PREDICTORS OF SELF‐REPORTED GAINS IN A RELATIONSHIP‐BASED HOME‐VISITING PROJECT FOR MOTHERS AFTER CHILDBIRTH

We assessed mothers’ self‐reported gains from a postpartum home‐visiting (HV) project in which home visitors are volunteer mothers from the community. Hypotheses were that gains are positively related to (a) mothers’ felt‐closeness with their home visitor, (b) mothers’ level of sociodemographic risk, and (c) the home visitors’ preproject training in support services for families or children (Professionalism). One hundred sixty‐four clients returned written evaluations of the HV project. Items assessing gains were reduced to two factors: Improved Well‐Being (“Self”) and Improved Infant Care (“Infant”). Repeated measures general linear models, with Gains (Self, Infant) as the repeated measure, and multiple regression analyses evaluated the hypotheses. Across the sample, gains on both factors were moderate, although gain scores were higher regarding Self than for Infant. Results show that (a) Mothers’ felt‐closeness with their volunteer was strongly related to mothers’ gains; (b) high‐risk mothers gained more from the project than did mothers of lower risk, particularly regarding Infant Care; and (c) mothers visited by volunteers who were professionals reported more substantial gains than did mothers visited by volunteers who were not professionals. Findings can help explain variance in mothers’ gains from such projects and could be useful in improving their efficacy.     

Health-related quality of life among people living with hiv disease in small communities and rural areas

Abstract

While many studies have examined the life quality of HIV-infected persons in large metropolitan areas, few studies have investigated quality of life issues among persons living with HIV disease in America's small and rural communities. In the present study, 78 people living with HIV/AIDS in small and rural communities (i.e., populations <25,000) reported on their health-related quality of life. Many respondents reported decreased social, emotional, functional, and physical well-being. Results revealed that participants' emotional well-being and the quality of their relationship with their doctor were related to their overall quality of life. The majority of participants (73%) expressed interest in participating in a telephone-linked support group involving other people living with HIV designed to improve quality of life.     

Is spousal support always helpful to patients with asthma or diabetes? A prospective study

The current study examined effects of three ways of providing spousal support (active engagement, protective buffering, and overprotection) on self-efficacy and physical and mental health in patients with diseases imposing a high demand on self-management routines (36 asthma patients and 21 diabetic patients). Employing a nine-month prospective design, we hypothesized that active engagement would be positively related to health and self-efficacy, that overprotection would have a negative impact, and that the impact of protective buffering would depend on symptom level at baseline. Results confirmed the latter hypothesis while either positive or negative effects of active engagement and overprotection were absent. These findings are discussed with respect to the role of spousal support in diseases requiring self-management behaviour.     

The impact of social support on the acceptance process among RA patients: A qualitative study

Acceptance is an important component of pain management, being associated with improved quality of life and lower levels of pain and depression. In enabling patients with chronic diseases to accept unpleasant consequences and to establish a new way of living, the support they receive from their social environment may play a decisive role. In this article, we identify the key sources and types of social support that are relevant for rheumatoid arthritis (RA) patients, and explore when and how those sources are important across the different stages of the acceptance process. We conducted a qualitative study involving 20 semi-structured interviews with RA patients in Switzerland. Analysis of the data followed the precepts of grounded theory. We found that, amid the complexity and variety of patients’ struggles for acceptance, there were some common experiences or ‘key moments’ in which social support played an important role. While three sources of support – family, physicians and the external social context – are fundamental for RA patients, all three may inhibit as well as encourage acceptance, due to the invisible and unpredictable character of the disease. There is a pervasive risk either of underestimating patients’ suffering or of over-supporting, both of which prevent patients accepting the disease and developing a new ‘normal’ life. We conclude that sources of social support need to find a middle way between scepticism and solicitousness.     

Attitudes towards cancer as a function of experience with the disease: A test of three models

Abstract

The present study develops and tests three models that can account for the relationship between cancer attitudes and experience with the disease. Individuals were classified according to the extent of their experience with cancer: personal experience, familial experience and minimal experience. In three studies, each using a different sample and different method of attitude measurement, it was found that those with personal cancer experience held the most positive attitudes towards cancer, while those with familial cancer experience held the most negative attitudes. These findings are consistent with the predictions of the proposed dual process model. Results are discussed in terms of the importance of understanding the impact that cancer attitudes have on the physical and emotional management of the disease.     

