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Liu X, Li Y, Li L, Li J, Yang J, Huang L, Yao M, Yang L, Yang Q. The Potential Mediating Effect of Symptom Burden on Demoralization Through Locus of Control and Coping Strategies in Chinese Patients With Cancer. Cancer Nurs 2024:00002820-990000000-00237. [PMID: 38598755 DOI: 10.1097/ncc.0000000000001350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Demoralization is a psychological syndrome that is highly prevalent in patients with cancer and detrimental to individuals' physical and mental health. To explore effective intervention, we first determined the relationships between locus of control, coping strategies, symptom burden, and demoralization. OBJECTIVE The aim of this study was to determine the relationship between symptom burden, locus of control, coping strategies, and demoralization in patients with cancer. METHODS In this descriptive-correlational study, 273 valid patients were selected with convenience sampling method from a hospital in China. Data were collected using the Chinese version of the M.D. Anderson Symptom Inventory, the Chinese version of the Multidimensional Health Locus of Control Scale, the Chinese version of the Medical Coping Modes Questionnaire, and the Mandarin version of the Demoralization Scale. Data were analyzed using descriptive and inferential statistics using SPSS and AMOS. RESULTS A total of 115 patients (42.12%) experienced clinical demoralization (Mandarin version of the Demoralization Scale > 30). Symptom burden (β = 0.295, P < .001), confrontation (β = -0.117, P = .028), and resignation (β = 0.456, P < .001) had direct effects on demoralization. Symptom burden also had an indirect effect on demoralization through the mediating role of resignation (β = 0.026, P = .002). Meanwhile, locus of control can affect demoralization entirely through the indirect mediating role of coping strategies (chance locus of control via resignation [β = 0.138, P < .01], powerful locus of control via confrontation [β = -0.017, P < .05]). CONCLUSIONS Symptom burden affects demoralization not only directly but also indirectly. Coping strategies play an important mediating role between symptom burden, locus of control, and demoralization in patients with cancer. IMPLICATIONS FOR PRACTICE It is urgent to screen demoralization and identify patients with high symptom burden, maladaptive locus of control, or coping strategies. For the patients targeted, a more comprehensive and systematic approach to symptom management and more appropriate guidance related to adaptive coping strategies are needed.
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Affiliation(s)
- Xiaoxin Liu
- Author Affiliations: Clinic Nursing Teaching and Research Section (Ms Liu; Dr L. Li; Mss J. Li, J. Yang, Huang, Yao, and L. Yang; and Mrs Q Yang), Department of Oncology (Mss Liu, J. Yang, Huang, Yao, and L. Yang, and Mrs Q. Yang), and Patient Service Center (Ms Y. Li), The Second Xiangya Hospital of Central South University; Xiangya Nursing School, Central South University (Dr L. Li); and Department of General Surgery, The Second Xiangya Hospital of Central South University (Ms J. Li), Changsha, China
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Winarsunu T, Utami LA, Fasikhah SS, Anwar Z. Hope therapy: Can it treat hopelessness and internal locus of control on diabetes mellitus patients? PLoS One 2023; 18:e0286418. [PMID: 37310950 DOI: 10.1371/journal.pone.0286418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/16/2023] [Indexed: 06/15/2023] Open
Abstract
Patients with diabetes mellitus (DM) are always required to be able to control a healthy lifestyle throughout their life to avoid various diseases that can accompany the previous illness. However, psychological factors in the form of despair due to lack of hope make people with diabetes more depressed and less able to control behavior and maintain blood sugar stability, so an excellent internal locus of control is needed to be stronger. This study aimed to determine the effect of hope therapy in reducing hopelessness and increasing internal locus of control in people with DM. The research design used a experimental study with ten randomly selected respondents divided into two groups, namely the control group and the experimental group. Data retrieval using the locus of control scale and the beck hopelessness scale. Data analysis used non-parametric analysis, namely the Mann Whitney test, Wilcoxon test, and Spearman's Rank Correlation test. The results of the Mann-Whitney U test on the internal locus of control variable show a value of 0.000 and a p score of 0.008 (p <0.05), it can be concluded that there are differences in the internal locus of control in the experimental group compared to the internal locus of control in the control group. The hopelessness variable shows a value of 0.000 and a p score of 0.008 (p <0.05), this indicates that there is a difference in hopelessness in the experimental group and the control group. There is a decrease in hopelessness and an increase in internal locus of control in people with DM given hope therapy.
