Exploring the validity of the Affect Balance Scale with a sample of family caregivers

Individual antecedents of workplace victimisation: The role of negative affect, personality and self-esteem in junior doctors' exposure to bullying at work

Previous studies have indicated that junior doctors commonly experience workplace bullying and that it may adversely impact medical training and delivery of quality healthcare. Yet, evidence on the precursors of bullying among them remains elusive. Drawing on the individual-disposition hypothesis, the present paper examined the relationships of negative affect, personality and self-esteem with workplace bullying among junior doctors. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia using mixed effects logistic regression was performed. The results indicate that participants with moderate (AOR 4.40, 95% CI 2.20-8.77) and high degree (AOR 13.69, 95% CI 6.46-29.02) of negative affect as well as high degree of neuroticism (AOR 2.99, 95% CI 1.71-5.21) have higher odds of being bullied compared to their counterparts. The findings present evidence that individual traits are associated with junior doctors' exposure to bullying. While victim blaming should be avoided, this suggest that antibullying measures with an interpersonal focus should be considered when developing antibullying initiatives targeted at junior doctors. This includes primary intervention such as cognitive training, secondary interventions such as resource enhancement building and conflict management skills training, and tertiary interventions such as counselling.

Penile transplantation: the US experience and institutional program set-up

Penile transplantation using vascularized composite allografts is an emerging technique to treat genital loss. In the United States, this procedure has been performed successfully at Massachusetts General Hospital in a patient who had previously undergone treatment for penile cancer. The Johns Hopkins Medical Institutions has developed a research protocol to perform penile transplantation in patients with genital loss secondary to trauma. The process of selecting the appropriate candidate for genitourinary (GU) vascularized composite allograft surgery is rigorous including extensive physical examination, laboratory testing, imaging and psychological evaluations. After transplantation, limiting the potential complications associated with immunosuppression is critical given that the procedure is intended to improve quality of life and is not life-saving. Ultimately, penile transplant is a surgical intervention which may have numerous applications. Optimization of the pre-operative screening process, surgical technique, and immunosuppressive protocol is required to establish this method as the standard treatment for patients with genital loss and limited reconstructive options.

Identifying Motives of Midlife Black Triathlete Women Using Survey Transformation to Guide Qualitative Inquiry

Demonstrating health disparities related to race, age, and gender, older Black women (BW) are the most sedentary demographic group in the United States. Increasing PA in mid-life is important, as it improves health as BW age into their later years. Advancing our understanding of the exercise motives of BW triathletes presents a "reverse engineering" opportunity to identify motives that could influence sedentary mid-life BW to increase their activity. The purposes of this study were to: (a) utilize an innovative survey transformation method to adapt a measure developed primarily in Caucasian males, i.e., the Motivations of Marathoners Scale for Triathletes (MOMS-T) into a qualitative interview guide for use with BW triathletes; (b) use this interview guide to identify culturally based motives for triathlon participation among BW not previously addressed by the MOMS-T and; (c) interpret the novel motivational domains of the MOMS-T discovered, in order to gain understanding and influence subsequent interventions. Purposive sampling was used to select 12 interview participants from 121 self-identified Black female US residents aged ≥36 years with recent experience completing or training for a triathlon. The interviews identified four culturally based themes, including improving body composition to become "more lean", physical attractiveness, triathlete family, and camaraderie. These novel themes were related to existing MOMS-T scales, but the current MOMS-T questions did not illuminate their culturally distinct aspects. The process of survey transformation provides a viable approach to identify important culturally based characteristics and to adapt surveys to cultural minority populations, particularly when study resources are limited.

A one-year follow-up study of family caregivers of institutionalized elders with dementia

The purpose of this one-year follow-up study was to determine whether the caregiving experience of primary caregivers (N = 142) of institutionalized demented elders changed over time and to identify the factors predictive of caregiver well-being after a year. Based on the stress and coping model of Lazarus and Folkman, five dimensions of this experience were considered: caregivers’ stressors, their cognitive appraisal of these stressors, social support, coping strategies and well-being (psychological distress and positive affect). MANOVA and t test results revealed that two stressors changed over time. The elders’ functional impairment deteriorated and their depressive behaviors decreased. However, there was no change in the appraised disturbance associated with these stressors. Conflicts in informal social support decreased significantly, but there was no change in well-being. More formal support at T1 was predictive of decreased psychological distress and increased positive affect at T2. A coping strategy, the use of affective regulation at T1, was also predictive of increased positive affect at T2. Knowledge of the caregiving experience over time and of predictors of caregiver well-being provides guidelines for interventions that could be directed at this clientele by health care workers in institutional settings.

Predictors of the Psychological Well-Being of Primary Caregivers Living With a Demented Relative: A 1-Year Follow-Up Study

This 1-year follow-up study aimed to examine the predictors of change in psychological well-being, using two negative indicators (psychological distress and negative feelings about the caregiver role) and two positive indicators (positive feelings about the caregiver role and positive affect) of well-being. The sample consisted of primary caregivers (n = 180) cohabiting with a demented relative. Four variables were involved in predictive relationships with psycho logical well-being The first variable, appraisal of the disturbance from dysfunctional behaviors at Time 1, was selectively predictive of an increase in the two negative indicators over a year. The second and third variables, increased conflicts in the exchange of informal support and less frequent informal support at Time 1, were predictive of an increase in psychological distress. The fourth variable, frequent use of affective-stimulative dementia management strategies at Time 1, appeared to predict an increase in the two positive indicators of well-being. Knowledge of these four predictors can be useful in designing interventions that target the improvement of well-being.

