Richard Lefrançois

Efficacy of a support group programme for care-givers of demented patients in the community: a randomized controlled trial.

Dementia induces morbidity not only in the patients but also in the families taking care of them. Many studies described the impact of care-giving on physical and psychological health. Support groups were designed to alleviate the burden of care-givers. The objective of this study was to measure the efficacy of a support group programme for care-givers of demented patients in the community. Forty-one primary care-givers were randomly assigned to a study (n=23) or a control group (n=18). Subjects of the study group attended a structured programme of eight 2-h sessions. These weekly sessions consisted of information on the disease, role-playing on management of behavior problems, discussion on emotional impact of care-giving, and learning of stress management techniques. Subjects of the control group were referred to informal monthly meetings of the Alzheimers Society. Subjects of both groups were evaluated at the entry (T1), after 8 weeks (T2) and after 8 months (T3). The outcome variables were the Burden Interview, the Revised Memory and Behavior Problems Checklist, the Brief Symptoms Inventory, the Alzheimers Disease Knowledge Test and a questionnaire on health care utilization. Compared with the control group, subjects of the study group yielded only a significant increase in knowledge about the disease (p<0.0001) but no significant difference on the other outcome variables. It is concluded that this type of support group programme seems to have only a minimal impact on morbidity and on the burden of care-givers. These results are similar with two other studies examining the same issue.

Reliability of a New Measure of Self-Actualization

The purpose of this study was to investigate both the internal consistency and temporal reliability of the Measure of Self-actualization of Potential. Results from the initial pilot study (n = 414) used to develop the inventory are compared with those of a new sample (n = 156) designed to evaluate its stability. Responses from the new sample support our initial findings of moderate to relatively high alpha coefficients for the two main scales and five subscales. Test-retest reliability for the new set of responses indicates high stability, with intraclass correlation coefficients ranging from .74 to .88. For the over-all scale, Cronbach alpha reaches .90 and the intraclass coefficient .87. In addition to better psychometric properties, the new inventory has two other advantages over the Personal Orientation Inventory, fewer items and a self-report format.

Exposure and risk factors among elderly drivers: a case-control study

To study the risk factors associated with exposure, aging, and other characteristics of elderly drivers, a case-control survey of 557 licensed drivers was conducted among residents of medium-sized, small towns and rural areas in Quebec, Canada. The subjects, aged 68 and over, were selected from the database of the provincial Automobile Insurance Board. The case group was chosen on the basis of performance, either accidents or violations, during the preceding three years. Cases were matched to a control group (blank file for the last three years) on a stratification basis (age, gender, region) in the proportion of two controls for one case. The survey which was conducted through a mail questionnaire achieved a participation rate of nearly 60%. The logistic regression method was used to assess the risk (odds ratios). The results of this study reveal that risk is proportional to the frequency of daily vehicle use or annual kilometrage. The hypothesis that elderly drivers who rarely expose themselves are at more risk is thus rejected. Vulnerable subgroups were the most elderly (> 77), city or suburban residents, the unmarried, and white collars (during active life).

Valued Activities of Everyday Life Among the Very Old

Abstract Based on panel data from the Quebec Longitudinal Study on Aging, this article investigates the preferred types of activity of 80-85 year-olds, contrasting for gender and functional health condition. Both MANCOVA (p <.05) and ANCOVA (p <.01), with repeated measures, were used to assess the significance of a change in activity commitment. Results showed that respondents were more involved in emotional, spiritual, and social types of activity. Engagement in activities among older adults did not change significantly over a 1-year period. A reduced capacity in performing instrumental activities of daily living was found to have the most detrimental effect on valued activity. These results indicate that incapacity may have an adverse impact not only on physical activity, but on all other types of activity as well. The analyses suggest that the elderly manage to compensate for the loss in one type of activity by increasing their commitment in other types.

DEVELOPMENT AND VALIDATION OF A SEXUAL ACTUALIZATION MEASURING INSTRUMENT FOR THE ELDERLY

The objective of this study was to develop a measuring instrument for assessing sexual actualization of the elderly and test some of its metrological properties. The assistance of experts on sexology, gerontology, and the actualization of potential was required. The questionnaire was sent twice, at a 2-week interval, to individuals who showed an interest in the study. Of the 115 people who answered the questionnaire, 52 were women, with a mean age of 67.3, and 63 were men, with a mean age of 68.9. The results show good temporal stability (intraclass correlation coefficient =.89) and strong internal consistency (Cronbachs alpha =.97). Two construct validity studies were conducted. The first consisted in comparing the Sexual Actualization Questionnaire (SAQ) and a general well-being scale; no significant relationship was found (r =.07; p =.41). However, the results of the second study, which compared the SAQ scores of the senior individuals who had been sexually active with those who had not, were significant (p <.05).

Stressful life events and psychological distress of the very old: does social support have a moderating effect?

The purpose of this paper was to examine whether social support has a moderating effect on the relationship between exposure to stressful life events and psychological distress. To test this, 224 men and women aged 81-86 were sampled from two municipal regional counties: Sherbrooke (and vicinity) and Trois-Rivières, in the Province of Quebec, Canada. The French version of the Geriatric Scale of Recent Life Events, the Psychiatric Symptom Index, and the Social Provision Scale were used. Multiple regression analyses revealed that social support did not cancel out the deleterious effect of life events on the outcome measure. The negative aspect of social interaction may explain why social support did not have a protective effect. Also, social isolation resulting from psychological distress could reduce the opportunity for instrumental help and emotional support.

PERSPECTIVE: A Psychological Outlook on the Concept of Transcendent Actualization

Transcendent actualization is viewed by Maslow, Assagioli, and Frankl as an optimal way to give spiritual meaning to ones existence and to live this meaning in everyday life. The purposes of this article are to present the concept of transcendent actualization; to discuss the prepersonal, personal, and transpersonal levels of growth; and to briefly describe the four components of transcendent actualization: In-Depth Perception and Holistic Perception, under Metacognition, and Presence of Being and Beyond Ego-Orientation, under Metamotivation.

Étude de fiabilité de la version française du MFAQ (santé physique)

The purpose of this study is to estimate the reliability of the French version of the M.F.A.Q. method, a tool used to measure the physical health of the elderly. During the survey, four interviewers assessed 15 subjects each by using the M.F.A.Q. Following this, all 60 participants were evaluated two months later, this time without the subjects being present. In addition, a geriatric specialist also assessed the 60 questionnaires a posteriori. The results show an intra-rater reliability (a 96% performance rate within a 1-point difference on a scale of 6) and an inter-rater reliability (Kappas, on a scale from good to moderate; alpha of Cronbach = 0.93) which were acceptable. An analysis of the covariance reveals that age does not figure in the judgments. The authors express certain reservations, but conclude that this instrument of measurement is flexible, easy to administer, in addition to its metrological properties being satisfactory.

TEMPORAL STABILITY OF THE TRANSCENDENT ACTUALIZATION INVENTORY

This paper describes a study of the temporal stability of a new inventory, the Transcendent Actualization Inventory, which aims to estimate actualization of psychospiritual potential. For 200 subjects, the test-retest reliability was .84 for Time 1 vs Time 2. Cronbach coefficient α was .81 at Times 1 and 2, as previously reported (N = 478).