Chronic illness is defined as a long-term disease that challenges a person's physical, psychological and spiritual wellbeing. However, individuals may adapt to their condition by adopting spiritual coping strategies that may or may not include religiosity. Part 1 of this article presents the methodology of this cross-sectional comparative study, which explored the spiritual coping of patients with chronic illness receiving rehabilitation services in Malta (n=44: lower limb amputation n=10; chronic heart disease n=9; osteoarthritis-in an institution n=10 and in the community n=15); and in Norway (n=16: post-hip/shoulder surgery n=5; chronic heart disease n=5; chronic pain n=6). Data were collected from seven purposive samples during focus group sessions. Roy's Adaptation Model (1984) and Neuman's Systems Model (2010) guided the study. While acknowledging the limitations of this study, the findings presented in Part 2 identify commonalities in the spiritual coping of patients irrespective of cultural differences between Malta and Norway. A set of recommendations address clinical practice, education and further research.
We have proposed that declines in adaptive capacity, defined as the ability to adapt to multiple stressors, may serve as an indicator of risk for fatigue. A comprehensive measure of adaptive capacity does not exist.
In this paper we describe construction of an instrument to measure adaptive capacity, the Adaptive Capacity Index (ACI).
Descriptive and psychometric.
Six sites providing palliative care in Western Canada.
=18 years old, diagnosed with advanced cancer, able to read and write English, Mini-Mental Status Exam score =22. Pilot study n=48; Main study n=225 stratified using the Edmonton Symptom Assessment Scale (ESAS) tiredness score (=0 to =2 n=60; =3 to =6 n=108; =7 and =10 n=57).
Following ethics approval, 17 experts in symptom management assisted with content validation and consenting individuals completed the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Profile of Mood States-Vigor short form (POMS-Vsf), and the ACI. A research assistant collected demographic information and assigned an Eastern Cooperative Oncology Group (ECOG) score. Data were analyzed using descriptive and inferential statistics (i.e., exploratory factor analyses, correlation, multivariate analyses of variance, and multiple regression).
Five 6-item ACI factors/subscales (Cognitive Function, Stamina/Muscle Endurance, Sleep Quality, Emotional Reactivity, and Social Interaction) were identified. The ACI-total scale and its subscales were internally consistent (Cronbach's alpha 0.76-0.89), and were significantly correlated with each other, and with each fatigue measure (Pearson's r ranging from -0.724 to 0.634). The ACI total score was sensitive to changes in the ESAS tiredness score. Stamina/Muscle Endurance, Cognitive Function, and Sleep Quality predicted 60.8% of the variance in FACT-F. Stamina/Muscle Endurance and Social Interaction predicted 36.8% of the variance in POMS-Vsf. Stamina/Muscle Endurance and Sleep Quality predicted 8% of the variance in ECOG.
The ACI is reliable and has beginning evidence of validity. In future studies we will examine relationships between ACI subscale scores and subsequent increases in fatigue and explore linkages to physiological processes. We will also establish ACI norms for early and late stage cancers and explore variations in ACI subscale scores base on age or gender.
The transition to parenthood is an overwhelming life event. From a theoretical perspective, transition to parenthood is a developmental transition that contains certain phases and patterns.
This study aim was twofold (i) discover, describe and comprehend transitional conditions that parents perceive as facilitating and inhibiting during transition to parenthood and to (ii) use that knowledge to develop recommendations for professional interventions that support and facilitate transition to parenthood.
Meleis transition theory framed the study's deductive qualitative approach - from planning to analysis.
In a secondary analysis, data were analysed (as per Meleis transition theory) from two studies that implemented interviews with 60 parents in Sweden between 2013 and 2014. Interview questions dealt with parents' experiences of the transition to parenthood - in relation to experiences with parent-education groups, professional support and continuity after childbirth.
A university research ethics board has approved the research.
These factors facilitated transition to parenthood: perceiving parenthood as a normal part of life; enjoying the child's growth; being prepared and having knowledge; experiencing social support; receiving professional support, receiving information about resources within the health care; participating in well-functioning parent-education groups; and hearing professionals comment on gender differences as being complementary. These factors inhibited transition to parenthood: having unrealistic expectations; feeling stress and loss of control; experiencing breastfeeding demands and lack of sleep; facing a judgmental attitude about breastfeeding; being unprepared for reality; lacking information about reality; lacking professional support and information; lacking healthcare resources; participating in parent-education groups that did not function optimally; and hearing professionals accentuate gender differences in a problematic way.
Transition theory is appropriate for helping professionals understand and identify practices that might support parents during transition to parenthood. The study led to certain recommendations that are important for professionals to consider.
The authors, nurses who run a day program out of Centre hospitalier Ste-Thérèse de Shawinigan to help friends or families of schizophrenic patients, explore what makes the service so successful. Called Centre Info-Famille-Contact-Schizo, it was the brainstorm of psychiatrist Dr. Pierre Lalonde, who maintains that such families need information and support; after all, they are true allies of the patient.
The Occupational Case Analysis Interview and Rating Scale (OCAIRS) was developed based on the Model of Human Occupation with the intention of assessing patients' occupational adaptation. Several studies examining the quality of this instrument have been completed; however, none have discussed the internal validity of the instrument or the appropriateness of the rating scale. The purpose of this study is to validate the internal validity of the OCAIRS and to test the quality of the rating scale. The results indicate that the OCAIRS is a valid measure of occupational adaptation. Each item was shown to have its own rating scale structure, however, all items together still shared the same five-point rating scale.
On-going restructuring in the Danish care for the elderly is to a very high degree based on recognition of the significance of habits and rituals, as well on the knowledge of what is needed to alter them. Habits and rituals are concepts that are often confused in everyday patterns of thought. It is necessary to be able to distinguish between the two concepts before change can be effected. To varying degrees people are characterised by unconscious and conscious habits as well as inherited and personal rituals. Personal development, age, support from one's surroundings, and so on, determine the degree to which a person may continue or alter acquired patterns of habit and ritual.
This article is part of the Twin Mother's Study, a study that examines influences on maternal adjustment. A number of studies have investigated the importance of genetic factors for mental health, but few of these examine how genes and the environment influence resiliency/salutogenic factors. This article investigates the relative importance of genetic and environmental influences on resiliency/salutogenic factors. This study includes 326 twin pairs (150 monozygotic and 176 dizygotic) who are mothers, who are living with their spouse, and who are part of the Swedish twin register. Using self-report structured questionnaires, we assessed salutogenic factors, depression, and quality of life; however, we analyzed the questionnaires completed by the mothers. Statistical analyses were conducted using structural equation modeling. We conclude that nonshared environmental components were of principal importance in individual resiliency/salutogenic factors in a genetically informative design, but we also noted that genetic influences were important. The shared environment had mainly no effect.