Dyadic Dimensions Research Articles

Attachment styles and healthcare utilization: exploring the role of the patient-doctor relationship

BackgroundWith the purpose of improving healthcare, past research has examined the link between healthcare utilization and attachment. It is suggested that an individual’s attachment style influences both the quality of their patient-physician relationship and healthcare utilization patterns. Nevertheless, most studies concentrate on the individual aspect, overlooking the dyadic dimension; specifically, the investigation of how insecure attachment relates to health behavior within patient-physician relationships. This gap leaves the role of the patient-doctor relationship in this process unclear. Therefore, to elucidate this complex interplay, we hypothesized that the correlation between attachment and healthcare utilization is mediated by the quality of the patient-physician-relationship.MethodParticipant selection was based on electoral districts, a random-route procedure, and the Kish selection grid. The participants were visited by a trained interviewer who collected psychometric and sociodemographic information. Participants answered the Experiences in Close Relationships-Revised questionnaire (ECR-RD8) and the Patient-Doctor Relationship Questionnaire (PDRQ-9). Additionally, participants were asked about their healthcare utilization. The final sample consisted of N = 2.275 participants.ResultsIn average the participants reported consulting their primary health care practitioner M(SD) = 4.44 (4.76) times in the past 12 months. Generally, the participants rated the quality of the relationship with their primary health care practitioner close to “totally appropriate” (M = 4.12 ± .69). The degree of insecure attachment manifested towards the lower extremity of the scale. The total effect of the mediation analyses was significant. Regardless, the indirect effect indicated a trend result with minimal effect sizes.ConclusionThe findings of the current study bridged the gap between attachment styles and healthcare utilization. Nonetheless, our results suggested insufficient support for the mediating role of the primary care physician in the relationship between attachment style and healthcare utilization. Considering the characteristics of the sample, this outcome may not apply in a clinical context. However, further research is needed to shed light in the revealed trends and indicate implications.

Perceived organizational support, self-efficacy and cognitive reappraisal on resilience in emergency nurses who sustained workplace violence: A mediation analysis.

The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self-efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. A cross-sectional study. From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self-efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self-efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self-efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self-efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self-regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self-efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses.

Challenges in Preloss Care to Parents Facing Their Child's End-of-Life: A Qualitative Study From the Clinicians Perspective.

Bereavement care for parents predominantly focuses on care after child loss. However, Health Care Professionals (HCPs) feel responsible for supporting parents who are grieving losses in their child's end-of-life. Preloss care is tailored to the parents' needs, thus highly varying. To better understand the nature of preloss care, this study aims to gain insight into the challenges HCPs encounter while providing care for parents during their child's end-of-life. Exploratory qualitative research using semistructured interviews with physicians and nurses working in neonatology and pediatrics in 3 university pediatric hospitals and 1 child home care service. A multidisciplinary team thematically analyzed the data. Twenty-two HCPs participated in this study. From the HCPs' inner perspective, three dyadic dimensions in preloss care delivery were identified that create tension in HCPs: sustaining hope versus realistic prospects, obtaining emotional closeness versus emotional distance, and exploring emotions versus containing emotions. Throughout preloss care delivery, HCPs weighed which strategies to use based on their perception of parental needs, the situation, and their own competencies. HCPs remained with lingering uncertainties on whether the preloss care they provide constituted optimal care. As a result of the experienced tension, HCPs are at risk for prolonged distress and possibly even compassion fatigue. In order to maintain a positive emotional balance in HCPs, education should focus on adapting positive coping strategies and provide hands-on training. Furthermore, on an institutional level a safe environment should be fostered and well-being could be enhanced through learning by sharing as a team.

Does getting along matter? Tourist-tourist rapport in guided group activities

Guided group activities, where tourists consume with other tourists, are common and important. Although the tourism and services literature suggests customer-employee rapport impacts customer satisfaction, the composition and impact of tourist-tourist rapport in guided group activities have received minimal attention. We use a three-study mixed method approach to conceptualize and examine tourist-tourist rapport in guided group activities. Study 1 identifies two recognized dyadic dimensions of tourist-tourist rapport (enjoyable interaction and personal connection) and two new group-based dimensions (group attentiveness and service congruity). Study 2 (video experiment) and Study 3 (field experiment) find that enjoyable interaction and personal connection mediate the relationship between group attentiveness and service congruity with satisfaction. Thus, tourist-tourist rapport in a group context is more multidimensional and complex than previously conceptualized for customer-employee rapport and non-group contexts. Further, we find tourist-tourist rapport is a critical service factor such that high levels satisfy, while low levels dissatisfy.

