Predictors of Appraisal and Psychological Well-Being in Alzheimer's Disease Family Caregivers

The objective of this study was to test a model of stress, appraisal, and adaptation in 114 family caregivers of patients diagnosed with dementia of the Alzheimer's type (white non-Hispanic, N = 64; Hispanic-American, N = 50). Results of structural equation analysis show that appraised caregiver burden played a central role in determining the psychological well-being of family caregivers. The findings indicate that this mediating variable, negative caregiver appraisal, was predicted by increased functional limitations and behavioral disturbances in the patient, poorer perceived physical health, and lower levels of perceived emotional support. Contrary to a priori hypotheses, functional limitations in the patient also exhibited a direct association with caregiver depression. Further, patient cognitive impairment and caregiver ethnicity were not related to caregiver appraisal. Overall, these results support the role of appraised burden in mediating the relationships between caregiving factors and the adaptational outcome of depression. The implications of these findings, limitations of the study, and future directions are discussed.     

Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia

There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross‐sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equation modeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis–stress perspective. Goodness‐of‐fit indices (χ²/df = 1.406, GFI = 0.919, CFI = 0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis–stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden.     

What's Stressful About Caring?1

Karasek's (1979) demand-discretion theory of job strain and satisfaction was tested in a cross-sectional survey of informal carers of elderly people (n= 108) identified from a preliminary screening survey. The theory was largely supported by the findings. Multivariate analysis of variance showed that carer well-being and satisfaction with caring work were predicted by high levels of demand arising from the needs of elderly dependents and the interaction of high demands with discretion over meeting demands. The results allow some clarification of previously inconsistent findings from caregiver well-being research and have implications for the design of services to relieve carers of the burden of care.     

Illness representations,coping and psychological adjustment to Parkinson's disease

The present study reports an application of the common sense model (CSM) of illness representations to the prediction of psychological distress in people with Parkinson's disease (PD). The study sought to (i) examine cross-sectional and prospective associations between illness representations, coping and psychological distress, and (ii) test the hypothesis that coping would mediate any relationships between illness representations and psychological distress. Patients with PD (n = 58) completed the Illness Perception Questionnaire-Revised, the Medical Coping Modes Questionnaire and the Hospital Anxiety and Depression Scale. Patients (n = 57) were followed-up at 6 months. Illness representations explained large amounts of variance in time 1 anxiety (R ² = 0.42) and depression (R ² = 0.44) as well as additional variance in time 2 anxiety (ΔR ² = 0.12) and depression (ΔR ² = 0.09) after controlling for baseline scores. In addition, avoidance mediated the effect of emotional representations on time 1 anxiety, and acceptance-resignation mediated the effects of both consequences and emotional representations on time 1 depression. The present study therefore provides partial support for the mediational model outlined in the CSM, as significant mediation effects were found only in the cross-sectional analyses.     

Testing the health promotion model for adherence and quality of life in individuals with multiple sclerosis

The nature of multiple sclerosis (MS) presents challenges to health-promoting behaviors (e.g. adherence) and quality of life. The Health Promotion Model (HPM) proposes that these outcomes are explained by individual characteristics (i.e. biological, social, psychological) and behavior-specific cognitions (e.g. self-efficacy). The current study sought to test the HPM in explaining self-reported adherence and MS quality of life among 121 MS patients receiving care in an MS clinic in the southeastern United States. Hierarchical regression models partially supported the HPM for adherence (R² = .27) and more fully for quality of life (QoL) (R² = .64). Depression and stigma were among the variables most strongly related to both adherence and QoL; contrary to HPM theory, self-efficacy was not significantly related to adherence but was to QoL. Thus, the HPM may help to guide strategies used to improve QoL among individuals living with MS; however, the model may need further refinement to be used with adherence.     

