Relationship functioning and sexuality among people with multiple sclerosis

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three-hundred eighty-one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health-related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients lives.     

Relationship functioning and sexuality among people with multiple sclerosis

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three‐hundred eighty‐one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health‐related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients' lives.     

The influence of caregiving stressors, social support, and caregiving appraisal on marital functioning among African American wife caregivers

Using a stress and coping framework, we examined the influence of caregiving stressors, social support, and caregiving appraisal on the marital functioning of 100 African American wife caregivers. Results of separate multivariate analyses revealed received church support, caregiving burden, and caregiving satisfaction significantly predicted wives' marital functioning, when caregivers' background characteristics (age and education), length of caregiving, whether first marriage, and urban versus rural location were controlled. Receiving church support was associated with increased marital functioning. Lower levels of caregiving burden were associated with increased marital functioning. Higher levels of caregiving satisfaction were associated with increased marital functioning. Findings illuminate wives' caregiving and marital experiences, and have implications for family therapy and future research.     

The relevance of situation awareness in older adults’ cognitive functioning: a review

Age-related declines in cognition may have detrimental effects on older adults’ ability to complete everyday activities that young- and middle-aged individuals perform automatically. Theories of cognitive aging have found deficits in older adults’ fluid intelligence, capacity for inhibition, number of processing resources, and speed of processing, and in recent years, studies have proposed cognitive strategies to ameliorate these declines. However, few strategies directly train the cognitive strategies necessary to improve performance in dynamic environments and physical activities. One such strategy may be the enhancement of situation awareness, the capability to perceive and understand one’s environment. Although the term has typically been applied to pilots and other expert performers, situation awareness may also be relevant to cognitive aging, where older adults’ perception and comprehension of their environment become critical to everyday functioning and physical activities. If older adults’ situation awareness can be facilitated, then it may be possible to reduce the impact of age-related cognitive declines, allowing older adults to successfully participate in dynamic situations and sports where the environment is constantly changing (e.g., driving and tennis). The following review outlines cognitive deficits in aging, details their relation to situation awareness, and discusses how training in situation awareness may reduce cognitive declines. Portions of this paper were reported at the annual meeting of the North American Society for the Psychology of Sport and Physical Activity in June, 2005.     

Self-perception of aging and health among older adults in Korea

The way that each individual perceives his or her own aging and health may be a key indicator of adaptation and well-being in old age. This study explored the determinants of self-perception of aging and health using 291 community-dwelling older adults in Korea (mean AGE=69.9). Older individuals with lower levels of education and economic status and various types of health problems (more chronic conditions, greater disability, poorer vision, and greater numbers of sick days) were found to have more negative self-perception of aging and health. In addition, a significant role of psychological factors was observed. For self-perception of health, sense of mastery was found to be a significant factor, and for self-perception of aging, neuroticism was observed to be significant along with sense of mastery. The mediating role of self-perception of health was supported that positive perception of health intervened the adverse effects of health problems on self-perception of aging. The findings demonstrate the important roles of psychological resources and subjective perceptions and suggest a need to consider them when planning interventions.     

The life-course origins of mastery among older people

In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past circumstances, particularly those reflecting status attainment and early exposure to intractable hardships, converge with stressors experienced in late life to influence elders' level of mastery. The impact of past conditions, however, does not necessarily directly affect the current mastery of older people. Instead, the effect of prior experiences on current mastery is mediated by what we refer to as life-course mastery: one's belief that one has directed and managed the trajectories that connect one's past to the present. Our analyses show that life-course mastery largely serves as the mediating channel through which individuals connect their past to their present.     

Network recall among older adults with cognitive impairments

Although it is widely accepted that personal networks influence health and illness, network recall remains a major concern. This concern is heightened when studying a population that is vulnerable to cognitive decline. Given these issues, we use data from the Social Network in Alzheimer Disease project to explore similarities and discrepancies between the network perceptions of focal participants and study partners. By leveraging data on a sample of older adults with normal cognition, mild cognitive impairment, and early stage dementia, we explore how cognitive impairment influences older adults’ perceptions of their personal networks. We find that the average individual is more likely to omit weaker, peripheral ties from their self-reported networks than stronger, central ties. Despite observing only moderate levels of focal-partner corroboration across our sample, we find minimal evidence of perceptual differences across diagnostic groups. We offer two broad conclusions. First, self-reported network data, though imperfect, offer a reasonable account of the core people in one’s life. Second, our findings assuage concerns that cognitively impaired older adults have skewed perceptions of their personal networks.     

Assessment of physical activity in older people with and without cognitive impairment

The purpose of this study was to validate a new interview-administered physical activity questionnaire (Assessment of Physical Activity in Frail Older People; APAFOP) in older people with and without cognitive impairment. The authors assessed feasibility, validity, and test-retest reliability in 168 people (n = 78 with, n = 88 without cognitive impairment). Concurrent validity was assessed against an inertia-based motion sensor and an established questionnaire. Sensitivity to change was tested in an ongoing study in patients with mild to moderate dementia (n = 81). Assessment of physical activity by the APAFOP and the motion sensor correlated well in the total sample (TS; p = .705), as well as in the subsamples with cognitive impairment (CI; p = .585) and without CI (p = .787). Excellent feasibility with an acceptance rate of 100%, test-retest reliability (intraclass correlation coefficients ranging from .973 (TS) to .975 (CI) to .966 (no CI), and sensitivity to change (effect sizes: 0.35-1.47) were found in both subsamples.     

