Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: Randomised controlled trial

Objective: To evaluate the impact of a provider initiated primary care outreach intervention compared with usual care among older adults at risk of functional decline. Design: Randomised controlled trial. Setting: Patients enrolled with 35 family physicians in five primary care networks in Hamilton, Ontario, Canada. Participants Patients: were eligible if they were 75 years of age or older and were not receiving home care services. Of 3166 potentially eligible patients, 2662 (84%) completed the validated postal questionnaire used to determine risk of functional decline. Of 1724 patients who met the risk criteria, 769 (45%) agreed to participate and 719 were randomised. Intervention: The 12 month intervention, provided by experienced home care nurses in 2004-6, consisted of a comprehensive initial assessment using the resident assessment instrument for home care; collaborative care planning with patients, their families, and family physicians; health promotion; and referral to community health and social support services. Main outcome measures: Quality adjusted life years (QALYs), use and costs of health and social services, functional status, self rated health, and mortality. Results: The mean difference in QALYs between intervention and control patients during the study period was not statistically significant (0.017, 95% confidence interval -0.022 to 0.056; P=0.388). The mean difference in overall cost of prescription drugs and services between the intervention and control groups was not statistically significant, (-$C165 (£107; €118; $162), 95% confidence interval -$C16 545 to $C16 214; P=0.984). Changes over 12 months in functional status and self rated health were not significantly different between the intervention and control groups. Ten patients died in each group. Conclusions: The results of this study do not support adoption of this preventive primary care intervention for this target population of high risk older adults. Trial registration: Clinical trials NCT00134836.

Would older adults turn to community support services for help to maintain their independence?

The purpose of this article is to determine whether middle-aged and older adults would identify community support services (CSSs) as a source of assistance for difficulties with the instrumental activities of daily living (IADLs). Furthermore, we determine factors related to the identification of home health and CSSs. Telephone interviews were conducted with 768 adults aged 50 and older. Respondents were presented with a vignette describing a situation where loss of independence is threatened. They were asked what they would do in that situation. Although less than 20% mentioned CSSs, nearly 50% mentioned either a home health or CSS. Findings suggest those less likely to mention a home health or CSS include men, older adults, and the foreign born. In addition, those with less education, functional health limitations, no social support, and a lack of knowledge of where to find information about CSSs mentioned home health or CSSs less often. © The Author(s) 2010.

Envolvimento dos estudantes na escola e perceção de suporte social: um estudo com alunos dos 2º e 3º ciclos do ensino básico

O envolvimento dos estudantes na escola tem ganho relevância no âmbito da comunidade científica. Apesar de não existir um consenso face à sua definição, todas apontam para o facto do envolvimento se relacionar com a forma como os estudantes se identificam e valorizam os resultados escolares, bem como, a sua participação em atividades escolares curriculares e extracurriculares. O suporte social visto como a perceção que o indivíduo tem de ser valorizado e aceite pelos outros contidos na sua rede social. A investigação tem demonstrado a relação existente entre estes dois conceitos. A existência de suporte social, mais especificamente o estabelecimento de relações positivas com o grupo de pares parece estar relacionada com um maior envolvimento dos estudantes na escola. O objetivo do presente estudo é compreender a relação entre o envolvimento dos estudantes na escola e a perceção de suporte social. O mesmo foi realizado numa escola em Évora, com alunos do 2º e 3º ciclos do ensino básico (335 alunos). Foram utilizados dois questionários: o QEEE – Questionário acerca do Envolvimento dos Estudantes na Escola e o QPSS – Questionário de Percepção de Suporte Social. Os resultados do presente estudo apontam para correlações estatisticamente significativas entre o suporte social e o envolvimento dos estudantes na escola, corroborando assim investigações já realizadas; ABSTRACT: Students engagement with school has won relevance within the scientific community. Although there is no consensus over its definition, all point to the fact that the engagement relate to how the students to identify and value the school results as well as their participation in curricular and extracurricular activities. The social support seen as the perception that the individual must be valued and accepted by others contained in your social network. The research has demonstrated the relationship between these both. The existence of social support, specifically the establishment of good relations with the peer group seems to be related to greater student engagement with school. The aim of this study is to understand the link between student engagement with school and perceived social support. It was conducted in a school in Évora, with students from 2nd and 3th cycles of middle school (335 students). We used two questionnaires: QEEE – Questionnaire about the Student Engagement with School and QPSS – Questionnaire for Perceived Social Support. The results of this study show statistically significant correlations between social support and students engagement with school, thus confirming previous research.

