Barbara Velsor-Friedrich

The Relationships Among Self-Esteem, Stress, Coping, Eating Behavior, and Depressive Mood in Adolescents

The prevalence of adolescent overweight is significant, almost 25% in some minorities, and often is associated with depressive symptoms. Psychological and psychosocial factors as well as poor coping skills have been correlated with unhealthy eating and obesity. The purpose of this study was to examine relationships among self-esteem, stress, social support, and coping; and to test a model of their effects on eating behavior and depressive mood in a sample of 102 high school students (87% minority). Results indicate that (a) stress and low self-esteem were related to avoidant coping and depressive mood, and that (b) low self-esteem and avoidant coping were related to unhealthy eating behavior. Results suggest that teaching adolescents skills to reduce stress, build self-esteem, and use more positive approaches to coping may prevent unhealthy eating and subsequent obesity, and lower risk of depressive symptoms.

Health Promotion in Adolescents: A Review of Pender’s Health Promotion Model:

Adolescents have unique health considerations as they transition from parent-managed healthcare to personal responsibility for health behavior. One question to consider is the goodness-of-fit of available theoretical models for explaining and predicting adolescent health-promoting behavior. This integrative review explored Pender’s health promotion model in relation to adolescent health. Specifically, this review summarizes the components of Pender’s model and the supporting theoretical underpinnings based in the social cognitive theory. Research literature related to the health promotion model and various aspects of teen health is explored. Recommendations for further research and theory development are discussed.

The Psychological Impact of Living With Diabetes Women's Day-to-Day Experiences

PURPOSE The purpose of this study is to understand the feelings of depression, anxiety, and anger experienced by women with type 2 diabetes and the impact these feelings have on their overall quality of life. METHODS Four focus groups (2 white, 2 African American) were conducted by ethnically matched professional moderators. Sessions were audiotaped, and transcriptions were analyzed using an inductive approach. Forty-one women (mean age, 55.6 years; SD = 7.9) who had type 2 diabetes for an average of 8.7 years (SD = 6.3) participated. Forty-two percent of the sample was African American. RESULTS The themes generated directly from the focus group data are (1) struggling with the changing health situation; (2) encountering challenges in relationships with self, family, and others; (3) worrying about the present and future; (4) bearing multiple responsibilities for self and others; and (5) choosing to take a break. Women also expressed feelings of depression, anxiety, and anger, which were primarily related to having diabetes as well as managing the multiple responsibilities of being a caregiver. There were more similarities than differences noted by race. CONCLUSIONS Women with type 2 diabetes experience feelings of depression, anxiety, and anger, which affect their health and overall quality of life. The findings suggest that health care providers should assess the psychological health of women with type 2 diabetes when developing plans of care. By understanding and addressing the emotional health of women with type 2 diabetes, the relationships between the patient, family, and health care provider may improve, allowing for more successful diabetes management.

Talking with teens about asthma management.

Asthma is a chronic illness that affects approximately 7 million children and adolescents in the United States. Teens seem to be at higher risk for poor asthma health outcomes because of the tumultuous changes associated with adolescence. The purpose of this study was to explore experiences and behaviors related to the self-management of teens with asthma. Teens from four different high schools participated in one of four focus groups. Based on these discussions, the following themes emerged related to teens’ management of their asthma: wanting to be normal, the unpredictability of the disease, the credibility of the teen with asthma, and self-management issues. Recommendations for developing education and management strategies for teens with asthma are discussed.

Adolescent asthma education programs for teens: review and summary.

The purpose of this review is to describe and evaluate education programs for teens with asthma. Although asthma educational programs for children are plentiful, this is not the case for adolescents. The developmental tasks of adolescence require asthma education programs that are uniquely tailored to this age group. Although several well-designed studies appear in the literature, further research is needed to evaluate the efficacy of asthma education programs among teens. Although the quality of research varies, demonstrated program benefits include improved asthma self-management, self-efficacy, family support mechanisms, and quality of life. Practice implications point to the need for education programs in schools and camp settings that are consistent with national asthma guidelines.

