Examining the relationship between daily changes in support and smoking around a self-set quit date

This study was funded by the Swiss National Foundation (100014_124516). We would like to thank all students who helped with data collection.

Investigation on Heart Rate Variability (HRV) and psycho-social-affective adjustment in Italian women with ovarian cancer

INTRODUZIONE: L���integrazione mente-corpo applicata ad un ambito patologico predominante in questi tempi, come il cancro, �� il nucleo di questa tesi. Il background teorico entro cui �� inserita, �� quello della Psiconeuroendocrinoimmunologia (Bottaccioli, 1995) e Psico-Oncologia. Sono state identificate, nella letteratura scientifica, le connessioni tra stati psicologici (mente) e condizioni fisiologiche (corpo). Le variabili emerse come potenzialmente protettive in pazienti che si trovano ad affrontare il cancro sono: il supporto sociale, l���immagine corporea, il coping e la Qualit�� della Vita, insieme all���indice fisiologico Heart Rate Variability (HRV; Shaffer & Venner, 2013). Il potenziale meccanismo della connessione tra queste variabili potrebbe essere spiegato dall���azione del Nervo Vago, come esposto nella Teoria Polivagale di Stephen Porges (2007; 2009). OBIETTIVI: Gli obiettivi principali di questo studio sono: 1. Valutare l���adattamento psicologico alla patologia in termini di supporto sociale percepito, immagine corporea, coping prevalente e qualit�� della vita in donne con cancro ovarico; 2. Valutare i valori di base HRV in queste donne; 3. Osservare se livelli pi�� elevati di HRV sono associati ad un migliore adattamento psicologico alla patologia; 4. Osservare se una peggiore percezione dell���immagine corporea e l���utilizzo di strategie di coping disadattive sono associate ad una Qualit�� della Vita pi�� scarsa. METODO: 38 donne affette da cancro ovarico, al momento della valutazione libere da patologia, sono state reclutate presso la clinica oncologica del reparto di Ginecologia dell���Azienda Ospedaliero-Universitaria di Parma, Italia. Ad ogni partecipante �� stato chiesto di compilare una batteria di test composta da: MSPSS, per la valutazione del supporto sociale percepito; DAS-59, per la valutazione dell���immagine corporea; MAC, per la valutazione delle strategie di coping prevalenti utilizzate verso il cancro; EORTC-QLQ30, per la valutazione della Qualit�� della Vita. Per ogni partecipante �� stato registrato HRV di base utilizzando lo strumento emWave (HeartMath). RISULTATI PRINCIPALI: Rispondendo agli obiettivi 1 e 2, in queste donne si �� rilevato una alto tasso di supporto sociale percepito, in particolare ricevuto dalla persona di riferimento. L���area rivelatasi pi�� critica nel supporto sociale �� quella degli amici. Per quanto riguarda l���immagine corporea, la porzione di campione dai 30 ai 61 anni, ha delle preoccupazioni globali legate all���immagine corporea paragonabili ai dati provenienti dalla popolazione generale con preoccupazioni riguardo l���aspetto corporeo. Invece, nella porzione di campione dai 61 anni in su, il pattern di disagio verso l���aspetto fisico sembra decisamente peggiorare. Inoltre, in questo campione, si �� rilevato un disagio globale verso l���immagine corporea significativamente pi�� alto rispetto ai valori normativi presenti in letteratura riferiti a donne con cancro al seno con o senza mastectomia (rispettivamente t(94)= -4.78; p<0.000001; t(110)= -6.81;p<0.000001). La strategia di coping pi�� utilizzata da queste donne �� lo spirito combattivo, seguito dal fatalismo. Questo campione riporta, inoltre, una Qualit�� della Vita complessivamente soddisfacente, con un buon livello di funzionamento sociale. L���area di funzionalit�� pi�� critica risulta essere il funzionamento emotivo. Considerando i sintomi prevalenti, i pi�� riferiti sono affaticamento, disturbi del sonno e dolore. Per definire, invece, il pattern HRV, sono stati confrontati i dati del campione con quelli presenti in letteratura, riguardanti donne con cancro ovarico. Il campione valutato in questo studio, ha un HRV SDNN (Me=28.2ms) significativamente pi�� alto dell���altro gruppo. Tuttavia, confrontando