The Relationship between Dementia Family Caregivers' Traditional Values and Beliefs about Caregiving and Well-being

Introduction: Canada’s aging population is diverse and this diversity will continue to grow for the next two decades (Government of Canada, 2002; Katz, 2005; Statistics Canada, 2010). Objective: to examine the relationship between dementia family caregivers’ traditionally-based beliefs about caregiving, their caregiving experience, and their well-being. Method: exploratory secondary data analysis of cross-sectional survey data from 76 community caregivers of persons with dementia in Ontario. Results: traditional values for caregiving was independently associated with coping resources and health status but not depression symptoms. Caregiver self-efficacy and social support both partially mediated the relationship between beliefs about caregiving and caregiver health status. Discussion: Findings from this exploratory study are consistent with stress process models of culture and caregiving. The finding that self-efficacy was associated with traditional values and that it mediated the relationship between traditional values and caregiver well-being is new to the literature.

Étude sur les déterminants sociaux de la détresse psychologique des étudiants universitaires canadiens

Ce mémoire porte sur les déterminants sociaux de la détresse psychologique des étudiants universitaires canadiens. Nous avons utilisé comme cadre théorique la théorie sociologique du stress (Pearlin et al. 1981). L’objectif de ce mémoire est, en premier lieu, d’examiner si l’expérience de la vie universitaire, en terme de stresseurs et de ressources, a une influence sur la prévalence de la détresse psychologique en tenant compte des différences selon le sexe. En second lieu, nous examinerons si la transition vers l’université augmente le risque du taux de morbidité psychiatrique et si les étudiants québécois qui ont fréquenté le Cégep sont moins vulnérables à cette transition. L’étude a été réalisée à partir des données de l’enquête sur les campus canadiens (2004), menée auprès d’un échantillon représentatif d’étudiants dans 40 universités canadiennes. L’utilisation de données secondaires impose des limites importantes notamment en ce qui concerne les mesures de stresseurs et de ressources. Il ressort de notre étude que les stresseurs liés à l’expérience de la vie universitaire (programme d’études, performance académique, insertion dans la vie para-académique, modalité résidentielle) contribuent de façon marginale à l’explication de la variation des symptômes de détresse psychologique. Les ressources protectrices (sentiment de contrôle et soutien social), pour leur part, expliquent une portion significative de ces variations. La transition vers l’université n’a pas d’effet sur la détresse psychologique sauf dans le cas des femmes québécoises, celles-ci étant plus vulnérables que celles plus avancées dans leur cursus académique. Les résultats soulignent également que certains processus de prolifération du stress sont spécifiques au genre.

Temporal patterning of competitive emotions : a critical review

An interactional model of stress that integrates current research on competitive affects and emphasizes the temporal dimensions of the stress process is forwarded. The literature reveals that the study of athletes' affective responses to competition has been narrowly focused on pre-competitive anxiety. Equivocal findings on temporal patterning of competitive anxiety suggest that a fundamental change in the empirical approach is needed because the current conceptualization of anxiety and other complex emotions is imprecise. The analysis of secondary emotions as patterns of discrete basic emotions, as suggested by differential emotions theorists, is proposed for consideration in future research. In this view, competitive anxiety is considered as a set of patterns of emotions rather than a unitary affect. The adoption of this approach could result in better operationalization of competitive anxiety as well as other secondary performance-related emotions. We propose that research on competitive affects should follow two parallel lines. The first should focus on the description of complex emotional states that reflect the idiosyncratic emotional experience and vocabulary of the athlete. The second should examine the sets of basic emotions experienced throughout competition, and focus on individual differences and factors determining those differences. The integration of the two approaches could lead to a better understanding of whether, how and why individuals differ in the interpretation of specific secondary emotions and their effect on performance. Moreover, it would permit the analysis of intra-individual variations in labelling secondary emotions with respect to different competitive contexts and temporal aspects.

Work and Family: a complex interplay. An Italian application of the DISC Model on health care workers

The present thesis investigates the issue of work-family conflict and facilitation in a sanitarian contest, using the DISC Model (De Jonge and Dormann, 2003, 2006). The general aim has been declined in two empirical studies reported in this dissertation chapters. Chapter 1 reporting the psychometric properties of the Demand-Induced Strain Compensation Questionnaire. Although the empirical evidence on the DISC Model has received a fair amount of attention in literature both for the theoretical principles and for the instrument developed to display them (DISQ; De Jonge, Dormann, Van Vegchel, Von Nordheim, Dollard, Cotton and Van den Tooren, 2007) there are no studies based solely on psychometric investigation of the instrument. In addition, no previous studies have ever used the DISC as a model or measurement instrument in an Italian context. Thus the first chapter of the present dissertation was based on psychometric investigation of the DISQ. Chapter 2 reporting a longitudinal study contribution. The purpose was to examine, using the DISC model, the relationship between emotional job characteristics, work-family interface and emotional exhaustion among a health care population. We started testing the Triple Match Principle of the DISC Model using solely the emotional dimension of the strain-stress process (i.e. emotional demands, emotional resources and emotional exhaustion). Then we investigated the mediator role played by w-f conflict and w-f facilitation in relation to emotional job characteristics and emotional exhaustion. Finally we compared the mediator model across workers involved in chronic illness home demands and workers who are not involved. Finally, a general conclusion, integrated and discussed the main findings of the studies reported in this dissertation.

