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PubMedDate not supplied

Responses to chronic illness: analysis of psychological and physiological adaptation.

The Adaptation Nursing Model provided the theoretical framework for the comparative analysis of psychological and physiologic adaptation of 211 adults representing three diagnostic groups (rheumatoid arthritis, hypertension, and multiple sclerosis). Data were collected through interviews and completion of the Mental Health Index, Health-Related Hardiness Scale, and Margin in Life. Psychological adaptation was found to be independent of diagnosis. Four predictor variables (health promotion activities, psychological distress, physiologic adaptation, and dependence on medications) significantly discriminated among the three groups and correctly classified 73.08% of the total sample. Presence of the hardiness characteristic was significantly related to psychological and physiologic adaptation, involvement in health promotion activities, and participation in patient education programs. It can be concluded that a diagnosis-specific view of psychological status is not tenable or clinically meaningful.

Adaptation, Physiological↗
PubMed2006

Coping and adapting to breast cancer: a six-month prospective study.

AIMS: To compare ways of coping with breast cancer in acute and chronic periods and to approach their efficiency on psychological adaptation at each time. METHODS: Psychometric evaluation of 151 breast cancer women the day before surgery (T1), and of 107 of them 6 months later (T2), with self-rated questionnaires (CHIP Scale, HADS), "t Student" tests, correlation analyses and multiple regression analyses. RESULTS AND DISCUSSION: The coping scores during the chronic period are related to those observed during the acute period, with a decrease of instrumental strategies and a stability of distraction and palliative coping. Relationships between CHIP and HADS plead for a deleterious impact of palliative coping on the mood in T2 and for a mood protecting effect of distraction in T1 and T2, without impact on anxiety and without effect of the instrumental coping. These hypotheses must take into account the fact that CHIP scores could be ambiguous measures assessing not only coping modes but also adaptation levels.

Adaptation, Psychological↗
PubMed1990

[Factors of social and occupational adaptation of patients with attack-like schizophrenia].

The clinical dynamics and social labor adaptation of patients with attack-like schizophrenia were examined with the aid of clinico-epidemiological and clinico-catamnestic investigations made in 496 persons. It has been established that the number of patients with decreased social and labor activity is three times higher as compared to that of patients with unfavourable clinical prerequisites. Four main types of adaptation were distinguished, depending on the combination of the clinical and social labor characteristics of patients. Possible factors of social labor adaptation were explored. It has been established that the development or dynamics of certain types of adaptation require the totality of influence including the clinical prerequisites and the individual biological characteristics that form the latter ones, the character of individual psychological adaptation, and a complex of social environmental influences including therapeutic ones.

Adaptation, Psychological↗
PubMed1997

Discursive strategies of subjects with high altitude hypoxia: extreme environment.

A discourse analysis was carried out on nine European lowlanders during a 2-month scientific expedition at high altitude including a 3-week stay in extreme survival conditions at the summit of Mt. Sajama (6542 m), in order to contribute to the understanding of psychological adaptation to extreme environments. This discourse analysis was part of a wide-ranging scientific investigation involving 12 scientific and medical research protocols which targeted human adaptation to high altitude chronic hypoxia. The objective of this study is to better understand the presence of linguistic markers capable of translating the subject's psychological state when faced with a threatening environment. This study was based on a method of propositional speech analysis developed by Ghiglione and Blanchet which emphasizes the cognitive function of verb categories, modalizers and adjuncts used by subjects. The method was developed in conjunction with psychopathological studies of the depressive state. Speech was recorded at time T1, 4 days after reaching the summit of Mt Sajama, and at time T2, 2 days before descending the mountain peak. These results revealed that in the absence of depression in any psychopathological sense of the word, normal subjects would react to their environment with a depressive component. However, the results of this study equally illustrate for some subjects a correspondence between those states with a depressive component and a physiological incomplete adaptation to high altitude. This correspondence could reflect the pathogenic effect of an adaptation deficit or could be in keeping with the literature concerning an incomplete adaptation effect induced by a latent depressive state.

