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Results for “Structural equation modeling”

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PubMed2006

Testing a model of symptoms, communication, uncertainty, and well-being, in older breast cancer survivors.

Among older, long-term breast cancer survivors, symptoms from previous treatment can generate uncertainty about whether they represent co-morbid conditions, recurrence, or normal aging. This uncertainty can result in emotional distress and thoughts of recurrence. Communication with health care providers may help women reduce uncertainty and improve both emotional and cognitive well-being. To assess the influence of symptoms, uncertainty, and communication with providers on well-being, data from 203 Caucasian and African American survivors, 5-9 years post treatment, were tested using structural equation modeling. Symptoms, age, and uncertainty had the strongest influence on well-being, regardless of race. There was an unexpected positive association between patient-provider communication and thoughts of recurrence. Descriptive analysis revealed that 52% of women were unable to achieve their desired decision-making role with health care providers.

Affect↗

PubMed2006

Relationship of early life stress and psychological functioning to adult C-reactive protein in the coronary artery risk development in young adults study.

BACKGROUND: Low socioeconomic status (SES) and a harsh family environment in childhood have been linked to mental and physical health disorders in adulthood. The objective of the present investigation was to evaluate a developmental model of pathways that may help explain these links and to relate them to C-reactive protein (CRP) in the Coronary Artery Risk Development in Young Adults (CARDIA) dataset. METHODS: Participants (n = 3248) in the CARDIA study, age 32 to 47 years, completed measures of childhood SES (CSES), early family environment (risky families [RF]), adult psychosocial functioning (PsyF, a latent factor measured by depression, mastery, and positive and negative social contacts), body mass index (BMI), and C-reactive protein. RESULTS: Structural equation modeling indicated that CSES and RF are associated with C-reactive protein via their association with PsyF (standardized path coefficients: CSES to RF, RF to PsyF, PsyF to CRP, CSES to CRP, all p < .05), with good overall model fit. The association between PsyF and CRP was partially mediated by BMI (PsyF to BMI, BMI to CRP, both p < .05). CONCLUSIONS: Low childhood SES and a harsh early family environment appear to be related to elevated C-reactive protein in adulthood through pathways involving psychosocial dysfunction and high body mass index.

Adult↗

PubMed2005

Perception of control over anxiety mediates the relation between catastrophic thinking and social anxiety in social phobia.

Cognitive models of social phobia (social anxiety disorder) assume that individuals with social phobia experience anxiety in social situations in part because they overestimate the social cost associated with a potentially negative outcome of a social interaction. Some emotion theorists, on the other hand, point to the perception of control over anxiety-related symptoms as a determinant of social anxiety. In order to examine the relationship between perceived emotional control (PEC), estimated social cost (ESC), and subjective anxiety, we compared three alternative structural equation models: Model 1 assumes that PEC and ESC independently predict social anxiety; Model 2 assumes that ESC partially mediates the relationship between PEC and anxiety, and Model 3 assumes that PEC partially mediates the relationship between ESC and anxiety. We recruited 144 participants with social phobia and administered self-report measures of estimated social cost, perceived anxiety control, and social anxiety. The results support Model 3 and suggest that "costly" social situations are anxiety provoking in part because social phobic individuals perceive their anxiety symptoms as being out of control.

Adolescent↗

PubMed2003

A model of mother-child coping and adjustment to HIV.

An increasing proportion of newly diagnosed AIDS cases is being reported among African American urban women. Recent research regarding the psychosocial and behavioral impact of a mother's HIV status on her uninfected children as well as a growing body of clinical evidence suggest that these children are extremely vulnerable and at risk for problems in psychosocial adjustment. The present paper reports the results of research designed to examine the pathways by which a mother's HIV-positive status affects the psychosocial adjustment of her uninfected school-age child. The principal predictor variables of the model are family sociodemographic characteristics, social support available to mother and child, HIV-related symptom distress in the mother, coping strategies of both mother and child, emotional distress of the mother, and quality of the parent-child relationship. The dependent variable is the psychosocial adjustment of the child. Data were collected on 147 mother-child dyads using standardized questionnaires and personal interviews. Eighty-six percent of the mothers were African American and over 96% were on public assistance. Structural equation modeling was used to test the proposed model of mother-child coping and adjustment. After adding three paths, the model had a good fit to the data (comparative fit index=0.94; root mean square estimate of error=0.06). Five model constructs accounted for 36% of the variance in child adjustment. The constructs in order of importance were maternal HIV-associated stressors, maternal emotional distress, child social support, child coping, and quality of parent-child relationship.