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Affiliation(s)
- Tulus Winarsunu
- Department of Psychology, University of Muhammadiyah Malang, Malang, Indonesia
| | - Lintang Aulia Utami
- Department of Psychology, University of Muhammadiyah Malang, Malang, Indonesia
| | | | - Zainul Anwar
- Department of Psychology, University of Muhammadiyah Malang, Malang, Indonesia
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Chen Y, Zhao H. Long-term care insurance, mental health of the elderly and its spillovers. Front Public Health 2023; 11:982656. [PMID: 36935677 PMCID: PMC10020345 DOI: 10.3389/fpubh.2023.982656] [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: 06/30/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
The paper studies the effects of the long-term care insurance (LTCI) program in China on the mental health of older adults and the wellbeing of their families. We employ the staggered difference-in-differences approach based on the LTCI pilots from 2015 to 2017. First, we find the LTCI program improves older adults' happiness and reduces depression symptoms significantly. The effects on the improvement in memory and cognition are associated with the elderly with activities of daily living-related need for care. Second, the effects of LTCI are partially mediated through providing community services, relieving care burdens, and reducing the incidence of diseases. More importantly, LTCI coverage improves caregivers' physical health and social activities, reflecting its welfare spillover effects. Furthermore, the relationship between LTCI and mental health differs due to the difference in LTCI designs and older adults' demographic characteristics. This presents a need to consider mental health in the services and evaluation criteria of LTCI.
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Affiliation(s)
- Yunfei Chen
- School of Economics, Shanghai University, Shanghai, China
| | - Hong Zhao
- School of Economics, Qingdao University, Qingdao, China
- *Correspondence: Hong Zhao
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Scheffers-Barnhoorn MN, Sharma-Virk M, van Balen R, van Eijk M, Achterberg WP. Coping strategies of older adults with a recent hip fracture within inpatient geriatric rehabilitation. Aging Ment Health 2022; 26:1436-1443. [PMID: 33663271 DOI: 10.1080/13607863.2021.1891199] [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] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Coping strategies may play an important role as facilitator or barrier for functional recovery after hip fracture. This study explored 1] active and passive coping strategies in hip fracture patients within inpatient geriatric rehabilitation (GR) 2] the association of these coping strategies with depression, anxiety, pain and health-related quality of life (HRQoL). METHOD Secondary data analysis (FIT-HIP trial). Participants were patients with hip fracture, aged 65+ years, admitted to post-acute GR units. Coping was assessed using the 'Active Tackling' and 'Passive Reacting' subscale of Utrecht Coping List (UCL). Depression, anxiety, pain and HRQoL was assessed using GDS-8, HADS-A, NPRS and EQ5D-VAS. Based on UCL norm tables - for both subscales - we dichotomized the group into (extremely) high use of this coping strategy i.e. 'predominantly active coping' (PAC), and 'predominantly passive coping' (PPC); versus their corresponding 'residual groups', i.e. the remaining participants. RESULTS 72 participants were included. Participants mostly used active coping (PAC: 33.3%), however those engaging in passive coping (23.6%) had significantly more depression and anxiety symptoms (GDS-8 ≥ 3: 31.1% respectively 9.1%, p = 0.040; HADS-A ≥ 7: 58.8% vs 10.9%; p = 0.00). CONCLUSION Active tackling and passive reacting coping strategies are used by up to one-third of patients with recent hip fracture. Passive coping was associated with more symptoms of depression and anxiety, which in turn may influence rehabilitation negatively. Screening of (passive) coping strategies could contribute to prompt identification of hip fracture patients at risk for negative health outcomes.
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Affiliation(s)
| | - Manju Sharma-Virk
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Romke van Balen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Monica van Eijk
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
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Moreira MTC, Gomes CS, Pinto JM. Influence of personal mastery on mobility disability among older adults: A systematic review. Arch Gerontol Geriatr 2022; 102:104750. [PMID: 35714474 DOI: 10.1016/j.archger.2022.104750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Personal mastery is a psychological resource recognized as a domain of quality of life that helps individuals cope with life strains. Despite its relevance, there is a lack surrounding the relationship between mobility disability and personal mastery. This study aimed to investigate the influence of personal mastery on mobility disability among older adults and identify the mechanisms that underlie this influence. METHODS A systematic review was conducted by searching four databases (i.e., PubMed, Scopus, ScienceDirect, and the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information) using combinations of the following words: mastery, personal mastery, self-control, mobility, disability, older adults, older people, and aging. We summarized and analyzed the findings of cross-sectional and longitudinal/prospective studies. RESULTS Twenty-one studies were included. There was high heterogeneity in how the studies had assessed mobility disability. Although a majority of the studies had used the Pearlin's Self-Mastery Scale (PSMS) to assess personal mastery, there were variations in the number of response anchors and scoring strategies that were used. Nevertheless, findings revealed that personal mastery influences mobility disability by acting as a protective resource against adverse outcomes among older adults. The authors of the reviewed articles had provided physiological and behavioral explanations for their findings. CONCLUSIONS Higher level of personal mastery can protect older adults from mobility disability, because it confers a sense of personal control, which in turn promotes positive physiological functioning and health behaviors. This knowledge contributes to the maintenance of physical functioning in old age.
