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Biomedical subjects

T A Revenson

Publications and source records attributed to T A Revenson.

At least 19 recordsLinked to original sources
PubMed1999

Family-level coping in juvenile rheumatoid arthritis: assessing the utility of a quantitative family interview.

OBJECTIVE: To explore the viability of a quantitative family interview to describe family-level coping strategies used to deal with juvenile rheumatoid arthritis (JRA)-related stressors for early and late adolescents. METHOD: A structured interview protocol with 30 adolescents with JRA and family members assessed ways JRA disrupts or changes family functioning. Emotional reactions, sequential phases of family response, and treatment adherence were discussed. Interviews were coded for family-level coping. To assess adjustment, family members completed the Youth Self Report and the Family Environment Scale. The pediatric rheumatologist provided medical information. RESULTS: The family interview produced both quantitative and qualitative data. Families reported multiple JRA-related stressors (mean 6.6). For many adolescents, treatment adherence was problematic. Families used all 3 types of coping strategies (appraisal-, problem-, and emotion-focused) to varying degrees. Problem-focused approaches were most commonly used and included seeking support (used by 73% of families), self-reliance (70%), and family coordination (70%) for dealing with specific problems, and seeking information about JRA (67%). Emotion-focused approaches, such as impulsive outbursts and diminished awareness of others' feelings, were associated with problematic adjustment. Few differences were found between the families of early and late adolescents. CONCLUSION: The quantitative family interview has the potential to be a useful tool in documenting JRA-related stressors, family-level coping processes, and how family-level coping is associated with treatment adherence and psychosocial adjustment.

Adaptation, Psychological↗
PubMed1999

Gender differences in coping with infertility: a meta-analysis.

Infertility is a stressor that affects both husbands and wives. The literature suggests that infertility is more stressful for women, although most studies have not included men/husbands. If the experience of infertility is different for women and men, the next question is whether women and men cope differently. Meta-analytic procedures were used to review the empirical evidence (1966-1995) on gender differences in coping with infertility among heterosexual married couples; all studies used a standardized coping measure [The Ways of Coping Checklist-Revised (Folkman et al., 1986)]. Significant gender differences were found for half the strategies studied: Women used the strategies of Seeking Social Support, Escape-Avoidance, Planful Problem-Solving, and Positive Reappraisal to a greater degree than their partners. The findings suggest that coping at both the individual and the couple level be considered in the treatment of infertile couples and that gender be considered before planning an intervention.

Adaptation, Psychological↗
PubMed1996

Coping and social support resources among Latinas with arthritis.

OBJECTIVE: To examine the coping strategies and social support resources of Latinas (Hispanic women with arthritis. METHODS: A sample of 109 Latinas of low socioeconomic status with arthritis were interviewed. Most interviews were conducted in Spanish. In open-ended responses, participants described how they cope with their illness. Respondents also named the two individuals who help them most when they do not feel well because of their illness. RESULTS: Engaging in activities was the most commonly reported coping strategy, followed by the use of religion or prayer. Respondents relied more on family members (especially daughters) than friends for support. CONCLUSIONS: Coping responses to arthritis may reflect culture-based notions of "coping," as well as culturally valued norms, such as familism. The extent to which findings illustrate cultural, gender, or socioeconomic status factors requires further study.

Adaptation, Psychological↗
PubMed1995

Relative contributions of spousal support and illness appraisals to depressed mood in arthritis patients.

OBJECTIVE: To examine the ability of cognitive appraisals of illness and spousal support to modify depressed mood in arthritis patients. METHODS: Psychosocial data were collected from 64 married patients with rheumatoid arthritis (RA) within 2 years of diagnosis and at an 18-month followup. RESULTS: The interaction of challenge appraisals with positive support received from the spouse was related to changes in depression over time. There was an increase in depression as challenge appraisals increased when accompanied by greater receipt of positive support, whereas individuals who did not experience a sense of challenge in response to the diagnosis of RA had the lowest levels of residualized depression when they also received higher positive support from their spouses at the beginning of the study. CONCLUSION: The results are considered in terms of the cognitive-behavioral mediation model suggested by Kerns and associates concerning the relationship of chronic pain to depression and have implications for interventions aimed at arthritis patients and their spouses.

Arthritis, Rheumatoid↗
PubMed1995

Marriage, social support, and adjustment to rheumatic disease.

The family is an important source of support for the patient with RA. At the same time, the illness creates stresses for family members that may affect their well-being or inhibit their ability to provide support to the patient. In designing support interventions, one cannot assume that difficulties in adjusting to chronic illness reflect a lack of support from the family or that the patient should be the sole target of intervention.

Adaptation, Psychological↗
PubMed1994

Sexuality and rheumatic disease: the significance of gender.