Surfing the Net in Later Life: A Review of the Literature and Pilot Study of Computer Use and Quality of Life

The Internet offers new opportunities for communication that can help older adults avoid social isolation. Although elders may need more time and assistance in learning computer systems, many are embracing this new technology. There is growing potential not only for recreation and communication through the Internet but also the delivery of services. This study examines the feasibility of providing Internet and electronic mail access to older adults in a retirement community and the extent to which this improves psychosocial well-being. In contrast to members of a comparison group, a trend toward decreased loneliness was observed among participants. In addition, the number of computer-related problems decreased and use of the applications increased throughout the study. These preliminary results support the feasibility of implementing computer-based interventions with the potential of improving psychosocial well-being among older adults.

Confirmatory Analysis of the Bradburn Affect Balance Scale and its Relationship with Morale in Older Canadian Adults

La mesure des constructions psychologiques dépend des définitions objectives et des relations démontrées entre les items, les échelles et les théories pertinentes. Dans cette étude nous avons examiné ces relations pour la mesure de l’émotion telle que reflétée par l’«Affect Balance Scale» de Bradburn . Les résultats des analyses confirmatoires des données de 187 adultes canadiens âgés (âge moyen: 69.7) montrent qu’une structure bidimensionnelle rend mieux compte des données que le modèle unidimensionnel bipolaire suggéré par la clé de correction originale. Les deux dimensions, cependant, ont montré des modèles parallèles de corrélations avec deux mesures du« morale » et une mesure de la désirabilité sociale, mais ces modèles différaient du score d’ABS unidimensionnel classique. Les résultats suggèrent que l’«Affect Balance Scale» de Bradburn devrait être utilisée prudemment et qu’il faut rendre le score de deux dimensions faciles à distinguer.

What is a missed dose? Implications for construct validity and patient adherence

The construct 'missed dose' is central to many assessments of medication adherence. However, few studies have investigated how patients or clinicians conceptualize missed doses or the extent of the concordance or discordance between clinicians and patients. To address this gap we conducted semi-structured interviews with 45 sero-positive African American adults taking HAART and 17 of their clinicians. Results reveal large variability in missed dose conceptions among both patients and physicians and significant differences between the two groups. Overall, patients reported a stricter definition of missed dose than did clinicians. Fifty-five percent of patients thought that a pill-taking delay of six hours beyond the prescribed dosing time constituted a missed dose, by comparison, only one physician agreed with this assessment. More than one-third of patients thought that the proper response to a missed dose would be to skip it altogether, but only about 12% of clinicians agreed. These findings have implications for the construct validity of self-report measures of adherence, for patient adherence behaviours based on missed dose conceptions and for patient-physician relationships and communication within the clinical environment.

Role integration and perceived health in Asian American women caregivers

In this study, role involvement, role integration (including role stress and role satisfaction), and perceived health were examined in 50 Asian American women who were caregivers of aging parents in addition to being wives, mothers, and employees. Their mean age was 47.8 years. Twenty-nine of the participants were Chinese and 21 Filipino, with an average length of caregiving for each group of 11 years. All participants were born outside the United States. Instruments used in the study were translated and back-translated into Chinese and Tagalog and tested for validity and reliability. The association of role involvement, role integration, role stress, and role satisfaction with perceived physical and psychological health in the combined and separate groups was examined. Role involvement was not associated with health in the combined group of caregivers but was associated with overall health in the sample of Chinese women. Role integration was positively associated with all three perceived health measures in the Filipino group but not in the Chinese group. Role satisfaction was consistently high in both groups. Role satisfaction and psychological well-being were significantly correlated for the combined group and for the Filipino caregivers. Total role stress was significantly correlated with overall health and current health only in the combined group. Thus, support that helps to decrease role stress and to increase role satisfaction may be more effective than efforts to decrease the extent of role involvement.

Is there a difference between family caregiving of institutionalized elders with or without dementia?

Based on the stress and coping model of Lazarus and Folkman, the aim of this comparative study was to determine whether the caregiving experience of the caregivers of an institutionalized demented relative is different from the one of the caregivers whose relative does not suffer from dementia. Five dimensions of the caregiving experience were considered: stressors, cognitive appraisal of the stressors, social support, coping strategies and well-being. The sample consisted of primary caregivers of a demented and a nondemented relative. Results revealed that the caregivers of a demented relative were exposed to more stressors than the caregivers of a nondemented relative. Functional impairment as well as depressive behaviors were appraised as more disturbing. According to MANCOVA analysis, formal and informal social support seems to play a protective role in the psychological distress of the caregivers of a demented relative. There was no difference between the two groups with regard to their coping strategies. Overall, the caregivers of a demented relative seemed to experience some dimensions of caregiving in a different way compared with their counterparts, and the nature of dementia in itself helps to explain this difference.

Emerging concerns of older stroke patients about assistive device use

Assistive devices minimize limitations from physical impairment and are integral to rehabilitation. Little is known about older patients' concerns, perceptions, and beliefs about assistive devices. This study used a structured, qualitative approach to describe device perceptions of 103 stroke patients in rehabilitation. Six dimensions of patient concerns were identified, including the operation and utility of devices, social contexts and consequences, and attributions of cultural meanings of use. Initial device use posed cultural value dilemmas originating in discrepancies between sociocultural beliefs and conflicting normative expectations. Knowledge of these dimensions suggests new areas for social science research and refinements to clinical practice.