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Affiliation(s)
| | - Cintia Sulino Gomes
- Undergraduate Program in Physical Therapy, Federal University of Triangulo Mineiro, Brazil.
| | - Juliana Martins Pinto
- Laboratory of Physical Therapy and Public Health, Department of Physical Therapy, Institute of Health Sciences, Federal University of Triangulo Mineiro, Brazil.
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Li Y, Chan WCH, Chen H, Ran M. Widowhood and depression among Chinese older adults: examining coping styles and perceptions of aging as mediators and moderators. Aging Ment Health 2022; 26:1161-1169. [PMID: 34121528 DOI: 10.1080/13607863.2021.1935455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objectives: Based on the stress-coping framework, this study examined the role of coping styles and perceptions of aging in the relationship between widowhood and depression through two alternative pathways-mediation and moderation-with a national probability sample of older adults in China.Method: The data came from the baseline wave of the China Longitudinal Aging Social Survey of 2014. Our final sample featured 8,404 older adults.Results: The results of structural equation modeling showed a good fit for the total sample (NFI = .909, IFI = .916, GFI = .963, RMSEA = .038) and indicated the significant direct impact of widowhood on depression among Chinese older adults. Moreover, the findings of mediating effects found compared with a married group, widowed older adults used less problem-focused coping and had more negative perceptions of aging, which in turn, predicted higher depression; they were also more likely to use emotion-focused coping, which in turn, predicted lower depression. The results of moderation analysis demonstrated that a higher level of negative perceptions of aging significantly worsened the adverse effects of widowhood on depression.Conclusion: Overall, our findings highlight the importance of a cognitive approach to targeting programs for widowed older adults in China, with a focus on strengthening their abilities to alter maladaptive copings styles and reauthor their life narratives.
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Affiliation(s)
- Yunjun Li
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, China
| | - Wallace Chi Ho Chan
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, China
| | - Honglin Chen
- Department of Social Work, Fudan University, Shanghai, China
| | - Maosheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
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Association between Agility, Health-Related Quality of Life, Depression, and Anthropometric Variables in Physically Active Older Adult Women with Depression. Healthcare (Basel) 2022; 10:healthcare10010100. [PMID: 35052264 PMCID: PMC8775181 DOI: 10.3390/healthcare10010100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction. Depressive disorders are mental disorders that last over time, and seriously affect the lives of the people who suffer from them, diminishing their quality of life, reducing their motor capacity, and incapacitating them in their daily lives. It is a major problem worldwide. Objective. To study the association between agility, health-related quality of life (hrqol), anthropometric status, and depression status in older adult women with depression. Design. Data collected from 685 physically active older women with depression were analyzed. Result. A moderate inverse correlation (r = −0.34) is shown between Time Up & Go (TUG) and EuroQol Five-Dimensional Three-Level Version (EQ-5D-3L). Between TUG and Geriatric Depression Scale (GDS), there is a small direct correlation (r = 0.14) between them. Between TUG and anthropometric data, all observed correlations are significant. Conclusions. There is a significant association between agility, health-related quality of life, depression, and anthropometric data in physically active older women with depression.
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Tan MM, Su TT, Ting RSK, Allotey P, Reidpath D. Religion and mental health among older adults: ethnic differences in Malaysia. Aging Ment Health 2021; 25:2116-2123. [PMID: 32741203 DOI: 10.1080/13607863.2020.1799939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Religion and spirituality gain importance as a person ages. Research has shown that religion has a salutary effect on mental health, and it is associated with health differently across ethnic groups. The current study examined ethnic differences in the association between religion and mental health among older adults in a predominantly Muslim population and multicultural setting. METHODS Data of 7068 participants (4418 Malays, 2080 Chinese and 570 Indians) aged ≥55 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory (SEACO) were analyzed using bivariate and multiple regressions. Analyses were stratified by ethnicity. RESULTS The importance of having an enriched religious/spiritual life was associated with higher scores of depression, anxiety and stress among Chinese and higher score of depression among Malays, while belief in a higher power was associated with better mental health among Malays, Chinese and Indians. CONCLUSION The current study showed that there were ethnic variations in the associations between religion and mental health, and the associations depended on the religious variable included in the analysis. The findings of this study showed that religion could be another potential channel to improve mental health among older adults by accommodating and understanding their religious beliefs.