il valore medio di questo campione con i dati normativi sulla popolazione sana (Me=50ms), i nostri valori risultano drasticamente pi�� bassi. In ultimo, donne che hanno ricevuto diagnosi di cancro ovarico in et�� fertile, sembrano avere maggiore HRV, migliore funzionamento emotivo e minore sintomatologia rispetto alle donne che hanno ricevuto diagnosi non in et�� fertile. Focalizzando l���attenzione sulla ricerca di relazioni significative tra le variabili in esame (obiettivo 3 e 4) sono state trovate numerose correlazioni significative tra: l���et�� e HRV, supporto percepito , Qualit�� della Vita; Qualit�� della Vita e immagine corporea, supporto sociale, strategie di coping; strategie di coping e immagine corporea, supporto sociale; immagine corporea e supporto sociale; HRV e supporto sociale, Qualit�� della Vita. Per verificare la possibile connessione causale tra le variabili considerate, sono state applicate regressioni lineari semplici e multiple per verificare la bont�� del modello teorico. Si �� rilevato che HRV �� significativamente positivamente influenzata dal supporto percepito dalla figura di riferimento, dal funzionamento di ruolo, dall���immagine corporea totale. Invece risulta negativamente influenzata dal supporto percepito dagli amici e dall���uso di strategie di coping evitanti . La qualit�� della vita �� positivamente influenzata da: l���immagine corporea globale e l���utilizzo del fatalismo come strategia di coping prevalente. Il funzionamento emotivo �� influenzato dal supporto percepito dalla figura di riferimento e dal fatalismo. DISCUSSIONI E CONCLUSIONI: Il campione Italiano valutato, sembra essere a met�� strada nell���adattamento dello stato psicologico e dell���equilibrio neurovegetativo al cancro. Sicuramente queste donne vivono una vita accettabile, in quanto sopravvissute al cancro, ma sembra anche che portino con s�� preoccupazioni e difficolt��, in particolare legate all���accettazione della loro condizione di sopravvissute. Infatti, il migliore adattamento si riscontra nelle donne che hanno avuto peggiori condizioni in partenza: stadio del cancro avanzato, pi�� giovani, con diagnosi ricevuta in et�� fertile. Pertanto, �� possibile suggerire che queste condizioni critiche forzino queste donne ad affrontare apertamente il cancro e la loro situazione di sopravvissute al cancro, portandole ad ���andare avanti��� piuttosto che ���tornare indietro���. Facendo riferimento alle connessioni tra variabili psicologiche e fisiologiche in queste donne, si �� evidenziato che HRV �� influenzata dalla presenza di figure significative ma, in particolare, �� presumibile che sia influenzata da un���appropriata condivisione emotiva con queste figure. Si �� anche evidenziato che poter continuare ad essere efficaci nel proprio contesto personale si riflette in un maggiore HRV, probabilmente in quanto permette di preservare il senso di s��, riducendo in questo modo lo stress derivante dall���esperienza cancro. Pertanto, HRV in queste donne risulta associato con un migliore adattamento psicologico. Inoltre, si �� evidenziato che in queste donne la Qualit�� della Vita �� profondamente influenzata dalla percezione dell���immagine corporea. Si tratta di un aspetto innovativo che �� stato rilevato in questo campione e che, invece, nei precedenti studi non �� stato indagato. In ultimo, la strategia di coping fatalismo sembra essere protettiva e sembra facilitare il processo di accettazione del cancro. Si spera sinceramente che le ricerche future possano superare i limiti del presente studio, come la scarsa numerosit�� e l���uso di strumenti di valutazione che, per alcuni aspetti come la scala Evitamento nel MAC, non centrano totalmente il target di indagine. Le traiettorie future di questo studio sono: aumentare il numero di osservazioni, reclutando donne in diversi centri specialistici in diverse zone d���Italia; utilizzare strumenti pi�� specifici per valutare i costrutti in esame; valutare se un intervento di supporto centrato sul miglioramento di HRV (come HRV Biofeedback) pu�� avere una ricaduta positiva sull���adattamento emotivo e la Qualit�� della Vita.

