Life Appraisal Research Articles

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis.

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p<0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p<0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients' quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.

Development of the 6S Dialogue Tool to facilitate person-centred palliative care.

To develop and psychometrically test the 6S Dialogue Tool. The 6S Dialogue Tool was elaborated to provide knowledge to nurses about patients' preferences in congruence with the 6S person-centred palliative care model, which includes the S-concepts of self-image, symptom relief, self-determination, social relationships, synthesis and strategies. The tool needs to be scrutinized for appropriateness. A qualitative study investigating construct validity of the 6S Dialogue Tool. Forty-six patients in palliative care services in Sweden responded to 15 questions from May 2015 - August 2016. Responses were analysed with qualitative content analysis. Six categories, capturing the meaning of the 6S-concepts, were formulated: Maintaining everyday life; Challenges in everyday life; Maintaining control; Maintaining selected relationships; Appraisal of life; and Appraisal of the future. The responses to the 6S Dialogue Tool questions reflect the intent of the 6S-concepts. Nurses should integrate the 6S-concepts and the questions in their approach to facilitate to co-create meaningful palliative care in dialogue with the patient. Patients' preferences must be explored to co-create palliative care in accordance with their own needs and beliefs. The 6S Dialogue Tool questions are suitable for obtaining patients' preferences and could be used as an approach in palliative care. Patients, families and nurses will have the potential to co-create palliative care and to improve possibilities for patients to have an appropriate death.

The role of dispositional mindfulness in a stress-health pathway among Parkinson's disease patients and caregiving partners.

Parkinson's disease (PD) patients and their caregivers experience significant distress that impacts physical, emotional and social functioning in the patient, and in turn, has a significant impact on the caregiver. Lower levels of stress have been associated with a better prognosis in PD. The quality of dispositional mindfulness-innate present moment, non-judgmental awareness-has consistently been associated with less perceived stress, greater well-being, and better physical health in both clinical and healthy populations. To date, associations of mindfulness with distress, depression, sleep problems, and other variables that define health-related quality of life have not been examined in the context of PD patient/caregiver dyads. We investigated the impact of dispositional mindfulness in a stress-health model among eighteen dyads consisting of PD patients and their caregivers. Multilevel linear modeling (actor-partner interdependence models) revealed significant associations between dispositional mindfulness and stress appraisal, interpersonal support, depressive symptoms, sleep, and health-related quality of life (HRQOL) within both dyadic partners. As expected, results demonstrated significant associations of distress with interpersonal support, depressive symptoms, sleep and HRQOL for both PD patients and caregivers. Dispositional mindfulness was associated with reduced distress and its downstream clinical consequences. These results support an ameliorative role for dispositional mindfulness among PD patients and caregivers, as a protective factor against psychosocial burdens imposed on couples related to disease and caregiving. Findings suggest future studies should explore mindfulness training as a therapeutic option.

La Evaluación. Una mirada desde América Latina y el Caribe

En las últimas décadas en América Latina y el Caribe emerge un marcado interés por la evaluación de y desde la gestión pública. No obstante, el devenir de la práctica de la evaluación discurre desde hace más de medio siglo como una especie de eslabón invisible, emergiendo o “sumergiéndose” de distintas maneras sin que, hasta el momento, se avizore una sincronía de condiciones requeridas (voluntad política, capacidad técnica, desarrollo institucional y otras) para comprometer su visibilidad de manera sostenida. En este artículo, se identifican, caracterizan y sistematizan cursos de acción o recorridos, con sus respectivos itinerarios e intersecciones, que permiten decantar características o atributos de modelos de evaluación, desde los cuales se derivan las principales conceptualizaciones que permiten entender las prácticas y pautas más destacadas en los patrones de evaluación vigentes en el imaginario institucional y societario. El artículo tiene como propósito principal llamar la atención sobre los contenidos y formas de expresión de tales patrones y su herencia subsistente, ya que no siempre se tiene conciencia de ello, lo que se traduce en yuxtaposición o superposición de enfoques, métodos e indicadores de evaluación. Situación ésta que incide en las posibilidades de fortalecimiento y consolidación de una cultura de evaluación como propósito de futuro y de largo alcance.

