Maria Elena Magrin

The combined contribution of social support and coping strategies in predicting post-traumatic growth: a longitudinal study on cancer patients.

Objectives: The aim of this study is to investigate the role of social support and coping strategies in enhancing post‐traumatic growth (PTG) in cancer patients. The study focused on both avoidance and approaching coping and on four distinct types of social support: (a) perceived availability, (b) actual received, (c) satisfaction with received support, and (d) the competence of caregiver to satisfy the patients basic psychological needs of autonomy, competence, and relatedness.

Social Support and Adherence to Treatment in Hypertensive Patients: A Meta-Analysis

BackgroundIt is important to examine factors associated with patient adherence to hypertension control strategies.PurposeA meta-analysis was conducted to examine whether social support was related to adherence to healthy lifestyle and treatment medication in hypertensive patients.MethodsJournal articles were searched in medical (CINAHL, MEDLINE), psychological (PsycINFO, PsycARTICLES), and educational (ERIC) electronic databases; in reference lists of selected papers; and in the reference list of a previous review.ResultsFindings of a set of meta-analyses indicated that (a) structural social support was not significantly related to overall adherence, (b) functional social support was significantly and positively related to overall adherence, (c) these findings were further confirmed in meta-analyses conducted on specific types of adherence, and (d) most results were characterized by heterogeneity across studies that was partially explained by moderator analyses.ConclusionsFunctional social support, but not structural social support, was associated with adherence in hypertensive patients.

Seeking and experiencing meaning: exploring the role of meaning in promoting mental adjustment and eudaimonic well-being in cancer patients.

OBJECTIVE The present study is the result of theory-driven research investigating the role of the search for and presence of meaning in enhancing both mental adjustment and eudaimonic well-being in cancer patients. METHOD A cross-sectional study involved 266 cancer patients currently in the treatment and management phase of their illness. Data were collected by a written questionnaire. The search for meaning was assessed with the Seeking of Noetic Goals Test, and the presence of meaning was assessed using the Purpose in Life Test. Mental adjustment to a cancer diagnosis was assessed by two subscales of the Italian version of the Mini-Mental Adjustment to Cancer Scale, and eudaimonic well-being was assessed with the Psychological Well-Being Scale. Correlation and mediation analyses based on five thousand bootstrapping samples were performed. RESULTS The mediation analyses showed that the presence of meaning totally or partially mediated the effect of the search for meaning on both mental adjustment and eudaimonic well-being. Further correlation analyses showed a high negative correlation between eudaimonic well-being and hopelessness. SIGNIFICANCE OF RESULTS Our results appear relevant from both the theoretical and clinical points of view. They support a deeper understanding of the combined contribution of the search for and presence of meaning in promoting well-being in cancer patients. Simultaneously, they are consistent with suggestions from recent studies on the clinical psychology of posttraumatic growth and emphasize the relevance of eudaimonic well-being as a protective factor for hopelessness.

A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators.

Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed.

A longitudinal study on the information needs and preferences of patients after an acute coronary syndrome

BackgroundResearch has shown that the provision of pertinent health information to patients with cardiovascular disease is associated with better adherence to medical prescriptions, behavioral changes, and enhanced perception of control over the disease. Yet there is no clear knowledge on how to improve information pertinence. Identifying and meeting the information needs of patients and their preferences for sources of information is pivotal to developing patient-led services. This prospective, observational study was aimed at exploring the information needs and perceived relevance of different information sources for patients during the twenty-four months following an acute coronary syndrome.MethodsTwo hundred and seventeen newly diagnosed patients with acute coronary syndrome were enrolled in the study. The patients were primarily men (83.41 %) with a mean age of 57.28 years (range 35–75; SD = 7.98). Patients’ needs for information and the perceived relevance of information sources were evaluated between 2 and 8 weeks after hospitalization (baseline) and during three follow-ups at 6, 12 and 24 months after baseline. Repeated measures ANOVA, Bonferroni post hoc tests and Cochran’s Q Test were performed to test differences in variables of interest over time.ResultsResults showed a reduction in information needs, but this decrease was significant only for topics related to daily activities, behavioral habits, risk and complication. At baseline, the primary sources of information were specialists and general practitioners, followed by family members and information leaflets given by physicians. Relevance of other sources changed differently over time.ConclusionThe present longitudinal study is an original contribution to the investigation of changes in information needs and preferences for sources of information among patients who are diagnosed with acute coronary syndrome. One of the main results of this study is that information on self-disease management is perceived as a minor theme for patients even two years after the event. Knowledge on how patients’ information needs and perceived relevance of information sources change over time could enhance the quality of chronic disease management, leading health-care systems to move toward more patient-tailored care.

