Marital role strain,illness intrusiveness,and their impact on marital and individual adjustment in end-stage renal disease

Abstract

A marital role theory approach was used to investigate individual psychosocial well-being and marital adjustment in 89 end-stage renal disease (ESRD) patients and their spouses. Four different patient groups were selected according to a continuum of clinical milestones in the treatment of ESRD, including pre-dialysis (n=17), incenter dialysis (n=18), home dialysis (n=19), and posttransplant patients (n=17). A nephrology clinic control group (n=18) was also included. Standardized instruments were employed to investigate marital role strain (Marital Role Questionnaire, KDS-15), marital adjustment (Locke-Wallace Marital Adjustment Test), subjective well-being (Affect Balance Scale, Rosenberg Self-Esteem Inventory), and psychopathology (Symptom Checklist 90-R). Hierarchical multiple regression analyses provided strong and consistent support for the major hypotheses relating elevated marital role strain to compromised marital adjustment and individual well-being. Further analyses demonstrated that increased perceived intrusiveness of ESRD was significantly related to greater marital role strain, poorer marital adjustment, and decreased individual well-being. This is consistent with the idea that perceived intrusiveness may be an important mediator of marital role strain and of coping with chronic illness. “Objective” intrusiveness, defined in terms of patient group, was not significantly related to marital or individual well-being. These findings support a dyadic approach to the psychosocial study of chronic illness.     

Impact of social support on health status and life satisfaction in people with a spinal cord injury

Abstract

Purpose: Assessment of the impact of received social support on functional health status and life satisfaction in people with spinal cord injury (SCI). Design: Respondents were 176 people with SCI between 18 and 65 years of age and living in the community. Mean time after injury was 3.6 years. Problem-oriented and emotion-oriented support, received from family members, friends and relatives, and professionals were assessed with the Sources of Social Support Inventory. Health status was assessed with the Sickness Impact Profile 68 and life satisfaction with the Life Satisfaction Questionnaire. Structural equation modelling with LISREL V8 was used to study relationships of different types and sources of social support with health status and life satisfaction.Results: Emotion-oriented support led to better psychological functioning and to greater life satisfaction. In addition, emotion-oriented support from the family led to greater satisfaction with relationships and emotion-oriented support from friends and acquaintances led to less satisfaction with social life. Problem-oriented support was not clearly related to health status and life satisfaction; there was only a negative relation between problem-oriented support and satisfaction with social life. Support, problem-oriented or emotion-oriented, from health-care professionals showed no relationships with health status or life satisfaction.Conclusions: Emotion-oriented support from family members and friends was most important for people with SCI. Greater problem-oriented support appears to be related to poorer life satisfaction.     

The dimensional structure of benefit finding in multiple sclerosis and relations with positive and negative adjustment: A longitudinal study

Benefit finding is a meaning making construct that has been shown to be related to adjustment in people with MS and their carers. This study investigated the dimensions, stability and potency of benefit finding in predicting adjustment over a 12 month interval using a newly developed Benefit Finding in Multiple Sclerosis Scale (BFiMSS). Usable data from 388 persons with MS and 232 carers was obtained from questionnaires completed at Time 1 and 12 months later (Time 2). Factor analysis of the BFiMSS revealed seven psychometrically sound factors: Compassion/Empathy, Spiritual Growth, Mindfulness, Family Relations Growth, Lifestyle Gains, Personal Growth, New Opportunities. BFiMSS total and factors showed satisfactory internal and retest reliability coefficients, and convergent, criterion and external validity. Results of regression analyses indicated that the Time 1 BFiMSS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (positive states of mind, positive affect, anxiety, depression) after controlling for Time 1 adjustment, and relevant demographic and illness variables. Findings delineate the dimensional structure of benefit finding in MS, the differential links between benefit finding dimensions and adjustment and the temporal unfolding of benefit finding in chronic illness.     

Social support,social integration,and health-related quality of life over time: Results from the Fitness and Arthritis in Seniors Trial (FAST)

The present study tested whether baseline perceived social support and social integration predicted baseline and follow-up measures of health-related quality of life for 364 older adults with osteoarthritis. The findings are secondary analyses of a randomized controlled trial of an exercise intervention. Multiple regression analyses indicate that perceived social support was related to baseline measures of functioning in psychological (depressive symptoms, social functioning, and life satisfaction) and physical domains (self-rated disability, observed physical function, and perceived health), after accounting for demographic and clinical status factors. At 18-month follow-up (additionally controlling for exercise intervention and baseline outcomes), social support significantly predicted changes in psychosocial functioning, but was unrelated to changes in self-reported and observed physical health. The findings indicate that social support is an important predictor of long-term psychosocial outcomes, but is less important than baseline clinical status for physical health endpoints in this cohort of older adults. In contrast, social integration was not a consistent predictor of outcomes.     

