Managing multiple chronic conditions in Singapore – Exploring the perspectives and experiences of family caregivers of patients with diabetes and end stage renal disease on haemodialysis

Objective: Diabetes mellitus (DM) is the commonest cause of end stage renal disease (ESRD). Despite increasing DM-ESRD prevalence and high dependency on care, there is a lack of literature on DM-ESRD caregivers. We sought to explore the perspectives and experiences of caregivers of patients with DM undergoing haemodialysis in Singapore.

Design: This study employed an exploratory, qualitative design comprising in-depth interviews with caregivers of DM-ESRD patients.

Methods: Semi-structured interviews were conducted with a sample of 20 family caregivers (54.2 ± 12.6 years; 75% female) of DM-ESRD patients. Data were analysed using Thematic Analysis.

Results: Key caregiving challenges identified were managing diet, care recipients’ emotions and mobility dependence. Patients’ emotional reactions caused interpersonal conflicts and hindered treatment management. Difficulties in dietary management were linked to patients’ erratic appetite, caregivers’ lack/poor understanding of the dietary guidelines and caregivers’ low perceived competence. Limited resources in terms of social support and finances were also noted. Physical and psychological well-being and employment were adversely affected by caregiving role.

Conclusion: This study highlights distinctive aspects of the DM-ESRD caregiving experience, which impact on caregivers’ health and challenge care. Disease management programmes should be expanded to support caregivers in dealing with multimorbidity.     

Factor structure and psychometric characteristics of the beck depression inventory-II

The present study evaluated the factor structure and psychometric properties of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in the nonclinical sample of 230 young adults. The BDI-II is a revised version of the BDI-IA. We evaluated the fit of three alternative models to the sample data, using confirmatory factor analysis. Results provided support for the fit of the oblique three-factor model. The BDI-II and factor scales had satisfactory coefficient alpha indices. We obtained gender differences on the BDI-II item, total, and factor scale scores. We examined the relations of the BDI-II with demographic variables and with other self-report measures of social desirability, anxiety, depression, stress, and self-esteem. We also examined the issue of whether specific self-report measures of anxiety and depression assess separate or different constructs. We discuss the limitations of the present study.     

Effects of documentary and fictional television formats on children's acquisition of schemata for unfamiliar occupations

Children's acquisition of real-world role schemata from factual and fictional television was tested experimentally in two studies. In study 1, 144 second- and fifth-graders saw a drama and a documentary about a caterer or a film director. In study 2, 125 fifth-graders saw the caterer tapes under conditions of high or low attentional involvement. Role schemata about real caterers or directors were measured by free response, frequency ratings, and multiple choice questions. Children acquired schemata about real occupations from bath documentary and fictional programs. On some measures, their schemata were influenced more by documentary than by fiction, but that difference faded slightly after a month. Level of involvement did not reduce the difference between real and fictional videos. Children learn social role schemata from both fictional and factual television, but they acquire more schema information from real than from fictional TV, at least when fiction is signaled by obvious cues (e.g., comedy) or when it is not percieved as socially realistic.     

The social phobia and anxiety inventory: Further validation in two nonclinical samples

The Social Phobia and Anxiety Inventory (SPAI) has been developed to assess specific symptoms of social phobia and agoraphobia. Although the SPAI was developed with both clinical and nonclinical populations, research with this measure is currently focused primarily on clinical samples. We examined the factor structure and psychometric properties of the SPAI in adult community and college undergraduate samples. We found that single-sample and multisample confirmatory factor analyses provided support for extending use of the correlated two-factor SPAI subscales to our nonclinical samples. In addition, we found evidence for the internal consistency reliability of the SPAI subscales in both samples. Limitations and suggestions for future research are discussed.     

Les habiletés et régulations motrices au cours de l'escalade et de la descente d'un escalier hélicoïdal chez des enfants de 17 à 27 mois