Extending the Common Sense Model to Explore the Impact of the Fear of COVID-19 on Quality of Life in an International Inflammatory Bowel Disease Cohort

The aim of this cross-sectional study was to use an extended common sense model (CSM) to evaluate the impact of fear of COVID-19 on quality of life (QoL) in an international inflammatory bowel disease cohort. An online study involving 319 adults (75% female, mean (SD) 14.06 (15.57) years of symptoms) completed the Gastrointestinal Symptom Rating Scale, Brief Illness Perceptions Questionnaire, Fear of Contracting COVID-19 Scale, Brief-COPE, Depression, Anxiety and Stress Scale, and the EUROHIS-QOL. The extended CSM had an excellent fit (χ² (9)?=?17.06, p?=?.05, χ²/N?=?1.90, RMSEA?=?0.05, SRMR?=?0.04, CFI?=?.99, TLI?=?.97, GFI?=?0.99), indicating the influence of gastrointestinal symptoms on QoL was mediated by illness perceptions, fear of COVID-19, adaptive and maladaptive coping, and psychological distress. Interventions targeting the fear of COVID-19 in the context of an individual’s perceptions will likely enhance QoL during the pandemic.

     

Growing Up Perfect: Perfectionism,Problematic Internet Use,and Career Indecision in Emerging Adults

Among emerging adults who are career indecisive, perfectionism and problematic Internet use (PIU) are underdeveloped areas of inquiry. The authors examined the relationship between perfectionism and PIU to measure their contributions to career indecision. The full model was significant, yielding an R² of .46 (p < .0001). PIU accounted for the majority of variance in career indecision (adjusted R² = .32). Career indecision was also related to maladaptive but not adaptive perfectionism. Counseling implications are discussed.     

Ezekiel’s classic estimator of the population squared multiple correlation coefficient: Monte Carlo-based extensions and refinements

Abstract

Ezekiel’s adjusted R² is widely used in linear regression analysis. The present study examined the statistical properties of Ezekiel’s measure through a series of Monte Carlo simulations. Specifically, we examined the bias and root mean squared error (RMSE) of Ezekiel’s adjusted R² relative to (a) the sample R² statistic, and (b) the sample R² minus the expected value of R². Simulation design factors consisted of sample sizes (N?=?50, 100, 200, 400), number of predictors (2, 3, 4, 5, 6), and population squared multiple correlations (ρ² = 0, .10, .25, .40, .60). Factorially crossing these design factors resulted in 100 simulation conditions. All populations were normal/Gaussian, and for each condition, we drew 10,000 Monte Carlo samples. Regarding systematic variation (bias), results indicated that with few exceptions, Ezekiel’s adjusted R² demonstrated the lowest bias. Regarding unsystematic variation (RMSE), the performance of Ezekiel’s measure was comparable to the other statistics, suggesting that the bias-variance tradeoff is minimal for Ezekiel’s adjusted R². Additional findings indicated that sample size-to-predictor ratios of 66.67 and greater were associated with low bias and that ratios of this magnitude were accompanied by large sample sizes (N?=?200 and 400), thus suggesting that researchers using Ezekiel’s adjusted R² should aim for sample sizes of 200 or greater in order to minimize bias when estimating the population squared multiple correlation coefficient. Overall, these findings indicate that Ezekiel’s adjusted R² has desirable properties and, in addition, these findings bring needed clarity to the statistical literature on Ezekiel’s classic estimator.     

Resolving the theory of planned behaviour's ‘expectancy-value muddle’ using dimensional salience

The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theory's belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the ‘expectancy-value muddle’. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18–24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R ²?=?0.21) and intention (adjusted R ²?=?0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.     

Dynamic interplay of depression,perfectionism and self-regulation on procrastination

This study aimed at investigating the intercorrelation among affective, cognitive and behavioural components on procrastination. A total of 402 undergraduate students (115 males, 286 females, 1 not indicated) participated in the study. Students completed the General Procrastination Scale, Depression, Anxiety and Stress Scale, Frost Multidimensional Perfectionism Scale and Self-regulation Inventory. A constructed hypothesised model was tested by utilising path analysis. Overall, the analysis indicated that the model sufficiently explained the data. The findings showed the multicorrelation among the variables, ranging from 14 to 58. Squared multiple correlation coefficients (R²) of procrastination revealed that endogenous and mediator variables explained 33% of the total variance in procrastination. The results demonstrated the importance of affect, cognition and behaviour on problematic delay referred to as procrastination.     

