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PubMed2000

Antarctica natural laboratory and space analogue for psychological research.

This introduction to the special issue traces the history of psychosocial concerns related to Antarctic exploration, from the heroic age of early explorers through the International Geophysical Year (IGY) of 1957 to 1958 to recent and current systematic research projects. The introduction discusses the organization and topics of international psychological investigations in polar stations and summarizes the articles that follow. Living in Antarctica imposes some unusual restrictions as well as opportunities, and it requires psychological adaptation to extreme environmental circumstances. The thrust of previous scientific and popular literature has been to focus on the negative effects of the situation and ignore the positive ones; however, ongoing studies are bringing about a more balanced view. Having an accurate understanding is important not only intrinsically and for appropriate application in the Antarctic itself but also in analogous extreme and unusual environments. These include extended space flight and space habitation, such as the projected voyage to Mars.

Adaptation, Psychological↗

PubMed1977

Report on a three-year follow-up of 100 cases of suicidal attempts in Shiraz, Iran.

One hundred cases of attempted suicide were followed up after three years. Only 50 records were recovered and of these 26 subjects were personally contacted. There had been only one subsequent suicide and three suicide attempts after three years. The possible relationship between psychiatric intervention and the low incidence of subsequent suicide attempts was discussed. The psychological adaptation after a suicidal attempt was also discussed.

Adaptation, Psychological↗

PubMed2001

The relevance of lowered personal control for patients who have stoma surgery to treat cancer.

OBJECTIVES: The objective of this study was to explore the experience of patients who had stoma surgery to treat cancer in order to explicate why problems associated with stoma surgery are not decreasing despite technical improvements in stoma care. DESIGN: A longitudinal design was used in order to capture the process of preparing for surgery and dealing with its aftermath. Participants were interviewed using a semi-structured protocol on three occasions; 1-2 weeks before surgery (eight participants), 1-2 weeks after surgery (seven participants), and 3 months after surgery (four participants). METHOD: Transcripts were analysed guided by the procedures of grounded theory. This involved developing categories from the data and linking them together to form a conceptual understanding of our participants' experience. RESULTS: Lowered personal control was the most important concept to emerge from the analysis. We identified perceived causes of lowered control, its mitigating factors, the strategies used to manage this experience and the consequences of these processes. CONCLUSIONS: We make three recommendations based on the conclusion that improvements could be implemented in the psychological aspects of stoma care and, in particular, the enabling of patient perceived self-efficacy. First, improvements could be made in doctor-patient communication with doctors becoming more aware of their psychological impact on patients. Second, specialist stoma care nurses could be trained to recognize patients with dysfunctional self-efficacy beliefs and/or delayed psychological adaptation. Finally, we identify a need for more prolonged practical and emotional support for at least some stoma out-patients.

Adaptation, Psychological↗

PubMed2006

Response shift in outcome assessment in patients undergoing total knee arthroplasty.

BACKGROUND: A response shift is a psychological change in one's perception of the quality of life following a change in health status. This phenomenon initially was recognized in patients with terminal diseases who, despite a worsening of the physical condition, did not necessarily report deterioration in quality of life. The purpose of the present study was to examine the role of response shift in patients undergoing total knee replacement surgery. METHODS: Consecutive candidates undergoing total knee replacement for the treatment of degenerative arthritis completed a Western Ontario and McMaster Universities Osteoarthritis questionnaire preoperatively (Pre-Test). At six months postoperatively, the patients completed two questionnaires: one on how they felt currently (Post-Test), and one on how they perceived themselves to have been prior to surgery (Then-Test). The study cohort comprised 125 subjects, including ninety-one women and thirty-four men, with a mean age (and standard deviation) of 68+/-9.5 years. The impact of response shift was examined statistically. RESULTS: With use of the Then-Test methodology, a significant (p<0.05) response shift was observed in the domains of pain, physical function, and total Western Ontario and McMaster Universities Osteoarthritis score, indicating that patients perceived themselves as having been more disabled than what they had reported before surgery. In measuring outcome, this translates into the treatment effect being greater when adjusting for the presence of a response shift. With the numbers available, age, gender, comorbidity, and amount of recovery did not have a significant impact on response shift when adjusted for the preoperative level of disability. CONCLUSIONS: Patients who have undergone total knee replacement demonstrate a response shift in the measurement of their outcome at six months postoperatively. Although the response shift effect in the present study did not affect the interpretation of clinical results, we have highlighted the different patterns of individuals' psychological adaptation to a change in health status. This is an essential component of assessing the success or failure of surgical interventions as quantified with self-administered quality-of-life measures.