Rede e apoio social entre idosos atendidos em um ambulat��rio de Geriatria

O objetivo geral deste estudo foi analisar a rela����o entre a rede e apoio social, satisfa����o com o apoio social recebido e as vari��veis sociodemogr��ficas, de sa��de f��sica e mental, dos idosos atendidos em um Ambulat��rio de Geriatria de um Hospital Geral Terci��rio do interior paulista. Trata-se de um estudo descritivo, transversal e explorat��rio, realizado com 98 idosos atendidos no referido ambulat��rio. Para a coleta de dados, utilizaram-se o Mini Exame do Estado Mental, um question��rio de caracteriza����o sociodemogr��fica e de sa��de, a Escala de Depress��o Geri��trica (EDG-15), o ��ndice de Katz, a Escala de Lawton e Brody, a Escala de medida da rede e apoio social do Medical Outcomes Study e a Escala de Satisfa����o com o Suporte Social. Os aspectos ��ticos foram respeitados conforme a Resolu����o 466/2012 do Conselho Nacional de Sa��de. A m��dia de idade dos idosos foi de 80,1 anos, 70,4% eram mulheres, 49,0% vi��vos; a m��dia de anos de estudo foi 2,3; 24,5% dos idosos residiam com o c��njuge e filhos ou somente com os filhos; a renda familiar m��dia foi de R$1.773,70. Quanto �� capacidade funcional, 80,6% eram independentes para as atividades b��sicas da vida di��ria e 88,8% eram parcialmente dependentes para as instrumentais. Os idosos possu��am, em m��dia, 5,3 diagn��sticos m��dicos e os sintomas depressivos estiveram presentes para 61,2% deles. Quanto �� rede social, o escore total m��dio foi de 6,4 pessoas para contato na rede, sendo que 36,7% apresentavam m��dio contato e participa����o em atividades sociais. Em rela����o ao apoio social, o maior escore m��dio foi para a dimens��o material (90,2) e o menor para a intera����o social positiva (81,8); j�� para a satisfa����o com o suporte social, 36,7% e 32,7% apresentaram alta e m��dia satisfa����o, respectivamente. Foi encontrada correla����o inversa entre os escores de todas as dimens��es da escala de apoio social e os escores da EDG-15, indicando que quanto maior o apoio social em todas as dimens��es, menor �� a presen��a de sintomas depressivos e houve diferen��as estatisticamente significativas para todas as dimens��es, material (p=0,014), afetiva (p=0,026), intera����o (p=0,011), emocional (p=0,001) e informa����o (p=0,005); j�� a correla����o entre os escores das dimens��es da escala de apoio social e os escores na escala de Lawton e Brody, foi inversa e fraca para as dimens��es material (r=-0,157) e informa����o (r=-0,027), sugerindo que quanto menor a independ��ncia para as AIVDs, maior o apoio social nas referidas dimens��es, por��m, n��o houve diferen��a estatisticamente significativa, material (p=0,121) e informa����o (p=0,789). A correla����o entre os escores da EDG-15 e os escores da escala de satisfa����o com o apoio social, foi inversa e moderada (r=- 0,467), indicando que quanto maior a satisfa����o com o apoio social, menor a presen��a de sintomas depressivos, sendo estatisticamente significativa (p=0,000). Evidencia-se a import��ncia de conhecer se os idosos est��o inseridos em rede social e se percebem o apoio social para um melhor direcionamento da assist��ncia prestada ao idoso e para o planejamento e formula����o de pol��ticas p��blicas, programas e projetos voltados a essa popula����o

Support groups and cardiac rehabilitation: Effects of partner participation on anxiety and depression

This study analyzes the effect on levels of patient anxiety and depression of a partner joining a cardiac rehabilitation program support group, also taking into account the sex of the patient. The study was undertaken using a two-group comparison design with pre-and post-test measures in non-equivalent groups. The sample comprised patients in the cardiac rehabilitation program (CRP) at the Ram��n y Cajal Hospital, Madrid (Spain). Analysis of covariance (ANCOVA) showed direct effects of sex and partner participation in support groups on the anxiety trait. Similarly, interaction effects were observed between the sex variable and partner participation. These results indicate the pertinence of designing separate groups for patients and partners. �� 2014 Universidad Complutense de Madrid and Colegio Oficial de Psic��logos de Madrid.

Everyone Has Their Scars: Meaning Making In a Burn Survivor Support Group.