Mindfulness and psychological well-being among black South African university students and their relatives

This study investigated the relationship between mindfulness and psychological well-being in a convenience sample of black South African students (n = 203) and their parents and other relatives (n = 204) (66.1% = female; age range 18–73). The students self-reported on their mindfulness on the Mindful Attention Awareness Scale and psychological well-being on the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, Adult Trait Hope Scale and the Meaning in Life Questionnaire. A multivariate regression model was specified and analysed via structural equation modelling in Mplus 7.3. Results revealed that mindfulness scores strongly predicted elevated levels of meaning and positive affect, and lowered levels of negative effect, and were moderately strong predictors of life satisfaction and hope. The findings imply that mindfulness likely plays an important role in relation to the psychological well-being of cross-generational African culture community members.     

Predicting Intention to Save Water: Theory of Planned Behavior,Response Efficacy,Vulnerability, and Perceived Efficiency of Alternative Solutions1

These 2 studies attempted to predict people's intention to save water. Study 1 used a model based on Ajzen's (1991) theory of planned behavior (TPB) and other variables: vulnerability, 2 collective efficacy variables, and subjective effectiveness of alternative solutions (SEAS) to ease drought impact. Study 2 tested a model similar to that of Study 1, but with 2 personal efficacy variables added. Respondents in both studies were residents of Taiwan (Ns= 166 and 210). Analysis indicated that the modified models (R²>.32) were better than the TPB model (R²<.19), and SEAS and response efficacy had crucial effects on people's intentions to retrofit. The studies also found some significant but inconsistent effects of income, dwelling, and education.     

Factor Structure of Patient and Caregiver Ratings on the Dementia Quality of Life Instrument

ABSTRACT

Preliminary evidence suggests that quality of life reports from patients diagnosed with mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) are as reliable and valid as data provided by caregivers. To date, no studies compared the factor structure of data provided by caregivers and patients. Factor analyses are important to conduct because they are an indicator of validity. This study compared the factor structure of patient and caregiver reports on the Dementia Quality of Life scale (DQoL). Participants (N?=?67) were patients diagnosed with amnestic MCI or mild AD and their caregivers. Principal axis factor analyses were run separately on patient and caregiver report data. The three-factor solutions for patient and caregiver data were nearly identical. Three factors corresponding to positive affect, negative affect, and aesthetics emerged reliably from analyses. Thus, data from patients demonstrated a factor structure that was highly consistent with caregiver report data and conformed to meaningful psychological constructs.     

Hostility and quality of life among Hispanics/Latinos in the HCHS/SOL Sociocultural Ancillary Study

Objective: The purpose of this study was to determine if hostility is associated with physical and mental health-related quality of life (QoL) in US. Hispanics/Latinos after accounting for depression and anxiety.

Methods: Analyses included 5313 adults (62% women, 18–75 years) who completed the ancillary sociocultural assessment of the Hispanic Community Health Study/Study of Latinos. Participants completed the Center for Epidemiological Studies Depression Scale, Spielberger Trait Anxiety Scale, Spielberger Trait Anger Scale, Cook–Medley Hostility cynicism subscale and Short Form Health Survey. In a structural regression model, associations of hostility with mental and physical QoL were examined.

Results: In a model adjusting for age, sex, disease burden, income, education and years in the US., hostility was related to worse mental QoL, and was marginally associated with worse physical QoL. However, when adjusting for the influence of depression and anxiety, greater hostility was associated with better mental QoL, and was not associated with physical QoL.

Conclusions: Results indicate observed associations between hostility and QoL are confounded by symptoms of anxiety and depression, and suggest hostility is independently associated with better mental QoL in this population. Findings also highlight the importance of differentiating shared and unique associations of specific emotions with health outcomes.     

The relationship of children's hope to pediatric asthma treatment adherence

This study investigated the relationship between hope and adherence to a daily inhaled steroid regimen among 48 asthma patients ages 8–12 years old who participated in a 14 day adherence assessment. Participants completed the Children's Hope Scale, and parents completed a questionnaire aimed at demographic and disease-related information. Adherence was measured by electronic monitoring of the use of the participant's metered-dose inhaler. A multivariate model predicting nonadherence was built, including FEV₁ in the first step and children's hope level in the second step. This model was a significant predictor of adherence (Nagelkerke R ²?=?0.24, p?=?0.01). No other demographic or psychosocial variables were significant predictors of adherence. These findings highlight the need to attend to psychosocial predictors of adherence, specifically hope, and may help practitioners target these factors in their efforts to increase adherence among pediatric asthma patients.     

