Social support and adaptation to stress by the elderly

Role of self-efficacy and social support in short-term recovery after total hip replacement: a prospective cohort study

Background

Despite the overall success of total hip replacement (THR) in patients with symptomatic osteoarthritis (OA), up to one-quarter of patients report suboptimal recovery. The aim of this study was to determine whether social support and general self-efficacy predict variability in short-term recovery in a Norwegian cohort.

Methods

We performed secondary analysis of a prospective multicenter study of 223 patients who underwent THR for OA in 2003–2004. The total score of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 3 months after surgery was used as the recovery variable. We measured self-efficacy using the General Self-Efficacy Scale (GSES) and social support with the Social Provisions Scale (SPS). Preoperative and postoperative scores were compared using Wilcoxon tests. The Mann–Whitney U test compared scores between groups that differed in gender and age. Spearman’s rho correlation coefficients were used to evaluate associations between selected predictor variables and the recovery variable. We performed univariate and multiple linear regression analyses to identify independent variables and their ability to predict short-term recovery after THR.

Results

The median preoperative WOMAC score was 58.3 before and 23.9 after surgery. The mean absolute change was 31.9 (standard deviation [SD] 17.0) and the mean relative change was 54.8% (SD 26.6). Older age, female gender, higher educational level, number of comorbidities, baseline WOMAC score, self-efficacy, and three of six individual provisions correlated significantly with short-term recovery after THR and predicted the variability in recovery in the univariate regression model. In multiple regression models, baseline WOMAC was the most consistent predictor of short-term recovery: a higher preoperative WOMAC score predicted worse short-term recovery (β = 0.44 [0.29, 0.59]). Higher self-efficacy predicted better recovery (β = −0.44 [−0.87, −0.02]). Reliable alliance was a significant predictor of improved recovery (β = −1.40 [−2.81, 0.01]).

Conclusions

OA patients’ general self-efficacy and the expectation of others’ tangible assistance predict recovery after THR. Researchers and clinicians should target these psychosocial factors together with the patients and their families to improve the quality of care and surgical outcomes.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-017-0649-1) contains supplementary material, which is available to authorized users.

Social cognitive correlates of physical activity among persons with multiple sclerosis: Influence of depressive symptoms

BACKGROUND

Physical inactivity and elevated depressive symptoms are both highly prevalent and correlated among persons with multiple sclerosis (MS). Variables from Social Cognitive Theory (SCT) might be differentially correlated with physical activity in persons with MS who have elevated depressive symptoms.

PURPOSE

This study investigated the influence of elevated depressive symptoms on correlates of physical activity based on SCT in persons with MS.

METHODS

Participants (mean age = 50.3 years, 87% female, 69% Caucasian) completed questionnaires on physical activity, depressive symptoms, self-efficacy, social support, outcome expectations, functional limitations, and goal setting. The questionnaires were delivered and returned through the U.S. Postal Service. The sample (N = 551) was divided into 2 subgroups (i.e., elevated vs non-elevated levels of depressive symptoms) for statistical analyses. Bivariate correlations and stepwise multiple regressions were conducted using SPSS.

RESULTS

Self-efficacy (r = 0.16), functional limitations (r = 0.22) and goal-setting (r = 0.42) were significantly (p < 0.05) associated with physical activity among the elevated depressive sample. The regression analysis indicated that self-efficacy predicted physical activity in Step 1 (β = 0.16, p < 0.05), but was no longer significant when goal-setting (β = 0.06, p > 0.05) entered the model. All social cognitive variables were significantly associated with physical activity levels (r = 0.16-0.40, p < 0.001) among the non-elevated depressive sample. Self-efficacy predicted physical activity in Step 1 (β = 0.24, p < 0.001), but it was no longer significant once goal-setting, functional limitations, and self-evaluative outcome expectations entered the model.

CONCLUSION

Based on SCT, self-efficacy and goal-setting represent possible targets of behavior interventions for increasing physical activity among persons with MS who have elevated depressive symptoms. There is a larger set of targets among those with MS who do not have elevated symptoms.

Substance Misuse–Related Parental Child Maltreatment

In Australia, children removed from the parental home because substance use–related child maltreatment issues are commonly placed in grandparent custodial care; however, the longer term relational costs of this approach have yet to be determined. Conventional, summative, and directive content analyses were conducted on data extracted from 88 Australian custodial grandparent completed Grandcarer Needs, Wellbeing and Health Surveys. Conventional analysis revealed the most common reason grandparents gave for their assumption of custodial care was drug use–related acts of parental child maltreatment. Summative analysis revealed antidepressants, marijuana, Valium, ice, and amphetamines were the most commonly used parental drugs and that these drugs were frequently used in combination with dexamphetamine, antipsychotics, heroin, ecstasy, and cocaine. Directed analysis contextualized the strain that drug use–related custodial caregiving places on grandparents’ financial resources, and how this strain is burdensome when the grandparents’ annual income is less than Aus$80,000. It also contextualizes the need for future research to explore family reunification desires/barriers.

Is General or Alcohol-Specific Perceived Social Support Associated with Depression among Adults in Substance Use Treatment?

