401
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Gooren LJ, Kreukels B, Lapauw B, Giltay EJ. (Patho)physiology of cross-sex hormone administration to transsexual people: the potential impact of male-female genetic differences. Andrologia 2014; 47:5-19. [PMID: 25495275 DOI: 10.1111/and.12389] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 12/11/2022] Open
Abstract
There is a limited body of knowledge of desired and undesired effects of cross-sex hormones in transsexual people. Little attention has been given to the fact that chromosomal configurations, 46,XY in male-to-female transsexuals subjects (MtoF) and 46,XX in female-to-male transsexual subjects (FtoM), obviously, remain unchanged. These differences in their genomes cause sex differences in the functions of cells. This study reviews sex differences in metabolism/cardiovascular pathology, immune mechanisms, bone (patho)physiology and brain functions and examines whether they are, maybe partially, determined by genetic mechanisms rather than by (cross-sex) hormones. There do not appear to be major genetic impacts on the changes in bone physiology. Also immune functions are rather unaffected and the evidence for an increase of autoimmune disease in MtoF is preliminary. Brain functions of transsexuals may have differed from controls before cross-sex hormones; they do undergo shifts upon cross-sex hormone treatment, but there is no evidence for changes in sex-specific brain disease. The prevalence of cardiovascular disease is higher in MtoF receiving oestrogens than in FtoM receiving androgens. While type of oestrogen and route of administration might be significant, it is reasonable to speculate that nonhormonal/genetic factors play a role.
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Affiliation(s)
- L J Gooren
- Emeritus VU Medical Center, Amsterdam, The Netherlands; Androconsult, Chiang Mai, Thailand
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402
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Woods SB, Priest JB, Roush T. The biobehavioral family model: testing social support as an additional exogenous variable. FAMILY PROCESS 2014; 53:672-685. [PMID: 24981970 DOI: 10.1111/famp.12086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n = 1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends' social support, and relatives' social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (χ(2) = 846.04, p = .000, SRMR = .039, CFI = .924, TLI = .914, RMSEA = .043). Negative marital interactions predicted biobehavioral reactivity (β = .38, p < .001), as did relatives' social support, inversely (β = -.16, p < .001). Biobehavioral reactivity predicted disease activity (β = .40, p < .001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.
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Affiliation(s)
- Sarah B Woods
- Department of Family Sciences, Texas Woman's University, Denton, TX
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403
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404
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Åslund C, Larm P, Starrin B, Nilsson KW. The buffering effect of tangible social support on financial stress: influence on psychological well-being and psychosomatic symptoms in a large sample of the adult general population. Int J Equity Health 2014; 13:85. [PMID: 25260355 PMCID: PMC4189745 DOI: 10.1186/s12939-014-0085-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 09/15/2014] [Indexed: 11/21/2022] Open
Abstract
Introduction Financial stress is an important source of distress and is related to poor mental and physical health outcomes. The present study investigated whether tangible social support could buffer the effect of financial stress on psychological and psychosomatic health. Methods Two separate postal surveys were sent to random samples in five counties in Sweden in 2004 and 2008, with a total of 84 263 respondents. The questionnaires included questions about financial stress, tangible social support, psychosomatic symptoms, and psychological well-being (General Health Questionnaire-12). Results Individuals with high financial stress and low tangible social support had six to seven times increased odds ratios for low psychological well-being and many psychosomatic symptoms. By contrast, individuals with high financial stress and high tangible social support had only two to three times increased odds ratios for low psychological well-being and three to four times increased odds ratios for many psychosomatic symptoms, suggesting a buffering effect of tangible social support. Consistent with the buffering hypothesis, there were significant interactions between financial stress and social support, particularly in relation to low psychological well-being. Conclusions Social support had its strongest effect at high levels of financial stress. The question whether the altering of our social networks may improve physical health is important for the prevention of ill health in people experiencing financial stress. Strengthening social networks may have the potential to influence health-care costs and improve quality of life.
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405
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Merz EL, Roesch SC, Malcarne VL, Penedo FJ, Llabre MM, Weitzman OB, Navas-Nacher EL, Perreira KM, Gonzalez F, Ponguta LA, Johnson TP, Gallo LC. Validation of interpersonal support evaluation list-12 (ISEL-12) scores among English- and Spanish-speaking Hispanics/Latinos from the HCHS/SOL Sociocultural Ancillary Study. Psychol Assess 2014; 26:384-94. [PMID: 24320763 PMCID: PMC4048059 DOI: 10.1037/a0035248] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Interpersonal Support Evaluation List-12 (ISEL-12; Cohen, Mermelstein, Kamarck, & Hoberman, 1985) is broadly employed as a short-form measure of the traditional ISEL, which measures functional (i.e., perceived) social support. The ISEL-12 can be scored by summing the items to create an overall social support score; three subscale scores representing appraisal, belonging, and tangible social support have also been proposed. Despite extensive use, studies of the psychometric properties of ISEL-12 scores have been limited, particularly among Hispanics/Latinos, the largest and fastest growing ethnic group in the United States. The current study investigated the reliability and structural and convergent validity of ISEL-12 scores using data from 5,313 Hispanics/Latinos who participated in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Participants completed measures in English or Spanish and identified their ancestry as Dominican, Central American, Cuban, Mexican, Puerto Rican, or South American. Cronbach's alphas suggested adequate internal consistency for the total score for all languages and ancestry groups; coefficients for the subscale scores were not acceptable. Confirmatory factor analyses revealed that the one-factor and three-factor models fit the data equally well. Results from multigroup confirmatory factor analyses supported a similar one-factor structure with equivalent response patterns and variances between language groups and ancestry groups. Convergent validity analyses suggested that the total social support score related to scores of social network integration, life engagement, perceived stress, and negative affect (depression, anxiety) in the expected directions.
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Affiliation(s)
- Erin L. Merz
- San Diego State University
- University of California, San Diego
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406
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Seeman TE, Gruenewald TL, Cohen S, Williams DR, Matthews KA. Social relationships and their biological correlates: Coronary Artery Risk Development in Young Adults (CARDIA) study. Psychoneuroendocrinology 2014; 43:126-38. [PMID: 24703178 DOI: 10.1016/j.psyneuen.2014.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/14/2014] [Accepted: 02/15/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Analyses test the hypothesis that aspects of social relationships (quantity of ties, social support and social strain) are associated with differences in levels of biological risk across multiple major physiological regulatory systems and consequently overall multi-systems risk (i.e., allostatic load [AL]). METHODS Data are from the Coronary Artery Risk Development in Young Adults (CARDIA) study--a bi-ethnic, prospective, multi-center epidemiological study, initiated in 1985-1986 to track the development of cardiovascular risk in young adulthood (N=5115). At the year 15 follow-up when participants were between 32 and 45 years of age, additional social and biological data were collected; biological data used to assess AL were collected at the Oakland, CA and Chicago, IL sites (N=844). RESULTS Social strains were most strongly and positively related to overall AL (Cohen's d=.79 for highest vs. lowest quartile), and to each of its component biological subsystems, independent of social ties and support as well as sociodemographics and health behaviors. Social ties and emotional support were also negatively related to AL (Cohen's d=.33 and d=.44 for lowest vs. highest quartiles of ties and support, respectively) though controls for social strains reduced these associations to non-significance. Social support and social strain were more strongly related to overall AL than to any of its component subscales while social ties were less strongly related to AL and to its component subscales. There was no evidence that effects differed by sex, age or ethnicity. CONCLUSIONS Findings focus attention on the particularly strong relationship between social strains and profiles of biological risk and support the cumulative impact of social factors on biological risks, showing larger effects for cumulative AL than for any of the individual biological systems.
