Preventive behaviour and health status among the elderly

Abstract

The research describes the range of preventive health behaviours undertaken by the elderly, investigates the dimensionality of preventive health behaviour, and explores the relationship between preventive health behaviour, self-assessed and medically assessed health status. Previous research has relied mainly on self-reports of health status. Data from medical examinations and interviews with 115 elderly individuals (aged 65–75) indicated that most elderly persons performed some intentional preventive health practices, as well as a broad range of normative preventive health practices. Particular clusters of preventive health behaviour emerged when the data were subjected to cluster analysis. A short index consisting of five personal preventive health behaviours found in other studies to have a protective effect on long-term health was found to have a low to moderate correlation with the medical and self-assessments of health status employed in the study. These findings indicate particular types of preventive health behaviour of importance for health promotion programmes with the elderly.     

Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors.

Childhood cancer patients have a greater likelihood of long-term survival than ever before. This study examined both the perceived family functioning of adolescents who had successfully completed treatment for pediatric cancer and the relationship between family functioning and post-treatment adjustment. Eighty-eight adolescent survivors of hematologic malignancies were assessed regarding their family functioning, mental health, self-esteem, global competence, and problem behaviors. Contrary to expectations about the influence of cancer on these families, adolescent cancer survivors reported lower levels of family cohesion than the normative sample of healthy adolescents and their families. While current age, gender, age at diagnosis, and time since treatment completion were generally not associated with adolescents' adjustment, perceived family cohesion and adaptability were strongly related to post-treatment psychological adjustment.     

Understanding behavioural clusters: Identifying differences between clusters of health behaviours on key constructs

Objective: To uncover the rationale underlying the perceived distinction between clusters of health behaviours by identifying cognitive constructs that differentiate among them, and creating a ‘cognitive profile’ for each behavioural cluster. Thus, different determinants and characteristics of health behaviours (e.g. ‘perceived behavioural control’, ‘impact on health’, ‘effort’, ‘non-health rewards’, ‘habit’) were used to compare health behaviour meta-clusters (physical and psychosocial) and clusters (e.g. nutrition behaviours, substance abuse, medical practices).

Methods: A sample of lay people (N = 1956) judged items representing behavioural clusters delineated in the Health Behaviour Taxonomy on 14 constructs.

Results: Significant differences emerged between the physical and psychosocial meta-clusters, as well as among their sub-clusters. For example, physical behaviours were higher on ‘perceived behavioural control’ and ‘impact on health’ compared to psychosocial behaviours, and nutrition was perceived highest on ‘effort’ and ‘non-health rewards’ compared to the other clusters of the physical meta-cluster.

Conclusion: The findings increase our understanding of the logic underlying lay people’s cognitive schema of health behaviour clusters. ‘Cognitive profiles’ that explain differences between the clusters were identified, which can be used to design health messages and interventions targeting multiple health behaviours.     

Family Functioning and Attachment Among Young Adults in Western and Non-Western Societies

Abstract

Family functioning (FF) is associated with patterns of adults’ close relationship attachment, which works differently in western and non-western societies. In this study, the relationship between FF and attachment (A), as well as the difference in relationship between FF and A across western and non-western societies were examined. A total of 600 young adults (294 males, 306 females) were recruited from western and non-western societies through the SurveyCircle and social media and communication applications. The data was analyzed using PLS-SEM and multigroup analysis, and the results showed that in western and non-western societies, family adaptability and cohesion were significantly associated with anxiety, close, and depend attachments. Unexpectedly, higher family adaptability was associated with higher anxiety attachment. The associations among family adaptability and cohesion with anxiety, close, and depend attachments showed that the strengths of the relationships are significantly different in western and non-western societies, except for the association between family cohesion and anxiety. Based on these results, the cultural differences in terms of FF and young adults’ close relationship attachment were presented for future research, family therapy, and the society.     

Functional illness and family functioning: a comparison of healthy and somaticizing adolescents

This study examined the usefulness of the Circumplex Model of Marital and Family Functioning for discriminating between families of healthy adolescents and families of adolescents with functional somatic complaints. The findings did not support the expected curvilinear relationship between symptomatology and the FACES II family dimensions of cohesion and adaptability. Questions are raised regarding the degree of correspondence between the constructs of enmeshment and rigidity as assessed clinically and as measured by the Circumplex Model.     