Predictors of parental distress during acute phase of pediatric hematopoietic stem cell transplantation in Japan: A multicenter prospective study.

The purposes of this study were (1) to describe the levels of anxiety and depressive symptoms in parents of children undergoing hematopoietic stem cell transplantation (HSCT) before (Time 1 [T1]) and one month after transplantation (Time 2 [T2]), and (2) to identify the pre-HSCT factors that predict anxiety and depressive symptoms in fathers and mothers one month after transplantation. A prospective quantitative study was conducted at four children's hospitals between June 2015 and September 2016 using self-administered questionnaires and medical records. Parents from 23 families, including 19 fathers and 23 mothers, completed the Hospital Anxiety and Depression Scale (cutoff score: 8) and provided information regarding their stress appraisal, coping strategies, family functioning, demographic characteristics, and children's health-related quality of life. Hierarchical multiple regression analysis was performed to identify the variables that predicted T2 paternal and maternal anxiety and depressive symptoms. Among the parents, 15 fathers (79%) and 11 mothers (48%) reported anxiety symptoms, and 13 fathers (68%) and 9 mothers (39%) reported depressive symptoms above the cutoff level for clinical relevance at T1. Similarly, 11 fathers (58%) and 6 mothers (26%) reported anxiety symptoms, and 10 fathers (53%) and 9 mothers (39%) reported depressive symptoms above the cutoff level at T2. Overall, parents' anxiety and depressive symptoms did not differ significantly between T1 and T2. For fathers, both T1 depressive symptoms and the understanding of their children's medical situation through communication with other parents and consultation with medical staff predicted T2 paternal depressive symptoms. For mothers, T1 maternal anxiety symptoms and marital satisfaction predicted T2 anxiety symptoms. The medical staff should understand that parents of children undergoing HSCT experience considerable psychological distress throughout the treatment process, and therefore, they should adopt unique approaches to reduce such distress.

Colin Conyngham Turpin (1928-2019): An Appraisal of His Life and Legal Career

Colin Conyngham Turpin (1928-2019): An Appraisal of His Life and Legal Career

THE MESSAGE OF THE CASTAWAY: ORPHIC THEMES IN THE POETRY OF KRZYSZTOF KARASEK

Although Krzystof Karasek counts among the most outstanding representatives of the Nowa Fala (New Wave) generation, his poems have not been subject to detailed analysis so far. The author attempts to highlight the meaning of the Orphic threads in Krzysztof Karasek’s poetry written after 1989. For more than twenty years Karasek’s poems have been tied to each other by a suggestive figure of a hero named by the poet a ‘castaway’. This castaway’s characteristics include distance to himself and lack of delusion about the condition of the world after personal and cultural collapse. Still, it also includes great appraisal of life. The poet, defining the figure of the castaway, calls in a number of castaway figures, characters after catastrophe, among which one can find the mythical Orpheus. The article addresses the originality of Karasek’s idea with regard to his polemical texts which engaged with Zbigniew Herbert’s and Julian Kornhauser’s works.

EXAMINING COHORT AND GENDER DIFFERENCES IN CENTENARIAN LIFE SATISFACTION

The aim of this study was to examine cohort differences in life satisfaction among a sample of N = 264 centenarians residing in Oklahoma. Of particular consideration was conducting an item response analysis of the Satisfaction with Life Scale (SWLS; Diener et al., 1995) based on three cohort groups of centenarian men and women (1899–1905, 1906–1910, and 1911–1915). Independent sample t-tests were conducted but no statistically significant differences emerged relative to overall life satisfaction scores across the sample. However, centenarian men (M = 5.70, SD = 1.69) reported conditions of their life to be better than centenarian women (M = 5.11, SD = 1.94). A one-way analysis of variance was further conducted to examine specific cohort differences. Analyses resulted in statistically significant differences between cohorts with regard to the appraisal of an “ideal life” (F = 3.95, p = .02), as well as living life over and “changing nothing” (F = 3.05, p = .05). Post hoc analysis further revealed that later born cohorts (1911–1915; M = 5.67, SD = 1.76) perceived their current life to be more ideal than earlier-born (1906–1910; M = 5.01, SD = 1.96). Post-hoc analyses revealed no significant cohort differences relative to living life over and changing nothing. Results will be used to further highlight socio-historical influences and proximal conditions that contribute to positive life appraisal in very old age. This has implications for geriatric practitioners who seek to improve quality-of-life for long-lived adults.