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Affiliation(s)
- Teresa E Seeman
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Tara L Gruenewald
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Harvard University, Boston, MA, United States
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
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407
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Low perceived social support is associated with CD8+CD57+ lymphocyte expansion and increased TNF-α levels. BIOMED RESEARCH INTERNATIONAL 2014; 2014:635784. [PMID: 24868535 PMCID: PMC4020546 DOI: 10.1155/2014/635784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/10/2014] [Indexed: 01/08/2023]
Abstract
Social support has been supposed to have a positive impact on the function of the immune system. However, the relationship between perceived social support and immune function has not yet been fully investigated. In this cross-sectional study, we investigated the link between perceived social support and lymphocyte subpopulations and cytokines. 232 healthy subjects provided a blood sample and completed the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. Lymphocyte immunophenotypes and cytokines were determined. Significantly increased CD8+CD57+ lymphocytes and TNF-α levels were found in group with low perceived social support. Multivariate linear regression corrected for possible confounders confirmed a significant role of perceived social support in predicting the number of CD8+CD57+ lymphocyte and TNF-α levels. This study supports the association between perceived social support and immune function. In particular, poor social support may be related to a state of chronic inflammation sustained by CD8+CD57+ lymphocyte expansion and increased TNF-α levels.
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408
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Hostinar CE, Sullivan RM, Gunnar MR. Psychobiological mechanisms underlying the social buffering of the hypothalamic-pituitary-adrenocortical axis: a review of animal models and human studies across development. Psychol Bull 2014; 140:256-282. [PMID: 23607429 PMCID: PMC3844011 DOI: 10.1037/a0032671 10.1037/a0032671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Discovering the stress-buffering effects of social relationships has been one of the major findings in psychobiology in the last century. However, an understanding of the underlying neurobiological and psychological mechanisms of this buffering is only beginning to emerge. An important avenue of this research concerns the neurocircuitry that can regulate the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. The present review is a translational effort aimed at integrating animal models and human studies of the social regulation of the HPA axis from infancy to adulthood, specifically focusing on the process that has been named social buffering. This process has been noted across species and consists of a dampened HPA axis stress response to threat or challenge that occurs with the presence or assistance of a conspecific. We describe aspects of the relevant underlying neurobiology when enough information exists and expose major gaps in our understanding across all domains of the literatures we aimed to integrate. We provide a working conceptual model focused on the role of oxytocinergic systems and prefrontal neural networks as 2 of the putative biological mediators of this process, and propose that the role of early experiences is critical in shaping later social buffering effects. This synthesis points to both general future directions and specific experiments that need to be conducted to build a more comprehensive model of the HPA social buffering effect across the life span that incorporates multiple levels of analysis: neuroendocrine, behavioral, and social.
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Affiliation(s)
| | - Regina M Sullivan
- Emotional Brain Institute, Nathan S. Kline Institute, Department of Child and Adolescent Psychiatry, New York University Langone Medical Center
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409
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Dolatian M, Mirabzadeh A, Forouzan AS, Sajjadi H, Alavimajd H, Mahmoodi Z, Moafi F. Relationship between Structural and Intermediary Determinants of Health and Preterm Delivery. J Reprod Infertil 2014; 15:78-86. [PMID: 24918080 PMCID: PMC4032973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 04/09/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Preterm birth is a major health problem that leads to infant morbidity and mortality. The main goal of this study was to find the relationship between social determinants of health and preterm delivery. METHODS A prospective longitudinal cohort study was carried out on 500 pregnant women in their 24th to 28th gestational weeks in 2012. The pregnant women filled out a self-report questionnaire on the structural determinant, perceived stress, and perceived social support. The participants were followed up until labor and the data about mother and the newborn were collected after labor. The data were analyzed by SPSS 21 and Lisrel 8.8 software programs using pathway analysis. RESULTS The final path model fit well (CFI=0.96; RMSEA=0.060). Path analysis showed that among structural factors, income had a direct effect (β=0.06) and the factors of income (β=0.00594), number of children (family size) (β=-0.024), as well as mother's education (β=-0.0084) had the greatest overall effect on gestational age at birth respectively. Also, the results showed that among intermediate factors of social determinants of health, stress in the direct path (β=-0.12) and among the overall effects, the perceived stress (β=-0.12) and perceived social support (β=0.0396) affected the gestational age at birth. CONCLUSION The current study showed that some structural and intermediary determinants such as income and perceived stress had an effect on preterm labor.
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Affiliation(s)
- Mahrokh Dolatian
- Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Arash Mirabzadeh
- Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Corresponding Author: Arash Mirabzadeh, Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. E-mail:
| | - Ameneh Setareh Forouzan
- Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Homeira Sajjadi
- Social Determinant of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Alavimajd
- Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Department of Midwifery, Faculty of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran
| | - Farnoosh Moafi
- Department of Midwifery, Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
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410
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O'Neal CW, Wickrama KAS, Ralston PA, Ilich JZ, Harris CM, Coccia C, Young-Clark I, Lemacks J. Examining change in social support and fruit and vegetable consumption in African American adults. J Nutr Health Aging 2014; 18:10-4. [PMID: 24402382 DOI: 10.1007/s12603-013-0376-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine (a) inter-individual variation in African Americans' fruit and vegetable social support, behavior, and consumption trajectories by estimating latent growth curves (LGCs) and (b) the associations between these trajectories over time. DESIGN As part of a larger intervention study, data were collected from mid-life and older African Americans yearly for three years. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender. SETTING Six churches in North Florida. PARTICIPANTS Two hundred and thirty one (73% women; median age range of 57-63) older African Americans. MEASUREMENTS A structured questionnaire elicited personal data as well as information on dietary social support, eating-related behaviors, and fruit and vegetable dietary intake. RESULTS Age was positively associated with initial social support but negatively associated with the rate of change in social support. More important, the rate of change in dietary social support predicted eating-related behavior trajectories, which influenced the rate of change in fruit and vegetable consumption over time after controlling for the intervention. CONCLUSION These findings illustrate the mediating role of eating-related behaviors and the inter-locking nature of social support, behavior and consumption trajectories. This research has implications for future research as well as community interventions and programs.
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Affiliation(s)
- C W O'Neal
- C.W. O'Neal, Human Development and Family Science; University of Georgia, 107 Family Science Center II; Athens, GA 30602, ; (706) 542-2972
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411
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Lundberg T, Olsson M, Fürst CJ. The perspectives of bereaved family members on their experiences of support in palliative care. Int J Palliat Nurs 2013; 19:282-8. [PMID: 24151739 DOI: 10.12968/ijpn.2013.19.6.282] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To explore family members' supportive interactions in palliative care and the emotional experiences that they associate with these interactions. METHODS Qualitative individual interviews were performed with bereaved family members recruited from an urban palliative care service in Sweden. The interviews were analysed using inductive qualitative content analysis. RESULTS Five categories of supportive interactions with staff members were linked with emotional consequences: informational support, supportive encounters, professional focus of staff, a supportive environment, and bereavement support. Having a dialogue with family members nurtured certainty and security, supportive encounters gave a warm and comforting feeling, and bereavement support contributed to feelings of strength. Environmental factors contributed to dignity. CONCLUSION Supportive interactions with staff and within a home-like environment help to build resilience if tailored to the family member's own needs.
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Affiliation(s)
- Tina Lundberg
- Palliative Research Centre, PO Box 11189, SE-100 61 Stockholm, Sweden.