Prestadores de cuidados familiares a doentes com VIH/SIDA: perfil psico-emocional e social

RESUMO: Com o presente estudo pretendemos identificar a sobrecarga resultante do envolvimento familiar com os doentes portadores de VIH/SIDA. Numa breve introdução teórica, procedemos à revisão dos conceitos sobrecarga familiar e dos sentimentos/emoções vivenciados pelos prestadores de cuidados. Metodologia: Estudo do tipo descritivo e exploratório, com uma amostra de 51 indivíduos, cuja finalidade consiste na caracterização dos prestadores de cuidados familiares a doentes com VIH/SIDA. Objectivos: Identificar quem o doente com VIH/SIDA, considera ser a pessoa significativa nos cuidados informais. Caracterizar, do ponto de vista sócio-demográfico, os doentes e os prestadores de cuidados familiares. Identificar sentimentos e emoções de vivências, que justifiquem o sofrimento emocional e as repercussões na sobrecarga familiar nos prestadores de cuidados informais. Instrumentos: Na avaliação da sobrecarga familiar, utilizámos o Questionário de Problemas Familiares”- FPQ (Family Problemas Questionnaire). Para identificação dos Acontecimentos de Vida, adoptámos a escala de Holmes e Rahe (Life Events); Para identificação do estrato social escolhemos escala de Graffar. Finalmente, para a caracterização sócio-demografica concebemos dois questionários: um dirigido aos doentes e o outro aos prestadores de cuidados informais. Conclusões: A sobrecarga da doença VIH/SIDA, nos prestadores de cuidados familiares, não é uniforme nas diferentes dimensões. A dimensão sobrecarga subjectiva é superior à objectiva. O suporte social revela-se fraco, relacionado com as perdas familiares, devidas a morte, pelas relações familiares disfuncionais, entre os membros da família, pela falta de apoio e informação dos técnicos de saúde. O sexo feminino é predominante nos cuidadores. As mães e esposas são o grau de parentesco dominante. Os solteiros são o grupo mais afectado pelo VIH/SIDA. Os cuidadores apresentam idade superior à dos doentes. O estrato social preponderante é o médio baixo e o baixo. Os familiares, apesar da atitude negativa dos doentes perante os cuidadores, mantêm-se envolvidos. Segundo a avaliação multiaxial proposta pelo DM-IV, constatámos, ao nível do eixo I, sintomatologia clínica do tipo das perturbações depressivas e perturbações da ansiedade. No eixo IV, os cuidadores evidenciam problemas psicossociais e ambientais, nomeadamente nas categorias problemas com o grupo de apoio primário, problemas relacionados como grupo social, problemas educacionais, problemas de alojamento, problemas económicos. Os problemas relacionados com o grupo de apoio primário, são os que mais parecem contribuir para os problemas psicossociais e ambientais.---------------------------------------ABSTRACT: This study wants to describe several problems as a result of the family’s relationship with HIV/AIDS patients, like overload. In a brief theoric introduction, we made a small revision about the concepts of family’s overload, and feelings or emotions that have been lived by the people who provide cares to the patients with this chronic disease. Methodology: This is a describing and exploratory study, with a sample with 51 individuals, with the aim to characterize the people inside the family who give care HIV/AIDS patients. Aim: To identify who are the most important people in informal cares from the patient perspective. To characterize, in a social-demographic point of view, patients and the people who take care of them. To identify feelings and emotions that could explain an emotional suffer, and some causes in the family burden. Means: to evaluate the family’s overload we used the Family Problems Questionnaire (FPQ). To identify life events we adopted the Holmes and Rahe scale. To identify the social stratum we used the Graffer scale. Finally to do a socio-economic characterization we did two kinds of questionnaire, the first one was directed for the patients, and the second one was chosen for the people who give care. Conclusions: The HIV/AIDS disease burden on the people who takes familiar cares isn’t uniform on several areas that we studied. The subjective overload it is superior to the objective. The social support is weak and poor, and related with family losses by dead, dysfunctional family relationships, and the lack of support and information by the medical staff. Mothers and wives are the dominant relative degree. And the singles are the major group with HIV/AIDS disease. The people who take care are usually older than the sick. The major social status is low or medium-low. The relatives keep evolved though the negative attitude of the sick. According with the evaluation multiaxial proposed by the DM-IV, in axle 1 we note clinic sintomatologic belonging to the type depressive perturbations and perturbations of the anxiety. Regarding with axle IV the caretakers show up psycho-social and environmental problems, namely on the categories: problems with the primary support group and problems related as social group, educational problems, accommodation problems and.

