The impact of older person’s frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.
Qual Life Res. 2017 May 31;:
Authors: Oldenkamp M, Hagedoorn M, Wittek R, Stolk R, Smidt N
PURPOSE: To examine the impact of changes in an older person’s frailty on the care-related quality of life of their informal caregiver.
METHODS: Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health). Care-related quality of life was measured with the Care-Related Quality of Life instrument (CarerQoL-7D), containing two positive (fulfilment, perceived support) and five negative dimensions (relational problems, mental health problems, physical health problems, financial problems, problems combining informal care with daily activities).
RESULTS: 660 older person/caregiver couples were included. Older persons were on average 79 (SD 6.9) years of age, and 61% was female. Caregivers were on average 65 (SD 12.6) years of age, and 68% was female. Results of the multivariable linear and logistic regression analyses showed that an increase in older person’s frailty over time was related to a lower total care-related quality of life of the caregiver, and to more mental and physical health problems, and problems with combining informal care with daily activities at follow-up. A change in the older person’s psychological well-being was most important for the caregiver’s care-related quality of life, compared to the other health domains.
CONCLUSIONS: Health professionals observing decreasing psychological well-being of an older person and increasing hours of informal care provision should be aware of the considerable problems this may bring to their informal caregiver, and should tailor interventions to support informal caregivers according to their specific needs and problems.
PMID: 28567602 [PubMed – as supplied by publisher]
The role of pain behaviour and family caregiver responses in the link between pain catastrophising and pain intensity: A moderated mediation model.
Psychol Health. 2017 Apr;32(4):422-438
Authors: Mohammadi S, Dehghani M, Sanderman R, Hagedoorn M
OBJECTIVES: This study investigated the mediating role of pain behaviours in the association between pain catastrophising and pain intensity and explored the moderating role of family caregivers’ responses to pain in the link between pain behaviours and pain intensity.
METHODS: The sample consisted of 154 chronic pain patients and their family caregivers. Patients completed questionnaires regarding pain intensity, pain catastrophising, pain behaviours and their caregivers’ responses to their pain. Family caregivers reported their responses to the patients’ pain.
RESULTS: Pain catastrophising was associated with pain intensity (r = 0.37) and pain behaviours partly mediated this association. The positive association between pain behaviours and pain intensity was significant only if patients reported that their family caregivers showed high levels of solicitous (effect = .49) and distracting responses (effect = .58), and if caregivers reported to show high levels of solicitous responses (effect = .51). No support was found for negative responses as a moderator neither based on patients’ perception of negative responses nor based on caregivers’ perception of negative responses.
CONCLUSIONS: The findings are in line with the idea that family caregivers’ solicitous and distracting responses convey to patients that their condition is serious, which may reinforce patients’ pain and pain behaviours, especially in those who catastrophise.
PMID: 28042705 [PubMed – in process]
Sustaining program effectiveness after implementation: The case of the self-management of well-being group intervention for older adults.
Patient Educ Couns. 2017 Jun;100(6):1177-1184
Authors: Goedendorp MM, Kuiper D, Reijneveld SA, Sanderman R, Steverink N
OBJECTIVE: The Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity.
METHODS: In the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants’ baseline characteristics. Professionals completed questions regarding program fidelity.
RESULTS: No significant differences were found on effect outcomes and adherence between IMP and RCT (all p≥0.135). Intervention effect sizes were equal (0.47-0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations.
CONCLUSION: The effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity.
PRACTICE IMPLICATIONS: The SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.
PMID: 28089311 [PubMed – in process]
Delay in diagnosis of testicular cancer.
J Clin Oncol. 2004 Jul 15;22(14_suppl):4602
Authors: Fleer J, Sleijfer DT, Hoekstra-Weebers JE, Hoekstra HJ
4602 Background: Delay in presentation of a testis tumor may result in an advanced stage of disease at diagnosis, which may affect disease free and overall survival. The aim of this study was to determine variables related to delay in diagnosis of testicular cancer (TC).
METHODS: A questionnaire was developed to assess patient delay (time from first symptom till first consultation with general practitioner (GP)) and doctor delay (time from first consultation with GP till final diagnosis). In addition, patient and disease characteristics possibly related to patient and/or doctor delay, were collected: age, marital status, educational level, extensiveness of the disease (stage I vs disseminated disease), number of symptoms, change in testicle as a symptom, pain as a symptom, patients’ knowledge of TC, appraisal of symptoms as threatening, embarrassment, and whether the doctor referred the patient immediately for further examination.
RESULTS: 48 men (median age 25, range 16-44 years) who were consecutively referred to the Groningen University Hospital completed the questionnaire. Median patient delay was 30 (range 1-365) days. Only educational level correlated with patient delay (r=-.30, p=.03). Median doctor delay was 14 (0-240) days. After first consultation, only 20 patients (42%) were immediately referred for further examination. The remaining 28 patients were not immediately referred, which led to a significantly longer doctor delay (median = 23 days, t=-4.47, p90 days. Age was significantly related to total delay (r=-.33, p=.03). Six patients (12.5%) did not have a change in testicle as presenting symptom, but this was not related to delay. Extensiveness of disease was not related to delay.
