Coping with a diagnosis of Alzheimer's disease: A client and caregiver perspective

The purpose of this study was to examine how individuals and their caregivers cope with a diagnosis of Alzheimer's disease. The sample size consisted of six patients with Alzheimer's disease and seven caregivers. The caregivers included spouses and adult children. The study was conducted at an academic medical center in the South Florida area. Using a phenomenological approach, data were collected by audiotaped interviews. Data were analyzed following the seven steps of Colaizzi (1978).^ The results of the study indicated that clients experienced fear, social withdrawal, decreased self-esteem and a need for love and support. Caregivers experienced psychological strain, burden, lifestyle adjustments and sacrifice. Both clients and caregivers identified numerous strategies for coping with Alzheimer's disease. The findings reflect the need for a holistic approach to promoting the quality of life for patients and caregivers. ^

Comparative analysis of a moderating and mediating model of stress, appraisal, and coping in Hispanic and non-Hispanic Alzheimer's disease caregivers

This dissertation utilizes a cross-sectional study to examine the phenomenon of caregiving within a theoretically grounded stress, appraisal, and coping model. Hispanic and non-Hispanic caregivers were studied to examine the factors associated with variance in caregiver appraisal, coping, and outcomes of caregiving strain (depression and somatic complaints) and caregiving gain (life satisfaction, mastery, and personal gain). A purposive sampling strategy was used to recruit 204 Alzheimer's disease caregivers in South Florida. A self-report questionnaire was used to collect demographic data, and to measure stress, appraisal, coping, and psychological well-being of caregivers. Regression equations were developed to compare moderating and mediating models of appraisal and coping. Emotion-focused coping skills were found to significantly moderate the effects of stress (F [1,195] = 4.62, p < .05), explaining approximately 21% of the variance in satisfaction was found to moderate the effects of stress (F [1,195] = 7.09; p < .05), explaining approximately 27% of the variance in personal gain and approximately 8% of the variance in life satisfaction (F [1,195] = 4.14; p < .05). Appraisal of Burden was found to significantly mediate the effects of stress, explaining approximately 30% of the variance in somatic complaints (F [1,196] = 31.60; p < .001) and 32% of the variance in depression (F [1,196] = 38.18; p < .001). The results of the analyses indicate that appraisal and coping skills are important variables in the stress process. The results of this study underscore the importance of accounting for positive and negative outcomes in providing a fuller understanding of the stress, appraisal and coping process of Alzheimer's Disease caregivers. ^

Influence of religious coping on the substance use and HIV risk behaviors of recent Latino immigrants

This study examines the influence of acculturative stress on substance use and HIV risk behaviors among recent Latino immigrants. The central hypothesis of the study is that specific religious coping mechanisms influence the relationship that acculturative stress has on the substance use and HIV-risk behaviors of recent Latino immigrants. Within the Latino culture religiosity is a pervasive force, guiding attitudes, behaviors, and even social interactions. When controlling for education and socioeconomic status, Latinos have been found to use religious coping mechanisms more frequently than their Non-Latino White counterparts. In addition, less acculturated Latinos use religious coping strategies more frequently than those with higher levels of acculturation. Given its prominent role in Latino culture, it appears probable that this mechanism may prove to be influential during difficult life transitions, such as those experienced during the immigration process. This study examines the moderating influence of specific religious coping mechanisms on the relationship between acculturative stress and substance use/HIV risk behaviors of recent Latino immigrants. Analyses for the present study were conducted with wave 2 data from an ongoing longitudinal study investigating associations between pre-immigration factors and health behavior trajectories of recent Latino immigrants. Structural equation and zero-inflated Poisson modeling were implemented to test the specified models and examine the nature of the relationship among the variables. Moderating effects were found for negative religious coping. Higher levels of negative religious coping strengthened an inverse relationship between acculturative stress and substance use. Results also indicated direct relationships between religious coping mechanisms and substance use. External and positive religious coping were inversely related to substance use. Negative religious coping was positively related to substance use. This study aims to contribute knowledge of how religious coping influence's the adaptation process of recent Latino immigrants. Expanding scientific understanding as to the function and effect of these coping mechanisms could lead to enhanced culturally relevant approaches in service delivery among Latino populations. Furthermore this knowledge could inform research about specific cognitions and behaviors that need to be targeted in prevention and treatment programs with this population.

