnson is able to address, cope, and overcome life’s situations. However the PSS (27), DUKE anxiety subscale (66.

67) combined with high scores on the IPIP-NEO subdomains of anxiety (69) and anger (70) indicate while Mrs.Johnson is capable of overcoming stressful events, she is more accessible to feelings of frustration and less likely to deal with such events in a calm and collective manner. Mrs. Johnson’s use of nightly sleeping aids also supports such findings. Combined with IPIP-NEO subdomain scores of cooperation (10); friendliness (17); assertiveness (93); and achievement-striving (95); Mrs. Johnson’s interpersonal relations have a tendency to become explosive during stressful events. Based on Mrs.

Johnson’s own recollection, she has the tendency to become withdrawn and aggressively rude towards colleagues during stressful periods. Therefore, when challenged by stressful episodes, Mrs.Johnson’s subordinates are more likely to experience rude, uncooperative, tyrant behaviors. Mrs.

Johnson’s introverted personality is supported with IPIP-NEO extraversion domain (28); friendliness subdomain (17) and DUKE social health (60). Along with no mention of a network of friends it can be concluded that Mrs. Johnson, is quite, reserved, and enjoys solitude instead of large crowds.

In regards to Mrs. Johnson’s interpersonal relationships, the WTC scale (4. 7) and IPIP-NEO agreeableness domain (34) indicates that while Mrs. Johnson may not reach out to others or sacrifice her entire self, she is willing to tend to the needs of others.

It can be conclude that Mrs.Johnson would for example, provide emotional support to someone in need as long as such support does not negatively affect her own physical, emotional, or mental health. Reviewing Mrs. Johnson’s IPIP-NEO, low scores for the openness to experience domain (30) suggest that she is more likely to be conservative and practical, thinking simply in plain black and white terms.

However, the subdomains of adventurousness (71) and intellect (75) suggests that Mrs. Johnson is open to trying new things and/or traveling to foreign lands and more likely to be open-minded to new and/or unusual ideas and intellectual debates. These finding suggest that while Mrs.

Johnson is usually conservative in daily routines, she does have the occasional urge to act spontaneously and respond to liberal ideas though they may not be those of her own. For example, Mrs. Johnson may on whim decide to vacation in Africa, and later engage in a debate of why the native rituals should not be viewed as inhumane, with a fellow co-worker who initiates the debate, otherwise Mrs.

Johnson keep her viewpoints as private opinions. Combined, these findings imply that Mrs. Johnson enjoys her solitude and remains conservative in her daily routines, however she possess the capabilities and intellect needed to adjust and accept new experiences and ideas. Also, Mrs.Johnson’s introverted personality allows her to have daily productive interactions with others without allowing them to invade her personal boundaries. Scores of 60, 50, and 0 on the DUKE subscales of physical health, pain, and disability respectively, and a knee injury documented during interviewing, suggest that Mrs. Johnson’s physical health is average. Mrs.

Johnson’s documented occasional use of a mild-dosage over-the-counter pain medication associated with knee pain and a documented medical physical also supports the findings of average physical health. IJS (64) and WTC (4. 7) scores indicate moderate levels of job satisfaction. Based on WTC results it can be concluded that Mrs.Johnson experiences both personal and professional satisfaction from providing nursing services to those in need. In contrast the moderate score of 64 on the IJS combined with PSS (27), DUKE anxiety subscale (66.

67) and initial interview notes pertaining to occupational induced stress reveal moderate levels of job dissatisfaction. However, high scores on the IPIP-NEO conscientiousness domain (98) indicate Mrs. Johnson is a hard-working, loyal, dedicated, and trust-worthy employee. Efficacy (80) and assertiveness (93) subdomains support Mrs. Johnson’s claims of contentment with her current position as lead LPN. It can be concluded that while Mrs.Johnson is currently experiencing high levels of occupational stress, overall she is content with her current position and will remain will remain dedicated and loyal to the company while actively seeking to advance to higher levels of occupational success.

CONCLUSION/RECOMMENDATION Sandra Johnson is a 32 year old bi-racial (African American and Hispanic) female who is married with three children. She is currently employed as Lead LPN for Greenrun Medical Center. Mrs. Johnson was referred for psychological evaluation as a prerequisite for joining the company’s nursing missionary. Based on a battery of psychological tests, it the recommendation of this examiner that the offer for her to join the nursing missionary in Rawanda be withdrawn for the following reasons: a) Mrs.Johnson is experiencing high levels of occupational induced stress and anxiety.

From her own admission she is experiencing burnout which is having an adverse affect on her job performance. Being introduced to a foreign land, its rituals, natives, and customs and working with limited resources are all factors that will increase her current levels of anxiety and stress, bearing negatively on her overall mental and emotional health. b) While Mrs.

Johnson’s assessments conclude that she is of average health, however her admitted use of nightly sleeping pills, and erratic sleeping patterns are a cause for concern. Mrs. Johnson is also taking over-the-counter for pain associated with an knee injury.Giving the nature of her duties as Lead LPN, what currently appears to be minor stress related physical ailments have the potential to increase to major medical emergencies. c) Mrs. Johnson is currently experiencing moderate, at the most job dissatisfaction and when placed in stressful situations Mrs.

Johnson’s interpersonal relations tend to decrease dramatically. She is more likely to become an uncooperative, demanding, mean-spirited, and withdrawn individual. From her own admission she becomes aggressively rude and withdrawn from employees and colleagues during stressful incidents. Her supervisory role in Rawanda requires that she be able to handle difficult situations along with staff-members in an effective and efficient manner without creating a hostile working environment.


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