Adaptation, Psychological↗

PubMed2005

Health-related quality of life in multiple sclerosis: psychometric analysis of inventories.

OBJECTIVE: Measuring health-related quality of life (HRQoL) enables attainment of a comprehensive picture of chronic patients' conditions. The aim was to gain insight into HRQoL as viewed by Israeli multiple sclerosis (MS) patients, with an eye to its cross-cultural applicability, using psychometric analysis and a regression-based procedure. METHODS: The reliability and validity of the MSQoL-54 was assessed in 215 Israeli MS patients. Subsequently a novel method in QoL research for assessing the relative importance to patients of different aspects of the construct, comparing these between males and females, was applied. Using factor analysis, the degree to which the MSQoL-54 dimensions are applicable in our population and the existence of a separate dimension of Fatigue were tested. Finally, structural equation modelling (SEM) was used to examine relationships between QoL dimensions. RESULTS: The MSQoL-54 showed reliabilities and validities comparable to those found in other populations. Females attach importance to emotional aspects of QoL, while males are more concerned with physical aspects. The distinction between Emotional and Physical dimensions emerged from SEM, as did a distinction between Fatigue and Energy, the former being primarily Physical, and the latter Emotional. SEM indicated a reciprocal causality between Physical and Emotional dimensions. CONCLUSIONS: Based on internal structure, reliability and validity, the MSQoL-54 is applicable to Israeli MS patients. However, the scale's Social Function dimension is indecisively defined, which requires further study. QoL research in MS should distinguish between emotional and physical Fatigue. Assessing importance of QoL dimensions should inform clinicians in tailoring treatment to the individual patient.

Adolescent↗

PubMed2001

Intergenerational cycle of maltreatment: a popular concept obscured by methodological limitations.

OBJECTIVE: The intergenerational transmission of child maltreatment is a controversial subject. Much of existing research is plagued with at least three fundamental weaknesses: (1) using case status to define subjects: (2) adopting a dichotomous perspective that does not consider the reality of maltreatment on various continua; and (3) using operational definitions that fail to differentiate between maltreatment subtypes. We controlled for these problems and examined the structure of child maltreatment and its influence on later parenting practices in an ethnically-diverse community sample. METHOD: Data from a community sample of parents (N = 383) were analyzed with a Structural Equation Modeling methodology. Reliable and valid continuous measures of child maltreatment (Child Trauma Questionnaire) and parenting practices (Parental Acceptance and Rejection Questionnaire) were used. RESULTS: Results revealed a moderately strong effect from a general factor of Child Maltreatment to a general factor of Poor Parenting for both mothers and fathers, supporting a common dysfunction transmission process. For mothers. Family Neglect by itself also led to poor parenting, and sexual abuse as a child led to aggressive parenting. For fathers, Child Maltreatment had a different structure, as sexual abuse was distinct from the factors of Family Abuse and Family Neglect. Also, for fathers, sexual abuse led to rejecting parenting practices. CONCLUSIONS: This study supports the intergenerational cycle of child maltreatment hypothesis in such a way that several weaknesses in much of existing research were controlled. Clinical implications and potential mechanisms of transmission are discussed.

Adult↗

PubMed2004

Intergenerational transmission of depression: test of an interpersonal stress model in a community sample.

An interpersonal stress model of depression transmission was tested in a community sample of nearly 800 depressed and never-depressed women and their 15-year-old children. It was hypothesized that maternal depression (and depression in the maternal grandmother) contributed to chronic interpersonal stress in the mothers, affecting quality of parenting and youths' social competence. In turn, poor social functioning and interpersonal life events caused at least in part by the youths were predicted to be the proximal predictors of current depressive symptoms and diagnoses. Structural equation modeling confirmed the predicted associations among variables and the link between youth chronic and episodic interpersonal stress and depression. Additionally, the association between maternal and child depression was entirely mediated by the predicted family and interpersonal stress effects.

Adult↗

PubMedDate not supplied

Postural stability in the elderly: empirical confirmation of a theoretical model.