The relationship between job structure, burnout, and coping methods among public school county bus drivers, bus aides, mechanics, and clerical workers

The purpose of this study was to examine the relationship between the structure of jobs and burnout, and to assess to what extent, if any this relationship was moderated by individual coping methods. This study was supported by the Karasek's (1998) Job Demand-Control-Support theory of work stress as well as Maslach and Leiter's (1993) theory of burnout. Coping was examined as a moderator based on the conceptualization of Lazarus and Folkman (1984). ^ Two overall overarching questions framed this study: (a) what is the relationship between job structure, as operationalized by job title, and burnout across different occupations in support services in a large municipal school district? and (b) To what extent do individual differences in coping methods moderate this relationship? ^ This study was a cross-sectional study of county public school bus drivers, bus aides, mechanics, and clerical workers (N = 253) at three bus depot locations within the same district using validated survey instruments for data collection. Hypotheses were tested using simultaneous regression analyses. ^ Findings indicated that there were statistically significant and relevant relationships among the variables of interest; job demands, job control, burnout, and ways of coping. There was a relationship between job title and physical job demands. There was no evidence to support a relationship between job title and psychological demands. Furthermore, there was a relationship between physical demands, emotional exhaustion and personal accomplishment; key indicators of burnout. ^ Results showed significant correlations between individual ways of coping as a moderator between job structure, operationalized by job title, and individual employee burnout adding empirical evidence to the occupational stress literature. Based on the findings, there are implications for theory, research, and practice. For theory and research, the findings suggest the importance of incorporating transactional models in the study of occupational stress. In the area of practice, the findings highlight the importance of enriching jobs, increasing job control, and providing individual-level training related to stress reduction.^

The relationship between coping strategies and level of depression among spousal caregivers of elders with dementia

Caregivers are often under a great deal of stress while caring for their spouses with dementia. It is when the stress builds up and becomes overwhelming that the caregiver is at risk for developing depression. The primary objective of this study was to determine which cognitive and behavioral coping strategies are associated with lower levels of depression; once these strategies are identified, interventions can be established to educate these caregivers. Thirty-two spousal caregivers participated in this study. They each filled out a questionnaire, which contained three sections. The first section asked them for demographic information about themselves and their spouses; the second section consisted of a coping strategies scale; and, the third section contained a depression scale. Results of this study indicate that problem-focused coping strategies were associated with a lesser degree of depressive symptomatology, whereas most of the emotion-focused strategies were associated with a greater degree of depressive symptomatology among the present sample of spousal caregivers. In addition, no relationship was found between the length of time providing care to their spouses and their level of depression.

Coping with life events through possible selves

This study examines the integration of life events into the possible selves repertoire and explores the potential relationship between event-related possible selves and coping. The sample consisted of 198 participants, with age ranging from 18 - 84. Participants were administered interviews consisting of demographic information, the Possible Selves Interview, the Social Readjustment Rating Scale, the Ways of Coping Checklist-Revised, the Satisfaction with Life Scale, and the General Well-Being Schedule. Results indicate that the Integration of stressful events into the possible selves repertoire positively impacted coping. This study paves the way for important prevention programs aimed at promoting an individual's well being.