Studying Predictors of Posttraumatic Growth in Cancer Patients

Coherently, with the Organismic valuing theory of growth, the research firstly intended to verify the effectiveness of the pattern of accommodative versus assimilative strategies in predicting posttraumatic growth and, secondly, to verify the effectiveness of autonomy-supportive posttrauma social environment (i.e., caregiver) in predicting accommodative versus assimilative strategies in a group of mixed cancer patients. A structured questionnaire was offered to 150 cancer patients prevalently diagnosed with Stage 1 or Stage 2 breast cancer or gastro-enteric cancer (M = 52 years old; SD = 7.70), an average of 35-month postdiagnosis, using the Posttraumatic Growth Inventory, the Brief Cope, the Impact Scale and the Impact of Event Scale, the Need Satisfaction in Relationship Scale. The accommodative strategy of coping strongly positively correlates with posttraumatic growth (PTG). On the contrary, assimilative strategy weakly correlates with PTG. Furthermore, a model of the pattern of accommodative processes was tested by path analysis. The model was significant and accounted for high amount of variance symptoms of intrusion that started up the process toward growth, predicting the impact of the event on identity of patients that in turn channeled the ruminative process toward an approach strategy of coping. The approach coping strategy was the reliable direct predictor of PTG. No other predictors of growth correlate significantly with autonomy-supportive stile of caring. The quality of personal struggle with the new reality of trauma is the key variable in determining the extent to which posttraumatic growth occurs. On the contrary, the role of the autonomy-supportive social context is unclear.

Changes in physical activity among coronary and hypertensive patients: A longitudinal study using the Health Action Process Approach

Objectives: Physical activity (PA) is a key factor in cardiovascular disease prevention. Through the Health Action Process Approach (HAPA), the present study investigated the process of change in PA in coronary patients (CPs) and hypertensive patients (HPs). Design: Longitudinal survey study with two follow-up assessments at 6 and 12 months on 188 CPs and 169 HPs. Main outcome measures: Intensity and frequency of PA. Results: A multi-sample analysis indicated the equivalence of almost all the HAPA social cognitive patterns for both patient populations. A latent growth curve model showed strong interrelations among intercepts and slopes of PA, planning and maintenance self-efficacy, but change in planning was not associated with change in PA. Moreover, increase in PA was associated with the value of planning and maintenance self-efficacy reached at the last follow-up Conclusions: These findings shed light on mechanisms often neglected by the HAPA literature, suggesting reciprocal relationships between PA and its predictors that could define a plausible virtuous circle within the HAPA volitional phase. Moreover, the HAPA social cognitive patterns are essentially identical for patients who had a coronary event (i.e. CPs) and individuals who are at high risk for a coronary event (i.e. HPs).

