Psychometric properties of the Perceived Social Support Questionnaire (PSSQ), a new measure of perceived social support among older adults.

OBJECTIVE: Based on literature and available questionnaires, the present study aimed at creating and validating the Perceived Social Support Questionnaire (PSSQ): a 4-item scale assessing the perceived social support in older adults. Normative scores were also computed. METHODS: Three hundred and two participants (mean age 87.68) selected from ongoing population-based studies completed a phone interview. Among these, 247 completed a second interview 4 months later allowing assessing the questionnaire fidelity over time. RESULTS: The factor analysis evidenced two dimensions: availability of social support and satisfaction with it. Both dimensions had a satisfactory internal consistency but weak intraclass correlation coefficient. Univariate analyses revealed that age, number of calls per week and living environment marginally associated with the availability score. The satisfaction score was associated with perceived health status, sadness, depressive mood, feeling of loneliness, anxiety, and the perception of social support during the pandemic context. The norms computed were stratified on age. CONCLUSIONS: The PSSQ is a short and easy-to-administer tool allowing assessing perceived social support in older population. Despite a weak fidelity that could actually be explained by changes in perceived social support over time, the questionnaire revealed good psychometric qualities and validity.

Older Adults and the COVID-19 Pandemic, What About the Oldest Old? The PACOVID Population-Based Survey.

Introduction: The literature draws a mitigated picture of the psychosocial effects of the lockdown in older adults. However, the studies conducted so far are mainly based on web surveys which may involve selection bias. The PACOVID survey relies on a population-based design and addresses the attitudes, psychological and social experiences of the oldest old regarding the pandemic and lockdown and their impact. Material and Methods: Cross-sectional phone survey involving 677 persons. Baseline report on attitudes, psychological, and social experiences of the oldest old, regarding the pandemic and lockdown measures. Results: The mean age was 87.53 (SD 5.19). About 46% were living alone during the lockdown. Concerning difficulties, "none" was the most frequent answer (35.6%). For questions addressing how often they had felt sad, depressed, or lonely (CESD-scale), the most frequent answers were "never/very rarely" (58.7, 76.6, 60.8%) and 27.1% had anxious symptomatology (STAI scale). Most (92.9%) felt socially supported. Engaging in leisure activities was the most frequent coping strategy, and for numerous participants the lockdown did not represent much of a change in terms of daily routine. A very good knowledge and awareness of COVID-19 and the safety measures was observed. Comparisons with measures collected before the pandemic showed low changes in subjective health and the CES-D questions. Discussion: With a methodological design limiting selection bias, our results claim for a weakened psychosocial impact even though the participants are concerned and aware of the pandemic issues. These results highlight the resources and resilience abilities of older persons including in advancing age.

Living in rural area: A protective factor for a negative experience of the lockdown and the COVID-19 crisis in the oldest old population?

OBJECTIVES: Some factors influence the experience of the COVID-19 pandemic (health, loneliness, digital access...), but what about the living area? The objective was to compare between rural and urban areas, the psychological and social experiences of the older individuals with regard to the COVID-19 crisis during the first French lockdown. METHODS: The sample included participants of three existing population-based cohorts on aging. Telephone interviews conducted by psychologists focused on the lockdown period. Data collected included living environment, professional assistance, social support, contacts with relatives, difficulties encountered, health, and knowledge and representations of the epidemic. The negative experience was defined by the presence of at least two of the following items: high anxiety symptomatology, depressive symptoms, worries or difficulties during the lockdown and insufficient social support. RESULTS: The sample included 467 participants, aged on average 87.5 years (5.2), 58.9% were female and 47.1% lived in rural areas. Persons living in rural area had better social support, greater family presence, a less frequent feeling of imprisonment (OR = 0.60, 95 CI% = 0.36-0.99), 95% had a garden (vs. 56%), fewer depressive symptoms and lower anxiety scores, but also tended to lower comply with the health measures. Finally, they had an almost twofold lower risk of having a negative experience of the lockdown compared to their urban counterparts (OR = 0.55, 95% CI = 0.33-0.92, p = 0.0223). CONCLUSIONS: The oldest old living in rural area experienced the first lockdown better than the urbans. Living conditions, with access to nature, a greater social support and family presence, could have contributed to these findings.

Patient education interventions for colorectal cancer patients with stoma: A systematic review.