Alcohol use disorders are among the most common mental health disorders in the world and incur considerable costs for individuals and society. Previous research has demonstrated that perceived social support (PSS) may decrease rates of depression and relapse in individuals seeking treatment for alcohol use. The current study developed and investigated a self-report measure for perceived social support for sobriety from alcohol (PSSA) in a sample of men and women in residential treatment for substance use (N = 231), and examined the relationship between general or alcohol-specific perceived social support and depression. Analyses demonstrated sound factor structure, reliability, and validity for the PSSA. Additionally, the new measure of PSS for alcohol sobriety was negatively and uniquely associated with depression, even after controlling for general PSS, enacted social support, and negative social interactions. Overall, findings demonstrated that the PSSA was associated with fewer depressive symptoms, even after accounting for other known correlates of depression. Future research should replicate and extend these findings and examine whether this new measure predicts abstinence from alcohol following treatment.

The Role of Intergenerational Relations in the Association between Life Stressors and Depressive Symptoms

This study investigates the association between intergenerational relations and depressive symptoms of older adults in Taiwan. Using data from two waves of the Surveys of Health and Living Status of the Elderly in Taiwan, a population-based sample of adults aged 60 and older, the links between intergenerational relations between parents and their adult children, life stressors (major life events and daily hassles), and depressive symptoms are examined. The authors find that higher reports of exposure to stressors—both daily hassles and major life events—are associated with higher levels of psychological distress. Intergenerational ties with children appear to have only a modest effect on levels of depressive symptoms that depends on both the kind of stressor and the aspect of the parent-child relationship

The Effects of an Acute Stressor on Depressive Symptoms among Older Adults

This study uses longitudinal data to examine the potential moderating effects of social support and age among older adults exposed to an acute stressor. Using a sample of 651 older persons, data were gathered in the spring of 1992 and in the fall of 1993, approximately 60 days after the peak impact of flooding in the Midwest. Results indicate a positive association between pre- and postflood depression and a negative association between social support and postflood depression. For the youngest of the two older age groups, there is also a positive association between flood exposure and post-flood depression, controlling for prior levels of depression. Age interactions reveal that social support moderates the effects of flood exposure on depression only for the younger age group.

Stress, Social Support, and Negative Interaction in Later Life

The aim of this research is to examine the impact of stress on supportive social relationships in later life. Although a number of researchers propose that exposure to life stress increases the amount of assistance provided by significant others, findings from studies with older adults are equivocal. Three potential explanations for these contradictory findings are examined. The results, which are based on a nationwide survey of older people, reveal that the relationship between stress and social support is contingent upon the nature of the stressor as well as the source of support. It was further predicted that negative interaction would play an important role in this process, but consistent findings failed to emerge from the data. The theoretical implications of these findings are discussed.

Social Support as a Factor in African-American Adolescents' Sexual Risk Behavior

African-American adolescents (N = 295) reporting high or low levels of social support completed measures of AIDS knowledge, health locus of control, attitudes toward condoms, self-reported sexual behavior for the preceding 12 months, perceptions of personal HIVrisk, and self-and response-efficacy ratings. Adolescents with less social support were less knowledgeable about AIDS, held more negative attitudes toward condoms, and were lower in selfefficacy than adolescents with higher levels of social support. Adolescents with fewer social supports also were significantly more likely to engage in casual sex, reported more nonmonogomouspartners, morefrequent coercions into unwanted sexual activity, and higher rates of sexually transmitted diseases. African-American males with low social support scores engaged in more frequent unprotected sexual activity with a larger number of sex partners and used condoms less often. The implications of these results for prevention efforts targeting minority adolescents are discussed.

Social Support, Health and Satisfaction among the Elderly with Chronic Conditions in Taiwan

This study examines possible relationships between perceived social support, physical and mental health, satisfaction towards hospital services, and satisfaction towards life-asa-whole, among the community elderly with chronic conditions. A sample of 172 Chinese elderly living in a metropolitan Taiwanese city were home-interviewed. Results indicated that (a) the elderly perceived good social support, and tangible support was the most important aspect; (b) the elderly did not perceive great impact of illness(es) upon their life, and both physical and mental health were satisfactory; (c) the elderly were generally satisfied with both the hospital services and life-as-a-whole; (d) apart from health and illness factors, social support appeared to have profound and pervasive protective effects on adjustment and satisfaction of the elderly.

The Validity of Self-Reports of Physician Use Among the Older Population

This study assessed the validity of older person self-reports of doctor visits, examining variation in the validity of these reports due to factors commonly used in models of health service use. Data were from a sample of 215 healthy, community-dwelling older persons. Participantswere interviewed three times in person at 6-month intervals. They also completed brief mail questionnaires each month between the personal interviews. Information about physical health status and health service use was obtained from the participants' personal physicians. One-way ANOVA tests of means and multinomial logit analyses indicated those respondents reporting more physician visits were significantly less likely to report the same number of visits as the doctors reported and were more likely to underreport than overreport the number of visits. Among the nonsignificant relationships with reporting style were several measures of health status. Implications of recall period length on the validity of these reports are discussed.

