‘Old and ill’ : death anxiety and coping strategies influencing health professionals' well-being and dementia care

INTERGENERATIONAL SUPPORT AND WELL-BEING OF OLDER ADULTS IN CHANGING FAMILY CONTEXTS

This dissertation consists of three papers that examine the complexities in upward intergenerational support and adult children’s influence on older adults’ health in changing family contexts of America and China. The prevalence of “gray divorce/repartnering ” in later life after age 55 is on the rise in the United States, yet little is known about its effect on intergenerational support. The first paper uses the life course perspective to examine whether gray divorce and repartnering affect support from biological and stepchildren differently than early divorce and repartnering, and how patterns differ by parents’ gender. Massive internal migration in China has led to increased geographic distance between adult children and aging parents, which may have consequences for old age support received by parents. This topic has yet to be thoroughly explored in China, as most studies of intergenerational support to older parents have focused on the role of coresident children or have not considered the interdependence of multiple parent-child dyads in the family. The second paper adopts the within-family differences approach to assess the influence of non-coresident children’s relative living proximity to parents compared to that of their siblings on their provision of support to parents in rural and urban Chinese families. The study also examines how patterns of the impact are moderated by parents’ living arrangement, non-coresident children’s gender, and parents’ provision of support to children. Taking a multigenerational network perspective, the third paper questions if and how adult children’s socioeconomic status (SES) influences older parents’ health in China. It further examines whether health benefits brought by adult children’s socioeconomic attainment are larger for older adults with lower SES and whether one of the mechanisms through which adult children’s SES affects older parents’ health is by changing their health behaviors. These questions are highly relevant in contemporary China, where adult children have experienced substantial gains in SES and play a central role in old age support for parents. In sum, these three papers take the life course, the within-family differences, and the multigenerational network perspective to address the complexities in intergenerational support and older adults’ health in diverse family contexts.

Designing Happiness: Architecture and urban design for joy and well-being

Scientific studies exploring the environmental and experiential elements that help boost human happiness have become a significant and expanding body of work. Some urban designers, architects and planners are looking to apply this knowledge through policy decisions and design, but there is a great deal of room for further study and exploration. This paper looks at definitions of happiness and happiness measurements used in research. The paper goes on to introduce six environmental factors identified in a literature review that have design implications relating to happiness: Nature, Light, Surprise, Access, Identity, and Sociality. Architectural precedents are examined and design strategies are proposed for each factor, which are then applied to a test case site and building in Baltimore, Maryland. It is anticipated that these factors and strategies will be useful to architects, urban designers and planners as they endeavor to design positive user experiences and set city shaping policy.

Unemployment, parental distress and youth emotional well-being: The moderation roles of parent-youth relationship and financial deprivation

We investigated, in a sample of 112 unemployed parents of adolescents aged 10-19 years, the links between parental distress and change in youth emotional problems related to parental unemployment, and the moderation roles of parent-youth relationship and financial deprivation. Data were analyzed using descriptive statistics and correlations. Further, simple moderation, additive moderation, and moderated moderation models of regression were performed to analyze the effects of parental distress, parent-youth relationship and financial deprivation in predicting change in youth emotional problems related to parental unemployment. Results show that parental distress moderated by parent-youth relationship predicted levels of change in youth emotional problems related to parental unemployment. This study provides evidence that during job loss, parental distress is linked to youth emotional well-being and that parent-youth relationships play an important moderation role. This raises the importance of further researching parental distress impacts on youth well-being, especially during periods of high unemployment rates.

Economic well-being and poverty among the elderly: an analysis based on a collective consumption model

We apply the collective consumption model of Browning, Chiappori and Lewbel (2006) to analyse economic well-being and poverty among the elderly. The model focuses on individual preferences, a consumption technology that captures the economies of scale of living in a couple, and a sharing rule that governs the intra-household allocation of resources. The model is applied to a time series of Dutch consumption expenditure surveys. Our empirical results indicate substantial economies of scale and a wifeís share that is increasing in total expenditures. We further calculated poverty rates by means of the collective consumption model. Collective poverty rates of widows and widowers turn out to be slightly lower than traditional ones based on a standard equivalence scale. Poverty among women (men) in elderly couples, however, seems to be heavily underestimated (overestimated) by the traditional approach. Finally, we analysed the impact of becoming a widow(er). Based on cross-sectional evidence, we find that the drop (increase) in material well-being following the husbandís death is substantial for women in high (low) expenditure couples. For men, the picture is reversed.