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Affiliation(s)
- Min Min Tan
- South East Asia Community Observatory (SEACO), Monash University, Selangor, Malaysia.,Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Monash University, Selangor, Malaysia.,Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia
| | - Rachel Sing-Kiat Ting
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia.,International Institute for Global Health, United Nations University, Cheras, Malaysia
| | - Daniel Reidpath
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia.,International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Psychological Resources and Driving Status: A Study of Current and Former Drivers 55 Years of Age and Older. Can J Aging 2021; 40:396-404. [PMID: 34053474 DOI: 10.1017/s0714980820000434] [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: 11/07/2022] Open
Abstract
Psychological resources can help individuals adjust to changes associated with aging. In this study, we examined the effect of demographic, health, and psychological resource variables in explaining driving status among adults 55 years and older. A convenience sample of 222 adults between the ages of 55 and 91 years (mean = 72.20 years) completed questionnaires that included measures of driving status, self-rated health, and psychological resources (e.g., life control, life purpose, and locus of control). Multiple logistic regression models that controlled for confounders were constructed with driver status (i.e., current driver or former driver) as the outcome. Former drivers were older, reported being in poorer health, and reported more depression symptoms. After controlling for age and health, current drivers reported higher levels of life control and life purpose and a more internal locus of control. Results highlight the importance of considering psychological resources when examining driving cessation.
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Halse I, Bjørkløf GH, Engedal K, Rokstad AMM, Persson K, Eldholm RS, Selbaek G, Barca ML. Applicability of the locus of control of behaviour scale for people with dementia. Aging Ment Health 2020; 24:2111-2116. [PMID: 31402698 DOI: 10.1080/13607863.2019.1652244] [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] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the applicability of the Locus of Control of Behaviour scale (LoCB) for people with dementia. METHOD A sample of 534 participants with dementia (78.4 mean age, 58% female) were included. Assessment included the LoCB, the Montgomery-Aasberg Depression Rating Scale (MADRS), the Mini-Mental Status Examination Norwegian revised (MMSE-NR) and the Instrumental Activities of Daily Living (I-ADL). Completion percentages and internal reliability of LoCB were examined for predefined MMSE-NR groups (0-4, 5-9, 10-14, 15-19, 20-24, 25-27, and 28-30). Factors associated with completion were analysed, and a principal component analysis (PCA) of the LoCB was performed. Sum score and component subscale scores were compared to MADRS and MMSE-NR scores. RESULTS In total, 234 participants completed the LoCB. Completion percentages ranged from 74% (MMSE-NR 28-30) to 0% (MMSE-NR 0-9). Internal reliability was between 0.80 and 0.72 in groups with MMSE-NR > 9, except in MMSE-NR 20-24 (0.52). Age, MMSE-NR and education were associated with completion. The PCA yielded three components - powerful others, internal, and luck/fate - with explained variance of 41.3%. Participants with MADRS > 7 scored higher on the LoCB sum score, powerful others and internal subscale scores. No difference was found regarding the luck/fate subscale score. MMSE-NR did not affect LoCB scores. CONCLUSION Older age, less education, and more cognitive impairment decreased the likelihood of completion. However, psychometric test results indicate that those who completed the LoCB understood the questions, even with severe cognitive impairment. We conclude, therefore, that the LoCB is applicable for investigating control orientation among people with dementia.
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Affiliation(s)
- Ingeborg Halse
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Karin Persson
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
| | - Rannveig Sakshaug Eldholm
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Geriatrics, St. Olavs Hospital, Trondheim, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maria Lage Barca
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
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Maaswinkel IM, van der Aa HPA, van Rens GHMB, Beekman ATF, Twisk JWR, van Nispen RMA. Mastery and self-esteem mediate the association between visual acuity and mental health: a population-based longitudinal cohort study. BMC Psychiatry 2020; 20:461. [PMID: 32972387 PMCID: PMC7513319 DOI: 10.1186/s12888-020-02853-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/03/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND With deteriorating eyesight, people often become dependent on others for many aspects of their daily lives. As a result, they feel less 'in control' and experience lower self-esteem. Lower sense of mastery and self-esteem are known to predict depression, but their roles in people with visual impairment have only marginally been investigated. Therefore, this study aimed to determine the influence of mastery and self-esteem on the relationship between visual acuity and mental health. METHODS A longitudinal cohort study was performed using data from the Longitudinal Aging Study Amsterdam (LASA), collected between 2001 and 2012. A community-based population of 2599 older adults were included, who were randomly selected from population registers. Outcomes of interest were the Pearlin Mastery Scale, Rosenberg Self-Esteem Scale, Center for Epidemiologic Studies - Depression scale and the Hospital Anxiety Depression Scale - Anxiety subscale. Linear mixed models were used to establish the association between visual acuity and mental health over time. RESULTS Mean age was 72 years, 56% was female and 1.2% qualified as having low vision. Visual impairment was associated with a lower sense of mastery (β = - 0.477, p < 0.001), lower self-esteem (β = - 0.166, p = 0.008) and more depression (β = 0.235, p < 0.001). No significant association between visual acuity and anxiety was found. The relationship between visual acuity and depression was mediated by self-esteem (25%) and sense of mastery (79%). CONCLUSIONS Vision loss was associated with depression. This association was mediated by self-esteem and sense of mastery. This provides us with new possibilities to identify, support and treat those at risk for developing depression by aiming to increase their self-esteem and sense of mastery.
