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Results for “ADAPTATION, PSYCHOLOGICAL”

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PubMed1996

Adolescents' well-being and perceived control across 14 sociocultural contexts.

The sweeping sociopolitical changes in Eastern Europe and the importance of self-related resources in facilitating adolescents' transitions to adulthood motivated this study on the effects of sociocultural context on adolescents' perceived control and well-being (N = 3,844; 7 Western contexts, 7 Eastern). The authors found that the mean levels of well-being and perceived control varied along stable Western vs. unstable Eastern sociohistorical contexts: (a) Eastern adolescents showed lower levels of well-being (perhaps related to economic aspects of change) and (b) higher levels of perceived control (perhaps related to perceived freedoms implied in the direction of change). Notably, however, the individual-difference relations (correlations) among the constructs were very uniform across the 14 settings, suggesting that the adaptive psychological interface between well-being and personal control is relatively robust against sociopolitical influences.

Adolescent↗

PubMed2004

Beliefs and practices of patients with advanced cancer: implications for communication.

The aim of this study was to investigate the beliefs that patients with advanced cancer held about the curability of their cancer, their use of alternatives to conventional medical treatment, and their need to have control over decisions about treatment. Of 149 patients who fulfilled the criteria for participation and completed a self-administered questionnaire, 45 patients (31%) believed their cancer was incurable, 61 (42%) were uncertain and 39 (27%) believed their cancer was curable. The index of need for control over treatment decisions was low in 53 patients (35.6%) and high in only 17 patients (11.4%). Committed users of alternatives to conventional medical treatments were more likely to believe that their cancer was curable (P<0.001) and to have a higher need for control over decisions about treatment (P<0.004). The mean need for control scores were highest in patients who believed that their cancer was curable, or who were uncertain about the curability of their cancer, but who acknowledged that their oncologist had reported that the cancer was incurable. The diverse beliefs, attitudes and actions of these patients were consistent with a range of psychological adaptations to a life-threatening illness, some realistic and others illusory. Illusory responses influence what communication can achieve in daily oncology practice.

Attitude of Health Personnel↗

PubMed2004

Exploring quality of life following high spinal cord injury: a review and critique.

STUDY DESIGN: Review. OBJECTIVES: To explore the concept of quality of life (QOL), critique the practice and problems of assessing QOL following spinal cord injury (SCI) and to review the findings of studies into QOL for people with SCI both below and above the level of C4. METHODS: Relevant articles were identified from the Medline and CINAHL databases for approximately the period 1990-2003, cross-indexing 'spinal cord injury' or 'quadriplegia/tetraplegia' with 'quality of life', 'life satisfaction', 'social adjustment' or 'psychological adaptation'. This search was augmented through papers identified in reference lists. Articles were excluded if they were designed solely to examine the impact of a specific intervention upon QOL; or if they examined satisfaction with various life domains without explicitly linking these to perceptions of QOL. Papers were also accessed that addressed the philosophical and epistemological issues involved in QOL conceptions and assessment. RESULTS: Review of the literature highlights the philosophical and methodological difficulties associated with the quantitative measurement of a qualitative experience; and with the assessment of life domains chosen by researchers. Analysis of QOL research undertaken among people with all levels of SCI demonstrates that dissatisfaction with life following injury arises primarily from social disadvantage. However, little research has been conducted specifically to ascertain perceptions of QOL among people with high SCI. CONCLUSIONS: Ensuring the relevance of future research into QOL following high SCI requires qualitative methodology and mixed methods. Further research is needed to determine how rehabilitation professionals can act on the findings of their QOL assessments and enhance the QOL experienced by people with spinal cord injury in the context of their environments. SPONSORSHIP: The early phase of this study was supported by: University of British Columbia Graduate Fellowship; Rick Hansen Man in Motion Foundation (studentship); Social Sciences and Humanities Research Council of Canada: doctoral fellowship.

Activities of Daily Living↗

PubMed2000

Attitudes to radical gynecological oncology surgery in the elderly: a pilot study.

