A parallel-group, randomised controlled trial of a multimedia, self-directed, coping skills training intervention for patients with cancer and their partners: design and rationale

Introduction:

Religious/spiritual coping in people with chronic kidney disease undergoing hemodialysis

The objective of the present study is to investigate the use of religious/spiritual coping mechanisms in patients with chronic kidney disease undergoing hemodialysis, by means of interviews using a sociodemographic questionnaire and the religious/spiritual coping scale. Data analysis was performed using descriptive statistics and multiple linear regression. A total of 123 individuals were interviewed, 79.6% of whom presented a high score for religious/spiritual coping and none of whom presented low or irrelevant scores. The variables that affected the religious/spiritual coping behavior were: gender, age group, treatment time, family income, and religious practice. In conclusion, the participants used religious/spiritual coping mechanisms as a strategy to cope with the disease, particularly women with a higher family income who attend church every week.

军队医学科技人员身心健康与影响因素的研究

To study the relationship between mental-physical health and coping behavior,job stress and job motivation in medical laboratory scientists and technicians. A cross-section survey was conducted,using the anxiety rating scale(SAS), depression rating scale(SDS), coping behavior rating scale,self-rating subhealth scale,self-rating stress scale,and self-rating job motivation scale among 289 medical laboratory scientists and technicians with analysis of ANOVA and Regression. The study was carried out in three steps:step1 is to analyze the general situation of the mental-physical health.Step 2 is to analyze the features of the main influencial facotors.Step 3 is to study the influence of the relative factors on mental-physical health.The following are the results: 1.The anxiety and depression scores of the medical researchers and technicians were 30±6 and 37±8 respectively,both significantly lower than those of the national norm（34±6 and 42±11 respectively,both P<0.01）,which are of significant difference. The depression score of the associate chief technician was 42±7, significantly higher than those of the medical researchers and technicians with any other professional titles (all P<0.05）, and the anxiety score of the associate chief technicians was 32±7, significantly higher than that of the research fellows（28±4, P<0.05），with no significant difference to the score of the medical researchers and technicians with other professional titles. The depression score,anxiety score and the subhealth score of the age group of 36～49 were 39±9,31±7 and 32±9 respectively, both higher than that of the age group of 20～35 （36±8,29±6 and 29±7 respectively,both P<0.05）,while there is much diference among other age groups. And the subhealth status has nothing to do with marital status,education background and professional titles. 2.The coping behaviors,job stress and motivation of the military medical laboratory scientists and technicians. 1）Coping behaviors:The seeking help score of the associate chief technicians was 2.8±0.5,not significantly different from that of the associate research fellows（2.8±0.5）,but significantly lower than those of the medical researchers and technicians with other professional titles(all P<0.01),and whose self-blame score was higher than that of the research fellows,which is of significant difference.The self-blame score and the imagination score of the associate research fellows were 2.0±0.5 and 2.4±0.5 respectively, significantly higher than that of the research fellows(1.6±0.4, 2.1±0.4,both P<0.01). The seeking help score of the females was 3.1±0.5, significantly higher than that of the males(2.9±0.5, both P<0.01),and the solving problem score was 3.4±0.6,significantly lower than the male(3.6±0.7, both P<0.01).There is no any significant difference in coping behaviors among researchers and technicians of different marital status,education background and age groups. 2)Job stress: The score of job stress of the age group of 35~49 and 50~60 were 23±8 and 25±6 respectively,significantly higher than that of the 20~35(21±7,both P<0.05). There is no any significant difference in job stress among researchers and technicians of different marital status,gender,professional titles and education background. 3)The score of meeting personal desire for reputation and interests of the males was 19.6±5.4，significantly higher than that of the females(18.4±5.0, both P<0.05), while there is no significant difference in job motivation among researchers and technicians of different titles,education,age and marital status. 3.The relationship of the mental-physical health of the military medical laboratory scientists and technicians with their coping behaviors,job stress and motivations 1) Coping behaviors:Regression analysis showed that, the best predictors of subhealth were anxiety,depression and escaping (β=-0.40,β=0.23, β=0.14, both P<0.01).the best predictors of anxiety and depression were active coping behaviors and negative coping behaviors (β=-0.40,β=0.40, both P<0.01).The moderate(rational) coping behaviors is the best predictor only of anxiety and of significant difference. 2)job stress : Regression analysis demonstrated that anxiety,depression,job stress 2 and job stress 4 are the best predictor for subhealth;job stress 12 is the best retro-predictor for depression; job stress 3 and 8 are the best predictor for depression;and job stress 2 and 9 are the best predictor for anxiety ,which are of significant difference. 3)Motivation:Regression analysis demonstrated that depression is the best predictor for subhealth while motivation itself doesn't predict subhealth;with respect to the specific contents of motivation,"probing unknown rules and making contributions to the human society "is the best retro-predictor for depression and has nothing to do with anxiety prediction. 4) The combined influences of coping behaviors,job stress and motivations: Regression analysis showed that, the best predictors for subhealth were anxiety,depression and job stress(β=0.41,β=0.24, β=0.19, both P<0.01).the best predictors for anxiety and depression were active coping behaviors and negative coping behaviors (β=-0.40,β=0.40, both P<0.01).The moderate(rational) coping behaviors is the best predictor only for anxiety and of significant difference. CONCLUSIONS: Regression analysis showed that the best predictors for anxiety and depression were active coping behaviors and negative coping behaviors, the best predictors for subhealth were anxiety,depression and job stress.Coping behaviors, job stress and motivations have significant influences on the mental-physical health of the military medical researchers and and technicians. Among them,coping behavior is the most important factor while job stress and motivation follow. Seeking help more often,less self-blame ,imagination and job stress could help release the anxiety, depression and improve the subhealth of the medical researchers and technicians. The findings of this study indicate we should address the physical and mental health of the military laboratory researchers and technicians.