Hopelessness and Related Variables among Cancer Patients in the Southern European Psycho-Oncology Study (SEPOS).

BACKGROUND: Although hopelessness has been studied in cancer, no data are available in non-English-speaking countries. OBJECTIVE: The authors sought to amass data from Southern European countries (Italy, Portugal, Spain, and Switzerland) in order to fill this void. METHOD: A group of 312 cancer patients completed the Mini-MAC Hopelessness subscale, the Hospital Anxiety and Depression Scale (HADS), the Cancer Worry Inventory (CWI), and a six-item Visual Analog scale (VAS) to measure intensity of physical symptoms, general well-being, difficulty in coping with cancer, intensity of social support from close relationships, leisure activity, and support from religious beliefs. RESULTS: Regression analysis indicated that HADS-Depression, VAS Maladaptive Coping and Well-Being, and the CWI explained 42% of the variance. CONCLUSION: Hopelessness in cancer patients seems not exclusively to correspond to depression, but is related to various other psychosocial factors, such as maladaptive coping, as well.

Identification and ethnic diversity underlie support for multicultural rights : a multilevel analysis in Bulgaria

Bulgaria is historically a multicultural society, composed of the Bulgarian (ethnic) majority and a number of ethnic minorities among which Bulgarian Turks and Roma are the largest. Both minority communities are stigmatized in contemporary Bulgaria, though to different degrees and for different reasons. Ethnic minorities' rights to preserve their culture, customs, and language are a topic of contentious debate. The purpose of this study was to examine individual- and context-level antecedents of the ethnic Bulgarian majority's support for multicultural rights of ethnic minorities. Multilevel regression analyses were conducted with International Social Survey Programme ISSP 2003 data (N = 920 in 28 Bulgarian districts). At the individual-level, an ethnic conception of the nation and anti-Roma symbolic prejudice were negatively related to support for multicultural rights, whereas national identification was positively related to the support of these rights. Over and above individual-level effects, and in line with recent extensions of intergroup contact theory, thepercentage ofBulgarianTurks withindistricts was positively related to support for multicultural rights. Importantly, support for multicultural rights was particularly high in districts characterized by ethnic diversity, that is, in districts with high proportions of both Bulgarian Turks and Roma. The beneficial effects of ethnic diversity and theoretical implications of findings are discussed.

The exercise leader's gender and physique salience : effects on self-presentational concerns in an exercise context