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Affiliation(s)
- I. M. Maaswinkel
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - H. P. A. van der Aa
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - G. H. M. B. van Rens
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.414480.d0000 0004 0409 6003Elkerliek Hospital, Ophthalmology, Helmond, The Netherlands
| | - A. T. F. Beekman
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, The Netherlands
| | - J. W. R. Twisk
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - R. M. A. van Nispen
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Abstract
Background and objectives: We explore the internal and external resources that older adults use to negotiate adversity and related to later life. We investigated the experiences older adults had with adversity and explored the factors that promote and protect resilience and the how these factors shaped the process of managing adversity related to aging.Research design and methods: Semi-structured interviews were conducted with 64 resilient adults ranging in age from 53 to 94 years of age, with an average of 71. Participants were defined as resilient on the basis of their willingness to identify as such. Grounded Theory coding techniques were applied to identify themes reflecting distinct ways in which participants dealt with what they indicated were the most significant hardships and adversities in their lives.Results: What emerged from the narratives about resilience and adversity were accounts of expressions of resilience that reflected the importance in having a resilient identity. Three major themes reflecting psychological and behavioral factors were derived from the data: 1. having vital components of resilience, or behaviors and beliefs in place, that encompass resilience as a way of being; 2. a broad but articulate set of strategies that participants actively engaged with to manage adversity, and 3. a set of protective practices used to prevent risk and prevail in the face of hardship.Discussion and implications: Findings suggest that dealing with adversity in later life requires the use of substantial internal and external resources in what can characterized as a proactive fashion. The results are presented as an interpretation of the participants' perceptions of their resilience and the role it plays in self-concept, strategic planning, and proactive practices. Implications for helping to put resilience into everyday practice are considered.
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Affiliation(s)
- Lydia K. Manning
- College of Graduate Studies and the Division of Human Services at Concordia University-Chicago
| | - Lauren Bouchard
- Concordia University-Chicago in Leadership and Gerontology. Concordia University-Chicago, 7400 Augusta Street, River Forest, IL 60305
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Thumala D, Gajardo B, Gómez C, Arnold-Cathalifaud M, Araya A, Jofré P, Ravera V. Coping processes that foster accommodation to loss in old age. Aging Ment Health 2020; 24:300-307. [PMID: 30596452 DOI: 10.1080/13607863.2018.1531378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: Flexible adjustment or accommodation to loss is healthy; however, little is known about how it can be achieved in old age. We sought to identify and characterize effective coping processes for achieving accommodation at this stage of life. Our aim was to foster the activation of the psychological resources of those who must deal with significant losses to which they will inevitably need to adapt.Method: Qualitative study with a sample of men (n = 16) and women (n = 19) aged 60 years and up. Information was collected through observation and content analysis applied to 35 in-depth interviews, using Atlas-Ti (v7).Results: Eighteen coping processes implemented in response to loss were identified and characterized. Although no single process led to full adjustment by itself, the difference between the participants who accommodated and those who lacked accommodation was reflected in the predominance of certain processes. This approach enabled us to identify 13 effective processes, such as the search for meaning and the use of humor, which were generally used by participants who had achieved accommodation. The processes regarded as ineffective, such as avoidance and procrastination, were used more often by those who displayed insufficient accommodation.Conclusion: It was confirmed that accommodation to losses in old age not only results from "the passage of time"; rather, it can be fostered by people's active efforts. Knowledge of these practices can help practitioners orient mental health interventions for older adults who have difficulty coping in healthy ways and preserving their subjective well-being.
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Affiliation(s)
- Daniela Thumala
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile.,Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Bárbara Gajardo
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Camila Gómez
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | | | - Alfonso Araya
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Pamela Jofré
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Valeria Ravera
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
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14
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Tuna E, Balcı Ş. Associated Factors of Psychological Symptoms Among Unemployed Turkish Adults: The Role of Personality Factors and Rumination. Psychol Rep 2019; 123:1557-1577. [PMID: 31735117 DOI: 10.1177/0033294119886251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Unemployment has been associated with adverse mental health outcomes including depression and suicide. In the last decades, unemployment rates have increased substantially in Turkey; yet, factors and mechanisms that play a role in experiencing psychological symptoms among unemployed individuals are not well understood. The aim of this study was to investigate the role of personality characteristics on psychological symptoms among unemployed Turkish adults and to test the mediating role of rumination as a dysfunctional cognitive strategy. The sample consisted of 217 unemployed Turkish adults who completed self-report measures on neuroticism, external locus of control, rumination, and psychological symptoms. The results of the structural equation modeling indicated that rumination partially mediated the relationship between personality variables (i.e., neuroticism and external locus of control) and psychological symptoms, thus verifying the hypothesis of the study. The direct paths from trait neuroticism and external locus of control to psychological symptoms were also significant. Results revealed that a tendency to attribute future outcomes to external factors and an increased tendency to experience negative emotions are associated with engaging passively in rumination, which in turn predicts psychological symptoms. Interventions are suggested to focus on effective coping strategies along with increasing individuals' perceived control over life and future.
