Individual and family factors associated with self-esteem in young people with epilepsy: A multiple mediation analysis

Assessment of stigmatization and self-esteem in patients with epilepsy

AIM

This study was conducted to examine the relationship between stigmatization and self-esteem of patients with epilepsy.

METHODS

This cross-sectional study was conducted with 216 patients at a university hospital in Van, a province in eastern Turkey. The researcher prepared the data collection tools, including a personal information form, Jacoby Stigma Scale and the Rosenberg self-esteem scale, in line with the literature. The Jacoby stigma scale was applied to assess stigma. Data analysis was performed using t-test, one-way analysis of variance (ANOVA), and Tukey, LSD coefficient.

RESULTS

The mean total stigmatization score of patients with epilepsy was 21.11 ± 10.00, while the mean total self-esteem score was 20.26 ± 5.16. The study found a significant negative correlation between stigmatization and self-esteem scores (r = -0.411; p < 0.05).

CONCLUSION

The research study revealed that patient with epilepsy have a high perception of stigma and low selfesteem levels.

A reliability generalization meta-analysis of the family resilience assessment scale (FRAS)

PROBLEM

Practitioners and researchers frequently rely on the Family Resilience Assessment Scale (FRAS) to assess family resilience, and previous research reported varying reliability statistics for the measurements with the scale. The present study aims to generalize the reliability of the FRAS based on Cronbach's alpha coefficients reported in the selected studies.

ELIGIBILITY CRITERIA

We selected relevant research on various databases, including Web of Science, PubMed, ProQuest, Scopus, YÖK Thesis Center, DergiPark, and TR Index.

SAMPLE

Satisfying our inclusion criteria, fifty-five studies were included in the present study.

RESULTS

We calculated the reliability generalization coefficients for the FRAS total score to be 0.951 (95% CI [0.942, 0.958]) and 0.949 for Family Communication and Problem Solving, 0.792 for Utilizing Social and Economic Resources, 0.861 for Maintaining a Positive Outlook, 0.635 for Family Connectedness, 0.873 for Family Spirituality, and 0.702 for Ability to Make Meaning of Adversity.

CONCLUSIONS

In a nutshell, our findings secure substantial insights into the reliability of the FRAS and its subscales for prospective researchers and practitioners. In this study, generalized Cronbach's alpha values imply average, good, and acceptable reliability for the FRAS subscales and total score, except for Family Connectedness.

IMPLICATIONS

The distinct contribution of our research may be to reemphasize the significance of avoiding reliability induction and to raise awareness among prospective researchers of evaluating the reliability of any measurement they would obtain.

Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents' psychological adjustment

BACKGROUND

This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness.

METHODS

A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis.

RESULTS

Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45-0.48) were higher than parents (r = 0.18-0.23). In the line of congruence, there were positive linear (a1 = 1.09-1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01).

CONCLUSION

The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.

Medication adherence and its relationship with self-esteem among patients with epilepsy in Isfahan, Iran

Medication adherence is of utmost importance in achieving the desired therapeutic outcome and effectively managing seizures in patients with epilepsy (PWE). It is imperative to recognize self-esteem as a psychological determinant that potentially influences the optimal compliance with anti-seizure medications (ASMs) among PWE. The objective of this study was to explore medication adherence and its relationship with self-esteem among individuals diagnosed with epilepsy in Isfahan, Iran.

METHODS

This descriptive-analytical study was conducted in the year 2021, encompassing a cohort of 250 PWE who were referred to designated medical facilities in Isfahan, Iran, and were selected by the consecutive sampling technique. A 3-part instrument including demographic components, the Rosenberg Self-Esteem Scale, and the Morissky Drug Adherence Questionnaire employed for data collection.

RESULTS

The mean and standard deviation of adherence to the medicinal regimen in the participants were 6.9 ± 2.02, and 46.4 % had a low level of adherence to the medication regimen (total score 0-6). At the same time, the mean and standard deviation of self-esteem in these patients was 5.11 ± 2.11. There was a statistically significant and direct correlation between adherence to the prescribed drug regimen and self-esteem (rs = 0.464, p = 0.00).

CONCLUSION

Based on the findings of the study that showed a statistically significant and positive correlation between self-esteem and adherence to the medication regimen, it is advisable to enhance and advocate for these factors in PWE.

