Anxiety Symptoms as Predictors of Nursing Home Placement in Patients with Alzheimer's Disease

Anxiety symptoms are fairly common among patients with Alzheimer's Disease (AD). Such symptoms are likely to make patient care more problematic and, therefore, increase the risk of nursing home placement. Anxiety symptoms were evaluated on the basis of physician examinations, in conjunction with caregiver interviews, in 372 community-dwelling AD patients. Patients received annual follow-up for 1–12 years (M = 4.4). Patients who exhibited anxiety symptoms at baseline assessment were significantly more likely to enter nursing homes, regardless of initial cognitive status or other risks for institutionalization. There was a 15% increase in risk for each point on a 0–5 scale. This study supports the hypothesis that anxiety symptoms increase the risk of nursing home placement in patients with AD. Consequently, there is a need for better understanding of the causes of anxiety in AD and for the development of effective methods of assessment and treatment.     

Lower back pain in nurses working in home care: linked to work–family conflict,emotional dissonance,and appreciation?

In industrial countries home care services for elderly people living in the community are growing rapidly. Home care nursing is intensive and the nurses often suffer from musculoskeletal pain. Time pressure and job control are job-related factors linked to the risk of experiencing lower back pain (LBP) and LBP-related work impairment. This survey investigated whether work-family conflict (WFC), emotional dissonance and being appreciated at work have incremental predictive value. Responses were obtained from 125 home care nurses (63% response rate). Multiple linear regression showed that emotional dissonance and being appreciated at work predicted LBP intensity and LBP-related disability independently of time pressure and job control. WFC was not a predictor of LBP-related disability in multiple regression analyses despite a zero-order correlation with it. Redesigning the working pattern of home care nurses to reduce the emotional demands and improve appreciation of their work might reduce the incidence of LBP in this group.     

Discerning reported suicide attempts within a youthful offender population

With suicide being the third leading cause of death among young people, early identification of risk is critical, particularly for those involved with the juvenile courts. In this study of court-involved youth (N = 433) in two Midwest counties, logistic regression analysis identified some expected and unexpected findings of important demographic, educational, mental health, child welfare, and juvenile court-related variables that were linked to reported suicide attempts. Some of the expected suicide attempt risk factors for these youth included prior psychiatric hospitalization and related mental health services, residential placement, and diagnoses of depression and alcohol dependence. However, the most unexpected finding was that a court disposition to shelter care (group home) was related to a nearly tenfold increased risk in reported suicide attempt. These findings are of importance to families, mental health professionals, and juvenile court personnel to identify those youth who are most at risk and subsequently provide appropriate interventions to prevent such outcomes.     

The longitudinal effects of early behavior problems in the dementia caregiving career

Using multiregional, 3-year data from early career dementia caregivers, this study determines how behavior problems that occur early in the caregiving career influence time to nursing home placement and change in burden and depression over time. A Cox proportional hazards model indicated that caregivers who managed frequent behavior problems earlier are more likely to institutionalize. After controlling for important time-varying covariates in a series of growth-curve models, caregivers who were faced with severe, early behavior problems reported greater increases in burden and depression over the 3-year study period. The findings suggest the need to consider experiences early in the dementia caregiving career when accounting for key longitudinal outcomes and also emphasize the importance of attrition when attempting to model the health implications of informal long-term care over time.     

Potential consequences of abandonment in preschool-age: Neuropsychological findings in institutionalized children

Objective: Several longitudinal studies had shown that early deprivation and institutionalization during the first six months of life affects the emotional, cognitive, social and neurophysiologic development. Nevertheless, our understanding of possible similar effects of delayed institutionalization, in preschool-age remains unclear to this day. The goal of this study is to evaluate the cognitive performance of institutionalized children with history of preschool-age physical abandonment. Method: 18 male institutionalized children with history of abandonment during the preschool-age (2-5 years old) and comparison group matched by age, handedness, gender, educational and socioeconomic level were tested on multiple tasks of attention, memory and executive functions. Results: We found a cognitive impairment in the institutionalized children in several measures of attention, memory and executive functions. This is the first report of cognitive impairment related to late abandonment and institutionalization effects (after 2 years old), extending the already known effects on early institutionalization. Conclusions: This preliminary study suggests that environmental factors including abandonment and institutional care, can affect not only the infancy period, but also the preschool period providing new insights into our understanding of neurocognitive development.     

