Relationships among hardiness, social support, severity of illness, and psychological well-being in women with rheumatoid arthritis

Resilience, pain, and the brain: Relationships differ by sociodemographics

Chronic musculoskeletal (MSK) pain is disabling to individuals and burdensome to society. A relationship between telomere length and resilience was reported in individuals with consideration for chronic pain intensity. While chronic pain associates with brain changes, little is known regarding the neurobiological interface of resilience. In a group of individuals with chronic MSK pain, we examined the relationships between a previously investigated resilience index, clinical pain and functioning measures, and pain-related brain structures, with consideration for sex and ethnicity/race. A cross-sectional analysis of 166 non-Hispanic Black and non-Hispanic White adults, 45-85 years of age with pain ≥ 1 body site (s) over the past 3 months was completed. Measures of clinical pain and functioning, biobehavioral and psychosocial resilience, and structural MRI were completed. Our findings indicate higher levels of resilience associate with lower levels of clinical pain and functional limitations. Significant associations between resilience, ethnicity/race, and/or sex, and pain-related brain gray matter structure were demonstrated in the right amygdaloid complex, bilateral thalamus, and postcentral gyrus. Our findings provide compelling evidence that in order to decipher the neurobiological code of chronic pain and related protective factors, it will be important to improve how chronic pain is phenotyped; to include an equal representation of females in studies including analyses stratifying by sex, and to consider other sociodemographic factors.

Resilience factors may buffer cellular aging in individuals with and without chronic knee pain

Telomere length, a measure of cellular aging, is inversely associated with chronic pain severity. While psychological resilience factors (e.g., optimism, acceptance, positive affect, and active coping) are associated with lower levels of clinical pain and greater physical functioning, it is unknown whether resilience may buffer against telomere shortening in individuals with chronic pain. Additionally, a broader conceptualization of resilience that includes social and biobehavioral factors may improve our understanding of the relationship between resilience, chronic pain, and health outcomes. In individuals with and without chronic knee pain, we investigated whether (1) psychological resilience would be positively associated with telomere length and if (2) a broader conceptualization of resilience including social and biobehavioral factors would strengthen the association. Seventy-nine adults, 45 to 85 years of age, with and without knee pain completed demographic, health, clinical pain, psychological, social, and biobehavioral questionnaires. Resilience levels were determined by summing the total number of measures indicating resilience based on published clinical ranges and norms. Blood samples were collected, and telomere length was determined. In regression analyses controlling for sex, race, age, and characteristic pain intensity, greater psychological resilience and psychosocial/biobehavioral resilience were associated with longer telomeres ( p = .0295 and p = .0116, respectively). When compared, psychosocial/biobehavioral resilience was significantly more predictive of telomere length than psychological resilience ( p < .0001). Findings are promising and encourage further investigations to enhance understanding of the biological interface of psychosocial and biobehavioral resilience factors in individuals with musculoskeletal chronic pain conditions.

Hardiness, Successful Aging, and HIV: Implications for Social Work

<p>With dramatic developments in the treatment of HIV/AIDS, life expectancy is increasing, resulting in more middle-aged and older adults living with this disease. Little is known about the problems, and especially the strengths, of those living and aging with HIV. Hardiness is used in the gerontological literature to describe and explain how people age successfully, despite traumatic life events and chronic diseases. Similarly, the concept of hardiness may be used to guide clinicians, researchers, and clients on how to age successfully with HIV. This article provides a review of hardiness in aging and HIV, and emphasizes its importance in facilitating successful aging with this disease. Conceptual and methodological concerns in studying hardiness and successful aging are addressed. Potential interventions and clinical implications for social work are posited for augmenting qualities of hardiness in people aging with HIV.</p>

A qualitative study of hardiness and social support among underserved, inner-city minority adults recovering from oral surgery

