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Rothpletz-Puglia P, Smith J, Pavuk C, Leotta J, Pike K, Presley CJ, Krok-Schoen JL, Braun A, Cohen MK, Rogers GT, Chui KKH, Zhang FF, Spees CK. A theoretical explanation for how a nutrition counseling and medically tailored meal delivery program benefitted participants living with lung cancer. Support Care Cancer 2024; 32:428. [PMID: 38869623 DOI: 10.1007/s00520-024-08616-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus intensive nutrition counseling intervention to create a theoretical explanation about how the intervention worked. METHODS This interpretive qualitative study included the use of semi-structured interviews with active participants in a randomized controlled trial aimed at understanding how a medically tailored meal plus nutrition counseling intervention worked for vulnerable individuals with lung cancer treated at four cancer centers across the USA. During the 8-month long study, participants in the intervention arm were asked to be interviewed, which were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory. RESULTS Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention's mechanism of action. The explanatory process includes three linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life. CONCLUSIONS These findings provide evidence that a Food is Medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals' adjustment to their diagnosis and resulted in perceived positive behavior change.
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Affiliation(s)
- Pamela Rothpletz-Puglia
- Rutgers, The State University of New Jersey, School of Health Professions, New Brunswick, NJ, USA
| | - Jade Smith
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Chloe Pavuk
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Jana Leotta
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Kimberli Pike
- Rutgers, The State University of New Jersey, School of Health Professions, New Brunswick, NJ, USA
| | - Carolyn J Presley
- The James Comprehensive Cancer Center, Columbus, OH, USA
- Division of Medical Oncology, Department of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- The James Comprehensive Cancer Center, Columbus, OH, USA
- School of Health and Rehabilitation Sciences, Division of Health Sciences, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Ashlea Braun
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences, Tulsa, OK, USA
| | - Mary Kathryn Cohen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gail T Rogers
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Kenneth Kwan Ho Chui
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Colleen K Spees
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA.
- The James Comprehensive Cancer Center, Columbus, OH, USA.
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Watanabe T, Tanabe K, Tsukao A, Kuno S. Effects of Changes in Frequency of Going Out during the COVID-19 Pandemic on ikigai (Sense of Purpose in Life) and Mental Health in Middle-Aged and Older Adults in Japan. J Cross Cult Gerontol 2024; 39:125-135. [PMID: 38691203 PMCID: PMC11093776 DOI: 10.1007/s10823-024-09504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
To clarify whether changes in frequency of going out due to the COVID-19 pandemic affect ikigai (sense of purpose in life) and mental health in Japanese middle-aged and older adults. In a questionnaire survey mailed to 16,866 adults aged > 40 years in Japan in September 2020, 7,973 responses were received (response rate, 47.3%) in October 2020. Following exclusions, data from 6,978 individuals (50.6% female, mean age 67.8 ± 12.2 years) were available for analysis. Respondents were categorized based on changes in frequency of going out, reflecting changes in social and/or physical activity, during the pandemic compared with before it: the previously active group went out often before but less often during the pandemic; the remained active group continued going out often; and the inactive group continued not going out often. Whether these changes affected the respondents' ikigai and mental health was investigated. The previously active group had a significantly higher proportion of individuals with decreased ikigai during the pandemic than the other groups. Mental health score decreased in all groups during the pandemic, but more so in the previously active group (-3.21), followed by the inactive and then the remained active groups (-1.45 and -1.28, respectively). Previously active individuals showed the greatest decline in ikigai and mental health among the three groups. These findings suggest that continuing to engage in appropriate physical and social activities, including going out, while following appropriate infection control measures, even under restrictions, can help people maintain ikigai and mental health.
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Affiliation(s)
- Takeshi Watanabe
- R&D Center for Smart Wellness City Policies, University of Tsukuba, Tsukuba, Japan.
| | - Kai Tanabe
- R&D Center for Smart Wellness City Policies, University of Tsukuba, Tsukuba, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Akiko Tsukao
- Tsukuba Wellness Research Co., Ltd., Chiba, Japan
| | - Shinya Kuno
- R&D Center for Smart Wellness City Policies, University of Tsukuba, Tsukuba, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
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Lyon ME, Fraser JL, Thompkins JD, Clark H, Brodie N, Detwiler K, Torres C, Guerrera MF, Younge T, Aoun S, Trujillo Rivera EA. Advance Care Planning for Children With Rare Diseases: A Pilot RCT. Pediatrics 2024; 153:e2023064557. [PMID: 38699801 PMCID: PMC11153326 DOI: 10.1542/peds.2023-064557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Pediatric rare diseases are often life-limiting conditions and/or require constant caregiving. Investigators assessed the initial efficacy of the FAmily CEntered (FACE) pediatric advance care planning (pACP), FACE-Rare, intervention on families' quality of life. METHODS A pilot-phase, single-blinded, intent-to-treat, randomized controlled clinical trial enrolled families from 1 pediatric quaternary hospital between 2021 and 2023. Intervention families received 3 weekly 60-minute (FACE-Rare pACP) sessions: (1) Carer Support Needs Assessment Tool or Action Plan, (2) Carer Support Needs Assessment Tol Action Plan Review, and (3) Pediatric Next Steps: Respecting Choices pACP. Controls received treatment as usual (TAU). Outcome measures were Beck Anxiety Inventory, Family Appraisal of Caregiving, Functional Assessment of Chronic Illness Therapy (FACIT)-Spirituality, and health care utilization. Generalized mixed effect models with γ response assessed the intervention effect at 3-month follow-up. RESULTS Children (n = 21) were aged 1 to 10 years, 48% male, 24% Black; and 100% technology dependent. Primary family caregivers (n = 21) were aged 30 to 43 years, 19% male, 19% Black; and 27% household income below the Federal poverty level. Dyads underwent 1:1 randomization: 9 to FACE-Rare and 12 to TAU. TAU caregivers reported statistically lower meaning and peace than FACE-Rare caregivers (0.9, P = .03, confidence interval [CI]: 0.75-0.99). Black caregivers reported significantly less caregiver distress (0.7, P = .04, CI: 0.47-0.98) than non-Black caregivers. Poor families reported more anxiety (3.5, P = .002, CI: 1.62-7.94), more caregiver strain (1.2, P = .006, CI: 1.07-1.42); and less family well-being (0.8, P = .02, CI: 0.64-0.95). CONCLUSIONS FACE®-Rare was feasible, acceptable, safe, and demonstrated initial efficacy, providing greater feelings of meaning and peace to caregivers. Poverty impacted well-being. A multisite trial is needed to determine generalizability.
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Affiliation(s)
- Maureen E. Lyon
- Children’s National Hospital, Washington, District of Columbia
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Jamie L. Fraser
- Children’s National Hospital, Washington, District of Columbia
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | | | - Heidi Clark
- Children’s National Hospital, Washington, District of Columbia
| | - Nicola Brodie
- Children’s National Hospital, Washington, District of Columbia
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | | | - Clarivet Torres
- Children’s National Hospital, Washington, District of Columbia
| | | | - Tamiko Younge
- Children’s National Hospital, Washington, District of Columbia
| | - Samar Aoun
- Peron Institute, Palliative Care, The Western University of Australia, Perth, Washington, Australia
| | - Eduardo A. Trujillo Rivera
- Children’s National Hospital, Washington, District of Columbia
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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Faria M, Ganz A, Galkin F, Zhavoronkov A, Snyder M. Psychogenic Aging: A Novel Prospect to Integrate Psychobiological Hallmarks of Aging. Transl Psychiatry 2024; 14:226. [PMID: 38816369 PMCID: PMC11139997 DOI: 10.1038/s41398-024-02919-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/20/2023] [Accepted: 05/08/2024] [Indexed: 06/01/2024] Open
Abstract
Psychological factors are amongst the most robust predictors of healthspan and longevity, yet are rarely incorporated into scientific and medical frameworks of aging. The prospect of characterizing and integrating the psychological influences of aging is therefore an unmet step for the advancement of geroscience. Psychogenic Aging research is an emerging branch of biogerontology that aims to address this gap by investigating the impact of psychological factors on human longevity. It is an interdisciplinary field that integrates complex psychological, neurological, and molecular relationships that can be best understood with precision medicine methodologies. This perspective argues that psychogenic aging should be considered an integral component of the Hallmarks of Aging framework, opening the doors for future biopsychosocial integration in longevity research. By providing a unique perspective on frequently overlooked aspects of organismal aging, psychogenic aging offers new insights and targets for anti-aging therapeutics on individual and societal levels that can significantly benefit the scientific and medical communities.
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Affiliation(s)
- Manuel Faria
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Ariel Ganz
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Alex Zhavoronkov
- Deep Longevity, Hong Kong, China
- Insilico Medicine, Hong Kong, China
- Buck Institute for Research on Aging, Novato, CA, USA
| | - Michael Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA.
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Gouttefarde P, Gay E, Guyot J, Kamdem O, Socpa A, Tchundem G, Dupré C, Nkenfou C, Bongue B, Barth N, Adam S. The shifts in intergenerational relations in Cameroon and their potential impact on the health of older adults. BMJ Glob Health 2024; 9:e014678. [PMID: 38754898 PMCID: PMC11097879 DOI: 10.1136/bmjgh-2023-014678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Africa is experiencing a gradual demographic shift due to rising life expectancy and increasing urbanisation. In sub-Saharan Africa, elderly individuals typically reside with their children. The rise in life expectancy by almost a decade and the prevalence of precarious living conditions raise concerns about the sustainability of the healthcare system, which has traditionally relied on intergenerational solidarity. METHODS The research aims to analyse the evolving role of older adults in Cameroonian society and to examine the potential impact of this change on intergenerational relationships and the health of older adults. A qualitative methodology was employed, using intergenerational focus groups in Cameroon. RESULTS Traditionally, older adults held a central role in knowledge transmission through discourse. However, the modernisation of society is challenging this position.The emergence of new technologies, particularly communication tools, is leading to a questioning of older adults' experiential knowledge. Societal changes are contributing to a decline in respect for older adults in discourse. Older adults deplore these societal changes and fear for their place in society while young people are questioning the central role of older people in society. DISCUSSION These changes could reduce the sense of usefulness of older people, with negative consequences for their health. Several studies have highlighted the impacts of ageism on the health of older adults in industrialised countries. However, there are little data on the impact of the marginalisation of older adults on their health in industrialising societies. Further research is needed to study the impact on the health of older adults.