The Structure and Stability of Perceived Togetherness in Elderly People during a 5-Year Follow-Up

The objective of this study was to study the structure andstability of perceived togetherness using cross-sectional and longitudinal confirmatory factor analysis models. Togetherness was measured with the self-administered Social Provision Scale (SPS). The sample consisted of 111 persons interviewed in connection with the Evergreen project’s 5-year follow-up at ages 80 and 85. One and two-factormodels were specified separately at two different pointsof measurement. The stability of the factor models’ structure and the level of latent factors was studied using longitudinal factor analysis models. The two-factor model fit the data better than the one-factor model. Perceived togetherness was differentiated into factors of emotional and social togetherness. The structure of perceived togetherness remainedunchanged during the 5-year follow-up. In terms of means, the latent factors showed a statistically highly significant decline in time (i.e. perceived togetherness decreased with increasing age).

Family, Peer, and Staff Social Support in Nursing Home Patients: Contributions to Psychological Well-Being

This study examined whether nursing home patients identified social support as coming from institutional peers and staff as well as family members. Associations among social support from those three sources, psychological well-being, and motivation to participate in treatment were explored in 32 patients. A majority described peer and staff support networks that were as large as or larger than their family support network. Subjective perceptions of support, but not size of network, were associated with well-being. Perceived support from peers was associated with less depression, greater positive affect, and greater motivation. Perceived support from staff and family was less consistently associated with well-being and motivation. Results suggest that peer and staff support contribute to the well-being of older adults and may complement family support during inpatient admissions or residential stays. Clinical and programmatic interventions that facilitate peer and staff support might enhance patient well-being and stimulate participation in self-care.

Home Satisfaction: Related Health and Psychosocial Variables

In later life, the home plays an increasing role as a site for leisure activities, social interaction, and personal growth. This research examined variables that were hypothesized to relate to home satisfaction for older adults. Home satisfaction was also compared to life satisfaction. Sixty-four older adults provided information on home satisfaction; health capacity; the psychosocial variables of self-esteem, locus of control, and social support; and life satisfaction. Home satisfaction was best predicted by health and by self-esteem In contrast, life satisfaction was best predicted by the three psychosocial variables. The outcomes of this research suggested the usefulness of a goodness-of-fit model for understanding and augmenting home satisfaction in later life.

Perceived Support, Help Seeking, and Adaptation to Stress among Older Black and White Women Living Alone

This research tested two models of stress buffering to examine how older women living alone adapted to the stresses in their daily lives. No support was found for the suppressor model, but some support for the moderator model of stress buffering. Both perceived support and enacted support moderated the effect of stressors for psychological distress. Confidants were an important source of support for these older women. Both the perception that a friend was available with whom they could discuss their problems and the frequency of confiding moderated the negative impact of stress for psychological distress. Although confidants were a significant source of support for both Black and White women, support from relatives and friends moderated the effect of stressors only for Black women. Black women experienced greater economic hardship and more functional limitations than White women, but they draw on multiple sources of support to adapt to those stressors.

Relationships Among Life Events and Psychological Well-Being: More Evidence for a Two-Factor Theory of Well-Being

Relationships between 11 major life events and changes in psychological well-being were examined in a three-generation sample: grandparents, their adult children, and their young adult grandchildren. Psychological well-being was measured using the Bradburn Affect Balance Scale. Life events included marriages; divorces; births of children; deaths of spouses, children, and parents; health declines; hospitalizations; improved standard of living; retirement; and retirement of one's spouse. Both positive and negative affect demonstrated similar stability over 14 years and were equally predictable from the life events. However, consistent with a two-factor conceptualization of psychological well-being, for all generations, desirable life events predicted change in positive affect whereas undesirable events predicted change in negative affect; cross-domain prediction was minimal. Results further indicated that whether life events are expected may be more important in predicting subsequent psychological well-being than whether they are desirable or undesirable.

Supporting Community Health Workers After a Disaster: Findings From a Mixed-Methods Pilot Evaluation Study of a Psychoeducational Intervention

OBJECTIVE

Community health workers (CHWs) in disaster-affected areas are at risk for emotional distress, as they support others while they may be in the process of rebuilding their own lives. The Resilience and Coping for the Healthcare Community (RCHC) intervention was developed in response to the stress CHWs faced after Hurricane Sandy. The intervention uses psychoeducation to help participants identify common stress responses, recognize signs of job burnout, and utilize healthy coping strategies.

METHODS

A mixed-methods pilot of the RCHC intervention was conducted in 2013 with a convenience sample of staff from 6 federally qualified health centers (n=69). Validated measures of stress, coping, compassion fatigue and satisfaction, burnout, stress, and social provisions and a measure of perceived knowledge were administered at baseline, after the workshop, and at a 3-week follow-up. Semi-structured interviews were conducted with 10 randomly selected participants and were analyzed by using content analysis.

RESULTS

From baseline to the post-workshop assessment, perceived knowledge scores increased from 24.59 to 30.34, t(62)=5.16 (P<0.001), and acute stress scores decreased significantly from 10.53 to 6.78, t(64)=4.74 (P<0.001). Significant increases from baseline to the 3-week follow-up (n=45) were found for perceived knowledge (24.05 to 27.24; t(40)=5.37; P<0.001), and social provisions (27.34 to 28.39; t(44)=2.15; P<0.05).

CONCLUSIONS

Our qualitative findings indicated that the respondents valued learning about common stress responses and incorporating coping as part of a daily routine. Team building and normalization of emotions were seen as ancillary benefits that would reduce stress levels in the workplace. In conclusion, the RCHC intervention shows promise and should be investigated further in experimental studies. (Disaster Med Public Health Preparedness. 2016;page 1 of 8).