Using qualitative data, this study examines hardiness and social support among twenty-two African American and Hispanic subjects, at least 18 years of age, who received treatment for a jaw fracture and participated in an hour-long focus group to discuss the treatment they received at King/Drew Medical Center, an inner-city hospital in Los Angeles, California. Treatment was either a non-surgical wiring of the teeth closed for six to eight weeks or surgical placement of a metal bone plate in the lower jaw with a short period of jaw fixation following surgery. A mandibular fracture is one of the most common orofacial traumas for minority individuals, and the majority of these fractures among patients at urban trauma centers are a result of interpersonal violence. Thus the link between psychosocial stress and oral health is evident, yet exposure to daily stress does not automatically place one at risk for distress. Some people under daily stress have hardiness, conceptualized as an internal personal resource consisting of control, commitment, and challenge. This study examines hardiness and social support relevant to an underserved, minority population. Hardiness and social support were identified and noted in order of frequency according to participant characteristics of treatment type, gender, and ethnicity. Main themes related to hardiness and social support are highlighted with verbatim quotes providing additional context to the theme presented.

Are there more than cross-sectional relationships of social support and support networks with functional limitations and psychological distress in early rheumatoid arthritis? The European Research on Incapacitating Diseases and Social Support Longitudinal

OBJECTIVE

To investigate whether greater social support and support network are cross-sectionally associated with less functional limitations and psychological distress in patients with early rheumatoid arthritis (RA); whether this association is constant over time; and whether increases in social support or support network are associated with less functional limitations and psychological distress.

METHODS

Subjects were from the European Research on Incapacitating Diseases and Social Support cohort and had early RA. Social support, support network, functional limitations (Health Assessment Questionnaire), and psychological distress (General Health Questionnaire) were assessed annually. Variance and covariance analyses with repeated measures were performed.

RESULTS

A total of 542 subjects were assessed for 3 years. On average, patients with a greater amount of specific social support or a stronger specific support network experienced less functional limitation and less psychological distress. Changes in a given subject's functional limitations and psychological distress did not depend on his or her baseline social support or support network. Neither social support nor support network change over time.

CONCLUSION

There may be a cross-sectional link between specific social support or support network and functional limitations and psychological distress, but no longitudinal association could be evidenced.

Comparison of family stresses, strengths, and outcomes after trauma and surgery

This study aimed to compare family stresses, strengths, and outcomes after motor vehicle crashes, gunshot wounds, and coronary artery bypass graft surgery. A multivariate descriptive design based on the resiliency model of family stress was used. A convenience sample of 127 family members participated within 2 days of admission to the intensive care unit. Family stresses were measured using the Family Inventory of Life Events and the Acute Physiology, Age, and Chronic Health Evaluation Scale (APACHE III). Family strengths were measured by the Family Hardiness Index and the Family Crisis Oriented Personal Evaluation Scale. Family outcomes were measured by the Family Member Well-Being Index and the Family Adaptation Scale. Family members ranged in age from 18 to 80 years (Mean, 42 years). Most of the participants in the study were women (64%) with previous intensive care unit experience (83%). The patients ranged in age from 19 to 78 years (Mean, 44 years). Multivariate analysis of variance was used to control for group differences in family member age, education, and income along with patient age and race. The results indicated that family members of patients who have experienced motor vehicle crashes, gunshot wounds, or coronary artery bypass graft surgery reported no significant differences in family strengths of hardiness and family outcomes of well-being and adaptation. However, families of patients with gunshot wounds reported significantly more stress (F = 7.94; P< 0.01) and less use of coping strategies (F = 4.33; P< 0.01) than families of patients who have experienced motor vehicle crashes or coronary artery bypass graft surgery. Interventions that address family stress and develop or mobilize coping are needed for selected families after admission of a family member to the intensive care unit.