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Affiliation(s)
- Pauline Gouttefarde
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Etienne, France
- Gérontopôle Auvergne Rhône Alpes, Saint-Etienne, France
| | - Elsa Gay
- Gérontopôle Auvergne Rhône Alpes, Saint-Etienne, France
- Jean Monnet University, PRESAGE Institut, Saint-Etienne, France
| | - Jessica Guyot
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Etienne, France
- Jean Monnet University, PRESAGE Institut, Saint-Etienne, France
| | - Odette Kamdem
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Etienne, France
- Jean Monnet University, PRESAGE Institut, Saint-Etienne, France
| | - Antoine Socpa
- Anthropology department, Center for Applied Social Sciences Research and Training, Université de Yaoundé 1, Yaoundé, Cameroon
| | - Guylène Tchundem
- Cameroonian Laboratory for Studies and Research on Contemporary Societies; Center for Applied Social Sciences Research and Training, University of Yaoundé 1, Yaoundé, Cameroon
| | - Caroline Dupré
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Etienne, France
- Jean Monnet University, PRESAGE Institut, Saint-Etienne, France
| | - Céline Nkenfou
- Systems Biology Laboratory, Chantal Biya International reference centre, Yaoundé, Cameroon
- Department of Biology, Higher Teachers Training College, University of Yaounde I, Yaoundé, Cameroon
| | - Bienvenu Bongue
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Etienne, France
- Jean Monnet University, PRESAGE Institut, Saint-Etienne, France
| | - Nathalie Barth
- INSERM, U1059, SAINBIOSE, DVH, Lyon University, Jean Monnet University, Saint-Etienne, France
- Gérontopôle Auvergne Rhône Alpes, Saint-Etienne, France
| | - Stéphane Adam
- Psychology of Senescence Unit, University of Liège, Liège, Belgium
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Radomski MV, Anheluk M, Carroll G, Zola J. Purpose in Life as an Explicit Outcome of Occupational Therapy. Am J Occup Ther 2024; 78:7803347010. [PMID: 38502315 DOI: 10.5014/ajot.2024.050428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Purpose in life is increasingly understood to be important to health and well-being. Despite occupational therapy's long history of using occupations to advance health and the linkage between a subclass of occupations and purpose in life, the term is nearly absent from the American Occupational Therapy Association's documents and the profession's empirical literature. We propose that the profession explicitly name purpose in life as among our intervention outcomes and address disruptions of purpose in life in practice. This can be accomplished by first investing in purpose in our own lives, discussing the topic with colleagues and students, identifying possible purpose disruptions in our clients, and using direct or indirect intervention approaches to help clients reconnect to purpose in their lives. By explicitly naming purpose in life as part of the domain of occupational therapy, we become poised to leverage human occupation to address both a broad societal gap and our clients' needs for a renewal of purpose in life.
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Affiliation(s)
- Mary Vining Radomski
- Mary Vining Radomski, PhD, OTR/L, is Senior Scientific Adviser, Courage Kenny Research, Allina Health, Minneapolis, MN;
| | - Mattie Anheluk
- Mattie Anheluk, MOT, OTR/L, is Outpatient Occupational Therapist and Research Therapist, Courage Kenny Rehabilitation Institute, Minneapolis, MN
| | - Ginger Carroll
- Ginger Carroll, MS, OT, is Project Manager, Juniper, a program of Trellis, Arden Hills, MN
| | - Joette Zola
- Joette Zola, BS, OTR/L, is Outpatient Occupational Therapist and Research Therapist, Courage Kenny Rehabilitation Institute, Minneapolis, MN
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Ford KJ, Burns RJ. The role of positive psychological wellbeing in walking speed differences among married and unmarried English older adults. Aging Ment Health 2024; 28:684-691. [PMID: 37846896 DOI: 10.1080/13607863.2023.2268032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
Objectives: Walking speed has been identified as an important indicator of functional independence and survival among older adults, with marital status being related to walking speed differences. We explored explanatory factors, with a focus on positive psychological wellbeing, in walking speed differences between married and non-married individuals in later life. Methods: We used wave 8 (2016/17) cross-sectional data from adults aged 60-79 years who participated in the English Longitudinal Study of Ageing (n = 3,743). An Oaxaca-Blinder decomposition was used to compute walking speed differences between married and unmarried individuals, and the portion of those differences that could be explained by characteristic differences in those groups, particularly wellbeing. Results: Overall, married individuals had walking speeds that were 0.073 m/s (95% confidence interval: 0.055-0.092 m/s) faster than their unmarried counterparts. This was primarily driven by differences between the married and separated/divorced group, and the widowed group. Included covariates explained roughly 89% of the overall walking speed difference. Positive psychological wellbeing consistently explained a significant portion of walking speed differences, ranging between 7% to 18% across comparisons. Conclusion: Although wealth has been previously found to partially explain walking speed differences by marital status, we found that positive psychological wellbeing also demonstrated pertinence to these differences.
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Affiliation(s)
| | - Rachel J Burns
- Department of Psychology, Carleton University, Ottawa, Canada
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8
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Schult TM, Mohr DC, Greenfield RH, Reddy KP. The Impact of Involvement in Whole Health System for Veterans or Participating in It for Oneself on Job Attitudes in VA Employees. J Occup Environ Med 2024; 66:e131-e136. [PMID: 38588074 DOI: 10.1097/jom.0000000000003062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE The aim of the study is to examine how involvement in the Whole Health System of care, clinically and personally (through employee-focused activities), would affect employee satisfaction, engagement, burnout, and turnover intent in the Veterans Health Administration. METHODS Multivariate logistic regression analysis of cross-sectional survey from Veterans Health Administration employees was used to determine the influence of Whole Health System involvement and Employee Whole Health participation on job attitudes. RESULTS Whole Health System involvement was associated higher job satisfaction, higher levels of engagement, lower burnout, and lower turnover intent. A similar pattern of results was identified when looking specifically at Employee Whole Health participation and associated job attitudes. CONCLUSIONS Employees who are either directly involved in delivering Whole Health services to veterans or who have participated in Whole Health programming for their own benefit may experience a meaningful positive impact on their well-being and how they experience the workplace.
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Affiliation(s)
- Tamara M Schult
- From the Veterans Health Administration, Office of Patient Centered Care and Cultural Transformation, Washington, DC (T.M.S., R.H.G., K.P.R.); Veterans Health Administration, National Center for Organization Development, Cincinnati, Ohio (D.C.M.); and Washington University School of Medicine, St Louis, Missouri (K.P.R.)
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9
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Fleischer A, Humphrey C. Women's Experiences after Hormone Positive Breast Cancer: Beginning of Radiation to 3-4 Years Post-Radiation. Occup Ther Health Care 2024; 38:364-384. [PMID: 36112023 DOI: 10.1080/07380577.2022.2121991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 08/23/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
This study found that a breast cancer survivor cohort who were 3-4 years post-treatment returned to near baseline activity levels, and their important activity categories were nearly evenly distributed among instrumental activities of daily living, high-demand leisure, and social participation. When describing their experiences, three themes emerged: exercise is important physically and emotionally, participating in important activities feels good, and plans have been made to continue engaging in important activities. Further research is needed to compare activity resumption among those receiving or not receiving occupational therapy-at different timepoints-to understand when occupational therapy can make the greatest impact.
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Affiliation(s)
- Anne Fleischer
- Occupational Therapy Program, Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati
| | - Casey Humphrey
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University
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10
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Svensson LG. Raison d'être in Turbulent Times: Academics, Legerdemain Surgery, and a Leadership Theorem. J Thorac Cardiovasc Surg 2024:S0022-5223(24)00235-6. [PMID: 38692476 DOI: 10.1016/j.jtcvs.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Lars G Svensson
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH.
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11
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Rothpletz-Puglia P, Smith J, Pavuk C, Leotta J, Pike K, Presley CJ, Krok-Schoen J, Braun A, Cohen MK, Rogers GT, Kwan HKC, Zhang FF, Spees C. How a Medically Tailored Meal Intervention with Intensive Nutrition Counseling Created Active Coping with Behavior Change for Vulnerable Patients with Lung Cancer. RESEARCH SQUARE 2024:rs.3.rs-3915333. [PMID: 38352464 PMCID: PMC10862975 DOI: 10.21203/rs.3.rs-3915333/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Purpose The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus nutrition counseling intervention to create a theoretical explanation about how the intervention worked. Methods This interpretive qualitative study included the use of semi-structured interviews with active intervention participants. Purposeful sampling included vulnerable (uninsured, rural zip code residency, racial/ethnic minority, 65 years old, and/or low-income) individuals with lung cancer treated at four cancer centers across the United States. Interviews were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory. Results Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention's mechanism of action. The explanatory process includes 3 linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus intensive nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life. Conclusions These findings provide evidence that a food is medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals' adjustment to their diagnosis and resulted in perceived positive behavior change.
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12
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Courtney RE, Schadegg MJ, Bolton R, Smith S, Harden SM. Using a Whole Health Approach to Build Biopsychosocial-Spiritual Personal Health Plans for Veterans with Chronic Pain. Pain Manag Nurs 2024; 25:69-74. [PMID: 37839983 DOI: 10.1016/j.pmn.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
Chronic pain affects over 50 million Americans per year and costs society billions of dollars annually. It is widely accepted that the biomedical model is outdated and research on the biopsychosocial model of chronic pain has increased in recent years, concurrent with investigations into self-management of chronic pain. The Veterans Health Administration (VHA) has incorporated both of these approaches into their Whole Health System. This work describes the VHA Whole Health System, reviews the literature on alignment between the Whole Health System's Circle of Health and chronic pain, and explains how the VHA Whole Health model may be used as a method for organizing self-management strategies within a personal health plan in the context of chronic pain. Given the infusion of nurses throughout the healthcare system, nurses are in a unique position to champion this biopsychosocial-spiritual approach to care.
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Affiliation(s)
- Rena E Courtney
- PREVAIL Center for Chronic Pain, Salem, VA Health Care System, Salem, Virginia; Virginia Tech Carilion School of Medicine, Salem, Virginia.
| | - Mary J Schadegg
- NYU Grossman School of Medicine/NYU Langone Health, New York, New York
| | - Rendelle Bolton
- Center for Healthcare Organization and Implementation Research, Bedford VA Health Care System, Bedford, Massachusetts
| | - Stephanie Smith
- PREVAIL Center for Chronic Pain, Salem, VA Health Care System, Salem, Virginia
| | - Samantha M Harden
- Virginia Tech Carilion School of Medicine, Salem, Virginia; Virginia Tech, Blacksburg, Virginia
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Holloway J, Sayeed O, Jurivich D. Tellegacy: An Intergenerational Wellness and Health Promotion Project to Reduce Social Isolation and Loneliness in Older Adults: A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7094. [PMID: 38063524 PMCID: PMC10706816 DOI: 10.3390/ijerph20237094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023]
Abstract
Emerging research demonstrates that social isolation and loneliness are linked to significant physical and mental health conditions. To address these concerns, the Tellegacy program was developed as an intergenerational health-promoting intervention to ameliorate older adult social isolation and loneliness in an effort to increase wellness. The purpose of this study was to reflect on testing of the Tellegacy program as a behavioral intervention. University students trained in goal setting, mindfulness, and listening strategies were paired with 11 older adults in the northern Midwest area via weekly in-person and phone conversations. Oral reminiscence therapies were used and books containing their stories were given to the older adults after participation. Older adults were surveyed using the University of California Los Angeles Loneliness Scale, Satisfaction of Life Scale, and patient health questionnaire-9 (PHQ-9) scale to elucidate the effectiveness of the intervention. Improved scores in loneliness, satisfaction of life, and PHQ-9 demonstrated favorable improvements in older adults. Additional benefits for the student Legacy Builder were revealed from self-reported changes. This suggests the potential benefits of structured encounters between trained students and isolated or lonely older adults. The Tellegacy intergenerational feasibility program warrants further studies to fully demonstrate its impact on health outcomes.