The study investigated whether physiological factors related to specific body systems can explain postural control as measured by the scalar distance at a given time between the center of pressure (COP) and the center of mass (COM), the COP-COM variable. The data from 46 healthy subjects and 29 subjects with disabilities due to stroke or diabetic peripheral neuropathy were analyzed. The biomechanical variable COP-COM was determined using two force platforms and an optoelectric system. Three systems were considered as possible predictors of the COP-COM amplitude: sensory (somatosensory and vision), musculoskeletal and central processor. A confirmatory analysis was done using structural equation modeling. Strength explained 23.74% of the COP-COM amplitude in the antero-posterior (A/P) with eyes open (EO) condition, and in the medio-lateral (M/L) direction strength explained 40.73 and 28.75% in the EO and eyes closed (EC) respectively. In the A/P direction with EC, 51.75% of the COP-COM amplitude variance was explained mainly by the somatosensory system. This study highlight the role of peripheral somatosensory input and muscle strength in the maintenance of postural stability during quiet stance in the elderly. The indirect action of the different systems on the COP-COM amplitude supports the systems theory.

Aged↗

PubMed2005

Family functioning, perceived control, and anxiety: a mediational model.

Research has focused on defining which types of family interactions promote development of anxiety. Control has emerged as an important construct in anxious families. Central to conceptualizing the relationship between family functioning, control beliefs, and anxiety is establishing a sequential relationship among these variable, which may entail mediating or moderating relationships, or relationships that change over the course of development. The current study investigated whether control acts as a moderator or a mediator between perceived family environment and anxiety in your adults. An undergraduate sample (N=364) completed the family assessment device (FAD), anxiety control questionnaire (ACQ), Beck anxiety inventory (BAI), and a demographic questionnaire. Structural equation modeling (SEM) was used to test both moderating and mediating models. No moderating effects were found. Sense of control mediated the relation between aspects of family functioning and anxiety. Theoretical implications and suggestions for future research are discussed.

Adolescent↗

PubMed1999

Mode of physical activity and self-efficacy in older adults: a latent growth curve analysis.

A randomized controlled trial examined the effect of two physical activity modes on changes in self-efficacy over the course of a 12-month period in older, formerly sedentary adults (N = 174, M age = 65.5 years). Participants were randomized into either an aerobic activity group or a stretching and toning group. Structural equation modeling was employed to conduct multiple sample latent growth curve analyses of individual growth in exercise and physical self-efficacy over time. Results revealed a curvilinear growth pattern for both types of efficacy with increases occurring over the first 6 months followed by declines at the 6-month follow-up. There was a significant treatment by mean level growth interaction for exercise efficacy with both groups increasing over time, but the aerobic group evidenced a twofold increase in growth over the stretching group. Structural analyses indicated that frequency of exercise participation was a significant predictor of overall growth in efficacy, and improvements in fitness were only related to exercise efficacy growth in the stretching group. Findings are discussed in terms of social cognitive theory and further application of latent growth curve modeling to studies of physical activity effects in older adults.

Activities of Daily Living↗

PubMed2003

Intergenerational transmission of health: the role of intrapersonal, interpersonal, and communicative factors.

A model of household dietary behaviors based on adults' and children's intrapersonal, interpersonal, and communicative factors is introduced and tested. To the extent that children's health behaviors are influenced by adults' health behaviors, it is hypothesized that children's behavioral determinants, including self-efficacy, knowledge, and use of health information, will be affected by household adults' behavioral determinants. Household communication is expected to affect the behaviors and the behavioral determinants of adults and children. Data come from the Stanford Five-City Project. Structural equation models revealed that adults' dietary behavior was influenced by their self-efficacy, knowledge, and discussion between adults and children. Children's dietary behavior was influenced by their self-efficacy, knowledge, and use of health information. Adults' intrapersonal determinants of dietary behavior predicted corresponding children's measures. Implications for health education efforts directed at children include encouraging household discussion about health and focusing on adults as agents of change as an integral campaign strategy.

Adolescent↗

PubMedDate not supplied

Multidimensional causal model of dental caries development in low-income preschool children.

Despite the decline in the incidence of dental caries in the United States over the past several years, the condition remains a significant problem for the nation's poor children. Efforts to identify the factors responsible for caries development in samples of children of low socioeconomic status have primarily focused on a limited number of variables, and those have been predominantly biological (mutans streptococci, for example). Resulting models of caries development have usually shown good sensitivity but poor specificity. They have had limited implications for treatment. In an effort to produce a comprehensive model of caries development, 184 low-income preschool children were clinically assessed for mutans streptococci and for decayed, missing, or filled surfaces of deciduous teeth twice, first at age 4 years (baseline) and again a year later (year 1 assessment). As the clinical assessments were being done, caretakers were being interviewed to obtain data from five domains: demographics, social status, dental health behaviors, cognitive factors such as self-efficacy (self-confidence) and controllability, and perceived life stress. Data were analyzed using a structural equations modeling approach in which variables from all domains, plus baseline decayed missing and filled surfaces and baseline mutants, were used together to create a model of caries development in the year 1 assessment. Results confirmed earlier work that suggested that caries development at a 1-year followup was strongly dependent on earlier caries development. Early caries development in this sample was determined in part by mutans levels and by dental health behaviors. These behaviors themselves were accounted for partly by a cognitive factor. The results support the advantages of employing multidimensional models and provide some direction for intervention to reduce caries incidence.