OBJECTIVES: To describe the various types of patient education interventions for colorectal cancer patients with stoma and to examine their effects on quality of life, psychosocial skills and self-management skills. METHODS: A systematic review was performed. Six electronic databases were searched. Inclusion criteria were: studies about patient education applying quantitative methods including digestive stoma adults with colorectal cancer. The primary outcome was quality of life. Secondary outcomes were psychosocial and self-management skills. RESULTS: Thirteen studies were identified and included. Five studies examined quality of life and three reported improvements. Patient education improved some psychosocial and self-management skills. Contrasting findings were reported for specific-disease quality of life, emotional distress, length of hospital stay, stoma complications and readmission rate. CONCLUSIONS: Patient education has a positive impact on some psychosocial and self-management skills, indicating that this area should be developed. Contrasting findings were reported for quality of life. Methodologies are heterogeneous making it difficult to produce evidence-based guidelines. This article proposes tools to carry out further studies on this subject and to improve understanding. PRACTICE IMPLICATION: Further education intervention for stoma patients with colorectal cancer should be standardized in terms of intervention, duration and outcome measures to compare intervention and determine best practice.

Quality of life in aphasic patients 1 year after a first stroke.

PURPOSE: This study had twofold objective: (1) assessing change and dynamic processes over time between severity of aphasia and functional autonomy and (2) examining the temporal relationships between functional autonomy, depressive mood and quality of life in stroke patients with aphasia. METHOD: Prospective study of patients with aphasia consecutively included after a first stroke and examined 1 year later at home (n = 101). Assessment included a visual analogical scale assessing QoL, a functional autonomy scale, a severity of aphasia scale, a communication questionnaire and a depression scale. Structural equation modeling was used to estimate competitive models, in which depressive mood or QoL was the ultimate endogenous variable (i.e., vulnerability vs. scar model). RESULTS: One year after stroke, there were a slight improvement in language impairment (stability coefficient = .61, p < .001) and a moderate improvement in functional autonomy (stability coefficient = .44, p < .001). There were prospective reciprocal effects between severity of aphasia and functional autonomy, i.e., each state exerted a temporal dynamic prediction on the other over time. Cross-sectional results from path analysis showed that depressive mood negatively predicted QoL (i.e., scar model); there was no evidence of the reverse association. CONCLUSION: Results and their practical relevance in treatment were discussed. Predicting as soon as possible which factors would be related to late QoL in stroke patients with aphasia is of major importance.

Dyadic Cross-Sectional Associations Between Negative Mood, Marital Idealization, and Relationship Quality.

This study aimed to evaluate (a) dyadic associations between relationship quality (RQ) and both depressive and anxious mood (DM and AM), (b) reciprocity hypotheses of negative mood within dyadic interactions, and (c) mediational role of marital idealization between negative mood and relationship quality. Actor-partner interdependence models (APIMs) were performed using data from a sample of 198 dyads. Our results showed that (a) these two facets of negative mood did not have the same weight on RQ and that they had a gender-specific effects pattern, and (b) there was no support for the mood transmission hypothesis. Men's DM displayed direct and indirect (via marital idealization) actor as well as partner effects on RQ, whereas women's DM displayed only a direct actor effect on RQ. There were no significant direct actor effects of AM on RQ, meaning that this link is fully mediated by marital idealization. However, only women's AM showed such indirect effects on RQ.

[Construct and validation of a quality of life's scale for older French people]. / Élaboration et validation d'une échelle de qualité de vie adaptée aux personnes âgées (EQVPA).

Given changing and subjective aspects of quality of life, the current assessment scales are often encompassing and not very adapted for older people. Thus, the present validation study has several objectives: 1) To elaborate a specific measure of the quality of life of older people, given the characteristics and problems of this population; 2) To propose a simple scale to use for any health care professional and fast passation to encourage the inclusion of such measures in the framework of a comprehensive care of the elderly; 3) To validate this scale in a large cohort of retired older farmers. This scale resulted in 14 items illustrating the various dimensions of quality of life of older people. It was then proposed for validation in a large cohort of retired elderly farmers of 65 years and over, and living at home. After exploratory factor analysis of subjects' responses to the EQVPA, five items were extracted explaining 48.8% of the total variance. Its internal consistency was satisfactory (Cronbach's alpha=0.72). The five items permitted to assess daily and social activities in environment, social and familial relationships, physical and functional health and mental health. The results showed that quality of life is significantly correlated with greater life satisfaction, more social support and social network, higher level of subjective health, lower level of functional impairments, lower level of anxious and depressive symptoms, and lower level of routinization. Validation of the tools such as EQVPA seems important for the prevention and preservation of the quality of life of older people.

Illness perception of migraineurs from the general population.