Self-presentation is the process by which individuals attempt to monitor and control how others perceive and evaluate them (Leary, 1992; Leary & Kowalski, 1990). Self-presentational concerns have been shown to influence a number of exercise-related behaviours, cognitions, and affective responses to exercise (e.g., social anxiety). Social anxiety occurs when an individual wants to create a specific impression on others, but is unsure (s)he will be successful (Leary & Kowalski, 1995). Social physique anxiety (SPA) is a specific form of social anxiety related the evaluation of one's body (Hart, Leary, & Rejeski, 1989). Both social anxiety and SPA may act as deterrents to exercise (Lantz, Hardy, & Ainsworth, 1997; Leary, 1992), so it is important to examine factors that may influence social anxiety and SPA; one such factor is self-presentational efficacy (SPE). SPE is one's confidence in successfully making desired impressions on others (Leary & Atherton, 1986) and has been associated with social anxiety and SPA (Leary & Kowalski, 1995; Gammage, Martin Ginis, & Hall, 2004). Several aspects of the exercise environment, such as the presence of mirrors, clothing, and the exercise leader or other participant characteristics, may be manipulated to influence self-presentational concerns (e.g., Gammage, Martin Ginis et aI., 2004; Martin & Fox, 2001; Martin Ginis, Prapavessis, & Haase, 2005). Given that the exercise leader has been recognized as one of the most important influences in the group exercise context (Franklin, 1988), it is important to further examine how the leader may impact self-presentational concerns. The present study examined the impact of the exercise leader's gender and physique salience (i.e., the extent to which the body was emphasized) on SPE, state social anxiety (SSA), and state social physique anxiety (SPA-S) of women in a live exercise class. Eighty-seven college-aged female non- or infrequent exercisers (i.e., exercised 2 or fewer times per week) participated in a group exercise class led by one of four leaders: a female whose physique was salient; a female whose physique was non-salient; a male whose physique was salient; or a male whose physique was non-salient. Participants completed measures of SPE, SSA, and SPA-S prior to and following completion of a 30- minute group exercise class. In addition, a measure of social comparison to the exercise leader and other participants with respect to attractiveness, skill, and fitness was completed by participants following the exercise class. A MANOV A was conducted to examine differences between groups on postexercise variables. Results indicated that there were no significant differences between groups on measures ofSPE, SSA, or SPA-S (allp's > .05). However, when all participants were collapsed into one group, a MANOV A showed a significant time effect (F(3, 81) = 19.45,p < .05, 1')2= .419). Follow-up ANOVAs indicated that post-exercise SPE increased significantly, while SSA and SPA-S decreased significantly (SPE: F(I, 83) = 30.87,p < .001,1')2 = .27; SSA: F(I,83) = 11.09,p < .001, 1')2 = .12; SPA-S: F (1,83) = 42.79,p < .001, 1')2 = .34). Further, results of a MANOVA revealed that participants who believed they were less fit than other group members (i.e., made negative social comparisons) reported significantly more post-exercise SSA and SP A-S than those who believed they were more fit than the other participants (i.e., made positive comparisons; SSA: F(2, 84) = 3.46, p < .05, 1')2 = .08; SPA-S: F(2, 84) = 5.69, p < .05, 1')2 = .12). These results may indicate that successfully completing an exercise class may serve as a source of SPE and lead to reduced social anxiety and SPA-S in this population. Alternatively, characteristics of the exercise leader may be less important than characteristics of the other participants. These results also suggest that the types of social comparisons made may influence self-presentational concerns in this sample. Future research should examine how the type of social comparison (i.e., negative or positive) made to the other group members may either generate or reduce anxiety. Also, factors that contribute to the types of social comparisons made with other exercisers should be examined. Implications for practice and research are discussed.