Causality↗

PubMed1996

Precursors, mediators and problem drinking: path analytic models for men and women.

Direct and mediating effects of mechanisms hypothesized to account for the association between parental problem drinking and later problem drinking by offspring were investigated. Specifically, a "negative affect" submodel was proposed in which family environment, self-esteem, alienation, likelihood of attaining valued goals, psychopathology, and drinking motives would all mediate the parental-problem-drinking to offspring-problem-drinking relationship. Subjects were 350 female and 300 male, eighteen to twenty-three year-old undergraduates. Multivariate analyses of variance revealed differences in a majority of study variables between subjects with and without a family history of parental problem drinking. Structural equation modeling identified associations separately for paternal and maternal problem drinking and offspring alcohol use. Direct and mediating effects were tested with path analysis separately for male and female respondents. Both parents' drinking affected later problematic alcohol use by offspring. The opposite-sexed parents' drinking had a more negative influence on subjects' self-perception. For both men and women, parental problem drinking reduced adaptive family functioning, which was subsequently linked to problem personality characteristics, more personal drinking motives, and greater alcohol involvement. Specific mediating mechanisms varied between models for each sex. Implications regarding these models are discussed.

Adult↗

PubMed2026

From fear to empowerment: the impact of employees AI awareness on workplace well-being - a new insight from the JD-R model.

PURPOSE: The primary purpose of the study was to explore the impact of health workers' awareness of artificial intelligence (AI) on their workplace well-being, addressing a critical gap in the literature. By examining this relationship through the lens of the Job demands-resources (JD-R) model, the study aimed to provide insights into how health workers' perceptions of AI integration in their jobs and careers could influence their informal learning behaviour and, consequently, their overall well-being in the workplace. The study's findings could inform strategies for supporting healthcare workers during technological transformations. DESIGN/METHODOLOGY/APPROACH: The study employed a quantitative research design using a survey methodology to collect data from 420 health workers across 10 hospitals in Ghana that have adopted AI technologies. The study was analysed using OLS and structural equation modelling. FINDINGS: The study findings revealed that health workers' AI awareness positively impacts their informal learning behaviour at the workplace. Again, informal learning behaviour positively impacts health workers' workplace well-being. Moreover, informal learning behaviour mediates the relationship between health workers' AI awareness and workplace wellbeing. Furthermore, employee learning orientation was found to strengthen the effect of AI awareness on informal learning behaviour. RESEARCH LIMITATIONS/IMPLICATIONS: While the study provides valuable insights, it is important to acknowledge its limitations. The study was conducted in a specific context (Ghanaian hospitals adopting AI), which may limit the generalizability of the findings to other healthcare settings or industries. Self-reported data from the questionnaires may be subject to response biases, and the study did not account for potential confounding factors that could influence the relationships between the variables. PRACTICAL IMPLICATIONS: The study offers practical implications for healthcare organizations navigating the digital transformation era. By understanding the positive impact of health workers' AI awareness on their informal learning behaviour and well-being, organizations can prioritize initiatives that foster a learning-oriented culture and provide opportunities for informal learning. This could include implementing mentorship programs, encouraging knowledge-sharing among employees and offering training and development resources to help workers adapt to AI-driven changes. Additionally, the findings highlight the importance of promoting employee learning orientation, which can enhance the effectiveness of such initiatives. ORIGINALITY/VALUE: The study contributes to the existing literature by addressing a relatively unexplored area - the impact of AI awareness on healthcare workers' well-being. While previous research has focused on the potential job displacement effects of AI, this study takes a unique perspective by examining how health workers' perceptions of AI integration can shape their informal learning behaviour and, subsequently, their workplace well-being. By drawing on the JD-R model and incorporating employee learning orientation as a moderator, the study offers a novel theoretical framework for understanding the implications of AI adoption in healthcare organizations.

Humans↗

PubMed2005

A model of executive functions in very old community dwellers: evidence from The Sydney Older Persons Study.