Does age-related inequality of cancer care reflect patient preference or physician prejudice? We hypothesize no difference between elderly and younger patients' desire for optimal surgery and disease cure, and psychological adaptation to cancer. A newly developed questionnaire to assess attitudes to radical gynecological surgery in the elderly (ARGOSE) and a battery of established instruments were administered to 54 gynecological cancer patients (32 aged 65 + years; and 22 aged < 65 years) by structured interview. Disease diagnosis differed between cohorts (P = 0.007), but treatment modalities were similar (P = 0.46). There was no difference between cohorts in desire for optimal surgery and disease cure. Trends suggest the young consider a patient's age is less important than do the elderly, but the elderly may oppose age-related economic rationing of treatment more than the young. Furthermore, elderly individuals tend to perceive their seniors too elderly for treatment, but not themselves. The elderly believe more strongly that doctors should make management decisions. Perceptions of change in body image after cancer treatment did not differ between cohorts. The influence of age in determining attitudes is complex. A larger study with increased power is indicated to examine trends revealed in this pilot study.

Journal Article↗

PubMed2002

Measuring control appraisals in chronic pain.

Research has established a positive association between appraisals of control over pain and indexes of adaptive psychologic and physical functioning among persons with chronic pain. A number of measures of control appraisals have been used in the research literature. The current study sought to determine the number of factors or dimensions embedded in these commonly used measures of pain control appraisal. The study also sought to determine the association between the control appraisal construct(s) and measures of patient functioning. Two hundred fifty-two persons with chronic pain completed a questionnaire packet that included multiple measures of control appraisals. A factor analysis resulted in 6 factors: 1 factor representing beliefs about control over life in general, 1 representing perceived control over the effects of pain on one's life, and remaining 4 factors that appear to be more closely tied to perceived control over pain itself. Consistent with previous research, control appraisals made a significant contribution to the prediction of functioning (depression, disability, and pain interference). Most importantly, perceived control over the effects of pain on one's life and perceived control over life in general were more strongly associated with functioning than perceptions of control over pain itself.

Journal Article↗

PubMed1984

Psychosocial status in chronic illness. A comparative analysis of six diagnostic groups.

Assumptions that psychological attributes are specific to particular diagnoses characterize many investigations of chronically ill patients. We studied 758 patients, each of whom had one of six different chronic illnesses, to determine and compare their scores on the Mental Health Index. Five groups of physically ill patients (with arthritis, diabetes, cancer, renal disease, or dermatologic disorders) did not differ significantly from one another or from the general public, but all had significantly higher scores for psychological status when compared with the sixth group, patients under treatment for depression. There was a significant direct relation between higher mental-health scores and advancing age across all patient populations. Patients with recently diagnosed illness in all groups had poorer mental-health scores than did patients whose illness had been diagnosed more than four months previously. A direct relation between declining physical status and mental-health scores was observed. These results suggest that psychological adaptation among patients with chronic illnesses is remarkably effective and fundamentally independent of specific diagnosis.

Adult↗

PubMed2004

Living with a chronic deteriorating disease: the trajectory with muscular dystrophy over ten years.

PURPOSE: The aim of the study was to elucidate experiences of living with muscular dystrophy in terms of consequences for activity over 10 years. METHODS: The study population was identified in a prevalence study in a county of Sweden. Forty-six persons of this cohort with MD were interviewed. A qualitative research approach was chosen. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) was used for categorization. RESULTS: Nearly all the subjects experienced a deterioration of physical capacity. Most obvious were the restrictions on mobility and increased fatigue and feebleness. The persons described psychosocial consequences of the muscular dystrophy as well as stigma when the disability had become more obvious. In spite of reported distress several persons experienced better psychological adaptation over time. The image of the future was often dark but several focus on today and avoid thoughts about the future. ICF showed some limitation with regard to temporal aspects, emotions and the subjective perspective. CONCLUSIONS: The knowledge of the trajectory with MD is important in order to offer the best possible treatment and support. Repeated assessment by ICF can serve as a valuable source of such knowledge, and a development of the classification would increase its usefulness in future analysis of functioning and disability.