Do early parental postnatal depression,attachment style and perceived social support affect neurodevelopmental outcomes of premature infants?

BackgroundThe birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups.MethodsThis prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants’ corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age.ResultsPostnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers’ depression scores were inversely associated with cognitive development (p = 0.030, R² = 0.080, B=-0.283) and mothers’ anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R² = 0.108, B=-0.329) at the age of corrected 6 months old.ConclusionsOur findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers’ depressive symptomatology and maternal anxious/ambivalent attachment.     

The relationship between children's overweight and quality of life: A comparison of Sizing Me Up,PedsQL and Kid-KINDL

Background/Objective: Overweight and obese children are likely to encounter negative impact on psychological well-being and quality of life (QoL). Hence, for overweight and obese children, measuring QoL could go beyond simply assessing objective medical parameters and cover their physical health, psychological well-being, and social interaction. Generic (Kid-KINDL and Pediatric Quality of Life Inventory [PedsQL]) and weight-related (Sizing Me Up) measures are two major types of QoL measurement instruments; however, little is known about the differences between them. Method: We recruited 569 3rd to 6th graders from eleven schools in Southern Taiwan. In addition to the three QoL questionnaires, the Child Depression Inventory and Rosenberg Self-Esteem Scale were applied. Results: Depression had significantly negative associations with all three QoL questionnaires. Self-esteem was only associated with Kid-KINDL. Body mass index had a significantly stronger relationship with Sizing Me Up than its relationships with PedsQL and Kid-KINDL. In other words, the items related to body size concerns in Size Me Up significantly contributed to impaired overweight/obese children’s QoL. Conclusions: The study further identified the characters and strength of these QoL measures for better suggestions on evaluating physical and psychological issues for overweight/obese children.     

Organizational Justice: Personality Traits or Emotional Intelligence? An Empirical Study in an Italian Hospital Context

The purpose of this study was to investigate the role of personality traits and emotional intelligence in relation to organizational justice. The Organizational Justice Scale, the Eysenck Personality Questionnaire–Revised Short Form, and the Bar‐On Emotional Quotient Inventory were administered to 384 Italian nurses. The emotional intelligence dimensions explained a greater percentage of the incremental variance in relation to the four organizational justice dimensions (distributive: ΔR²= .11; procedural: ΔR²= .12; interpersonal: ΔR²= .19; informational: ΔR²= .16) with respect to personality traits (distributive: R²= .06; procedural: R²= .08; interpersonal: R²= .12; informational: R²= .09). The results highlight the role of emotional intelligence in explaining organizational justice, thereby offering new research and intervention perspectives.     

Predicting the Performance of Dental Hygiene Behaviors: An Examination of the Fishbein and Ajzen Model and Self-Efficacy Expectations1

This study examined the value of the Fishbein and Ajzen model of behavioral intentions and Bandura's concept of self-efficacy expectations as prospective predictors of the dental hygiene behaviors of young adults. All participants (73 males and 58 females) completed self-report measures of the predictor variables and 60% of that group (N = 77) then recorded brushing and flossing behaviors over a four-week period. The Fishbein and Ajzen model accounted for a significant proportion of the variance in intentions to brush (R²= .32) and intentions to floss (R²= .30). Intentions were in turn related to self-monitoring records of brushing and flossing frequency (rs= .52 and .61). Introducing self-efficacy expectations into the Fishbein and Ajzen model failed to improve the prediction of brushing and flossing frequency. However, self-efficacy was predictive of behavioral intentions, adding significantly to the variance accounted for by the attitudinal and subjective norm components of the Fishbein and Ajzen model. These data suggest that self-efficacy expectations are important in understanding protective health behaviors and that the inclusion of a self-efficacy component in the Fishbein and Ajzen model deserves consideration.