OBJECTIVE: This study aims to describe the cognitive representations of migraine through the migraineurs' discourse. METHOD: A sample of subjects taken at random from a representative sample of the French general population is interviewed about their representations of migraine. A content analysis is performed using the ALCESTE software. RESULTS: The population is composed of 51 subjects. The analysis shows that throughout the corpus, the word 'migraine' does not appear spontaneously. It seems that migraine as a chronic disease that may require long-term treatment is not well understood; people have rather a 'successive crises' representation of illness. In reaction to the crises, it is surprising not to find any clue evoking the field of catastrophsising. However, the cognitive coping strategy of resignation is to be found. The favourite interlocutor to start therapeutic education of the patient is the doctor since subjects say that they do not expect anything of the kind from the media. CONCLUSION: The results allow us to understand better why migraineurs do not consult for their illness and do not follow recommendations concerning treatments utilisation. The results allow to propose interventions that include patient education taking into account patients' cognitive representations of their illness.

Structured self-management education maintained over two years in insufficiently controlled type 2 diabetes patients: the ERMIES randomised trial in Reunion Island.

BACKGROUND: Self-management education programs can reduce the complications and mortality in type 2 diabetes. The need to structure these programs for outpatient and community care with a vision for long-term maintenance has been recognised. In Reunion Island, an area affected by epidemiological and nutritional transition, diabetes affects 18% of the adult population over 30 years, with major social disparities, poor glycaemic control and frequent cardiovascular complications. METHODS/DESIGN: ERMIES is a randomised controlled trial designed to test the efficacy of a long-term (2 years) structured group self management educational intervention in improving blood glucose in non-recent, insufficiently controlled diabetes. After an initial structured educational cycle carried out blind for the intervention arm, patients will be randomised in two parallel group arms of 120 subjects: structured on-going group with educational intervention maintained over two years, versus only initial education. Education sessions are organised through a regional diabetes management network, and performed by trained registered nurses at close quarters. The educational approach is theoretically based (socio-constructivism, social contextualisation, empowerment, action planning) and reproducible, thanks to curricula and handouts for educators and learners. The subjects will be recruited from five hospital outpatient settings all over Reunion Island. The main eligibility criteria include: age ≥18 years, type 2 diabetes treated for more than one year, HbA1c ≥ 7.5% for ≥3 months, without any severe evolving complication (ischaemic or proliferative retinopathy, severe renal insufficiency, coronaropathy or evolving foot lesion), and absence of any major physical or cognitive handicap. The primary outcome measure is HbA1c evolution between inclusion and 2 years. The secondary outcome measures include anthropometric indicators, blood pressure, lipids, antidiabetic medications, level of physical activity, food ingestion, quality of life, social support, anxiety, depression levels and self-efficacy. An associated nested qualitative study will be conducted with 30 to 40 subjects in order to analyse the learning and adaptation processes during the education cycles, and throughout the study. CONCLUSIONS: This research will help to address the necessary but difficult issue of structuring therapeutic education in type 2 diabetes based on: efficacy and potential interest of organising on-going empowerment group-sessions, at close quarters, over the long term, in a heterogeneous socioeconomic environment. TRIAL REGISTRATION: ID_RCB number: 2011-A00046-35Clinicaltrials.gov number: NCT01425866.

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 nurse's 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.

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.

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

UNLABELLED: 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. AIM: To identify coping strategies of LBP patients, and their influence on LBP evolution. METHODS: Ninety nine patients were assessed just after an acute LBP episode and one year later. Assessment tools included medical and social reports, scales of anxiety, depression, quality of life, locus of control (LOC), social support and coping strategies. RESULTS: One year after the initial episode, 67% of patients have improved and 33% had a chronic pain. A principal components analysis showed that two main dimensions might be identified inside the outcome: functional and emotional non-adjustment. Functional non-adjustment was predicted by male gender, reduction of activity, and history of trauma over one year. Emotional non-adjustment was only predicted by trait-depression. Reactions to pain were structured in four factors: distraction-praying, helplessness-hopelessness, cognitive restructuration and perceived control. Two of these factors predicted adjustment one year later: distraction-praying had a direct effect on functional non-adjustment, and helplessness-hopelessness on emotional issue. CONCLUSIONS: Besides somatic factors, psychosocial predictors of LBP chronic evolution may be identified. Both aspects must be taken into account in order to prevent chronic pain. Perhaps cognitive-behavior therapy may help LBP patients to cope with pain in a better way.

The body-image questionnaire: an extension.

The 19-item Body-Image Questionnaire, developed by our team and first published in this journal in 1987 by Bruchon-Schweitzer, was administered to 1,222 male and female French subjects. A principal component analysis of their responses yielded an axis we interpreted as a general Body Satisfaction dimension. The four-factor structure observed in 1987 was not replicated. Body Satisfaction was associated with sex, health, and with current and future emotional adjustment.