Accidental Falls↗

PubMedDate not supplied

Ego function as a correlate of addiction.

Eighty-nine substance abusers in an urban treatment facility completed the self-report version of the Ego Function Assessment as well as the Addiction Severity Index. Statistical analyses delineate ego functions that relate to specific disruptions in the social and psychological adaptation of the substance abuser. Distinct profiles of ego functions are highlighted based on patterns of intravenous drug injection. Education levels are showen to correlate with ego function strengths. Results are interpreted from the social perspective of drug abuse.

Adult↗

PubMed1987

Social support structures of women in treatment for alcoholism.

The authors in this article explore the weak social support structures of alcoholic women to identify those critical elements that might be usefully attended to in treatment. Data were derived from a comparison between survey questionnaires from 301 alcohol-dependent women and 136 nonalcohol-dependent women. Results showed that alcoholic women reported less social support than their nonalcoholic peers as children and adolescents. Alcoholic women reported less current support than controls; were more likely to be separated or divorced; and described their existing relationships as less happy and less supportive. Additionally, the current study reports that the linking of social support to various aspects of psychological adaptation offers a theoretical base for developing broad-based preventive and treatment interventions.

Adult↗

PubMed2003

Exercise activates the endocannabinoid system.

Extensive documentation exists showing that exercise induces analgesia and sedation. Despite decades of research attempting to explicate a neurochemical basis for these phenomena, the mechanism underlying these changes is unknown. Using trained male college students running on a treadmill or cycling on a stationary bike for 50 min at 70-80% of maximum heart rate, we report here the first evidence that exercise of moderate intensity activates the endocannabinoid system, suggesting a new mechanism for exercise-induced analgesia and possibly other physiological and psychological adaptations to exercise.

Adolescent↗

PubMed2006

Patients' beliefs about the causes of heart disease: relationships with risk factors, sex and socio-economic status.

BACKGROUND: Patients' beliefs about the causes of their heart disease (causal attributions) are important to effective medical communication, psychological adaptation, and adherence to advice. We assessed the extent to which causal attributions relate to risk factors, sex and socio-economic status in men and women diagnosed with acute coronary syndrome. DESIGN: We conducted an interview and questionnaire study of 171 acute coronary syndrome patients assessed within 5 days of admission to three hospitals in the London area. METHOD: Patients rated beliefs in the role of 16 factors in causing their heart disease. Associations between attributions and risk factors were assessed, and differences in beliefs by sex and socio-economic status (defined by educational attainment) analysed. RESULTS: The most common attributions were to stress, smoking, high blood pressure, chance or bad luck, and heredity. Attributions were strongly associated with risk factors: 90% of smokers attributed heart disease to smoking, compared with 0% never smokers; 90.4% of hypertensives attributed heart disease to high blood pressure, 72.2% of patients with a positive family history to heredity, 85% of obese patients to being overweight, and 49% of sedentary patients to lack of exercise. Attributions to stress were related both to current mood and reports of recent life stress. There were few sex differences, but higher socio-economic status patients were more likely to attribute heart disease to heredity and genetic factors. CONCLUSIONS: Causal beliefs about heart disease are strongly associated with risk factors. Effective communication about modifiable risk factors may influence causal beliefs and stimulate lifestyle change, thereby promoting secondary prevention.

Female↗

PubMed2002

Effect of forage intake on bodyweight and performance.