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Affiliation(s)
- Ezgi Tuna
- Department of Psychology, Çankaya University, Ankara, Turkey
| | - Şeyma Balcı
- Department of Psychology, Çankaya University, Ankara, Turkey
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15
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Musich S, Wang SS, Slindee L, Kraemer S, Yeh CS. The impact of internal locus of control on healthcare utilization, expenditures, and health status across older adult income levels. Geriatr Nurs 2019; 41:274-281. [PMID: 31727348 DOI: 10.1016/j.gerinurse.2019.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 10/24/2019] [Indexed: 02/08/2023]
Abstract
Our objectives were to 1) determine the prevalence of locus of control (LOC) dimensions stratified by older adult income levels; 2) characterize internal LOC attributes within income subgroups; and 3) investigate LOC associations with healthcare utilization and expenditures; self-rated health and functionality. The survey sample was identified from adults age ≥65 years with diagnosed pain conditions. Internal LOC characteristics were determined from logistic regressions; outcomes regression-adjusted. Among respondents, internal prevalence for low (N = 554), medium (N = 1,394) and high income (N = 2040) was 27%, 30% and 30%, respectively. Internal was associated with high resilience, less stress, exercise and less opioid use across income levels. Lower-income internal was additionally associated with diverse social networks, physical therapy and less drug use. Those with high internal generally had lower healthcare utilization and expenditures; better self-rated health and functionality. Internal LOC is a powerful positive resource associated with better health outcomes, especially influential for lower income.
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Affiliation(s)
- Shirley Musich
- Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, United States.
| | - Shaohung S Wang
- Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, United States.
| | - Luke Slindee
- Optum Enterprise Analytics, 11000 Optum Circle, Eden Prairie, MN 55344, United States.
| | - Sandra Kraemer
- Medicare & Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN 55440, United States.
| | - Charlotte S Yeh
- AARP Services, Inc., 601 E. Street, N.W., Washington, D.C. 20049, United States.
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16
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Musich S, Wang SS, Slindee L, Kraemer S, Yeh CS. The association of pain locus of control with pain outcomes among older adults. Geriatr Nurs 2019; 41:521-529. [PMID: 31078323 DOI: 10.1016/j.gerinurse.2019.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 11/30/2022]
Abstract
Our primary objective was to 1) determine the prevalence of pain locus of control (LOC) subscales in a population of older adults with pain conditions, and 2) estimate their associated protective effects on pain outcomes. A mailed survey was sent to a stratified sample of older adults age≥65 with diagnosed back pain, osteoarthritis and/or rheumatoid arthritis. Multivariate logistic regression modeling was used to determine the relative protective associations of positive resources, including LOC, resilience and social networks, on pain outcomes. Among respondents (N = 3,824), 31% were identified as internal; 34% as powerful others; and 35% as chance. In adjusted models, internal was associated with outcomes of lower pain severity, reduced chronic opioid use and increased physical functionality. Powerful others was partially protective; chance was associated with the poorest outcomes. Multidimensional pain programs should incorporate the enhancement of positive resources, including LOC, to maximize the effectiveness of pain management strategies.
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Affiliation(s)
- Shirley Musich
- Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, United States.
| | - Shaohung S Wang
- Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, United States.
| | - Luke Slindee
- Informatics & Data Science, Optum, 12700 Whitewater Drive, Minnetonka, MN 55343, United States.
| | - Sandra Kraemer
- Medicare & Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN 55440, United States.
| | - Charlotte S Yeh
- AARP Services, Inc., 601 E. Street, N.W., Washington, DC 20049, United States.
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17
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Seah B, Kowitlawakul Y, Jiang Y, Ang E, Chokkanathan S, Wang W. A review on healthy ageing interventions addressing physical, mental and social health of independent community-dwelling older adults. Geriatr Nurs 2019; 40:37-50. [DOI: 10.1016/j.gerinurse.2018.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/01/2018] [Indexed: 01/23/2023]
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18
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Clark EM, Williams BR, Huang J, Roth DL, Holt CL. A Longitudinal Study of Religiosity, Spiritual Health Locus of Control, and Health Behaviors in a National Sample of African Americans. JOURNAL OF RELIGION AND HEALTH 2018; 57:2258-2278. [PMID: 29322285 PMCID: PMC6039282 DOI: 10.1007/s10943-017-0548-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present longitudinal study examined religious beliefs and behaviors, spiritual health locus of control (SHLOC), and selected health-related behaviors and outcomes in a national sample of 766 African American adults. Participants were interviewed by telephone three times over a 5-year period. Results indicated that stronger religious beliefs and religious behaviors were associated with greater changes in active SHLOC. There was some evidence of direct effects of religious beliefs and behaviors on changes in health behaviors. Religious behaviors were related to greater passive SHLOC over time across some health outcomes. Passive SHLOC was associated with some less desirable health outcomes over time.