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Affiliation(s)
- Jeremy Holloway
- Department of Geriatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202, USA;
| | - Owais Sayeed
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75080, USA;
| | - Donald Jurivich
- Department of Geriatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202, USA;
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14
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Beck-da-Silva L. Stress Reduction, Meditation and Mindfulness Program for Heart Failure Patients: Some Light in the Darkness. Arq Bras Cardiol 2023; 120:e20230713. [PMID: 38055541 DOI: 10.36660/abc.20230713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Affiliation(s)
- Luís Beck-da-Silva
- Departamento de Medicina Interna da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Serviço de Cardiologia do Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
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Cavalcante VN, Mesquita ET, Cavalcanti ACD, Miranda JSDS, Jardim PP, Bandeira GMDS, Guimarães LMR, Venâncio ICDDL, Correa NMC, Dantas AMR, Tress JC, Romano AC, Muccillo FB, Siqueira MEB, Vieira GCA. Impact of a Stress Reduction, Meditation, and Mindfulness Program in Patients with Chronic Heart Failure: A Randomized Controlled Trial. Arq Bras Cardiol 2023; 120:e20220768. [PMID: 37909602 PMCID: PMC10586813 DOI: 10.36660/abc.20220768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 07/10/2023] [Accepted: 08/16/2023] [Indexed: 11/03/2023] Open
Abstract
Heart Failure is a significant public health problem leading to a high burden of physical and psychological symptoms despite optimized therapy. To evaluate primarily the impact of a Stress Reduction, Meditation, and Mindfulness Program on stress reduction of patients with Heart Failure. A randomized and controlled clinical trial assessed the effect of a stress reduction program compared to conventional multidisciplinary care in two specialized centers in Brazil. The data collection period took place between April and October 2019. Thirty-eight patients were included and allocated to the intervention or control groups. The intervention took place over 8 weeks. The protocol assessed the scales of perceived stress, depression, quality of life, anxiety, mindfulness, quality of sleep, a 6-minute walk test, and biomarkers analyzed by a blinded team, considering a p-value <0.05 statistically significant. The intervention resulted in a significant reduction in perceived stress from 22.8 ± 4.3 to 14.3 ± 3.8 points in the perceived stress scale-14 items in the intervention group vs. 23.9 ± 4.3 to 25.8 ± 5.4 in the control group (p-value<0.001). A significant improvement in quality of life (p-value=0.013), mindfulness (p-value=0.041), quality of sleep (p-value<0.001), and the 6-minute walk test (p-value=0.004) was also observed in the group under intervention in comparison with the control. The Stress Reduction, Meditation, and Mindfulness Program effectively reduced perceived stress and improved clinical outcomes in patients with chronic Heart Failure.
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Affiliation(s)
- Vaisnava Nogueira Cavalcante
- Universidade Federal FluminenseNiteróiRJBrasilUniversidade Federal Fluminense, Niterói, RJ – Brasil
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Evandro Tinoco Mesquita
- Universidade Federal FluminenseNiteróiRJBrasilUniversidade Federal Fluminense, Niterói, RJ – Brasil
| | | | | | - Paola Pugian Jardim
- Universidade Federal FluminenseNiteróiRJBrasilUniversidade Federal Fluminense, Niterói, RJ – Brasil
| | | | | | | | | | - Angela Maria Rodrigues Dantas
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - João Carlos Tress
- Complexo Hospitalar de NiteróiNiteróiRJBrasilComplexo Hospitalar de Niterói (CHN), Niterói, RJ – Brasil
| | - Ana Catarina Romano
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Fabiana Bergamin Muccillo
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ – Brasil
| | - Marina Einstoss Barbosa Siqueira
- Universidade Federal FluminenseDepartamento de Fundamentos de Enfermagem e AdministraçãoRio de JaneiroRJBrasilUniversidade Federal Fluminense - Departamento de Fundamentos de Enfermagem e Administração, Rio de Janeiro, RJ – Brasil
| | - Glaucia Cristina Andrade Vieira
- Universidade Federal FluminenseDepartamento de Fundamentos de Enfermagem e AdministraçãoRio de JaneiroRJBrasilUniversidade Federal Fluminense - Departamento de Fundamentos de Enfermagem e Administração, Rio de Janeiro, RJ – Brasil
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16
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Salvatore M, Clark-Boucher D, Fritsche LG, Ortlieb J, Houghtby J, Driscoll A, Caldwell-Larkins B, Smith JA, Brummett CM, Kheterpal S, Lisabeth L, Mukherjee B. Epidemiologic Questionnaire (EPI-Q) - a scalable, app-based health survey linked to electronic health record and genotype data. Epidemiol Health 2023; 45:e2023074. [PMID: 37591787 PMCID: PMC10867525 DOI: 10.4178/epih.e2023074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 08/19/2023] Open
Abstract
The Epidemiologic Questionnaire (EPI-Q) was established to collect broad, uniform, self-reported health data to supplement electronic health record (EHR) and genotype information from participants in the University of Michigan (UM) Precision Health cohorts. Recruitment of EPI-Q participants, who were already enrolled in 1 of 3 ongoing UM Precision Health cohorts-the Michigan Genomics Initiative, Mental Health Biobank, and Metabolism, Endocrinology, and Diabetes cohorts-began in March 2020. Of 54,043 retrospective invitations, 5,577 individuals enrolled, representing a 10.3% response rate. Of these, 3,502 (63.7%) were female, and the average age was 56.1 years (standard deviation, 15.4). The baseline survey comprises 11 modules on topics including personal and family health history, lifestyle, and cancer screening and history. Additionally, 11 optional modules cover topics including financial toxicity, occupational exposure, and life meaning. The questions are based on standardized and validated instruments used in other cohorts, and we share resources to expedite development of similar surveys. Data are collected via the MyDataHelps platform, which enables current and future participants to share non-Michigan Medicine EHR data. Recruitment is ongoing. Cohort data are available to those with institutional review board approval; for details, contact the Data Office for Clinical and Translational Research (DataOffice@umich.edu).
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Affiliation(s)
- Maxwell Salvatore
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Dylan Clark-Boucher
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
| | - Lars G. Fritsche
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Jacob Ortlieb
- Precision Health, University of Michigan, Ann Arbor, MI, USA
| | - Janet Houghtby
- Precision Health, University of Michigan, Ann Arbor, MI, USA
| | - Anisa Driscoll
- Precision Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Jennifer A. Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, Ann Arbor, MI, USA
| | | | - Sachin Kheterpal
- Precision Health, University of Michigan, Ann Arbor, MI, USA
- Anesthesiology, Michigan Medicine, Ann Arbor, MI, USA
| | - Lynda Lisabeth
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
- Precision Health, University of Michigan, Ann Arbor, MI, USA
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Martinez JM, Homeier DC, Fowler C, Wilber KH. Conceptualizing Person-Centered Care in Elder Mistreatment Intervention: Use of a Well-Being Framework. THE GERONTOLOGIST 2023; 63:973-982. [PMID: 36434169 DOI: 10.1093/geront/gnac170] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Person-centered care (PCC) applied to elder mistreatment interventions is an approach to include victim priorities. Although PCC may improve outcomes by supporting choice, victim preferences are often difficult to support, especially in high-risk situations. We studied the adaptation of PCC structures and process to a pilot intervention, aimed at including client preferences in a multidisciplinary team's plans to address complex elder mistreatment. RESEARCH DESIGN AND METHODS Case study analysis was used to examine the process of integrating client priorities into a risk-reduction plan. A well-being framework was used to understand the relationship between safety and preferences. Purposive sampling identified a case study of a high-risk victim with history of refusing help who agreed to work with the Service Advocate, a member of a multidisciplinary team. RESULTS PCC required a relationship of trust, honed over several weeks by prioritizing the clients' perspective. Client preferences included remaining at home, continuing the relationship with the abuser, and maintaining a sense of mastery. Individualized definitions of "safety" were unrelated to elder mistreatment risk. Assistance included working with the suspected perpetrator, which is not offered by most elder mistreatment interventions, and resulted in some risk reduction. Reasons for refusing help were a desire for control and fear of loss of well-being assets. DISCUSSION AND IMPLICATIONS Individualized definitions of well-being should be considered in measuring intervention success. Future research could determine guidelines on what levels of elder mistreatment risk are acceptable, and how to monitor clients for safety while supporting autonomy.
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Affiliation(s)
- Julia M Martinez
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Diana C Homeier
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Cherie Fowler
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Kathleen H Wilber
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Cramer CL, Marsh K, Krebs ED, Mehaffey JH, Beller JP, Chancellor WZ, Teman NR, Yarboro LT. Long term employment following heart transplantation in the United States. J Heart Lung Transplant 2023; 42:880-887. [PMID: 36669942 DOI: 10.1016/j.healun.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/28/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Employment is an important metric of post-transplant functional status and the quality of life yet remains poorly described after heart transplant. We sought to characterize the prevalence of employment following heart transplantation and identify patients at risk for post-transplant unemployment. METHODS Adults undergoing single-organ heart transplantation (2007-2016) were evaluated using the UNOS database. Univariable analysis was performed after stratifying by employment status at 1-year post-transplant. Fine-Gray competing risk regression was used for risk adjustment. Cox regression evaluated employment status at 1 year with mortality. RESULTS Of 10,132 heart transplant recipients who survived to 1 year and had follow-up, 22.0% were employed 1-year post-transplant. Employment rate of survivors increased to 32.9% by year 2. Employed individuals were more likely white (70.8% vs 60.4%, p < 0.01), male (79.6% vs 70.7% p < 0.01), held a job at listing/transplant (37.6% vs 7.6%, p < 0.01), and had private insurance (79.1% vs 49.5%, p < 0.01). Several characteristics were independently associated with employment including age, employment status at time of listing or transplant, race and ethnicity, gender, insurance status, education, and postoperative complications. Of 1,657 (14.0%) patients employed pretransplant, 58% were working at 1-year. Employment at 1year was independently associated with mortality with employed individuals having a 26% decreased risk of mortality. CONCLUSION Over 20% of heart transplant patients were employed at 1 year and over 30% at 2 years, while 58% of those working pretransplant had returned to work by 1-year. While the major predictor of post-transplant employment is preoperative employment status, our study highlights the impact of social determinants of health.
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Affiliation(s)
| | - Katherine Marsh
- University of Virginia Health System, Charlottesville, Virginia
| | | | | | - Jared P Beller
- University of Virginia Health System, Charlottesville, Virginia
| | | | | | - Leora T Yarboro
- University of Virginia Health System, Charlottesville, Virginia.