Challenge stressors: longitudinal effects on self attitudes, work attitudes, and health.

Recent research suggests that some stressors (i.e. hindrance stressors) have mainly negative consequences, whereas others (i.e. challenge stressors) can simultaneously have positive and negative consequences (e.g., LePine et al., 2005). Although a number of studies have dealt with potential outcomes of challenge stressors, some criteria have received only limited attention (e.g., positive self-attitudes; cf. Widmer et al., 2012), and some have been neglected altogether (i.e., physical health outcomes). Furthermore, while sophisticated methods – such as meta-analyses (e.g., LePine et al., 2005), diary studies (Ohly & Fritz, 2010), and multi-source analyses (Wallace et al., 2009) – have been applied to the framework, there are no longitudinal studies. We report results from a longitudinal study containing three waves, with two time-lags of one month each (N = 393). We analyzed relationships between challenge stressors and work attitudes (e.g. job satisfaction), self attitudes (e.g. self-esteem), and health indicators (e.g. sleep quality) using cross-lagged SEM. We expected positive effects of challenge stressors to appear only when their negative variance is controlled (e.g. by including hindrance stressors as a suppressor variable; cf. Cavanaugh et al., 2000). As the positive aspects of challenge stressors relate to self-affirming experiences, we also expected positive effects to be especially strong for self attitudes. Regarding work attitudes, the only significant paths found were from work attitudes to challenge stressors over both time lags. Regarding health, there was a significant cross-sectional association at time 1, which was negative, as expected. Longitudinally, a positive path from challenge stressors to health for both time lags was found only when hindrances stressors were controlled, confirming the expected suppressor effect. Hindrance stressors had a negative effect on health. For self-attitudes, there was a positive cross-sectional association at time one. In addition, a positive effect on self attitudes was found longitudinally for both time lags, but only when hindrance stressors were controlled. Additional analyses showed that the positive longitudinal effect on health was mediated by self attitudes. Although the lack of associations with work attitudes was surprising, our results indicate that challenge stressors contain aspects that provide an opportunity to develop self-esteem through demanding work situations, thereby contributing to personal growth and thriving at the workplace. They also confirm the ambiguous nature of challenge stressors, as, with one exception, positive effects were found only when hindrance stressors were controlled (cf. Widmer et al., 2012). Finally, our results confirm the importance of self-related attitudes in the stress process.

Ethnic differences in adolescents' mental distress

Objectives. The aims of this cross-sectional study were to (1) examine differences among four ethnic groups of middle school students (Anglos, African Americans [AAs], Hispanics, and Asians) on (a) three indicators of mental distress (depression, somatic symptoms, suicidal ideation) (b) social stress (general social stress, process-oriented stress, discrimination) and resources (family relationships, coping, self-esteem) and (2) identify significant risk factors and resources for each ethnic group by examining the moderating effects of ethnicity. ^ Methods. Respondents included 316 students from three schools (144 Anglos, 66 AAs, 77 Hispanics, 29 Asians/Others) who completed self-administered questionnaires. Social stress and somatic symptoms were measured by using the SAFE-C and Somatic Symptom Scale, respectively. The DSD was used to assess depression and suicidal ideation. Resources were measured by using the FES, age-appropriate adaptations of two existing coping scales, and Rosenberg's Self-Esteem Scale. For specific aims, descriptive statistics, ANOVA, ANCOVA, and logistic regression analysis were used. ^ Findings. No statistically significant ethnic group or gender differences were observed in depression and somatic symptoms, but the odds of experiencing depression symptoms were about 9.7 times greater for Hispanic females than for the referent group, Anglo males. Hispanics were also 2.04 times more likely to have suicidal ideation than Anglos ( P < 0.05). AAs and Hispanics reported significantly higher levels of stress than Anglos (OR: 2.2–4.3, 0.00 ≤ P ≤ 0.03). These findings imply that adolescents in these ethnic groups may be exposed to considerable amounts of stress even if they do not exhibit significant symptoms of mental distress yet. Negative moderating effects for ethnicity were found by the significant interaction between ethnicity and social stress in somatic symptoms among AAs and Hispanics. This finding indicates that AA and Hispanic adolescents may require higher levels of social stress to exhibit the same amount of somatic symptoms as Anglo adolescents. Observed ethnic differences in social stress and interaction between social stress and ethnicity in relation to somatic symptoms demonstrated a need for subsequent longitudinal studies, and provided a rationale for incorporating social stress as a critical component not only in research but also in culturally sensitive prevention programs. ^

