Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

Roles of Leisure in Coping with Stress Among University Students: A Repeated-Assessment Field Study

This article reports findings of a study to examine the effects of leisure coping on various stress coping outcomes including: immediate outcomes (perceived coping effectiveness, perceived satisfaction with coping outcomes, and perceived stress reduction) and distal or long-term outcomes (physical and mental ill-health and psychological well-being), above and beyond the contributions of general coping - coping not directly associated with leisure. A repeated-assessment field design was used to examine ways in which university students cope with stressors in their daily lives. The study found that leisure coping beliefs (leisure-generated dispositional coping resources) significantly predicted lower levels of mental and physical ill-health and greater levels of psychological well-being above and beyond the effects of general coping. Also, the use of leisure coping strategies (situation-specific stress coping strategies through leisure) was significantly associated with higher levels of perceived coping effectiveness and stress reduction when the effects of general coping were taken into account. Significant contributions of specific leisure coping dimensions were found as well.     

Les interventions préventives en santé mentale du jeune enfant vues par leurs bénéficiaires : l’exemple du projet CAPEDP

ObjectiveHome-visiting programs have become one of the most popular early childhood interventions, though their impact on parents and children remain uncertain. Outcomes measures often rely on experimental quantitative design and little space is offered for the voices of those served by these interventions. This paper presents the results of a qualitative protocol performed by the research team with participants in the CAPEDP project which took place in France from 2005 to 2011.MethodAll 184 women who had accepted at least one home visit in the CAPEDP programme were contacted and invited to participate. Individual and group interviews were conducted with the first 16 who accepted to participate. The semi-structured interview schedule addressed their overall appreciation of the project, their initial concerns, the quality of their relationship with their home visiting psychologist, positive and negative aspects of the intervention and any recommendations they might have for future interventions. Interviews were recorded, transcribed and anonymised. An inductive categorical thematic analysis was performed by the research team.ResultsParticipants expressed overall satisfaction with the CAPEDP intervention, underlining the quality of the relationships with the home visitors, usefulness of parental guidance, the fact that the intervention could be adapted to suit their own personal agenda, routine and needs, the importance of learning how to accept help and give help to others. Less positive aspects included the fact that the home visitors were not mothers themselves and that they lacked technical experience, the difficulty ending the relationship at the end of the 27-month project, insufficient integration of fathers, the difficult and time-consuming evaluation protocol and the lack of interaction with other parents during the intervention.ConclusionAlthough mothers who accepted to participate in the qualitative interview schedule may have had a more positive overall experience of the CAPEDP project than those who declined to participate, participants’ points of view provide potentially useful indications for adapting future home-visiting programs to the French context.     

Demands,resources, and work ability: A cross-national examination of health care workers

Understanding work ability, with the goal of promoting it, is important for individuals as well as organizations. It is especially important to study work ability in health care workers, who face many work-related challenges that may threaten work ability. We studied various job demands, job resources, and interactions of demands and resources relating to work ability using the Job Demands–Resources model as a framework. Acute care health care workers from six nations (US, Australia, UK, Brazil, Croatia, and Poland) completed a survey. Role demands related to work ability in the Australia sample only, and supervisor support related to work ability in the Australia sample only. Yet, high levels of supervisor support significantly moderated (buffered) negative relationships between physical demands and work ability in the US sample, along with negative relationships between role demands and work ability in both the Croatia and UK samples. Skill discretion related to work ability in every nation sample, and therefore appears to be particularly important to work ability perceptions. In addition, skill discretion moderated (buffered) a negative relationship between role demands and work ability in the Australia sample. We therefore recommend that interventions to help preserve or improve work ability target this important job resource.     

The relationship between forgiveness and history of suicide attempt

The sentiment of forgiveness in relationship to suicide attempts/completions has been mostly examined through studies of suicide notes and the experiences of survivors and therapists – not attempters. In a cross-sectional sample of 304 consecutive primary care patients, we examined sentiments about forgiveness using the Forgiveness Scale, comparing those individuals with versus without past suicide attempts. According to findings, individuals with past suicide attempts (N?=?55; 19.1%) evidenced significantly lower composite scores on the Forgiveness Scale. As for individual items, compared to participants without past suicide attempts, those with past suicide attempts were significantly less believing of forgiveness by others, were less likely to forgive themselves, and to a lesser degree, were less forgiving of others. There were no between-group differences with regard to confession of wrongdoing or existential forgiveness by God. Findings may offer some salient avenues of therapeutic inquiry and endeavour in the psychological healing of individuals with past suicide attempts.     

