A one year study of coping,social support and quality of life in parkinson's disease

Abstract

The role of coping and social support in the quality of life for Parkinson's Disease (PD) patients is not well understood. Most studies are cross-sectional and concentrate on depression as an outcome measure. The aim of the present study was to explore the role of coping and social support in quality of life for patients with PD. Self-report measures were completed by 105 sufferers of PD; 75 completed the same questionnaire a year later. Patients had the most problems with social function, followed by problems with mobility control and psychological autonomy and communication. After controlling for age, gender and illness duration, the number of PD symptoms predicted mobility control, social functioning and psychological function. Passive coping explained additional variance in most functional domains with more passive coping being related to increased problems. The quality of life was highly stable over the course of the year. Active coping was related to superior psychological functioning one year later. In fact, this was the only coping and social support variable related to functioning after one year, when controlling for previous functions. The results are discussed in terms of the importance of symptom management in PD.     

Social comparisons and quality of life among survivors of childhood cancer and their mothers

Abstract

Sixty-three survivors of childhood cancer (mean age 17 years), currently well and off-treatment, and their mothers were interviewed individually about their experiences and the impact of their illness on their lives. Survivors also completed four questionnaire measures of different aspects of quality of life (perceptions of illness experience, future worries, health problems and body image satisfaction), whereas mothers recorded their perceptions of their child's quality of life on the same four scales. These scales showed good internal consistency and convergent validity for both survivors and mothers. Mothers also completed a measure of their own quality of life (the SF-36). The interviews with both survivors and mothers were content-analysed for statements expressing social comparisons. These statements were coded according to whether the comparison implied a favourable, neutral or unfavourable evaluation of the individual survivor. Mothers who made a higher proportion of unfavourable comparisons reported worse adjustment for their child on all four scales and described their own quality of life more negatively. Among survivors, those who made a higher proportion of unfavourable comparisons gave significantly more negative self-ratings on one of the four scales. Correlations between survivors' and mothers' ratings on the four scales were positive, but comparatively low. This reinforces concerns about using parents as proxy judges of young people's quality of life, although the correlations were more satisfactory in the case of younger rather than older (>18.5 years) survivors. Mothers who rated their own quality of life as less satisfactory reported more problems for their child on all four scales, irrespective of how the survivors described themselves.     

Psychosocial effects associated with dental fear in adult dental patients with avoidance behaviours

Abstract

The most obvious consequence of a genuine dental phobic reaction is the avoidance of necessary dental care. Previous research has indicated that such avoidance has adverse effects on an individual's oral health status, and also reduces the quality of life. However, systematic investigations in this area of dentistry are few and clinical observations and interviews may often fail to elicit information regarding the impairment created outside the dental situation. The present investigation assessed the presence and levels of emotional and social life effects among dental phobic patients with regard to the prevalence of dental and general fears and the length of time for which dentistry had been avoided. It was shown that a majority of the patients felt that they had to curtail their social relations, and many, especially long-term avoiders, reported wide-spread negative social life effects. Often this had extended into feelings of loneliness or to overt social isolation. It remains to be seen whether fear of dentistry itself produces disadvantage or whether these effects are mainly related to personality factors, which can also promote the development of dental fear. Alternatively, poor dental health, which is probably more frequent in anxious patients, may be perceived by these patients and thus impair social relationships.     

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.     

A self-esteem measure for patients with cancer

Abstract

In assessing the quality of life of patients with cancer. :in important. though largely ignored. variable is self-esteem. The development of an instrument to measure self-esteem, using visual analogue scales, is described. This instrument was administered to 170 patients with newly diagnosed early breast cancer. Hodgkin's disease and non-Hodgkin's lymphoma three months and one year alter diagnosis. The instrument was acceptable to patients; internal consistency and test-retest reliability data are reported. Self-esteem scores were inversely correlated with depression and trait anxiety scores, and positively correlated with internal locus of control. Self-esteem was not significantly affected by tumour grade or stage. or by the extent to which patients felt disabled by the symptoms and side effects of their disease and treatment. The implications of these findings are discussed.     

