Krystal Warmoth

Creating psychological connections between intervention recipients: development and focus group evaluation of a group singing session for people with aphasia

Objectives The study sought to identify key design features that could be used to create a new framework for group-based health interventions. We designed and tested the first session of a group intervention for stroke survivors with aphasia which was aimed at nurturing new psychological connections between group members. Setting The intervention session, a participant focus group and interviews with intervention facilitators were held in a local community music centre in the South West of England. Participants A convenience sample of 10 community-dwelling people with poststroke aphasia participated in the session. Severity of aphasia was not considered for inclusion. Intervention Participants took part in a 90-min group singing session which involved singing songs from a specially prepared song book. Musical accompaniment was provided by the facilitators. Primary and secondary outcome measures Participants and group facilitators reported their experiences of participating in the session, with a focus on activities within the session related to the intervention aims. Researcher observations of the session were also made. Results Two themes emerged from the analysis, concerning experiences of the session (‘developing a sense of group belonging’) and perceptions of its design and delivery (‘creating the conditions for engagement’). Participants described an emerging sense of shared social identity as a member of the intervention group and identified fixed (eg, group size, session breaks) and flexible (eg, facilitator responsiveness) features of the session which contributed to this emergence. Facilitator interviews and researcher observations corroborated and expanded participant reports. Conclusions Engagement with health intervention content may be enhanced in group settings when intervention participants begin to establish positive and meaningful psychological connections with other group members. Understanding and actively nurturing these connections should be a core feature of a general framework for the design and delivery of group interventions.

Older adults’ perceptions of ageing and their health and functioning: a systematic review of observational studies

Abstract Many older people perceive ageing negatively, describing it in terms of poor or declining health and functioning. These perceptions may be related to older adults’ health. The aim of this review was to synthesise existing research on the relationship between older adults’ perceptions of ageing and their health and functioning. A systematic search was conducted of five electronic databases (ASSIA, CINAHL, IBSS, MEDLINE and PsycINFO). Citations within identified reports were also searched. Observational studies were included if they included perceptions of ageing and health-related measures involving participants aged 60 years and older. Study selection, data extraction and quality appraisal were conducted using predefined criteria. Twenty-eight reports met the criteria for inclusion. Older adults’ perceptions of ageing were assessed with a variety of measures. Perceptions were related to health and functioning across seven health domains: memory and cognitive performance, physical and physiological performance, medical conditions and outcomes, disability, care-seeking, self-rated health, quality of life and death. How ageing is perceived by older adults is related to their health and functioning in multiple domains. However, higher quality and longitudinal studies are needed to further investigate this relationship.

Fear of cancer recurrence and physical well-being among Chinese cancer survivors: the role of conscientiousness, positive reappraisal and hopelessness

PurposeThe degree to which conscientiousness contributes to well-being in Chinese cancer survivors and the mechanisms through which conscientiousness is associated with well-being remain unclear. Based on Lent’s restorative well-being model [1], the current study tested a mediation model of the contribution of conscientiousness, positive reappraisal, and hopelessness to fear of cancer recurrence (FCR), and physical well-being in a sample of 238 Chinese cancer survivors.MethodParticipants completed self-report questionnaires. Path analysis was used to analyze the linear relationships between the variables.ResultsThe empirical model supported the mediator roles of positive reappraisal and hopelessness. Specifically, the results indicated that conscientiousness was first associated with positive reappraisal, which in turn was associated with decreased hopelessness, resulting in decreased FCR and improved physical well-being. In addition, the results showed that conscientiousness was associated with decreased hopelessness, which was then associated with decreased FCR and greater physical well-being.ConclusionConscientiousness confers benefits on FCR and physical well-being through the mechanisms of positive reappraisal and decreased hopelessness.

Differences in quality of life between American and Chinese breast cancer survivors

ObjectiveIt has been speculated that cancer survivors in Asia may have lower quality of life (QOL) compared with their Western counterparts. However, no studies have made international comparisons in QOL using a comprehensive measure. This study aimed to compare Chinese breast cancer survivors’ QOL with US counterparts and examine if demographic and medical factors were associated with QOL across groups.MethodThe sample consisted of 159 breast cancer patients (97 Chinese and 62 American) who completed the Functional Assessment for Cancer Therapy Breast Cancer (FACT-B) scale before the start of radiotherapy in Shanghai, China and Houston, USA.ResultsHigher income was associated with higher QOL total scores in both Chinese and American cancer patients, but QOL was not significantly associated with other factors including age, education, disease stage, mastectomy, and chemotherapy. Consistent with hypotheses, compared to their US counterparts, Chinese breast cancer survivors reported lower QOL and all four subdimensions including functional well-being (FWB), physical well-being (PWB), emotional well-being (EWB), and social well-being (SWB); they also reported more breast cancer-specific concerns (BCS). Differences were also clinically significant for Functional Assessment for Cancer Therapy General (FACT-G) scale total scores and the FWB subscale. After controlling for demographic and medical covariates, these differences remained except for the SWB and BCS. Furthermore, Chinese breast cancer survivors receiving chemotherapy reported significantly lower FACT-G scores than those who did not, but this difference did not emerge among US breast cancer survivors.DiscussionChinese breast cancer survivors reported poorer QOL on multiple domains compared to US women. Findings indicate that better strategies are needed to help improve the QOL of Chinese breast cancer survivors, especially those who underwent chemotherapy.

Relationship between perceptions of ageing and frailty in English older adults

Abstract Older adults’ negative beliefs about ageing are related to their health and functioning, but little is known about how perceptions of ageing (POA) relate to frailty status. This study aimed to explore the relationship between POA and frailty. Secondary analysis of data used were from the English Longitudinal Study of Ageing Waves 2 and 5. A POA score was based on participants’ responses to 12 statements using a five-point Likert scale at baseline, and a Frailty Index (FI) score was calculated for each participant for both waves. Multiple linear regression models were conducted to assess the relationship between POA and frailty cross-sectionally and longitudinally in models controlled for age, gender, depression symptoms, and socioeconomic status. Older adults with more negative POA had greater frailty (β = .12, p < .001). Negative POA predicted greater frailty 6 years later (β = .03, p < .05). Future work regarding the mechanisms of this relationship is needed to identify ways of intervening to improve health.

Relation of social constraints on disclosure to adjustment among Chinese American cancer survivors: A multi-processes approach

The present study examines the association between social constraints and depressive symptoms among Chinese American breast cancer survivors, and the mechanism underling this association. A multiprocesses model is tested to examine the mediating roles of ambivalence over emotional expression (AEE), avoidance, intrusive thoughts, and social support in the association between social constraints and depressive symptoms among Chinese American breast cancer survivors.