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Biomedical subjects

C M Connell

Publications and source records attributed to C M Connell.

At least 19 recordsLinked to original sources

Racial, ethnic, and cultural differences in the dementia caregiving experience: recent findings.

PURPOSE: This research reviewed studies that compare two or more racial, ethnic, national, or cultural groups on aspects of the dementia caregiving experience. DESIGN AND METHODS: Electronic databases were searched to find studies published between 1996 and 2000 in peer-reviewed journals that met the above criteria. RESULTS: Twenty-one studies based on 18 samples were identified. These articles included comparisons involving the following groups of caregivers: African Americans, Chinese, Chinese Americans, Koreans, Korean Americans, Latinos, Whites, and residents of 14 European Union countries. Consistent with previous research, White caregivers were more likely to be spouses when compared to other groups. White caregivers tended to report greater depression and appraised caregiving as more stressful than African American caregivers. Findings were mixed regarding differences in coping and social support, but suggested that minority groups may not have more available support than Whites. Common methodological limitations were a lack of noncaregiving control groups and failure to test specific pathways by which the grouping variable (e.g., race) exerts its impact on outcome variables. IMPLICATIONS: Future studies in this area should use both quantitative and qualitative research methods to specify the pathways by which race, ethnicity, and culture affect the caregiving experience, and should expand their focus beyond the primary caregiver to include the effects of caregiving on families and networks.

Aged↗

The costs of caring: impact of dementia on family caregivers.

With the aging of the population, an increasing number of older adults are diagnosed with Alzheimer's disease or a related disorder. Most people with a dementing illness will be cared for at home by a family member, who may experience a variety of physical, emotional, financial, and social burdens associated with the caregiving role. The purpose of this article is to (a) examine the physical and psychological effects of providing care to a family member with a dementing illness, (b) describe the factors that help determine the nature and magnitude of these effects, and (c) discuss several approaches to caregiver intervention designed to reduce the negative impact of this challenging role. Sociodemographic characteristics (e.g., gender, relationship to the patient, culture, race, ethnicity), caregiver resources (e.g., coping, social support, availability of a companion animal), and personal characteristics (e.g., personality, health behaviors) shape the dementia caregiving experience and have implications for interventions designed to prevent or lessen the stress and burden that often accompany the role.

Caregivers↗

Effect of adults' self-regulation of diabetes on quality-of-life outcomes.

OBJECTIVE: To examine the relationships among cognitive representations of diabetes, diabetes-specific health behaviors, and quality of life using Leventhal and Diefenbach's self-regulation model of illness (Leventhal H, Diefenbach M: The active side of illness cognition. In Mental Representation in Health and Illness. SkeltonJA, Croyle RT, Eds. New York, Springer-Verlag, 1991, p. 247-272). RESEARCH DESIGN AND METHODS: This research involved secondary analysis of a mailed survey completed by 296 adults (ages 20-90 years). Structural equation modeling was conducted to investigate relationships among cognitive representations, diabetes-specific health behaviors, and quality of life. Model differences by diabetes type were also investigated. RESULTS: Findings indicated that certain cognitive representation constructs were related to increased diabetes-specific health behaviors, decreased sense of burden, and positive quality-of-life outcomes. Individuals levels of understanding of diabetes and their perceptions of control over diabetes were the most significant predictors of outcomes. However, diabetes-specific health behaviors were related to an increased sense of burden that was negatively associated with quality of life. Multigroup analyses indicated that this self-regulatory model provided a good fit for individuals with type 1 diabetes, those with type 2 diabetes who take insulin, and those with type 2 diabetes who do not take insulin. CONCLUSIONS: These findings advance what is known about cognitive representations of illness and the self-regulation of diabetes as well as the relationships between cognitive representations of illness, quality of life, and behavioral factors. In particular, results from this study suggest the need for further study to address ways of reducing the burden of diabetes associated with health behaviors and decreased quality of life.

Adult↗

Older adults in health education research: some recommendations.

A review of articles published in two health education journals is provided to examine the extent to which older adults were included in published research. The review suggests that older adults were included in about 15% of the research articles published in Health Education and Behavior and Health Education Research. Of the articles that include older adults, age differences in study processes and outcomes are rarely examined, and very few studies advance specific hypotheses based on a theoretical or conceptual model of aging or older adulthood. Several recommendations for health education research are suggested.