In the Burn Care literature, there is little on the lived experiences of burn support group members, the perceived benefits of burn support groups for the members, and even less on the meaning the survivors make of the support they receive. In order to provide effective services and to meet the psychosocial needs of burn survivors, it is important to understand the influence a support group has on its members as well as the personal experiences of those individuals who attend these groups. The purpose of this study was to explore the meaning that burn survivors make in a burn survivor support group. A non-random, purposeful convenience sample of six self-identified burn survivors was interviewed using a guided in-depth interview technique to explore their experiences in the support group. Key informant interviews and group observations served to triangulate the data collected in the individual interviews. The experiences of the group's members coalesced around five main themes: acceptance of self, perspective change, value of community, reciprocity, and structural meaning making components. The findings demonstrated the overall positive impact the support group had on psychosocial recovery. Additionally, analysis suggested that the meaning making process experience included Post Traumatic Growth and highlighted the importance of community in psychosocial recovery. Burn survivors reported unique growth opportunities that allowed them to integrate their injury into their identity within an encouraging and safe environment. Certain factors, such as improving group attendance, were addressed and both survivors and support staff generated suggestions for reaching others in need of support.

Social determinants and health effects of low and high severity intimate partner violence

PURPOSE: We sought to analyze whether the sociodemographic profile of battered women varies according to the level of severity of intimate partner violence (IPV), and to identify possible associations between IPV and different health problems taking into account the severity of these acts. METHODS: A cross-sectional study of 8,974 women (18-70 years) attending primary healthcare centers in Spain (2006-2007) was performed. A compound index was calculated based on frequency, types (physical, psychological, or both), and duration of IPV. Descriptive and multivariate procedures using logistic regression models were fitted. RESULTS: Women affected by low severity IPV and those affected by high severity IPV were found to have a similar sociodemographic profile. However, divorced women (odds ratio [OR], 8.1; 95% confidence interval [CI], 3.2-20.3), those without tangible support (OR, 6.6; 95% CI, 3.3-13.2), and retired women (OR, 2.7; 95% CI, 1.2-6.0) were more likely to report high severity IPV. Women experiencing high severity IPV were also more likely to suffer from poor health than were those who experienced low severity IPV. CONCLUSIONS: The distribution of low and high severity IPV seems to be influenced by the social characteristics of the women involved and may be an important indicator for estimating health effects. This evidence may contribute to the design of more effective interventions.

Apoyo social formal a un grupo de madres con hijos menores de un a��o

Objetivo: este trabajo pretende analizar el apoyo social formal a un grupo de madres con hijos menores de un a��o. M��todo: estudio cualitativo, descriptivo interpretativo, en el cual participaron diez mujeres en un grupo focal que se reuni�� en siete ocasiones. Resultados: a partir del an��lisis de contenido de las din��micas grupales se detecta que el apoyo formal informativo es el m��s frecuente y resulta dif��cil separarlo del emocional. Los profesionales, a trav��s del apoyo informativo, tratan temas relacionados con la promoci��n de la salud y prevenci��n de la enfermedad y acompa��an a las madres en este rol. Conclusi��n: para las madres el apoyo formal brindado por el personal de enfermer��a es positivo y percibido como un refuerzo en su vivencia de la maternidad, y debe estar enmarcado en un contexto cultural.

Satisfacci��n en la provisi��n de redes de apoyo social en grupos de acompa��amiento a la maternidad

Objetivos: Conocer la percepci��n del grado de satisfacci��n que tienen las madres, con hijos menores de un a��o y que participan en las din��micas grupales que los CAP ofrecen, en relaci��n al contenido y redes de provisi��n del Apoyo Social (AS) as�� como las causas que disminuyen la satisfacci��n en el receptor de este apoyo. Material y m��todos: Estudio con dise��o cualitativo y enfoque fenomenol��gico. La poblaci��n objeto de estudio estaba constituida por madres participantes en din��micas grupales de cinco CAP de la provincia de Barcelona. Como instrumento de recogida de datos se emple�� la entrevista semiestructurada, entre julio de 2011 y julio de 2012; todas fueron grabadas, transcritas y analizadas. Resultados: AS informal: la mayor��a de las madres est��n muy satisfechas-completamente satisfechas con el AS informativo, emocional y evaluativo procedente de las enfermeras; identific��ndose 4 categor��as que contribuyen en esta percepci��n: contacto profesional/accesibilidad, disparidad y/o actualizaci��n, confianza y no procede. AS formal, la mayor��a de las madres est��n muy satisfechas-completamente satisfechas con el AS informativo, emocional, evaluativo y t��cnico procedente de la pareja y madre (abuela materna); identific��ndose 8 categor��as en esta percepci��n: disparidad y/o actualizaci��n en los consejos, exigencia, empat��a, confianza, inseguridades, tiempo, distancia y no procede. Conclusiones: Los factores identificados deber��an considerarse en los planes de mejora de la satisfacci��n y acompa��amiento de las madres en este momento de profundos cambios en su vida; dado que aportar un AS satisfactorio repercute en la promoci��n de la salud y prevenci��n de la enfermedad.