Attitudes Toward Spirituality and Spiritual Care among Iranian Nurses and Nursing Students: A Cross-Sectional Study

Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.     

Workplace Violence and Worker Injury in Elderly Care Settings

Abstract

Many incidents of injury, assault, and abuse occur in health care settings. To better examine the situational context of the workplace, this paper examines whether workers providing care to elderly persons experience injuries that are consistent with the “for-profit” and “interpersonal conflict” explanations of elder abuse or neglect. Using data from the Bureau of Labor Statistics, results indicate that nursing home workers and home health care workers have higher rates of workplace injuries resulting from assaults and overexertion than do other workers. The data suggest that there are unique structural and situational factors present in the nursing home, which create a work setting vulnerable to conflict, violence, and elder abuse.     

Neuropsychological functioning in preschool-age children with sickle cell disease: the role of illness-related and psychosocial factors.

Cognitive and academic deficits have been identified in school-aged children with sickle cell disease (SCD). However, there have been very few identified studies that examine neuropsychological functioning in preschool-age children with SCD. It is important to understand effects of SCD from a developmental perspective and to consider the contribution of environmental factors in this at-risk population. Neuropsychological functioning of preschool-age children with SCD and no history of overt stroke (n = 26) was examined across several domains (language, immediate memory/brief attention, visuospatial/visuoconstructional, motor/visuomotor). The mean Full Scale IQ for the sample was 89.0. Performance on the Immediate Memory/ Brief Attention domain was significantly higher than the other domains, although the pattern of performance was relatively consistent, with mean standard scores ranging from 88.0 to 95.0. Disease severity was not significantly related to cognitive functioning in this group of young children with SCD. Socioeconomic status (SES) was significantly correlated with most domain scores and, based on regression analyses, accounted for 18% to 47% of the variance in functioning. Psychosocial factors, such as number of children living in the home and parental stress levels, were negatively associated with Motor/Visuomotor skills, and weekly hours in school/day care was positively associated with language-related skills. Results suggest that, at this young age, psychosocial risk factors appear to be appropriate targets for intervention, with the goal of improving long-term outcome in children with SCD. Further investigations should include comparison to a matched control group.     

Neuropsychological Functioning in Preschool-age Children with Sickle Cell Disease: The Role of Illness-related and Psychosocial Factors

Cognitive and academic deficits have been identified in school-aged children with sickle cell disease (SCD). However, there have been very few identified studies that examine neuropsychological functioning in preschool-age children with SCD. It is important to understand effects of SCD from a developmental perspective and to consider the contribution of environmental factors in this at-risk population. Neuropsychological functioning of preschool-age children with SCD and no history of overt stroke (n = 26) was examined across several domains (language, immediate memory/brief attention, visuospatial/visuoconstructional, motor/visuomotor). The mean Full Scale IQ for the sample was 89.0. Performance on the Immediate Memory/ Brief Attention domain was significantly higher than the other domains, although the pattern of performance was relatively consistent, with mean standard scores ranging from 88.0 to 95.0. Disease severity was not significantly related to cognitive functioning in this group of young children with SCD. Socioeconomic status (SES) was significantly correlated with most domain scores and, based on regression analyses, accounted for 18% to 47% of the variance in functioning. Psychosocial factors, such as number of children living in the home and parental stress levels, were negatively associated with Motor/Visuomotor skills, and weekly hours in school/day care was positively associated with language-related skills. Results suggest that, at this young age, psychosocial risk factors appear to be appropriate targets for intervention, with the goal of improving long-term outcome in children with SCD. Further investigations should include comparison to a matched control group.     

Factors Influencing Level of Stress During the Nursing Home Decision Process

This investigation examined whether characteristics of elders and their caregivers and facets of the nursing home decision-making context were associated with recalled levels of stress during nursing home decision-making. Employing a conceptual framework based upon the literature on caregiver stress and nursing home decision-making, we considered a number of factors that might influence sponsors' stress as decisions were being made about nursing home placements. We examined data from telephone interviews with a sample of 142 sponsors (responsible parties) of first-time, recently admitted nursing home residents. Higher levels of reported stress were directly associated with more factors triggering the decision to admit, higher levels of competing demands, and limited time. Employment was indirectly related to higher stress through its impact on demands. Hospitalization and being the spouse or an adult child of the resident were indirectly related to stress because they were associated with limited available time. The results offer some insights into the types of individuals who may be vulnerable to higher levels of stress and the kinds of interventions that might avert high stress in the nursing home decision process.     