Self-promotion and online shaming during COVID-19: A toxic combination

A public shaming frenzy has spread through social media (SM) following the instigation of lockdown policies as a way to counter the spread of COVID-19. On SM, individuals shun the idea of self-promotion and shame others who do not follow the COVID-19 guidelines. When it comes to the crime of not taking a pandemic seriously, perhaps the ultimate penalty is online shaming. The study proposes the black swan theory from the human-computer interaction lens and examines the toxic combination of online shaming and self-promotion in SM to discern whether pointing the finger of blame is a productive way of changing rule-breaking behaviour. A quantitative methodology is applied to survey data, acquired from 375 respondents. The findings reveal that the adverse effect of online shaming results in self-destructive behaviour. Change in behaviour of individuals shamed online is higher for females over males and is higher for adults over middle-aged and older-aged.

Perceived stress, resilience, and stress coping in patients with drug resistant epilepsy and functional dissociative seizures

PURPOSE

Depression and anxiety are psychiatric disorders related to chronic stress, commonly found in patients with drug-resistant epilepsy (DRE) and functional dissociative seizures (FDS). The present study compares the levels of perceived stress, resilience, and the styles of stress coping among patients with DRE (n=60), FDS (n=28), and controls (n=31).

METHODS

We performed a cross-sectional study. All patients underwent Video Electroencephalography to confirm the diagnosis and completed the psychiatric assessment (SCID I and II of DSM IV) supported by several instruments validated in Spanish.

RESULTS

FDS scored higher in perceived stress (p = 0.004) with lower levels of resilience compared to controls (p = 0.01). Stress coping subscales show higher scores in negative self-focus and hostility in patients with FDS compared to controls (p=0.003). Similarly, DRE patients scored higher in perceived stress (p = 0.001), and presented lower levels of resilience (p = 0.004) with higher levels of hostility compared to controls (p=0.02). However, no significant differences were found between FDS and DRE on stress coping variables. Anxiety scores and depression rates were higher in the FDS group compared to DRE (p=0.008) and higher in DRE compared to controls (p<0.05). A positive correlation between depression and perceived stress was found (r = 0.6, p=0.0001).

CONCLUSIONS

Our results delineate a more detailed picture of the psychological profile of this population, emphasizing the importance of stress factors in patients with FDS and DRE. Combined intervention strategies which enhance stress coping may be appropriate to direct treatment and psychotherapy.

Family Resilience Scale Short Form (FRS16): Validation in the US and Chinese Samples

Family resilience, which refers to the processes through which a family adapts to and thrives from adversities, has growing importance in recent years. In response to the need for further research on family resilience, the present research aims to abbreviate and validate Sixbey's Family Resilience Assessment Scale (FRAS) into a 16-item version Family Resilience Scale Short Form in the US (FRS16) and Chinese (FRS16_C) samples. The samples included 1,236 (Study 1) and 1,135 (Study 2) participants from the US and China, respectively. Results of confirmatory factor analysis (CFA) supported the proposed three-factor structure of FRS16: Family Communication and Connectedness, Positive Framing, and External Support across two samples. Overall, the reliability and validity of full and subscales of FRS16 and FRS16_C were satisfactory. Multi-group CFA revealed that both configural and metric invariance are supported, suggesting that participants in the US and Chinese samples assign comparable meaning to the latent factors of FRS16. Results suggested that FRS16 and FRS16_C are valid instruments for family resilience in the US and Chinese samples.

Cross-cultural adaptations of the Family Resilience Assessment Scale: a systematic review protocol of measurement properties

OBJECTIVE

The review aims to critically appraise the measurement properties and adaptation processes of all cross-cultural adaptations of the Family Resilience Assessment Scale.

BACKGROUND

A number of family resilience instruments have been developed over the past decade; however, the Family Resilience Assessment Scale reports the best psychometric properties among populations with health issues. Since its publication in 2005, numerous translations and adaptations have been undertaken to use with culturally diverse populations. A systematic review of the properties of the Family Resilience Assessment Scale's cross-cultural adaptations is needed to evaluate the adapted versions' quality (validity, reliability, and responsiveness).

INCLUSION CRITERIA

Studies of interest include validation and cross-cultural adaptation studies of the Family Resilience Assessment Scale as well as research publications reporting psychometric properties of cross-cultural adaptations in specific populations.

METHODS

Nine databases will be consulted: CINAHL, PubMed, Embase, PsycINFO, PubPsych, Health and Psychosocial Instruments database, ProQuest Dissertations and Theses, ScienceDirect, and Web of Science. The search will be limited to publications since 2005 without language restrictions. Articles will be screened by two independent reviewers and will undergo risk of bias assessment. The measurement properties of retrieved instruments will be assessed following COSMIN guidelines. Data extraction will be piloted and completed by two independent reviewers using an adapted extraction form. Psychometric properties will be reported in a narrative synthesis and further supported by a summary table.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO (CRD42020219938).

