A structural model of the relationships among stress, coping, benefit-finding and quality of life in persons diagnosed with colorectal cancer

This study has used the structural equation modelling to examine the role of benefit-finding (BF) in the context of the stress and coping model. In the study, 1276 individuals diagnosed with colorectal cancer completed a written questionnaire and telephone interview at around 4.5 months (on average) and 12 months post-diagnosis. Analyses revealed that the final model fit the data, where stress, coping and BF accounted for 63% of the variance in Time 1 quality of life (QOL). Threat appraisal, coping resources, avoidant coping and BF directly impacted on Time 1 QOL, while threat appraisal, social support and approach coping directly impacted on BF. Approach coping and BF had differential relationships with stress, coping resources and outcomes, indicating that BF may not be a meaning-based coping strategy, as proposed by Folkman [Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207–1221]. Theoretical and clinical implications are discussed.     

The utility of socio-demographics,knowledge and health belief model variables in predicting reattendance for mammography screening: A brief report

Abstract

The aims of the present study were to investigate socio-demographic and knowledge variables as predictors of re attendance for mammography screening and to examine the utility of the Health Belief Model (HBM) in predicting reattendance for mammography screening above and beyond socio-demographic and knowledge variables. A total of 88 reattenders and 44 non-reattenders of an Australian breast screening service completed a questionnaire assessing socio-demographics (age, marital status, education, physician recommendation and family history), knowledge and HBM variables. Results showed that reattenders were more likely to be older, married and report physician involvement than non-reattenders. Family history and knowledge did not significantly predict reattendance. Of the HBM variables, perceived benefits was related to reattendance above and beyond socio-demographics. Results support the utility of the HBM as a focus for improving regular attendance for breast screening. It is concluded that non-reattenders should be investigated as a seperate group to women who have never attended for mammography screening.     

Gender and Generativity Issues in Parenting: Do Fathers Benefit More Than Mothers From Involvement in Child Care Activities?

This study explored fatherhood from an Eriksonian developmental perspective and proposed parenting as a key stimulus for fathers' societal generativity. The aims of the study were to examine (1) whether parental generativity (greater time spent in child care activities and higher levels of psychological involvement in the role of parenting) was related to higher levels of societal generativity in fathers, (2) which kinds of child care activities were related to the development of societal generativity in fathers, and (3) whether the same relationships applied to mothers. A total of 134, predominantly White, middle class, Australian cohabiting parents completed questionnaires. Results indicated that parental generativity was related to fathers' societal generativity, but not to mothers. However, particular child care activities that promoted children's social–emotional development were related to fathers' societal generativity, whereas activities that promoted children's academic–intellectual development were related to mothers' societal generativity.     

Cortisol changes interact with the effects of a cognitive behavioural psychological preparation for surgery on 12-month outcomes for surgical heart patients

Previous studies offer contradictory evidence regarding the effects of cortisol changes on health outcomes for surgical heart patients. Increased cortisol and inflammation have been related to psychological stress while separate studies have found an inverse relation between cortisol and inflammation. Psychological preparations for surgery can reduce stress and improve outcomes and may interact with cortisol changes. Following from these relationships, we hypothesised that a preparation for surgery will interact with changes in cortisol to affect outcomes. Measures were the SF 36 General Health and Activities, medical visits and satisfaction. Eighty-five patients were randomly assigned to standard care plus a psychological preparation or standard care alone using a single-blind methodology. Data on psychological and biological functioning were collected at admission, 1 day prior and 5 days post-surgery, and 12-months after hospital discharge. General health and activities, and medical visits were related to the interaction of cortisol change and psychological preparation in support of the hypothesis. Patients were more satisfied in the preparation group than controls. Based on these findings, some outcomes from psychological preparations may be affected by changes in levels of cortisol. These results caution against a one-size-fits-all approach to psychological preparations.     

The effects of parental illness and other ill family members on youth caregiving experiences

Informed by a model of family role redistribution derived from the family ecology framework, this study examined differences in two proposed psychological components of role redistribution (youth caregiving experiences and responsibilities) between youth of a parent with illness and their peers from ‘healthy’ families controlling for the effects of whether a parent is ill or some other family member, illness type and demographics. Based on self-report questionnaire data, four groups of Australian children were derived from a community sample of 2474 youth (‘healthy’ family, n = 1768; parental illness, n = 336; other family member illness (OFMI), n = 254; both parental and OFMI, n = 116). The presence of any family member with a serious illness is associated with an intensification of youth caregiving experiences relative to peers from healthy families. This risk is elevated if the ill family member is a parent, if more illnesses are present and by certain youth and family demographics, and especially by higher caregiving responsibilities. The presence of a family member, particularly a parent, with a serious medical condition has pervasive increased effects on youth caregiving compared to healthy families, and these effects are not fully accounted for by illness type, demographics or caregiving responsibilities.     

Adjustment to multiple sclerosis: application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS.     

Benefit finding in multiple sclerosis and associations with positive and negative outcomes.

This study examined the direct and stress-buffering effects of benefit finding on positive and negative outcomes. A total of 502 people with multiple sclerosis completed a questionnaire at Time 1 and, 3 months later, at Time 2 (n = 404). Measures of illness were collected at Time 1, and number of problems, stress appraisal, benefit finding, subjective health, and negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) outcomes were measured at Time 2. Factor analyses showed the Benefit Finding scale to have 2 dimensions: Personal Growth and Family Relations Growth. Hierarchical regressions showed that after controlling for the effects of demographics, illness, problems, and appraisal, benefit finding showed strong direct effects on the positive outcomes. Benefit finding did not have a direct effect on distress or subjective health but had a weak association with negative affect. Family Relations Growth had a stress-buffering effect on distress.