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19
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Juul L, Bonde EH, Fjorback LO. Altered self-reported resting state mediates the effects of Mindfulness-Based Stress Reduction on mental health: a longitudinal path model analysis within a community-based randomized trial with 6-months follow-up. Front Psychol 2023; 14:1154277. [PMID: 37408978 PMCID: PMC10318305 DOI: 10.3389/fpsyg.2023.1154277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/22/2023] [Indexed: 07/07/2023] Open
Abstract
Background A large body of randomized controlled trials (RCTs) has shown that mindfulness-based interventions are effective for improving mental health, but research is lacking in regards to the mechanisms of change. We aimed to investigate the mediating effects of self-reported altered resting state of Mindfulness-Based Stress Reduction (MBSR) on mental health, when provided as a universal intervention in a real-life context. Methods Autoregressive path models with three time points of measurement, and contemporaneous and constant b paths were used in an RCT. The RCT took place in all five geographical regions of Denmark and included 110 schools and 191 schoolteachers. The schools were randomized 1:1 in each geographical region to intervention or a wait-list control group. The intervention was the standardized MBSR. Data were collected at baseline and after 3 and 6 months. The outcomes were perceived stress, measured by Cohen's Perceived Stress Scale (PSS), symptoms of anxiety and depression, measured by Hopkins Symptom Check List-5 (SCL-5), and well-being measured by WHO-5 Well-being Index (WHO-5). The mediator was resting state measured by the Amsterdam Resting State Questionnaire (ARSQ). Results Statistically significant mediated effects of altered ARSQ-subscales scores for Discontinuity of Mind, Planning, and Comfort were found for the MBSR effect on all outcomes; PSS, SCL-5 and WHO-5. Furthermore, statistically significant mediated effects of altered sleepiness subscale score of the effects on PSS and SCL-5 of MBSR were found. No statistically significant mediating effects of the subscales Theory of Mind, Self and Somatic Awareness for the MBSR intervention effect were found. Conclusion The results support that the MBSR program can alter self-reported resting state, towards less mind wandering and more comfort, measured by the ARSQ, and that this may explain some of the mechanisms regarding the effectiveness of MBSR on mental health at 6 months, when provided as a universal intervention. The study provides insight into an active ingredient of how MBSR may improve mental health and well-being. It supports the suggestions that mindfulness meditation may be a sustainable way of training the mental health.Clinical trial registration:ClinicalTrials.gov, identifier NCT03886363.
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20
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Friedman EM, Teas E. Self-Rated Health and Mortality: Moderation by Purpose in Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6171. [PMID: 37372758 DOI: 10.3390/ijerph20126171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/10/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
Poor self-rated health consistently predicts reduced longevity, even when objective disease conditions and risk factors are considered. Purpose in life is also a reliable predictor of diverse health outcomes, including greater longevity. Given prior work in which we showed that purpose in life moderated the association between chronic conditions and health-related biological factors, the aim of the current study was to examine the role of purpose in life in moderating the relationship between subjective health and mortality. We also examined potential differences in these associations by race/ethnicity. Data were from two large national longitudinal studies-the Health and Retirement Study (HRS) and the Midlife in the United States (MIDUS) study-with a 12- to 14-year follow-up period for mortality estimates. Results of logistic regression analyses showed that purpose in life and self-rated health were both significantly positively associated with longevity, and that purpose in life significantly moderated the relationship between self-rated health and mortality. Stratified analyses showed similar results across all racial/ethnic groups, with the exception of Black MIDUS participants. These results suggest that greater purpose in life may provide a buffer against the greater probability of mortality associated with poor subjective health.
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Affiliation(s)
- Elliot M Friedman
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN 47907, USA
| | - Elizabeth Teas
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN 47907, USA
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21
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Burrow AL. Beyond Finding Purpose: Motivating a Translational Science of Purpose Acquisition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6091. [PMID: 37372678 DOI: 10.3390/ijerph20126091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
A broad interest in finding purpose is understandable, as having purpose is situated in notions of "the good life" and is linked in studies to greater health and wellbeing. Yet, the empirical basis for whether purpose is truly findable is inadequate, lacking guidance from theories predicting behavioral capacities that drive its acquisition. If feeling purposeful is as favorable as studies suggest, then more transparent and precise explanations of how it is derived are needed; otherwise, the field risks illuminating this resource while leaving the pathways to it unlit. Here, I call for a translational science of purpose acquisition directed at gathering and disseminating evidence of the processes by which this sense can be cultivated. I introduce a minimal viable framework for integrating basic and applied investigations into purpose by bridging laboratory research, intervention and implementation efforts, community-engaged practices, and policies to accelerate testing and strategies for enhancing this salubrious sense in people's lives.
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Affiliation(s)
- Anthony L Burrow
- Department of Psychology, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY 14853, USA
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Curran T, Losi R, Pymm J, O’Neill JA, Goveia N, Flanagan A, Jakkam R, Hansen K, Gauvreau K, Gauthier N. Positive mindset and exercise capacity in school-aged children and adolescents with congenital heart disease. Front Pediatr 2023; 11:1133255. [PMID: 37334214 PMCID: PMC10272603 DOI: 10.3389/fped.2023.1133255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Patients with congenital heart disease (CHD) have variable degrees of peak oxygen consumption (VO2) that can be improved with supervised fitness training. The ability to exercise is affected by anatomy, hemodynamics, and motivation. Motivation is in part related to mindset, or personal attitudes and beliefs, and a more positive mindset around exercise has been associated with better outcomes. It is unknown whether variations in measured peak VO2 in patients with CHD are related to having a positive mindset. Methods Patient's ages 8-17 years with CHD were administered quality of life and physical activity questionnaires at the time of their routine cardiopulmonary exercise test. Those with severe hemodynamic burden were excluded. Patients were grouped based on disease classification. Mindset was evaluated via validated questionnaires including a PROMIS Meaning and Purpose (MaP) survey and an Anxiety survey. Pearson correlation coefficients were calculated to estimate the magnitude of the association between percent predicted peak oxygen consumption (pppVO2) and questionnaire scores overall and within CHD subgroups. Results Eighty-five patients participated; median age was 14.7 years, 53% were female, 66% had complex CHD, 20% had simple CHD, and 14% had single ventricle heart disease. Mean MaP scores were significantly lower in all CHD groups compared to population norms (p < 0.001). As a group, MaP scores were positively associated with the amount of reported physical activity (p = 0.017). In patients with simple CHD, MaP scores were positively associated with pppVO2 (p = 0.015). The association was even stronger for MaP:Anxiety, with worse ratios associated with lower pppVO2 (p = 0.005). Patients with complex and single ventricle CHD did not show a similar association. Conclusions Patients with CHD, regardless of severity, had lower meaning and purpose scores than the general population, and these scores were associated with amount of reported physical activity. In the simple CHD subset, having a more positive mindset was associated with higher peak VO2 and a more negative mindset with lower peak VO2. This relationship was not seen with more significant CHD. While underlying CHD diagnoses are not modifiable, mindset and peak VO2 are, and consideration should be given to measuring both as each may be a target for intervention.
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Rozanski A, Blumenthal JA, Hinderliter AL, Cole S, Lavie C. Cardiology and lifestyle medicine. Prog Cardiovasc Dis 2023; 77:4-13. [PMID: 37059409 DOI: 10.1016/j.pcad.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 04/09/2023] [Indexed: 04/16/2023]
Abstract
Poor lifestyle habits, such as physical inactivity and poor diets, are highly prevalent within society and even more so among patients with chronic disease. The need to stem poor lifestyle habits has led to the development of a new field of Lifestyle Medicine, whose mission is to prevent, treat, and even reverse chronic diseases through lifestyle interventions. Three fields within Cardiology relate to this mission: Cardiac Rehabilitation, Preventive Cardiology, and Behavioral Cardiology. Each of these three fields have contributed substantially to the reduction of cardiovascular disease (CVD) morbidity and mortality. The historic contributions of these three cardiac fields are reviewed as well as the challenges each of these fields has faced in optimizing the application of lifestyle medicine practices. A shared agenda between Cardiology and the American College of Lifestyle Medicine could further the utilization of behavioral interventions. This review suggests seven steps that could be shared by these organizations and other medical societies. First, there is a need to develop and promulgate the assessment of lifestyle factors as "vital signs" during patient visits. Second, developing a strong partnership between the fields of Cardiology and Physiatry could improve important aspects of cardiac care, including a potential redesign of cardiac stress testing. Third, behavioral evaluations should be optimized at patients' entrée points into medical care since these may be considered "windows of opportunity". Fourth, there is a need to broaden cardiac rehabilitation into inexpensive programs and make this program eligible for patients with risk factors but no known CVD. Fifth, lifestyle medicine education should be integrated into the core competencies for relevant specialties. Sixth, there is a need for inter-societal advocacy to promote lifestyle medicine practices. Seventh, the well-being effects of healthy lifestyle behaviors, such as their impact on one's sense of vitality, should be emphasized.
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Affiliation(s)
- Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - Alan L Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Steven Cole
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States of America; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, United States of America
| | - Carl Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, LA, United States of America
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Rozanski A. The pursuit of health: A vitality based perspective. Prog Cardiovasc Dis 2023; 77:14-24. [PMID: 37037404 DOI: 10.1016/j.pcad.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
The larger number of adults who enter their senior years with a high burden of chronic diseases has led to new metrics designed to promote health pro-activity, such as the calculation of one's "healthspan". These efforts call for re-evaluation as to what is meant by "health". A large body of epidemiologic and clinical investigation identifies that good health is shaped by specific health behaviors (aerobic exercise, resistance training, sleep, and good diet quality) and four psychological determinants (positive emotions, positive mindsets, purposeful living, and social connectivity). In common, each of these determinants produce "vitality", which can be defined as having the pleasing sensation of feeling energetic. Having a strong sense of vitality produces a sense of agency, provides resilience, and serves as a leading indicator of good health. Importantly, vitality can be assessed as a single item "vital sign" in clinical practice and can be promoted by recommending simple steps to patients, such as suggesting that they initiate walking or other aerobic activities. Because health habits and psychological determinants of health are inter-related, such simple steps can initiate a "virtuous cycle" of health improvement. An emphasis on vitality can also encourage patients to become more cognizant of their level of energy and manage it through health-promoting behaviors rather than quick fix behaviors. Finally, vitality assessment and prescription can promote more successful aging. In sum, an updated and more clinically useful definition of health recognizes that it is a dynamic entity that is influenced at any time by one's engagement in physical and psychological practices that promote health. Accordingly, an updated definition of health is proposed: good health is characterized by physical and psychological well-being and is associated with vitality.