Social comparison and body image in non or infrequent exercisers and exercisers

Body image refers to an individual's internal representation ofhis/her outer self (Cash, 1994; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). It is a multidimensional construct which includes an individual's attitudes towards hislher own physical characteristics (Bane & McAuley, 1998; Cash, 1994; Cash, 2004; Davison & McCabe, 2005; Muth & Cash, 1997; Sabiston, Crocker, & Munroe-Chandler, 2005). Social comparison is the process of thinking about the self in relation to others in order to determine if one's opinions and abilities are adequate and to assess one's social status (Festinger, 1954; Wood, 1996). Research investigating the role of social comparisons on body image has provided some information on the types and nature of the comparisons that are made. The act of making social comparisons may have a negative impact on body image (van den Berg et ai., 2007). Although exercise may improve body image, the impact of social comparisons in exercise settings may be less positive, and there may be differences in the social comparison tendencies between non or infrequent exercisers and exercisers. The present study examined the nature of social comparisons that female collegeaged non or infrequent exercisers and exercisers made with respect to their bodies, and the relationship of these social comparisons to body image attitudes. Specifically, the frequency and direction of comparisons on specific tal-gets and body dimensions were examined in both non or infrequent exercisers and exercisers. Finally, the relationship between body-image attitudes and the frequency and direction with which body-related social comparisons were made for non or infrequent exercisers and exercisers were examined. One hundred and fifty-two participants completed the study (n = 70 non or ill infrequent exercisers; n = 82 exercisers). Participants completed measures of social physique anxiety (SPA), body dissatisfaction, body esteem, body image cognitions, leisure time physical activity, and social comparisons. Results suggested that both groups (non or infrequent exercisers and exercisers) generally made social comparisons and most frequently made comparisons with same-sex friends, and least frequently with same-sex parents. Also, both groups made more appearance-related comparisons than non-appearance-related comparisons. Further, both groups made more negative comparisons with almost all targets. However, non or infrequent exercisers generally made more negative comparisons on all body dimensions, while exercisers made negative comparisons only on weight and body shape dimensions. MANOV As were conducted to examine if any differences on social comparisons between the two groups existed. Results of the MANOVAs indicated that frequency of comparisons with targets, the frequency of comparisons on body dimensions, and direction of comparisons with targets did not differ based on exercise status. However, the direction of comparison of specific body dimensions revealed a significant (F (7, 144) = 3.26,p < .05; 1]2 = .132) difference based on exercise status. Follow-up ANOVAs showed significant differences on five variables: physical attractiveness (F (1, 150) = 6.33,p < .05; 1]2 = .041); fitness (F(l, 150) = 11.89,p < .05; 1]2 = .073); co-ordination (F(I, 150) = 5.61,p < .05; 1]2 = .036); strength (F(I, dO) = 12.83,p < .05; 1]2 = .079); muscle mass or tone (F(l, 150) = 17.34,p < .05; 1]2 = 1.04), with exercisers making more positive comparisons than non or infrequent exercisers. The results from the regression analyses for non or infrequent exercisers showed appearance orientation was a significant predictor of the frequency of social comparisons N (B = .429, SEB = .154, /3 = .312,p < .01). Also, trait body image measures accounted for significant variance in the direction of social comparisons (F(9, 57) = 13.43,p < .001, R2adj = .68). Specifically, SPA (B = -.583, SEB = .186, /3 = -.446,p < .01) and body esteem-weight concerns (B = .522, SEB = .207, /3 = .432,p < .01) were significant predictors of the direction of comparisons. For exercisers, regressions revealed that specific trait measures of body image significantly predicted the frequency of comparisons (F(9, 71) = 8.67,p < .001, R2adj = .463). Specifically, SPA (B = .508, SEB = .147, /3 = .497,p < .01) and appearance orientation (B = .457, SEB = .134, /3 = .335,p < .01) were significant predictors of the frequency of social comparisons. Lastly, for exercisers, the results for the regression of body image measures on the direction of social comparisons were also significant (F(9, 70) = 14.65,p < .001, R2adj = .609) with body dissatisfaction (B = .368, SEB = .143, /3 = .362,p < .05), appearan.ce orientation (B = .256, SEB = .123, /3 = .175,p < .05), and fitness orientation (B = .423, SEB = .194, /3 = .266,p < .05) significant predictors of the direction of social comparison. The results indicated that young women made frequent social comparisons regardless of exercise status. However, exercisers m,a de more positive comparisons on all the body dimensions than non or infrequent exercisers. Also, certain trait body image measures may be good predictors of one's body comp~son tendencies. However, the measures which predict comparison tendencies may be different for non or infrequent exercisers and exercisers. Future research should examine the effects of social comparisons in different populations (i.e., males, the obese, older adults, etc.). Implications for practice and research were discussed.