Effectiveness of Acceptance and Commitment Therapy for Depression, Psychological Well-Being and Feeling of Guilt in 7 - 15 Years Old Diabetic Children

Background: Diabetes imposes restrictions on physical, emotional, and social functioning of children and adolescents. Objectives: The aim of this study was to determine effectiveness of acceptance and commitment therapy (ACT) for depression, psychological well-being and feeling of guilt in 7 - 15 years old diabetic children. Patients and Methods: This was a clinical trial with pre-test and post-test design with control group. The study population consisted of 34 participants selected using convenient sampling out of all 7 - 15 years old patients that referred to the Diabetes Association of Tabriz. They were randomly allocated into two equal groups (experimental and control). The experimental group participated in therapy sessions and the control group did not receive any intervention. The research instruments were reynolds child depression scale (RCDS), eysenck feelings of guilt scale and satisfaction with life scale (SWLS). Results: Multivariate covariance analysis (MANCOVA) showed that the treatment was effective on variables of depression, psychological well-being and feeling guilty in 7 - 15 years old diabetic children (P < 0.001). Conclusions: The aforementioned treatment is effective and suggested to be used in other psychosomatic diseases of children.

Living alone and living together: their significance for well-being

Differential rates of demographic change between the developed and developing nations contribute to disparate living arrangements and contrasting cultural understandings of living together and alone. Among some cohorts in the developed world, who can afford it, living alone is seen as a lifestyle choice and representative of independence, thus not compromising of wellbeing. In some contexts living arrangements have minimal impact on wellbeing. However, in parts of the developing world, and among other cohorts in developed countries, living alone represents despair, abandonment and loneliness leading to diminished wellbeing. Overriding this cultural difference is the unambiguous population level data from across the world showing that intimate partnerships, particularly marriage, provide a protective shield against low personal wellbeing scores. The jury is still out on whether this protective effect necessarily involves cohabitation. The current rise in living- apart-together relationships and the possible future trend of living together virtually, through second life and other digital media, raises further questions about the nexus between living arrangements and wellbeing.

Brief reminiscence activities improve state well-being and self-concept in young adults: a randomised controlled experiment

Reminiscence-based psychotherapies have been demonstrated to have robust effects on a range of therapeutic outcomes. However, little research has been conducted on the immediate effects of guided activities they are composed of, or how these might differ dependent on the type of reminiscence. The current study utilised a controlled experimental design, whereby 321 young adults (mean age = 25.5 years, SD = 3.0) were randomised to one of four conditions of online reminiscence activity: problem-solving (successful coping experiences), identity (self-defining events contributing to a meaningful and continuous personal identity), bitterness revival (negative or adverse events), or a control condition (any memory from their past). Participants recalled autobiographical memories congruent with the condition, and answered questions to facilitate reflection on the memories. The results indicated that problem-solving and identity reminiscence activities caused significant improvements in self-esteem, meaning in life, self-efficacy and affect, whereas no effects were found in the bitterness revival and control conditions. Problem-solving reminiscence also caused a small effect in increasing perceptions of a life narrative/s. Differences between the conditions did not appear to be explained by the positive-valence of memories. These results provide evidence for the specific effects of adaptive types of problem-solving and identity reminiscence in young adults.

Change in well-being amongst participants in a four-month pedometer-based workplace health program

BACKGROUND: There is increasing uptake of workplace physical activity programs to prevent chronic disease. While they are frequently evaluated for improvement in biomedical risk factors there has been little evaluation of additional benefits for psychosocial health. We aimed to evaluate whether participation in a four-month, team-based, pedometer-based workplace health program known to improve biomedical risk factors is associated with an improvement in well-being, immediately after the program and eight-months after program completion.