Family Resilience and Its Association with Psychosocial Adjustment of Children with Chronic Illness: A Latent Profile Analysis

PURPOSE

The purpose of this study was to investigate the characteristics of family resilience in a sample of Chinese families with children diagnosed with chronic illness using Latent Profile Analysis (LPA). In particular, we examined the association of family resilience profiles with the psychosocial adjustment of children, and identified the socio-demographic correlates of these latent profiles.

DESIGN AND METHODS

A cross-sectional study was conducted at comprehensive hospitals and children hospitals in three cities (Hangzhou, Ningbo and Wenzhou) of Zhejiang province, China. Parents (n = 277) of children diagnosed with a chronic illness completed a socio-demographic questionnaire, the Chinese version of the family resilience assessment scale, and the Strengths and Difficulties Questionnaire.

RESULTS

A three-class solution was found to demonstrate the best fit [low family resilience (74.7%), moderate family resilience (14.1%), and high family resilience (11.2%)]. One-way ANOVA revealed significant differences between the three groups with respect to peer relationship problems and pro-social behaviors of children. On multinomial logistic regression analysis, the type of childhood chronic disease, time since diagnosis, family monthly income, medical insurance, and parents employment status significantly predicted the profile membership.

CONCLUSION

Inadequate family resilience was found to be a common phenomenon in families with children affected by chronic illness. Family resilience profiles were associated with psychological adjustment of children.

PRACTICE IMPLICATION

Our findings may help inform tailored family-strength based interventions to promote better psychosocial adjustment of children with chronic illness.

The measurement of the mediator and its influence on statistical mediation conclusions

In psychology, the causal process between 2 variables can be studied with statistical mediation analysis. To make a causal interpretation about the relation between variables, researchers who use the statistical mediation model make many assumptions about the variables in the model, among which are measurement assumptions about the mediator. For example, researchers often assume that the measure of the mediator yields scores that are reliable and that have a valid interpretation. In this article, we address how several measurement challenges affect the conclusions of statistical mediation analysis, and how researchers can use different psychometric models to study theoretically different causal processes. We use simulated data sets to illustrate how 10 well-fitting and theoretically sound statistical mediation models could significantly detect the indirect effect or miss it entirely depending on how the mediator is represented in the model. In the example, power to detect the indirect effect varied by the amount of true mediator variance that the psychometric model of the mediator was able to isolate. Different strategies to incorporate psychometric methods into mediation research are discussed and future directions are considered. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Community integration, self-esteem, and perceived stigma in a Nigerian sample with epilepsy

OBJECTIVE

The objective of the study was to investigate the levels, interrelationships, and associated factors of community integration (CI), perceived stigma (PS), and self-esteem in people living with epilepsy (PWE) in Anambra and Enugu States of south-east Nigeria.

METHODS

This was a cross-sectional survey involving 70 consenting adults living with epilepsy consecutively recruited from three purposively sampled specialized clinics in Anambra State. The Reintegration to Normal Living Index, the Epilepsy Stigma Scale, and the Rosenberg Self-Esteem Scale were used to estimate CI, PS, and self-esteem, respectively among the participants. Data were analyzed at 0.05 level of significance.

RESULTS

The mean age of the participants (28.6% females) was 34.91 ± 16.21 years. The participants had moderate PS score (43.54 ± 14.20), poor self-esteem score (17.63 ± 6.12), and mild-to-moderately restricted CI score (67.83 ± 24.72). Participants' PS, CI, and self-esteem significantly correlated with one another (p < 0.05) with PS and self-esteem being significant predictors of CI. Participants' PS had a significant correlation with their age at onset of epilepsy, while their self-esteem and CI significantly correlated with their seizure episodes (p < 0.05). Participants' PS and CI were significantly different across different categories of their occupational and educational statuses. Perceived stigma also varied across participants' marital status with divorced participants having the worst score (p < 0.05).

CONCLUSION

People living with epilepsy had moderate PS, poor self-esteem, and mild-to-moderate CI, which correlated significantly with one another. Results suggest the possibility of using CI as an outcome for assessing the effectiveness of stigma and self-esteem interventions during epilepsy rehabilitation.

Using a psychological contract of safety to predict safety climate on construction sites

INTRODUCTION

The fact that safety climate impacts safety behavior and delivers better safety outcomes is well established in construction. However, the way workers safety perception is inclined and developed is still unclear.