Acclimatization↗
PubMed1991

The factor analytic structure of the Roberts Apperception Test for Children: a comparison of the standardization sample with a sample of chronically ill children.

A confirmatory principal component factor analysis of the Roberts Apperception Test for Children was conducted using the standardization sample and a sample of chronically ill children. An interpretation of three- and four-factor solutions identified the three-factor solution as superior to the four-factor solution as measured by chi-square goodness of fit and coefficients of convergence. A cluster analysis using Ward's minimum variance method was calculated to determine the typical profiles that best describe the chronically ill sample. Results of this analysis reveal two distinct profiles that differ primarily on the level of adaptive psychological functioning.

Adaptation, Psychological↗
PubMed2002

Acculturation and adaptation of Soviet Jewish refugee adolescents: predictors of adjustment across life domains.

This study explores how acculturation is related to adaptation across different life spheres for 162 Soviet Jewish refugee adolescents in a suburban community in Maryland. Because the different contexts of refugee adolescents' lives vary in acculturative demands, different patterns of acculturation should be related to adaptation in different life spheres. The study uses a multidimensional measure of acculturation and assesses acculturation to both American and Russian cultures as it relates to psychological adaptation, peer relations, and school and family outcomes. Findings support the general ecological thesis that acculturation to different cultures is differentially related to adaptation across life domains. Acculturation to American culture predicted better grades and perceived support from American peers. Acculturation to Russian culture predicted perceived support from Russian peers. Both American acculturation and Russian acculturation predicted reduced loneliness and perceived support from parents. Further, different dimensions of acculturation, such as language and identity, were differentially related to adaptation. Implications for acculturation theory and measurement are drawn, and cautions are offered about the interpretation of acculturation studies using single proxies such as language use or preference.

Acculturation↗
PubMedDate not supplied

Factors that influence adolescent adaptation to sickle cell disease.

OBJECTIVE: To examine whether psychosocial factors play a more important role than biomedical risk factors in predicting adolescent adaptation to sickle cell disease (SCD); to determine whether psychosocial factors moderate the relationship between biomedical risk factors and adaptation. METHODS: Ninety African American adolescents from the multisite Cooperative Study of Sickle Cell Disease were recruited to complete a battery that included measures of psychosocial status and psychological adaptation. Data regarding their health status were collected from medical records. RESULTS: The findings revealed that intrapersonal (self-esteem, social assertiveness), stress-processing (use of social support), and social ecological factors (family relations) were significant predictors of adaptation; however, biomedical factors did not predict adaptation. There was no evidence that psychosocial factors moderated the relationship between biomedical risk factors and adaptation. CONCLUSIONS: Psychosocial factors proved to be better predictors of adaptation than biomedical risk factors. Additional research is needed to better understand the nature of the interrelationships among biomedical risk factors, psychosocial factors, and adaptation.

Adaptation, Psychological↗
PubMed1992

Psychological adjustment of children with asthma: effects of illness severity and recent stressful life events.

Although children with chronic illness are at greater risk for decreased psychological adjustment than physically healthy children, little is known about the factors that lead to increased risk. Eighty-one children with asthma between the ages of 6 and 14 years and their parents participated in a study to determine the relative contribution of background variables (age, gender, and socioeconomic status), recent stressful life events, and illness severity to psychological adaptation. Overall 11.5% of the children had CBCL Total Behavior Problems scores above the 98th percentile. Multiple regression revealed that lower SES, negative life change, and high illness severity were predictive of less optimal psychological adjustment. The results highlight the need for interventions to improve coping with both disease and nondisease issues.

Adaptation, Psychological↗
PubMedDate not supplied

Physical and psychologic rehabilitation outcomes for pediatric patients who suffer 80% or more TBSA, 70% or more third degree burns.