Adaptation, Psychological↗

PubMed2000

Measuring psychological adjustment to HIV infection.

AIMS: A modified version of the Mental Adjustment to Cancer Scale (The Mental Adjustment to HIV Scale--MAHIVS) was used to evaluate patterns of psychological adjustment in response to HIV infection. METHODS: A sample of 164 HIV positive homosexual/bisexual men were recruited across three Australian centers (79 asymptomatic (CDC II/III) and 85 symptomatic HIV infection (CDC IV)). Factor analysis of the MAHIVS was conducted and the predictive validity of the MAHIVS was investigated using the General Health Questionnaire, while The Diagnostic Interview Schedule was used to assess current and lifetime psychiatric disorder. Other measures of adjustment/coping were used to investigate the construct validity of the MAHIVS (neuroticism, locus of control, defense style). RESULTS: Factor analysis of the MAHIVS detected four factors: Hopelessness, Fighting Spirit/Self Efficacy, Personal Control, and Minimization. Hopelessness and Fighting Spirit factors exhibited acceptable levels of internal consistency and validity, with significant correlations detected with psychological symptoms and significant association with other measures of psychological adjustment and personality. Fighting Spirit emerged as a potential indicator of psychological resilience, whereas Hopelessness was significantly associated with psychological symptoms and current major depression (but not past depression). CONCLUSIONS: The findings indicate the validity of the MAHIVS and support the presence of common themes in the psychological adaptation to life-threatening illness that can be detected across disease categories and groups.

Adaptation, Psychological↗

PubMed1976

Risk-taking propensity, depression and parasuicide.

One hundred patients admitted consecutively to an inpatient psychiatric unit were given questionnaires to measure risk-taking propensity and depression. The purpose was to study the relationship between risk-taking, depression, and recent suicide attempts. It was found that depressed patients showed a bimodal clustering towards the extremes of risk-taking. There was a history of suicide attempts only when a certain threshold of risk-taking was exceeded. These findings are discussed with relation to defensive styles of psychological adaptation and to arousal thresholds.

Adaptation, Psychological↗

PubMed2004

[Psychological changes during rehabilitation for newly visually impaired people].

In study 1, the purpose was to examine the psychological changes during rehabilitation for newly visually impaired people. Before and after the 6 months rehabilitation training, we conducted Yatabe-Guilford Personality Inventory and Manifest Anxiety Scale (MAS). The results showed that scores of depression, cyclic tendencies, feeling of inferiority, nervousness, lack of objectivity, and anxiety decreased and ascendance increased significantly. In study 2, we compared the differeces of scores between those who needed psychotherapy in addition to rehabilitation training and those who didn't. People who needed psychotherapy scored significantly higher on the depression and lack of objectivity scales than those who didn't. Supportive and behavioral counseling was conducted, however no significant changes were observed before and after psychotherapy as a whole. Furthermore, the relations among the methods, purposes and effects of psychotherapy were not observal. As a conclusion, we need to develop methods of psychotherapy which accelerate the acceptance of disability and improve psychological adaptation sufficiently.

Adaptation, Psychological↗

PubMedDate not supplied

[Evaluating the quality of life of 42 heart transplant patients and candidates: a cross-sectional study].

OBJECTIVE: Although evaluation of heart transplant candidates and recipients is usually based on objective clinical variables, self-assessment has been proved to be an important component of treatment evaluation. Quality of life is a multidimensional concept, a mix of objective and subjective measures, that could reflect the adjustment to the illness and its treatment. Few studies have reported on quality of life in heart transplantation candidates. This exploratory study, conducted in Bordeaux (France), was designed to assess both objectively and subjectively the quality of life in heart transplant candidates and recipients and to determine the relationships between subjective and objective variables. METHOD: The assessment was cross-sectional; 21 candidates evaluated at an average of 10 (Sd 21.4) months into the waiting period, were matched with 21 recipients at 29.5 months post operative. Subjective evaluation of the quality of life was self-assessed by the Tableau d'évaluation assistée de la qualité de la vie (TEAQV) and the Nottingham Health Profile (NHP). A semi structured psychiatric interview, and the NYHA (New York Heart Association) cardiac insufficiency score provided objective measurements. RESULTS: The NHP and TEAQV mean scores were not not significantly different between the two groups: candidates (C) and recipients (R) reported similar subjective data regarding positive quality of life experience. The objective data indicated significant disadvantages for the candidate group: the cardiac insufficiency score was worse in the candidates [(NYHA mean score: (C) = 2.7 Sd 0.56 vs (R) = 0.7 Sd 0.8, t de Student p < 0.01)] and the DSM III-R axis 1 diagnoses were more frequent in the candidates [(C) = 16/21 vs (R) = 9/21 Chi2 p < 0.05)]. There was a prevalence of adjustment disorders in the candidates. Significant correlations were found between NYHA and NHP mean scores (r = 0.6, p < 0.01) and NYHA and physical and psychological dimensions of the TEAQV (r = -0.65 and r = -0.55, p < 0.01) in the recipient group. In the candidate group, no correlation was found between these scores. CONCLUSION: In the recipient group, objective and subjective assessment showed greater concordance than in the candidate group. Despite more objective physical and moderate yet frequent psychiatric complications, the candidate group reported as positively as did the recipients upon the quality of their life experience. This could be the result of psychological adaptation to the stressful situation. These data were in accordance to several earlier reports. However, the literature has remained controversial upon the evaluation of the quality of life of the candidates. The results of this study, limited by some methodological bias (the small number of patients assessed), need to be confirmed in a prospective study.