Struggling with food and eating - life after major upper gastrointestinal surgery

Purpose

Few qualitative studies have explored patients' experience of food and eating following major upper gastrointestinal cancer surgery. The aim of this article was to explore the longer-term impact of different types of major upper gastrointestinal surgeries on people's relationship with food.

Methods

Twenty-six people having had major upper gastrointestinal cancer surgery greater than 6 months ago participated in semi-structured interviews. These interviews aimed to explore a person's physical, emotional and social relationship with food and eating following surgery. Interviews were tape-recorded, transcribed and analysed using an inductive thematic analysis approach.

Results

Interview findings revealed a journey of adjustment, grieving and resignation. The physical symptoms and experiences of people differed between types of surgery, but the coping mechanisms remained the same.

Conclusions

The grieving and resignation people experienced suggest adjustment and coping similar to that of someone with a chronic illness. Remodeling of health services is needed to ensure this patient group receives ongoing management and support.

Cortisol response to acute stress in jundiá Rhamdia quelen acutely exposed to sub-lethal concentrations of agrichemicals

Exposure to agrichemicals can have deleterious effects on fish, such as disruption of the hypothalamus-pituitary-inter-renal axis (HPI) that could impair the ability of fish to respond to stressors. In this study, fingerlings of the teleost jundiá (Rhamdia quelen) were used to investigate the effects of the commonly used agrichemicals on the fish response to stress. Five common agrichemicals were tested: the fungicide - tebuconazole, the insecticide - methyl-parathion, and the herbicides - atrazine, atrazine + simazine, and glyphosate. Control fishes were not exposed to agrichemicals and standard stressors. In treatments 2-4, the fishes were exposed to sub-lethal concentrations (16.6%, 33.3%, and 50% of the LC50) of each agrichemical for 96 h, and at the end of this period, were subjected to an acute stress-handling stimulus by chasing them with a pen net. In treatments 5-7 (16.6%, 33.3%, and 50% of the LC50), the fishes were exposed to the same concentrations of the agrichemicals without stress stimulus. Treatment 8 consisted of jundiás not exposed to agrichemicals, but was subjected to an acute stress-handling stimulus. Jundiás exposed to methyl-parathion, atrazine + simazine, and glyphosate presented a decreased capacity in exhibiting an adequate response to cope with stress and in maintaining the homeostasis, with cortisol level lower than that in the control fish (P < 0.01). In conclusion, the results of this study clearly demonstrate that the acute exposure to sub-lethal concentrations of methyl-parathion, atrazine + simazine, and glyphosate exert a deleterious effect on the cortisol response to an additional acute stressor in the jundiá fingerlings. © 2008 Elsevier Inc. All rights reserved.

Qualidade de vida de crianças e adolescentes asmáticos: Sua relação com estratégias de enfrentamento materno

Objective: To evaluate the quality of life of asthmatic children and adolescents, its relation with sociodemographic and clinical variables, and maternal coping strategies. Methods: Cross-sectional study in which children and adolescents with asthma answered a quality of life questionnaire, and their mothers did the same with a coping scale. Results: Out of the 42 children and adolescents investigated, 74% were classified as having mild/severe persistent asthma; 19%, mild persistent asthma; and 7%, intermittent asthma. A total of 69% of the participants showed impaired quality of life with mean scores ranging between 4.7 and 3.5, with greater harm in the domain of symptoms (score=3.6). There was a significant association between maternal schooling and the general index of quality of life, whereas maternal coping strategies were not associated with the severity of asthma. A large number of strategies used by mothers to cope with their children's crises were related to the management of stressors or to religious practices, and the latter presented negative correlation with the children's quality of life general index, showing that mothers whose children had worse quality of life used more religious coping. Conclusions: Asthmatic children, particularly those with moderate/severe persistent asthma, showed significant alterations as to quality of life. The high percentage of mothers using religious strategies, particularly in face of more severe clinical conditions, seem to indicate that they feel powerless to act, thus requiring concrete and useful orientation to low income families.