METHODS: At baseline (2008), 762 adults (aged 40 ± 10 SD years, 42% male) employed in primarily sedentary occupations and voluntarily enrolled in a physical activity program were recruited from ten Australian worksites. Data was collected at baseline, at the completion of the four-month program and eight-months after program completion. The outcome was the WHO-Five Well-being Index (WHO-5), a self-administered five-item scale that can be dichotomised as 'poor' (less than 52%) or 'positive' (more than or equal to 52%) well-being.

RESULTS: At baseline, 75% of participants had positive well-being (mean: 60 ± 19 SD WHO-5 units). On average, well-being improved immediately after the health program (+3.5 units, p < 0.001) and was sustained eight-months later (+3.4 units from baseline, p < 0.001). In the 25% with poor well-being at baseline, 49.5% moved into the positive well-being category immediately after program completion, sustained eight-months later (p < 0.001).

CONCLUSIONS: Clinically relevant immediate and sustained improvements in well-being were observed after participation in the health program. These results suggest that participation in workplace programs, such as the one evaluated here, also has the potential to improve well-being.

The influence of instructor support, family support and psychological capital on the well-being of postgraduate students: a moderated mediation model

The influence of instructor support, family support and psychological capital (PsyCap) on the subjective well-being of postgraduate business students, including whether PsyCap mediates the proposed support – well-being relationship were examined in this study. It was further investigated whether family support moderates this proposed mediated relationship. Direct positive relationships between instructor support and well-being, and between PsyCap and well-being were found. It was also found that PsyCap mediates the instructor support – well-being relationship. Finally, it was found that family support moderates this mediated relationship in such a way that the relationship is stronger among students with lower levels of family support.

Dimensions of religious/spiritual well-being in relation to personality and stress coping: initial results from Bosnian young adults

The aim of this study was to examine possible relationships between religious/spiritual well-being (RSWB), the Big Five personality factors, and stress coping strategies among Bosnian young adults. Therefore, a first Bosnian translation of the Multidimensional Inventory of Religious/Spiritual Well-being was applied on a sample of 290 (181 females) Bosnian undergraduate students. RSWB dimensions such as hope, forgiveness, or general religiosity were found to be substantially related with more favorable personality dimensions as well as with more adequate stress coping. As a conclusion RSWB dimensions were confirmed as being an important resource for mental health for this sample of Bosnian adolescents.

Height, weight and well-being for rural, urban and migrant workers in China

In general, the happiness literature has paid little attention to the relationship between physical appearance and well-being. In this paper, we examine the link between weight, height and well-being for three distinct samples in China given that attractiveness effects likely vary greatly across sociocultural contexts. As China has recently undergone rapid economic transformation in the urban areas, this empirical exercise is particularly interesting because it can highlight how changing social norms have affected the relationship between physical appearance and subjective well-being. For the rural and migrant samples, we find that for both men and women, big and tall individuals have higher levels of well-being. This is consistent with the notion that the strong are better off when more labor intensive work is the norm. For the urban sample and for urban males in particular, no well-being penalty is found for being obese, unlike previous results based on Western samples. It is very likely that the unique Chinese cultural practice of network building banquets and feasting is behind this finding.

The applicability of self-regulation theories in sport: Goal adjustment capacities, stress appraisals, coping, and well-being among athletes

We examined a model, informed by self-regulation theories from the health psychology literature, which included goal adjustment capacities, appraisals of challenge and threat, coping, and well-being. Two-hundred and twelve athletes from the United Kingdom (n 147)= or Australia (n = 65), who played team (n = 135) or individual sports (n = 77), and competed at international (n = 7), national (n = 11), county (n = 67), club (n = 84), or beginner (n = 43) levels participated in this study. Participants completed measures of goal adjustment capacities and stress appraisals two days before competing. Athletes also completed coping and well-being questionnaires within three hours of their competition ending.The way an athlete responded to an unattainable goal was associated with his or her well-being in the period leading up to and including the competition. Goal reengagement positively predicted well-being, whereas goal disengagement negatively predicted well-being. Further, goal reengagement was positively associated with challenge appraisals, which in turn was linked to task-oriented coping, and task-oriented coping positively associated with well-being.When highly-valued goals become unattainable, consultants and coaches could encourage athletes to generate alternative approaches to achieve the same goal or help them develop a completely new goal in order to promote well-being among athletes.