Adaptation, Psychological↗

PubMed1979

[Study of the long-term psychological consequences of heart valve prostheses].

The present follow-up period of cardiac surgery allows assessment of the long-term consequences of valvular prostheses, the short-term consequences having already been the object of many studies. 50 patients of both sexes, operated on for aortic or mitral valve disease between 1973 and 1974 were interviewed to assess their degree of psychological adaptation with regard to their cardiac status and the principal factors of adaptation. The position of the prosthetic valve (aortic or mitral) seemed to be of little importance and the prognosis depended rather on sex, age at operation, previous personality, intelligence quotient, postoperative psychiatric complications and the interval between diagnosis of the disease and operation.

Adaptation, Psychological↗

PubMed2002

Human factor observations of the Biosphere 2, 1991-1993, closed life support human experiment and its application to a long-term manned mission to Mars.

Human factors are a key component to the success of long-term space missions such as those necessitated by the human exploration of Mars and the development of bioregenerative and eventually self-sufficient life support systems for permanent space outposts. Observations by participants living inside the 1991-1993 Biosphere 2 closed system experiment provide the following insights. (1) Crew members should be involved in the design and construction of their life support systems to gain maximum knowledge about the systems. (2) Individuals living in closed life support systems should expect a process of physiological and psychological adaptation to their new environment. (3) Far from simply being a workplace, the participants in such extended missions will discover the importance of creating a cohesive and satisfying life style. (4) The crew will be dependent on the use of varied crops to create satisfying cuisine, a social life with sufficient outlets of expression such as art and music, and to have down-time from purely task-driven work. (5) The success of the Biosphere 2 first 2-year mission suggests that crews with high cultural diversity, high commitment to task, and work democracy principles for individual responsibility may increase the probability of both mission success and personal satisfaction. (6) Remaining challenges are many, including the need for far more comprehensive real-time modeling and information systems (a "cybersphere") operating to provide real-time data necessary for decision-making in a complex life support system. (7) And, the aim will be to create a noosphere, or sphere of intelligence, where the people and their living systems are in sustainable balance.

Adaptation, Psychological↗

PubMed2005

An operational approach to long-duration mission behavioral health and performance factors.

NASA's participation in nearly 10 yr of long-duration mission (LDM) training and flight confirms that these missions remain a difficult challenge for astronauts and their medical care providers. The role of the astronaut's crew surgeon is to maximize the astronaut's health throughout all phases of the LDM: preflight, in flight, and postflight. In support of the crew surgeon, the NASA-Johnson Space Center Behavioral Health and Performance Group (JSC-BHPG) has focused on four key factors that can reduce the astronaut's behavioral health and performance. These factors are defined as: sleep and circadian factors; behavioral health factors; psychological adaptation factors; and human-to-system interface (the interface between the astronaut and the mission workplace) factors. Both the crew surgeon and the JSC-BHPG must earn the crewmember's trust preflight to encourage problem identification and problem solving in these four areas. Once on orbit, the crew medical officer becomes a valuable extension of the crew surgeon and BHPG on the ground due to the crew medical officer's constant interaction with crewmembers and preflight training in these four factors. However, the crew surgeon, BHPG, and the crew medical officer need tools that will help predict, prevent, monitor, and respond to developing problems. Objective data become essential when difficult mission termination decisions must be made. The need for behavioral health and performance tool development creates an environment rich for collaboration between operational healthcare providers and researchers. These tools are also a necessary step to safely complete future, more autonomous exploration-class space missions.