Beta-Endorphin Modulates the Effect of Stress on Novelty-Suppressed Feeding

Although stress is implicated in the pathophysiology of mood and anxiety disorders, not all individuals who suffer stressful life events develop psychopathology. Differential susceptibility to stress may be influenced by genetically mediated differences in hypothalamic-pituitary-adrenal (HPA) axis activity and moderation of the stress response by the opioid peptide beta-endorphin (beta-E). The present study investigated genetic contributions to coping behavior by examining anxious behavior of transgenic mice with varying capacities to synthesize beta-E [B6.129S2-Pomc(tm1Low)/J; regulated by insertion of a premature stop codon into one or both copies of the proopiomelanocortin (POMC) gene], both under normal conditions and following 3 min of forced swim (FS). Ten minutes after this stress exposure or a control manipulation, acutely food-deprived female and male transgenic mice were subjected to a novelty-suppressed feeding (NSF) test, during which their interaction with an almond slice located in the center of an open field box was measured. There was an interaction between genotype and stress for latency to approach the almond and whether or not the almond was approached, such that mice with low or absent beta-E displayed a stronger aversion to novelty-feeding after stress exposure than did mice with normal levels. These data provide evidence for a moderating effect of beta-E on the behavioral response to stress. Genotypic differences in anxious behavior emerged when mice were stressed prior to behavioral assessment, suggesting that beta-E plays a role in coping behavior. These findings indicate that genetic variability in sensitivity of the beta-E system to stress may contribute, at least in part, to heritable differences in stress reactivity as well as vulnerability to stress-related psychopathology.

A phenomenological exploration of how West Indian professionals in South Florida perceive their career construction

This phenomenological study explored how West Indian professionals in South Florida perceive their career construction. The study used Savickas’s (2005) theory of career construction as its theoretical framework. Semi-structured interviews were conducted, transcribed, and analyzed for 15 West Indian professionals, who self-identified as West Indians and met all the criteria for this study. Interview data were analyzed using inductive, deductive, and comparative analyses. Five themes emerged from the inductive analysis of the data: (a) vocational influences, (b) adjustment challenges, (c) employment patterns, (d) career mobility patterns, and (d) career success perceptions. The theory of career construction guided the deductive analysis. The deductive analysis revealed that both extrinsic and intrinsic influences were equally influential in shaping the participants’ vocational personalities. The deductive analysis also revealed that the participants used three of the career adaptive dimensions: career concern, control, and confidence. Career concern manifested as planning for the future through educational attainment and performing meaningful work. Career control manifested as continuous learning and maintaining secondary careers. Career confidence manifested as self-efficacy expectations, beliefs about one’s ability to perform a behavior that produces desired outcomes. The participants’ life themes or challenges included navigating their identity, starting over, and adjusting to their environment. The comparative analysis revealed that all five themes from the inductive analysis were evident in each of the three tenets of Savickas’s (2005) career construction theory (i.e., vocational personality, career adaptability, and life themes). Career compromises emerged as coping behavior to facilitate the participants’ social and occupational integration. The findings of this study imply that the participants constructed their sense of self in relation to those around them and that their vocational behaviors tend to mobilize and reinforce a mixture of personality and ability. The findings also imply that the participants’ decision-making style and habitual pattern of decision making, may be embedded in their culturally norms, producing a specific cognitive style. Finally, the findings imply that the participants’ career adaptive dimensions were grounded in their attitudes, beliefs, and competencies and overall self-concept. Recommendations for further research are given.

Testing a model of physical activity among mothers and fathers of young children: integrating self-determined motivation, planning, and the theory of planned behavior

Parents are at risk for inactivity; however, research into understanding parental physical activity (PA) is scarce. We integrated self-determined motivation, planning, and the theory of planned behavior (TPB) to better understand parental PA. Parents (252 mothers, 206 fathers) completed a main questionnaire assessing measures underpinning these constructs and a 1-week follow-up of PA behavior to examine whether self-determined motivation indirectly influenced intention via the TPB variables (i.e., attitude, subjective norm, and perceived behavioral control) and intention indirectly influenced behavior via planning. We found self-determined motivation on intention was fully mediated by the TPB variables and intention on behavior was partially mediated by the planning variables. In addition, slight differences in the model’s paths between the sexes were revealed. The results illustrate the range of important determinants of parental PA and provide support for the integrated model in explaining PA decision making as well as the importance of examining sex differences.