Predictors of shy children's coping with a social conflict : mediators and moderators

Shy children are at risk for later maladjustment due to ineffective coping with social conflicts through reliance on avoidance, rather than approach-focused, coping. The purpose of the present study was to explore whether the relation between shyness and children's coping was mediated by attributions and moderated by personality selftheories and gender. Participants included a classroom-based sample of 175 children (93 boys), aged 9-13 years (M = 10.11 years, SD = 0.92). Children completed self-report measures assessing shyness, attributions, personality self-theories and coping strategies. Results showed that negative attribution biases partially mediated the negative relations between shyness and social support seeking, as well as problem-solving, and the positive association between shyness and externalizing. Moreover, self-theories moderated the relation between shyness and internalizing coping at the trend level, such that the positive relation was exacerbated among entity-oriented children to a greater degree than incrementally-oriented children. In terms of gender differences, shyness was related to lower use of social support and problem-solving among incrementally-oriented boys and entity-oriented girls. Thus, shy children's perceptions of social conflicts as the outcome of an enduring trait (e.g., social incompetence) may partially explain why they do not act assertively and aggress as a means of social coping. Furthermore, entity-oriented beliefs may exacerbate shy children's reliance on internalizing actions, such as crying. Although an incrementally-oriented stance may enhance shy girls' reliance on approach strategies, it does not appear to serve the same protective role for shy boys. Therefore, copingoriented interventions may need to focus on restructuring shy children's social cognitions and implementing gender-specific programming for their personality biases.

The Impact of Personal Trainer’s Leadership Style on Self-Presentational Concerns, Enjoyment, Task Self-Efficacy and Intention to Exercise in an Introductory Weight Training Orientation

The purpose of the present study was to examine two leadership styles of personal trainers (bland versus enriched) to evaluate their effects on exercise-related outcomes. Participants were 103 university women with no previous experience weight training. Participants were randomly assigned to one of the two leadership style conditions. They completed primary measures prior to being introduced to the personal trainer. Next, participants completed an introductory weight training session, followed by post-manipulation measures. The leadership styles were successfully manipulated. Participants in the enriched leadership style condition reported significantly higher levels of enjoyment and intention to exercise. Participants in the bland leadership style condition reported significantly higher levels of social anxiety; no differences were found for task self-efficacy, self-presentational efficacy, social physique anxiety, or handgrip performance between groups. Thus, an enriched leadership style of personal trainers can increase positive psychological outcomes.

Symptômes dépressifs et consommation problématique de substances psychoactives : effets modérateurs du contexte social

Seulement une minorité d’adolescents qui consomment des substances psychoactives développe des problèmes significatifs reliés à cette consommation. Il importe donc de connaître et de comprendre les processus par lesquels se développe la consommation problématique afin de pouvoir la prévenir. Cette étude examine le rôle des symptômes dépressifs et des relations sociales dans le développement de la consommation problématique à l’adolescence. Plus précisément, elle vise à déterminer, à l’aide d’un devis longitudinal corrélationnel prospectif, si le soutien des pairs, le soutien des parents et la qualité de la relation maître-élève ont des effets modérateurs protecteurs sur la relation entre les symptômes dépressifs et la consommation problématique. L’échantillon utilisé pour cette étude est tiré de la Stratégie d’Intervention Agir Autrement et comprend 4473 adolescents. Des régressions linéaires multiples ont été effectuées et ont démontré que les symptômes dépressifs et le soutien des parents augmentent le risque d’une consommation problématique, alors que le soutien des pairs le diminue. De plus, les résultats confirment le rôle protecteur du soutien des pairs, mais indiquent que le soutien des parents exacerbe le lien entre les symptômes dépressifs et la consommation problématique. Par ailleurs, la qualité de la relation maître-élève est associée à une consommation moins problématique uniquement chez les jeunes qui n’ont pas beaucoup de symptômes dépressifs. Les implications de ces résultats sont discutées.