Coping strategies and quality of life in women with advanced breast cancer and their family caregivers

Abstract

This study examines the effects of personal resources of both heart patients and their close social partners on patients' coping and quality of life. Generalized personal resources (self-efficacy beliefs, dispositional optimism, self-regulation competence) and outcomes were assessed by questionnaire 1–3 days before surgery (n = 122) and again six months later (n= 50). Outcome variables were coping styles, social resources (social support and social integration), emotional states, and further measures of quality of life. Patients' personal resources were dominant in the prediction of most of the outcomes. Partners' resources were uniquely related to social support, social integration, and quality of life as perceived by the patients. Further, partners' personality resources predicted changes in patients' loneliness and energy levels during the six-month interval.     

Illness perceptions in dialysis patients and their association with quality of life

The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions and quality of life were assessed with the IPQ-R and the SF-36 in 91 HD and 42 PD patients participating in the NECOSAD-study. Compared to HD patients, PD patients experienced more personal control and had a better understanding of the illness. Illness perceptions explained from 17 to 51% of the variance in quality of life scores. Perception of more symptoms, more consequences and lower personal control were associated with lower well-being. The concept of illness perceptions is useful in understanding the impact of ESRD and of dialysis treatment on quality of life. Interventions aimed at providing more knowledge about ESRD and dialysis, and provision of skills to coping with the illness and its consequences may improve quality of life in dialysis patients.     

Less Engagement in Pleasurable Activities Is Associated With Poorer Quality of Life for Veterans With Comorbid Postdeployment Conditions

The presence of multiple comorbid conditions is common after combat deployment and complicates treatment. A potential treatment approach is to target shared mechanisms across conditions that maintain poorer health-related quality of life (HRQOL). One such mechanism may be decrements in pleasurable activities. Impairment in pleasurable activities frequently occurs after deployment and may be associated with poorer HRQOL. In this brief report, we surveyed 126 veterans who had previously sought an assessment at a Veterans Affairs postdeployment health clinic and assessed pleasurable activities, HRQOL, and postdeployment health symptoms. Forty-three percent of veterans met our criteria for all 3 postdeployment conditions (posttraumatic stress disorder, depression, and chronic widespread physical symptoms). Greater engagement in pleasurable activities was associated with better HRQOL for all veterans regardless of type or level of postdeployment health symptoms. Future research should study if interventions that encourage veterans with postdeployment health conditions to engage in pleasurable activities are effective rehabilitation strategies.     

Cognitive Structure,Content Knowledge,and Classificatory Reasoning

Classificatory reasoning was studied in 58 children, 7 and 8 years old, who differed in operational level as well as in expertise. Knowledge about dinosaurs was used to distinguish expertise level. The children's performance on class-inclusion tasks involving the dinosaur content was a function of operational level. An overall effect of expertise was found for children's performance on class-membership measures. Furthermore, on the class-membership measures, expertise did not significantly influence the performance of children at the concrete-operational level, but it did for children at the pre-operational level. The results suggest that domain-specific knowledge and operational level may have different but interacting influences on children's classificatory reasoning.     

Reinforcement or compensation? The effects of parents' work and financial conditions on adolescents' work values during the Great Recession

The Great Recession brought many changes to the work and financial lives of American families. Little is known, however, about how changes in parental work conditions in recessionary times influence children's vocational development. Drawing on data from the Youth Development Study, we examine whether parents' recessionary experiences shape adolescents' work values. The findings indicate that adolescents' work values are shaped through a cross-generational reinforcement model; both extrinsic and intrinsic values are stronger when parental work conditions are more rewarding. In an exception to this pattern, unemployment among parents with low levels of education (high school degrees or less) is positively associated with children's extrinsic and intrinsic orientations, more consistent with a compensation model.