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Affiliation(s)
- Eddie M. Clark
- Department of Psychology, Saint Louis University, Morrissey Hall, 3700 Lindell Blvd., St. Louis, MO 63108, USA. . Phone: (314) 977-2272
| | - Beverly Rosa Williams
- UAB Comprehensive Center for Healthy Aging, CH19 218K, 1720 2nd Ave S, Birmingham, AL 35294-1304, USA. . Phone: (205) 789-5814
| | - Jin Huang
- Center on Aging and Health, Johns Hopkins University, Baltimore MD, 21205, USA. . Phone: (410) 502-6635
| | - David L. Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore MD, 21205, USA. . Phone: (410) 955-0491
| | - Cheryl L. Holt
- Department of Behavioral and Community Health, 1234W School of Public Health Bldg. (255), 422 Valley Drive, School of Public Health, University of Maryland, College Park, MD 20742, USA. . Phone: (301) 405-6659
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Kurtović A, Vuković I, Gajić M. The Effect of Locus of Control on University Students' Mental Health: Possible Mediation through Self-Esteem and Coping. THE JOURNAL OF PSYCHOLOGY 2018; 152:341-357. [DOI: 10.1080/00223980.2018.1463962] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Ana Kurtović
- Faculty of Humanities and Social Sciences Osijek
| | - Iva Vuković
- Faculty of Humanities and Social Sciences Osijek
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20
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Stroke Patients Motivation Influence on the Effectiveness of Occupational Therapy. Rehabil Res Pract 2018; 2018:9367942. [PMID: 30155309 PMCID: PMC6091285 DOI: 10.1155/2018/9367942] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/30/2018] [Indexed: 11/18/2022] Open
Abstract
Introduction Individuals who have experienced stroke are often described as apathetic, having lost of interest, and unmotivated. This might be a problem in achieving treatment results. It is still unclear what impact age and gender have on the motivation. The Aim of Research To evaluate motivation influence on the effectiveness of occupational therapy in patients with stroke. Methods Study included 30 patients who experienced acute stroke. Multidimensional Health Locus of Control (MHLC) scale has been used for motivation assessment. Internal persons' motivation was evaluated to determine how much a person believes that his recovery depends on his own behaviour and external persons' motivation—how a person relates his state of health to the impact of the surrounding people. Performance of daily activities was assessed using Functional Independency Measure (FIM). Results At the beginning of rehabilitation of the patients with stroke, external motivation was greater than the internal one. At the end of rehabilitation internal motivation has increased by 1.8±0.4 points, while the external motivation decreased by 2.4±0.6 points (p<0.05). At the beginning of rehabilitation patients independence in activities of daily living assessed with FIM was 70.0±2.9 points. At the end of rehabilitation their ability to perform daily activities improved by 26.9±1.9 points and reached 96.9±2.7 points (p<0.05). We found statistically significant (p<0.05) moderate correlation (r=0.72) between patients internal motivation at the beginning of the rehabilitation and increase of independence after rehabilitation. Conclusion Older patients had lower internal motivation than younger ones, and independence in daily activities improvement was influenced by younger age and by brain damage depth.
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Calado GDA, Rigon IB, Moritz JLW, Wolf P, Lin K. Cross-cultural adaptation of Rotter's General Locus of Control instrument. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:66-71. [DOI: 10.1590/2237-6089-2017-0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/05/2018] [Indexed: 01/27/2023]
Abstract
Abstract Objective To perform a cross-cultural adaptation of the General Locus of Control (GLoC) questionnaire, which measures where people place causation of events in their lives, i.e., if they interpret events as being the result of their own actions or external factors. Methods After translation and back-translation, a multidisciplinary committee judged and elaborated different versions of the GLoC questionnaire, with a focus on conceptual equivalence, content, comprehensibility and adjustment to the Brazilian socioeconomic context. The final version was tested on 71 healthy subjects, of whom 36 were reinterviewed and answered the GLoC questionnaire twice, after a mean of 73.06±74.15 days (range = 29-359). Results The participants' mean age was 30.82±12.83 years (range = 18-69), 62% were women, and mean years of schooling were 12.54±4.21. Test-retest reliability (Pearson's) was r = 0.828. Internal consistency resulted in a Cronbach's alpha of 0.906. The mean GLoC score obtained was 8.77±3.11 (n = 71). Conclusion The Portuguese version of the GLoC questionnaire is a faithful adaptation of Rotter's original questionnaire.