Vérification des liens entre les stresseurs, le soutien social, la santé psychologique au travail et la qualité de la relation élève-enseignant

La relation élève-enseignant (REE) est reconnue comme étant optimale lorsqu’elle est fortement chaleureuse et faiblement conflictuelle. Sur le plan empirique, plusieurs évidences montrent que la qualité de la REE est liée significativement à divers indicateurs de la réussite scolaire. De façon générale, celles-ci affirment que plus un élève entretient une relation optimale avec son enseignant, plus ses résultats scolaires sont élevés, plus il adopte des comportements prosociaux, et plus il présente des affects et des comportements positifs envers l’école. Des études précisent également que l’influence de la qualité de la REE est particulièrement importante chez les élèves à risque. Si les effets positifs d’une REE optimale sont bien connus, les facteurs favorisant son émergence sont quant à eux moins bien compris. En fait, bien que certains attributs personnels de l’élève ou de l’enseignant aient été identifiés comme participant significativement à la qualité de la REE, peu d’études ont investigué l’importance des facteurs psychologiques et contextuels dans l’explication de ce phénomène. Souhaitant pallier cette lacune, la présente étude poursuit trois objectifs qui sont: 1) d’examiner les liens entre les stresseurs, le soutien social, la santé psychologique au travail (SPT) et la qualité de la REE; 2) de vérifier l’effet médiateur de la SPT dans la relation entre les stresseurs, le soutien social et la qualité de la REE, et; 3) d’examiner les différences quant aux liens répertoriés auprès d’élèves réguliers et à risque. Afin d’atteindre ces objectifs, 231 enseignants québécois de niveau préscolaire et primaire ont été investigués. Les résultats des analyses montrent que les comportements perturbateurs des élèves en classe prédisent positivement le conflit entre l’enseignant et les élèves à risque. Ils montrent également que le soutien des parents et le soutien du supérieur prédisent respectivement la présence de REE chaleureuses chez les élèves réguliers et à risque. La SPT de l’enseignant prédit quant à elle positivement la présence de REE chaleureuses et négativement la présence de REE conflictuelles. Les résultats de cette recherche montrent aussi que le soutien social affecte indirectement la présence de REE chaleureuses par le biais de la SPT de l’enseignant.

Une étude sur les conditions de l’organisation du travail, le soutien social hors-travail et l’épuisement professionnel

L’objectif principal de ce mémoire est de vérifier l’effet modérateur du soutien social hors-travail sur la relation entre les conditions de l’organisation du travail et l’épuisement professionnel. Dans un deuxième temps, nous cherchons aussi à déterminer l’effet direct que peut entretenir chacune des variables sur le niveau d’épuisement professionnel. Pour nous aider à réaliser notre recherche nous avons utilisé des données secondaires provenant de l’Équipe de Recherche sur le Travail et la Santé Mentale, qui sont basées sur un échantillon de 410 travailleurs (civil et policier) du Service de Police de la Ville de Montréal (SPVM) atteint de décembre 2008 à février 2009. Les analyses multivariées réalisées ont révélé que plusieurs facteurs du travail ont une influence sur le niveau d’épuisement professionnel des employés du SPVM. En effet, l’utilisation des compétences, l’autorité décisionnelle et le soutien social au travail sont trois facteurs du travail qui agissent comme protecteur contre l’épuisement professionnel. À l’inverse, les demandes psychologiques, les demandes contractuelles (c’est-à-dire les horaires de travail irréguliers ou imprévisibles), la supervision abusive ainsi que le conflit travail-famille sont quatre autres facteurs du travail qui font augmenter significativement le niveau d’épuisement professionnel. De plus, nos résultats soutiennent que le fait de vivre en couple, de ne pas avoir d’enfant, de vivre un conflit famille-travail et d’avoir un score élevé au trait de personnalité amabilité sont tout autant de caractéristiques associées à un haut niveau d’épuisement professionnel.Parallèlement, les analyses multivariées n’ont pas permis de confirmer le lien modérateur du soutien social hors-travail sur la relation entre les conditions de l’organisation du travail et l’épuisement professionnel.

L’impact d’une interaction sociale centrée sur le trauma sur la réactivité physiologique d’individus avec un état de stress post-traumatique, en fonction de leurs symptômes et de leur soutien social.