Effects of Coping-Skills Training in Low-Income Urban African-American Adolescents with Asthma

Background. Minority teens with asthma are at particular risk for this life-threatening disease due to increased morbidity and mortality rates in addition to the normal challenges of adolescence. Objective. The purpose of this randomized controlled trial (n = 137) was to determine the effects of a coping-skills training program (intervention) compared with standard asthma education (attention control) in African-American teens with asthma. Methods. Adolescents were recruited from five African-American dominant high schools serving low-income areas of Chicago. Data were collected at baseline, 2 months (immediately following the intervention), 6 months, and 12 months. Results. Both groups improved over time, with significant increases in asthma-related quality of life, asthma knowledge, and asthma self-efficacy, accompanied by decreases in symptom days and asthma-related school absences. Conclusions. Findings suggest that coping-skills training as implemented in this study provided no additional benefit beyond that experienced in the control group. However, group-based interventions delivered in the school setting may be beneficial for low-income, minority teens with asthma.

The asthma belief survey: development and testing.

Accurate evaluation of asthma self-efficacy is essential to the effective management of asthma. This article describes the development and testing of the Asthma Belief Survey (ABS). The instrument is a 15-item tool that uses a 5-point self-report scale to measure asthma self-efficacy in relation to daily asthma maintenance and an asthma crisis. This instrument was tested with a sample of 79 African American school children, who attended eight inner-city elementary schools. The mean age of the sample was 11.05 years with a range of 8 to 14 years. The majority of students had been diagnosed with asthma prior to the age of 5 years. The Asthma Belief Survey demonstrated good psychometric properties: good Cronbachs alpha reliability coefficient (.83), coherence as a single scale measuring childrens self-efficacy in treating their own asthma, and significant relationships with scales of asthma knowledge (r = .51, p < .000) and asthma self-care practices (r = .52, p < .001). The Asthma Belief Survey has sound reliability and validity evidence to support its use to measure a childs asthma self-management self-efficacy. The practitioner can use this instrument to assess a childs self-efficacy in the areas of asthma health maintenance and avoidance of asthma episodes.

Factors predictive of depression in first-year college students

Starting college is a challenging time for first-year students and is often accompanied by emotions such as depression, which can negatively affect academic performance and quality of life. This descriptive correlational study examined stress, coping, depressive symptomology, spirituality, and social support in a convenience sample of first-year students (N = 188) from two private colleges. Results indicated that 45% of students demonstrated greater than average levels of stress and 48% reported clinically significant depressive symptomology. Significant relationships existed between depressive symptoms and stress (p < 0.01) and depressive symptoms and social support (p < 0.01). Less social support was associated with more stress (p < 0.01). The results suggested that interventions targeting stress reduction in first-year students should be considered for decreasing depressive symptoms to enhance their college experience. \

The effects of coping skills training among teens with asthma.

This pilot study used a pretest and posttest design to examine the effect of a school-based intervention, Coping Skills Training, among teens with asthma (N = 39) aged 14 to 18 years randomly assigned to treatment and control groups from three midwestern high schools. Variables included asthma self-efficacy, social support, asthma-related quality of life, peak expiratory flow rate, asthma diary symptoms, and rescue medication usage. The treatment group scored significantly higher on self-efficacy (p < .001), activity-related quality of life (p = .05), and social support (p < .001) compared with the control group after using ANCOVA to adjust for baseline scores. Significant improvements were also noted from pre- to posttest in the treatment group for self-efficacy (p < .001) and quality of life (p = .02). This study indicates that Coping Skills Training is an important intervention for further study with teens with asthma.

School-based management of the child with an acute asthma episode.

Asthma is a chronic inflammatory disorder of the airways that affects 5 million American children. In the past decade, asthma morbidity has dramatically increased. This increase is particularly apparent in poor minority inner-city children. School-based health centers offer a conveniently located setting for the acute treatment and long-term management of childhood asthma. Treatment of asthma using the most recent management guidelines offered in a school setting should result in a decrease in the morbidity and mortality associated with pediatric asthma.