The experience of quality of life among older people

Although quality of life has been in the focus of attention for over a decade there are few studies available investigating, how the old and the oldest old experience their quality of life or what quality of life actually means for them? To illuminate this, eleven in-depth interviews were conducted with six women and five men (80+) living in their home. An interpretative hermeneutic phenomenological analysis revealed that quality of life in old age meant a preserved self and meaning in existence. Maintained self-image meant that the older people experienced a coherent life with an intact meaning. How quality of life was valued depended on the meaning the old people attached to the areas of importance as well as how they were evaluated. Additionally, areas not generally included when measuring quality of life became discernible. The meaning of home, how life was viewed, thoughts about death and dying, and telling ones story proved to be areas of importance for their perception of quality of life. Thus, indicating that older people's view of quality of life is more complex than some of today's most commonly used quality of life instruments capture and that quality of life assessment tools needs to measure beyond pure health indices. For nursing care the use of life review in everyday care, and an open way towards existential topics as well as a family oriented care along with preventive work helping people to remain in their own homes may enhance their experience of quality of life.     

The good daughters: Acculturation and caregiving among Mexican-American women

This study explores the dynamics of informal care of the elderly in Mexican-American families. Quantitative and qualitative data drawn from interviews with caregivers are presented, which illustrate how acculturation affects the caregiving experience itself and its consequences in terms of stress, burden, rewards, and overall satisfaction. The burden of caregiving for both highly acculturated and less acculturated caregivers was substantial, but there were dramatic differences between the groups in levels of satisfaction. Contrary to expectations, the less acculturated caregivers experienced greater stress, burden, and significantly lower satisfaction even though they were more clearly fulfilling role obligations and they had more family members available to assist with caregiving. Implications for policy and practice are discussed.     

Normalisation and 'Normal' Ageing: the social construction of dependency among older people with learning difficulties

This paper discusses the new phenomenon of the survival into old age of the increasing numbers of people with learning difficulties. This raises both theoretical and practical policy issues. In the UK health and social services for older people and for people with learning difficulties have followed quite different paths. One has been based on a limited, age discriminatory view of 'normal' ageing; the other has focused on a potentially liberating concept of normalisation. This distinction is being challenged by the advent of older people with learning difficulties, which is raising questions such as, what is the meaning of normalisation in older age? We focus on this key question, illustrating the different principles behind service provision for these two groups and argue that the concept of normalisation is flawed when applied to older people. The alternative of social integration is proposed as the basis for organising health and social services for both older people and those with learning difficulties.     

Employment situation and life changes for people with disabilities: evidence from Nepal

In this study we attempt to bring attention to the situation of people with disabilities in the developing world by focusing on the labor market of Nepal. Utilizing a unique dataset collected from people with hearing, physical, and visual impairments through questionnaire-based interview methods, we compare across employment based on type of impairments and education levels to identify variation in occupational choices, as well as examining any positive life changes brought by employment. Results indicated that people with hearing, physical or visual impairments often dominated a specific employment sector. Numbers of people with physical, hearing and visual impairments were respectively large in the non-governmental organization sector, restaurants, and local schools. In addition to income, greater social inclusion, respect in the community, more friends, increased confidence, and discovering the new abilities were some of the positive life changes experienced by employees with disabilities.     

Relational Trajectories from Parent and Child to Grandparent and New Parent

This qualitative study follows earlier research of new parents (Dun & Sangster, 2013) to explore grandparents’ understanding of communication with their adult children during the arrival of a new generation. In semistructured interviews, 29 grandparents described positive and negative interactions with a child (or child-in-law). Participants graphed changes in the intergenerational relationship with the first-time parents, from the moment the pregnancy was announced through their interview, when the grandchild was up to two years of age. Inductive analysis showed four trajectories, which we describe in detail using informants’ reports. Highlighting the volatility of the transition from a parent and child to grandparent and new parent, the most common patterns were Turbulent and Dipped, and the results include variants of these two trajectories. We compare grandparents’ retrospectively recalled experiences with the reports of new parents from previous research to facilitate a deeper understanding of intergenerational relationships during a highly unsettled transition.     

The salience of terminology: Housing research with older people from minority ethnic communities

In this article we focus on recent literature on the housing needs of older people from minority ethnic communities. Such research has undoubtedly benefited particular communities in demonstrating that their needs have been neglected to date. However, the terminology used to describe ethnicity often assumes an unproblematic black-white divide in that it defines communities as discrete and homogeneous groups. Moreover, whilst much research in this field is described as concerned with 'black and minority ethnic' communities, it is in effect about specifically defined 'black' communities with little or no room for other minority ethnic communities. We argue in this paper, using two examples, that this has consequences for resource distribution and for funding of initiatives to help minority ethnic communities.     