The horse evolved to survive on rations high in forage. Many performance horses are fed rations containing reduced levels of forage, with a corresponding increase in concentrate supply. Such reductions in forage intake are widely established to be associated with a corresponding number of physiological and psychological adaptations. Therefore, the influence of forage intake on bodyweight (bwt) and performance was investigated. Four Thoroughbred-type geldings in light to moderate work received 4 diets (100% forage [100H]; 80% forage:20% concentrate [80H]; 60% forage:40% concentrate [60H] and 50% forage:50% concentrate [50H]) in a 4 x 4 Latin-square design. A submaximal standardised exercise test (SET) was performed for each diet. Rate of passage, bwt and water intakes were measured throughout the trial and maximum, recovery heart rates and postexercise rectal temperatures recorded for each SET. Mean +/- s.e. bwt was significantly (P<0.001) higher for the 100H compared to the 50H ration (556.89 and 546.28 kg, respectively). Rate of passage of digesta was significantly (P<0.01) slower for the 100H compared to the 50H ration. Water intakes and SET maximum and 1 min recovery heart rates were significantly (P<0.05) higher (mean +/- s.e. 44.72 and 39.07 l/day, 186 and 165 beats/min, and 105 and 96 beats/min, respectively) for 100H compared to the 50H diet. Post-SET rectal temperatures tended to increase with increasing forage intakes, although these effects were not significant (mean 39.85 and 38.65 degrees C for the 100H and 50H diets, respectively). In conclusion, forage intake has significant effects on equine bwt and submaximal performance and a compromise needs to be made between the potential detrimental effects of high forage intake on performance and the potential detrimental effects of low forage intake on equine welfare.

Adaptation, Physiological↗

PubMed1980

A note on behavioural treatment in the rehabilitation of myocardial infarction patients.

Ten patients, diagnosed as suffering acute myocardial infarction were allocated to an Experimental (behavioural counselling with relaxation training) group, or a Control (waiting list) group. Measures of electromyogram activity, covert and self-rated anxiety, serum enzymes, length of illness and outcome were made. Experimental subjects had 12 weekly sessions of counselling on a variety of topics relating to psychological adaptation to the illness, plus relaxation training. The results show a significant reduction in muscle tension in experimental subjects after training. Significant changes were also found respecting covert anxiety. Self-rated anxiety and SGOT levels were related. More experimental than control subjects returned to work.

Anxiety↗

PubMed1998

The sexual competition hypothesis for eating disorders.

A hypothesis is presented for eating disorders, based on Darwinian theory, that contends that these syndromes together with the phenomenon of the pursuit of thinness are manifestations of female intra-sexual competition. It is suggested that eating disorders originate in the human female's psychological adaptation of concern about physical attractiveness which is an important component of female 'mate attraction' and 'mate retention' strategies. It is argued that present-day environment of Western countries presents a range of conditions which have led to the overactivation or the disruption of the archaic female sexual strategy of maximizing 'mate value'. The present hypothesis deals with the ultimate level of causation and is therefore compatible with a range of theories of proximate causation. Although the present hypothesis is not directly testable, it makes predictions that are testable and refutable. Finally it is suggested that the sexual competition hypothesis has more explanatory power than existing evolutionary theories of eating disorders.

Biological Evolution↗

PubMed2006

Assessment of health-related quality of life in chronic dialysis patients with the COOP/WONCA charts.

BACKGROUND: The aim of the present work was to determine the health-related quality of life (HRQOL) of our patients on hemodialysis using the COOP/WONCA charts. A further aim was to explore its psychometric characteristics. METHODS: The present study included all patients attending the hemodialysis unit of our hospital. The comparative study of the results was conducted with other population groups in which this questionnaire has been applied previously (primary-care patients, their accompanying persons, pregnant women, Alzheimer patient carers and drug addicts). The dimensional structure of the questionnaire was explored by factorial analysis of principal components, and internal consistency was evaluated with the Cronbach alpha factor. Concurrent validity was determined by comparative analysis of the results of the COOP/WONCA charts with those of another questionnaire, the 36-item short form of the Quality of Life Score (SF-36). To do so, 60 randomly chosen patients completed both questionnaires. RESULTS: 98.9% of patients completed the COOP/WONCA charts in their entirety. The mean scores of all the charts, with the exception of overall health, are in the range of what could be called 'favorable area of quality of life' (below 3). With respect to the rest of the groups, the dialysis patients had the best scores on the 'feelings' and 'social activities' charts and none of the worst ones. The joint factorial analysis revealed that the questionnaire has a 3-factor structure: factor 1 or daily functioning, factor 2 or quality of life and health, factor 3 or the psychosocial factor. The Cronbach alpha value for the 9 charts was 0.766. All the correlations between equivalent dimensions of questionnaires COOP/WONCA and SF-36 were statistically significant (p < 0.01). The convergent validity mean was 0.57 and the discriminant validity mean was 0.22, appreciably lower than convergent validity. CONCLUSIONS: This study shows that the process of psychological adaptation to problems deriving from dialysis is satisfactory. Moreover, the COOP/WONCA charts are a useful instrument for the determination of the HRQOL in hemodialysis patients without losing psychometric quality.