Reduce temptation or resist it? Experienced temptation mediates the relationship between implicit evaluations of unhealthy snack foods and subsequent intake

A more negative implicit evaluation of unhealthy food stimuli and a more positive implicit evaluation of a weight-management goal have been shown to predict lower consumption of unhealthy food. However, the associations between these evaluations, temptation to indulge and consumption of unhealthy food remain unclear. The current study investigated whether temptation would mediate the relationship between implicit food and goal evaluations and consumption (resembling an antecedent-focused route to self-control of eating), or whether those evaluations would moderate the relationship between temptation and consumption (resembling a response-focused route). A sample of 156 women (17–25 years), who tried to manage their weight through healthy eating, completed two implicit association tasks assessing implicit food and goal evaluations, respectively. Intake of four energy-dense snack foods was measured in a task disguised as a taste test, and participants reported the strength of experienced temptation to indulge in the snacks offered. Negative implicit food evaluation was associated with lower snack intake, and temptation mediated this relationship. Implicit goal evaluation was unrelated to both temptation strength and snack consumption. The findings contribute to an understanding of how negative implicit unhealthy food evaluation relates to lower consumption, namely through the mediation of temptation to indulge in those foods.     

Quality-of-life assessment in HIV-infected psychiatric outpatients: Perceived health,functional status,symptoms, and preferences for cardiopulmonary resuscitation

Abstract

The current study had two purposes: (1) to describe the reliability and validity of a measure of quality of life (QOL) in HIV-infected psychiatric outpatients, and (2) to predict cardiopulmonary resuscitation (CPR) preferences from disease stage, depression, and other QOL factors. We studied 63 patients, who were seen in one year at an HIV/AIDS psychiatry clinic. The results provide evidence for the validity of our instrument as a measure of health status in an HIV-infected psychiatric population. Overall symptoms were the strongest associates of functional limitations. disability, and perceived health, but depression was also significantly associated with all measures of QOL. Twenty-two patients (35.5%) would not have wanted to be revived if their heart stopped beating the day of the study. Disease stage and poor mental health were independent predictors of this preference, but severity of depression, social support, fatigue, perceived health, functional limitations, and life satisfaction were not.     

Quality-of-life after penile prosthesis placed at radical prostatectomy

Abstract

The clinical and psychosocial effects of immediate penile prosthesis implantation at the time of radical prostatectomy (RP) were investigated in 97 consecutive patients and 68 partners. Prosthesis recipients reported more frequent sexual contact, fewer marital problems and slightly fewer sexual functioning problems than the RP-alone patients. There were no group differences on any sociodemographic characteristics, on disease recurrence, on physical and psychosocial functioning, or on reported depression. Patients who chose the prosthesis did, however, evidence less of a link between depression and functional limitations and between depression and marital problems. They also had lower levels of agreement with their partners in reporting their own depression, as compared to the patients who opted for RP surgery alone. We conclude that the penile prosthesis was associated with an increased frequency of sexual contact, a reduction in reported marital problems, and stylistic differences between the two patient groups in dealing with affect.     

Changes in need satisfaction and motivation orientation as predictors of psychological and behavioural outcomes in exercise referral

Employing Self-Determination Theory (Deci & Ryan, 1985) as a theoretical framework, this study examined psychological need satisfaction and motivational regulations as predictors of psychological and behavioural outcomes in exercise referral (ER). ER patients (N?=?293; mean age 54.49) completed the measures of motivational regulations, psychological need satisfaction, health-related quality of life, life satisfaction, anxiety, depression and physical activity at entry, exit and 6 months following the end of a supervised exercise programme. Change in (Δ) intrinsic motivation during the scheme significantly predicted adherence and Δ habitual physical activity. Δ psychological need satisfaction from entry to exit significantly predicted Δ habitual physical activity from exit to 6-month follow-up. Δ psychological need satisfaction significantly predicted Δ motivational regulation and Δ psychological outcomes. Contrary to expectations, Δ self-determined regulation did not significantly predict Δ psychological outcomes during the structured part of the scheme, however, it did significantly predict Δ in psychological outcomes from exit to 6-month follow-up. These findings expand on cross-sectional research to demonstrate that psychological need satisfaction during supervised ER longitudinally predicts motivational regulation and psychological outcomes up to 6 months after a structured programme.     

Proximal and distal effects of mortality salience on willingness to engage in health promoting behavior along the life span

The current studies examine proximal and distal mortality salience effects on the willingness to engage in health-promoting activities and explore the roles of age and self-esteem. In Study 1, 164 participants completed a self-esteem scale, were assigned to a mortality salience or a neutral condition, and then completed a scale, tapping their willingness to engage in health promoting activities. Findings revealed that in the proximal mode, mortality salience led the young and middle-aged adults to report higher willingness to promote health behaviors, whereas older adults tended to show a lower willingness to promote their health compared to the control condition. In Study 2, a total of 251 participants completed the same series of questionnaires, including a distracting task immediately after the mortality salience manipulation. Findings revealed that, in the distal mode, whereas death reminders did not affect young adults, mortality salience led middle-aged participants to express higher willingness to conduct health-promoting behaviors than in a control condition. The mortality salience induction did not affect older adults with high self-esteem, but led low self-esteem individuals to report higher willingness to promote their health. The differences between the reactions of the different age groups in both the defense modes are discussed in view of the terror management theory.     

Predictors of quality of life enjoyment and satisfaction in individuals living with HIV and AIDS in a resource-constrained setting in South Africa

The burden of HIV disease is concentrated in sub-Saharan Africa, particularly in South Africa (SA). Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of the study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) among individuals infected with HIV. A battery of questionnaires, which included the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), were administered to 121 participants. Data was analysed using SPSS. Of the total sample (n = 121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25–49 years old experienced psychological distress. Those who were not on antiretroviral treatment (ART) were significantly affected (66%). Psychological distress was significantly prevalent among HIV positive individuals and also the strongest predictor of Q-LES among these individuals.