[PP.32.04] PREDICTORS OF PWV PROGRESSION OVER A THREE YEARS FOLLOW UP: FOCUS ON PSYCHOLOGICAL CHARACTERISTICS

Objective: Abnormal large artery function plays an important role in the pathogenesis of cardiovascular (CV) diseases. Prior studies have suggested that the principal determinants of arterial stiffening are age, Blood Pressure (BP) and others CV risk factors such as dyslipidemia and diabetes. However the role of psychological characteristics on the long-term progression of arterial stiffness has not yet been evaluated. The aim of the current longitudinal study was to evaluate the psychological determinants of the Pulse Wave Velocity (PWV) progression over a 3 years follow-up period in treated hypertensives subjects. Design and method: We enrolled 350 consecutive 18–80 aged outpatients, followed by the Hypertension Unit of S. Gerardo Hospital (Monza, Italy) affected by essential hypertension. At baseline (T0) anamnestic data, clinical BP, laboratory data and PWV were evaluated; also psychological tests were performed. In a subgroup of 50 subjects, after a median follow-up time of 2.96 ± 0.33 years, we performed again psychological tests and PWV examination (T1). Psychological tests were administered by trained researchers for measuring perceived stress, resiliency factors (self-esteem, sense of coherence), and perceived social support. Results: At T0 the mean age was 55.9 ± 10.1years, SBP and DBP were 135.6 ± 17.7 and 82.5 ± 9.1mmHg and PWV was 8.6 ± 2.1m/s. Despite a significant improvement in the blood pressure control (from 72 to 84%; PAS from 135.6 ± 17.7 to 130.1 ± 14.2, p = 0.08; PAD from 82.5 ± 9.1 to 77.5 ± 9.4, p < 0.05), at follow-up examination PWV didn’t showed significant changes (from 8.6 ± 2.1 to 8.6 ± 2.4, p = 0.87) with a mean deltaPWV of −0.05 ± 2.8m/s. Focusing on PWV changes over the follow-up period and on psychological test, subjects where then divided accordingly to their deltaPWV in those in which an increase was showed and those in which the values decrease. For similar baseline values, subjects with positive deltaPWV showed higher T1 values of stress (37.4 ± 1.1vs36.8 ± 0.8, p = 0.02) and lower values of self-esteem (2.9 ± 0.5 vs 3.3 ± 0.4, p = 0.02), sense of coherence (4.4 ± 0.7vs4.9 ± 0.8, p = 0.02), and a worse family climate (3.5 ± 0.9vs4.1 ± 0.8, p = 0.02). No significant differences were showed regarding BP values and CV risk factors. Conclusions: The current longitudinal study shows that arterial stiffness didn’t shown any significant changes despite BP improvement. PWV increase is related to higher stress and lower self-esteem and familiar support.

Qualitative study of posttraumatic growth: free or driven interview?