Introduction: Les personnes ayant développé un état de stress post-traumatique (ÉSPT) évitent systématiquement d’aborder avec leurs proches le sujet du trauma ainsi que tout élément y étant associé. Cette forme d’évitement peut entraver le processus naturel de rétablissement. Les hypothèses suivantes peuvent être énoncées à cet égard. Tout d’abord, une discussion avec une personne proche et centrée sur le trauma peut être vécue comme étant anxiogène et, par conséquent, provoquer une augmentation de la fréquence du rythme cardiaque, d’ailleurs communément connue sous le nom de réactivité du rythme cardiaque. La réactivité provoquée par une telle situation peut positivement varier en fonction de l’intensité des symptômes d’ÉSPT. Cette association entre les symptômes et la réactivité peut, à son tour, varier en fonction des perceptions de la personne anxieuse du soutien social de la part de son proche et/ou de son entourage. Il en va de même pour les individus ayant développé un trouble anxieux comparable, soit le trouble panique (TP). Toutefois, toutes ces hypothèses n’ayant pas été jusqu’à maintenant vérifiées empiriquement, la présente thèse a eu pour objectif de les tester. Méthodologie: Un total de 46 personnes avec un ÉSPT et de 22 personnes avec un TP ont complété des entrevues diagnostiques et des questionnaires auto-rapportés concernant leurs symptômes ainsi que leurs perceptions des interactions sociales soutenantes et non soutenantes ou négatives avec leur proche significatif et leur entourage. Elles ont également participé à une interaction sociale avec une personne proche et centrée sur leur trouble anxieux, situation qui incluait également des mesures continues du rythme cardiaque. Résultats: Les résultats ont démontré qu’une interaction sociale centrée sur le trauma avec une personne proche provoquait une augmentation significative de la fréquence du rythme cardiaque des participants en comparaison à une interaction sociale non conflictuelle et non anxiogène avec cette même personne. Cette réactivité du rythme cardiaque corrélait de façon significative et positive avec l’intensité de leurs symptômes d’ÉSPT. Les résultats ont également permis de constater que l’hypothèse de modération concernant les perceptions d’interactions sociales positives était partiellement confirmée, soit pour les symptômes d’évitement; les perceptions d’interactions sociales négatives étant quant à elles associées de façon significative et positive à cette réactivité (c.à.d. suivant un effet principal). Quant aux personnes avec un TP, une atténuation significative dans la fréquence de leur rythme cardiaque fut observée dans le contexte analogue, atténuation qui était positivement liée à la sévérité de leurs attaques de panique. Certaines dimensions de leurs perceptions de soutien social étaient significativement et négativement liées à cette atténuation (c.à.d. suivant un effet principal). Discussion: La présente thèse a notamment démontré qu’il existait des liens entre les symptômes d’ÉSPT et la réactivité du rythme cardiaque dans le contexte d’une interaction sociale avec un proche et centrée sur le trauma. Elle a également permis de constater que les symptômes d’ÉSPT et les perceptions d’interaction sociales positives et négatives peuvent prédire cette réactivité. Dans l’avenir, des devis longitudinaux pourront informer davantage à propos de la direction des liens ici explorés.

How do social interactions with a significant other affect PTSD symptoms? An empirical investigation with a clinical sample.

Social support and coping are both related to posttraumatic stress disorder (PTSD) symptoms, but the mechanisms underlying their relationships remain unclear. This study explores these relationships by examining the perceived frequency of supportive and countersupportive interactions with a significant other in PTSD patients. Ninety-six participants with PTSD were recruited and completed questionnaires assessing social interactions, ways of coping, and PTSD symptoms. Associations of social interactions (r2 = 4.1%–7.9%, p < .05) and coping (r2 = 15.9%– 16.5%, p < .001) with symptoms were independent, and suggested a direct association between social interactions and PTSD. Countersupportive interactions were more associated to symptoms than supportive interactions. Our findings suggest the development of psychotherapies that integrate social support interventions.