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412
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Uebelacker LA, Eaton CB, Weisberg R, Sands M, Williams C, Calhoun D, Manson JE, Denburg NL, Taylor T. Social support and physical activity as moderators of life stress in predicting baseline depression and change in depression over time in the Women's Health Initiative. Soc Psychiatry Psychiatr Epidemiol 2013; 48:1971-82. [PMID: 23644722 PMCID: PMC3796164 DOI: 10.1007/s00127-013-0693-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine whether social support and/or physical activity buffer the association between stressors and increasing risk of depression symptoms at baseline and at 3-year follow-up. METHODS This is a secondary analysis of data from the Women's Health Initiative Observational Study. 91,912 community-dwelling post-menopausal women participated in this prospective cohort study. Depression symptoms were measured at baseline and 3 years later; social support, physical activity, and stressors were measured at baseline. RESULTS Stressors at baseline, including verbal abuse, physical abuse, caregiving, social strain, negative life events, financial stress, low income, acute pain, and a greater number of chronic medical conditions, were all associated with higher levels of depression symptoms at baseline and new onset elevated symptoms at 3-year follow-up. Social support and physical activity were associated with lower levels of depressive symptoms. Contrary to expectation, more social support at baseline strengthened the association between concurrent depression and physical abuse, social strain, caregiving, and low income. Similarly, more social support at baseline increased the association between financial stress, income, and pain on new onset depression 3 years later. Physical activity similarly moderated the effect of caregiving, income, and pain on depression symptoms at baseline. CONCLUSION Stressors, social support, and physical activity showed predicted main effect associations with depression. Multiplicative interactions were small in magnitude and in the opposite direction of what was expected.
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Affiliation(s)
- Lisa A Uebelacker
- Alpert Medical School of Brown University, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA,
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413
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Depressive Symptoms in Women With Physical Disabilities: Identifying Correlates to Inform Practice. Arch Phys Med Rehabil 2013; 94:2410-2416. [DOI: 10.1016/j.apmr.2013.07.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/07/2013] [Accepted: 07/01/2013] [Indexed: 11/22/2022]
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414
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Kakai H. A community of healing: psychosocial functions of integrative medicine perceived by oncology patients/survivors, healthcare professionals, and CAM providers. Explore (NY) 2013; 9:365-71. [PMID: 24199776 DOI: 10.1016/j.explore.2013.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A whole systems research approach was used to explore the psychosocial functions attributed to an Integrative Medicine oncology program. Field research was conducted at a cancer clinic to answer the following questions: (1) what meanings do the participants attribute to the Integrative Medicine oncology program; (2) what contributes to sustaining the Integrative Medicine program; and (3) what role does the Integrative Medicine program play in the lives of the participants. METHODS Participant observation and in-depth interviews were conducted at a community-based cancer clinic that offers various complementary modalities along with conventional cancer treatments. PARTICIPANTS The data were obtained from a total of 23 participants including cancer patients/survivors, caregivers, volunteers who provided the complementary therapies, and healthcare professionals at the clinic. RESULTS Results indicated that the Integrative Medicine program had three major psychosocial functions for those involved. Participants viewed the Integrative Medicine program as a place (1) to exchange health/medical information and learn from others' experiences and expertise, (2) to give and receive emotional support, and (3) for the individual to act on his/her transformed new identity and new life goals through serving others. CONCLUSIONS The results illustrate the positive psychosocial impacts an Integrative Medicine program may bring to individuals involved in it and suggest the value of using a whole systems research (WSR) approach to Integrative Medicine research.
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Affiliation(s)
- Hisako Kakai
- Department of International Communication, School of International Politics, Economics and Communication, Aoyama Gakuin University, 4-4-25 Shibuya, Shibuya-ku, Tokyo, Japan.
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415
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Ekbäck M, Benzein E, Lindberg M, Arestedt K. The Swedish version of the multidimensional scale of perceived social support (MSPSS)--a psychometric evaluation study in women with hirsutism and nursing students. Health Qual Life Outcomes 2013; 11:168. [PMID: 24112950 PMCID: PMC3816155 DOI: 10.1186/1477-7525-11-168] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 10/07/2013] [Indexed: 11/10/2022] Open
Abstract
Background The Multidimensional Scale of Perceived Social Support (MSPSS) is a short instrument, developed to assess perceived social support. The original English version has been widely used. The original scale has demonstrated satisfactory psychometric properties in different settings, but no validated Swedish version has been available. The aim was therefore to translate, adapt and psychometrically evaluate the Multidimensional Scale of Perceived Social Support for use in a Swedish context. Method In total 281 participants accepted to join the study, a main sample of 127 women with hirsutism and a reference sample of 154 nursing students. The MSPSS was translated and culturally adapted according to the rigorous official process approved by WHO. The psychometric evaluation included item analysis, evaluation of factor structure, known-group validity, internal consistency and reproducibility. Results The original three-factor structure was reproduced in the main sample of women with hirsutism. An equivalent factor structure was demonstrated in a cross-validation, based on the reference sample of nursing students. Known-group validity was supported and internal consistency was good for all scales (α = 0.91-0.95). The test-retest showed acceptable to very good reproducibility for the items (κw = 0.58-0.85) and the scales (ICC = 0.89-0.92; CCC = 0.89-0.92). Conclusion The Swedish version of the MSPSS is a multidimensional scale with sound psychometric properties in the present study sample. The simple and short format makes it a useful tool for measuring perceived social support.
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Affiliation(s)
- Maria Ekbäck
- Department of Dermatology, University Hospital Örebro and School of Health and Medical Sciences, Örebro University, Örebro, SE 70185, Sweden.
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416
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Shaw WS, Campbell P, Nelson CC, Main CJ, Linton SJ. Effects of workplace, family and cultural influences on low back pain: What opportunities exist to address social factors in general consultations? Best Pract Res Clin Rheumatol 2013; 27:637-48. [DOI: 10.1016/j.berh.2013.09.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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417
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Ye Y. The role of illness factors and patient satisfaction in using online health support groups. HEALTH COMMUNICATION 2013; 29:355-363. [PMID: 23845117 DOI: 10.1080/10410236.2012.757526] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Drawing on the behavioral model of health services use and the PRECEDE-PROCEED model, this research explores various correlates of participation in online health support groups based on the 2007 Health Information National Trend Survey data. Results show that controlling for demographics, emotional health and family cancer history were significant correlates, whereas perceived general health status approached statistical significance, and personal cancer history and cancer worry were not significant. Moreover, patient-provider communication satisfaction approached statistical significance, and patient satisfaction with received health care was not statistically significant. Theoretical and practical implications of these results are discussed.
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Affiliation(s)
- Yinjiao Ye
- a Department of Communication Studies , University of Rhode Island
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418
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Jordan M, Livingstone JB. Coaching vs Psychotherapy in health and Wellness: Overlap, Dissimilarities, and the Potential for Collaboration. Glob Adv Health Med 2013. [DOI: 10.7453/gahmj.13.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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419
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Jordan M, Livingstone JB. Coaching vs Psychotherapy in health and Wellness: Overlap, Dissimilarities, and the Potential for Collaboration. Glob Adv Health Med 2013; 2:20-7. [PMID: 24416682 PMCID: PMC3833547 DOI: 10.7453/gahmj.2013.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Health coaches and psychotherapists both work with the art and science of facilitating change in their patients and clients. While the evolving field of health coaching and the established disciplines of clinical or counseling psychology share major areas of overlap, there are also significant distinctions between the two fields. This article outlines those similarities and dissimilarities with the intention of fostering a cooperative and mutually enriching stance between the two helping professions for the benefit of the respective professionals and the countless clients and patients they serve.