Enhancing Quality of Life Through an Innovative, Multidisciplinary Model of Supportive Cancer Care and Rehabilitation

Background: Advancements in diagnosis and cancer treatment mean survival rates have improved but as a consequence many people are living with the adverse physical effects of complex treatments, financial hardship, work and relationship stress, and fear of recurrence. Person-centered, holistic care is required to help people maximize all aspects of their quality of life when living with and beyond their cancer, but debate continues around which models are economically sustainable and effective in achieving the desired outcomes. Maggie's ( www.maggiescentres.org ) is an innovative, multidisciplinary model of holistic supportive cancer care, widely regarded as an exemplar of best practice in cancer rehabilitation and supported self-management. In 2017 Maggie's received 249,247 visits across the network of centres in the UK, Hong Kong and Tokyo. The Maggie's program is designed to incorporate evidence based psychoeducation techniques delivered by multidisciplinary oncology professionals; offer personalised and understandable treatment and lifestyle information; and maximize the opportunity for social-support. Outcome evaluation is embedded within the model of care. Aim: To illustrate the holistic Maggie's model using outcome data from “Managing Stress” and “Living with and after Prostate Cancer (LWAPC)” courses to provide examples of the impact Maggie´s makes in enhancing quality of life. Methods: A subset of participants in “Managing Stress” and “Living with and after Prostate Cancer” courses across the network of UK Maggie´s Centres completed pre and post course standardized questionnaires. Results: Participants in “Managing Stress” found significant improvements in overall psychological well-being and quality of life (QoL) (t(40)=3.28, P = .002) and significant improvements in their ability to tolerate uncertainty (t(47) = 3.23, P = .002). Participants in the LWAPC found significant improvements in overall prostate cancer specific QoL ( t(37)=3.603, P = .001), general well-being ( t(37)=2.61, P = .013), and emotional well-being ( t(37)=2.62, P = .013). Also, significant reductions were found in overall negative appraisal of life (t(52)=2.96, P = .005), overall health worries (t(52) 2.28, P = 0.27), worries about the future (t(52) = 2.85, P = .006) and uncertainty (t(52) = 3.89, P &lt; .001). Conclusion: Globally, the supportive care needs of people affected by cancer are changing but the Maggie's model of care offers valuable lessons that can be generalized across varied support settings to meet these emerging needs.

Microbial, Physicochemical, and Sensory Analyses-Based Shelf Life Appraisal of White Fresh Cheese Packaged into PET Waste-Based Active Packaging Film

Microbial, Physicochemical, and Sensory Analyses-Based Shelf Life Appraisal of White Fresh Cheese Packaged into PET Waste-Based Active Packaging Film

Quality of life disparities between persons with schizophrenia and their professional caregivers: Network analysis in a National Cohort

BackgroundDisparities between mental health patients and their professional caregivers in quality of life appraisals have been identified, however, the structure that such disparities assume is unknown. AimsTo examine the network structure of quality of life appraisals and disparities using network analysis. MethodsParticipants were 1639 persons with schizophrenia using psychiatric rehabilitation services and their primary professional caregivers (N=582). Quality of life for persons with schizophrenia was measured based on an abbreviated version of the Manchester Short Assessment of Quality of Life. Appraisals were made self-reported and by professional caregivers. Disparities scores between the aforementioned were computed. Network analysis was performed on all quality of life appraisals. Sensitivity analyses were conducted. ResultsThe self-appraised network significantly (p<0.05) differed by network strength compared to the caregiver-appraised network. Self-appraised network communities (clusters of quality of life items) were health conditions and socioeconomic system, whereas caregiver-appraised network communities were social activities, and combined socioeconomic and health conditions. Strength centrality was highest for self-appraised social status and for caregiver-appraised residential status (Z=1.63, Z=1.12, respectively). The disparity scores network clustered into two communities: social relations and combined financial and health conditions. The most central appraisal disparities were in social status. ConclusionsQuality of life differed when self-appraised by persons with schizophrenia compared to when appraised by their professional caregivers, yet the salient role of social relations was shared. The latter may be an initial focus of discussion by persons with schizophrenia and their caregivers.