Nous rapportons dans cet article des données nouvelles sur les comportements d'escalade et de descente d'un escalier hélicoïdal par 12 enfants, dans un local spécialement aménagé. Âgés entre 17 et 21 mois au début de la recherche, ils ont été répartis en deux groupes: pour l'un, la première marche était triangulaire; pour l'autre, quadrangulaire. Les měmes enfants ont été étudiés entre 23 et 27 mois dans les měmes conditions et selon le měme protocole, mais avec une inversion de la configuration de la première marche. On observe que: (1) dès la classe d'âges de 17 à 21 mois, les enfants des deux groupes privilégient le pied droit pour attaquer la première marche, avec le plus souvent alternance des deux pieds sans diminution du pas et sans arrět; (2) la configuration de la première marche joue un rôle significatif dans la fréquence de choix du pied d'attaque en début d'escalade et en fin de descente; (3) les comportements en fin d'escalade et en début de descente apparaissent influencés par la configuration du sommet de l'escalier et par la configuration de la première marche d'escalade; (4) entre 23 et 27 mois, l'influence des facteurs de développement est particulièrement nette en début d'escalade et en fin de descente; (5) les comportements en fin d'escalade et en début de descente apparaissent influencés par une combinaison de facteurs de développement, de la configuration du sommet de l'escalier, des expériences individuelles au début de l'escalade et des expériences individuelles au cours de la première partie de l'étude.     

Observing tutorial dialogues collaboratively: insights about human tutoring effectiveness from vicarious learning

The goals of this study are to evaluate a relatively novel learning environment, as well as to seek greater understanding of why human tutoring is so effective. This alternative learning environment consists of pairs of students collaboratively observing a videotape of another student being tutored. Comparing this collaboratively observing environment to four other instructional methods—one-on-one human tutoring, observing tutoring individually, collaborating without observing, and studying alone—the results showed that students learned to solve physics problems just as effectively from observing tutoring collaboratively as the tutees who were being tutored individually. We explain the effectiveness of this learning environment by postulating that such a situation encourages learners to become active and constructive observers through interactions with a peer. In essence, collaboratively observing combines the benefit of tutoring with the benefit of collaborating. The learning outcomes of the tutees and the collaborative observers, along with the tutoring dialogues, were used to further evaluate three hypotheses explaining why human tutoring is an effective learning method. Detailed analyses of the protocols at several grain sizes suggest that tutoring is effective when tutees are independently or jointly constructing knowledge: with the tutor, but not when the tutor independently conveys knowledge.     

A preliminary look at loneliness as a moderator of the link between perfectionism and depressive and anxious symptoms in college students: does being lonely make perfectionistic strivings more distressing?

An integrative model involving perfectionism [Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470] and loneliness as predictors of depressive and anxious symptoms was proposed and tested in 383 college students. Beyond the expected additive influences of the two predictors in the prediction of symptoms, loneliness was also hypothesized to moderate the link between perfectionism and symptoms. Results indicated that other-oriented perfectionism predicted anxious symptoms, whereas socially prescribed perfectionism predicted both depressive and anxious symptoms. Loneliness was found to add incremental validity to these predictions. Moreover, the Perfectionism x Loneliness interaction was found to further augment the prediction of depressive and anxious symptoms. These findings are taken to offer support for a more contextual model of perfectionism. Some implications of the present findings are discussed.     

The Influences of Parent and Peer Attachment on Bullying

Individuals with secure attachments to parents and peers are less likely to be bullies and victims of bullying. The current study examined the interplay between gender, parent attachment, and peer attachment as factors related to roles (bullying involvement, defending a victim, and outsider) during bullying. One-hundred forty-eight adolescents (M age?=?15.68) completed surveys about parent and peer attachment and roles during bullying. Findings indicated that females were less likely than males to be involved in bullying and were more likely than males to defend a victim or be an outsider (ps?<?.05). Greater attachment security to parents and peers was associated with less involvement in bullying and greater defending of victims (ps?<?.05). Additionally, a significant three-way interaction demonstrated that greater peer attachment security predicted less bullying involvement for those with lower parent attachment security (p?<?.05), but not for those with higher parent attachment security (p?>?.05). However, this was only true for males (p?<?.01). These results indicate that having a secure attachment to peers may be a potential protective factor against bullying involvement for males with insecure attachments to parents. Future research should examine the possible mechanisms involved in the association between attachment and bullying, such as empathy, aggression, or social information processing.     

Transformative professional learning: an ecological approach to agency through critical reflection

Within the global economy, education leverages social and economic improvement. Teachers are positioned as drivers and agents of compliance within change processes. Addressing this concern, we investigate intern teacher agency, as transformative professional learning, that occurs through a process of critical reflection. Critical reflection is conceived as an important element of teacher agency within the current political milieu. This article addresses the role of critical reflection in school-based intern teacher professional learning (PL). It is argued that intern teacher agency is inherent in transformative PL characterized through partnerships, which provide scope for decision-making and critical reflection.