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Affiliation(s)
- Meg Jordan
- California Institute of Integral Studies, San Francisco, United States
| | - John B Livingstone
- Harvard Medical School, Society of Behavioral Medicine; Gaffney and Livingstone Consultants in Health Care Design and Coaching, Provincetown, Massachusetts, United States
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420
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Mirabzadeh A, Dolatian M, Forouzan AS, Sajjadi H, Majd HA, Mahmoodi Z. Path analysis associations between perceived social support, stressful life events and other psychosocial risk factors during pregnancy and preterm delivery. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:507-14. [PMID: 24349750 PMCID: PMC3840839 DOI: 10.5812/ircmj.11271] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 04/06/2013] [Accepted: 04/07/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although several socio-medical risk factors have been identified for preterm labor, there is a gap in understanding the underlying etiology of preterm labor. OBJECTIVES The current study aimed to analyze the relationship pathway of perceived social support, stressful life events, and other psychosocial risk factors during pregnancy with incidence of preterm labor. MATERIALS AND METHODS In a prospective cohort study in four hospitals in Tehran, 500 pregnant women in their 24th to 28th gestational weeks were studied. They filled out a self-report questionnaire on perceived social support, depression, anxiety, stress and stressful life events. Sociodemographic characteristics were also assessed. The participants were followed up until labor, and the data about mother and the newborn were collected after labor. The data were analyzed by SPSS 16 and Lisrel 8.8 software programs using pathway analysis. RESULTS The final path model fit well (CFI = 0.96; RMSEA = .064). The results showed that depression, anxiety, and stress (β = -0.18) directly, and stressful life events indirectly (β= -0.0396) had the most predict on gestational age at labor. Perceived social support, directly through socioeconomic status (β=0.25), and indirectly through stress, depression and anxiety (β= -0.26) affected the gestational age at birth (β= 0.0468). CONCLUSIONS The current study showed that supporting pregnant mother moderates psychological problems such as stress, anxiety, and depression, and hence reduces preterm labor.
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Affiliation(s)
- Arash Mirabzadeh
- Department of Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
- Department of Psychiatric, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Mahrokh Dolatian
- Department of Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
- Corresponding author: Mahrokh Dolatian, Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel: +98-2188202512, Fax: +98-2188202512, E-mail:
| | - Ameneh Setare Forouzan
- Department of Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Homeira Sajjadi
- Department of Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedical Sciences, ShahidBeheshti University of Medical Sciences, Tehran, IR Iran
| | - Zohreh Mahmoodi
- Faculty of Nursing and Midwifery, Department of Midwifery, Alborz University of Medical Sciences, Karaj, IR Iran
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421
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Abstract
OBJECTIVE The purpose of this qualitative study was to investigate how frontline healthcare professionals witness and understand disparity in cancer care. METHOD Six healthcare providers from a range of care settings, none with < 15 years of frontline experience, engaged with researchers in an iterative process of identifying and reflecting on equity and disparity in cancer care. This knowledge exchange began with formal interviews. Thematic analysis of the interviews form the basis of this article. RESULTS Participants drew attention to health systems issues, the meaning and experience of discontinuities in care for patients at personal and community levels, and the significance of social supports. Other concerns raised by participants were typical of the literature on healthcare disparities. SIGNIFICANCE OF RESULTS Providers at the front lines of care offer a rich source of insight into the operation of disparities, pointing to mechanisms rarely identified in traditional quantitative studies. They are also well positioned to advocate for more equitable care at the local level.
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422
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Teal CR. Considering the development of doctor-patient relationships: a call and a caution. MEDICAL EDUCATION 2013; 47:436-438. [PMID: 23574054 DOI: 10.1111/medu.12149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Cayla R Teal
- Office of Undergraduate Medical Education, Baylor College of Medicine, One Baylor Plaza, MS: BCM300, Houston, Texas 77030-3411, USA.
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423
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Hostinar CE, Sullivan RM, Gunnar MR. Psychobiological mechanisms underlying the social buffering of the hypothalamic-pituitary-adrenocortical axis: a review of animal models and human studies across development. Psychol Bull 2013; 140:256-82. [PMID: 23607429 DOI: 10.1037/a0032671] [Citation(s) in RCA: 452] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Discovering the stress-buffering effects of social relationships has been one of the major findings in psychobiology in the last century. However, an understanding of the underlying neurobiological and psychological mechanisms of this buffering is only beginning to emerge. An important avenue of this research concerns the neurocircuitry that can regulate the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. The present review is a translational effort aimed at integrating animal models and human studies of the social regulation of the HPA axis from infancy to adulthood, specifically focusing on the process that has been named social buffering. This process has been noted across species and consists of a dampened HPA axis stress response to threat or challenge that occurs with the presence or assistance of a conspecific. We describe aspects of the relevant underlying neurobiology when enough information exists and expose major gaps in our understanding across all domains of the literatures we aimed to integrate. We provide a working conceptual model focused on the role of oxytocinergic systems and prefrontal neural networks as 2 of the putative biological mediators of this process, and propose that the role of early experiences is critical in shaping later social buffering effects. This synthesis points to both general future directions and specific experiments that need to be conducted to build a more comprehensive model of the HPA social buffering effect across the life span that incorporates multiple levels of analysis: neuroendocrine, behavioral, and social.
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Affiliation(s)
| | - Regina M Sullivan
- Emotional Brain Institute, Nathan S. Kline Institute, Department of Child and Adolescent Psychiatry, New York University Langone Medical Center
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424
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Fortmann AL, Gallo LC. Social support and nocturnal blood pressure dipping: a systematic review. Am J Hypertens 2013; 26:302-10. [PMID: 23382479 PMCID: PMC3888008 DOI: 10.1093/ajh/hps041] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 09/22/2012] [Accepted: 10/06/2012] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Attenuated nocturnal blood pressure (BP) dipping is a better predictor of cardiovascular disease (CVD) morbidity and mortality than resting BP measurements. Studies have reported associations between social support, variously defined, and BP dipping. METHODS A systematic review of the literature was conducted to investigate associations of functional and structural social support with nocturnal BP dipping assessed over a minimum of 24 hours. RESULTS A total of 297 articles were identified. Of these, 11 met criteria for inclusion; all studies were cross-sectional in design and included adult participants only (mean age = 19 to 72 years). Evidence was most consistent for an association between functional support and BP dipping, such that 5 of 7 studies reported statistically (or marginally) significant positive associations with BP dipping. Statistically significant functional support-BP dipping associations were moderate (standardized effect size (d) = 0.41) to large (d = 2.01) in magnitude. Studies examining structural support were fewer and relatively less consistent; however, preliminary evidence was observed for associations of marital status and social contact frequency with BP dipping. Statistically significant structural support findings were medium (d = 0.53) to large (d = 1.13) in magnitude. CONCLUSIONS Overall, findings suggest a link between higher levels of functional support and greater nocturnal BP dipping; preliminary evidence was also observed for the protective effects of marriage and social contact frequency. Nonetheless, the relatively small number of studies conducted to date and the heterogeneity of findings across meaningful subgroups suggest that additional research is needed to substantiate these conclusions.
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Affiliation(s)
- Addie L Fortmann
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.
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425
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Capponi I, Bacro F, Boudoukha AH. Effets différentiels des types de soutien social sur l'anxiété maternelle périnatale. ACTA ACUST UNITED AC 2013. [DOI: 10.3917/bupsy.525.0209] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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426
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Yapko MD. Treating depression with antidepressants: drug-placebo efficacy debates limit broader considerations. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2013; 55:272-90. [PMID: 23488253 DOI: 10.1080/00029157.2012.707156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The core issue regarding antidepressants for many clinicians is whether they perform significantly better than placebos. However, this article suggests eight additional concerns beyond drug efficacy alone to consider regarding antidepressants including: (1) formulating only a one-dimensional, biological view of depression; (2) defining the client's role as passive in treatment; (3) economic corruption of the research and reporting; (4) false or misleading consumer advertising; (5) conflicting data that confuse practitioners and consumers alike; (6) over- and under-prescription of medications; (7) drug side-effects; and (8) harm to the environment. The enhanced effects of psychotherapy utilizing hypnosis offer a means of avoiding most, if not all, of the problems associated with the use of antidepressants as a primary form of treatment.