Social Motivation: Costs and Benefits of Selfishness and Otherishness

We examine recent evidence on the consequences of selfishness and otherishness for psychological well-being, physical health, and relationships. In the first sections, we consider recent evidence regarding the costs and benefits of giving time, money, and support to others and the costs and benefits of taking or receiving those things from others. Then, because the behaviors of giving and taking can be motivated either by selfish or otherish concerns, we next consider the costs and benefits of the motivation underlying giving and taking. We also examine why and for whom selfishness and otherishness have consequences for psychological well-being, physical health, and relationships. We focus on mechanisms identified in research, including intrapsychic mechanisms such as positive and negative affect, self-esteem and self-efficacy, a sense of meaning and purpose in life, and a sense of connectedness to or isolation from others, as well as interpersonal processes such as reciprocation of support and responsiveness.

Fatigue in Older Adults Postmyocardial Infarction

OBJECTIVE

The purpose of this study was to comprehensively examine putative factors that may independently contribute to fatigue and subsequent persistence of fatigue in elderly adults 6-8 months post-myocardial infarction (MI). Studies suggest cardiac function, comorbidities, daytime sleepiness, depression, anemia, interleukins, and social support are correlates of fatigue; however, no studies have systematically examined these factors 6 months post-MI in an aging population.

METHODS

Study participants included 49 women and men (N = 98) ages 65-91 who were 6-8 months post-MI. Data collection included the demographic health status questionnaire (heart rate, blood pressure, body mass index, and medications), fatigue-related comorbidity scale, revised Piper fatigue scale, Epworth sleepiness scale, geriatric depression scale, social provisions scale, and venous blood tests (B-natriuretic peptide, hemoglobin, and interleukin-6).

RESULTS

Fatigue persisted after MI in 76% of older men and women with no difference by sex. Only depression scores (P trend = 0.0004) and mean arterial pressure (P trend = 0.015) were found to be linearly independent predictors for fatigue, controlling for age, Il-6 levels, and body mass index.

CONCLUSION

Post-MI depression and mean arterial blood pressure are important to assess when examining fatigue post-MI in older populations.

Exploring the Relationship of Religiosity, Religious Support, and Social Support Among African American Women in a Physical Activity Intervention Program

Religious belief has been linked to a variety of positive mental and physical health outcomes. This exploratory study will address the relationship between religious involvement and social connectedness among African American women. Results from a physical activity intervention research project (N = 465) found that total religious support and social support were significantly negatively correlated with total religiosity, while total general social support was significantly positively correlated with total religious support. Overall, the study indicates that more research is needed on ways to encourage interaction between the positive dimensions of both religiosity and social support to bring about healthy behaviors.

Social Support and Treatment Outcome in Alcohol Dependence Syndrome in Armed Forces

INTRODUCTION

Social factors play vital role in unfolding of alcohol use disorders in any given population. Several factors beyond the confines of treatment settings influence treatment outcome in alcohol dependence syndrome. Social support has positive effect in treatment outcome of alcohol dependence syndrome. This has not been much studied in India in past. Therefore we decided to study the perception of social support in cases of alcohol dependence syndrome admitted in a busy hospital in armed forces.

AIM

The aim was to study the perception of social support across relapsed and abstinent group and see if it reached any statistical proportion and also to see if any socio-demographic variables also affected perception of social support.

MATERIALS AND METHODS

Fifty five consecutive male patients of alcohol dependent syndrome without a co-morbid neurological/psychiatric diagnosis were assessed for their perception of social support after taking informed consent. They were explained the procedure and their alcoholic milestones were recorded in specially designed pro-forma. Subjects were then divided in abstinent and relapsed group. Subsequently they were assessed for their perception of social support by administering Social provision scale and Social support questionnaire.

STATISTICAL ANALYSIS

Data were tabulated and statistically analysed by using chi square test, Mann Whitney U-Test and Rank ANOVA test where applicable p-value <.05 was taken as significant.

RESULTS

Results indicated that perception of social support across abstinent (n=18) and relapsed (n= 37) group reached significant statistical proportion as measured by social provision scale and social support questionnaire. Duration of use, dependence and family history of alcoholism did not influence perception of social support across patient population. There was inverse relationship between patients with alcohol related problem and their perception of social support. Professional and qualified soldiers perceived higher social support than soldiers and lesser qualified individuals.

CONCLUSION

Abstinent group perceived better social support than relapsed group and soldiers in upper socio-occupational status and less alcohol related problems perceived more social support than soldiers with lower socioeconomic status and more alcohol related problems. Psychosocial therapy must be incorporated in management of Alcohol dependence syndrome.

Trajectories of Perceived Social Support Among Low-Income Female Survivors of Hurricane Katrina

The purpose of this study was to explore trajectories of perceived social support among low-income women who survived Hurricane Katrina, and were surveyed prior to the hurricane and approximately one and four years thereafter (N = 562). Latent class growth analysis provided evidence of four trajectories of perceived support: High Increasing (35.9%), High Decreasing (20.3%), Low Stable (41.1 %), and Low Decreasing (2.7%). Bereavement was significantly predictive of membership in the Low Stable trajectory, relative to the High Increasing and High Decreasing trajectories. Higher psychological distress and indicators of greater social network size, density and closeness were significantly predictive of membership in the Low Decreasing trajectory, relative to the High Increasing and High Decreasing trajectories.