Examining effectiveness of an immigrant labor market integration intervention. The role of acculturation, discrimination, self-efficacy, outcome expectances, action and coping planning.

The designing of effective intervention tools to improve immigrants’ labor market integration remains an important topic in contemporary Western societies. This study examines whether and how a new intervention tool, Working Life Certificate (WLC), helps unemployed immigrants to find employment and strengthen their belief of their vocational skills. The study is based on quantitative longitudinal survey data from 174 unemployed immigrants of various origins who participated in the pilot phase of WLC examinations in 2009. Surveys were administered in three waves: before the test, right after it, and three months later. Although it is often argued that the unemployment among immigrants is due either to their lack of skills and cultural differences or to discrimination in recruitment, scholars within social psychology of behavior change argue that the best way of helping people to achieve their goals (e.g. finding employment) is to build up their sense of self-efficacy, alter their outcome expectances in a more positive direction or to help them to construct more detailed action and coping plans. This study aims to shed light on the role of these concepts in immigrants’ labor market integration. The results support the theories of behavior change moderately. Having positive expectances regarding the outcomes of various job search behaviors was found to predict employment in the future. Together with action and coping planning it also predicted increase in job search behavior. The intervention, WLC, was able to affect participants’ self-efficacy, but contrary to expectations, self-efficacy was found not to be related to either job search behavior or future labor market status. Also, perceived discrimination did not explain problems in finding employment, but hints of subtle or structural discrimination were found. Adoption of Finnish work culture together with strong family culture was found to predict future employment. Hence, in this thesis I argue that awarding people diplomas should be preferred in immigrant integration training as it strengthens people’s sense of self-efficacy. Instead of teaching new information, more attention should be directed at changing people’s outcome expectances in a more positive direction and helping them to construct detailed plans on how to achieve their goals.

Religious Coping, Social Support and Subjective Severity as Predictors of Posttraumatic Growth in People Affected by the Earthquake in Chile on 27/2/2010

The aim of this research is to study the impact of religious coping, social support and subjective severity on Posttraumatic Growth (PTG) in people who lost their homes after the earthquake in Chile in 2010 and who now live in transitional shelters. One hundred sixteen adult men and women were evaluated using a subjective severity scale, the Posttraumatic Growth Inventory (PTGI), the Multidimensional Scale of Perceived Social Support (MSPSS) scale of social support and the Brief RCOPE scale of religious coping. The multiple linear regression analysis shows that social support and positive religious coping have an impact on PTG. On using a bootstrap estimate, it was found that positive religious coping fully mediates the relationship between subjective severity and PTG.

Stress in parents of children born very preterm is predicted by child externalising behaviour and parent coping at age 7 years

Objective: To examine factors which predict parenting stress in a longitudinal cohort of children born very preterm seen at age seven years.
Methods: We recruited 100 very preterm (< 32 weeks GA) child-parent dyads and a control group of 50 term-born dyads born between 2001 and 2004 with follow-up at seven years. Parents completed the Parenting Stress Index, Ways of Coping Questionnaire, Child Behavior Check List, Beck Depression Inventory and the State Trait Anxiety Inventory questionnaires. Child IQ was assessed using the Wechsler Intelligence Scale-IV.
Results: After controlling for maternal education, parents of preterm children (95% CI, 111.1 to 121.4) scored higher (p = .027) on the Parenting Stress Index than term born controls (95% CI, 97.8 to 113.2). Regression analyses showed that child externalising behaviour, sex and parent escape/avoidance coping style, predicted higher parenting stress in the preterm group. Parents of preterm girls expressed higher levels of stress than those of boys. 
Conclusions: Maladaptive coping strategies contribute to greater stress in parents of very preterm children. Our findings suggest that these parents need support for many years after birth of a very preterm infant.

Influência dos processos de identificação, motivação e estratégias de coping no comportamento aditivo

Dissertação de Mestrado, Psicologia, especialidade de Psicologia da Saúde, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2007

Self-deception as affective coping. An empirical perspective on philosophical issues.

In the philosophical literature, self-deception is mainly approached through the analysis of paradoxes. Yet, it is agreed that self-deception is motivated by protection from distress. In this paper, we argue, with the help of findings from cognitive neuroscience and psychology, that self-deception is a type of affective coping. First, we criticize the main solutions to the paradoxes of self-deception. We then present a new approach to self-deception. Self-deception, we argue, involves three appraisals of the distressing evidence: (a) appraisal of the strength of evidence as uncertain, (b) low coping potential and (c) negative anticipation along the lines of Damasio's somatic marker hypothesis. At the same time, desire impacts the treatment of flattering evidence via dopamine. Our main proposal is that self-deception involves emotional mechanisms provoking a preference for immediate reward despite possible long-term negative repercussions. In the last part, we use this emotional model to revisit the philosophical paradoxes.