The development and validation of the Sense of Support Scale

Two studies were conducted to develop and validate the Sense of Support Scale (SSS). Study 1, which consisted of scale development and an evaluation with a sample of corporate and university employees, supported the scale's internal consistency and construct validity. Study 2, which was conducted with a sample of undergraduate students, was designed to evaluate the revised and shortened version of the SSS. The scale was found to be internally consistent and had a high test-retest reliability. Concurrent validity was supported by significant correlations to the Social Provisions Scale and the Interpersonal Support Evaluation List. Construct validity was supported by significant positive correlations to hardiness and approach-coping and significant negative correlations to avoidance-coping, stress, and symptoms of illness. The relationship between the SSS and symptoms of illness supported a main effect rather than a stress-buffering model. Implications for using the SSS to investigate the influences of social support on health are discussed.

Perceived stressors and coping strategies among individuals with rheumatoid arthritis

The purpose of this study was to identify the stressors perceived by individuals with rheumatoid arthritis (RA) and to describe coping strategies used to cope with illness-related stressors and their perceived effectiveness. Data were collected from 53 patients attending a rheumatology clinic. Results revealed that pain was the predominantly perceived stressor followed by limitation in mobility, difficulties in carrying out activities of daily living, helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships, difficulties performing at work, and discomfort of the treatment. Subjects used optimistic and confrontive coping strategies more frequently than other coping strategies and optimistic coping strategies were perceived to be most effective. Point biserial correlation revealed a number of significant relationships between specific stressors and use of coping strategies: interference in family relationships and use of evasive coping strategies (r = 0.27, P < 0.05), and threat to self-esteem and use of both evasive (r = 0.45, P < 0.01) and emotive (r = 0.28, P < 0.01) coping strategies. Similarly, a number of significant relationships were found between specific stressors and the effectiveness of the coping strategies: interference in family relationships and the effectiveness of both evasive (r = 0.31, P < 0.05) and emotive (r = 0.38, P < 0.01) coping strategies, and threat to self-esteem and the effectiveness of emotive coping (r = 0.29, P < 0.05).

Expanding the scope of continuity theory. Application to gerontological nursing

Continuity Theory is a psychosocial theory of aging which posits that as middle-aged and elderly adults adapt to changes associated with the normal aging process, their past experiences, decisions, and behaviors will form the foundation for their present and future decisions and behaviors. Regardless of the clinical setting, nurses working with elderly individuals may find Continuity Theory helpful in viewing the experience of elders in a holistic way that incorporates a life course perspective. By applying Continuity Theory to clinical practice, nurses may be better able to provide individualized, clinically appropriate care to elders.

Social support, stress, and age in women undergoing breast biopsies

The relationship among stress, age, and social support was explored in 30 women scheduled for a breast biopsy. Stress was determined using the State Trait Anxiety Inventory. Social support strength and network size were measured using the Norbeck Social Support Questionnaire in this correlational study. Findings demonstrated that women do experience stress before their biopsies. Stress was also found to have a negative correlation with social support strength. Moreover, although statistically insignificant, these women tended to have increased stress with aging until age 40, then stress decreased with increasing age. Additional research should replicate the natural age division of < or = 40 years and > 40 years in a larger sample of women. Advanced practitioners are ideally suited to affect patient outcomes by providing social support. This social support could consist of facilitated support groups or access to the information needed by women during this stressful diagnostic experience.

Relationships Among Faculty Practice Involvement, Perception of Role Stress, and Psychological Hardiness of Nurse Educators

This study examined the relationships of role stress and psychological hardiness and identified predictors of role stress in nurse educators overall and in those either involved or not involved in faculty practice. In addition, the study examined differences in psychological hardiness and role stress between nurse educators either involved or not involved in faculty practice. Data were obtained through three mailed self-report questionnaires from 871 nurse educators employed full-time in a National League for Nursing (NLN)-accredited school of nursing with both undergraduate and graduate programs. The findings revealed significant negative correlations between role stress and psychological hardiness and between components of role stress and components of psychological hardiness. Predictors of role stress were identified. No significant difference was found in role stress or in psychological hardiness between nurse educators involved and those not involved in faculty practice.