CONCLUSIONS: Surprisingly, having disseminated disease and having a change in a testicle as presenting symptom were not related to delay, but younger and lower educated men appeared to be more likely to report delay in diagnosis. Over half of the men were not immediately referred for further examination, resulting in a significantly longer GP delay. This finding stresses the responsibility of GPs in the diagnostic process of TC. No significant financial relationships to disclose.
PMID: 28015713 [PubMed – in process]
Chronic multimorbidity impairs role functioning in middle-aged and older individuals mostly when non-partnered or living alone.
PLoS One. 2017;12(2):e0170525
Authors: Müller F, Hagedoorn M, Tuinman MA
BACKGROUND: Due to the aging of the population, society includes a growing proportion of older individuals prone to chronic morbidity. This study aimed to investigate the adverse effects of single and multiple chronic morbidity on psychosocial health and whether these effects are more pronounced in individuals who are non-partnered or living alone.
MATERIALS AND METHODS: Baseline data from the ‘Lifelines Cohort Study’ collected between 2006 and 2013 in the Netherlands were used. Individuals aged 50+ (n = 25,214) were categorized according to their health status (healthy, single chronic morbidity, multiple chronic morbidity), relationship status (partnered, non-partnered), and living arrangement (living with someone, living alone). Analyses of covariance (ANCOVA) were performed to study the main- and the interaction-effects on mental health and role functioning as assessed with the RAND-36.
RESULTS: Irrespective of having chronic morbidity, having a partner was associated with better mental health when partners shared a home. Individuals with single and especially multiple chronic morbidity had impaired role functioning. Having a partner mitigated the adverse effects of multimorbidity on role functioning, but only in individuals who shared a home with their partner. Non-partnered individuals with multimorbidity and those not sharing a home with their partner demonstrated impaired role functioning.
CONCLUSIONS: The results demonstrate that multimorbidity negatively affects role functioning, but not the mental health, of middle-aged and older individuals. Sharing a home with a partner can mitigate these adverse effects, while other combinations of relationship status and living arrangement do not. Offering intervention to those individuals most vulnerable to impaired functioning may relieve some of the increasing pressure on the health care system. An individual’s relationship status along with one’s living arrangement could foster the identification of a target group for such interventions attempting to sustain physical functioning or to adapt daily goals.
PMID: 28151967 [PubMed – in process]
Changes of Perceived Control after Kidney Transplantation: a prospective Study.
J Adv Nurs. 2017 Jan 25;:
Authors: Schulz T, Niesing J, Homan Van Der Heide JJ, Westerhuis R, Ploeg RJ, Ranchor AV
AIMS: To determine if kidney transplantation is associated with increases of perceived control and how changes of perceived control affect the course of psychological distress until one year after transplantation.
BACKGROUND: Low levels of perceived control are associated with reduced well-being among dialysis patients.
DESIGN: Prospective longitudinal cohort study.
METHODS: Perceived control (Mastery Scale) and psychological distress (GHQ-12) were prospectively assessed before (T0; n = 470) and three (T1; n = 197), six (T2; n = 210) and twelve (T3; n = 183) months after transplantation. Differences between T1 and T0 perceived control were used to stratify the sample into three groups (control gain, stable control and control loss). Socio-demographic and clinical variables, including complications, were examined as potential correlates and the course of psychological was distress compared across groups. Data were collected between July 2008 – July 2013.
RESULTS: Perceived control showed a small increase overall, with 35.1%, 50.0% and 14.9% reporting gain, stable level and loss respectively. Patients with secondary schooling were overrepresented in the control loss group. The course of psychological distress varied across perceived control change groups, with patients in the control gain group experiencing a significant reduction of psychological distress.
CONCLUSION: A considerable number of patients report increased levels of perceived control after transplantation that are associated with a subsequent decrease of psychological distress. Results emphasize the importance of perceived control and could inform interventions to facilitate well-being after kidney transplantation. This article is protected by copyright. All rights reserved.
PMID: 28122152 [PubMed – as supplied by publisher]
Group and Individual Mindfulness-Based Cognitive Therapy (MBCT) Are Both Effective: a Pilot Randomized Controlled Trial in Depressed People with a Somatic Disease.
Mindfulness (N Y). 2016;7(6):1339-1346
Authors: Schroevers MJ, Tovote KA, Snippe E, Fleer J
Depressive symptoms are commonly reported by individuals suffering from a chronic medical condition. Mindfulness-based cognitive therapy (MBCT) has been shown to be an effective psychological intervention for reducing depressive symptoms in a range of populations. MBCT is traditionally given in a group format. The aim of the current pilot RCT was to examine the effects of group-based MBCT and individually based MBCT for reducing depressive symptoms in adults suffering from one or more somatic diseases. In this study, 56 people with a somatic condition and comorbid depressive symptoms (i.e., Beck Depression Inventory-II [BDI-II] ≥14) were randomized to group MBCT (n = 28) or individual MBCT (n = 28). Patients filled out questionnaires at three points in time (i.e., pre-intervention, post-intervention, 3 months follow-up). Primary outcome measure was severity of depressive symptoms. Anxiety and positive well-being as well as mindfulness and self-compassion were also assessed. We found significant improvements in all outcomes in those receiving group or individual MBCT, with no significant differences between the two conditions regarding these improvements. Although preliminary (given the pilot nature and lack of control group), results suggest that both group MBCT and individual MBCT are associated with improvements in psychological well-being and enhanced skills of mindfulness and self-compassion in individuals with a chronic somatic condition and comorbid depressive symptoms. Our findings merit future non-inferiority trials in larger samples to be able to draw more firm conclusions about the effectiveness of both formats of MBCT.