Cognitive behavioral interventions for depression among Hispanic people: promising meta-analytic evidence for deep cultural adaptations

ABSTRACT

Depressive disorders are common among Hispanic people. Evidence-informed guidelines indicate cognitive behavioral interventions (CBI), but they were developed primarily with non-Hispanic White people. Narrative studies of clients and workers along systematic review evidence suggested that well-defines cultural adaptations of CBIs would likely improve outcomes among Hispanics people with diverse mental health problems. We advanced the meta-analytic hypothesis that CBIs incorporating so-called “deep structure” cultural adaptations will be more effective than otherwise similar, but more superficially, “surface structure” or non-adapted interventions with depressed Hispanic people. This meta-analysis synthesized evidence from nine typically randomized trials in the United States with one subsample from the Commonwealth of Puerto Rico. Most clients were young women, living in poverty and suffering a reactive depressive episode. We found statistical and practical support for our hypothesis. In most practice contexts, CBI success rates were between 15% and 30% better than those typically observed with other usual practices. Moreover, these effects were maintained at 6- to 12-month follow-up. Given the size and growth of the Hispanic American population, their prevalent experience of depression, and the size of the intervention effects, these synthesized findings seem of potentially great human, clinical, and policy significance.     

Promoting reflective practice with older people: Learning and teaching strategies

Social work with older people is often characterised as low status employment and is dominated by medicalised constructions of old age. Consequently, there is a need for educational responses that address students' negative attitudes toward older people and enable the development of practice skills in this area. The present paper evaluates an elective course for third year social work students that challenged their perceptions of their own and others' ageing, and stimulated a reflective approach to practice with older people. Reflective learning techniques were employed in the course, including observations in aged care service settings. Students in the course showed a high degree of interest in working with older people in the future and, although this did not increase much throughout the course, they evaluated it positively, noting greater awareness of issues affecting older people.     

The acceptability of educational Interventions: Qualitative evidence from children and young people in care

There has been a proliferation of educational interventions that aim to address the disadvantage experienced by children and young people in care. However, the existing evidence-base has been limited by a dearth of theoretically-driven approaches and the inadequate involvement of the target population in developing interventions' theory of change or delivery mechanisms. The present study reports data from focus groups with care-experienced young people (n = 26) aged 16–27 regarding the acceptability of educational interventions that have already been developed and subjected to evaluation via a randomized controlled trial. Although participants highlighted the merit of interventions that address social and emotional competencies, and have a clear relational component, they primarily felt that existing approaches fail to address the structural barriers to academic attainment. These include placement instability, inadequate resources, and lack of time and skills amongst carers. Participants indicated a preference for interventions delivered by carers. They equally suggested a preference for approaches that are universal rather than indicated. The variation in acceptability across interventions, both in terms of theory of change and delivery mechanisms, indicates the need to involve children and young people in the development of interventions intended to address their educational outcomes. Further theoretical, methodological and substantive research needs to be conducted in order to further enhance this process of involvement.     

Trust and reciprocity among international groups: Experimental evidence from Austria and Japan

This paper explores national identity in trust and reciprocity at the intra- and international levels by adopting a modified trust game played among groups from Austria and Japan, wherein subjects play the roles of trustor and trustee consecutively without any information feedback. Although the intranational trust levels in both countries are identical, the international trust for Japanese groups is less than that of Austrian groups. On the other hand, the international reciprocity for Japanese groups is greater than that of Austrian groups. Additionally, the Japanese reciprocation level toward Austrians is higher than that toward Japanese.     

The urban neighborhood and cognitive functioning in late middle age

This study examines the association of cognitive functioning with urban neighborhood socioeconomic disadvantage and racial/ethnic segregation for a U.S. national sample of persons in late middle age, a time in the life course when cognitive deficits begin to emerge. The key hypothesis is that effects of neighborhood on cognitive functioning are not uniform but are most pronounced among subgroups of the population defined by socioeconomic status and race/ethnicity. Data are from the third wave of the Health and Retirement Survey for the birth cohort of 1931 to 1941, which was 55 to 65 years of age in 1996 (analytic N = 4,525), and the 1990 U.S. Census. Neighborhood socioeconomic disadvantage has an especially large negative impact on cognitive functioning among persons who are themselves poor, an instance of compound disadvantage. These findings have policy implications supporting "upstream" interventions to enhance cognitive functioning, especially among those most adversely affected by neighborhood socioeconomic disadvantage.     

Social capital and older people in farming communities

This study draws on data from interviews with older people aged 65 to 85 (n = 65) to assess the extent to which the concept of social capital can be used to inform our understanding of social networks in farming families. Findings indicate that key indicators of social capital such as trust, reciprocity and co-operation strongly influence and determine social relations. Interestingly, though contrary to much of the literature on social capital, a strong community spirit can exist where associational activities are extremely limited. Older people in this community have few opportunities for social interaction, yet this did not affect their perception of being part of a close knit community. Significantly this work challenges the assumption that older people are simply recipients of social capital and demonstrates that they are also important producers of social capital. The article contends that the relevance of this concept to older people in these rural communities has not been fully explored and is poorly understood.