Background: Many psycho-oncology studies use posttraumatic growth (PTG) measures designed for general trauma experiences, and as such they may not take into account life changes associated with a health-related context. Method: Study 1, a thematic analysis of written narratives (N = 209), emphasised cancer survivors’ newfound compassion. Study 2, with 504 prostate cancer survivors, measured the Posttraumatic Growth Inventory including five additional items derived from Study 1 to represent increased compassion. Findings: A Principal Components Analysis revealed a six-component structure after deleting eight items. Components related to compassion, new possibilities, relating to others, personal strength, appreciation of life, and spiritual change. Compassion accounted for 48.9% of variance, with the overall model accounting for 79.9% of variance. Strong factorability, internal consistency, and convergent validity were demonstrated. Discussion: The salience of newfound compassion after cancer was demonstrated. This research has important implications for accurately assessing the post-diagnosis trajectory of adjustment after cancer.Special Issue: Abstracts supplement: “Well-being, quality of life and caregiving” : 27th Conference of the European health psychology society, Bordeaux, France, 16th – 20th July 2013Background: Self-affirmation (i.e., focusing on a valued aspect of the self-concept) can promote health behaviour change. This study aimed to see if self-affirmation increased physical activity (PA) regardless of threat level presented in health messages. Methods: Sixty-eight participants were randomly allocated to condition in a 2 (self-affirmation, no affirmation) x 2 (high threat, low threat) between-participants design. Participants completed the Godin Leisure-Time Exercise Questionnaire at baseline and one week later to assess PA. Findings: A two-way ANCOVA with affirmation condition and threat level as predictor variables, controlling for baseline PA, was performed on follow up PA. Baseline PA was a significant predictor (F(1,63) = 399.63, p<0.001) and the main effect of affirmation condition approached significance (F(1,63) = 3.55, p=0.06). There were no other significant effects. Discussion: This study provides further evidence that self-affirmation can increase PA, but found no interaction between self-affirmation and threat level presented in health messages.Background: Contemporary alcohol research suggests that implicit attitudes are important predictors of drinking behaviour and there is growing interest surrounding factors influencing them. Research suggests that evaluative conditioning (EC) influences implicit attitudes and at a population level the most obvious and prolific use of EC is advertising. Methods: Participants (n= 51, mean age= 22.43) completed alcohol- and chocolate-related Implicit Association Tests (IAT) before viewing an advertisement for either chocolate or beer. Participants then completed post-test IATs before being provided with chocolate and beer products and asked to consume as much as they wanted. Findings: Viewing a beer advertisement produced a significant positive shift in alcohol-related implicit attitudes from pre- to post-test. No other significant effects on implicit attitudes or behaviour were found. Discussion: Alcohol advertisements are effective in changing alcohol-related implicit attitudes; however the influence on behaviour requires further investigation. Implications for the manipulation of alcohol-related implicit attitudes are discussed.Background: Recent research has highlighted the importance of automatic processes in predicting impulsive health risk behaviour. This has led to the creation of health behaviour models such as the Prototype Willingness Model (PWM) which take into account dual processes when predicting health behaviour. The current research argues that individuals are more likely to engage in impulsive drinking behaviour on a weekend as opposed to a weekday as there are fewer constraints placed upon drinking behaviour. Methods: Participants (n= 61, mean age= 22) completed an alcohol Implicit Association Test as well as a questionnaire assessing variables on the PWM and drinking behaviour. Findings: More positive alcohol-related automatic cognitions were significantly related to increased levels of both frequency and quantity of self-reported weekend drinking behaviour but were not significantly related to weekday drinking behaviour. Discussion: Automatic processes successfully predicted drinking behaviour when there were fewer constraints placed upon individuals.Background: The Prototype Willingness Model (PWM) suggests that there are two separate antecedents to behaviour: intention and willingness. Whereas intention is suggested to be rational and deliberative, willingness is more automatic and impulsive. The current study used a cross-cultural sample in order to examine the differing predictive power of the PWM for drinking behaviour. Methods: A sample of 193 individuals from Australia (n=108) and Singapore (n=85) completed a questionnaire measuring alcohol consumption and variables on the PWM. Findings: Willingness to drink significantly predicted alcohol consumption in Singaporeans. Both willingness and intention to drink significantly predicted frequency of alcohol consumption Discussion: The antecedents of the PWM differentially predict alcohol consumption in culturally different samples. Implications for health interventions aimed to reduce drinking across cultures are discussed.Background. Parenting has been associated with child weight status. This study aims to evaluate the effects on parenting skills and BMI-SDS of the BBOFT+ overweight prevention program, compared to care-as-usual (CAU). Method. In a cluster-randomized trial, 2500 parents participated. Parent-reported weight and length were used. Parenting was measured with subscales control and reinforcement of the parenting strategies for eating and activity scale (PEAS) and the warmth subscale from the Child Rearing Questionnaire. Results. The first univariate analyses show that at age 15 months, no statistically significant differences in BMI- SDS, parental control, reinforcement or warmth were found between the BBOFT+ and the CAU group. Further cluster analyses need to be conducted. Results from age 36 months will be presented during the conference, which will include all subscales of the PEAS and an assessment of parenting styles. Conclusion. The intervention does not seem to have an effect on BMI-SDS or parenting.Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content.

Post-traumatic growth as a trigger for social identification: a longitudinal study on liver transplant patients