Distancing oneself from God: relationships with borderline personality symptomatology

Self-harm behaviour traditionally has been associated with borderline personality disorder. In this study, we examined the relationship between borderline personality symptomatology and intentionally distancing oneself from God as self-punishment, based on the assumption that such self-punishment may represent a form of self-harm behaviour. Data from four previous samples of primary care outpatients collected over a two-year period were combined (N?=?1511). Borderline personality was assessed with two measures: the borderline personality scale of the Personality Diagnostic Questionnaire-4 (PDQ-4) and the Self-Harm Inventory (SHI). Point-biserial correlation coefficients revealed that those who endorsed distancing oneself from God as punishment scored relatively higher on both the PDQ-4 (r?=?0.40, p?<?0.001) and the SHI (r?=?0.46, p?<?0.001). Similarly, when compared to respondents who denied ever having distanced themselves from God as punishment, those who did were more likely to exceed the clinical cut-off score on the PDQ-4 (47.3% vs. 10.9%, X^{2 ?}=?152.53, p?<?0.001) and the SHI (57.3% vs. 11.4%, X^{2 ?}=?224.12, p?<?0.001). Findings support our hypothesis that distancing oneself from God as punishment may be a form of self-harm behaviour associated with borderline personality symptomatology.     

Health numeracy and cognitive decline in advanced age

ABSTRACT

The study aimed at investigating health numeracy in cognitively well performing healthy participants aged from 50 to 95 years as well as in participants with cognitive impairment, but no dementia (CIND). In cognitively well performing participants (n = 401), demographic variables and cognitive abilities (executive functions, reading comprehension, mental calculation, vocabulary) were associated with health numeracy. Older age, lower education, female gender as well as lower cognitive functions predicted low health numeracy. The effect of older age was partly mediated by executive functions and calculation abilities. Participants with CIND (n = 51) performed significantly lower than healthy controls in health numeracy. The findings suggest that cognitively well performing old individuals have difficulties in understanding health-related numerical information. The risk of misunderstanding health-related numerical information is increased in persons with CIND. As these population groups are frequently involved in health care decisions, particular attention has to be paid to providing numerical information in comprehensible form.     

Exploring the Validity of the Values-In-Action Inventory of Strengths (VIA-IS) in an African Context

This study explored the validity of the Values-In-Action Inventory of Strengths (VIA-IS) in an African context. A convenience sample of 256 African students completed the VIA-IS in English. The majority of strengths subscales had good reliability coefficients and mean scores comparable to those reported in a Western context. Satisfactory criterion-related validity was established through correlations with other well-being indices. First and second order confirmatory factor analyses only partly supported construct validity. All strengths subscales consisted of more than one factor. The hypothesised six-virtue cluster pattern was partially supported. Exploratory factor analysis suggested the possibility of an emic factor pattern of strengths consisting of 3 components: Within the first factor, Intrapersonal and Relationship Strengths, two clusters are distinguished, namely, Intrapersonal Strengths, and Horizontal and Vertical Relationship Strengths. The second factor was Integrity in Group Context. Thus, the VIA-IS has merit, but is not completely valid in its original form.     

Character strengths and well-being among volunteers and employees: Toward an integrative model

The endorsement and deployment of character strengths in occupational contexts are two promising components for understanding how people create well-being. In this study, a model integrating character strengths, satisfaction with occupational activities, and meaning and well-being was proposed and tested in two samples of volunteers and a sample of working adults. The model fit the data well in all three samples. Results demonstrated that deploying strengths at work provided key links to satisfaction with voluntary and paid occupational activities and to meaning among both young and middle-aged volunteers, and adult working women. Among adult volunteers and paid workers, endorsing strengths was related to meaning, while both endorsing and deploying strengths were related to well-being. Together, these studies provide a model for understanding how strengths may play a role in how both volunteer and paid workers find meaning, well-being, and satisfaction.     

Adult Israeli Community Norms for the Brief Symptom Inventory (BSI)

The study aim is to establish Israeli norms for the Brief Symptom Inventory (BSI). A nationwide representative sample of 510 community respondents (age range 35–65, 51.4% women) completed the Hebrew version of the BSI. The data showed high internal reliabilities for the 9 BSI scales, as well as for their total score, indicated by the General Severity Index (GSI). Higher levels of GSI were found for widowed, divorced, and single respondents than for married respondents. Higher GSI was also found for unemployed and retired men than the self-employed and employees, validating the GSI as a measure of distress. Most importantly, the scores of the Israeli GSI, as well as each of the 9 scales, were higher than those reported in either the U.S. or the British norms. These findings may indicate that Israeli society is experiencing relatively high distress, highlighting the need for establishing BSI norms for each culture.