Social networks and partner stress as predictors of adherence to medication, rehabilitation attendance, and quality of life following acute coronary syndrome.

OBJECTIVE: This study examined whether social network size and partner stress predicted medication adherence, cardiac rehabilitation attendance, and quality of life 12 months following hospitalization for an acute coronary syndrome (ACS). DESIGN: ACS patients (N = 193, M age = 60.6 years, SD = 11.4 years, 23% female) were recruited shortly following admission to 4 local hospitals. A prospective design was employed with follow-up data collected 12 months following hospital admission. MAIN OUTCOME MEASURES: Data were gathered on social network size and partner stress. The main outcomes assessed at 12 months were medication adherence, cardiac rehabilitation attendance, and quality of life (Short Form 36). RESULTS: Partner stress predicted medication nonadherence, odds ratio: 2.89, (95% CI = 1.21, 6.95). ACS patients with large social networks were more likely to attend rehabilitation, odds ratio: 3.42, (95% CI = 1.42, 8.25). Analyses were adjusted for age, gender, clinical risk scores, readmission/recurrence, and negative affectivity. Both partner stress and smaller social network size were associated with poorer quality of life. CONCLUSION: Social network size and partner stress may partly exert their influence on coronary heart disease morbidity and mortality through recovery behaviors and maintenance of quality of life.     

The storm and stress (or calm) of early adolescent self-concepts: within- and between-subjects variability

This study uses intraindividual variability and change methods to test theoretical accounts of self-concept and its change across time and context and to test the developmental implications of this variability. The 5-year longitudinal study of 541 youths in a rural Pennsylvania community from 3rd through 7th grade included twice-yearly assessments of self-concept (academic and social), corresponding external evaluations of competence (e.g., teacher-rated academic skills, peer-nominated "likeability"), and multiple measures of youths' overall adjustment. Multiphase growth models replicate previous research, suggesting significant decline in academic self-concept during middle school but modest growth in social self-concept from 3rd through 7th grade. Next, a new contribution is made to the literature by quantifying the amount of within-subject variability (i.e., "lability") around these linear self-concept trajectories as a between-subjects characteristic. Self-concept lability was found to associate with a general profile of poorer competence and adjustment and to predict poorer academic and social competence at the end of 7th grade above and beyond level of self-concept. Finally, there was substantial evidence that wave-to-wave changes in youths' self-concepts correspond to teacher and peer evaluations of youths' competence, that attention to peer feedback may be particularly strong during middle school, and that these relations may be moderated by between-subjects indicators of youths' general adjustment. Overall, findings highlight the utility of methods sensitive to within-subject variation for clarifying the dynamics of youths' self-system development.     

A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self-Help Settings

A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents' psychiatric severity were examined at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity reported significantly more days using psychiatric medication, decreased outpatient psychiatric treatment, yet no significant differences for number of days abstinent and time living in an Oxford House. These findings suggest that a high level of psychiatric severity is not an impediment to residing in self-run, self-help settings such as Oxford House among persons with psychiatric comorbid substance use disorders.     

Varied intensities of training, predicted maximum oxygen uptake and the minimum threshold hypothesis

In this study, 24 sedentary first-year male university students aged 17 to 24 yr. were assigned to one of four groups. Three of the groups underwent a 6-wk. training program consisting of a 30-min. bicycle ergometer ride, three times per week. A fourth group acted as a control. The experimental groups trained at workload intensities corresponding to predetermined heart rates of 125, 140, and 155 bpm, respectively. Analysis of scores indicated that changes in aerobic capacity occurred only if the intensity of training exceeded a minimal level. Essentially, these results replicated data from other studies.     

The Impact of a Child’s Cancer on the Father’s Relationship with His Spouse in Korea

A father of a child with cancer experiences psychological stress related to his child’s cancer diagnosis and treatment, which may affect his relationship with his spouse. Nevertheless, little attention has been paid to how having a child with cancer affects the marital relationship from the perspective of the father. We examined the impact of the child’s cancer on the father’s relationship with his spouse in Korea. We conducted in-depth interviews with 20 fathers (mean age?=?41.35 years; SD?=?4.49) of children who were diagnosed with cancer before the age of 19 and were within 5 years of the diagnosis. The mean age of the child with cancer was 9.1 years (SD?=?3.68), and the mean age at diagnosis was 6.4 years (SD?=?4.08). The analysis of the interviews revealed the following four themes (and eight subthemes): conflicts between spouses (lack of father’s participation in caregiving, financial and work-related stress), mental suffering (heartbroken, torn between caregiving and work), change in communication (child-focused communication, avoiding communication), and change in the marital relationship (neglected relationship, new trust built in the relationship). A father’s increased conflict in the marital relationship after his child’s diagnosis of cancer was intensified by his limited involvement in child care and parenting responsibilities. An understanding of the change in the father’s relationship with his spouse can inform the development of a psychosocial intervention that may strengthen a father’s emotional intelligence and resilience, which could improve the marital relationship.     