Background: Many psycho-oncology studies use posttraumatic growth (PTG) measures designed for general trauma experiences, and as such they may not take into account life changes associated with a health-related context. Method: Study 1, a thematic analysis of written narratives (N = 209), emphasised cancer survivors’ newfound compassion. Study 2, with 504 prostate cancer survivors, measured the Posttraumatic Growth Inventory including five additional items derived from Study 1 to represent increased compassion. Findings: A Principal Components Analysis revealed a six-component structure after deleting eight items. Components related to compassion, new possibilities, relating to others, personal strength, appreciation of life, and spiritual change. Compassion accounted for 48.9% of variance, with the overall model accounting for 79.9% of variance. Strong factorability, internal consistency, and convergent validity were demonstrated. Discussion: The salience of newfound compassion after cancer was demonstrated. This research has important implications for accurately assessing the post-diagnosis trajectory of adjustment after cancer.Special Issue: Abstracts supplement: “Well-being, quality of life and caregiving” : 27th Conference of the European health psychology society, Bordeaux, France, 16th – 20th July 2013Background: Self-affirmation (i.e., focusing on a valued aspect of the self-concept) can promote health behaviour change. This study aimed to see if self-affirmation increased physical activity (PA) regardless of threat level presented in health messages. Methods: Sixty-eight participants were randomly allocated to condition in a 2 (self-affirmation, no affirmation) x 2 (high threat, low threat) between-participants design. Participants completed the Godin Leisure-Time Exercise Questionnaire at baseline and one week later to assess PA. Findings: A two-way ANCOVA with affirmation condition and threat level as predictor variables, controlling for baseline PA, was performed on follow up PA. Baseline PA was a significant predictor (F(1,63) = 399.63, p<0.001) and the main effect of affirmation condition approached significance (F(1,63) = 3.55, p=0.06). There were no other significant effects. Discussion: This study provides further evidence that self-affirmation can increase PA, but found no interaction between self-affirmation and threat level presented in health messages.Background: Contemporary alcohol research suggests that implicit attitudes are important predictors of drinking behaviour and there is growing interest surrounding factors influencing them. Research suggests that evaluative conditioning (EC) influences implicit attitudes and at a population level the most obvious and prolific use of EC is advertising. Methods: Participants (n= 51, mean age= 22.43) completed alcohol- and chocolate-related Implicit Association Tests (IAT) before viewing an advertisement for either chocolate or beer. Participants then completed post-test IATs before being provided with chocolate and beer products and asked to consume as much as they wanted. Findings: Viewing a beer advertisement produced a significant positive shift in alcohol-related implicit attitudes from pre- to post-test. No other significant effects on implicit attitudes or behaviour were found. Discussion: Alcohol advertisements are effective in changing alcohol-related implicit attitudes; however the influence on behaviour requires further investigation. Implications for the manipulation of alcohol-related implicit attitudes are discussed.Background: Recent research has highlighted the importance of automatic processes in predicting impulsive health risk behaviour. This has led to the creation of health behaviour models such as the Prototype Willingness Model (PWM) which take into account dual processes when predicting health behaviour. The current research argues that individuals are more likely to engage in impulsive drinking behaviour on a weekend as opposed to a weekday as there are fewer constraints placed upon drinking behaviour. Methods: Participants (n= 61, mean age= 22) completed an alcohol Implicit Association Test as well as a questionnaire assessing variables on the PWM and drinking behaviour. Findings: More positive alcohol-related automatic cognitions were significantly related to increased levels of both frequency and quantity of self-reported weekend drinking behaviour but were not significantly related to weekday drinking behaviour. Discussion: Automatic processes successfully predicted drinking behaviour when there were fewer constraints placed upon individuals.Background: The Prototype Willingness Model (PWM) suggests that there are two separate antecedents to behaviour: intention and willingness. Whereas intention is suggested to be rational and deliberative, willingness is more automatic and impulsive. The current study used a cross-cultural sample in order to examine the differing predictive power of the PWM for drinking behaviour. Methods: A sample of 193 individuals from Australia (n=108) and Singapore (n=85) completed a questionnaire measuring alcohol consumption and variables on the PWM. Findings: Willingness to drink significantly predicted alcohol consumption in Singaporeans. Both willingness and intention to drink significantly predicted frequency of alcohol consumption Discussion: The antecedents of the PWM differentially predict alcohol consumption in culturally different samples. Implications for health interventions aimed to reduce drinking across cultures are discussed.Background. Parenting has been associated with child weight status. This study aims to evaluate the effects on parenting skills and BMI-SDS of the BBOFT+ overweight prevention program, compared to care-as-usual (CAU). Method. In a cluster-randomized trial, 2500 parents participated. Parent-reported weight and length were used. Parenting was measured with subscales control and reinforcement of the parenting strategies for eating and activity scale (PEAS) and the warmth subscale from the Child Rearing Questionnaire. Results. The first univariate analyses show that at age 15 months, no statistically significant differences in BMI- SDS, parental control, reinforcement or warmth were found between the BBOFT+ and the CAU group. Further cluster analyses need to be conducted. Results from age 36 months will be presented during the conference, which will include all subscales of the PEAS and an assessment of parenting styles. Conclusion. The intervention does not seem to have an effect on BMI-SDS or parenting.Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content.