Executive functions (EF) are generally described as showing greater sensitivity to ageing compared to other cognitive domains. Numerous pitfalls exist in the measurement of EF due to loose definitions and lack of agreement on these concepts and uncertainty about the constructs being measured. To this date, the validity of EF constructs has not been examined in the old-old population. Performance of 122 randomly selected community dwellers aged between 81 and 97 years on nine EF tasks (seven of which commonly used in clinical practice) was examined. Factor analytic procedures using structural equation modelling (SEM) failed to satisfactorily explain the data according to four a priori models, the first two models reflecting two major constructs commonly found in current models of EF ("set" and "switch"), the last two reflecting task requirements. The best measure for each task was extracted using statistically driven analyses and further SEM revealed an orthogonal two-factor model which provided a good fit of the data, explaining between 8% and 25% of the total variance. This model can be interpreted in terms of reactive and spontaneous flexibility as proposed by Eslinger and Grattan (1993), with the first factor reflecting internally driven strategies and the second environment dependent strategies. Furthermore, these findings also suggest that: (a) unique tasks of EF may not be applicable to all age groups due to individual experience and changes in strategies; and (b) current clinical instruments may be inadequate to measure very specific aspects of the complex construct of EF.

Aged↗

PubMedDate not supplied

Maternal social support predicts birth weight and fetal growth in human pregnancy.

OBJECTIVE: Low birth weight is a primary cause of infant mortality and morbidity. Results of previous studies suggest that social support may be related to higher birth weight through fetal growth processes, although the findings have been inconsistent. The purpose of this investigation was to test a model of the association between a latent prenatal social support factor and fetal growth while taking into account relations between sociodemographic and obstetric risk factors and birth weight. METHOD: A prospective study was conducted among 247 women with a singleton, intrauterine pregnancy receiving care in two university-affiliated prenatal clinics. Measures of support included support from family, support from the baby's father, and general functional support. Sociodemographic characteristics were also assessed. Birth outcome and obstetric risk information were abstracted from patients' medical charts after delivery. RESULTS: Structural equation modeling analyses showed that a latent social support factor significantly predicted fetal growth (birth weight adjusted for length of gestation) with infant sex, obstetric risk, and ethnicity in the model. Marital status and education were indirectly related to fetal growth through social support. The final model with social support and other variables accounted for 31% of the variance in fetal growth. CONCLUSIONS: These findings suggest that prenatal social support is associated with infant birth weight through processes involving fetal growth rather than those involving timing of delivery. Biological and behavioral factors may contribute to the association between support and fetal growth, although these mechanisms need to be further explored. These results pave the way for additional research on fetal growth mechanisms and provide a basis for support intervention research.

Adolescent↗

PubMed2005

Development and validation of a brief version of the dyadic adjustment scale with a nonparametric item analysis model.

The main purpose of the current research was to develop an abbreviated form of the Dyadic Adjustment Scale (DAS) with nonparametric item response theory. The authors conducted 5 studies, with a total participation of 8,256 married or cohabiting individuals. Results showed that the item characteristic curves behaved in a monotonically increasing function for all items of the brief 4-item version of the DAS (DAS-4). The DAS-4 proved to be informative at all levels of couple satisfaction. Compared with the 32-item version of the DAS (DAS-32), it was as effective in predicting couple dissolution and was significantly less contaminated by socially desirable responding. In addition, structural equation modeling demonstrated that the underlying latent construct measured by the DAS-4 was very stable over a 2-year period. This brief version has the advantage of being less time consuming and constitutes a promising alternative to the original DAS-32 for clinicians and researchers.

Adult↗

PubMed2005

Construct validation of the Greek SF-36 Health Survey.

OBJECTIVE: To test the construct validity of the Short-Form 36 (SF-36) Health Survey, using structural equation modeling (SEM). METHODS: Cross-sectional survey was conducted. Data were collected from 1007 participants in a stratified sample of adult general population, interviewed face-to-face by trained interviewers. RESULTS: SEM analyses supported the superiority of the eight first-order factor model of health. Higher-order analyses suggested that a model with three correlated second-order factors (physical health, general well-being, general mental health) and one third-order factor (health) provided a satisfactory fit to the data. CONCLUSIONS: These results confirm the multidimensional structure of the SF-36 and underscore the feasibility of multinational comparisons of health status using this instrument. They also support the use of eight subscale scores in parallel with three second-order summary scores rather than one overall score.

Adult↗