Aged↗

Racial, ethnic, and cultural differences in dementia caregiving: review and analysis.

This study provides a review and analysis of the empirical research published since 1985 that has examined the impact of race, culture, and/or ethnicity on the dementia caregiving experience. Ten of the 12 studies included in the review focused on comparisons between Black and White caregivers; one examined differences between Black and Hispanic caregivers, and one focused on White and Hispanic caregivers. Compared to White caregivers, non-White caregivers: a) were less likely to be a spouse and more likely to be an adult child, friend, or other family member, b) reported lower levels of caregiver stress, burden, and depression, c) endorsed more strongly held beliefs about filial support, and d) were more likely to use prayer, faith, or religion as coping mechanisms. Strategies for advancing research in this area are discussed.

Black or African American↗

Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses.

This study describes the health behaviors (alcohol consumption, exercise, sleep patterns, smoking, and weight maintenance) of a sample of older adult spouse caregivers (N = 233) and investigates the predictors of decreased self-care since caregiving began. Multiple regression results indicate that caregivers who experience greater developmental burden, report a greater number of depressive symptoms, perform a greater number of activities of daily living (ADL) tasks in caregiving and spend more hours in a day providing care, and who have lower self-efficacy for both self-care and spouse care are at greater risk for negative health behavior change. Results have implications for the identification of caregivers who may be particularly vulnerable to the negative health impact of caregiving.

Aged↗

Spouse caregivers' attitudes toward obtaining a diagnosis of a dementing illness.

OBJECTIVES: To examine attitudes of spouse caregivers about the process of obtaining a diagnosis of a dementing illness, including perceived benefits and obstacles to obtaining a diagnosis and suggestions for improving the process. DESIGN: A mail survey of spouse caregivers of dementia patients followed by the Michigan Alzheimer's Disease Research Center. PARTICIPANTS: The 233 spouse caregivers of dementia patients who returned a completed questionnaire. RESULTS: More than three-fourths of the sample rated the following benefits of obtaining a diagnosis as very or extremely important: ruling out other causes of memory or behavior problems, allowing family members to get information about dementia, may qualify my spouse for drug treatment, and will allow me to plan for the future. Primary obstacles included the time required to obtain a diagnosis, the cost of procedures, lack of access to physicians trained to diagnose dementing illnesses, and not receiving a referral from a primary care physician (41.6%, 41.0%, 40.8%, and 24.1% of the sample, respectively, agreed or strongly agreed that the factor posed a barrier to obtaining a diagnosis). Content analysis of responses to two open-ended questions identified problematic or stressful aspects of obtaining a diagnosis and suggestions for making the process easier for the patient and family. CONCLUSION: Results suggest the need to provide an orientation to the diagnosis and assessment process for patients and family members, develop a training session for physicians to better prepare them to address the emotional needs of patients and families and to disclose the diagnosis in an informative and compassionate manner, and provide outreach education to primary care physicians to increase knowledge and awareness of dementing illnesses and to increase referrals to community-based services and health professionals able to address the concerns of family members.

Adult↗

Development and validation of the Diabetes Care Profile.

To determine the reliability and the validity of the Diabetes Care Profile (DCP), an instrument that assesses the social and psychological factors related to diabetes and its treatment, two studies with separate populations and methodologies were conducted. In the first study, the DCP was administered to, and physiologic measures collected from, individuals with diabetes being cared for in a community setting (n = 440). In the second study, the DCP and several previously validated scales were administered to individuals with diabetes receiving care at a university medical center (n = 352). Cronbach's alphas of individual DCP scales ranged from .60 to .95 (Study 1) and from .66 to .94 (Study 2). Glycohemoglobin levels correlated with three DCP scales (Study 1). Several DCP scales discriminated among patients with different levels of disease severity. The results of the studies indicate that the DCP is a reliable and valid instrument for measuring the psychosocial factors related to diabetes and its treatment.

Adult↗

A research agenda for health education among underserved populations.

This article summarizes the outcome of health education efforts among populations that, due to their cultural heritage, have received limited services. The literature reviewed shows that programs found to be effective in one population cannot be assumed to be equally effective with a different population. An argument is made for the design of culturally appropriate and group-specific interventions which would properly serve the various underserved populations. Research needs to be conducted to identify appropriate approaches and intervention strategies, as well as the group-specific sociopsychological characteristics (attitudes, norms, values, expectancies) that are related to health-damaging and protective behaviors.