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427
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Tay L, Tan K, Diener E, Gonzalez E. Social Relations, Health Behaviors, and Health Outcomes: A Survey and Synthesis. Appl Psychol Health Well Being 2012; 5:28-78. [PMID: 23281315 DOI: 10.1111/aphw.12000] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Louis Tay
- Singapore Management University; Singapore
| | | | - Ed Diener
- University of Illinois and the Gallup Organization; USA
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428
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Kiropoulos LA, Meredith I, Tonkin A, Clarke D, Antonis P, Plunkett J. Increased Psychosocial Stress in Greek-Born Immigrants Compared to Anglo-Australians with Coronary Heart Disease: The Healthy Heart, Healthy Mind Study. Heart Lung Circ 2012; 21:794-802. [DOI: 10.1016/j.hlc.2012.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/11/2012] [Accepted: 07/18/2012] [Indexed: 11/30/2022]
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429
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Nelson SE, Gray HM, Maurice IR, Shaffer HJ. Moving ahead: evaluation of a work-skills training program for homeless adults. Community Ment Health J 2012; 48:711-22. [PMID: 22350627 DOI: 10.1007/s10597-012-9490-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/18/2012] [Indexed: 11/29/2022]
Abstract
This study examines the impact of a work-skills program grounded in an integrated services approach on both employment and related life domains among homeless individuals. Six hundred thirty-eight participants in a 14-week work-skills program at a large day center in New England completed assessments at intake between 1999 and 2007; a subsample of 333 also completed assessments at graduation from the program; a smaller subsample of 55 participants were re-assessed 6 months after graduation. These assessments measured work and related life skills, employment, housing status, general health status, substance use, self-esteem and self-efficacy, and legal involvement. Results revealed improvement in all types of work and related life skills, employment and income, and multiple other life domains from baseline to graduation and follow-up. Exploratory analyses suggested that improvements in work and related life skills were associated with improvement in self-esteem and self-efficacy, and that these improvements predicted stable housing situations at follow-up. Overall, these findings indicate that, for individuals struggling with the challenges of homelessness, completion of a work-skills program has a positive impact on skills and employment, and on a diverse set of life domains.
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Affiliation(s)
- Sarah E Nelson
- Division on Addiction, Cambridge Health Alliance, Medford, MA 01060, USA.
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430
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Proudfoot JG, Jayawant A, Whitton AE, Parker G, Manicavasagar V, Smith M, Nicholas J. Mechanisms underpinning effective peer support: a qualitative analysis of interactions between expert peers and patients newly-diagnosed with bipolar disorder. BMC Psychiatry 2012; 12:196. [PMID: 23140497 PMCID: PMC3549948 DOI: 10.1186/1471-244x-12-196] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/07/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increasing burden on mental health services has led to the growing use of peer support in psychological interventions. Four theoretical mechanisms have been proposed to underpin effective peer support: advice grounded in experiential knowledge, social support, social comparison and the helper therapy principle. However, there has been a lack of studies examining whether these mechanisms are also evident in clinical populations in which interpersonal dysfunction is common, such as bipolar disorder. METHOD This qualitative study, conducted alongside a randomized controlled trial, examined whether the four mechanisms proposed to underpin effective peer support were expressed in the email exchange between 44 individuals newly-diagnosed with bipolar disorder and their Informed Supporters (n = 4), over the course of a supported online psychoeducation program for bipolar disorder. A total of 104 text segments were extracted and coded. The data were complemented by face-to-face interviews with three of the four Informed Supporters who participated in the study. RESULTS Qualitative analyses of the email interchange and interview transcripts revealed rich examples of all four mechanisms. The data illustrated how the involvement of Informed Supporters resulted in numerous benefits for the newly-diagnosed individuals, including the provision of practical strategies for illness management as well as emotional support throughout the intervention. The Informed Supporters encouraged the development of positive relationships with mental health services, and acted as role models for treatment adherence. The Informed Supporters themselves reported gaining a number of benefits from helping, including a greater sense of connectedness with the mental health system, as well as a broader knowledge of illness management strategies. CONCLUSIONS Examples of the mechanisms underpinning effective peer support were found in the sample of emails from individuals with newly-diagnosed bipolar disorder and their Informed Supporters. Experiential knowledge, social support, social comparison and helper therapy were apparent, even within a clinical population for whom relationship difficulties are common. Trial registration number ACTRN12608000411347.
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Affiliation(s)
- Judith G Proudfoot
- Black Dog Institute and School of Psychiatry, University of New South Wales, Randwick, NSW, Australia.
| | - Amisha Jayawant
- Black Dog Institute and School of Psychiatry, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Alexis E Whitton
- Black Dog Institute and School of Psychiatry, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Gordon Parker
- Black Dog Institute and School of Psychiatry, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Vijaya Manicavasagar
- Black Dog Institute and School of Psychiatry, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Meg Smith
- School of Social Sciences, University of Western Sydney, Penrith South, NSW, Australia
| | - Jennifer Nicholas
- Black Dog Institute and School of Psychiatry, University of New South Wales, Hospital Road, Randwick, NSW, Australia
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431
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Min JY, Lee KJ, Park JB, Cho SI, Park SG, Min K. Social engagement, health, and changes in occupational status: analysis of the Korean Longitudinal Study of Ageing (KLoSA). PLoS One 2012; 7:e46500. [PMID: 23056323 PMCID: PMC3462751 DOI: 10.1371/journal.pone.0046500] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 09/02/2012] [Indexed: 11/18/2022] Open
Abstract
Background We focused on whether changes in the occupational status of older male adults can be influenced by social engagement and health status measured at the baseline. Methods This study used a sample of the Korean Longitudinal Study of Aging (KLoSA), and the study population was restricted to 1.531 men who were aged 55 to 80 years at the 2006 baseline survey and participated in the second survey in 2008. Social engagement and health status, measured by the number of chronic diseases, grip strength, and depressive symptoms as well as covariates (age, marital status, educational level, and household income) were based on data from the 2006 baseline survey. Occupational engagement over the first and second survey was divided into four categories: ‘consistently employed’ (n = 892), ‘employed-unemployed’ (n = 152), ‘unemployed-employed’ (n = 138), and ‘consistently unemployed’ (n = 349). Results In the multinomial model, the ‘consistently employed’ and ‘unemployed-employed’ groups had significantly higher social engagement (1.19 and 1.32 times, respectively) than the referent. The number of chronic diseases was significantly associated with four occupational changes, and the ‘unemployed-employed’ had the fewest chronic conditions. Conclusion Our finding suggests that social engagement and health status are likely to affect opportunities to continue working or to start working for older male adults.