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Affiliation(s)
- Alan Rozanski
- Division of Cardiology, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
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25
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Abellaneda-Pérez K, Cattaneo G, Cabello-Toscano M, Solana-Sánchez J, Mulet-Pons L, Vaqué-Alcázar L, Perellón-Alfonso R, Solé-Padullés C, Bargalló N, Tormos JM, Pascual-Leone A, Bartrés-Faz D. Purpose in life promotes resilience to age-related brain burden in middle-aged adults. Alzheimers Res Ther 2023; 15:49. [PMID: 36915148 PMCID: PMC10009845 DOI: 10.1186/s13195-023-01198-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Disease-modifying agents to counteract cognitive impairment in older age remain elusive. Hence, identifying modifiable factors promoting resilience, as the capacity of the brain to maintain cognition and function with aging and disease, is paramount. In Alzheimer's disease (AD), education and occupation are typical cognitive reserve proxies. However, the importance of psychological factors is being increasingly recognized, as their operating biological mechanisms are elucidated. Purpose in life (PiL), one of the pillars of psychological well-being, has previously been found to reduce the deleterious effects of AD-related pathological changes on cognition. However, whether PiL operates as a resilience factor in middle-aged individuals and what are the underlying neural mechanisms remain unknown. METHODS Data was obtained from 624 middle-aged adults (mean age 53.71 ± 6.9; 303 women) from the Barcelona Brain Health Initiative cohort. Individuals with lower (LP; N = 146) and higher (HP; N = 100) PiL rates, according to the division of this variable into quintiles, were compared in terms of cognitive status, a measure reflecting brain burden (white matter lesions; WMLs), and resting-state functional connectivity, examining system segregation (SyS) parameters using 14 common brain circuits. RESULTS Neuropsychological status and WMLs burden did not differ between the PiL groups. However, in the LP group, greater WMLs entailed a negative impact on executive functions. Subjects in the HP group showed lower SyS of the dorsal default-mode network (dDMN), indicating lesser segregation of this network from other brain circuits. Specifically, HP individuals had greater inter-network connectivity between specific dDMN nodes, including the frontal cortex, the hippocampal formation, the midcingulate region, and the rest of the brain. Greater functional connectivity in some of these nodes positively correlated with cognitive performance. CONCLUSION Expanding previous findings on AD pathology and advanced age, the present results suggest that higher rates of PiL may promote resilience against brain changes already observable in middle age. Furthermore, having a purposeful life implies larger functional integration of the dDMN, which may potentially reflect greater brain reserve associated to better cognitive function.
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Affiliation(s)
- Kilian Abellaneda-Pérez
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain. .,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. .,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - María Cabello-Toscano
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Lídia Mulet-Pons
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Lídia Vaqué-Alcázar
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Sant Pau Memory Unit, Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau-Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ruben Perellón-Alfonso
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina Solé-Padullés
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Núria Bargalló
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain.,Neuroradiology Section, Radiology Department, Diagnostic Image Center, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.,Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Josep M Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.,Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.,Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - David Bartrés-Faz
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain.
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The Time Is Now for a Whole-Person Health Approach to Public Health. Public Health Rep 2023:333549231154583. [PMID: 36762505 DOI: 10.1177/00333549231154583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Wang W, Wang J, Shi J, Li Y, Zhang X, Wu F, Wang Y, Li J, Hao M, Liu X, Zhai S, Wang Y, Gao N, Tian Y, Lu R, Yeo YH, Jia X, Ji F, Dang S. Associations of psychological wellbeing with COVID-19 hospitalization and mortality in adults aged 50 years or older from 25 European countries and Israel. Front Public Health 2023; 11:1124915. [PMID: 37213603 PMCID: PMC10194836 DOI: 10.3389/fpubh.2023.1124915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 05/23/2023] Open
Abstract
Background Lower psychological wellbeing is associated with poor outcomes in a variety of diseases and healthy populations. However, no study has investigated whether psychological wellbeing is associated with the outcomes of COVID-19. This study aimed to determine whether individuals with lower psychological wellbeing are more at risk for poor outcomes of COVID-19. Methods Data were from the Survey of Health, Aging, and Retirement in Europe (SHARE) in 2017 and SHARE's two COVID-19 surveys in June-September 2020 and June-August 2021. Psychological wellbeing was measured using the CASP-12 scale in 2017. The associations of the CASP-12 score with COVID-19 hospitalization and mortality were assessed using logistic models adjusted for age, sex, body mass index, smoking, physical activity, household income, education level, and chronic conditions. Sensitivity analyses were performed by imputing missing data or excluding cases whose diagnosis of COVID-19 was solely based on symptoms. A confirmatory analysis was conducted using data from the English Longitudinal Study of Aging (ELSA). Data analysis took place in October 2022. Results In total, 3,886 individuals of 50 years of age or older with COVID-19 were included from 25 European countries and Israel, with 580 hospitalized (14.9%) and 100 deaths (2.6%). Compared with individuals in tertile 3 (highest) of the CASP-12 score, the adjusted odds ratios (ORs) of COVID-19 hospitalization were 1.81 (95% CI, 1.41-2.31) for those in tertile 1 (lowest) and 1.37 (95% CI, 1.07-1.75) for those in tertile 2. As for COVID-19 mortality, the adjusted ORs were 2.05 (95% CI, 1.12-3.77) for tertile 1 and 1.78 (95% CI, 0.98-3.23) for tertile 2, compared with tertile 3. The results were relatively robust to missing data or the exclusion of cases solely based on symptoms. This inverse association of the CASP-12 score with COVID-19 hospitalization risk was also observed in ELSA. Conclusion This study shows that lower psychological wellbeing is independently associated with increased risks of COVID-19 hospitalization and mortality in European adults aged 50 years or older. Further study is needed to validate these associations in recent and future waves of the COVID-19 pandemic and other populations.
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Affiliation(s)
- Wenjun Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jingjing Wang
- Department of Pediatrics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juanjuan Shi
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yaping Li
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Zhang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fengping Wu
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yikai Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jia Li
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Miao Hao
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiongtao Liu
- Department of Operating Room, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Song Zhai
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuan Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ning Gao
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Tian
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Rui Lu
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yee Hui Yeo
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Xiaoli Jia
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- *Correspondence: Xiaoli Jia
| | - Fanpu Ji
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Fanpu Ji
| | - Shuangsuo Dang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shuangsuo Dang
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Andreasen AJ, Johnson MK, Tranel D. Stability of Psychological Well-being Following a Neurological Event and in the Face of a Global Pandemic. REHABILITATION COUNSELING BULLETIN 2022. [PMCID: PMC9780567 DOI: 10.1177/00343552221139878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study examined the stability of psychological well-being in people who have experienced a neurological event resulting in focal brain damage. Evidence suggests that psychological well-being is largely stable in healthy adult populations. However, whether such stability exists in neurological patients with acquired brain lesions is an open question. Given the trait-like characteristics of psychological well-being, we hypothesized that psychological well-being would be stable in neurological patients who are in the chronic epoch of recovery (≥3 months after the neurological event). Eighty participants (women = 40; age: M = 56, standard deviation ( SD) = 13) completed the Ryff Scales of Psychological Well-Being (PWBS) twice between 2016 and 2020 (Time 1 [T1] and Time 2 [T2]). The Ryff Scales measure various facets of well-being, including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Approximately half of participants completed their T2 assessment during the COVID-19 pandemic, creating an opportunity to investigate the effects of the pandemic on the stability of psychological well-being in a neurological population that may be particularly vulnerable to reduced well-being in this context. Pearson correlations and within-sample t-tests were conducted to examine the stability of self-reported well-being over time. Test–retest correlations ranged from .71 to .87, and no significant differences in well-being emerged across the two time points. Significant correlations between T1 and T2 were also evident in the subsample of participants who completed their second assessment during the COVID-19 pandemic. These findings provide evidence that long-term psychological well-being is remarkably reliable and consistent over time in patients who have experienced a major neurological event, even when an unprecedented global event occurred between measurement epochs. Treatment implications of these findings are discussed.
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Affiliation(s)
- Allison Julie Andreasen
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- University of Iowa, Iowa City, IA, USA
| | - Marcie King Johnson
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- University of Iowa, Iowa City, IA, USA
| | - Daniel Tranel
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- University of Iowa, Iowa City, IA, USA
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Bertman S. The heroic challenge of retirement. J Aging Stud 2022; 63:101080. [PMID: 36462923 DOI: 10.1016/j.jaging.2022.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the theme of retirement in the epic tale of Odysseus and the implications it can have for contemporary retirees in the light of recent empirical research. METHODS Homer's Odyssey (ca. 8th cent. B.C.E.) and Tennyson's poem "Ulysses" (1833) were closely read and compared to disclose the impact retirement had on a literary character who had for most of his life thrived on action. RESULTS While Homer avoided directly describing the quality of Odysseus' life once he had returned home from war, Tennyson focused on it, arguing that a life devoid of adventure would have been intolerable for such a personality. DISCUSSION Seeking out new adventures and experiences, despite one's age, may serve to mitigate one of the most common negative components of retirement today, boredom, and thereby lengthen and enhance the quality of retirees' lives.
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Kang Y, Cosme D, Lydon-Staley D, Ahn J, Jovanova M, Corbani F, Lomax S, Stanoi O, Strecher V, Mucha PJ, Ochsner K, Bassett DS, Falk EB. Purpose in life, neural alcohol cue reactivity and daily alcohol use in social drinkers. Addiction 2022; 117:3049-3057. [PMID: 35915548 DOI: 10.1111/add.16012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Alcohol craving is an urge to consume alcohol that commonly precedes drinking; however, craving does not lead to drinking for all people under all circumstances. The current study measured the correlation between neural reactivity and alcohol cues as a risk, and purpose in daily life as a protective factor that may influence the link between alcohol craving and the subsequent amount of consumption. DESIGN Observational study that correlated functional magnetic resonance imaging (fMRI) data on neural cue reactivity and ecological momentary assessments (EMA) on purpose in life and alcohol use. SETTING Two college campuses in the United States. PARTICIPANTS A total of 54 college students (37 women, 16 men, and 1 other) recruited via campus-based groups from January 2019 to October 2020. MEASUREMENTS Participants underwent fMRI while viewing images of alcohol; we examined activity within the ventral striatum, a key region of interest implicated in reward and craving. Participants then completed 28 days of EMA and answered questions about daily levels of purpose in life and alcohol use, including how much they craved and consumed alcohol. FINDINGS A significant three-way interaction indicated that greater alcohol cue reactivity within the ventral striatum was associated with heavier alcohol use following craving in daily life only when people were previously feeling a lower than usual sense of purpose. By contrast, individuals with heightened neural alcohol cue reactivity drank less in response to craving if they were feeling a stronger than their usual sense of purpose in the preceding moments (binteraction = -0.086, P < 0.001, 95% CI = -0.137, -0.035). CONCLUSIONS Neural sensitivity to alcohol cues within the ventral striatum appears to be a potential risk for increased alcohol use in social drinkers, when people feel less purposeful. Enhancing daily levels of purpose in life may promote alcohol moderation among social drinkers who show relatively higher reactivity to alcohol cues.