The positive impact of multiple sclerosis (MS) on carers: Associations between carer benefit finding and positive and negative adjustment domains

Purpose. This study examined benefit finding in MS carers including the dimensionality of benefit finding, relations between carer and care recipient benefit finding, and the effects of carer benefit finding on carer positive and negative adjustment domains. Method. A total of 267 carers and their care recipients completed questionnaires at Time 1 and 3 months later, Time 2 (n=155). Illness data were collected at Time 1, and number of problems, stress appraisal, benefit finding, negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) adjustment domains were measured at Time 2. Results. Qualitative data revealed seven benefit finding themes, two of which were adequately represented by the Benefit Finding Scale (BFS) [1] (Mohr et al. Health Psychology 1999; 18: 376). Factor analyses indicated two factors (Personal Growth, Family Relations Growth) which were psychometrically sound and showed differential relations with illness and adjustment domains. Although care recipients reported higher levels of benefit finding than carers, their benefit finding reports regarding personal growth were correlated. The carer BFS factors were positively related to carer and care recipient dyadic adjustment. Care recipient benefit finding was unrelated to carer adjustment domains. After controlling for the effects of demographics, care recipient characteristics, problems and appraisal, carer benefit finding was related to carer positive adjustment domains and unrelated to carer negative adjustment domains. Conclusion. Findings support the role of benefit finding in sustaining positive psychological states and the communal search for meaning within carer-care recipient dyads.

Relations between coping and positive and negative outcomes in carers of persons with multiple sclerosis (MS)

This study examined relations between stress and coping predictors and negative and positive outcomes in MS caregiving. A total of 222 carers and their care-recipients completed questionnaires at Time 1 and three months later, Time 2 ( n = 155). Predictors included care-recipient characteristics ( age, time since diagnosis, course and life satisfaction), and Times 1 and 2 carer problems, stress appraisal and coping. Dependent variables were Time 2 negative ( anxiety, depression) and positive outcomes ( life satisfaction, positive affect, benefits). Regressions indicated that, overall, the hypothesised direct effects of stress appraisal and coping strategies on positive and negative outcomes were supported. The hypothesised stress-buffering effects of positive reframing coping were also supported. All but one of the coping strategies were related to both positive and negative outcomes; specifically, practical assistance coping emerged as a unique predictor of distress. Of the model predictors, care-recipient life satisfaction emerged as the strongest and most consistent predictor of both positive and negative outcomes except benefit finding. Findings support the role of care-recipient characteristics and the carer's appraisal and coping processes in shaping both positive and negative outcomes. The guiding framework and findings have the potential to inform interventions designed to promote well-being in carers.

Stressors, mediators, and health care outcomes of home enteral nutrition in family caregivers and their older adult care recipients

Family caregivers manage home enteral nutrition (HEN) for over 77% of an estimated 1 of every 400 Medicare recipients. Increasing usage of HEN in older adults combined with reliance on family caregivers raises concerns for the quality, outcomes, and costs of care. These concerns are relevant in light of Medicare limitations on nursing assistance and non-reimbursement for nutrition services, despite annual costs of over $600 million. This study applied stress process theories to assess stressor, mediator, and outcome variables salient to HEN and caregiving. In-home structured interviews occurred with a multi-ethnic sample of 30 caregiving dyads at 1–3 months after discharge on HEN. Care recipients were aged ≥60 (M = 68.4 years) and did not have dementia. Caregivers were aged ≥21, unpaid, and lived within 45 minutes of care recipients. Caregivers performed an average of 19.7 tasks daily for 61.9 hours weekly. Training needs were identified for 33 functional, care management, technical, and nutritional tasks. Preparedness scores were low (M = 1.73/4.0), and positively correlated with competence, self-rated quality of care and positive feelings, and negatively with overload, role captivity, and negative feelings (Ps < .05). Caregivers had multiple changes in lifestyle and dietary behaviors. Lifestyle changes positively correlated with overload, and negatively with preparedness and positive feelings. Dietary changes positively correlated with number of tasks, overload, role captivity and negative feelings, and negatively with preparedness (Ps < .01). Fifty-seven percent of caregivers aged >50 were at nutrition risk. Care recipients fared worse. Average weight change was −4.35 pounds (P < .001). Physical complications interrupted daily enteral infusions. Water intake was half of fluid need and associated with signs of dehydration (P < .001). Physical and social function was poor, with older subjects more impaired ( P < .04). Those with better prepared or less overloaded caregivers had higher functionality and QOL (P < .002). Complications, type of feeding tube, and caregiver preparedness correlated with frequency of health care utilization (Ps < .05). Efficacy of HEN in older adults requires specialized caregiver training, attention to caregivers' needs, and frequent monitoring from a highly skilled multidisciplinary team including dietitians. ^