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Affiliation(s)
- Jin-young Min
- Institute of Health and Environment, Seoul National University, Chongno-gu Yongeun-dong 28, Seoul, Republic of Korea
| | - Kyung-jong Lee
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jae-beom Park
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sung-il Cho
- Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Shin-goo Park
- Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Kyoungbok Min
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
- * E-mail:
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432
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Abstract
The utility of real-time interactive voice and video telehealth for teaching pursed-lips breathing (PLB) in chronic obstructive pulmonary disease (COPD) is unknown. This was a pilot study to determine its feasibility and efficacy on the key variables of social support and dyspnea. A randomized control study design with repeated measures (baseline, 4 and 12 weeks) was used. All participants in the control and intervention groups received PLB instruction at baseline, but only the intervention group received one weekly PLB reinforcement session for 4 weeks via home computer and Skype™ software. Outcome measures were Medical Outcomes Study Social Support Survey and dyspnea assessment (visual analogue scales for intensity and distress, modified Borg after six-minute walk distance, and Shortness of Breath Questionnaire for activity-associated dyspnea). A total of 22 participants with COPD (mean FEV(1)% predicted = 56) were randomized; 16 (9 telehealth, 7 control) completed the protocol. Intent-to-treat analysis at week 4, but not week 12, demonstrated significantly improved total social support (P = 0.02) and emotional/informational subscale (P = 0.03) scores. Dyspnea intensity decreased (P = 0.08) for the intervention group with a minimal clinical important difference of 10.4 units. Analysis of only participants who completed the protocol demonstrated a significant decrease in dyspnea intensity (P = < 0.01) for the intervention group at both week 4 and 12. Real-time telehealth is a feasible, innovative approach for PLB instruction in the home with outcomes of improved social support and decreased dyspnea.
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Affiliation(s)
- Margaret Nield
- West Los Angeles VA Healthcare Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
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433
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Viewing loved faces inhibits defense reactions: a health-promotion mechanism? PLoS One 2012; 7:e41631. [PMID: 22911829 PMCID: PMC3402448 DOI: 10.1371/journal.pone.0041631] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Accepted: 06/27/2012] [Indexed: 11/19/2022] Open
Abstract
We have known for decades that social support is associated with positive health outcomes. And yet, the neurophysiological mechanisms underlying this association remain poorly understood. The link between social support and positive health outcomes is likely to depend on the neurophysiological regulatory mechanisms underlying reward and defensive reactions. The present study examines the hypothesis that emotional social support (love) provides safety cues that activate the appetitive reward system and simultaneously inhibit defense reactions. Using the startle probe paradigm, 54 undergraduate students (24 men) viewed black and white photographs of loved (romantic partner, father, mother, and best friend), neutral (unknown), and unpleasant (mutilated) faces. Eye–blink startle, zygomatic major activity, heart rate, and skin conductance responses to the faces, together with subjective ratings of valence, arousal, and dominance, were obtained. Viewing loved faces induced a marked inhibition of the eye-blink startle response accompanied by a pattern of zygomatic, heart rate, skin conductance, and subjective changes indicative of an intense positive emotional response. Effects were similar for men and women, but the startle inhibition and the zygomatic response were larger in female participants. A comparison between the faces of the romantic partner and the parent who shares the partner’s gender further suggests that this effect is not attributable to familiarity or arousal. We conclude that this inhibitory capacity may contribute to the health benefits associated with social support.
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434
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Mello S, Tan ASL, Armstrong K, Sanford Schwartz J, Hornik RC. Anxiety and depression among cancer survivors: the role of engagement with sources of emotional support information. HEALTH COMMUNICATION 2012; 28:389-396. [PMID: 22809393 PMCID: PMC4195239 DOI: 10.1080/10410236.2012.690329] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study explores cancer survivors' engagement with information about emotional support from doctors, interpersonal sources, and the media and examines to what extent such engagement affects subsequent self-reported anxiety and depression. Patients with colorectal, breast, or prostate cancer (n = 1,128) were surveyed over 3 years following diagnosis. Using lagged logistic regression, we predicted the odds of experiencing anxiety or depression based on earlier engagement with sources of emotional support, adjusting for prior symptoms and confounders. Among those reporting anxiety or depression (n = 476), we also asked whether information engagement affected the severity of those symptoms. Participants obtained information about emotional support from multiple sources, but most often from physicians. Discussions with physicians about emotional support increased the odds of cancer survivors subsequently reporting anxiety or depression by 1.58 times (95% CI: 1.06 to 2.35; p = 0.025), adjusted for prior symptoms and confounders. Scanning from media sources was also significantly associated with increased odds of reporting emotional symptoms (OR=1.72; 95% CI: 1.03 to 2.87; p = 0.039). However, among those who reported symptoms, doctor-patient engagement predicted slightly reduced interference of these symptoms with daily activities (B = -0.198; 95% CI: -0.393 to -0.003; p = 0.047). Important implications for health communication research and practice are discussed.
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Affiliation(s)
- Susan Mello
- Center of Excellence in Cancer Communication Research, University of Pennsylvania, Philadelphia, PA 19104, USA.
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435
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Bergvik S, Wynn R. The use of short message service (SMS) among hospitalized coronary patients. Gen Hosp Psychiatry 2012; 34:390-7. [PMID: 22516220 DOI: 10.1016/j.genhosppsych.2012.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 03/03/2012] [Accepted: 03/08/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The use of cell phones and short message service (SMS, also called "texting") has become pervasive in Western society and increasingly throughout the world. Despite the importance of this technology in everyday life, little is known about how patients draw on SMS to keep in contact with family and friends during their hospitalization. METHODS A questionnaire was distributed to patients with coronary artery disease discharged from a Norwegian university hospital during the period from June 2005 to June 2006. In addition to questions pertaining to demographics, illness and treatment, mental distress, personality traits, perceived control, Internet usage and lifestyle, respondents were asked if they had contact with family and friends by SMS while in the hospital. RESULTS Four hundred twelve responded (59%), of which 216 had undergone surgery and 196 had undergone percutaneous coronary interventions. Sixty-three percent had used SMS to keep in touch with family and friends during their stay at the hospital. Use of SMS was positively predicted by Internet usage, gender and the personality trait of Openness, and was negatively predicted by the belief that illness and health were caused by luck or destiny. CONCLUSIONS SMS is an important means of communication during hospitalization for a majority of coronary disease inpatients.
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Affiliation(s)
- Svein Bergvik
- Department of Clinical Medicine, University of Tromsø, Faculty of Health Sciences, Tromsø, Norway
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436
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Hsu HC, Jones BL. Multiple trajectories of successful aging of older and younger cohorts. THE GERONTOLOGIST 2012; 52:843-56. [PMID: 22403165 DOI: 10.1093/geront/gns005] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The purpose of this study was to apply group-based trajectory analysis to identify multiple successful aging trajectories by multiple indicators and to examine the factors related to successful aging among the elderly population in Taiwan. DESIGN AND METHODS Nation-representative longitudinal data collected from 1993 to 2007 and consisting of 2 cohorts were used, and the trajectories of the following 6 successful aging indicators were analyzed: chronic diseases, physical function difficulties, depressive symptoms, social support, social participation, and economic satisfaction. RESULTS Members of the cohorts fell into 4 groups: successful aging, usual aging (the older cohort)/insecure aging (the younger cohort), health declining, and care demanding. Successful aging trajectories reflected differences in self-rated health and life satisfaction. IMPLICATIONS This study provides empirical findings of the heterogeneity of successful aging trajectories in multidimensional indicators.
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Affiliation(s)
- Hui-Chuan Hsu
- Department of Health Care Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, Republic of China.
