Emotional and social repercussions of stroke on patient-family caregiver dyads: Analysis of diverging attitudes and profiles of the differing dyads

in PLoS ONE (2019), 14(4), 0215425

For patients, the social and emotional repercussions of stroke include shame, personality changes, and upheavals experienced by the couple (i.e. patient and main family caregiver). These impacts on the ... [more ▼]

For patients, the social and emotional repercussions of stroke include shame, personality changes, and upheavals experienced by the couple (i.e. patient and main family caregiver). These impacts on the couple ‘patient/family caregiver’ are scarcely documented. Focusing on the perceptions of the patients and the family caregivers living at home, two years after a stroke occurrence, the aims of the study were to analyse the concordance of attitudes towards the emotional and social repercussions of stroke and to determine the profiles of the differing dyads. Two researchers conducted separate face-to-face structured interviews with stroke survivors and their family caregivers. Eleven items, identified through a content analysis of interviews and after a qualitative process of generating questionnaire items, assessed the commonly experienced impact of stroke on the family, the social repercussions of stroke, and its emotional effects on the stroke survivors. The kappa concordance coefficient was used to determine the response convergence between patients and family caregivers. Four items, selected by a panel of experts, were included in logistic regressions (i.e., demographic characteristics and patients’ impaired functions) to identify the differing dyadic profiles. Family caregivers’ and patients’ attitudes towards the social repercussions of stroke were similar. Patients with motor deficiencies tended to underestimate the upheaval brought to their couple by stroke, whereas caregivers of language-impaired patients tended to underestimate their feelings of shame and demeaning. Communication disturbances, but also residual physical disabilities in stroke survivors, may affect the understanding of each other’s attitudes within dyads. In order to avoid dysfunctional relationships between family caregivers and patients, healthcare professionals need to pay special attention to this issue, especially in cases of aphasia and motor deficiencies. [less ▲]

Breaking bad news in different medical conditions : exploring the physicians and patients perspectives

in European Health Psychologist (2014)

Background: We aim to explore factors influencing the breaking bad news process in different medical contexts with irreversible conditions (others than cancer). Methods: 23 patients and 18 physicians ... [more ▼]

Background: We aim to explore factors influencing the breaking bad news process in different medical contexts with irreversible conditions (others than cancer). Methods: 23 patients and 18 physicians concerned by different chronic diseases were interviewed by psychologists. They received/broke bad news in the few months preceding the interview. Findings: Thematic analysis of interviews allowed to identify higher-order themes, and more specific themes for both, patients and physicians. The main topics covered by physicians concerned the determinants of the strategies to communicate with patients, the encountered difficulties, the initial training, the information, interpersonal relationships, emotional reactions, perception of its role, the specifics of the disease. The discourse of patients referred to three stages including specifics topics: the communication of bad news, the health care pathways, and the life with disease. Discussion: Data analysis highlight importance of patient and physician’s profiles, and specifics of disease, in the breaking bad news process. Recommendations to build tailored intervention for physicians by using formative self-assessment will be exposed. [less ▲]

Leben mit Typ-I-Diabetes - Aktuelle Forschungsbefunde aus der MONDIAB-Studie

Scientific Conference (2011, September)

Die Selbstregulationstheorie postuliert, dass Patienten eine aktive Rolle in der Krankheitsverarbeitung einnehmen und dabei insbesondere die Ziel- setzungen der jeweiligen Person bedeutsam sind (Leventhal ... [more ▼]

Die Selbstregulationstheorie postuliert, dass Patienten eine aktive Rolle in der Krankheitsverarbeitung einnehmen und dabei insbesondere die Ziel- setzungen der jeweiligen Person bedeutsam sind (Leventhal, 1970; Maes, Karoly, 2005). Vor dem Hintergrund dieser Annahmen befasst sich die Studie „MONDIAB” (von „mon diabète” abgeleitet) mit der Fragestellung, inwiefern psychosoziale Faktoren einen Einfluss auf das subjektive Gesund- heitserleben von Diabetes-Typ-I-Patienten aufweisen. Die Stichprobe der Studie umfasst insgesamt 328 Diabetes-Typ-I-Patienten im Alter von 16 bis 65 Jahren, von denen 120 Patienten sechs Monate später an einer Nach- befragung teilnahmen. Die Daten wurden mittels eines Online-Fragebogens erhoben. Unter anderem gesundheitsbezogene Kognitionen und Motivatio- nen, die wahrgenommene Unterstützung des Pflegeteams sowie die persön- lichen Lebensziele wurden erfasst. Die Befunde unterstreichen die Bedeutung der wahrgenommenen Kontrollüberzeugung und Motivation für die Diabetesdiät. Darüber hinaus zeigt sich, dass die erlebte Unterstützung des Pflegeteams in sowohl kurz- als auch langfristiger Hinsicht einen Einfluss auf den Zuckerspiegel der Patienten hat. Weiterhin belegt die Studie, dass die Einschränkung von persönlichen Lebenszielen durch die Krankheit einen Risikofaktor für das psychologische Wohlbefinden der Patienten darstellt. Demgegenüber erweisen sich Selbstwirksamkeit und soziale Unterstützung als Schutzfaktoren. Abschließend werden die Befunde im Hinblick auf An- satzpunkte für Interventionsmaßnahmen zur Verbesserung der Lebens- qualität der Betroffenen diskutiert. [less ▲]