Adaptation, Physiological↗

PubMed2006

[How children experience a parent being chronically ill: a qualitative analysis of interviews with children of hemodialysis patients].

Children's subjective experience of growing up with a somatically ill parent was studied by a qualitative analysis of individual interviews with children having a parent on hemodialysis. Transcripts of semi-structured interviews with 8 children and adolescents between 6 and 17 years and with one ill mother, whose father had had the same disease, were evaluated through structuring content analysis and psychoanalytical text interpretation. All individuals showed a strong sense of responsibility for their parents. In some cases this conflicted with their strives for autonomy. Almost all children tried to avoid conflicts with their parents. Younger children suffered from diffuse sadness, whereas children up from 11 years had concrete fears of medical complications or their parents' possible decease. In case parents spoke frankly about their illness, children felt relieved. Results suggest that growing-up with a chronically ill parent means a sustaining experience for a child, which requires enormous efforts of psychological adaptation. In preventive counselling concepts, parents should be strengthened in their competence as emotionally available attachment figures.

Adaptation, Psychological↗

PubMed1975

REM sleep and the analytic process: a psychophysiologic bridge.

Recent research on the physiology of REM sleep has supported the hypothesis that it serves processes of psychologic adaptation. This study examines the relationship between physiologic parameters of REM sleep and evidence in analytic material of the need for adaptation. Significant correlations were found between defensive strain before sleep and REM latency, and between change in defensive strain from evening to morning and total REM time.

Adaptation, Psychological↗

PubMed1990

Social support and outcome in teenage pregnancy.

This paper presents information on the role and significance of social support for the occurrence of health and birth problems among adolescent mothers and their babies. Pregnant teenagers (N = 268) were interviewed during the course of pregnancy and again approximately four weeks after delivery, and hospital records were abstracted. The significance of family support, friend support, and partner support, assessed during the pregnancy, were examined in relation to infant and mother outcomes assessed at or after the birth. Infant outcome was indexed by birth weight, with gestational age controlled; mother outcome in terms of psychological adaptation was indexed by depressive symptomatology among adolescent mothers. Socioeconomic background was found to influence relationships between social support and both infant and mother outcomes.

Adaptation, Psychological↗

PubMed1987

[The "Medical-Psychologic Questionnaire for Heart Patients": a study of the assessment of the validity of a study instrument for psychological health of patients following myocardial infarct].

Correlations between scales and items of the "MPFH", and physical performance of MI-patients, lead us to conclude that the self-perception of decreased physical performance after MI is often generalized and thus leads to a decrease in self-esteem, often connected with feelings of social isolation. This pattern of reaction can in itself be a new risk factor during rehabilitation. Psychological rehabilitation must therefore focus on both: 1. trying to find a meaningful balance between moderate increase in physical performance and psychological adaptation to the reduction in performance, and 2. trying to reduce the feeling of social isolation which comes along with decreased physical performance.

Adaptation, Psychological↗

PubMed1987

[Psychological characteristics related to arterial hypertension and smoking (data of a population study)].

An epidemiologic study of psychosocial variables, related to arterial hypertension and smoking, was carried out in 2039 men and women between 25 and 60 years of age. A relationship has been established between coronary risk factors and psychosocial characteristics, particularly social and psychologic adaptation. The data obtained can be useful for planning future studies of psychosocial features of individuals with arterial hypertension and smoking as coronary risk factors as well as the choice of psychosocial intervention methods.

Adaptation, Psychological↗

PubMed1983

Normal and pathological grief.

Physicians are often called on to care for patients and members of patients' families during the period of bereavement. The grief process serves a psychologically adaptive function and usually progresses in a predictable manner. Under certain unusual circumstances, however, the grieving process may become pathologically delayed or distorted, with serious consequences for the survivor's emotional and physical health. There are three phases of the normal grief process and particular guidelines for physician recognition and management of pathological grief reactions.

Adaptation, Psychological↗

PubMedDate not supplied

[Nursing research on the rehabilitation of neurological and neurosurgical patients].

A descriptive study was carried out on the main aspects related to the rehabilitation of neurological and neurosurgical patients. A review was made on books, symposium papers and theses; specialists were also consulted. Several variables were studied, among them, basic objectives and purposes of the rehabilitation program; peculiarities of the patient's psychologic adaptation to physical disability; assessment of handicaps; and the nurse's role in rehabilitation.

Adaptation, Psychological↗