Social and immigration factors in intimate partner violence among Ecuadorians, Moroccans and Romanians living in Spain

Background: Intimate partner violence (IPV) against women occurs in all countries, all cultures and at every level of society; however, some populations may be at greater risk than others. The aim of this study was to explore IPV prevalence among Ecuadorian, Moroccan and Romanian immigrant women living in Spain and its possible association with their personal, family, social support and immigration status characteristics. Methods: Cross-sectional study of 1607 adult immigrant women residing in Barcelona, Madrid and Valencia (2011). Prevalence rates and adjusted odds ratios (AORs) were calculated, with current IPV being the outcome. Different women���s personal (demographic), family, social support and immigration status characteristics were considered as explicative and control variables. All analyses were separated by women���s country of origin. Results: Current IPV prevalence was 15.57% in Ecuadorians, 10.91% in Moroccans and 8.58% in Romanians. Some common IPV factors were found, such as being separated and/or divorced. In Romanians, IPV was also associated with lack of social support [AOR 5.96 (1.39���25.62)] and low religious involvement [AOR 2.17 (1.06���4.43)]. The likelihood of current IPV was lower among women without children or other dependants in this subgroup [AOR 0.29 (0.093���0.92)]. Conclusion: The IPV prevalence rates obtained for Moroccan, Romanian and Ecuadorian women residing in Spain were similar. Whereas the likelihood of IPV appeared to be relatively evenly distributed among Moroccan and Ecuadorian women, it was higher among Romanian women in socially vulnerable situations related to family responsibilities and the lack of support networks. The importance of intervention in the process of separation and divorce was common to all women.

Professionals��� Perceptions of Support Resources for Battered Immigrant Women Chronicle of an Anticipated Failure

The aim of this study was to explore the experience of service providers in Spain regarding their daily professional encounters with battered immigrant women and their perception of this group���s help-seeking process and the eventual abandonment of the same. Twenty-nine in-depth interviews and four focus group discussions were conducted with a total of 43 professionals involved in providing support to battered immigrant women. We interviewed social workers, psychologists, intercultural mediators, judges, lawyers, and public health professionals from Spain. Through qualitative content analysis, four categories emerged: (a) frustration with the victim���s decision to abandon the help-seeking process, (b) ambivalent positions regarding differences between immigrant and Spanish women, (c) difficulties in the migratory process that may hinder the help-seeking process, and (d) criticisms regarding the inefficiency of existing resources. The four categories were cross-cut by an overarching theme: helping immigrant women not to abandon the help-seeking process as a chronicle of anticipated failure. The main reasons that emerged for abandoning the help-seeking process involved structural factors such as economic dependence, loss of social support after leaving their country of origin, and limited knowledge about available resources. The professionals perceived their encounters with battered immigrant women to be frustrating and unproductive because they felt that they had few resources to back them up. They felt that despite the existence of public policies targeting intimate partner violence (IPV) and immigration in Spain, the resources dedicated to tackling gender-based violence were insufficient to meet battered immigrant women���s needs. Professionals should be trained both in the problem of IPV and in providing support to the immigrant population.

Life Experiences of People Affected by Crohn���s Disease and Their Support Networks Scoping Review

This scoping review identifies and describes relevant studies related to the evidence published on life experiences and perceived social support of people affected by Crohn���s disease. Twenty-three studies were definitely selected and analyzed for the topics explored. The overall findings show patients��� needs and perceptions. There is a lack of evidence about patients��� perceived needs as well as the understanding of social support that has contributed to improve their life experiences with that chronic illness. Lack of energy, loss of body control, body image damaged due to different treatments and surgeries, symptoms related to fear of disease, feeling burdened loss related to independence, and so on are some of the concerns with having to live with those affected by the Crohn. To underline those experiences through this scoping review provides valuable data for health care teams, especially for the nursing profession, considered by those affected as one of the main roles along the whole pathological process. This review provides the basis for developing broader research on the relatively underexplored topics and consequently improves specific programs that could address patients��� needs.