The body matters: Understanding social differences in mental health

This doctoral dissertation illuminates the salience of body image to sociological investigations of mental health. It is argued that concerns over body-appearance evident in America embody a dimension of distress over the physical self that may be appropriately considered a mental health outcome, called body dysphoria. Using cross-sectional data on 1,183 young adults comprising Hispanic, African American, and non-Hispanic white males and females from varying social classes, a valid and reliable measure of body dysphoria is developed and demonstrated to be a distinct dimension of psychological distress. ^ From the standpoint of the sociology of mental health, the social distribution of body dysphoria makes known individual consequences of the stratified arrangements of society based on gender, race/ethnicity, and social class. Results reveal significant social differences in body dysphoria that are both consistent with and contrary to clinical studies attributing eating disorders to white, upper-class females. Body dysphoria is substantially greater among females supporting that unrealistic cultural ideals and standards of body-appearance remain disproportionately targeted at females in the development and presentation of self. Compared to non-Hispanic whites, Hispanics exhibit higher average levels of body dysphoria while African Americans exhibit lower levels of comparable proportion. The question is addressed whether identification with the dominant (white) culture influences distress over body-appearance among racial/ethnic minorities. A small inverse association is revealed between social class origin and body dysphoria suggesting that individuals from lower social class backgrounds are as greatly affected by body image concerns generally presumed to preoccupy upper social classes. ^ The stress process is a widely used theoretical paradigm for explaining structurally driven social differences in mental health outcomes. New evidence is introduced that the stress process may contribute to understanding body image problems. Regression analyses reveal that stress exposure has a significant positive association with body dysphoria that is mediated by varying psychosocial resources. Overall, the stress process explains the effects of social class origin and African American race/ethnicity on body dysphoria but does not account for the larger effects of being female or Hispanic. ^

The Revised Transactional Model (RTM) of occupational stress and coping : an improved process approach

Despite more than three decades of research, there is a limited understanding of the transactional processes of appraisal, stress and coping. This has led to calls for more focused research on the entire process that underlies these variables. To date, there remains a paucity of such research. The present study examined Lazarus and Folkman’s (1984) transactional model of stress and coping. One hundred and twenty nine Australian participants with full time employment (i.e. nurses and administration employees) were recruited. There were 49 male (age mean = 34, SD = 10.51) and 80 female (age mean = 36, SD = 10.31) participants. The analysis of three path models indicated that in addition to the original paths, which were found in Lazarus and Folkman’s transactional model (primary appraisal-->secondary appraisal-->stress-->coping), there were also direct links between primary appraisal and stress level time one and between stress level time one to stress level time two. This study has provided additional insights into the transactional process which will extend our understanding of how individuals appraise, cope and experience occupational stress.

Gender influences on the work-related stress-coping process

The increasing incidence of occupational stress is recognized as a global phenomenon that is having a detrimental impact on both individuals and organizations. This study aims to identify whether men and women adopt different stress and coping processes when subjected to stress in a work context. A total of 258 workers of various professions (males = 106, females = 152) participated in the study. Results indicated that men and women differ in their stress and coping processes, forming two very distinct groups and adopting specific process models when encountering a stressful situation at work. Limitations and implications from this study are discussed.

Numerical Simulation of Transient Thermal Field and Residual Stress in Laser Melting Process

以激光熔凝表面强韧化处理为背景,应用空间弹塑性有限单元和高精度数值算法同时考虑材料组织性能的变化模拟工件的温度场及残余应力,研究激光熔凝加工中瞬时温度场及残余应力数值模拟,同时考虑相变潜热及相变塑性的影响,用算例验证了模型的正确性,给出了不同时刻温度场分布及残余应力分布。

Deposition of low stress amorphous zinc tin oxide at ambient temperature using a remote plasma sputtering process suitable for delicate substrates

ZnxSnyOz thin films (<100nm thickness), deposited by remote sputtering from a metal target using a confined argon plasma and oxygen gas jet near the sample, were investigated for their material properties. No visible deformation or curl was observed when deposited on plastic. Materials were confirmed to be amorphous and range between 5 and 10 at.% Sn concentration by x-ray diffraction, x-ray photoemission spectroscopy and energydispersive x-ray spectroscopy. Factors affecting the material composition over time are discussed. Depletion of the Sn as the target ages is suspected. © The Electrochemical Society.