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Affiliation(s)
- Yoona Kang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Danielle Cosme
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jeesung Ahn
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Mia Jovanova
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Faustine Corbani
- Department of Psychology, Columbia University, New York, New York, United States
| | - Silicia Lomax
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ovidia Stanoi
- Department of Psychology, Columbia University, New York, New York, United States
| | - Victor Strecher
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States
| | - Peter J Mucha
- Department of Mathematics, Dartmouth College, Hanover, New Hampshire, United States
| | - Kevin Ochsner
- Department of Psychology, Columbia University, New York, New York, United States
| | - Dani S Bassett
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Emily B Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States.,Wharton Marketing Department, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States.,Wharton Operations, Information and Decisions Department, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Shiba K, Kubzansky LD, Williams DR, VanderWeele TJ, Kim ES. Purpose in life and 8-year mortality by gender and race/ethnicity among older adults in the U.S. Prev Med 2022; 164:107310. [PMID: 36283485 DOI: 10.1016/j.ypmed.2022.107310] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 10/31/2022]
Abstract
We examined the associations between a sense of purpose and all-cause mortality by gender and race/ethnicity groups. Data were from the Health and Retirement Study, a nationally representative cohort study of U.S. adults aged >50 (n = 13,159). Sense of purpose was self-reported at baseline (2006/2008), and risk of all-cause mortality was assessed over an 8-year follow-up period. We also formally tested for potential effect modification by gender and race/ethnicity. We observed the associations between higher purpose and lower all-cause mortality risk across all gender and race/ethnicity groups. There was modest evidence that the highest level of purpose (versus lowest quartile) was associated with even lower risk of all-cause mortality among women (risk ratio = 0.66, 95% confidence interval: 0.56, 0.77) compared to men (risk ratio = 0.80, 95% confidence interval: 0.69, 0.93; p-value for multiplicative effect modification =0.07). However, we observed no evidence of effect modification by race/ethnicity. Having a higher sense of purpose appears protective against all-cause mortality regardless of gender and race/ethnicity. Purpose, a potentially modifiable factor, might be a health asset across diverse populations.
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Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Human Flourishing Program, University of British Columbia, Vancouver, Canada.
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, University of British Columbia, Vancouver, Canada
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Sociology, University of British Columbia, Vancouver, Canada
| | - Tyler J VanderWeele
- Harvard University, Cambridge, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Human Flourishing Program, University of British Columbia, Vancouver, Canada
| | - Eric S Kim
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA; Department of Psychology, University of British Columbia, Vancouver, Canada
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Jiang F, Reilly TS, Mariano JM. Qualitative Purpose Profiles of Chinese Student Teachers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12745. [PMID: 36232044 PMCID: PMC9566101 DOI: 10.3390/ijerph191912745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/28/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Teachers are well positioned to help students cultivate their purpose in life, which is an asset that is associated with optimal development. Teachers must also have a grasp on their own sense of purpose, especially during times of intense social pressure and change, when the capability to sustain and support worthy aims may impart personal resilience and contribute to the social good. To train educators who have this capability, it is therefore vital for teacher education programs to in turn understand their own students' individualized purpose statuses. Using a qualitative person-centered approach, the current study identified purpose profiles of teacher education candidates in China as part of a larger multinational study. Three hundred and thirty-one participants wrote answers to questions about the content and fulfillment of their purpose in life, and statements were reliably coded for how specifically the respondents referenced their purpose, and for whether their purpose aimed to benefit others. A consensual qualitative research approach then identified four purpose profiles: beyond-the-self purpose, self-oriented life goal, daydreamer and purposeless. The meaning of these profiles and their significance for cultivating purpose among China's teachers are discussed.
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Affiliation(s)
- Fei Jiang
- Center for Ideological and Political Education, Northeast Normal University, Changchun 130024, China
| | - Timothy S. Reilly
- Department of Psychology, Ave Maria University, Ave Maria, FL 34142, USA
| | - Jenni Menon Mariano
- Department of Educational and Psychological Studies, University of South Florida, Tampa, FL 33620, USA
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Lee C, Sain D, Harari L, Kürüm E. Social Mobility and Sense of Purpose From Midlife to Old Age: Examining the Role of Major Life Events. Res Aging 2022:1640275221121588. [PMID: 36053240 DOI: 10.1177/01640275221121588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose in life (PIL) has been linked with numerous health benefits and adaptive aging, yet it diminishes with age, possibly due to loss of social or familial roles through life transitions. Drawing from the longitudinal surveys of the Midlife in the US study (n = 3418), we use time-varying coefficient models to investigate how the trajectory of PIL differs across cumulatively (dis)advantaged, upwardly mobile, and downwardly mobile groups and the role of major life events in shaping these trajectories. We found the upwardly mobile group exhibits higher PIL than the cumulatively disadvantaged and downwardly mobile groups. The consistently disadvantaged group experiences more adverse events at non-normative times. Socioeconomic status disparities in PIL during old age decrease after controlling for life events. We discuss how and why well-being changes and the role of structural and social factors in facilitating or impeding the development or maintenance of PIL over the life course.
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Affiliation(s)
- Chioun Lee
- 8790Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | | | - Lexi Harari
- 8790Department of Sociology, University of California-Riverside, Riverside, CA, USA
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Okuzono SS, Shiba K, Lee HH, Shirai K, Koga HK, Kondo N, Fujiwara T, Kondo K, Grodstein F, Kubzansky LD, Trudel-Fitzgerald C. Optimism and Longevity Among Japanese Older Adults. JOURNAL OF HAPPINESS STUDIES 2022; 23:2581-2595. [PMID: 36919080 PMCID: PMC10010677 DOI: 10.1007/s10902-022-00511-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Optimism has been linked to better physical health across various outcomes, including greater longevity. However, most evidence is from Western populations, leaving it unclear whether these relationships may generalize to other cultural backgrounds. Using secondary data analysis, we evaluated the associations of optimism among older Japanese adults. METHODS Data were from a nationwide cohort study of Japanese older adults aged ≥65 years (Japan Gerontological Evaluation Study; n = 10,472). In 2010, optimism and relevant covariates (i.e., sociodemographic factors, physical health conditions, depressive symptoms, and health behaviors) were self-reported. Optimism was measured using the Japanese version of the Life Orientation Test-Revised (LOT-R). Lifespan was determined using mortality information from the public long-term care insurance database through 2017 (7-year follow-up). Accelerated failure time models examined optimism (quintiles or standardized continuous scores) in relation to percent differences in lifespan. Potential effect modification by gender, income, and education was also investigated. RESULTS Overall, 733 individuals (7%) died during the follow-up period. Neither continuous nor categorical levels of optimism were associated with lifespan after progressive adjustment for covariates (e.g., in fully-adjusted models: percent differences in lifespan per 1-SD increase in continuous optimism scores= -1.2%, 95%CI: -3.4, 1.1 higher versus lower optimism quintiles= -4.1%, 95%CI: -11.2, 3.6). The association between optimism and lifespan was null across all sociodemographic strata as well. CONCLUSION Contrary to the existing evidence from Western populations, optimism was unrelated to longevity among Japanese older adults. The association between optimism, as evaluated by the LOT-R, and longevity may differ across cultural contexts.
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Affiliation(s)
- Sakurako S. Okuzono
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Department of Global Health Promotion, Tokyo Medical and Dental University, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, MA, USA
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, MA, USA
| | - Harold H. Lee
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
| | - Kokoro Shirai
- Department of Public Health, Graduate School of Medicine, Osaka University, Japan
| | - Hayami K. Koga
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
| | - Naoki Kondo
- Department of Social Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Fran Grodstein
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
- Rush Alzheimer’s Disease Center, Rush Medical College, Chicago, IL, USA
| | - Laura D. Kubzansky
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
| | - Claudia Trudel-Fitzgerald
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, MA, USA
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Lee S, Chey J, Ahn W, Woo C, Youm Y, Kim H, Oh N, Park H, Gim S, Lee E, Choi I. Psychological well‐being and salivary markers of inflammation: The moderating effect of age. Appl Psychol Health Well Being 2022; 15:466-478. [PMID: 35851762 DOI: 10.1111/aphw.12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
Increasing evidence suggests a significant impact of higher psychological well-being (PWB) on health outcomes; however, such associations have been studied exclusively in middle-aged to older adults. This study examined the aging effect on PWB measures as well as the moderating effect of age on the link between PWB and inflammation, using salivary markers by comparing the younger adults (n = 127; Mage = 22.98 years) versus older adults (n = 75; Mage = 75.60 years). Older adults showed significantly lower levels of PWB, particularly regarding purpose in life and personal growth. Moreover, higher purpose in life was associated with lower salivary IL-1ß and IL-6 (b = 0.83, p < .001; b = 0.81, p < .01) only in the older adult group but not in younger adults. These findings highlight the potential buffering effect of the sense of living well on physiological pathways in later life.
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Affiliation(s)
- Sung‐Ha Lee
- Center for Happiness Studies Seoul National University Seoul South Korea
| | - Jeanyung Chey
- Department of Psychology Seoul National University Seoul South Korea
| | - Woo‐Young Ahn
- Department of Psychology Seoul National University Seoul South Korea
- Department of Brain and Cognitive Sciences Seoul National University Seoul South Korea
| | - Choong‐Wan Woo
- Department of Biomedical Engineering Sungkyunkwan University Suwon South Korea
- Center for Neuroscience Imaging Research Institute for Basic Science (IBS) Suwon South Korea
- Department of Intelligent Precision Healthcare Convergence Sungkyunkwan University Suwon South Korea
| | - Yoosik Youm
- Department of Sociology Yonsei University Seoul South Korea
| | - Hairin Kim
- Department of Psychology Seoul National University Seoul South Korea
- Department of Psychiatry Seoul National University College of Medicine and SMG‐SNU Boramae Medical Center Seoul South Korea
| | - Naeun Oh
- Department of Psychology Seoul National University Seoul South Korea
| | - Hyeyoung Park
- Department of Psychology Seoul National University Seoul South Korea
| | - Suhwan Gim
- Department of Biomedical Engineering Sungkyunkwan University Suwon South Korea
- Center for Neuroscience Imaging Research Institute for Basic Science (IBS) Suwon South Korea
- Department of Intelligent Precision Healthcare Convergence Sungkyunkwan University Suwon South Korea
| | - Eunjin Lee
- Department of Biomedical Engineering Sungkyunkwan University Suwon South Korea
- Center for Neuroscience Imaging Research Institute for Basic Science (IBS) Suwon South Korea
- Department of Intelligent Precision Healthcare Convergence Sungkyunkwan University Suwon South Korea
| | - Incheol Choi
- Center for Happiness Studies Seoul National University Seoul South Korea
- Department of Psychology Seoul National University Seoul South Korea
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Conroy B, Murphy N, Romero-Ortuno R, Cunningham C, Horgan F. Examining the factors associated with community ambulation in an older adult day hospital population. Eur Geriatr Med 2022; 13:1137-1147. [PMID: 35788972 DOI: 10.1007/s41999-022-00666-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/01/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The ability of an older adult to walk independently in their community assists with maintaining independence, a healthy lifestyle and a good quality of life. In clinical practice, outdoor mobility is often one of the first activities, where a decline is observed. The aim of this study was to examine the factors associated with community ambulation in community dwelling older adults attending a day hospital. METHODS This was a cross-sectional observational study design. Inclusion criteria were community dwelling older adults, over 65 years, attending a day hospital and able to ambulate at least 10 m with or without an assistive device. The primary outcome measure was a community ambulation questionnaire. A range of other outcome measures were completed assessing motor, cognitive, executive function and behavioural domains. Multivariate logistic regression was employed to identify independent predictors of community ambulation. RESULTS 161 participants completed this study. The median age was 83 years (IQR 9), 64% were female and 49.1% lived alone. 55.3% of participants were classified as independent community ambulators. Mean gait speed was 0.8 m/s, median TUG score was 16.6 s and median frailty was 4 (IRQ 2) using the Clinical Frail Scale. Self-efficacy (p < 0.001) and gait speed (p = 0.030) were independently associated with community ambulation. CONCLUSIONS The findings demonstrate the complexity and multifactorial nature of community ambulation in older adults. This suggests the need to adopt a broader approach to the management of older adults, to promote the achievement of independent community ambulation.