Social Citizenship and Institution Building: EU-Enlargement and the Restructuring of Welfare States in East Central Europe. CES Germany & Europe Working Paper, No. 01.2, April 2001

With the EU-enlargement process well underway, this paper focuses on social citizenship as a conceptual frame for analyzing the restructuring of social institutions in applicant countries in East Central Europe. So far, comparative welfare state analysis has concentrated mainly on the developed economies of the OECD-countries; there is little systematic analytical work on the transitions in post-communist Europe. Theoretically, this paper builds on comparative welfare state analysis as well as on new institutionalism. The initial hypothesis is built on the assumption that emerging patterns of social support and social security diverge from the typology described in the comparative welfare state literature inasmuch as the transformation of postcommunist societies is distinctly different from the building of welfare states in Europe. The paper argues that institutionbuilding is shaped by and embedded in the process of European integration and part of governance in the EU. Anticipating full membership in the European Union, the applicant countries have to adapt to the rules and regulations of the EU, including the "social acquis." Therefore, framing becomes an important feature of institutional changes. The paper seeks to identify distinct patterns and problems of the institutionalization of social citizenship.

I'm a hypocrite, but so is everyone else: Group support and the reduction of cognitive dissonance

The impact of social support on dissonance arousal was investigated from a social identity view of dissonance theory. This perspective is seen as augmenting current conceptualizations of dissonance theory by predicting when normative information will impact on dissonance arousal and by indicating the availability of identity-related strategies of dissonance reduction. An experiment was conducted to induce feelings of hypocrisy under conditions of behavioral support or nonsupport. Group salience was either high or low, or individual identity was emphasized. As predicted, participants with no support from the salient in-group exhibited the greatest need to reduce dissonance through attitude change and reduced levels of group identification. Results were interpreted in terms of self being central to the arousal and reduction of dissonance.

Assessing the support needs of women with early breast cancer in Australia

The purpose of the current study was to access the degree to which the support needs of women with a newly diagnosed, early invasive, primary breast cancer and their families are being met. A random sample of 544 women diagnosed with early breast cancer was recruited to participate in a telephone survey via state and territory cancer registries. Sixteen percent of women reported not receiving enough support during their diagnosis and treatment, and only 65% of these women reported that their families received enough support. The primary sources of support for women and their families were medical practitioners (eg, surgeons, oncologists, and general practitioner) with very few women or family members utilizing mental health professionals. Given the importance of adequate support when being diagnosed and treated for breast cancer, urgent attention needs to be paid to training medical professionals in providing appropriate support and referrals for their patients.

Prospective study of individual, social, and environmental predictors of physical activity: women's leisure running

Background: Understanding and influencing the determinants of physical activity is an important public health challenge. We used prospective data to examine the influence of individual, social, and environmental factors on physical activity behaviour, using regular running as the behavioural model. Methods: Over 500 middle-aged women completed two consecutive questionnaires in 2000 and 2002. Logistic regression analyses were used to examine factors predicting adoption of and regression from regular leisure-time running during the follow-up. Results: Women who frequently used behavioural change skills were more likely to adopt regular running (OR=4.0, CI=1.7-9.5). There was an interaction between the enjoyment of running and family support: those who rated enjoyment of running high and reported high family support were less likely to adopt running (OR= 0.2, CI = 0.1-0.5). Women who reported infrequent use of motives were more likely (OR = 3.3, CI = 1.6-6.9) to regress from regular running. There was an interaction between perceived health and the neighbourhood environment: those who perceived themselves to be in poor health and had an unattractive neighbourhood were more likely (OR = 2.7, CI = 0.9-8.3) to regress from regular running. Conclusions: Behavioural skills and enjoyment may be of particular importance for the adoption of regular activity; social support and an aesthetically attractive neighbourhood are likely to have a key role in encouraging maintenance. (c) 2004 Elsevier Ltd. All rights reserved.