Factors affecting the psychological distress among unemployed and re-employed individuals

Purpose

– The purpose of this paper is to examine coping strategies, social support, and psychological distress for comparable samples of unemployed (n=389) and re-employed (n=270) individuals. The authors hypothesized that problem-focused coping and higher levels of social support would be associated with lower levels of psychological distress for unemployed vs re-employed participants.

Design/methodology/approach

– The cross-sectional design and the convenience sampling method were used in the study.

Findings

– Although unemployed participants reported poorer coping, higher levels of psychological distress, and lower levels of social support compared to re-employed participants; social support and coping strategies predicted psychological distress. Multiple regression analyses suggest that emotion-focused coping strategies were related to higher levels of psychological distress, whereas social support and problem-focused coping strategies were related to lower levels of psychological distress. Social support accounted for more variance in participants’ psychological distress above and beyond all other variables. Single and unemployed participants of the study used less problem-focused, more emotion-focused coping, and perceived lower social support than married unemployed. Gender and marital status of the unemployed were also significantly associated with psychological distress. In addition, older and less educated unemployed participants perceived less social support and used emotion-focused coping more frequently.

Practical implications

– The findings indicated that being female, single, older, and low educated are the potential sociodemographic risk factors for the psychosocial well-being of unemployed people.

Originality/value

– The favourable effects of certain coping strategies suggest the potential benefits of interventions to reduce reliance on emotion-focused coping and stimulate more problem-focused strategies in order to enhance psychological well-being.

Impact of a Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial

This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby's death in a Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, the authors measured grief change from a 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD viewers with DVD nonviewers and controls. DVD viewers reported higher grief at 3-month interviews compared with DVD nonviewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care.

A Comparison of Social Support among Adolescents with and without Visual Impairments in Jordan: A Case Study from the Arab Region

Introduction

Research to date on social support for adolescents with visual impairments (that is, blindness or low vision) has been primarily carried out in developed countries, and very little is known about the social support systems that are available for such adolescents in developing countries such as those in the Arab world. In the present study, social support among adolescents with and without visual impairments was investigated in Jordan, which is considered a developing country.

Methods

Study participants included 86 adolescents with visual impairments and 73 sighted adolescents. The instrument used to collect information in this study was an Arabic version of the Multidimensional Scale of Perceived Social Support (MSPSS).

Results

The level of social support reported by adolescents with visual impairments was higher than that reported by sighted adolescents. In all three domains of the MSPSS (family, friends, and significant others), students with visual impairments reported receiving more social support than those without impairments. However, there was no statistically significant effect for gender.

Discussion

The results of the study are not consistent with findings of previous studies, all of which were conducted in Western countries. The disparities in experiences of adolescents with visual impairments in developed and developing countries may be attributed to differences in cultural values as well as to the conceptualization of support by those involved.

Implications for practitioners

Special education teachers need to be aware of the cultural backgrounds of their students and to develop and implement culturally appropriate programs for them.

Influence of Social Factors to the Quality of Life of the Elderly in Malaysia

Introduction and Aim:

The increase in the life expectancy does not necessarily correlate with a higher quality of life. The objective of this study was to determine the influences of social factors to the quality of life of the elderly in Malaysia.

Methodology:

This cross sectional study was conducted in Penang, Malaysia among 2005 randomly sampled elderly using the WHOQOL-BREF scale. The sample was randomly collected from a list of residents of the state who are aged 60 years and older who receive the special aid provided by the Penang state government to all elderly residing in Penang irrespective of their socio and economic status.

Results:

Regression analysis showed that after controlling for demographic factors which include age, sex, race, marital status, education and employment; living with spouse and family members and being socially active were significantly associated with increased quality of life scores and being dependent on partner and children as compared to being selfdependent on mobility and having poor and moderate support as compared to good social support were significantly associated with decreased quality of life scores.

Conclusion:

The quality of life of the elderly is very much influenced by social factors.

Acute hospital admission for nursing home residents without cognitive impairment with a diagnosis of cancer

Studies of hospitalisation of cognitively intact nursing home (NH) residents with cancer are scarce. Knowledge about associations between socio-demographic, medical and social support variables and hospital admissions aids in preventing unnecessary admissions. This is part of a prospective study from 2004 to 2005 with follow-up to 2010 for admission rates. We studied whether residents with cancer have more admissions and whether socio-demographic and medical variables and social support subdimensions are associated with admission among cognitively intact NH residents with (n = 60) and without (n = 167) cancer aged ≥65 years scoring ≤0.5 on the Clinical Dementia Rating Scale and residing ≥6 months. We measured social support by face-to-face interview. We identified all respondents through NH medical records for hospital admission, linking their identification numbers to the hospital record system to register all admissions. We examined whether socio-demographic and medical variables (medical records) and social support subscales were associated with the time between inclusion and first admission. Residents with cancer had more admissions (25/60) than those without (53/167) (odds ratio 1.7). Social integration was correlated with admission (P = 0.04) regardless of cancer diagnosis. Residents with cancer had more hospital admissions than those without. Higher social integration gave more admissions independent of cancer diagnosis.