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Affiliation(s)
| | | | | | - Peter Wolf
- UFSC, Brazil; UFSC, Brazil; Danish Epilepsy Centre, Denmark
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22
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Bjørkløf GH, Engedal K, Selbæk G, Maia DB, Borza T, Benth JŠ, Helvik AS. Can depression in psychogeriatric inpatients at one year follow-up be explained by locus of control and coping strategies? Aging Ment Health 2018; 22:379-388. [PMID: 28051894 DOI: 10.1080/13607863.2016.1262817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Treatment of depression (in late life) is good. The short-term, but not long-term prognosis after treatment of depression in late life is good. To identify modifiable factors, we wanted to examine whether coping in terms of locus of control and coping strategies in depressed patients were associated with the prognosis of depression at follow-up, adjusted for sociodemographic information and health variables. METHOD In total, 122 patients (mean age 75.4 years; SD = 6.6) were followed up (median 13.7 months, Q1-Q3 386-441) with a diagnostic evaluation(ICD-10) for depression and assessment of depressive symptoms (MADRS). Coping was assessed using Locus of Control of behavior (LoC-scale) and Ways of Coping questionnaire (WoC-scale). RESULTS At follow-up, 37.7% were diagnosed with a depressive episode. A stronger external LoC and lower MMSE-NR score at baseline were in adjusted linear regression analysis significantly more associated to higher depressive symptom scores (MADRS). More use of problem-focused coping, a lower I-ADL functioning, but not emotion-focused coping at baseline were significantly associated with being depressed (ICD-10), at follow-up in adjusted logistic regression analysis. CONCLUSION LoC and coping strategies at baseline were associated with the prognosis of depression at follow-up, and may further be studied as indicators for choice of baseline intervention strategies.
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Affiliation(s)
- Guro Hanevold Bjørkløf
- a Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust , Tønsberg , Norway.,b Department for Mental Health Research and Development, Division for Mental Health and Addiction , Vestre Viken Hospital Trust , Lier , Norway.,c Institute of Health and Society, Faculty of Medicine , University of Oslo , Oslo , Norway
| | - Knut Engedal
- a Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust , Tønsberg , Norway
| | - Geir Selbæk
- a Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust , Tønsberg , Norway.,d Centre for Old Age Psychiatric Research Innlandet Hospital Trust , Ottestad , Norway.,e National School of Public Health, Fundação Oswaldo Cruz , Rio , Brazil
| | - Deborah Bezerra Maia
- f Department of Public Health and General Practice, Faculty of Medicine , Norwegian University of Science and Technology (NTNU)
| | - Tom Borza
- d Centre for Old Age Psychiatric Research Innlandet Hospital Trust , Ottestad , Norway
| | - Jūratė Šaltytė Benth
- g St Olav's University Hospital , Trondheim , Norway.,h Institute of Clinical Medicine, Campus Ahus, University of Oslo , Norway
| | - Anne-Sofie Helvik
- a Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust , Tønsberg , Norway.,i HØKH, Research Centre , Akershus University Hospital , Norway
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Gómez-Gallego M, Gómez-García J, Ato-Lozano E. The mediating role of depression in the association between disability and quality of life in Alzheimer's disease. Aging Ment Health 2017; 21:163-172. [PMID: 26513472 DOI: 10.1080/13607863.2015.1093603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND An understanding of the determinants of quality of life in Alzheimer's disease (AD) is required in order to develop effective interventions to promote patients' well-being. Most studies have pointed out depression, functional ability and environmental factors. However, unmeasured confounders can jeopardize the interpretation of the results. OBJECTIVES To explore the mediating role of depression in the association between functional status and QoL, and establish a procedure to detect confounding variables. METHODS A sample of 192 AD patients and their respective caregivers were recruited from day centers and health care centers in the region of Murcia (Spain). The mediating effect was evaluated using causal mediation analysis. Covariates were introduced into the model in a stepwise fashion and sensitivity analyses were performed to assess the influence of potential confounders. RESULTS Self-rated depression acted as a partial mediator between functional status and quality of life. The mediating effect was positive and significant even after including both patient- and caregiver-related covariates. Only if confounders explained more than 80% of the residual variance in the mediator or in the outcome, the mediating effects would not be positive. CONCLUSIONS The effect of lack of autonomy on the QoL is mostly explained by the negative consequences on mood status. The sensitivity analysis confirms the robustness of this finding.
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Affiliation(s)
- María Gómez-Gallego
- a Department of Psychology, Faculty of Health Sciences , Catholic University of Murcia , Murcia , Spain
| | - Juan Gómez-García
- b Department of Quantitative Methods, Faculty of Economics , University of Murcia , Murcia , Spain
| | - Ester Ato-Lozano
- c Department of developmental psychology, Faculty of Psychology , University of Murcia , Murcia , Spain
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