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437
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Yasin S, Chan CKY, Reidpath DD, Allotey P. Contextualizing chronicity: a perspective from Malaysia. Global Health 2012; 8:4. [PMID: 22397462 PMCID: PMC3342147 DOI: 10.1186/1744-8603-8-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 03/08/2012] [Indexed: 01/14/2023] Open
Affiliation(s)
- Shajahan Yasin
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Kuala Lumpur, Malaysia
| | - Carina KY Chan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Kuala Lumpur, Malaysia
| | - Daniel D Reidpath
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Kuala Lumpur, Malaysia
| | - Pascale Allotey
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Kuala Lumpur, Malaysia
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438
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Low social support is associated with an increased risk of postoperative delirium. J Clin Anesth 2012; 24:126-32. [DOI: 10.1016/j.jclinane.2011.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 06/21/2011] [Accepted: 07/04/2011] [Indexed: 11/19/2022]
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439
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Baron-Epel O. Differences in the Association between Social Support and Mental Health in a Multi-Cultural Population in Israel. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2009.9721795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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440
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Social support and clinical outcomes during antiviral therapy for chronic hepatitis C. J Psychosom Res 2011; 71:349-56. [PMID: 21999979 PMCID: PMC3197215 DOI: 10.1016/j.jpsychores.2011.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Revised: 05/04/2011] [Accepted: 05/05/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine if social support (SS) is associated with clinical outcomes during antiviral therapy for chronic hepatitis C virus (HCV). METHODS Data from 394 patients who participated in the prospective, longitudinal VIRAHEP-C study were examined. VIRAHEP-C enrolled 401 adults with HCV to evaluate factors associated with antiviral treatment response. Perceived SS was measured using the Medical Outcome Study Social Support Survey (MOS-SSS) at baseline and treatment week 24. Scores were calculated as a continuous variable ranging from 0% to 100% with higher scores indicating greater support. Two SS variables were created: (1) baseline SS (BL-SS) and (2) change in SS from baseline to treatment week 24 (CH-SS). The primary endpoint was sustained virological response (SVR) six months post-treatment. Intermediate outcomes included: symptom-reporting; virological response at treatment week 24; medication adherence; neuropsychiatric adverse events; and dose reductions and premature medication discontinuation. The relative risk of each outcome was estimated using modified Poisson regression models or linear mixed models. RESULTS BL-SS was relatively high (mean=79%). Overall, SS declined from baseline to treatment week 24 (median change: -1.3%; p<.01). Neither BL-SS nor CH-SS was associated with SVR. However, BL-SS was associated with multiple symptoms (fatigue, headache, irritability, aches/pains) during treatment, even after adjusting for baseline depression, which was significantly associated with symptom-reporting. CONCLUSIONS SS was not directly associated with efficacy measures, such as SVR. However, baseline SS predicted an increase in symptomatology over the course of antiviral therapy. Baseline depression was also significantly associated with symptom-reporting.
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441
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The relationship of different sources of social support and civic participation with self‐rated health. JOURNAL OF PUBLIC MENTAL HEALTH 2011. [DOI: 10.1108/17465721111175010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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442
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Iecovich E, Jacobs JM, Stessman J. Loneliness, social networks, and mortality: 18 years of follow-up. Int J Aging Hum Dev 2011; 72:243-63. [PMID: 21834390 DOI: 10.2190/ag.72.3.e] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We examined the influence of changes in loneliness and social support networks upon mortality during 18 years of follow-up among an elderly cohort and determined the gender-specific nature of this relationship. The study is based on data collected from the Jerusalem Longitudinal Study (1990-2008), which has followed a representative sample of 605 community-dwelling elderly people. Subjects were randomly selected from an age homogenous cohort born 1920-1921 and were aged 70, 78, and 85 when data were collected at baseline in 1990 and at follow-up in 1998 and 2005. All-cause mortality from age 70-88 was determined according to the National Death Registry. Sense of loneliness was found to be stable among the majority of the respondents. Loneliness among men was found in bivariate analyses to be a risk factor for mortality. Although multivariate analyses found that loneliness was not a significant predictor of mortality, nonetheless several social network factors (marital status at the baseline and living arrangements) were found to predict mortality among men. Loneliness and solitude among elderly men can be a risk factor of mortality. The findings imply that attention should be given to this high risk group.
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Affiliation(s)
- Esther Iecovich
- Faculty of Health Sciences, Department of Sociology of Health and Gerontology, Ben Gurion University of the Negev, Beer-Sheva, Israel.
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443
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Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study. Int J Behav Nutr Phys Act 2011; 8:77. [PMID: 21791105 PMCID: PMC3199735 DOI: 10.1186/1479-5868-8-77] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 07/26/2011] [Indexed: 11/10/2022] Open
Abstract
Background Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA), multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up. Methods This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study). LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group) and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS). To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group) and for those who had maintained LTPA since the beginning of the follow up (maintenance group). Results After adjusting for confounders, statistically significant associations (p < 0.05) between dimensions of social support and group LTPA were found in the engagement group. Also, the emotional/information dimension was associated with time spent on LTPA (OR = 2.01; 95% CI 1.2-3.9). In the maintenance group, material support was associated with group LTPA (OR = 1.80; 95% CI; 1.1-3.1) and the positive social interaction dimension was associated with time spent on LTPA (OR = 1.65; 95% CI; 1.1-2.7). Conclusions All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the practice of LTPA.
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444
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Hricik A, Donovan H, Bradley SE, Given BA, Bender CM, Newberry A, Hamilton R, Given CW, Sherwood P. Changes in caregiver perceptions over time in response to providing care for a loved one with a primary malignant brain tumor. Oncol Nurs Forum 2011; 38:149-55. [PMID: 21356653 DOI: 10.1188/11.onf.149-155] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine how family members of patients with a primary malignant brain tumor transition into the caregiver role and how their perceptions of this transition change over time. RESEARCH APPROACH Descriptive, qualitative. SETTING Neurosurgery and neuro-oncology clinics of a regional medical center. PARTICIPANTS 10 family caregivers of patients with a primary malignant brain tumor. METHODOLOGIC APPROACH A series of 11 open-ended questions addressing various aspects of the care situation were administered to each caregiver. The same questions were asked at baseline (within one month of the patient's diagnosis) and four months later. Content analysis was performed to identify themes among interviews. MAIN RESEARCH VARIABLES Patient changes, caregiver adjustments, and accessing support. FINDINGS Caregivers described difficulties stemming from the patient's tumor-related dysfunction and changes in their familial, occupational, and social roles. Support from family and friends was vital to caregivers' emotional health, but shock and fear were evident in all interviews. Becoming subsumed in the care situation was described as enmeshment. Caregivers reported difficulty in communicating with healthcare providers. When looking at change over time, three major themes emerged: Patient Changes: The New Normal; Caregiver Adjustments; and Accessing Support. CONCLUSIONS Caregivers require support in handling neurologic and physical sequelae, transitioning into new roles, and avoiding becoming enmeshed in the care situation. INTERPRETATION This study underlines the importance of continuing research in this area to provide the necessary interventions that will assist caregivers and provide support throughout their loved one's disease trajectory.
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Affiliation(s)
- Allison Hricik
- School of Nursing, University of Pittsburgh, Pennsylvania, USA
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445
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Cámara RJA, Lukas PS, Begré S, Pittet V, von Känel R. Effects of social support on the clinical course of Crohn's disease. Inflamm Bowel Dis 2011; 17:1277-86. [PMID: 21560191 DOI: 10.1002/ibd.21481] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/08/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND Social support has been found to be protective from adverse health effects of psychological stress. We hypothesized that higher social support would predict a more favorable course of Crohn's disease (CD) directly (main effect hypothesis) and via moderating other prognostic factors (buffer hypothesis). METHODS Within a multicenter cohort study we observed 597 adults with CD for 18 months. We assessed social support using the ENRICHD Social Support Inventory. Flares, nonresponse to therapy, complications, and extraintestinal manifestations were recorded as a combined endpoint indicating disease deterioration. We controlled for several demographic, psychosocial, and clinical variables of potential prognostic importance. We used multivariate binary logistic regression to estimate the overall effect of social support on the odds of disease deterioration and to explore main and moderator effects of social support by probing interactions with other predictors. RESULTS The odds of disease deterioration decreased by 1.5 times (95% confidence interval [CI]: 1.2-1.9) for an increase of one standard deviation (SD) of social support. In case of low body mass index (BMI) (i.e., 1 SD below the mean or <19 kg/m(2) ), the odds decreased by 1.8 times for an increase of 1 SD of social support. In case of low social support, the odds increased by 2.1 times for a decrease of 1 SD of BMI. Low BMI was not predictive under high social support. CONCLUSIONS The findings suggest that elevated social support may favorably affect the clinical course of CD, particularly in patients with low BMI.
