Caregiving in multiple sclerosis and quality of life: A meta-synthesis of qualitative research

Objective: The lack of adequate conceptualisation and operationalisation of quality of life (QoL) limits the ability to have a consistent body of evidence to improve QoL research and practice in informal caregiving for people with multiple sclerosis (MS). Thus, we conducted a meta-synthesis of qualitative research to improve the conceptual understanding of the experiences of MS carers and to identify factors that affect carers’ QoL.

Design: Systematic searches of five electronic databases yielded 17 qualitative studies which were synthesised using the principles of meta-ethnography.

Results: The synthesis resulted in nine inter-linking themes: Changes and losses; challenges revolving around MS; caregiving demands; burden of care; future concerns; external stressors; experiences of support; strategies used in managing the caregiving role; and motivating factors. Our findings suggest that MS carers can have both positive and negative experiences which may bring challenges and rewards to the carers.

Conclusion: We present a proposed QoL model for MS caregiving which can be used to inform the development of interventions for MS carers to improve their QoL. However, further empirical research is needed to examine the utility of this model and to explore the concept of QoL in MS carers in more detail.     

Depression and stressful environments: identifying gaps in conceptualization and measurement

Background and Objectives: Stress is well known as a trigger of depressive reactions, fear, anxiety, and behavioral disorders. However, there are many gaps in the conceptualization and measurement of environmental stress. Results: Exciting developments in the neuroscience of stress have increasingly expanded our knowledge of mechanisms by which stress may affect emotional and behavioral adjustment. Ironically, environmental stress has often been a silent player in human studies of stress processes. There is a significant need for increased efforts to include environmental stress variables in models of internalizing and other disorders. Measurement and conceptualization issues are prominent, and this article makes the case for improved methods of measuring acute, chronic, and early life stress, and for additional conceptualization of the dynamically changing and bidirectional effects of stress on disorder over time. Conclusions: There is a critical need for greater focus on and better measurement of the environment and its impact on emotional and other disorders, with emphasis on developmentally informed hypotheses. Empirical findings and new perspectives may contribute enormously to our understanding of normal and abnormal outcomes, and also to the challenge of effective interventions to promote mental health and optimal functioning.     

Parent–child warmth as a potential mediator of childhood exposure to intimate partner violence and positive adulthood functioning

Background and Objectives: Links between childhood exposure to intimate partner violence (IPV) and adult functioning are clear, but less research has examined the potential underpinnings of this association, especially the long-term effects of the parent–child relationship on adult well-being. We hypothesized that (i) childhood exposure to IPV would be negatively related to parent–child warmth and positively related to symptoms of psychopathology during adulthood and (ii) the relationship between IPV exposure and positive outcomes in adulthood (i.e., high life satisfaction and low psychopathology) would be mediated by parent–child warmth. Design: Participants included 703 Swedish adults (20–24). Methods: Participants responded to a self-report survey assessing violence exposure, parental warmth in childhood, and current mental health and well-being. Using multivariate regression and path analysis, models of the relationships between IPV exposure, parent–child warmth, symptoms of psychopathology during adulthood, and life satisfaction were examined. Mediation models were considered exploratory. Results: IPV exposure was related to lower levels of parent–child warmth, higher levels of psychopathology symptoms, and lower life satisfaction. The relationship between IPV exposure and positive outcomes in adulthood was mediated by parent–child warmth. Conclusions: Warm parent–child interactions may play a key role in long-term positive functioning for those exposed to IPV during childhood.     

Mediation and moderation of the effects of watching the angiography screen on patients

It has been reported that allowing patients to watch the coronary angiography screen during the procedure results in psychological benefits. This study aimed to investigate the roles of illness perceptions as mediators of this outcome and to examine whether individual differences in monitoring coping style moderated these effects. The experiment compared patients who were instructed to watch the monitor screen (n = 57) with those who were not (n = 51). Questionnaires were used to measure the research variables at one day and one month after the procedure. Results showed that watching the angiography screen increased patients’ personal and treatment control perceptions that mediated changes in self-assessed health, risk perceptions, negative affect, general and diet outcome expectancies, and diet and physical activity intentions. The behavior-related outcomes were moderated by monitoring coping style. These findings illustrate the significance of illness perceptions, perceived control and monitoring coping style in achieving desirable outcomes among patients undergoing coronary angiography, and reveal opportunities for interventions using medical imaging technologies.     