METHOD

In this research, the influence of supervisors' developing safety climate and its impact on workers' safety behavior and their conceptualization of safety is explored through the lens of the 'Psychological Contract' (PC). More specifically, it is argued that 'Psychological Contract of Safety' (PCS) is a vital factor in explaining how workers attach meaning to a supervisor behavior. Extant research suggests: (a) safety climate is based on the perception of workers regarding safety; and (b) PCS is based on perceived mutual obligations between workers and supervisors. As a result, this research argues that if PCS or mutual obligations between workers and supervisors are fulfilled, then safety climate of the workers will be positively influenced. A model is presented depicting PCS as an alternative intervention in understanding how safety climate could be influenced and predicted by the level of fulfillment of mutual safety obligations. Using Structural Equation Modeling (SEM) the model of the PCS is validated with data collected from a mega-construction project in Australia.

RESULTS

The results suggest that to have a positive and strong safety climate, top-level managers must ensure that mutual safety obligations between supervisor and workers are fulfilled. This enables the PCS to be introduced as a new 'predictor' of safety climate. Practical applications: The novel outcome of the research could be considered as a management intervention to modify supervisors' behavior to produce better safety outcomes.

Returning to Social Life: Development of Social Identity for Adolescent and Young Adult Survivors of Leukemia in Korea

OBJECTIVE

The purpose of this study is to investigate the life experiences and processes that occur as adolescent and young adult leukemia survivors return to social life using grounded theory.

METHOD

This study comprised 14 adolescents and young adults who visited a hospital for follow-up care after treatment of leukemia. We used in-depth interviews to examine the participants' experiences in returning to social life. The semistructured questionnaire examined "good and bad experiences in returning to social life," "sources of happiness and stress," and "strategies for managing stressful events."

RESULTS

We extracted 6 categories and 21 concepts from the interviews. We grouped the 6 categories into a core category and three phases: "catching up with others," "discovering myself," and "planning my future." A core category shown through all phases was "fear of recurrence." The "catching up with others" phase included themes of "feeling different from others" and "wanting to be like others." The "discovering myself" phase included "completing one thing at a time" and "recognizing myself as special." The "planning my future" phase included "looking for things I can do."

CONCLUSIONS

Self-esteem was an important issue for adolescent leukemia survivors; negative illness perception affected self-esteem in both adolescents and young adults. It is important for health care providers to develop programs to help adolescent and young adult leukemia survivors to perceive their disease experiences more positively and to take part in social life, including school life.

Young people's experiences of living with epilepsy: The significance of family resilience

OBJECTIVE

Young people with chronic illnesses, such as epilepsy, tend to have poorer psychosocial outcomes compared to their peers. Nevertheless, not all young people experience difficulties adapting to living with epilepsy. The aim of this study was to examine family processes, as little is known about their impact on young people's adaptation to the condition.

METHOD

Semi-structured interviews were conducted with 15 young people, aged between 13 and 16 years old, to explore their experiences of living with epilepsy from the perspective of family resilience.

RESULTS

Findings from these interviews provided in-depth descriptions of stressful circumstances encountered and family processes. These processes, which in turn promoted positive adaptation, included shared family beliefs, family connectedness, and communication processes that supported collaborative problem-solving.

CONCLUSION

Practitioners who support young people living with chronic conditions, such as epilepsy, should consider interventions that promote family connectedness, as it allows young people to turn to their families for support in times of stress. Additionally, it is important to explore young people's beliefs, helping them and their families construct a new sense of normality if necessary. Supporting open communication between family members, where differing views were acknowledged, is likely to be important in facilitating resilience.

Impaired responsibility dimension of self-esteem of Brazilian adolescents with epilepsy

This study aimed to compare the self-esteem of Brazilian adolescents with epilepsy and Brazilian adolescents without this condition and the correlations between self-esteem of these adolescents with depression and anxiety symptoms. Study participants were 101 adolescents of both sexes, aged 10-19years old, from elementary and high school education. Fifty patients diagnosed with uncomplicated epilepsy attending the pediatric epilepsy clinic of University Hospital composed the case group. The other fifty-one adolescents without this diagnosis were attending public schools in Campinas-SP region. The instruments used were: identification card with demographics and epilepsy data, Multidimensional Self-Esteem Scale, Beck Depression Inventory and Inventory of State-Trait Anxiety - IDATE. A statistically significant result was found in the Responsibility Self-esteem Dimension favoring the control group. Significant correlations between self-esteem scores and anxiety and depression symptoms were also found. The development of a chronic disease such as epilepsy leads to a change in the way the individual perceives himself and the social environment he is inserted, influencing his behavior. The way people with epilepsy experience their seizures is a subjective measure that will control his/her well-being. Childhood and adolescence form the basis for a healthy emotional development; thus, our results show the importance of studying how subjective variables relate to the physical aspects of a chronic disease in these life stages.