Choice,Control, and Adaptation Among Elderly Residents of Sheltered Care Settings1

This study examined how elderly residents' adaptation is affected by naturally occurring levels of choice and control in sheltered care facilities. A representative sample of 244 residential care facilities was assessed with the Multiphasic Environmental Assessment Procedure, which measures the quality of residential settings for older people. Overall, facility policies allowing more choice and control were associated with better rated resident well-being, less use of health, daily living assistance, and social-recreational services, and more integration in the community. Policy clarity and the facility social climate factors of independence, influence, and organization mediated the relationship between choice and control and adaptation, and also independently affected residents' adaptation. In addition, in facilities with functionally able residents, more choice and independence were associated with less use of services; in facilities with residents of poor functional ability, choice and independence were unrelated to use of services. Thus, policies that promote more choice and independence may improve adaptation among functionally able residents of sheltered care facilities, without having a detrimental influence on poorly functioning residents.     

Seeking medical care for a breast cancer symptom: determinants of intentions to engage in prompt or delay behavior

This study examined the cognitive structures underlying women's intentions to delay or not delay seeking medical care for a breast cancer symptom. Middle-aged women imagined that they had just discovered a particular change in their breast, and they completed a questionnaire that assessed variables specified by Ajzen and Fishbein's theory of reasoned action with respect to two alternative courses of action: immediately calling the doctor (i.e., prompt behavior) and monitoring the breast change on one's own (i.e., delay behavior). Also assessed were variables external to the theory that were drawn from previous research on cancer delay. Results showed that intentions to delay were positively associated with having favorable attitudes toward delay and with perceived social pressure to delay; the attitudinal factor, however, was more influential than the social factor in determining intentions. Underlying favorable attitudes toward delay were beliefs that delay would be likely to result in maintaining control over and avoiding the disruption of one's own and others' lives but would be unlikely to result in negative health outcomes. No external variable was found to contribute to intentions to delay above and beyond attitudinal and normative considerations.     

Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patient outcomes

Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n=63), hospital programs (n=31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.     

Repetition priming across the adult lifespan--the long and short of it

Previous reports suggest that repetition priming (i.e., enhanced processing of a stimulus after experience with that stimulus) is long lasting and impervious to the effects of age, in contrast to the pattern found with explicit memory. However, the nature of repetition priming in aged individuals remains unclear, as conflicting findings have also been reported. We used a longitudinal design to examine how repetition priming is affected by multiple stimulus repetitions (three presentations) and different delay intervals (no delay, 1 day, 1 week, and 1 month) in young adults, as well as in two groups of aging adults (young-elderly and old-elderly). Our findings extend previous reports that priming is long lasting, even when 1 month intervenes between the initial experience with an item and the subsequent priming test of that item (Cave, 1997), and is relatively impervious to the effects of age (Mitchell, et al., 1990). In addition, a more detailed characterization of priming and the effects of aging was revealed. Although priming is long lasting, remaining significant even at the month delay for all groups, it did decline over time and the rate of that decline differed with age. Both young-elderly and old-elderly groups showed a marked drop-off at 1 day, whereas young adults did not show a decline until 1 week. All groups benefited from multiple repetitions; however, this benefit disappeared at the month delay (in contrast to recognition memory, where the benefit remained significant). These findings support the assertion that repetition priming and explicit memory reflect the operation of distinct systems, and that these systems may undergo different rates of change in aging.     

Even with the Best of Intentions: Paternal Involvement and the Theory of Planned Behavior

Implicit in much of the fatherhood discourse is the assumption that if fathers want to take an active role in their children's lives, they could and would do so. While research has highlighted the factors associated with fathers' involvement, very few, if any, of these studies have been guided by a theory that accounts for both fathers' involvement intentions and their ability to follow through on those intentions. The theory of planned behavior and its emphasis on attitudes, the beliefs of significant others, and whether one has control over engaging in behavior is a conceptual fit to respond to questions related to the complex nature of paternal involvement. Using data from the Fragile Families and Child Well‐being Study, the purpose of this study was to test the utility of the theory of planned behavior in predicting fathers' involvement intentions and reports of involvement. The results revealed that the theory of planned behavior can be useful in examining paternal involvement and should be used in future research to enhance the fatherhood literature.     

Contextual Themes in Career Decision Making of Female Clients Who Indicate Depression

Difficulties concerning female counseling center clients' career decision making were explored in this qualitative study. The authors reviewed counseling intake and progress notes of 18 female students who sought counseling services at a university counseling center and who presented career concerns and reported feeling depressed. Most women in this study described their career decision‐making difficulties in the context of relationships with their parents or significant others. Both external (i.e., family relationships, family and culture, and relationships with significant others) and internal (i.e., developmental, developmental and mental health issues, and skill deficits) conditions emerged as significantly affecting these women's career decision‐making process.