Upstream and Downstream Correlates of Older People's Engagement in Social Networks: What are Their Effects on Health over Time?

This study tested the effects of social network engagement and social support on the health of older people moving into retirement, using a model which includes social context variables. A prospective survey of a New Zealand population sample aged 54–70 at baseline ( N = 2,282) was used to assess the effects on mental and physical health across time. A structural equation model assessed pathways from the social context variables through network engagement to social support and then to mental and physical health 2 years later. The proposed model of effects on mental health was supported when gender, economic living standards, and ethnicity were included along with the direct effects of these variables on social support. These findings confirm the importance of taking social context variables into account when considering social support networks. Social engagement appears to be an important aspect of social network functioning which could be investigated further.

Psychometric analysis of the short-form UCLA Loneliness Scale (ULS-6) in older adults

The aim of this investigation was to present new empirical evidence regarding the psychometric properties of the short-form UCLA Loneliness Scale (ULS-6) among Portuguese older people. The study included 1,154 persons (60 % women and 40 % men), aged 60-90 (M = 71.26; SD = 6.66). The psychometric properties of the ULS-6 were analysed by means of confirmatory factor analysis, internal consistency, and criterion-related validity methods. Confirmatory factor analysis supported a unidimensional structure of the measure with adequate values of various fit indices. The ULS-6 presented satisfactory psychometric properties, with a high level of internal consistency. Furthermore, the ULS-6 showed a negative relationship with self-esteem, satisfaction with life, and positive affect; and a positive one with negative affect. The results confirm that the ULS-6 provides a brief, psychometrically sound measure of loneliness that is appropriate for use among older adults.

Personality differences among patients with chronic aphasia predict improvement in speech-language therapy

BACKGROUND

Negative affectivity and neurocognitive deficits including executive dysfunction have been shown to be detrimental to rehabilitation therapies. However, research on the relationship between neuropsychological deficits and improvement in speech-language therapy (SLT) for aphasia is sparse.

OBJECTIVE

To examine the relationships among neurocognitive and psychological functioning and improvement in SLT following aphasia due to stroke.

METHODS

Fifty patients who were ≥ 9 months post stroke and enrolled in outpatient SLT to treat aphasia participated. Using standard language assessment measures, the authors evaluated language functioning at initiation of the study and after participants completed various SLT protocols. Executive functioning, visuospatial skills, attention, and memory also were assessed to provide indices of convergent and discriminant validity. Participants' mood and affectivity were evaluated by self-report, and their functional abilities and recovery of function since stroke were assessed via caregiver report.

RESULTS

A multiple regression model testing the combined powers of neurocognitive and psychological variables was significant (P = .004, R2 = 0.33), with psychological and neurocognitive functioning accounting for 15% of the variance in relative language change beyond that accounted for by stroke severity and gross cognitive functioning. Negative affectivity expressed on the Positive and Negative Affectivity Scale made unique contributions to the model.

CONCLUSIONS

Improvement in SLT is substantially related to neurocognitive and psychological functioning, particularly affectivity. Assessment of these characteristics may assist in identifying patients who are likely to improve and in tailoring treatment programs to yield optimal outcomes.

Social reactions to disclosure of sexual victimization and adjustment among survivors of sexual assault

How a support provider responds to disclosure of sexual victimization has important implications for the process of recovery. The present study examines the associations between various positive and negative social reactions to sexual assault disclosure and psychological distress, coping behavior, social support, and self-esteem in a sample of college women (N = 374). Social reactions to assault disclosure that attempted to control the survivor's decisions were associated with increased symptoms of posttraumatic stress, depression, and anxiety and lower perceptions of reassurance of worth from others. Blaming social reactions were associated with less self-esteem and engagement in coping via problem solving. Social reactions that provided emotional support to the survivor were associated with increased coping by seeking emotional support. Contrary to expectations, social reactions that treated the survivor differently were associated with higher self-esteem. Implications are discussed.

Predictors of quality of life in a longitudinal study of users with severe mental disorders

Background

Since the end of the 20th century, quality of life has become a key outcome indicator in planning and evaluation of health services. From a sample of 297 users with severe mental disorders from Montreal (Canada), this study aimed to identify the key predictors of subjective quality of life (SQOL).

Methods

Users were recruited and interviewed from December 2008 to September 2010 and re-interviewed approximately 18 months later. A comprehensive framework including socio-demographic data, clinical, needs and functionality variables, negative life events, social support and healthcare service use, and appreciation data were considered as predictors. Clinical records and eight standardized instruments were used.

Results

Lower severity of needs, schizophrenia, better social integration, better reassurance of worth, fewer drug abuse problems, and living in supervised housing are predictors of SQOL. With regard to needs, absence or lower severity of needs in the areas of company, daytime activities, social exclusion, safety to self, and benefits are linked to SQOL.

Conclusion

Reducing the severity of needs is especially beneficial to ensure a higher SQOL for users with severe mental disorders. To improve SQOL, priority must be given to programs and interventions that promote the development of a stimulating and supportive social network, and maintain a plurality of residential services matching the functional abilities of users.