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Affiliation(s)
- Rafael J A Cámara
- Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
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446
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Stilley CS, Flynn WB, Sereika SM, Stimer ED, DiMartini AF, deVera ME. Pathways of psychosocial factors, stress, and health outcomes after liver transplantation. Clin Transplant 2011; 26:216-22. [PMID: 21518004 DOI: 10.1111/j.1399-0012.2011.01467.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The impact of stress and individual factors on health outcomes in general medicine and transplantation are well documented. Few researchers have investigated the complex relationships between these constructs. This longitudinal study assessed coping style, self-regulatory ability, hostility, and social support at baseline among a cohort of 130 adult liver transplant recipients at the Starzl Transplant Institute, University of Pittsburgh Medical Center, and followed those subjects with interview and medical records data about personal and transplant-related stress, physical and mental health outcomes throughout the first post-transplant year. Results show a number of strong bidirectional relationships between coping style, self-regulatory ability, hostility, the caregiver relationship and family environment, personal and transplant-related stress over the second half of the first post-transplant year, and health (especially mental) outcomes at 12 months post-transplant. Stress mediates the relationship between psychosocial factors and mental health outcomes. The importance of those relationships to researchers and clinicians is discussed.
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Affiliation(s)
- Carol S Stilley
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
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447
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Abstract
AIMS AND OBJECTIVES To critically review evidence on the effects of psychological support during intensive care unit (ICU) treatment on adult ICU patients' psychological and physiological outcomes. Evidence from intervention studies on imagery and relaxation has been included, as well. BACKGROUND Stress and negative emotions may have both immediate, as well as long-term effects on ICU patients' psychological and physical well-being, and they are linked to delayed physical recovery. DESIGN, METHODS: A narrative critical review methodology was employed. Databases searched included Medline, CINAHL, PubMed, PsychInfo and the Cochrane Library. Experimental, quasi-experimental or pretest-posttest peer-reviewed intervention studies published since 1970 were included. RESULTS Fourteen studies: seven on nurse led relaxation, three on guided imagery, one on nurse-patient interaction, two on physician-patient interaction and one correlational study on perceived social support were included. The results suggest significant improvements in patients' outcomes: improved vital signs, decrease in pain ratings, anxiety, rate of complications and length of stay, and improved sleep and patient satisfaction. Eight studies employed randomized experimental, four quasi-experimental and two descriptive correlational designs. Two studies explored effects on patients' sleep, and two on procedure-related pain. CONCLUSIONS The literature is limited in exploring the effects of nurse-patient interactions. The amount and quality of psychosocial support in the ICU, as well as imagery and relaxation techniques, are linked to short-term and long-term patients' outcomes. RELEVANCE TO CLINICAL PRACTICE ICU nurses need to engage in psychological support in a systematic way, and to acknowledge the high priority of support interventions.
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Affiliation(s)
- Elizabeth D E Papathanassoglou
- Department of Nursing, Cyprus University of Technology, Siakoleion Centre for Health Studies, 2252 Latsia, Nicosia, Cyprus.
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448
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Liang J, Wang CN, Xu X, Hsu HC, Lin HS, Lin YH. Trajectory of functional status among older Taiwanese: Gender and age variations. Soc Sci Med 2010; 71:1208-17. [PMID: 20667642 PMCID: PMC3495238 DOI: 10.1016/j.socscimed.2010.05.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 04/29/2010] [Accepted: 05/07/2010] [Indexed: 11/29/2022]
Abstract
Current findings on gender and age differences in health trajectories in later life are equivocal and largely based upon data derived from Western developed nations. This study examines gender and age variations in the trajectory of functional status among older adults in Taiwan, a non-Western newly industrialized society. Data came from a sample of some 3500 Taiwanese aged 60 and over, initially surveyed in 1989 and subsequently followed in 1993, 1996, 1999, and 2003. Hierarchical linear models with time-varying covariates were employed in depicting the dynamics of functional status across gender and age. Women and the old-old experienced higher levels of disability and rates of increase than their male and young-old counterparts. Moreover, older women bore a disproportionately larger burden of disability. There are therefore significant gender and age variations in the trajectory of functional status among older Taiwanese. These findings provide evidence for the generalizability of prior observations to a non-Western society.
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Affiliation(s)
- Jersey Liang
- Department of Health Management and Policy, University of Michigan School of Public Health, United States.
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449
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Mildly negative social encounters reduce physical pain sensitivity. Pain 2010; 151:372-377. [PMID: 20800356 DOI: 10.1016/j.pain.2010.07.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 07/09/2010] [Accepted: 07/17/2010] [Indexed: 12/28/2022]
Abstract
While previous research has demonstrated a reduction in physical pain sensitivity in response to social exclusion, the manipulations employed have arguably been far removed from typical daily experience. The purpose of this study was to investigate the effects of relatively ordinary social encounters on the perception of pain. Healthy participants rated the intensity and unpleasantness of painful stimuli before and after engaging in a structured interaction with a confederate who was instructed to either be warm and friendly or indifferent. A control group was asked to perform a similar structured activity, but alone. Consistent with predictions, participants who experienced the mildly negative social exchange reported lower pain intensity and unpleasantness after the encounter relative to baseline, whereas those exposed to the positive social exchange did not evidence any change in pain ratings. These results were not mediated by changes in mood or perceived connectedness. If mildly negative social encounters can provoke an analgesic effect, it is possible that social hypoalgesia may be considerably more commonplace than previously realized. Discussion focuses on the role of stress-induced hypoalgesia, and the implications of the results for clinical assessments of pain.
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450
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Raggi A, Leonardi M, Mantegazza R, Casale S, Fioravanti G. Social support and self-efficacy in patients with Myasthenia Gravis: a common pathway towards positive health outcomes. Neurol Sci 2010; 31:231-5. [PMID: 19936879 DOI: 10.1007/s10072-009-0194-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 11/03/2009] [Indexed: 11/24/2022]
Abstract
Social support and self-efficacy, that was defined as one's belief in one's capabilities to enact a certain behaviour, have a mediating effect on health outcomes and, by facilitating healthy behaviours and compliance to treatment, reduce morbidity and mortality. This pilot study aims to test whether social support and self-efficacy have a positive effect in improving health outcomes of patients with Myasthenia Gravis. 74 patients (mean age 48.1; 67.6% female) were enrolled and reported low self-efficacy and health status, but good perceived social support. Men reported better self-efficacy than women, and those living with a partner reported higher social support levels. No differences were found stratifying for disease onset, disease stage and patients' working situation. Self-efficacy and tangible support were independent predictors of mental health status. These results provide a preliminary indication that psychosocial interventions aimed to increase self-efficacy could positively mediate mental health status in myasthenic patients, especially among women.
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Affiliation(s)
- Alberto Raggi
- Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute C. Besta, IRCCS Foundation, Via Celoria 11, 20133 Milan, Italy.
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