Advances in medical management have dramatically decreased the mortality of children with massive burn injuries, which raises many questions about the expected quality of life for these young survivors. In this article, we address this issue by examining the functional and psychological adaptation of 41 young survivors with 88% mean total body surface area (TBSA) burns and 85% mean third degree TBSA burns. Patient scores were compared with normative data on standardized psychological measures of adjustment and on performance of age appropriate activities of daily living (ADL) skills. Thirty-three of the 41 patients (80%) were independent in basic ADL skills. Eighty-six percent of the patients who were aged 10 years and older were independent in advanced ADL skills. Patients with amputated fingers were significantly more dependent in ADL skills than those without amputations (P < .05). Mean psychosocial adjustment scores were within normal limits and were not significantly related to functional independence in ADL skills.

Activities of Daily Living↗
PubMed1986

Personality traits that can affect adaptation after colectomy. A study of 10 patients treated for ulcerative colitis either with proctocolectomy and ileostomy or with colectomy, proctomucosectomy, ileal pouch and ileoanal anastomosis.

The purpose of the present study was to examine how specific personality traits and/or conflicts could serve to predict nonadaptability after surgical treatment for ulcerative colitis. In order to define the scope of the study and to establish more specific hypotheses, retrospective studies were conducted by in depth interviews with 10 patients. Five of the patients had undergone colectomy with proctomucosectomy and ileal pouch ad modum Parks, and 5 had had a proctocolectomy with ileostomy ad modum Brooke. The interviews were recorded on tape and analyzed by the interviewer as well as by an independent evaluator. In addition, the operating surgeon provided an independent evaluation of the patients' post-operative adaptation. There was good consensus between both sets of assessments based on interviews as well as between the interview diagnoses and the surgeon's evaluation. There was no observed correlation between prevailing psychiatric diagnostic categories and postoperative adaptation. Psychological factors, such as a discrepancy between body image and body ideal, alexithymic characteristics, abnormal aggression patterns, extensive physical exercise and muscular training, showed varying degrees of negative correlation with postoperative adaptation.

Adaptation, Psychological↗
PubMed1994

Mastectomy versus conservative surgery and radiation therapy. Psychosocial consequences.

BACKGROUND: Clinical trials comparing mastectomy to conservative surgery plus radiation therapy in the treatment of breast cancer have provided an opportunity to increase understanding of the biology of this disease and the psychological adaptation of the breast cancer patient. Because these local treatments appear to be equal in terms of survival, the question remains as to whether conservative surgery plus radiation therapy confers a measure of psychological comfort superior to that of mastectomy for women diagnosed with early-stage breast cancer. METHODS: One hundred forty-two women participating in a clinical trial randomizing patients to mastectomy or lumpectomy and radiation therapy were prospectively evaluated for psychological response to their respective local therapy. A baseline assessment before randomization and subsequent questionnaires at 6, 12, and 24 months after treatment were completed by patients entered in the clinical trial. RESULTS: At 6 months, mastectomy patients reported significantly less control over events in their lives (P = 0.003) and more problems with sexual relations (P = 0.021) than did their conservatively treated counterparts. In addition, there were marked differences between mastectomy patients and lumpectomy and radiation therapy patients in the degree of distress over their nude bodies, with P = 0.001 at 6 months, P = 0.019 at 12 months, and P = 0.057 at 24 months. CONCLUSIONS: From our findings, it appears that breast conservation therapy protects women's perception of their body but does not, over time, contribute to a more positive sexual adjustment.

Adaptation, Psychological↗
PubMed1989

Observations of a support group for automatic implantable cardioverter-defibrillator recipients and their spouses.

We studied the use of an 8-week group support intervention with recipients of automatic inplantable cardioverter-defibrillators (AICDs) and evaluated the effect of this treatment on both patients and spouses. Patients attending the Rhode Island Hospital Arrhythmia Clinic formed the study population. Six patients and their spouses formed the treatment group. Six patients living a distance (greater than 25 miles) from the hospital who were not able to attend the sessions formed a natural comparison group. Outcome was reported by a descriptive analysis of the group experience and assessment of changes in role functioning and psychologic adaptation after the intervention. Study results supported our hypothesis that group therapy was an effective treatment modality in promoting positive adjustment of patients to the AICD device. Furthermore, trends emerged suggesting positive shifts in both role functioning and psychologic adjustment in patients attending group sessions. These findings suggest that group therapy is a useful method of providing support and education for individuals receiving the AICD device.