Older Men's Lay Definitions of Successful Aging over Time: The Manitoba Follow-up Study

The concept of “successful aging” has become widely accepted in gerontology, yet continues to have no common underlying definition. Researchers have increasingly looked to older individuals for their lay definitions of successful aging. The present analysis is based on responses to five questionnaires administered to surviving participants of the male Manitoba Follow-up Study cohort ( www.mfus.ca ) in 1996, 2000, 2002, 2004, and 2006 ( n = 2,043 men were alive at a mean age of 78 years in 1996). One question on each survey asked: “What is YOUR definition of successful aging?” Applying content analysis to the 5,898 narratives received over the 11 years, we developed a coding system encompassing 21 main themes and 86 sub-themes defining successful aging. We quantitatively analyzed trends in prevalence of themes of successful aging prospectively over time. Our findings empirically support colleagues' past suggestions to shift from defining successful aging in primarily biomedical terms, by taking lay views into account.

Trajectories of psychological distress among low-income, female survivors of Hurricane Katrina

The purpose of this study was to investigate trajectories of psychological distress among low-income, primarily unmarried and African American women who survived Hurricane Katrina (N = 386). Data were collected in the year prior to the hurricane as well as approximately 1 and 3 years thereafter. Using Latent Class Growth Analysis (LCGA), we detected 6 distinct trajectory groups. Over half of the participants fit into a trajectory consistent with resilience; that is, they maintained low levels of psychological distress over the course of the study, but experienced an elevation in symptoms at the first predisaster time point followed by a return to predisaster levels. The other trajectories reflected a range of psychological responses to disasters and indicated that predisaster functioning had a major influence on postdisaster psychological outcomes. Degree of exposure to hurricane-related stressors, experiences of human and pet bereavement, perceived social support, and socioeconomic status were significant predictors of trajectory group membership. Implications for research and policy are discussed.

Exceptional Longevity: An Introduction to the IOWA Centenarian Study

The primary objective of the Iowa Centenarian Study is to further our understanding of determinants of exceptional longevity above and beyond health outcomes, particularly in rural environments. This introductory article provides a general overview of the study, its methodology and basic descriptive results. One hundred and fifty-two centenarians from a rural state participated in the study (average age was 101.6 years). Baseline data collection included questions on demographics, cognitive representation of being a centenarian, mental status, past family history, life events, activities of daily living, coping, physical health and health history, nutrition, exercise, personality, social support, mental health, economic status and perceptions, and fatigue. A subset of the baseline sample (n = 28) participated in a short-term longitudinal study that assessed stability and change in mental status, mental health, and activity. Four additional papers in this issue (Franke, Margrett, Heinz, & Martin, 2012; Garasky, Martin, Margrett, & Cho, 2012; Margrett, Hsieh, Heinz, & Martin, 2012; Martin, da Rosa, Margrett, Garasky, & Franke, 2012) will highlight substantive findings, including longitudinal analyses, in activities of daily living, economic status, mental status, and positive and negative affect.

Catastrophic interpretations and anxiety sensitivity as predictors of panic-spectrum psychopathology in chronic obstructive pulmonary disease

OBJECTIVE

Panic-spectrum psychopathology (denoting panic attacks and panic disorder) is highly prevalent in chronic obstructive pulmonary disease (COPD), and the cognitive model of panic has been proposed as an explanation of this high prevalence. In the current cross-sectional study we investigated factors predicting panic-spectrum psychopathology in COPD, and hypothesized that, consistent with the cognitive model, both the catastrophic interpretation of shortness of breath and elevated anxiety sensitivity would be significant predictors when variance shared with confounding variables was controlled.

METHODS

Sixty-two participants with COPD were interviewed with the Anxiety Disorders Interview Schedule for DSM-IV, Panic Disorder section, and completed measures of interpretation of breathing difficulty, anxiety sensitivity, anxiety, depression, disease-specific quality of life, and stressful life events. Objective disease severity was measured using forced expiratory volume in the first second.

RESULTS

Direct logistic regression was performed, and worse depressive symptoms, more catastrophic interpretations of shortness of breath, higher anxiety sensitivity, higher magnitude of recent stressful life events, and worse disease severity were each found to be significant unique predictors of panic-spectrum psychopathology in COPD after shared variance was controlled.

CONCLUSIONS

The results of the study provide support for the cognitive model of panic, and also suggest a diathesis-stress explanation of the development of panic-spectrum psychopathology in COPD. The findings have implications for future preventative psychological interventions.

To whom do college women confide following sexual assault? A prospective study of predictors of sexual assault disclosure and social reactions

A prospective methodology was used to explore predictors of sexual assault disclosure among college women, identify who women tell about sexual victimization, and examine the responses of informal support providers (N = 374). Women most often confided in a female peer. Increased coping via seeking emotional support, strong attachments, and high tendency to disclose stressful information predicted adolescent sexual assault disclosure and disclosure over the 7-month interim. Less acquaintance with the perpetrator predicted disclosure over the follow-up, including experiences of revictimization. Victim and perpetrator alcohol use at the time of the assault also predicted disclosure over the follow-up. Implications are presented.

The validation of a new measure quantifying the social quality of life of ethnically diverse older women: two cross-sectional studies

BACKGROUND

To our knowledge, the available psychometric literature does not include an instrument for the quantification of social quality of life among older women from diverse ethnic backgrounds. To address the need for a tool of this kind, we conducted two studies to assess the initial reliability and validity of a new instrument. The latter was created specifically to quantify the contribution of a) social networks and resources (e.g., family, friends, and community) as well as b) one's perceived power and respect within family and community to subjective well-being in non-clinical, ethnically diverse populations of older women.