PURPOSE: This study examined the relationship between functional disability and sexual satisfaction for both rheumatic disease patients and their spouses and compared their levels of sexual satisfaction to those of healthy comparison couples. METHODS: One hundred thirteen rheumatic disease couples and 37 comparison couples completed mailed questionnaires. Rheumatologists rated American College of Rheumatology functional classification. RESULTS: Greater functional disability was related to greater sexual dissatisfaction for patients and spouses. Rheumatic disease and comparison couples did not differ in sexual dissatisfaction. Women reported greater sexual dissatisfaction than men among patients, spouses, and comparison couples. CONCLUSIONS: Couples coping with rheumatic disease are able to maintain satisfying sexual relationships. However, when patients are more disabled, sexual dissatisfaction is greater among both patients and spouses. Health providers must be sensitive to issues of sexuality and be prepared to address these concerns among both patients and their partners. Men and women may have different concerns regarding sexuality.

Activities of Daily Living↗
PubMed1993

Coping with rheumatoid arthritis.

RA patients may develop a coping style early in the illness and utilize their favourite strategies when confronted with the stressor of illness. Little distinction was found between specific illness stressors, i.e. pain vs. disability, or whether a strategy had been successfully used before. In the face of a new illness, strategies may be tried out over a period of time, as the stressor is one for which everyday coping strategies are no longer appropriate or sufficient. As one health psychologist has written, 'Individuals' coping responses are often spontaneous; that is, people do what comes naturally to them and what has worked in the past. But sometimes these efforts will not be enough. The stressor may be so novel, so chronic, or so elusive that people's own efforts may be unsuccessful in reducing stress' (Taylor, 1985, p 213).

Adaptation, Psychological↗
PubMed1993

Social support interventions for rheumatoid arthritis patients: the cart before the horse?

Enthusiasm about the potential of social support to promote successful adaptation to chronic illness has already led to support interventions for arthritis patients designed to increase coping ability, reduce the need for professional mental health services, and limit periods of disability. But have we put the cart before the horse? Do these interventions achieve these goals? Existing interventions are reviewed, and a number of research issues are addressed from within an ecological framework, including the content of support interventions, the source of support, the type of support provided, support as an intervention variable versus outcome, and the need to target interventions not only to patients but to their family members and health professionals. It is suggested that future interventions be more theoretically grounded.

Adaptation, Psychological↗
PubMed1991

The effects of chronic illness on the spouse. Social resources as stress buffers.

This study examined the effects of rheumatoid arthritis (RA) on spouses' psychological well-being and the role of social resources in enhancing adaptation in the face of illness-related stress. Spouses of 42 patients with RA completed a mailed questionnaire assessing marital adjustment, social support received from the person with RA and from the close social network, and depressive symptoms. Illness-related stress was assessed using rheumatologists' assessments of patients' disease severity and patients' self-reports of depressive symptoms. Social resources within and outside the marriage were related to spouses' well-being through different pathways. Marital adjustment had a direct effect on well-being, such that greater marital adjustment was related to lower depression. In contrast, support from the social network operated in a stress-buffering fashion: When the patient's illness was more severe, spouses with greater network support experienced fewer depressive symptoms. Implications of these findings for psychosocial interventions are discussed.

Adult↗
PubMed1991

Assessing the impact of self-efficacy beliefs on adaptation to rheumatoid arthritis.

This article examines the influence of self-efficacy beliefs on problem-solving coping, functional disability, and psychological well-being for 101 recently diagnosed adult patients with rheumatoid arthritis (RA). Data were drawn from a longitudinal study of psychosocial adaptation to the onset of RA. Self-efficacy beliefs were associated with less functional disability assessed concurrently and 1 year later. Self-efficacy beliefs were also associated with greater use of problem-solving coping 1 year later. There was an interaction between pain and self-efficacy beliefs in the prediction of depression 1 year later: at low pain, self-efficacy beliefs were unrelated to depression, but at higher levels of pain, greater self-efficacy was related to greater depression. Finally, problem-solving coping mediated the relationship between disability and initial self-efficacy beliefs. The distinct patterns that emerge for pain, self-efficacy beliefs, and coping, with respect to functional status as compared to psychological status, are discussed.

Adaptation, Psychological↗
PubMed1991

An exploration of leadership in a medical mutual help organization.

Studied 45 current leaders of local chapters of a medical mutual help organization. Cluster analysis of variables depicting routes to leadership produced six clusters: Health Professionals with a Mission, Connected Health Professionals, Career Leaders, Grass-roots Founders, Connected Grass-roots Leaders, and Obligated Veterans. These clusters differed on criterion measures of burnout, hardiness, and perceived obligation to continue as a leader, e.g., Connected Health Professionals and Career Leaders were less burned out, more hardy, and perceived less of an obligation to continue in the leadership role than Health Professionals with a Mission. In terms of leadership activities, Help Provision and Advocacy constituted less than one fifth of all activities but were rated as most rewarding. In contrast, the activities that made up the bulk of leaders' work--building membership, system maintenance, and organizational growth--were not rated as particularly rewarding. Results are discussed in the context of research directions and practice.