Entering an academic discourse community: A case study of the coping strategies of eleven english as a second language students

This case study follows eleven non-English speaking students as they adapt to community college, content courses. The three classes examined are required freshman classes--Humanities, Social Environment, and Individual in Transition. In order to cope with the demands of these classes, students must penetrate the academic discourse community and have effective relationships with their instructors and their peers. The results of the study are based on interviews with eleven non-native speaking (NNS) students and their instructors and on an analysis of student writing assignments, course syllabi, and exams. Three general areas are examined: (a) students' first-language (L1) education, (b) the requirements of their content classes, and (c) the affective factors which influence their adaptation process. The case of these students reveals that: 1. Students draw on their L1 education, especially in terms of content, as they cope with the demands of these content classes. 2. In some areas L1 educational experiences interfere with students' ability to adapt. 3. The content classes require students to have well developed reading, writing, oral, and aural skills. 4. Students must use higher level cognitive skills to be successful in content classes. 5. Affective factors play a role in students' success in content classes. The discussion section includes possible implications of this data for college level English as a Second Language courses.

Trajetória de pessoas com AIDS em situação de vulnerabilidade social: à luz da história oral de vida

The epidemic caused by HIV presents a global, dynamic and unstable phenomenon, which depends on the individual and collective human behavior. Efforts to deconstruct the stigmatized image caused by infection of AIDS are still often associated with adoption of socially unacceptable behavior to be a circumscribed the susceptibilities of vulnerable individuals and communities to infection, illness and death by HIV. This study aimed to: narrate the trajectory of life of people with AIDS more vulnerable enrolled in the Municipal Social Assistance Parnamirim / RN. It is a study of qualitative, exploratory and descriptive approach, taking oral history of life as technical and methodological framework. The colony consisted of 186 people with AIDS. The network was comprised of 13 employees of both sexes, aged between 19 and 62 years old with positive diagnosis and agreed to voluntarily participate. After approval by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), in the opinion No. 719,926 CAAE: 30408114.5.0000.5537 on 6 June 2014 data were collected from August to September 2014. The employees signed the Informed Consent and Informed and letter of assignment. Held transcribing the interviews and later returned to respondents to retest, ie so that they confer what allowed us to carry out transcreation after consecutive readings. The reports were analyzed through Bardin content analysis. Guiding the analysis of the accounts of employees, we find three themes: Prejudice and discrimination in living with AIDS; Reacting to the diagnosis and the accession process to antiretroviral treatment; and religious coping in people with AIDS. It can be concluded in this study, that employees have shown great emotional impact after positive diagnosis for HIV / AIDS, especially with regard to social life, the family ties, work and above all to the prejudice of society. Treatment with antiretroviral drugs was seen as a motivation to regain dreams and plans for a future once uncertain, and even if it is not a cure therapy, provided the employees improved quality of life.

Trajetória de pessoas com AIDS em situação de vulnerabilidade social: à luz da história oral de vida

The epidemic caused by HIV presents a global, dynamic and unstable phenomenon, which depends on the individual and collective human behavior. Efforts to deconstruct the stigmatized image caused by infection of AIDS are still often associated with adoption of socially unacceptable behavior to be a circumscribed the susceptibilities of vulnerable individuals and communities to infection, illness and death by HIV. This study aimed to: narrate the trajectory of life of people with AIDS more vulnerable enrolled in the Municipal Social Assistance Parnamirim / RN. It is a study of qualitative, exploratory and descriptive approach, taking oral history of life as technical and methodological framework. The colony consisted of 186 people with AIDS. The network was comprised of 13 employees of both sexes, aged between 19 and 62 years old with positive diagnosis and agreed to voluntarily participate. After approval by the Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), in the opinion No. 719,926 CAAE: 30408114.5.0000.5537 on 6 June 2014 data were collected from August to September 2014. The employees signed the Informed Consent and Informed and letter of assignment. Held transcribing the interviews and later returned to respondents to retest, ie so that they confer what allowed us to carry out transcreation after consecutive readings. The reports were analyzed through Bardin content analysis. Guiding the analysis of the accounts of employees, we find three themes: Prejudice and discrimination in living with AIDS; Reacting to the diagnosis and the accession process to antiretroviral treatment; and religious coping in people with AIDS. It can be concluded in this study, that employees have shown great emotional impact after positive diagnosis for HIV / AIDS, especially with regard to social life, the family ties, work and above all to the prejudice of society. Treatment with antiretroviral drugs was seen as a motivation to regain dreams and plans for a future once uncertain, and even if it is not a cure therapy, provided the employees improved quality of life.