METHODS

In Study 1, we recruited a cross-sectional sample of primarily non-European-American older women (N = 220) at a variety of community locations. Participants were administered the following: a short screener for dementia; a demographic list; an initial pool of 50 items from which the final items of the new Older Women's Social Quality of Life Inventory (OWSQLI) were to be chosen (based on a statistical criterion to apply to the factor analysis findings); the Single Item Measure of Social Support (SIMSS); and the Medical Outcome Study 36-item Short-Form Health Survey (MOS SF-36). Study 2 was conducted on a second independent sample of ethnically diverse older women. The same recruitment strategies, procedures, and instruments as those of Study 1 were utilized in Study 2, whose sample was comprised of 241 older women with mostly non-European-American ethnic status.

RESULTS

In Study 1, exploratory factor analysis of the OWSQLI obtained robust findings: the total variance explained by one single factor with the final selection of 22 items was over 44%. The OWSQLI demonstrated strong internal consistency (α = .92, p < .001), adequate criterion validity with the SIMSS (r = .33; p < .01), and (as expected) moderate concurrent validity with the MOS SF-36 for both physical (r = .21; p < .01) and mental (r = .26; p < .01) quality of life. In order to confirm the validity of the 22-item OWSQLI scale that emerged from Study 1 analyses, we replicated those analyses in Study 2, although using confirmatory factor analysis. The total variance accounted for by one factor was about 42%, again quite high and indicative of a strong single-factor solution. Study 2 data analyses yielded the same strong reliability findings (i.e., α = .92, p < .001). The 22-item OWSQLI was correlated with the SIMSS (r = .27, p < .001) in the expected direction. Finally, correlations with the MOS SF- 36 demonstrated moderate concurrent validity for physical (r = .14; p < .01) and mental (r = .18; p < .01) quality of life, as expected.

CONCLUSIONS

The findings of these two studies highlight the potential for our new tool to provide a valid measure of older women's social quality of life, yet they require duplication in longitudinal research. Interested clinicians should consider using the OWSQLI in their assessment battery to identify older women's areas of lower versus higher social quality of life, and should establish the maximization of patients' social quality of life as an important therapeutic goal, as this variable is significantly related to both physical and mental health.

Parents' depressive symptoms and support from sons and daughters in Rural China

This investigation examined how initial levels of elder parents' depressive symptoms influenced financial, instrumental, and emotional support from sons and from daughters in rural China. Data derived from a two-wave (2001, 2003) longitudinal survey of 1,324 parents aged 60 and over living in rural areas of Anhui Province, China. Structural Equation Modeling with latent difference score was used to estimate the reciprocal relatioships between children's support and elder parents' depressive symptoms. Results showed that older parents who had higher levels of depressive symptoms at baseline experienced reduced financial, instrumental, and emotional support from sons, but not from daughters. In rural China where the patrilineal family system has distinguished sons and daughters with respect to their functions in elder parents' support networks, the roles of sons and daughters warrant further examination, particularly when elder parents have some depressive symptoms, which elevates the needs of the parents and puts a strain on intergenerational relationships.

The Effects of Types of Social Networks, Perceived Social Support, and Loneliness on the Health of Older People

Objectives: To use an ecological model of ageing ( Berkman, Glass, Brissette, & Seeman, 2000 ) which includes upstream social context factors and downstream social support factors to examine the effects of social networks on health. Method: Postal survey responses from a representative population sample of New Zealanders aged 55 to 70 years ( N = 6,662). Results: Correlations and multiple regression analyses provided support for a model in which social context contributes to social network type, which affects perceived social support and loneliness, and consequent mental and physical health. Ethnicity was related to social networks and health but this was largely accounted for by other contextual variables measuring socioeconomic status. Gender and age were also significant variables in the model. Discussion: Social network type is a useful way to assess social integration within this model of cascading effects. More detailed information could be gained through the development of our network assessment instruments for older people.

Dating Violence Victimization and Alcohol Problems: An Examination of the Stress-Buffering Hypothesis for Perceived Support

Recent evidence suggests that victims of dating violence consume alcohol at greater rates than their nonvictimized peers, placing them at risk for the negative consequences produced by alcohol use. Thus, research that examines factors that protect victims from consuming alcohol is needed. Toward this end, the present study sought to examine whether perceived support served as a stress-buffering (moderating) variable on the relationship between dating violence victimization and alcohol problems among a sample of currently dating college students (N = 440). Partial support was found for the stress-buffering effect of perceived support, but this varied depending on the type of victimization examined. Implications of these findings for victim interventions and dating violence prevention programming are discussed.

Some Thoughts on the Prevalence and Etiology of Depressive Conditions in the Elderly

This article reevaluates the issue of the prevalence of depressive conditions (clinical depressions and depressive symptoms) in the elderly with the help of recent epidemiological data. It then underlines several key aspects of the etiology of depressive conditions of older adults. The perspective is a psychosocial analysis, which considers the etiological contributions of three types of factors: the socio-demographic status of the person, life events, and the resources of the person. The article concludes by delineating the implications for research in this area.