Nicole Rascle

Psycho-social factors and coping strategies as predictors of chronic evolution and quality of life in patients with low back pain: A prospective study

Low back pain (LBP) is a major problem of public health. Chronic pain is the most difficult to treat and the most expensive. The way patients cope with their pain may influence its outcome.

The Associations of Social Support and Other Psychosocial Factors with Mortality and Quality of Life in the Dialysis Outcomes and Practice Patterns Study

BACKGROUND AND OBJECTIVES This study aimed to investigate the influence of social support and other psychosocial factors on mortality, adherence to medical care recommendations, and physical quality of life among hemodialysis patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Data on 32,332 hemodialysis patients enrolled in the Dialysis Outcomes and Practice Patterns Study (1996 to 2008) in 12 countries were analyzed. Social support and other psychosocial factors related to ESRD and its treatment were measured by patient self-reports of health interference with social activities, isolation, feeling like a burden, and support from family and dialysis staff. Cox regression and logistic regression were used to examine associations of baseline social support and other psychosocial factors with all-cause mortality and with other measured outcomes at baseline, adjusting for potential confounders. RESULTS Mortality was higher among patients reporting that their health interfered with social activities, were isolated, felt like a burden, and were dissatisfied with family support. Poorer family support and several psychosocial measures also were associated with lower adherence to the prescribed hemodialysis length and the recommended weight gain between sessions. Some international differences were observed. Poorer self-reported social support and other psychosocial factors were associated with poor physical quality of life. CONCLUSIONS Poorer social support and other psychosocial factors are associated with higher mortality risk, lower adherence to medical care, and poorer physical quality of life in hemodialysis patients. More research is needed to assess whether interventions to improve social support and other psychosocial factors will lengthen survival and enhance quality of life.

Personality traits and executive functions related to on-road driving performance among older drivers.

The present study investigated how executive functions and personality traits are related with driving performance among older drivers. Forty-two participants aged 60 and over were recruited to complete a battery of cognitive tests, measures of personality traits and an on-road driving test. Significant correlations were found between poor driving performances and low scores on tests assessing shifting and updating functions. In addition, extraversion had a negative relation with driving performance and made the only contribution, among the psychological factors, to the prediction of driving performance. Finally, gender and age emerged as the best predictors of on-road driving performance. Gender, personality traits and executive functions should be taken into account when studying safety among older drivers.

Health and aging in elderly farmers: the AMI cohort.

BackgroundThe health of the agricultural population has been previously explored, particularly in relation to the farming exposures and among professionally active individuals. However, few studies specifically focused on health and aging among elders retired from agriculture. Yet, this population faces the long-term effects of occupational exposures and multiple difficulties related to living and aging in rural area (limited access to shops, services, and practitioners). However, these difficulties may be counter-balanced by advantages related to healthier lifestyle, richer social support and better living environment. The general aim of the AMI cohort was to study health and aging in elderly farmers living in rural area through a multidisciplinary approach, with a main focus on dementia.Methods/designThe study initially included 1 002 participants, randomly selected from the Farmer Health Insurance rolls. Selection criteria were: being 65 years and older; living in rural area in Gironde (South-Western France); being retired from agriculture after at least 20 years of activity and being affiliated to the Health Insurance under own name. The study started in 2007, with two follow-up visits over 5 years. Baseline visits were conducted at home by a neuropsychologist then by a geriatrician for all cases suspected of dementia, Parkinson’s disease and depression (to confirm the diagnosis), and by a nurse for others. A large panel of data were collected through standardised questionnaires: complete neuropsychological assessment, material and social living environment, psychological transition to retirement, lifestyle (smoking, alcohol and diet), medications, disability in daily living, sensory impairments and some clinical measures (blood pressure, depression symptomatology, anxiety, visual test, anthropometry…). A blood sampling was performed with biological measurements and constitution of a biological bank, including DNA. Brain MRI were also performed on 316 of the participants. Finally, the three-year data on health-related reimbursements were extracted from the Health System database (medications, medical and paramedical consultations, biological examinations and medical devices), and the registered Long-Term Diseases (30 chronic diseases 100% covered by the Insurance System).DiscussionAMI is the first French longitudinal study on health and aging set up in a population of elderly farmers living in rural area through a multidisciplinary approach.

Short Form of Sarason's Social Support Questionnaire: French Adaptation and Validation

The original short form of Sarasons Social Support Questionnaire measures two dimensions of social support, availability and satisfaction. The factorial structure of the social support was assessed in a French sample along with the association between the dimensions of social support and personality traits such as Extraversion, Neuroticism, and Depression. A 6-item French version was administered to 648 subjects: 348 university freshmen (228 females, 120 males) and 304 unemployed men. A principal component analysis followed by oblique rotations was undertaken on each sample. This yielded two factors, Availability and Satisfaction. These results sustained the stability of the factorial structure from one culture to another. Validity and reliability were satisfactory. Moreover, these two dimensions were correlated with two personality scales (high extraversion, low depression). Such results agree with previous results establishing relations between social support and salutogenic dimensions of personality.