O crucifixo nos tribunais: a neutralidade religiosa e o uso dos espaços públicos

This thesis aims to analyze the cross exhibition in sessions halls and audiences of the judiciary, considered the religious freedom and the limitations arising from the idea of State neutrality. It is known that the 1988 Constitution protects freedom of expression of thought, conscience and religion, in its various aspects, proclaiming, on the other hand, the neutrality of the state, to reinforce these same freedoms. Thus, the aim is to avoid confusion between state and religion, admitted, however, collaboration of public interest, in respect of attitude to the beliefs and individual choices of citizens. In modern societies, the dualism between the civil power and religion has to do with laicity and a broader phenomenon that took the name of secularism, meaning the loss of space of religion in societies or even decreased idea religious belonging. It is based on this finding that the work develops with reference to concepts such as civil society and rule of law relevant to an accurate understanding of the problem. The methodology consists of bibliographic and documentary research through books and thesis, in addition to the legislation and some precedents related to the topic in question, looking to investigate whether, even though the predominantly Catholic Brazilian people and recognized the strong influence that Christian values exercise on the public authorities, it is possible to sustain the symbolic differentiation state, a republic that is said secular and democratic and which has as one of the fundamental objectives to promote the good of all, without any form of discrimination. Starting from the idea that the presence in buildings and public institutions, symbols and Catholic imagery, like the crucifix, has some difficulty in reconciling the guarantee of religious freedom and the principle of laicity, the idea is to exactly propose a solution who can respect pluralism and diversity in a context where Catholicism remains a strong presence.

ENSINO DO FENÔMENO RELIGIOSO NA ESCOLA PÚBLICA: área de conhecimento necessária para uma sociedade secularizada

Ao estudarmos a evolução histórica e o panorama atual do ensino religioso no Brasil, nos deparamos hoje com o problema da exclusão mútua de duas visões do seu tratamento na escola pública: ou deve existir o ensino religioso confessional ou não deve existir nenhum tipo de ensino religioso. Superando uma visão de laicidade de abstenção ao afirmar que o religioso, por definição, não nos diz respeito ou não diz respeito à ciência, e admitindo uma laicidade de inteligência ao defender que é nosso dever ou dever da ciência compreendê-lo como expressão humana e social, o ensino do fenômeno religioso pode superar essas duas visões, a partir de uma base epistemológica sólida para esta área de conhecimento, como já é prevista pela nossa legislação. Ele garante o respeito à diversidade e à pluralidade cultural da sociedade brasileira e contribui para a compreensão do fenômeno religioso como “objeto de cultura”. Ele é capaz de subsidiar práticas de ensino do fenômeno religioso no sistema de ensino laico, sem prejuízo de sua laicidade, mas a favor dela. A educação laica para a cidadania não pode ignorar as religiões pela sua forte presença e função na sociedade. É preciso decodificar criticamente as representações e práticas religiosas em nome da convivência mais construtiva entre as pessoas e extrair das tradições religiosas valores que contribuam para a vida humana na sua plenitude. Este modelo de ensinar a religião como fenômeno antropológico, social e cultural pode ainda cumprir uma função específica no que se refere ao conhecimento de si mesmo (identidade) e do outro para a aceitação do diferente (alteridade) apontando para a construção de valores éticos e de cidadania. Esta pesquisa se baseia em um grande levantamento bibliográfico e entrevistas com especialistas em laicidade e ensino do religioso a partir da proposta de Régis Debray adotada na França. Ela nos leva a concluir que o ensino do fenômeno religioso na escola pública do Brasil não é apenas necessário, mas até indispensável, se queremos uma educação que contribua para a formação dos nossos alunos e alunas para a convivência solidária.