Leveraging BIM for digital built environment asset management

A National Institute of Standards and Technology (NIST) study shows that all stakeholders in the capital facilities industry waste a huge amount of money looking for, validating, and/or recreating facility information that should be readily available. The total cost of these activities within the capital facilities industries in the United States was conservatively estimated at $15.8 billion in 2002, with two-thirds of that cost occurring during the facilities’ operations and maintenance phase. This is confirmed by the International Facility Management Association (IFMA) Maintenance Survey in 2009, which states that the loss of information generates an added cost of 12.4% of total annual mean OM (2) management of mechanical equipment status; (3) qualitative condition assessment of buildings; and (4) appraisal of the service life of building components and systems according to ISO 15686-8. These four tools allow to compute and control some key indicators of the asset, with also the possibility to compare them inside a portfolio. This paper presents the four tools, paying also attention to the workflows to be followed and to the different data needs of the stakeholders involved.

Correlating leisure and happiness: the relationship between the leisure experience battery and the Satisfaction With Life Scale

ABSTRACTHappiness can be understood as an internal condition achieved when an individual reflects on his or her life experience and judges it as good. The Satisfaction With Life Scale (SWLS) was designed to assess happiness based on a similarly understood subjective life appraisal. Using a random sample of college students (N = 507) and a paper survey, this study assessed the relationship between the SWLS and the four domains of the leisure experience battery (challenge, boredom, awareness, and distress). Pearson correlations and analysis of variance with Bonferroni’s post hoc comparisons were used to examine the relationships. Results reveal a significant relationship between the leisure experience battery and the SWLS (i.e. happiness). Specifically, preference for leisure challenge and leisure awareness were significantly and positively related to SWLS score. Leisure boredom and leisure distress were significantly and negatively related to SWLS score. Implications are discussed within the context of leisure education.

Valuation of Life as outcome and mediator of a depression intervention for older African Americans: the Get Busy Get Better Trial.

Previously, we showed that Get Busy Get Better (GBGB), a 10-session multicomponent home-based, behavioral intervention, reduced depressive symptom severity in older African Americans. As appraising the value of life is associated with depressive symptoms, this study examined whether GBGB enhanced positive appraisals of life and if, in turn, this mediated treatment effects on depressive symptoms. Data were from a single-blind parallel randomized trial involving 208 African Americans (≥55years old) with depressive symptoms (Patient Health Questionnaire, PHQ-9 ≥5). GBGB involved five components: care management, referral/linkage, stress reduction, depression education, and behavioral activation. A 13-item Valuation of Life (VOL) scale with two subfactors (optimism and engagement) was examined as an outcome and as mediating GBGB effects on PHQ-9 scores at 4months. Of 208 enrolled African Americans, 180 completed the 4-month interview (87=GBGB; 93=control). At 4months, compared with wait-list control group participants, the GBGB group had improved VOL (difference in mean changes from baseline = 4.67, 95% confidence interval 2.53, 6.80). Structural equation models indicated that enhanced VOL mediated a significant proportion of GBGB's impact on depressive symptoms, explaining 71% of its total effect, and its subfactors (optimism, explaining 67%; engagement, 52%). Valuation of Life appears malleable through an intervention providing resources and activation skills. GBGB's impact on depressive symptoms is attributed in large part to participants' enhanced attachment to life. Attention to VOL as mediator and outcome and the reciprocal relationship between mood and attachment to life is warranted. Copyright © 2017 John Wiley & Sons, Ltd.