The relationship of social support to physical and psychological aspects of AIDS

Abstract

This study explored the social support networks of 50 homosexual males with Acquired Immune Deficiency Syndrome (AIDS). Data gathered by self report questionnaires and medical records included diagnosis, number of medical symptoms, sociodemographics, extensive information about social support networks, mood state and physical health status. Variables associated with good psychological and physical adaptation included satisfaction with support, instrumental support and emotional support. Results of this study conflict with previous studies in that worse physical condition was not positively associated with satisfaction with support, was related to less instrumental support and was not associated with increased quantitative support. The measures of satisfaction with support, instrumental support and emotional support were all quite high, even though network size was small.     

Psychological support needs of patients with head and neck cancer and their caregivers: A qualitative study

Objective: The aim of this study was to explore the psychological support needs of patients with head and neck cancer (HNC) and their caregivers. The appropriate timing, length, format and content of sessions were also investigated.

Design: Eighty-three patients with HNC and 73 of their caregivers completed questionnaires at diagnosis. Follow-up questionnaires were mailed to patients six months later.

Main outcome measures: Free text-comments to open-ended questions in the questionnaires were analysed using an inductive thematic approach with coding and theme development directed by the content of responses. This was used to determine psychological support needs both at diagnosis and at six month follow-up.

Results: Patients described ‘just being there’, empathy, maintaining normality and practical support as helpful from family/friends. They desired information, honesty, positivity and empathy from clinical staff. Formal psychological support was desired by approximately 40% of patients and caregivers, particularly early after diagnosis and during treatment. Most participants desired face to face sessions, providing individualised information and coping strategies.

Conclusion: The results of this study suggest that psychological interventions for patients with HNC and their caregivers should be delivered early after diagnosis in face to face sessions, presenting honest and factual information about the disease and coping strategies.     

Differences between informants about type a,anger, and social support and the relationship with blood pressure

Abstract

In a study on the influence of different natural environments on self-perception and that of significant others, behavioral manifestations of Type A, Anger, and Social Support were assessed. It was hypothesized that due to different environmental demands, participants will be perceived as displaying differences in Type A behavior, anger, and social support at home and at work. Participants were 45 university employees, constituting a convenience sample. Assessment included Type A Structured Interview scores of participants and questionnaire scores for Type A, anger, and social support of participants who were also evaluated by their spouses and work supervisors. Other risk factors for coronary heart disease (i.e., blood pressure, smoking, previous heart condition, being sedentary, and family history) and their relationships with Type A, anger, and social support were also examined.

Participants and spouses agreed significantly on all measures, whereas participants and work supervisors agreed only on Type A behavior. Spouses' and work supervisors' evaluations of the participants' behavior were not or only marginally associated. Multiple regression analysis showed that the level of disagreement between the different informants with respect to Type A and social support were associated with elevated blood pressure. These results suggest that the perception of Vpe A behavior, anger, and social support may be situationally determined.     

The role of social support as a moderator of the acute stress response: In Situ versus empirically-derived associations

Abstract

This investigation was designed to (1) evaluate the role of social support during an acute naturalistic stressor i.e., emergency dental treatment, (2) assess whether an in situ and an empirical measure of support exhibited consistent relationships with anxiety and (3) examine the relationship between the in situ and empirical measures of support. All participants completed a measure of social support prior to treatment and an anxiety measure prior to and following treatment. The effect of support on pre-treatment anxiety, post-treatment anxiety and change in anxiety during the treatment process was assessed. According to the in situ support measure, individuals high in support were accompanied to the clinic, and individuals low in support were unaccompanied. According to the empirical support measure, individuals high in support had actual support scores above the sample median. Individuals low in support had actual support scores below the sample median. Individuals high in in situ support were found to have significantly higher levels of pre-treatment anxiety. No other effects of support were observed for either support measure. Furthermore, while there was some evidence that the in situ and empirical measures of support were associated with consistent outcomes, in the main, they exhibited independence.     

Augmenting the theory of planned behaviour: Motivation to provide practical assistance and emotional support to parents

Abstract

Surveys indicate that the highest proportion of people receiving informal care are parents (Green, 1988), yet a literature search showed that psychological studies of motivation to care for parents are limited. The present study utilised an augmented model of the theory of planned behaviour (Ajzen, 1985) including measures of anticipated regret and carer self-concept, to examine individuals' motivations to provide practical assistance and emotional support to their parents. Intention to provide emotional support was predicted by the theory of planned behaviour constructs, while intention to provide practical assistance was predicted by subjective norm and perceived behavioural control but not by attitude. Anticipated regret substantially improved prediction of both types of behavioural intention. These findings indicate that providing practical assistance and emotional support are motivated behaviours, governed by both rational and emotional factors, suggesting that future research may benefit from adopting a broader perspective based upon social psychological theory