Testing the health promotion model for adherence and quality of life in individuals with multiple sclerosis

The nature of multiple sclerosis (MS) presents challenges to health-promoting behaviors (e.g. adherence) and quality of life. The Health Promotion Model (HPM) proposes that these outcomes are explained by individual characteristics (i.e. biological, social, psychological) and behavior-specific cognitions (e.g. self-efficacy). The current study sought to test the HPM in explaining self-reported adherence and MS quality of life among 121 MS patients receiving care in an MS clinic in the southeastern United States. Hierarchical regression models partially supported the HPM for adherence (R² = .27) and more fully for quality of life (QoL) (R² = .64). Depression and stigma were among the variables most strongly related to both adherence and QoL; contrary to HPM theory, self-efficacy was not significantly related to adherence but was to QoL. Thus, the HPM may help to guide strategies used to improve QoL among individuals living with MS; however, the model may need further refinement to be used with adherence.     

Relations between symptom severity,illness perceptions,visceral sensitivity,coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ² (8) = 11.91, p = .16, χ²/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.     

Can virtue be learned? An exploration of student learning experiences in ethics courses and their implications for influencing moral character

What does it mean to teach virtue, or to learn it? We consider this question through an institutional review board (IRB) supported research study attending to student learning experiences in undergraduate ethics courses at a Catholic university with an explicit commitment to social justice. This essay draws on and interprets qualitative data concerning the outcomes of select pedagogical approaches that involve exposing students to the experiences of others: the use of narratives; participation in structured experiential learning activities; and community engagement through deep listening and facilitated dialogue. We focus our interpretation around the implications of these pedagogies in relation to student understanding of and attitudes regarding three character traits identified as “other‐regarding” virtues in theological and philosophical scholarship – altruism, compassion, and solidarity. This paper considers the implications of these pedagogies and the practical effects of different sorts of teaching strategies on students' self‐understanding as moral agents.     

Prévention des risques psychosociaux au sein d’établissements publics d’enseignement agricole : quand le diagnostic organisationnel participe d’une amélioration de la qualité de vie au travail

The aim of this article is to show that a diagnosis of psychosocial risks based on a mixed and participative methodology contributes to improving the quality of life at work. It is based on a “Quality of life at work” approach set up within a public educational institution for agricultural studies. The quantitative part includes the Job Content Questionnaire by Karasek, Siegrist's Effort/Reward Imbalance Questionnaire, the Maslach Burnout Inventory, the Negative Acts Questionnaire (revised) and the Hospital Anxiety and Depression Scale from Zigmond and Snaith. The qualitative part is based on focus group discussions. Results have brought to light the groups of employees which are most exposed to risks, especially those in the “school life” sector. They also show that lack of recognition, support and communication are problems experienced by all the staff members of the school. In order to enhance employees’ quality of life within the working environment, a multitude of co-constructed “tailor-made” ways and means of improvement have been suggested. The study shows how the selected methodology contributes to the quality of the diagnosis.     

Quality of life research: a case for combining photo-elicitation with interpretative phenomenological analysis

In this article, we provide practical and theoretical discussion of the use of two complementary research methods to explore quality of life. We present a case example of the use of photo-elicitation alongside interpretative phenomenological analysis and use examples from our research with people living with paraplegia and chronic pain to demonstrate how these methods can be combined to provide a participant-led understanding of quality of life. This discussion includes consideration of practical and ethical issues relevant to others wishing to combine these research methods. Furthermore, we highlight some of the potential practical and therapeutic opportunities provided by the approach through an illustration of how photographs work to enhance self-reflection and promote hermeneutic sense making.     

意义治疗的团体辅导对于戒毒者复吸倾向的影响

摘 要: 考察意义治疗的团体辅导对于戒毒者复吸倾向的干预效果。选择生命意义感较低的被试18名进入实验组,并选择与其分数匹配的18名被试组成对照组。后测结果表明,与控制组相比,实验组被试的价值感、效能感、成就感和生命意义感均有显著提升,复吸倾向显著降低。结论: 意义治疗的团体辅导能够显著提高戒毒人员的创造性价值类生命意义源和生命意义感,显著降低其复吸倾向。提升创造价值与对苦难的理解是提高生命意义感的有效途径。     

Depression,Panic-Fear,and Quality of Life in Near-Fatal Asthma Patients

The aim of this study was to assess the relationships between depressive symptoms and symptom-centered panic-fear (P-F), and reports of health-related quality of life (HRQOL), in persons with near-fatal asthma (NFA), controlling for age, gender, and pulmonary function. Forty persons with NFA were interviewed. Sociodemographic and clinical asthma-related information were collected. HRQOL was assessed by the SF-36 Health Questionnaire, depressive symptoms were assessed by the Beck Depression Inventory, and P-F was assessed by the P-F scale of the Asthma Symptom Checklist. Multiple regression analyses were carried out with the Physical Component Summary (PCS) and the Mental Component Summary (MCS) of the SF-36 as a dependent variable, and depressive symptoms, P-F, age, gender, and pulmonary function as independent variables. Results showed that P-F and age were associated with PCS, whereas depressive symptoms accounted for a marked percentage of the variance explained in MCS. Neither gender nor pulmonary function were related to HRQOL. In conclusion, depressive symptoms and P-F play an important role in how persons with NFA assess their HRQOL. These patient-centered variables are potentially modifiable and may offer new ways to intervene in order to improve HRQOL in persons with NFA.     

儿童社会生活适应量表的编制与应用

本研究编制的儿童社会生活适应量表具有较高的信度和效度,该量表包含五个因素:亲社会行为、居家、生活自我管理、情绪监控和社会交往。我国儿童的社会生活适应总体上存在显著的性别差异,具体体现在亲社会行为、居家、生活自我管理、情绪监控方面,女生显著高于男生。从年级的发展趋势看,儿童社会生活适应总体上呈上升趋势,他们的社会生活适应能力在不断增强。     

生活事件、负性自动思维及应对方式影响大学生抑郁的路径分析

对321名大学生施测青少年生活事件量表(ASLEC)、自动思维问卷(ATQ)、特质应对方式问卷(TCSQ)及流调中心用抑郁量表(CESD),以探讨生活事件、负性自动思维及应对方式对抑郁的影响模式。结果:(1)相关分析发现:生活事件、负性自动思维、消极应对方式均与抑郁呈显著正相关(p<0.01),生活事件与负性自动思维及消极应对方式呈显著正相关(p<0.01)。(2)路经分析发现:有六条显著路径影响抑郁。应对方式对抑郁产生直接的影响;自动思维可以直接影响抑郁,同时也可通过应对方式间接影响抑郁;生活事件对抑郁的直接影响不显著,其影响是经由负性自动思维及应对方式的中介作用而间接实现的。