Different subjective criteria for quality of life appraisal in youth with non-psychotic depression, recovering after first psychotic episode and healthy controls

IntroductionAlthough a plenty of instruments for quality of life in mental illnesses was developed, both general and specific instruments could be biased if the process of well-being appraisal is different in different illnesses.ObjectivesWe consider personal appraisal of quality of life as a result of the decision making process, which could have different subjective criteria in mental illnesses.AimsThe aim was to compare the contribution of the quality of life domains to the appraisals of general life satisfaction in mental illnesses.MethodsThree groups of males 17–28 years old (74 with non-psychotic depression, 90 developing recovery after the first psychotic episode and 185 healthy controls) filled quality of life and enjoyment questionnaire (version for mental illnesses) and Happiness Scale.ResultsModeration analysis reveals that in non-psychotic depression health, emotional sphere and functioning during the day are more important predictors of general well-being than in the two other groups. Patients developing recovery after psychotic episode are less oriented to the emotional and social domains and financial well-being when appraising their life satisfaction than other participants.ConclusionsResults demonstrate the importance of identifying and working with subjective criteria and process of appraisal of general well-being in patients with mental illnesses. Direct comparisons of quality of life in different clinical groups are biased by different subjective criteria that are important for patients.Disclosure of interestResearch supported by the grant of president of the Russian federation for the state support for young Russian scientists, project MK2193.2017.6.

Risk-Based Framework (RBF) for a UK Pan-European Supergrid

Interconnected electricity networks, or Supergrids, are considered as a possible solution to tackle challenges associated with near and far-future supply of electricity. These include, but are not limited to, reducing Green House Gas emissions and reliance on non-renewable fossil fuels. Supergrids can help to tackle these challenges, for example, by providing a reliable interconnection platform for wider application (and development) of renewable technologies. However, there is a range of risks and uncertainties associated with selecting appropriate interconnections. Heretofore these have been a hindrance to developing interconnections and therefore a Risk-Based Framework (RBF) which addresses these risks and uncertainties could encourage the wider uptake of Supergrids.This paper presents for the first time such a robust framework. The RBF comprises of four stages; (1) initial screening for selecting candidate countries, (2) risk identification, (3) risk semi-quantification and (4) risk quantification. In stage 4 the uncertainties associated with the identified risks are quantified using a cost-risk model under uncertainty based on a whole life appraisal approach. The usefulness of the approach, demonstrated using the UK as a case study, showed that greatest cost risks are associated with (a) regulatory framework, and (b) changes in energy policy. The most desirable interconnection option for the UK was identified as France.

Study on Defense Mechanisms to Cope With Stress Due to Stigma Among People Living With HIV/AIDS Reported in Eastern India: A Single Center Experience

Aim: To explore the stigmatizing pattern in people living with HIV/AIDS (PLWHA) and assess coping strategies adopted for quality of life (QOL) appraisal. Methods: In the background of a descriptive, cross-sectional research design, PLWHA attending HIV (human immunodeficiency virus) outpatient clinic at Medical College, Kolkata (n = 120) were enrolled through “snowball sampling.” A brief semistructured interview schedule was used to elicit data on socio-demographics. Stigma was assessed using a 4-point scale (40-item). Quality of life was assessed using WHOQOL-BREF (World Health Organization Quality-of-Life) scale (26-item). Results: About 96.7% reported being stressed. Stigma was mostly confronted in socio-familial context. Fear of being stigmatized was much higher compared with those who actually faced stigma (69.2% vs 27.5%; P &lt; .01). Quality of life negatively correlated with internalizing of stigma in the psychological domain ( P &lt; .01). Proportion experiencing actual stigma (women vs men: 79% vs 74%) experienced an above moderate QOL. Multiple defense mechanisms were identified. “Altruism,” “Anticipation,” and “Humor” were the most preferred defense strategies. However, such coping strategies appeared to be self-taught and only modestly helpful in managing perceived stigma. Conclusions: People living with HIV/AIDS should avoid internalizing stigmatized feeling and engage in social activities to work toward a better QOL.