Family and psychosocial predictors of obsessive compulsive disorder in a community sample of young adolescents

A two-stage epidemiologic study conducted between 1986 and 1988 in the southeastern United States investigated family and psychosocial predictors of obsessive compulsive disorder (OCD) and subclinical OCD in young adolescents. In the first stage, a life-event schedule and a family adaptability and cohesion scale were administered to a community sample of 3,283 adolescents. In stage two, the Schedule for Affective Disorders and Schizophrenia in School Age Children and the Children's Global Assessment Scale were administered to 488 mother-child pairs. In multivariable models family cohesion was the only significant correlate of OCD (odds ratio=0.95, 95% confidence interval 0.91–0.98). Gender, race, age, socioeconomic status, guardian status, adaptability, undesirable life events and desirable life events were not found to be significant predictors of OCD in models adjusting for cohesion. Note of the above variables were significantly associated with subclinical OCD. However, separate analyses of the 41 individual life events indicated seven specific events were significantly associated with OCD or subclinical OCD. These findings are at odds with the theory that overinvolvement of family members is a risk factor for OCD, though an association with overly rigid family structure cannot be eliminated based on these data. Further exploration of family characteristics is warranted.     

Predicting physical activity in adolescents: The role of compensatory health beliefs within the Health Action Process Approach

Objective: Compensatory health beliefs (CHBs), defined as beliefs that healthy behaviours can compensate for unhealthy behaviours, may be one possible factor hindering people in adopting a healthier lifestyle. This study examined the contribution of CHBs to the prediction of adolescents’ physical activity within the theoretical framework of the Health Action Process Approach (HAPA).

Design: The study followed a prospective survey design with assessments at baseline (T1) and two weeks later (T2).

Method: Questionnaire data on physical activity, HAPA variables and CHBs were obtained twice from 430 adolescents of four different Swiss schools. Multilevel modelling was applied.

Results: CHBs added significantly to the prediction of intentions and change in intentions, in that higher CHBs were associated with lower intentions to be physically active at T2 and a reduction in intentions from T1 to T2. No effect of CHBs emerged for the prediction of self-reported levels of physical activity at T2 and change in physical activity from T1 to T2.

Conclusion: Findings emphasise the relevance of examining CHBs in the context of an established health behaviour change model and suggest that CHBs are of particular importance in the process of intention formation.     

Greater number of group identifications is associated with healthier behaviour in adolescents

We investigated the relationship between group identification (with the family, school, and friendship groups) and adolescent health behaviour (smoking, binge drinking, and cannabis use). 1,111 students from 4 Scottish secondary (high) schools completed a questionnaire which included measures of group identification, group contact, health behaviours, and demographic variables. We found that identification with the family and school groups predicted reduced odds of substance use, whereas identification with the friend group predicted increased odds of substance use. Furthermore, the greater the number of social groups with which the participant strongly identified, the lower the odds that he/she participated in negative health behaviours. In contrast, merely having contact (rather than identifying strongly) with these groups increased the odds of participation in these behaviours. We suggest that group identification influences behaviour to the extent that it encourages adherence to group norms.     

Relationship of family socialization processes to adolescent moral thought

The author investigated the relationship between salient family processes and adolescent moral thought among a sample of 271 adolescents and their parents. Family-process variables measured were adaptability, cohesion, and parent-adolescent communication; adolescent moral thought was measured by the influence the adolescent participants attributed to sources of moral authority. Perceptions of high family cohesion were associated with the greatest influence attributed to the family as a source of moral authority. Perceptions of high family adaptability were associated with greater influence attributed to all sources of moral authority. Parent-adolescent dyads who perceived high positive communication showed strong parent-adolescent agreement on the levels of influence attributed to all sources of moral authority. The findings (a) support the view that a strong relationship exists between family-socialization processes and the content of adolescent moral thought and (b) redress an empirical imbalance in research literature.     

Academic Self-Efficacy,School Engagement and Family Functioning,Among Postsecondary Students in the Caribbean

A neglected area of study in adolescent development is family functioning in relation to adolescents’ sense of self and academic success. This study investigates students’ perceptions of their levels of family functioning (cohesiveness and adaptability) as it relates to their academic self-efficacy and school engagement, and answers the following questions: (1) Are there any significant differences in the academic self-efficacy beliefs and school engagement of Caribbean adolescents based on levels of family cohesion and family adaptability? (2) To what extent does the combination of family cohesion and family adaptability predict the academic self-efficacy and school engagement of Caribbean adolescents? Data were collected from a sample of 523 adolescents (197 males and 326 females) aged 17–19 years, enroled in postsecondary institutions in two Anglophone Caribbean countries (Barbados and St. Lucia). Results indicated that adolescents from families with balanced cohesion held significantly higher academic self-efficacy beliefs and school engagement levels than those from families with low cohesion. Regression analyses indicated that the family functioning model significantly predicted academic self-efficacy and school engagement. Interpretation of these results are discussed.     

Family Functioning and the Course of Adolescent Bipolar Disorder

The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age = 14.48 ± 1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents’ depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents’ manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.     