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Affiliation(s)
- Bronagh Conroy
- Physiotherapy Department, St James's Hospital, Dublin 8, Ireland.
| | - Niamh Murphy
- Physiotherapy Department, St James's Hospital, Dublin 8, Ireland
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin 8, Ireland
| | - Conal Cunningham
- Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin 8, Ireland
| | - Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
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Radomski MV, Anheluk M, Carroll GL, Grabe K, Halsten JW, Kath K, Kreiger RA, Lunos ME, Rabusch S, Swenson KK, Zola J. Preliminary Efficacy of an Occupation-Oriented Purpose in Life Intervention After Breast Cancer. Can J Occup Ther 2022; 89:115-126. [PMID: 35040344 DOI: 10.1177/00084174211073264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Purpose in life is important to health and well-being; purpose disruption often goes unidentified after breast cancer. Purpose. To evaluate the efficacy of a purpose renewal intervention and utility of a screening question for identifying people with purpose-related distress. Method. In this prospective pretest-posttest study, participants with breast cancer received an 8-session purpose renewal group intervention (n = 35). Participants completed standardized measures of meaning and purpose at pretest, posttest, and two-month follow-up and a forced-choice Purpose Status Question (PSQ) at pretest. Findings. Participants made statistically significant pretest-to-posttest and pretest-to-follow-up improvements. The PSQ demonstrated construct validity: 40% of participants lacked purpose direction at pretest and this subgroup made significantly greater improvements than participants who reported purpose direction at pretest. Implications. The PSQ warrants further study as a screener to identify people with purpose-related distress. Many breast cancer survivors may benefit from a purpose in life intervention; a subgroup may benefit more.
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Association between health literacy and purpose in life and life satisfaction among health management specialists: a cross-sectional study. Sci Rep 2022; 12:8310. [PMID: 35585083 PMCID: PMC9117675 DOI: 10.1038/s41598-022-11838-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/29/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose in life is anchored as a goal in national health promotion plans in several countries. Health literacy is the ability to find, understand, use, and evaluate health-related information; this ability has been investigated in terms of its effect on health outcomes and is said to play a critical role in health promotion. In the context of national health promotion, the effect of health literacy on purpose in life and life satisfaction remains unclear; therefore, this study aims to determine the effect of health literacy. A cross-sectional study was conducted on Japanese health management specialists (N = 1920). Health literacy was measured using the Communicative and Critical Health Literacy scale. Purpose in life and life satisfaction were measured using the Ikigai-9 scale and a Likert scale, respectively. We analyzed the associations between health literacy and purpose in life and life satisfaction with regression analyses. Age, sex, income, education, marital status, psychological stress, and diseases as present illness were adjusted in the statistical models. Our multiple linear regressions indicated that health literacy was significantly associated with purpose in life (β = 0.199, p < 0.001), after adjusting for covariates (age, sex, income, education, marital status, psychological factor, and disease status). Life satisfaction was also significantly associated with health literacy (β = 0.126, p < 0.001). Health literacy is associated with purpose in life and life satisfaction among specialists in health management. Health literacy plays a critical role in lifestyle-related disease prevention and health promotion. Interventions to improve health literacy may be warranted in the context of national health promotion.
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Kawakatsu Y, Yokoi K, Tanno K, Eakman AM, Hirayama K. Development of the Japanese Version of the Engagement in Meaningful Activities Survey. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:209-218. [PMID: 35466821 DOI: 10.1177/15394492221090624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To create a Japanese version of the Engagement in Meaningful Activities Survey (EMAS) and assess internal consistency, test-retest reliability, convergent and structural validity. METHOD We conducted a cultural translation and validation study of the Japanese version of the EMAS (EMAS-J) in a sample of 96 community-dwelling older adults in the Tohoku Region of Japan. RESULTS Internal consistency of the EMAS-J (α = .91) was very good. Low to moderate correlations were found with indicators of health-related quality of life, depression, and life purpose and meaning. Exploratory factor analysis indicated a two-factor structure within the EMAS-J; cultural differences in item-factor composition compared with previously reported EMAS factor structures are discussed. IMPLICATIONS The EMAS-J is a reliable and valid assessment of engagement in meaningful activities for older adults in Japan. The assessment can be used to evaluate the effects of occupation-based interventions upon health and well-being.
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Affiliation(s)
- Yuki Kawakatsu
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Kayoko Yokoi
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Katsuko Tanno
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | | | - Kazumi Hirayama
- Yamagata Prefectural University of Health Sciences, Yamagata, Japan
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Jiang H, Lan G, Zhu Q, Feng Y, Liang S, Li J, Zhou X, Lin M, Shao Y. Impacts of HIV-1 Subtype Diversity on Long-Term Clinical Outcomes in Antiretroviral Therapy in Guangxi, China. J Acquir Immune Defic Syndr 2022; 89:583-591. [PMID: 34966146 PMCID: PMC8900993 DOI: 10.1097/qai.0000000000002906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Comprehensively estimating the impacts of HIV-1 subtype diversity on long-term clinical outcomes during antiretroviral therapy (ART) can help inform program recommendations. METHODS The HIV-1 sequence data and clinical records of 5950 patients from all 14 prefectures in Guangxi, China, during 2008-2020 were included. Evolutional trends of CD4+ T-lymphocyte count and viral load were explored, and the effects of HIV-1 subtypes on clinical outcomes were estimated by the Cox proportional hazards model. The polymorphisms involved in drug resistance mutation were analyzed. RESULTS Compared with patients with CRF07_BC, patients with CRF01_AE and CRF08_BC showed poor immunologic and virologic responses to antiretroviral therapy. Although the median expected time from ART initiation to virologic suppression for all patients was approximately 12 months, patients with CRF01_AE and CRF08_BC had a long time to achieve immune recovery and a short time to occur immunologic failure, compared with patients with CRF07_BC. Adjusted analysis showed that both CRF01_AE and CRF08_BC were the negative factors in immune recovery and long-term mortality. In addition, CRF08_BC was a negative factor in virologic suppression and a risk factor of virologic failure. This poor virologic response might result from the high prevalence of drug resistance mutation in CRF08_BC. CONCLUSIONS Compared with patients with CRF07_BC, patients with CRF01_AE could benefit more from immediate ART, and patients with CRF08_BC are more suitable for PI-based regimens. These data emphasize the importance of routine HIV-1 genotyping before ART, immediate ART, and personalized ART regimens to improve the prognosis for patients undergoing ART.
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Affiliation(s)
- He Jiang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; and
- State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Guanghua Lan
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Qiuying Zhu
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Yi Feng
- State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Shujia Liang
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Jianjun Li
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Xinjuan Zhou
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; and
| | - Mei Lin
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Yiming Shao
- Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; and
- State of Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, China
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Kligler B. Whole Health in the Veterans Health Administration. Glob Adv Health Med 2022; 11:2164957X221077214. [PMID: 35273831 PMCID: PMC8902183 DOI: 10.1177/2164957x221077214] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/13/2022] [Indexed: 01/24/2023] Open
Abstract
The Whole Health System being developed and implemented at the Veterans Health Administration is an approach to care which aims to shift the discussion from "What's the Matter With You?" to "What Matters to You?" This article describes some of the progress and future challenges in the implementation of this approach across the VHA.
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Affiliation(s)
- Benjamin Kligler
- Executive Director, Office of Patient Centered Care & Cultural Transformation, Veterans Health Administration, Washington, NY, USA
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42
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Boyle PA, Wang T, Yu L, Barnes LL, Wilson RS, Bennett DA. Purpose in Life May Delay Adverse Health Outcomes in Old Age. Am J Geriatr Psychiatry 2022; 30:174-181. [PMID: 34175231 PMCID: PMC10151065 DOI: 10.1016/j.jagp.2021.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Test the hypothesis that a higher level of purpose in life is associated with an older age of Alzheimer's dementia onset and later mortality. DESIGN Prospective cohort studies of aging and Alzheimer's dementia. SETTING Community-based. PARTICIPANTS Two thousand five hundred fifty-eight older adults initially free of dementia underwent assessments of purpose in life and detailed annual clinical evaluations to document incident Alzheimer's dementia and mortality. General accelerated failure time models examined the relation of baseline purpose in life with age at Alzheimer's dementia diagnosis and mortality. EXPOSURES Purpose in life was assessed at baseline. MAIN OUTCOMES Alzheimer's dementia diagnosis was documented annually based on detailed clinical evaluations and mortality was documented via regular contacts and annual evaluations. RESULTS During a mean of 6.89 years of follow-up, 520 individuals were diagnosed with incident Alzheimer's dementia at a mean age of 88 (SD = 6.7; range: 64.1-106.5). They had a mean baseline level of purpose in life of 3.7 (SD = 0.47; range: 1-5). A higher level of purpose in life was associated with a considerably later age of dementia onset (estimate = 0.044; 95% CI: 0.023, 0.065); specifically, individuals with high purpose (90th percentile) developed Alzheimer's dementia at a mean age of about 95 compared to a mean age of about 89 for individuals with low purpose (10th percentile). Further, the estimated mean age of death was about 89 for individuals with high purpose compared to 85 for those with low purpose. Results persisted after controlling for sex and education. CONCLUSION AND RELEVANCE Purpose in life delays dementia onset and mortality by several years. Interventions to increase purpose in life among older persons may increase healthspan and offer considerable public health benefit.