Parents' attachment styles,mental representations,and institutionalization of children in Bulgaria

We first summarize the history, extent, and characteristics of institutionalization of non‐orphan children in Bulgaria. Then we describe a study of certain psychological characteristics of mothers who use institutionalization compared with mothers similar in ethnicity and close‐to‐poverty circumstances, those using state daycare programs, and those using weekly care programs for their children. Institutionalizing mothers had been institutionalized themselves far more often than had the other mothers. On two attachment measures, as expected, institutionalizing mothers were less secure and more insecure than daycare mothers, with weekly care mothers intermediate. On a parental representation task, results were somewhat more equivocal. Results suggest that psychological characteristics, especially attachment style, are important in decisions to use institutionalization as a means of child care.     

Parental Contributions to Preschoolers' Emotional Competence: Direct and Indirect Effects

The present study examines the contributions of (1) parental socialization of emotion and preschoolers' emotional interaction with parents to their emotional competence, and (2) parental socialization and child emotional competence to their general social competence. Both observational and self-report techniques were used to measure emotion socialization, emotional competence, and social competence of preschoolers (average age = 49.8 months) from 60 middle-socioeconomic-status families. Data were collected in both classroom and home settings. In general, the results suggest that parental modeling of expressive styles and emotional responsiveness to child emotions are important predictors of preschoolers' emotional competence and their overall social competence. Children whose parents were more affectively positive tended to display more positive emotion with peers, whereas children whose parents were more negative appeared less socially competent in the preschool. Parents who were better coaches of their children's emotions had children who understood emotions better. Age and sex moderated several of the study's key findings. The results are consistent with earlier research indicating that parental socialization of emotion impacts the child's emotional and social functioning both at home and in the preschool.     

Carers of adults with mental illness: Comparison of respite care users and non‐users

The aim of this study was to investigate the rate, type and duration of respite care use in carers of an adult with mental illness, and the differences between respite care users and non‐users on demographic, caregiving context and adjustment variables. A total of 106 carers completed a postal survey questionnaire. The majority (76%) of carers who accessed care used it weekly, fortnightly or monthly. The most common types of respite services were in‐home, day programs, and residential respite. The mean duration of respite care periods was 58.18 hr each time respite was used. Compared to respite care non‐users, carers who accessed respite care were more likely to live with their care‐recipient and provide more caregiving. They also reported more benefits associated with their caregiving. Findings suggest that respite care services need to be varied, available for carers on a weekly to monthly basis with a range in duration, but catering for higher use of 2‐day respite periods. Carers who are highly engaged in a range of caregiving tasks and who live with their care recipient are more likely to have a greater need for respite care. Future research should examine the effects of a range of respite care factors on carer adjustment outcomes.     

Predictor Variables Associated with Positive Fast Track Outcomes at the End of Third Grade

Progress has been made in understanding the outcome effects of preventive interventions and treatments designed to reduce children's conduct problems. However, limited research has explored the factors that may affect the degree to which an intervention is likely to benefit particular individuals. This study examines selected child, family, and community baseline characteristics that may predict proximal outcomes from the Fast Track intervention. The primary goal of this study was to examine predictors of outcomes after 3 years of intervention participation, at the end of 3rd grade. Three types of proximal outcomes were examined: parent-rated aggression, teacher-rated oppositional–aggressive behavior, and special education involvement. The relation between 11 risk factors and these 3 outcomes was examined, with separate regression analyses for the intervention and control groups. Moderate evidence of prediction of outcome effects was found, although none of the baseline variables were found to predict all 3 outcomes, and different patterns of prediction emerged for home versus school outcomes.     

105名留守农民的心理健康调查

为了解留守农民的心理健康状况,提高他们的心理健康水平提供依据。采用SCL-90量表进行随机抽样调查。105名留守农民的阳性项目数和总分都显著高于全国成人常模（P〈0．001）,心理问题的总检出率为33．3％;留守农民各年龄组在SCL-90因子分上存在显著差异（P〈0．05）。结果发现：留守农民的心理健康状况较差;受教育水平、年龄都影响留守农民的心理健康。但性别对留守农民的心理健康没有显著影响。     

Early lexical development of children raised in institutional care in Russia

Children abandoned to institutions display a host of developmental delays, including those involving general cognition and language. The majority of published studies focus on children over 3 years of age; little is known about whether these delays may be detected earlier when children undergo rapid lexical development. To investigate the early language development of children raised in institutional settings in the Russian Federation, we compared a group of children in institutional care (n = 36; 8–35 months) to their age-matched peers raised in biological families, who have never been institutionalized (n = 72) using the Russian version of the CDI. The results suggest that institutionalization is associated with pronounced delays in children's early language development with large and robust effect sizes. Among children with a history of institutionalization, these delays are also associated with difficulties in Daily Living skills, communication, and socialization.     