Examining Relationships Between Ethnic Identity, Family Environment, and Psychological Outcomes for African American Adolescents

Ethnic identity has been linked to a number of healthy psychological outcomes for African American adolescents. The levels of conflict and cohesion in the family environment have also been found to be predictive of adolescent mental health. This study examined whether the ethnic identity and levels of conflict and cohesion in the family environments were related to adolescents’ psychological adjustment. Participants included 61 African American adolescents, ages 10–14 years old, and their parents. Hierarchical regression models were used to determine the cumulative effects of ethnic identity and family functioning on adolescent mental health, specifically adolescent levels of depression, self-esteem, and interpersonal functioning. Results indicated that having a positive ethnic identity and a cohesive family environment were most strongly associated with psychological adjustment. Implications of these results are discussed in terms of family interventions.     

Children's loneliness, sense of coherence, family climate, and hope: developmental risk and protective factors

The study examined the contributions of individual and familial variables for the prediction of loneliness as a developmental risk and the sense of coherence as a protective factor. The sample consisted of 287 children from grades 5-6. Their loneliness, sense of coherence, hope, effort, and family climate were assessed. Separate hierarchical multiple regression analyses revealed that family cohesion and children's hope contributed to the explanation of the risk and protective outcomes. Yet, the contribution of the family adaptability was not significant. Cluster analysis of the family climate dimensions (i.e., cohesion and adaptability) was performed to clarify the interactive roles of family adaptability together with family cohesion. The authors identified 4 separate family profiles: Children in the 2 cohesive families' clusters (Cohesive Structured Families and Cohesive Adaptable Families) reported the lowest levels of loneliness and the highest levels of personal strengths. Children within rigid and noncohesive family cluster reported the highest levels of loneliness and the lowest levels of children's sense of coherence. The unique role of the family flexibility within nonsupportive family systems was demonstrated. The results further clarified the unique profiles' characteristics of the different family clusters and their adjustment indexes in terms of loneliness and personal strengths.     

Parental Morality and Family Processes as Predictors of Adolescent Morality

This study investigated the extent to which parents' moral thought and family processes are involved in the socialization of adolescent moral thought. Olson et al's (1992) Circumplex Model and White's (2000) Family Socialization Model provided the conceptual framework for predicting that families high in cohesion, adaptability and communication would facilitate the transmission of moral values between parents and adolescents more effectively than families low in these family processes. Results involving 218 adolescent-parent dyads revealed that perceived family cohesion and communication moderated the father-adolescent moral thought relationship; that several facets of both parents' morality significantly predicted adolescents' morality; and that all three family processes significantly predicted certain aspects of adolescent morality. Therefore the extent to which parents' socialize adolescent moral values will vary according to each parent's moral view, the strength of family processes and the content of moral thought being transmitted.     

Japanese social workers' healthy behaviours as related to masculinity: Focus on mental health workers and caregivers of children and nursing home residents

Due to the rapid ageing of the Japanese population, the demand for social services is increasing. However, these professions are not generally recognized yet. According to the report by Kawata (1984, 1986), social workers were distressed by low pay and low recognition for the profession, an inflexible, hierarchical administration system, and staff shortages. However, few studies have focused on social workers' healthy behaviours. The present study focused on the healthy behaviours of Japanese social workers and examined the relationship of these habits to masculinity and femininity, in addition to gender differences. To identify the healthy behaviours of social workers, we compared the behaviours of 32 mental health workers and 63 caregivers to those of 91 members of the general public who attended a summer course. Four questionnaires were administered: health locus of control (Watanabe, 1985), healthy behaviours (Munakata, 1996), health state, and Masculinity‐Humanity‐Femininity scale (Ito, 1978). The results revealed that females scored higher in masculinity than males, and females tended to assess their health state as poorer and were more active in preventive health than males. Social workers practice preventive healthy behaviours more than the general public. Between the two types of social workers, mental health workers tend to rely on medical services and believe that health and sickness are matters of luck, whereas caregivers tend to believe they can control their health by themselves. In the health locus of control, external control was more closely associated with poor health than internal control, and it was negatively correlated with masculinity. As masculinity is related to healthy behaviours, it may be an important factor influencing them. Both masculinity and femininity could be desirable, not for only better caregiving but also for the social workers' own health.     