Appraisal assessment in patient-reported outcome research: methods for uncovering the personal context and meaning of quality of life.

Recent work on patient-reported outcomes (PROs) focuses on precise, brief measures, which generally convey little about what an individual's rating actually means. Individual differences in appraisal are important and relevant to PRO research. This paper highlights the advantages of integrating appraisal assessment into clinical research. The most comprehensive method for assessing appraisal, the quality of life (QOL) Appraisal Profile, includes open-ended and multiple choice questions to assess four appraisal parameters: frame of reference, sampling of experience, standards of comparison, and combinatory algorithm. We illustrate with empirical findings four classes of investigation that would benefit from appraisal assessment: methodological, interpretation of change, the backstory of resilience, and clinical applications. A methodological investigation of HIV/AIDS patients revealed a range of cognitive schemas induced by the then-test response shift detection method, only 15% of which reflected the presumed process invoked. In this same study and in a study of people with multiple sclerosis (MS), interpretation of change in positive versus negative mental-health response shifts was characterized by different appraisal processes. In studying resilience in MS patients, patients with more reserve-building activities were more likely to use appraisals that emphasized the positive and more controllable aspects of their illness experience, as compared to lower-reserve patients. In underserved cancer patients, the QOL Appraisal Profile was used as a clinical interview to articulate current concerns and for personalized treatment decision-making to reduce burden and promote adherence. Integrating appraisal assessment can provide a more textured, person-centered understanding of person-factors not captured by standard PROs.

PRZESŁANIE ROZBITKA. WĄTKI ORFICKIE W POEZJI KRZYSZTOFA KARASKA

Although Krzystof Karasek counts among the most outstanding representatives of the Nowa Fala (New Wave) generation, his poems have not been subject to detailed analysis so far. The author attempts to highlight the meaning of the Orphic threads in Krzysztof Karasek’s poetry written after 1989. For more than twenty years Karasek’s poems have been tied to each other by a suggestive figure of a hero named by the poet a ‘castaway’. This castaway’s characteristics include distance to himself and lack of delusion about the condition of the world after personal and cultural collapse. Still, it also includes great appraisal of life. The poet, defining the figure of the castaway, calls in a number of castaway figures, characters after catastrophe, among which one can find the mythical Orpheus. The article addresses the originality of Karasek’s idea with regard to his polemical texts which engaged with Zbigniew Herbert’s and Julian Kornhauser’s works.

When global rating of change contradicts observed change: Examining appraisal processes underlying paradoxical responses over time.

Interpreting change scores is challenging when patients' global rating of change (GRC) scores contradict their observed change scores. We examine appraisal processes associated with having GRC-observed change contradictions. This secondary analysis of longitudinal multiple sclerosis (MS) registry data examined predictors of GRC scores in the whole sample (n=858). Logistic modeling then examined predictors of membership in one of two paradoxical subgroups (n=525): (a) Worsened GRC with unchanged observed Rand-12 Mental Component scores (MCS) (Symptom-Maximizers, n=171) versus no change GRC among stable MCS subsample; and (b) same GRC with declined observed MCS scores (Symptom-Minimizers, n=84) versus declining GRC among declining MCS subsample. Independent variables were cognitive appraisal processes from the Quality of Life (QOL) Appraisal Profile. GRC scores were more strongly associated with appraisal processes than with change in patient-reported outcomes (PROs) (R 2=11 and 2%, respectively). Symptom-Maximizers tended to focus on MS-related experiences and emphasize big changes; over time, they decreasingly defined QOL in terms of independence, increasingly focused on their MS, and increasingly compared themselves to doctor's predictions (Pseudo R 2=0.20). In contrast, Symptom-Minimizers tended not to recall recent episodes; over time, they focused increasingly on goals related to living situation and emphasized long-term concerns (Pseudo R 2=0.25). Appraisal explains more variance in GRC scores than do changes in PROs. People whose GRC assessment contradicts their observed change can be characterized by distinct cognitive appraisal processes reflecting response shift.