Inability to Withdraw from Work as Related to Poor Next‐Day Recovery and Fatigue among Women

Recovery from work stress is crucial in avoiding stress‐related ill‐health. The aim of this longitudinal study was to investigate whether processes that prolong the mental exposure to work stressors, such as inability to withdraw from work (IW), the core construct in overcommitment, predicts fatigue and poor next‐day recovery 6 months later over what is predicted by job control and job demands. Self‐ratings in questionnaires were completed by 160 women working in dental care at two time points, 6 months apart. Job demands, job control, and IW were used to predict fatigue and poor next‐day recovery, respectively. Multiple regression analyses show that having children living at home, high job demands, and high IW were associated with fatigue 6 months later. Job demands and IW, but not having children at home, predicted poor next‐day recovery. Mediation analyses using a bootstrapping procedure indicated that IW partly mediated the relationship between job demands and fatigue and between job demands and next‐day recovery. These findings highlight the importance of considering IW in relation to fatigue and recovery from work and that such factors should be included in interventions targeting work‐related stress.     

Infant day care. Maligned or malignant?

Today, the mothers of half the infants in the United States work outside the home. This concerns psychologists and parents because of the possible detrimental effects on these infants of separations from mother and experience in day care. Available data suggest that infants whose mothers work full time are somewhat more likely as one-year-olds to avoid their mothers after a brief separation and later to be less compliant with their mothers and more aggressive with their peers. The argument that these behaviors indicate that infants in day care are at risk for emotional insecurity and social maladjustment is evaluated in light of current research results. It is concluded that other interpretations of the data are more plausible and that further research on the factors moderating and mediating the effects of infant day care is needed.     

Mentoring Relationship Quality and Maltreated Children's Coping

Coping strategies are believed to protect against the harmful effects of maltreatment on children's psychosocial outcomes. Caregivers are thought to be critical in helping children develop adaptive coping strategies, yet many maltreated children have poor and/or insecure relationships with their parents. A quality relationship with a caring, non‐parental adult (e.g., a mentor), however, may be one strategy to promote healthy coping among maltreated children. Children (N = 154) in this study participated in a mentoring and skill‐based program for maltreated preadolescents placed in foster care. Hierarchical regression was used to assess the association between children's reports of their relationship with their mentor at the end of the intervention and four coping strategies (i.e., Active, Support‐seeking, Avoidance, and Distraction) 6 months following the intervention, while accounting for baseline coping strategies and other demographic factors. Above and beyond the covariates, better mentoring relationship quality was associated with children's greater use of Active and Distraction coping 6‐month post‐intervention. Mentoring relationship quality was not significantly associated with children's Avoidance or Support‐seeking coping. The findings suggest that mentoring programs may be a fruitful approach to improving vulnerable children's coping skills. Healthy coping is hypothesized to protect against the harmful effects of maltreatment and to promote resilience in the face of multiple stressors (Banyard & Williams, 2007 ; Boxer & Sloan‐Power, 2013; Cicchetti & Rogosch, 2009). It remains unclear, however, how best to promote positive coping among maltreated children, who are disproportionately exposed to numerous adverse childhood experiences (Raviv, Taussig, Culhane & Garrido, 2010). Theories of coping emphasize the importance of coping socialization through quality parent–child relationships (Kliewer et al., 2006; Skinner & Wellborn, 1994 ). Unfortunately, many maltreated children are exposed to poor quality and/or inadequate caregiving (Baer & Martinez, 2006), which may place them at risk for engaging in unhealthy or inappropriate forms of coping. It is reasonable to expect that positive relationships with other non‐parental adults (e.g., mentors) would affect coping behaviors given the positive impact that quality relationships have on a myriad of emotional and behavioral child outcomes (DuBois, Portillo, Rhodes, Silverthorn & Valentine, 2011; Keller & Pryce, 2012; Thomson & Zand, 2010 ). Because children in foster care often transition in and out of schools and home environments, a quality relationship with a mentor (a consistent presence in the child's life) may be well suited to promote healthy coping strategies.