Body Image and Self-Esteem: A Comparison of African-American and Caucasian Women

The purpose of this study was to assess howwomen's perceptions of themselves and their bodies varyby race/ethnicity and class. One hundred and fourteenfemale students (45 African-American, 69 Caucasian) from two Connecticut community colleges weresurveyed. We predicted that African-American women willreport higher levels of self-esteem and a more positivebody image than Caucasian women. These predictions were supported. Also as predicted,African-American women report possessing more masculinetraits and that men of their race tend less to preferthin, small figured women. Controlling for theseprotective factors substantially reduces therelationship between race/ethnicity and self-concept.African-American women's racial identity and exposure tothe dominant culture did not relate to self-conceptmeasures.     

Spousal caregiver confidence and recovery from ambulatory activity limitations in stroke survivors.

OBJECTIVE: This study examined whether spousal confidence in care-recipient recovery can predict recovery from activity limitations following stroke and how spousal confidence relates to stroke survivor self-efficacy for recovery. DESIGN: A prospective design was used. Measures were gathered from stroke survivor/spouse dyads at two time points, both postdischarge from the hospital following stroke (N=109). MAIN OUTCOME MEASURES: The dependent variable was recovery from ambulatory activity limitations over 6 weeks, as measured by the Functional Limitations Profile. A single spousal confidence item was tailored to an ambulatory behavior that the stroke survivors could not perform at Time 1. RESULTS: Spousal confidence was correlated with ambulation recovery (r=-0.23, p<.05) and stroke survivor self-efficacy for recovery (r=.25, p<.05). Higher spousal confidence was associated with a better recovery and greater stroke survivor self-efficacy for recovery, but not with initial health status or practical support received. CONCLUSION: The relationship between caregiver confidence, care-recipient self-efficacy for recovery, and recovery outcomes needs further elucidation.     

The effects of perceived social support on quality of life in patients awaiting coronary artery bypass grafting and their partners: testing dyadic dynamics using the Actor-Partner Interdependence Model

Patients awaiting coronary artery bypass grafting (CABG) need support from their partners or family caregivers to manage their self care successfully and to maximise quality of life. Partners need social support to help overcome the stressful tasks of an unexpected caregiving role. It is not known whether the individual's perceived social support contributes to their own, as well as their partner's quality of life. The aims of this study were to assess differences in social support and quality of life in patients and partners awaiting CABG, and to examine whether patients' and partners' perceived social support predicted their own, as well as their partner's quality of life before CABG. This cross-sectional study recruited 84 dyads (patients 84% males, aged 64.5 years and partners 94% females, aged 61.05 years). Perceived social support was assessed using the Medical Outcomes Study Social Support survey, with sub-scales for informational/emotional support, affectionate support, tangible support and positive social interaction. Quality of life was assessed using the Short-Form 12 Health Survey. Dyadic data were analysed using the Actor-Partner Interdependence Model, with distinguishable dyad regression. Results revealed the patients' informational/emotional support exhibited an actor effect on their own mental health (? = 0.19, p = 0.001); indicating those with low informational/emotional support had poorer mental health. There was a partner effect of the patients' informational/emotional support on their partner's mental health (? = 0.14, p = 0.024), indicating the patients' informational/emotional support was associated with the partner's mental health. None of the other types of social support exhibited an actor effect or a partner effect on the patient's or the partner's mental or physical health. More research into the relationship between social support and mental health is needed to help inform the design of interventions that target the dyad.     

Two alternative models of health behaviour and recovery from activity limitations due to acute injury: A prospective study

Cognitions influence recovery from activity limitations. In this study we aimed to independently test, compare and combine the common sense self-regulation model (CS-SRM) and social cognitive theory (SCT) in predicting recovery from activity limitations due to acute injury. Measures were gathered at two time points 5–6 weeks apart. The sample consisted of 146 university students (Mean age: 21.86, SD: 4.83, 62% female) with a heterogeneous range of injuries that limited their participation in physical activity. The dependent variable was recovery from activity limitations (Physical Functioning?–?Short Form-36). The predictor variables were measured using the Brief Illness Perception Questionnaire and SCT items designed according to theoretical recommendations. Time-line (TL) and self-efficacy (SE) were significant predictors of recovery in a multivariate analysis, controlling for reported pain at Time 1. A combined model including the best predictors from both models, TL (β = ?0.25, p < 0.05, R ² change = 0.17, p < 0.01) and SE (β =0.31, p < 0.05, R ² change = 0.05, p < 0.05), accounted for a significant amount of the variance in recovery from activity limitations. A combination of key variables from both models may be particularly useful for understanding the cognitive factors that influence recovery from activity limitations.