Pintura mural de carácter religioso en la provincia de Ciudad Real. Siglos XIII al XVIII

Históricamente se ha tenido a la provincia de Ciudad Real como mera espectadora de los cambios y transformaciones que, en todos los campos y durante todos los períodos históricos, se iban dando en el resto de España. Uno de esos campos a los que hacemos referencia es el artístico, más concretamente el que tiene como protagonista la obra pictórica mural realizada para edificios de carácter tanto público como privado. Mediante el presente trabajo quisiéramos contribuir, humildemente, a cambiar esta idea. El interés de las referidas manifestaciones murales que a lo largo y ancho del territorio provincial se localizan es, a nuestro juicio, evidente. El presente trabajo de tesis doctoral intenta fundamentar esta afirmación, para ello analizaremos una veintena de grupos pictóricos de evidente temática religiosa ejecutados sobre muro entre los siglos XIII al XVIII. Como en otros lugares de nuestra geografía nacional, la destrucción o abandono del patrimonio artístico es innegable Entendemos que esta afirmación queda patente recorriendo las localidades donde se ubica la obra objeto de nuestro estudio. Unas veces la ignorancia y, otras veces, los intereses económicos particulares, han supuesto la destrucción del patrimonio artístico de estas tierras. Añadamos a esta circunstancia el hecho de que, hasta no hace mucho tiempo, las investigaciones y estudios dedicados al patrimonio artístico de la provincia de Ciudad Real eran escasos. Más escasas aún, si cabe, eran hasta hace unos años las actuaciones concretas orientadas a la conservación o a la restauración de las manifestaciones artísticas de todo tipo localizadas dentro de los límites provinciales. Lo expuesto anteriormente se agravaba, aún más a nuestro parecer, en el terreno de la pintura mural. Una de las posibles explicaciones a este hecho habría que buscarla, como no, en los mayores costes económicos y exigencias técnicas que acarrea el mantenimiento y conservación de la pintura mural en comparación a la pintura de caballete...

Les stratégies de coping utilisées par les athlètes en situation de compétition sportive : développement d'un modèle multidimensionnel du coping de ses antécédents et de ses conséquences

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress

Purpose: The purpose of this study was toinvestigate moral distress in Irish psychiatric nurses. Design: A qualitative descriptive methodology was used. Findings: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings. Practice Implications: The findings indicate that while multidisciplinary teams appear to function well on the surface, situations that give rise to moral distress are not always acknowledged or dealt with effectively. Furthermore, unresolved moral conflict impacts upon the quality of clinical decision-making by not allowing open and transparent discussions that allow clinicians the opportunity to address their concerns adequately.

The Relationship Between Support Systems and Disease Burden for Families Coping with Sickle Cell Disease in South Africa and Cameroon

Background: Sickle cell disease (SCD) is a debilitating genetic blood disorder that seriously impacts the quality of life of affected individuals and their families. With 85% of cases occurring in sub-Saharan Africa, it is essential to identify the barriers and facilitators of optimal outcomes for people with SCD in this setting. This study focuses on understanding the relationship between support systems and disease outcomes for SCD patients and their families in Cameroon and South Africa.

Methods: This mixed-methods study utilizes surveys and semi-structured interviews to assess the experiences of 29 SCD patients and 28 caregivers of people with SCD across three cities in two African countries: Cape Town, South Africa; Yaoundé, Cameroon; and Limbe, Cameroon.

Results: Patients in Cameroon had less treatment options, a higher frequency of pain crises, and a higher incidence of malaria than patients in South Africa. Social support networks in Cameroon consisted of both family and friends and provided emotional, financial, and physical assistance during pain crises and hospital admissions. In South Africa, patients relied on a strong medical support system and social support primarily from close family members; they were also diagnosed later in life than those in Cameroon.

Conclusions: The strength of medical support systems influences the reliance of SCD patients and their caregivers on social support systems. In Cameroon the health care system does not adequately address all factors of SCD treatment and social networks of family and friends are used to complement the care received. In South Africa, strong medical and social support systems positively affect SCD disease burden for patients and their caregivers. SCD awareness campaigns are necessary to reduce the incidence of SCD and create stronger social support networks through increased community understanding and decreased stigma.