Meaning in life and its relationships with intrinsic religiosity,deliberate rumination,and emotional regulation

Meaning in life is one of the core elements of well‐being. Although meaning in life has received considerable research interest over the years, much of this research did not differentiate between the two categories of meaning, that is, search for meaning and meaning in life. The present study first investigated collective explanatory powers that intrinsic religiosity, deliberate rumination, and emotional regulation – three predictors selected based on past literature – have on these two types of meaning. In addition, mediational effects of deliberate rumination and emotional regulation in the links between intrinsic religiosity and search for meaning and presence of meaning were investigated. The participants were 326 undergraduate students in Seoul, South Korea. The hierarchical regression analyses found that while intrinsic religiosity contributed significantly in explaining only presence of meaning, deliberate rumination and emotional regulation had significant contributions in explaining both search for meaning and presence of meaning. Also, double mediational analysis using structural equation modelling revealed that deliberate rumination, but not emotional regulation, mediated the relationship between intrinsic religiosity and meaning in life. The implications and directions for future studies are also discussed.     

The relationship between impulsivity and suicide among rural youths aged 15–35 years: a case–control psychological autopsy study

In China, the gender ratio of suicide rates did not match the Western patterns, which was higher for females than males. However, the rural men were at relatively high risk of suicide in Liaoning province. Impulsivity was an important factor of suicide behaviors, but there was a lack of studies in China. This research aimed to study the relationship between impulsive personality traits and suicidal behavior among Chinese rural youths. Suicides were consecutively sampled from six randomly selected counties in Liaoning Province in China. Between 2005 and 2007, a total of 162 suicide victims were enrolled in the study along with 162 community controls matched for age, gender, and location. The psychological autopsy method was used to collect data from informants knowledgeable about the selected suicide victims and controls. The results showed the suicide victims in the study were more likely to demonstrate dysfunctional impulsivity and less likely to demonstrate functional impulsivity compared with the controls. Mental disorders, acute negative life events, and dysfunctional impulsivity contributed to the risk of suicide; educational and functional impulsivity were protective factors. Suicide prevention efforts in rural China may address impulsivity.     

Trust in the medical profession and patient attachment style

Attachment style is a person’s approach to interpersonal relationships, which develops from early experiences with primary caregivers and can remain stable into adulthood. Depending on a person’s attachment style, the amount of trust one has in others can vary when forming relationships, and trust is important in formation of the patient–physician relationship. The purpose of this study was to see if there is an association between attachment style and trust in physicians in general. Participants were recruited from an emergency department (ED) and an online university participant pool, and completed short questionnaires assessing attachment style and trust in the medical profession. Results revealed that individuals with a fearful attachment style reported significantly lower levels of trust in the medical profession than those with a secure attachment style. ED participants also reported higher levels of trust in the medical profession in comparison to student participants. This study provides a better understanding of trust in the medical profession, and insight into future care for patients who have low trust.     

Escapism motive for sport consumption as a predictor of meaning in life

The objective of this study was to examine whether spectator escapism motive for sport consumption could predict meaning in life, and to explore the role of psychological ownership in this relationship. A sample of 806 football spectators (African = 85%, male = 67.4%, Sesotho = 26.2%) completed the Motivation Scale for Sport Consumption (MSSC), the South African Psychological Ownership Questionnaire (SAPOS) and the Meaning in Life Questionnaire (MLQ). Structural equation modelling was utilised to investigate the postulated paths of the structural model. Escapism motive for sport consumption predicted meaning in life among spectators through psychological ownership. The sports escapism motive can yield positive psychological outcomes for sports fans.     

Voluntary work with sporting activities for Jewish children and teenagers: commitment to inclusiveness,Jewish identity,and a future Jewish life – an interview study

Membership in Jewish congregations seems to be declining and modern society has been described as a challenge to Jewishness and to the future for Jews as a people with shared characteristics and traditions. Activities for children and teenagers have gained increasing attention, since such activities might be a reassurance of a future Jewish life. To arrange such activities is, however, demanding and individuals who commit themselves to voluntary work are essential. In this study, six members of a Swedish Conservative congregation, who were committed to voluntary work with sporting activities for children and teenagers, were interviewed about the way in which they perceived their voluntary work. A thematic analysis was conducted. The volunteers concluded that everyone should feel included in the activities. They had a nuanced view of Jewish identity and also welcomed those who were not considered halakhically Jewish. Moreover, they wanted to support a positive Jewish identity in the new generation. Their work was perceived as meaningful even though they said that congregants who felt that the activities should adhere to Halakhah had criticized them. It is proposed that congregations should support voluntary workers and facilitate their efforts, otherwise experiences of misrecognition might evolve, experiences that are counterproductive for a vital congregational life.