Adaptation, Psychological↗
PubMed1994

The HIV-infected child: parental responses and psychosocial implications.

Four dimensions of psychological adaptation of 101 parents of HIV-infected children were examined. Heightened anxiety, depression, and anticipatory grief were associated with child's age at diagnosis, parent's HIV status, and parent's relationship to the child. Parents at higher risk for psychological distress were identified, and an optimum time point for intervention is suggested.

Adaptation, Psychological↗
PubMed2003

Psychological aspects and coping in haemophilic patients: a case-control study.

Although enormous progress has been made in recent years in the field of haemophilia, some problems still await solution, such as the risk of sudden haemorrhage, the sequelae of haemophilic arthropathy and social activities. We, therefore, carried out a case-control study in which some psychological dimensions (social expectations, tendency to depression, state of anxiety and self-esteem) were evaluated in a group of 60 haemophiliacs. A control group was formed of 78 healthy subjects matched for age, socio-economic class and level of education. The methodology used was the administration of self-assessment questionnaires which investigate and provide a quantitative measure of psychological dimensions. The results can be subjected to statistical analysis. Three self-assessment questionnaires were used: (i) the Marlowe-Crowne scale, (ii) the Beck Inventory version modified by Cusinato and (iii) the S.T.A.I.-form. Our aim was to evaluate: (i) whether there are significant differences in the considered psychological aspects between haemophiliacs and healthy subjects; (ii) whether there is a significant correlation between the psychological dimensions considered in the haemophiliacs and in the healthy subjects. The results showed that the haemophiliacs have a good psychological adaptation to their disease with the exception of their greater tendency to have less self-esteem than do the healthy subjects. As far as concerns the second aim, we found than self-esteem correlated with all the psychological variables investigated. This information could indicate the enormous importance that the psychological variable 'self-esteem' plays in haemophiliacs with respect to whether or not they develop depressive disorders and/or anxiety states.

Adaptation, Psychological↗
PubMed1991

Adaptation to chronic illness in childhood: diabetes mellitus.

The purpose of this paper is to discuss a conceptual frame of reference for the study of human responses to chronic illness in childhood using diabetes mellitus as a model case and to review the research findings on physiological and psychological adaptation. In addition, the implications of these studies for nursing practice are presented.

Adaptation, Physiological↗
PubMed1979

Behavior therapy as a test of psychoanalytic theory.

The author describes 4 patients in whom radically new symptoms appeared after intensive behavior therapy. He suggests that fresh symptoms are most likely to develop in a small minority of patients who are unable to learn more adaptive psychological defense mechanisms during or after behavior therapy and that psychoanalytic theory may help predict the nature of such symptoms.

Adaptation, Psychological↗
PubMed1988

Efficacy of relaxation techniques in hypertensive patients.

We examined 117 outpatients (20- to 45-year-old men) with mild essential hypertension before treatment, after the main treatment course (6 weeks), and at 12-month follow-up. The patients were randomized into two major groups: (a) a treatment group that received autogenic training (23 patients), biofeedback (24 patients), or breathing-relaxation training (23 patients) and (b) a control group that consisted of 24 patients who did not receive any intervention and 23 patients who were treated with a "psychological placebo." Clinical, psychological, and psychophysiological data from all patients who were offered relaxation therapy were analyzed. By the end of follow-up, and compared to the control group, the treatment group demonstrated a significant reduction in systolic and diastolic blood pressures, peripheral vascular resistance, and hypertensive response to emotional stress, and an improvement in psychological adaptation, quality of life, and capacity for work. Comparative analysis of the efficacy of different relaxation methods revealed that biofeedback and breathing-relaxation training resulted in the greatest reduction in blood pressure. The antihypertensive effect of relaxation therapy correlated positively with pretreatment blood pressure levels and negatively with the duration of illness and certain psychological features.

Adaptation, Psychological↗