Adult↗
PubMed1991

Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients.

This study considers social network interactions as a potential source of both stress and support for individuals coping with a chronic illness. The sample consisted of 101 recently-diagnosed rheumatoid arthritis patients. Symptoms of depression were assessed using the Center for Epidemiologic Studies Depression scale. Hierarchical multiple regression analyses examined the conjoint effects of social support and problematic interactions on symptoms of depression. Receipt of positive or helpful support from close friends and family was related to lower depression; receipt of problematic support was related to increased depression. A positive x problematic support interaction suggested that the costs of problematic support do not cancel out the benefits of positive support. Patients who reported both little support and a greater degree of problematic interactions experienced the highest level of symptoms. The findings emphasize the need to consider positive and negative aspects of support transactions conjointly in assessing their stress-reducing and health-protective potential.

Adaptation, Psychological↗
PubMed1989

Disability and coping as predictors of psychological adjustment to rheumatoid arthritis.

Rheumatoid arthritis (RA) patients have been identified as a medical population at risk for psychological disorder, largely because of the pain and functional disability that are the hallmarks of the disease. This study examined the degree to which self-reported functional disability and coping efforts contribute to psychological adjustment among adult RA patients over a 6-month period. Adaptive outcomes included maintaining a sense of worth, mastery, and positive affect despite the illness. Hierarchical multiple regression analyses indicated that increases in disability were related to decreased acceptance of illness and increased negative affect. Coping efforts were related to increases in positive affect. The findings provide modest support for the role individual coping efforts play in shaping illness-related outcomes. Although disability is not easily reversed, knowledge about coping strategies that moderate its psychological impact may provide a useful basis for designing psychological interventions to promote adjustment.

Adaptation, Psychological↗
PubMed1989

Compassionate stereotyping of elderly patients by physicians: revising the social contact hypothesis.

Departing from previous research on age stereotypes, this study examined degree of contact with elderly patients as a factor affecting age stereotyping by physicians. Included are measures of behavioral intentions as well as more traditional attitudinal measures. A total of 63 rheumatologists completed a brief questionnaire on which they rated a 53- or an 83-year-old target patient on a number of dimensions including psychological adjustment and need for support and information. Patients' age and physicians' degree of contact with elderly patients had few direct effects on physicians' ratings; their interaction, however, yielded a strong and consistent finding: The elderly patient was rated as less adjusted, autonomous, and instrumental and in greater need of support and information by high-contact physicians. These findings suggest that although negative age stereotypes are less prevalent than has previously been indicated, rheumatologists, particularly those who treat elderly patients, may draw on compassionate stereotypes in their care of elderly patients.

Adult↗
PubMed1987

Does coping help? A reexamination of the relation between coping and mental health.

In a longitudinal community survey of 291 adults, we explored the relation between coping strategies and psychological symptoms. Respondents completed the revised Ways of Coping Scale (Folkman & Lazarus, 1985) for a self-named stressful episode. Factor analysis produced eight coping factors: three problem focused, four emotion focused, and one (support mobilization) that contained elements of both. Multiple regression analyses indicated bidirectionality in the relation between coping and psychological symptoms. Those in poorer mental health and under greater stress used less adaptive coping strategies, such as escapism, but coping efforts still affected mental health independent of prior symptom levels and degree of stress. We compared main versus interactive effects models of stress buffering. Main effects were confined primarily to the emotion-focused coping scales and showed little or negative impacts of coping on mental health; interactive effects, though small, were found with the problem-focused scales. The direction of the relation between problem-focused scales and symptoms may depend in part on perceived efficacy, or how the respondent thought he or she handled the problem. Implications for the measurement of adaptive coping mechanisms and their contextual appropriateness are discussed.

Adaptation, Psychological↗
PubMed1987

Age differences in coping with chronic illness.

We examined the correlation between age and six coping strategies in a sample of 151 middle-aged and older chronically ill adults. Coping strategies included cognitive restructuring, emotional expression, wish fulfilling fantasy, self-blame, information seeking, and threat minimization. Older adults were less likely to use emotional expression or information seeking than were middle-aged adults in their efforts to cope with the illness. These strategies were related to age even when numerous illness characteristics (e.g., physical limitations) were used as control variables. Interaction effects showed that older adults who perceived their illnesses as highly serious were less likely than were others to cope by seeking information, reconstruing their illness as having positive aspects, or engaging in wishfulfilling fantasies, and more likely to cope by simply minimizing the illness's threat. Consideration of related research studies suggests that the age differences in emotional expression may be due to age-related shifts in the types of stresses experienced, whereas the age differences in information seeking may be more strongly linked to cohort phenomena.

Adaptation, Psychological↗