PMID: 27909465 [PubMed – in process]
Mindfulness and Self-compassion as Unique and Common Predictors of Affect in the General Population.
Mindfulness (N Y). 2016;7(6):1289-1296
Authors: López A, Sanderman R, Schroevers MJ
In contrast to the increased research interest in the benefits of mindfulness and self-compassion, relatively few studies have examined their unique and combined effects in predicting affect. This cross-sectional study examined the predictive value of mindfulness and self-compassion for depressive symptoms, negative affect, and positive affect in a large representative sample of community adults (N = 1736). The Five Facets of Mindfulness Questionnaire (FFMQ) was used as a measure of mindfulness and the Self-Compassion Scale (SCS) as a measure of self-compassion. Five FFMQ facets were explored: observe, describe, act with awareness, non-judgment, and non-reactivity. Two SCS facets were explored: its positive items (SCS Pos) and its negative items (SCS Neg). When simultaneously examining all seven facets of mindfulness and self-compassion, three of the five FFMQ facets and SCS Neg significantly predicted both depressive symptoms and negative affect, with SCS Neg and act with awareness being the strongest predictors. These findings suggest that a harsh attitude towards oneself and a lack of attention when acting have the greatest value in predicting the presence of psychological symptoms. With respect to positive affect, four of the five FFMQ facets (except non-judgment) were significant predictors, with no unique predictive value of the two SCS’s facets, suggesting that mindfulness is a more important predictor of positive affect than self-compassion, as measured by the FFMQ and SCS.
PMID: 27909464 [PubMed – in process]
Marijuana Use and Dependence in Chilean Adolescents and Its Association with Family and Peer Marijuana Use.
Int J Behav Med. 2016 Oct 3;:
Authors: Lobato M, Sanderman R, Pizarro E, Hagedoorn M
PURPOSE: The purpose of the study is to examine (1) whether family and peer marijuana use are independently related to adolescent marijuana use in Chile, (2) whether family and peer marijuana use are associated with adolescent marijuana dependence in adolescents using marijuana, and (3) whether the adolescent’s age moderates the association between family or peer use and adolescent marijuana use and/or dependence.
METHOD: This study used data from the National Survey on Drug Use in the General Population in Chile (a cross-sectional observational study), which was conducted in 2008 and 2010 in 4413 adolescents aged 12-19. Adolescents answered questions about their past-year marijuana use and dependence (ICD-10 criteria) and the marijuana use of their family and peers. Logistic regressions were performed while controlling for confounders.
RESULTS: Adolescents who had a family member who used marijuana were five times more likely to use the drug. Adolescents with a close friend who used marijuana were eight times more likely to use marijuana. When adolescents were using marijuana, they were three times more likely to be dependent if they had a family member who used the drug. However, no significant relationship was found between peer use and dependence. No statistically significant interactions were found between family or peer use and age.
CONCLUSION: Family and peer marijuana use was independently associated with adolescent’s past-year marijuana use; however, only family marijuana use was statistically associated with adolescent’s marijuana dependence.
PMID: 27699626 [PubMed – as supplied by publisher]
More Questions than Answers: Continued Critical Reanalysis of Fredrickson et al.’s Studies of Genomics and Well-Being.
PLoS One. 2016;11(6):e0156415
Authors: Brown NJ, MacDonald DA, Samanta MP, Friedman HL, Coyne JC
We critically re-examine Fredrickson et al.’s renewed claims concerning the differential relationship between hedonic and eudaimonic forms of well-being and gene expression, namely that people who experience a preponderance of eudaimonic well-being have gene expression profiles that are associated with more favorable health outcomes. By means of an extensive reanalysis of their data, we identify several discrepancies between what these authors claimed and what their data support; we further show that their different analysis models produce mutually contradictory results. We then show how Fredrickson et al.’s most recent article on this topic not only fails to adequately address our previously published concerns about their earlier related work, but also introduces significant further problems, including inconsistency in their hypotheses. Additionally, we demonstrate that regardless of which statistical model is used to analyze their data, Fredrickson et al.’s method can be highly sensitive to the inclusion (or exclusion) of data from a single subject. We reiterate our previous conclusions, namely that there is no evidence that Fredrickson et al. have established a reliable empirical distinction between their two delineated forms of well-being, nor that eudaimonic well-being provides any overall health benefits over hedonic well-being.
PMID: 27270924 [PubMed – as supplied by publisher]
Posted in PLoS One
Tagged J.C. Coyne