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Affiliation(s)
- Patricia A Boyle
- Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL.
| | - Tianhao Wang
- Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Lei Yu
- Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Lisa L Barnes
- Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Robert S Wilson
- Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - David A Bennett
- Rush University Medical Center, Rush Alzheimer's Disease Center, Chicago, IL; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
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Abaoğlu H, Doğu SE. Physical activity for a meaningful and purposeful life in typical adults: a cross-sectional study. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctoao23783103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Physical activity is a part of life and an essential element for health and well-being. Investigating the meaning and purpose that physical activity adds to life will guide occupation-based interventions. Objective This cross-sectional study aimed to examine the relationship between physical activity level and meaning and purpose in life in typical adults. Method The study included a total of 300 typical adults (181 female, 119 male). Demographic characteristics of the participants, such as age, gender, and educational status, were recorded. The International Physical Activity Questionnaire, the Life Attitude Profile-Revised, and the Purpose in Life Test were used as measurement tools. Spearman correlation coefficient was used to analyse the relationship between nonparametric variables. Results A weak positive correlation was found between the physical activity total scores, meaning in life sub-scores and total scores (r=0.25, p<0.01), and purpose in life total scores (r=0.16, p<0.01). Conclusion Our findings revealed that people engaging in more physical activity had a sense of meaning and purpose in life. Physical activity must take place in occupational therapy practices as an occupation that adds meaning and purpose to an individual's life. Further research is needed on this subject.
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Purpose in life, urgency, and the propensity to engage in risky and self-destructive behaviors. MOTIVATION AND EMOTION 2021. [DOI: 10.1007/s11031-021-09915-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Thomas MM, Pietrzak RH, Nguyen DR, Ryan D, Southwick SM, Mazure CM. Psychological Resilience in West Point Graduates: Results From a Nationally Representative Study. CHRONIC STRESS 2021; 5:24705470211053850. [PMID: 34761141 PMCID: PMC8573692 DOI: 10.1177/24705470211053850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Abstract
Background: The purpose of this study was to examine factors associated with psychological resilience in a nationally representative sample of West Point graduates. Aims: The aims of this study were to (a) employ a dimensional approach to operationalizing psychological resilience in a trauma-exposed population that had been highly trained and educated in persisting in the face of stress, was previously unstudied, and in which we could examine correlates of resilience, (b) identify key psychosocial factors, character traits, health variables, military experiences, and coping strategies as potential correlates of psychological resilience; and (c) examine whether reported gender moderated any of these associations in this population. Methods: A nationally representative sample of 1342 West Point graduates after gender integration from classes 1980 to 2011 were surveyed. Psychological resilience was operationalized using a discrepancy-based approach in which a measure of composite psychological distress (current posttraumatic stress disorder, generalized anxiety and depression symptoms) was regressed on measures of cumulative trauma burden. A multivariable linear regression model was then employed to identify factors that were independently associated with psychological resilience scores. Results: Purpose in life (29.8% of relative variance explained [RVE]), fewer perceived negative experiences in the military (20.6% RVE), social support (9.6% RVE), and grit (9.5% RVE) were the strongest correlates of psychological resilience scores for both women and men. Time in service was positively associated with resilience in women only. Conclusion: This study identifies key correlates of psychological resilience in West Point graduates, individuals who are highly trained to persevere in the face of stress and then were trauma-exposed. Most of these factors are modifiable and can be targeted in stress prevention and treatment interventions, especially for high-stress professions such as the military, frontline health care providers, and first responders.
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Affiliation(s)
| | | | | | - Diane Ryan
- Jonathan M. Tisch College of Civic Life, Tufts University, Medford, MA, USA
| | | | - Carolyn M Mazure
- Yale School of Medicine, Women's Health Research at Yale, New Haven, CT, USA
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Böhmer MC, la Cour P, Schnell T. A Randomized controlled trial of the Sources of Meaning Card Method: A new meaning-oriented approach predicts depression, anxiety, pain acceptance, and crisis of meaning in chronic pain patients. PAIN MEDICINE 2021; 23:314-325. [PMID: 34730813 DOI: 10.1093/pm/pnab321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 07/25/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Although considered the first-line psychological treatment of chronic pain, cognitive behavioural therapy has recently been criticized as being too limited, insufficient, and sometimes ineffective in the treatment of chronic pain patients. Moreover, important existential perspectives are sparsely or not at all integrated into CBT. We therefore propose to complement chronic pain treatment with a meaning-based intervention, the Sources of Meaning Card Method (SoMeCaM). This study tested its efficacy. DESIGN A randomized controlled trial was conducted with 42 chronic pain patients, comparing an intervention group (standard care and participation in the SoMeCaM, a meaning-oriented approach) with a control group (standard care). We evaluated both groups at baseline, 1 (t1) and 2 months (t2) after the intervention. The primary outcome assessed was pain acceptance, while depression, anxiety, pain intensity, pain medication, satisfaction with life, meaningfulness, and crisis of meaning were examined as secondary outcomes. RESULTS Comparisons within and between groups showed significant treatment effects at t1. Higher increases in pain acceptance and decreases in anxiety, depression and crisis of meaning were observed in the intervention group. Improvements in pain acceptance and anxiety persisted until t2, when pain intensity was also lower. Effect sizes at t2 were medium to large. CONCLUSION Our preliminary work demonstrates the importance of the existential perspective in chronic pain therapy.
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Affiliation(s)
- Miriam C Böhmer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Munich, Germany.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Peter la Cour
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Tatjana Schnell
- Institute of Psychology, Leopold-Franzens University, Innsbruck, Austria.,MF Norwegian School of Theology, Religion and Society, Oslo, Norway
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Kaspar R, Wahl HW, Diehl M. Awareness of Age-Related Change as a Behavioral Determinant of Survival Time in Very Old Age. Front Psychol 2021; 12:727560. [PMID: 34650486 PMCID: PMC8505719 DOI: 10.3389/fpsyg.2021.727560] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022] Open
Abstract
Although research on the association between subjective views of aging (VOA) and survival is scarce, more negative VOA have been found to be associated with increased all-cause mortality, even after controlling for possible confounders. Longitudinal studies on the predictive association of VOA with survival in individuals aged 80 years or older are, however, very limited. Thus, the aim of this study was to link adults' awareness of age-related change (AARC), a multidimensional measure of adults' subjective VOA, to survival time across a 3.5-year observation interval in advanced old age. To put the AARC construct in context, the study also considered related psychosocial concepts (i.e., perceived control and appraisal of life) essential for coping with late-life challenges as potential behavioral predictors of longevity. Data came from a representative panel study that included persons living in community and institutional settings. A total of 1,863 interviews were conducted at wave 1. This study used meta-data from wave 2 fieldwork 2 years after the initial assessment and death records obtained during panel maintenance after 3.5 years to estimate determinants of survival. Results showed that loss-related VOA indicated increased risk to survival, whereas gain-related VOA were predictive of longer survival. Both perceived age-related losses and perceived age-related gains exerted a significant independent effect on late-life mortality over and above socio-demographic background characteristics, perceived control, engagement with life, as well as health status. These findings suggest that the multidimensional examination of very old adults' VOA may help to better understand successful longevity in the Fourth Age.
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Affiliation(s)
- Roman Kaspar
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
| | - Hans-Werner Wahl
- Network Aging Research of Heidelberg University, Heidelberg, Germany
| | - Manfred Diehl
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
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Wu W, Shang Y, Calderón-Larrañaga A, Rizzuto D, Saadeh M, Dove A, Pan KY, Xu W. Association of life satisfaction with disability-free survival: role of chronic diseases and healthy lifestyle. Age Ageing 2021; 50:1657-1665. [PMID: 34120170 DOI: 10.1093/ageing/afab086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND this article investigates the association between life satisfaction and disability-free survival, and explores the roles of chronic diseases and healthy lifestyle in this association. METHOD a cohort of 2,116 functionally independent adults aged ≥60 was followed up to 12 years. At baseline, life satisfaction was assessed with the Life Satisfaction Index A (LSI-A). Disability-free survival was defined as the survival till the first occurrence of either death, dementia or physical disability. Information on lifestyle factors was collected via questionnaire. Chronic diseases were ascertained through clinical examinations at baseline and each follow-up. Data were analysed using Cox proportional hazard regression models and Laplace regression. RESULTS over follow-up, 1,121 participants died, developed dementia, or became disabled. High LSI-A versus Low LSI-A had a lower risk of death, dementia and physical disability (hazard ratio [HR] 0.79, 95% confidence intervals [CI] 0.67-0.94), and had a longer disability-free period by 1.73 (95% CI 0.18-3.32) years. In mediation analysis, accumulation of chronic diseases mediated 17.8% of the association between LSI-A and disability-free survival. In joint effect analysis, participants with high LSI-A and a favourable lifestyle profile had a HR of 0.53 (95% CI 0.41-0.69) for the composite endpoint, and lived 3.2 (95% CI 1.35-5.11) disability-free years longer than those with low life satisfaction and an unfavourable lifestyle profile. DISCUSSION high life satisfaction is independently associated with longer disability-free survival. This association is partially mediated by a lower burden of chronic diseases and is reinforced by healthy lifestyle.
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Affiliation(s)
- Wei Wu
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan 430065, China
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Ying Shang
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Amaia Calderón-Larrañaga
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Debora Rizzuto
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
- Stockholm Gerontology Research Center, Stockholm 11330, Sweden
| | - Marguerita Saadeh
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Abigail Dove
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
| | - Kuan-Yu Pan
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
- Amsterdam University Medical Center, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health Research Institute, 1081, The Netherlands
| | - Weili Xu
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 11330, Sweden
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Ironson G, Verhagen R, da Rosa B, Hylton E. Interview-Rated Meaning and Survival Over 17 Years in People Living With HIV. Psychosom Med 2021; 83:671-678. [PMID: 34267088 DOI: 10.1097/psy.0000000000000963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary purpose of this study was to determine whether meaning in life predicts survival in people living with HIV (PLWH) over 17 years. This study also examined whether interviewer- and transcript-rated meanings predict survival equivalently. A third purpose of the study was to investigate whether meaning in life adds to the prediction of survival over positive emotional expression. METHODS A diverse sample of people with HIV (n = 177) completed an interview on stress and coping at baseline and were followed up for survival up to 17 years. Meaning was measured by interviewer rating of four items (meaningful purpose, unfinished business, finding new meaning, and meaningful activities). Transcript-rated meaning was assessed by two independent raters. Cox proportional hazards regression was used to determine whether meaning predicted survival over 17 years. RESULTS Meaning in life predicted significantly greater survival, adjusting for biomedical and sociodemographic variables whether assessed by interviewer or by transcript raters. Hazard ratios suggest that the effect is moderate to large (2.66-3.45 for top versus bottom third; 2.05-2.49 for top versus bottom half). Significance was maintained after adjusting for positive emotion. CONCLUSIONS Meaning assessed by interview (by both interviewer and transcript ratings) predicted greater survival over 17 years in PLWH and did so above positive emotion. This adds to a literature that is primarily based on self-report questionnaires. Meaning may have beneficial effects for both psychological and physical health in PLWH.
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Affiliation(s)
- Gail Ironson
- From the Department of Psychology, University of Miami, Coral Gables, Florida
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50
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Rediscovering Meaning and Purpose: An Approach to Burnout in the Time of COVID-19 and Beyond. Am J Med 2021; 134:1065-1067. [PMID: 33989605 PMCID: PMC9746258 DOI: 10.1016/j.amjmed.2021.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022]
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