Adult↗

PubMed1989

Psychosomatic assessment of hirsute women.

Psychiatric illness, psychological distress and illness behavior were investigated in 30 hirsute women and 30 nonhirsute healthy control subjects matched for sociodemographic variables. The majority of patients showed a good psychological adaptation to illness: they did not report significantly more anxiety, depression, and abnormal illness behavior than controls. One-sixth of the patients, however, suffered from a clinically meaningful affective disorder. Further, hirsute patients displayed significantly more hostility and irritable mood than controls (p less than 0.01).

Adult↗

PubMedDate not supplied

Acceptance of external infusion pumps in patients with advanced breast cancer receiving continuous infusion fluorouracil.

BACKGROUND: We investigated the physical and psychological adaptation to a protracted continuous infusion system in a series of patients receiving protracted continuous infusion of 5-fluorouracil for advanced breast cancer. PATIENTS AND METHODS: The protracted continuous infusion of 5-fluorouracil was administered by means of a portable elastomeric pump (Baxter Seven-Day Infusor, 0.5 mL/hr) via an indwelling Groshong catheter. Patients were asked to complete a questionnaire exploring the impact of the continuous infusion system upon various aspects of daily life, the overall level of disturbance, the general judgement on its quality, and their willingness to resume the same kind of treatment in the future. All items were graded on a 4-point scale from 0 = not at all, to 4 = very much. RESULTS: Seventy-one patients were evaluated. All patients received 5-fluorouracil at the dose of 250 mg/m2/day as a protracted continuous infusion alone (n = 14) or in combination with vinorelbine (n = 45) or Taxol (n = 12). The median duration of the protracted continuous infusion before evaluation was 9 months (3-31). The mean level of disturbance to daily activities was 0.86 points. The activities most frequently disturbed by treatment included daily personal care (mean, 1.76 points) and sexual activity (mean, 1.20 points). Twenty-one patients required medical intervention because of problems related to the protracted continuous infusion system. The overall level of disturbance was rated at a mean level of 0.72 points, whereas the overall merits of the protracted continuous infusion system and the willingness of the patient to resume protracted continuous infusion in the future were rated at a mean level of 2.90 and 2.55 points, respectively. CONCLUSIONS: The system for the protracted continuous infusion of 5-fluorouracil was well tolerated by the patients, who were able in most cases to perform their daily activities with little or no disturbance, needing only occasional help, and were willing to resume the same treatment modality if necessary.

Activities of Daily Living↗

PubMed2004

Research issues in genetic testing of adolescents for obesity.

Obesity is often established in adolescence, and advances are being made in identifying its genetic underpinnings. We examine issues related to the eventual likelihood of genetic tests for obesity targeted to adolescents: family involvement; comprehension of the test's meaning; how knowledge of genetic status may affect psychological adaptation; minors' ability to control events; parental/child autonomy; ability to make informed medical decisions; self-esteem; unclear distinctions between early/late onset for this condition; and social stigmatization. The public health arena will be important in educating families about possible future genetic tests for obesity.

Adolescent↗