The link between infertility-related distress and psychological distress in couples awaiting fertility treatment: a dyadic approach

While there is broad evidence to suggest that individual stress increases, and that high couple relationship quality reduces the risk for psychological distress, our understanding of these associations in couples dealing with infertility remains limited. In this cross-sectional study, we used dyadic data-analysis (Actor-Partner Interdependence Model; APIM) to examine the effects of infertility-related distress (experienced as an individual risk factor) and couple relationship quality (experienced as a couple-based resource), on psychological distress in a sample of 116 infertile couples. 59% of women and 23% of men reported clinical levels of psychological distress, 71% of women and 45% of men reported infertility-related distress, and 3% of participants reported low couple relationship quality. Infertility-related distress predicted psychological distress at the individual level (‘actor effects’) while men’s infertility-related distress predicted women’s psychological distress (partner effect’). Women without medically assisted reproduction (MAR) treatment exposure reported significantly higher couple relationship quality than women with MAR exposure, and men without treatment exposure reported significantly lower infertility-related distress than men with exposure. The level of psychological distress depended on whether both or neither of the partners, or only one partner reported infertility-related distress. Couple relationship quality was not associated with distress, which may imply that dyadic dimensions other than overall satisfaction could be relevant in supporting couples facing infertility.

“Side by side”: Development of twin relationship dimensions from early to middle childhood and the role of zygosity and parenting

Twin relationships have a significant effect on the twins’ life and their families. In the first comprehensive study of this topic, our purpose was to examine the developmental courses of four dyadic dimensions of twins’ relationships: closeness, dependence, conflict and rivalry, and the impact of zygosity and parenting on their relationships. Parents reported on their twins’ relationships ( N = 1547 mothers and 536 fathers with data from at least one of four measurement points from 3 to 8–9 years of age). The sample included 322 monozygotic twin dyads (sharing virtually 100% of their genes), and 1194 dizygotic twin dyads (sharing 50% of their genetic variance, on average). Our findings indicated that closeness and dependence decreased while rivalry increased through childhood. Dependence and rivalry also presented quadratic change. The twins’ conflict increased only for dizygotic twins. As expected, we found that the twins’ closeness and dependence were highly associated, as did the associations between conflict and rivalry. The mostly nonsignificant associations of closeness with conflict and rivalry reinforced the notion that they are not bi-polar opposites. However, dependence was positively related to the twins’ conflict and rivalry. A zygosity effect was also evident as monozygotic twins had higher levels of closeness and dependence than dizygotic twins through childhood, but there was no significant difference in the levels of their conflict and rivalry. In congruence with family system theories, parental positivity predicted the twins’ closeness and dependence, and parental negativity predicted the twins’ dependence, conflict and rivalry. The results were discussed in light of an evolutionary perspective and the twins’ developmental challenges through childhood.

A theoretical framework of romantic creativity: Dyadic creativity in romantic relationships and plausible links with wellbeing

Everyday creative behaviours seem to be associated with high levels of wellbeing. Yet, the effects of creativity on wellbeing remain largely unknown, notably at a dyadic level, and particularly in the context of romantic relationships. Previous research has studied the effects of creativity on romantic relationships but has been limited by the two main epistemological assumptions that we present in this article. Consequently, very little is known about the effect of a form of creativity that may occur at a dyadic level in a romantic relationship, and that may have implications in the science of human flourishing. In other words, the research field lacks a theoretical framework for studying the effect of creativity in romantic relationships on wellbeing. The present theoretical framework aims to fill this gap by proposing a dyadic dimension of creativity embedded within wellbeing: romantic creativity. Romantic creativity is conceptualised as an observable, quantifiable, yet non-product-hierarchic phenomenon. It is defined as a dyadic process which favours new and meaningful directions in a romantic relationship through dynamics of discovery and self-expansion in one or both members of the dyad. This article describes the epistemological foundations of this theoretical framework and draws on existing research on self-expansion and the neuroscience of wellbeing to hypothesise the processes that might account for the effect of romantic creativity on human flourishing. We also identify two possible ontological perspectives for research on romantic creativity. The present article proposes that romantic creativity might help dyads to flourish through the processes implied in homeodynamics and dyadic self-expansion.

A thematic analysis of a sample of partnered lesbian, gay, and bisexual people’s concepts of sexual satisfaction

ABSTRACTSexual satisfaction is an important component of sexual health. There are few proposed conceptual definitions of sexual satisfaction and operational definitions are significantly limited. Those that exist were developed with heterosexual people. In this study, we performed thematic analysis on 60 Portuguese, partnered, sexual-minority people’s written answers to the question: “How would you define sexual satisfaction?” The results revealed a sex positive definition that includes intersecting individual and dyadic dimensions with social discourses relating to sexual minority identity and dominant patterns of relationships and sexuality. Findings highlight the need to consider LGB specific experiences in both research and clinical work.