Assessment and effects of Therapeutic Patient Education for patients in hemodialysis: A systematic review

OBJECTIVE This review examined the impact of Therapeutic Patient Education (TPE) programs in hemodialysis and the assessment of these programs. REVIEW METHODS AND DATA SOURCES: A systematic review was performed. Bibliographical research was done with a database in the social and human sciences (PsychINFO, PsycARTICLES, SocINDEX with Full Text and the Psychology and Behavioural Sciences Collection). References were also searched in several reviews specialized in nephrology-dialysis and in patient education. Articles were classified according three different outcomes: (1) physiological outcomes, (2) psychosocial outcomes, (3) or combined criteria. RESULTS 35 articles were selected. The majority dealt with purely physiological outcomes (18) and the minority concerned only psychosocial outcomes (4). Fifteen articles discussed both physiological and psychosocial outcomes, i.e. combined criteria. Beneficial effects were shown such as improvements in knowledge, adherence and quality of life. Most educational interventions were performed by nurses. CONCLUSION This systematic review found that educational programs in dialysis have become more numerous and efficient, with a prevalence of assessment based on physiological outcomes. TPE is a global management method based on both the physiological and the psychological well-being of the patient. Studies that take into account both physiological and psychosocial variables are very useful for understanding the effects of TPE programs on dialysis patients. The review shows that nurses play an important role in TPE and that they require varied communicational, educational, animation and assessment skills. These positive effects are encouraging for nurses to stimulate the development of TPE programs for dialysis patients in their multidisciplinary teams. The nurses role is important for the commitment of each health caregiver (nurse, physician, dietician, pharmacist, psychologist, etc.) for the global management of patients in the TPE process.

Anxiété et dépression en hémodialyse : validation de l’Hospital Anxiety and Depression Scale (HADS)

Anxiety and depression are considered as frequent disorders in end-stage renal disease patients. However studies on this topic are almost nonexistent in France. The Hospital Anxiety and Depression Scale (HADS, Zigmond & Snaith, 1983) is a well-used instrument in the international literature. Fast and easy to administer, it measures anxiety and depression symptomatology in physically ill patients. The purpose of the present study was to test the psychometric properties of the scale within a French sample of 207 hemodialysis patients. Exploratory factor analysis yielded two factors: anxiety and depression. Further analysis showed that the two factors presented good internal consistency, were significantly correlated to patients age and quality of life, but were not associated with years on dialysis. Moreover, differences were found for gender and dialysis modality (self-care units versus in center). The results of this study underline the relevance of using the HADS to identify anxiety and depression and confirm the importance to take into account these disorders to enhance patients quality of life and global care.

FRENCH ADAPTATION OF THE WAYS OF COPING CHECKLIST

A short form (42 items) of the Ways of Coping Checklist was administered to 468 French men and women. A factor analysis of the responses yielded three factors, accounting for about 35% of the total variance, and named Problem-focused Coping, Emotion-focused Coping, and Social Support seeking. The first two dimensions are close to those generally described in the literature. Some interesting relationships of scores appeared between personality and coping, notably, between anxiety and emotion-focused coping.

Psychometric Properties of the French Adaptation of the Multidimensional Body Self Relations Questionnaire–Appearance Scales

The present study investigated the psychometric properties of the French adaptation of the Multidimensional Body Self Relations Questionnaire–Appearance Scales, a widely used instrument in body image research. The questionnaire is composed of five subscales: Appearance Orientation, Appearance Evaluation, Overweight Preoccupation, Self-classified Weight, and the Body Areas Satisfaction Scale. Exploratory factor analyses were conducted on a sample of 765 subjects for the first two subscales. As expected, the analyses yielded two factors: Appearance Orientation and Appearance Evaluation. Internal consistencies ranged between .66 and .88 and test-retest reliabilities ranged between .78 and .85 for the five subscales. Appearance evaluation and the Body Areas Satisfaction Scale showed good convergent validity with the Body Image Questionnaire. Validity was supported by comparing scores for sex, for groups according to body mass index (underweight, normal weight, overweight, and obese), and by exploring the influence of social desirability.

Development and validation of the Work Stressor Inventory for Nurses in Oncology: preliminary findings

AIM This study is a report of the development and testing of the Work Stressor Inventory for Nurses in Oncology. BACKGROUND Stressors in oncology nursing are generally assessed using generic stress scales like the Nursing Stress Scale or the Health Professions Stress Inventory. However, qualitative investigations have highlighted the specific nature of the stress to which nurses are exposed. DESIGN The Work Stressor Inventory for Nurses in Oncology was developed using both qualitative and quantitative methodologies. METHOD For the item generation phase, a semi-structured interview was conducted with 59 nurses working in oncology units during 2007. A total of 51 work-related items were retained for the final survey. A convenience sample of 582 nurses working in oncology completed the survey between January 2008-June 2008. They also completed the General Health Questionnaire and the Maslach Burnout Inventory. The Work Stressor Inventory for Nurses in Oncology was further tested for theoretically supported constructs, internal consistency reliability and concurrent validity. FINDINGS The exploratory results revealed five factors: workload, dealing with death and dying, dealing with suffering, interpersonal conflicts, dealing with patients and relatives. The internal consistency of the five subscales was satisfactory. Correlation patterns between the Work Stressor Inventory for Nurses in Oncology dimensions and both mental health and burnout variables support the criterion-related validity of the scale. CONCLUSION Future quantitative or qualitative studies using this scale could add knowledge about the experiences of emotional and organizational stressors related to this area of nursing.