Attitude to Health↗

Creating capacity: establishing a health education research agenda for special populations.

On Day 2 of the joint CDC/SOPHE conference on Creating Capacity: Establishing a Research Agenda for Health Education, the participants were asked to identify research needs or special issues in working with children and adolescents, the elderly, women, men, and underserved groups. This article presents the priority research areas across subgroups identified by the participants. The cross-group priorities are followed by research recommendations for each subgroup.

Adolescent↗

Measurement of social interaction in change of health behavior.

A social network approach to measuring social interaction related to change of health behavior required 460 participants in a health promotion program to nominate up to five network members and to rate the supportiveness of each person in changing health behavior during the previous year. Exploratory factor analysis of intercorrelations of the eight items suggested two factors representing supportive and negative interaction with internal consistency reliability of .89 and .61, respectively.

Adult↗

Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes.

Tested was a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N = 362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model--largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression.

Adaptation, Psychological↗

Attitudes about autopsy: implications for educational interventions.

Although the role of autopsy in confirming diagnoses and advancing research is well documented, family members are inadequately informed about the procedure. The present study examined attitudes about autopsy among older adults. Focus group interviews were conducted with members of three caregiver support groups and two senior centers. Predominant themes included: benefits, barriers, religious views, and concerns about procedures. Results suggest the need to design educational interventions to: (a) involve family members in advance planning; (b) provide counseling regarding the purpose, process, and procedures of autopsy; and (c) facilitate communication skills and awareness of local autopsy services and policies among physicians.

Autopsy↗

Health education interventions among Native Americans: a review and analysis.

Relatively few health education interventions directed at preventive health behaviors and management of chronic illness among Native Americans have been reported in the literature. This article provides a selective review of health education interventions among Native Americans that address the prevention and management of chronic illnesses/conditions as well as preventive health behaviors. For each intervention included in the review, a description of its cultural relevance, sample, design, and evaluation is provided. Limitations are noted, as well as implications for research and practice.

Adolescent↗

Increasing coordination of the dementia service delivery network: planning for the Community Outreach Education Program.

Dementia is an emerging public health concern because of its prevalence and the cost and extent of care typically needed for people with cognitive disorders. When family members seek assistance in providing care, they frequently encounter a fragmented service delivery network. To increase the coordination of services for people with dementia, the Community Outreach Education Program (COEP) has been designed to provide educational interventions to disseminate information about the diagnosis, assessment, management, and treatment of dementia to health care professionals, service providers, staff of volunteer and community organizations, and family members. This article describes plans for the COEP within the context of a community development perspective.

Aged↗

Exercise beliefs and behaviors among older employees: a health promotion trial.

This health promotion trial included university faculty and staff aged 50 to 69 who had completed a health risk screening. Predictors of intention to exercise were education, gender, self-efficacy, outcome expectancy, perceived barriers, and baseline exercise frequency. Baseline exercise frequency was the only predictor of exercise behavior 1 year later.

Aged↗

The contribution of personality characteristics to the relationship between social support and perceived physical health.

Although a great deal of research has been conducted on the relationship between social support and physical health, the contribution of personality characteristics to this relationship has rarely been assessed. Structural equation modeling was employed to derive and test a model of the direct and indirect relationships between personality characteristics, social network size, the perceived availability of support, socially supportive behaviors, and perceived physical health with a sample of Pennsylvania adults. Significant paths indicate that individuals who perceive themselves as affiliative and as help seekers and help givers report larger social networks, receive more socially supportive behaviors, and perceive that more support is available to them. The perception that support is available shared a direct relationship with perceived physical health. The utility of including multiple measures of social support and personality characteristics related to receiving support in investigations of the relationship between social support and physical health is discussed.

Adult↗

Social support and human development: issues in theory, research, and practice.

The physical and psychological correlates and consequences of social support have received much attention in the past decade. To date, however, much research on social support has not been guided by an integrated theoretical or conceptual framework. In this report, a life span developmental perspective is suggested for the study of social support. The discussion addresses numerous conceptual, theoretical, and empirical concerns related to the investigation of support. Implications for designing, implementing, and evaluating support-related interventions are highlighted.

Aged↗