Climatic Factors as Determinants of International Migration: Redux

In this article, we revisit the issue of environmental change as a potential determinant of international migration, thereby providing an extension of our earlier paper. In contrast to Beine and Parsons (2015, The Scandinavian Journal of Economics, 117, 723–767) and in light of recent empirical contributions, we adopt an alternative identification strategy in which we only include fixed effects together with our measures of climatic change to quantify the net partial effect of climatic change on bilateral migration. Again drawing on panel data from 1960 to 2000, we further exploit the dyadic dimension of our data to highlight the importance of neighbouring countries and former colonial powers in determining the direction of climate-induced emigration. Our baseline results suggest that climatic shocks affect individuals’ financial constraints more than their desire to move. Our key findings are that natural disasters tend to deter emigration but importantly spur emigration to neighbouring countries. For middle-income origins, natural disasters, while deterring migration, foster emigration to former colonial powers. (JEL codes: F22, J61)

A Practitioners’ Guide to Gravity Models of International Migration

AbstractThe use of bilateral data for the analysis of international migration is at the same time a blessing and a curse. It is a blessing because the dyadic dimension of the data allows researchers to address a number of previously unanswered questions, but it is also a curse for the various analytical challenges it gives rise to. This paper presents the theoretical foundations of the estimation of gravity models of international migration, and the main difficulties that have to be tackled in the econometric analysis, such as the nature of migration data, how to account for multilateral resistance to migration or endogeneity. We also review some empirical evidence that has considered these issues.

A Multimethod Perspective on Emotional Availability in the Postpartum Period

SYNOPSIS Objective . This study investigates observed and self-reported emotional availability in clinically depressed and nondepressed mother–infant pairs. Design. Observations of mother–infant interaction were made during 30-min free-play interaction during the first year of life in clinically postpartum depressed (n = 49) and nondepressed mothers (n = 35) in Flanders (Belgium). Results . Postpartum depressed mothers had significantly lower scores on most emotional availability dimensions, both as observed by clinicians and on the self-report measure of emotional availability, except for observed hostility and self-reported intrusiveness and hostility, and appeared to have difficulty in being engaged in play interaction with their infants. Both dyadic dimensions of the self-report questionnaire, mutual attunement and affect quality, are related to all six observed dimensions; children seen by their mothers as able to involve them in play are scored as responsive and involving by external observers; mothers of involving infants were observed as more sensitive; self-reported hostility is associated with observed nonhostility and nonintrusiveness; and, as expected, self-reported maternal intrusiveness is not related to observed nonintrusiveness or with other aspects of observed emotional availability. Conclusion. The current study underlines the differences in most aspects of observed and self-reported emotional availability between postpartum depressed and nondepressed mothers, as well the potential divergences between observed and self-perceived aspects of this construct.

Dyadic Dimensions of Armed Conflict, 1946—2007

In 2007, 34 armed conflicts were active worldwide, up by one from 2006 and by five from 2003, the year with the lowest number of active armed conflicts since the 1970s. While the number of conflicts increased, the number of wars, i.e. conflicts with over 1,000 battle-related deaths in a year, dropped by one to four. Five of the conflicts from 2006 were no longer active in 2007, but during the year, two previously recorded conflicts (in Mali and Pakistan) were restarted by new actors and two (in Angola and Peru) by previously recorded rebel groups. For the first time since 2004, two new conflicts were recorded: a conflict over governmental power in Niger and a territorial conflict in DRC. A conflict may involve one or more dyads or pairs of warring parties. In the 236 conflicts active since 1946, 487 dyads have been recorded in the new UCDP Dyadic Dataset. While most intrastate conflicts involve a single rebel group fighting the government, in 30 of the conflicts two or more dyads were active simultaneously. In 2002 and 2003, over 30% of the active conflicts involved more than one rebel group. The number of active rebel groups and changes in the set of groups are important elements of the complexity of any armed conflict, and the study of these aspects should be greatly facilitated with the new dataset. By adding the dyadic dimension to the study of conflicts, the analysis of a range of phenomena that have hardly been captured by previously available data is made possible.

Algorithms for spline wavelet packets on an interval

The aim of this paper is to describe decomposition and reconstruction algorithms for spline wavelet packets on a closed interval. In order to generate packet spaces of dyadic dimensions, it is necessary to modify the approach for spline wavelets on an interval as studied by Chui, Quak and Weyrich in [3, 11].

Capabilities in Context: National Attributes and Foreign Policy in the Middle East

National capability can contribute to an explanation of foreign policy behavior if research is sensitive to the role of political context and the systems of which nations are a part. A nation's capability constrains and induces its policy and high-capability states are likely to be the dominant members of a system. Propositions related to both 'rank' and 'social field theory' are useful for understanding the level of interaction among states. The nature of that interaction, though, is largely a product of a political context promoted and reinforced by the behavior of states. These ideas can be applied to the Middle East where the gap between the regional rich and the poor has grown and the former have assumed a regional role commensurate with their capability. As the role of pan-Arabism has changed, capabilities have become important explanations for how regional states behave. A model composed of seven variable blocs is tested across 91 dyads for two five-year periods: 1957-1961 and 1968-1972. While designed to test the role of power capabilities, the model incorporates a variety of 'contextual' variables often emphasized in the literature on the Middle East region: ideology, regional linkage with the global system, regional bipolarity, domestic politics and economic exchange, and examines two dyadic dimensions of conflict and cooperation. The results indicate at least partial support for this study's hypotheses and approach, and the related assessments of Middle East politics.