Yes I can: The Role of self-efficacy in diabetes care

in Psychology and Health (2010), 25(1), 137-376

Based on the assumptions of social cognitive theory and self-regulation theory, the present study aimed at exploring psychosocial factors in self-care of diabetes (Edgar & Skinner, 2003; Iannotti et al ... [more ▼]

Based on the assumptions of social cognitive theory and self-regulation theory, the present study aimed at exploring psychosocial factors in self-care of diabetes (Edgar & Skinner, 2003; Iannotti et al., 2006; Nouwen et al., 2009). The study sample comprised N 1⁄4 99 patients with type 1 diabetes aged between 12 and 39 years. Participants completed the diabetes self-efficacy scale, the brief illness perceptions questionnaire, the WHO-five index and the summary of diabetes self-care activities scale. Results showed that illness perceptions (i.e. perceived consequences (r1⁄4􏰆0.28), personal control (r1⁄40.24), treatment control (r1⁄40.27), compre- hension (r1⁄40.27) and emotional response (r1⁄40.27)), as well as well-being (r1⁄40.42) and perceived diabetes self-efficacy (r 1⁄4 0.55) were significantly correlated with self-care. Furthermore, stepwise regression analyses elucidated self-efficacy (􏰈1⁄40.44) to be the most powerful predictor of self-care, as illness perceptions and well-being became non significant when introducing self-efficacy. Moreover, self-efficacy completely mediated the effect of well- being on self-care (Sobel t 1⁄4 3.74, p50.01). As for clinical implications of these results, it can be suggested that a stronger emphasise should be given on fostering patients’ confidence in their ability to effectively manage their diabetes. [less ▲]

Geteiltes Leid ist halbes Leid: Soziale Unterstützung, Angst und perzipierte Gesundheit

Scientific Conference (2009, September)

Do overweight students experience more physical aggression?

in Journal of Prenatal and Perinatal Psychology and Health (2009), 24

Findings demonstrated that overweight adolescents are more likely to be both victims and perpetrators of violent acts (Janssen, et al., 2004). This study tested this weight-based victimization/perpetrator ... [more ▼]

Findings demonstrated that overweight adolescents are more likely to be both victims and perpetrators of violent acts (Janssen, et al., 2004). This study tested this weight-based victimization/perpetrator hypothesis. The study sample comprised N = 649 middle school students, which were regrouped in three weight categories (i.e. underweight, normal weight, overweight) according to the cut-offs proposed by the International Obesity Taskforce. In order to analyze group differences between the weight categories, three same sized groups (N = 75) were randomly created from the whole data set. Results confirmed that overweight students are more likely to be victimized but not to become perpetrators themselves compared to their peers. Logistic regressions showed that risk factor of being physically aggressed were being anxious (OR = 2.34), having low self-esteem (OR = 0.58), having a higher BMI (OR = 1.11) and being male (OR = 0.26). Results will be discussed with respect to psychosocial interventions. [less ▲]

Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender differentials: a population-based study

in International Journal of Health Geographics (2007), 2

The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge ... [more ▼]

The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. Methods: The sample comprised 6,216 people aged ≥ 15 years randomly selected from the population in northeastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia). A deprivation score (D) was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa) computed with logistic models. Results: Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D ≥ 3. More men than women reported tobacco use (30.2% vs. 21.9%) and alcohol abuse (12.5% vs. 3.3%), whereas psychotropic drug use was more common among women (23.8% vs. 41.0%). Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D ≥ 3), alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D ≥ 3) and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D ≥ 3). These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women). Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. Conclusion: Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial measures. [less ▲]