Resisting temptation: alcohol specific self-efficacy mediates the impacts of compensatory health beliefs and behaviours on alcohol consumption

Awareness of health risks linked with excessive alcohol consumption appears to have little influence on how much some people drink. Compensatory health beliefs (CHBs), in which the consequences of unhealthy behaviour are considered to be neutralised by additional healthy behaviours, are one way of justifying poor health choices. Currently, the role of CHBs within the context of drinking behaviour is not well understood. This research examined associations between alcohol specific compensatory health beliefs (ACH-Beliefs) and behaviours (ACH-Behaviours), alcohol consumption and alcohol specific self-efficacy (ASE), via an online survey completed by 249 participants, aged 18 + years (63.1% female; M age = 41.62 years; SD = 14.80). Higher ACH-Beliefs were associated with increases in ACH-Behaviours. While both predicted alcohol consumption, a greater proportion of variance was explained by ACH-Behaviours. ASE was a significant mediator of those relationships, suggesting that those with higher ASE may be better equipped to regulate drinking behaviour. Recommendations for future research include measuring both CHBs and behaviours within an experimental design, and further investigation of related cognitions such as compensatory behaviour intentions. Alcohol misuse interventions may wish to consider the potential roles of CHBs and behaviours in facilitating maladaptive coping strategies, and how addressing these may reduce harms.     

隔代照料与中老年人心理健康：家庭亲密度的中介作用

研究旨在考察隔代照料与中老年人心理健康的关系以及家庭亲密度的中介作用。采用流行病调查中心抑郁量表（CES-D）、生活满意度量表（SWLS）和家庭环境量表（FES-CV）亲密度分量表测量中老年人抑郁症状、生活满意度和家庭亲密度。自编隔代照料问卷测量中老年人的隔代照料频率。共计325位45岁及以上有照顾孙辈经验的社区中老年人参加了问卷调查。结果发现：第一,隔代照料强度与中老年人的抑郁症状、生活满意度存在显著负相关;第二,家庭亲密度部分中介了隔代照料与抑郁症状、生活满意度的负向关系。结果表明,隔代照料对中老年人心理健康既有积极作用,也有消极作用,家庭亲密度在一定程度上部分中介了上述关系。     

Relationship between Family Functioning and Possible Selves in Adolescents from Argentina

Abstract

The goal of this study was to analyze the relationship between different family functioning types and the content, valence, and structure of adolescents’ possible selves (PSs). Participants were adolescents (n?=?392) of both genders (female = 54.9%) from private and catholic high schools in the city of Buenos Aires, Argentina (age, M?=?14.92, SD?=?1.52). We performed a cluster analysis to explore family functioning profiles in terms of communication with parents, promotion of challenges, family cohesion, and flexibility. In order to study family functioning type and PSs content association, we performed a chi-squared test. To study family functioning type differences in PSs valence and structure we conducted a one-way MANOVA. The chi-squared test indicated that there was no significant association between family functioning type and adolescents’ PSs spontaneous content. On the other hand, the MANOVA revealed the existence of significant differences in PSs valence between each type of family functioning group. In regard to the structure of PSs, there were no significant differences between family functioning types. In conclusion, adolescents who perceived positive family functioning have more positive PSs. Family functioning type was not related to PSs content and structure.     

Mediation,moderation, and context: Understanding complex relations among cognition,affect, and health behaviour

Objective: Researchers have historically treated cognition and affect as separate constructs in motivating health behaviour. We present a framework and empirical evidence for complex relations between cognition and affect in predicting health behaviour.

Main Outcome, Design and Results: First, affect and cognition can mediate each other’s relation to health behaviour. Second, affect and cognition can moderate the other’s impact. Third, context can change the interplay of affect and cognition. Fourth, affect and cognition may be indelibly fused in some psychological constructs (e.g. worry, anticipated regret and reactance). These four propositions in our framework are not mutually exclusive.

Conclusion: Examination of the types of complex relations described here can benefit theory development, empirical testing of theories and intervention design. Doing so will advance the understanding of mechanisms involved in regulation of health behaviours and the effectiveness of interventions to change health behaviours.     

The contribution of parenting practices in a risk and resiliency model of children's adjustment

A risk and resiliency model of children's adjustment was evaluated, with a focus on the relationship of parenting practices to risk and protective factors. Risk factors included family stress, family conflict, parent psychopathology and low socio‐economic status. Protective factors included family cohesion, family social support and family moral– religious orientation. The research hypothesis was that parenting practices would have a direct effect on child outcomes, as well as a moderating effect on the relationship between risk and protective factors and child outcomes. Three different outcomes were utilized: disruptive behaviour disorders, adaptive emotional functioning and school achievement. Participants were 80 children aged 6–12 years and their mothers. Hierarchical regression analyses suggested that the combination of family risk and protection and parenting practices was highly predictive of child functioning for both disruptive externalizing behaviours and positive emotional adaptation. It was found that negative family factors were more highly associated with negative child outcomes, whereas positive family factors were more highly associated with positive child outcomes. Family risk factors and poor parenting primarily accounted for the variance in externalizing child behaviours. Alternately, family protective factors and positive parenting primarily accounted for the variance in child adaptive behaviours. Parenting practices had a direct effect on child outcomes, but was not a strong moderator of the relationship between risk and protection factors and child outcomes.