Psychosocial Adjustment In Women Research Articles

Psychosocial adjustment of women to living with HIV/AIDS

Psychosocial adjustment to living with HIV/AIDS was examined in a purposive sample of 146 New York City, African-American, Puerto Rican, and White non-Hispanic women using the Psychosocial Adjustment to Illness Scale, self-report version (PAIS-SR). Puerto Rican participants reported significantly more problems than African-Americans on the Summary Scale and the Domestic Environment and Psychological Distress domain subscales and significantly more problems than either Whites or African-Americans on the Social Environment domain subscale. Problematic sexual relationships were found to be significantly associated with race/ethnicity, although scores did not differ significantly between any two groups. On average, women in all three racial/ethnic groups reported high levels of psychosocial adjustment problems to their illness relative to normative data for cancer patients. These findings suggest that, while all HIV-infected women may be at risk for problematic psychosocial adjustment to living with HIV/AIDS, Puerto Rican women may be especially vulnerable.

Psychosocial adjustment and quality of life in women with breast cancer and benign breast problems: A controlled comparison

Comparison of psychosocial adjustment in women with breast cancer (BC) and women with benign breast problems (BBP) has been hampered by a failure to control for age differences between these groups, as well as a failure to assess positive psychosocial adaptation in addition to psychological distress. Age-matched women with breast cancer ( n = 80) and benign breast problems ( n = 80) completed measures of psychological distress, positive psychosocial adaptation, and general quality of life (QOL). Breast cancer patients had completed primary treatment for breast cancer a mean of 24.6 months prior to participation (range, 6–57 months). Comparison of the BC and BBP groups indicated that the BC group reported (1) poorer physical health and functioning, (2) no differences in psychological distress, and (3) greater positive psychosocial adaptation, such as improved life outlook, enhanced interpersonal relationships, and deeper spiritual and religious satisfaction. Results support the theoretical position that cancer is a transitional event, that is, a traumatic event that alters an individual's assumptive world with the potential to produce long-lasting changes of both a positive as well as negative nature. This underscores the importance of using measures of both psychological distress and positive psychosocial adaptation when assessing psychological adjustment following transitional events such as breast cancer.

Psychosocial factors of coronary heart disease in women: A review

Although coronary heart disease is the leading cause of death in women in most industrialized countries, much less research has been carried out on this topic to date than in men. This article gives an overview of psychosocial factors of coronary heart disease in women, focussing on psychosocial risk factors for coronary heart disease in women such as socioeconomic status, employment status, chronic troubling emotions, social support and bereavement/widowhood. A second focus lies on psychosocial adjustment in women once coronary heart disease has become manifest, i.e. well-being, return to work, sexual activity and rehabilitation outcome after a myocardial infarction or coronary artery bypass grafting. Via a computerized literature research in Medline, Psychlit and Sociofile over the period 1980–1994 all studies on these topics were collected and reviewed. Comparatively more research has been undertaken on psychosocial risk factors for than on psychosocial adjustment to coronary heart disease in women. Low social class, low educational attainment, the double loads of work and family, chronic troubling emotions and lack of social support emerge as documented risk factors in women. Regarding psychosocial adjustment to coronary heart disease in women, there is a paucity of data, and studies including large samples of women and adjusting for gender are warranted. Psychosocial adjustment in women after a myocardial infarction seems to be worse than in men, whereas results on adjustment after coronary artery bypass grafting are inconclusive. Return to work rates after myocardial infarction or coronary artery bypass grafting are significantly lower in women than in men. Data on sexual activity of women after myocardial infarction or coronary artery bypass grafting are scarce, and there seems to be a complete lack of physician counseling on this topic. Studies on rehabilitation outcome report poorer programme uptake, poorer adherence and significantly higher drop-out rates for women than for men, yet those women who complete cardiac rehabilitation show the same or even greater functional improvements than men.

Psychosocial adjustment of women with mastalgia

Abstract Psychosocial adjustment of 54 women with mastalgia referred to a breast unit has been assessed using standardized interviews and questionnaires. Patients with severe mastalgia (n = 33) experienced significantly more depression, anxiety and social dysfunction than those with non-severe mastalgia (n = 21). The levels of anxiety and depression observed among patients with severe mastalgia were similar to those of a group of patients with operable breast cancer on the morning of their operation (n = 32). 29 of the patients with severe mastalgia, who were treated with the GnRH analogue, goserelin (3.6 mg given monthly for 6 courses), underwent further psychosocial assessment after treatment. Patients experiencing severe pain 10 months after starting treatment showed no improvement in their psychosocial functioning. Levels of depression and social impairment were statistically significantly improved among those patients who had pain reduction. Their levels of anxiety also improved, but remained high after treatment and were similar to those in women who were still experiencing severe pain. Both psychosocial and physical needs of patients with severe mastalgia must be addressed as part of an effective and comprehensive management approach.

Causal Attribution, Control, and Adjustment to Breast Cancer

The authors explored the extent to which causal thinking and perceptions of control were associated with the psychosocial adjustment of women with breast cancer. A causal attributions interview, questions about perceived control, and two questionnaires about adjustment were completed by 195 women. Regression analyses indicated that perceived loss of control was the most important factor in predicting overall adjustment and thinking about Why me? was the second most important factor, whereas thinking about Why me? was first and perceived loss of control was second in predicting psychological distress. The findings indicated that clinicians who work with cancer patients should be alert to possible adjustment problems in patients who express concern about Why me? that feelings of loss of control may be a valuable feature in assessment, and that education about the growing effectiveness of therapies for breast cancer seems to be an especially important strategy for enhancing adjustment to the disease.

Psychosocial adjustment in women with breast cancer

There is a plethora of studies investigating psychosocial adjustment in women with breast cancer, its correlates, clinical course, and prognosis. These studies have been conducted with varying degrees of methodologic rigor. An assessment has been made of the quality of this existing evidence to identify from the best evidence the factors which predict the adjustment status of women with breast cancer. Studies have been reviewed, using methodologic standards for the critical appraisal of studies on prognosis, developed by Sackett and colleagues in the Department of Clinical Epidemiology and Biostatistics at McMaster University (Hamilton, Ontario, Canada). Few of the studies investigating psychosocial adjustment of women with breast cancer meet all of the criteria for reviewing studies of clinical course and prognosis. This review focuses the direction and methodologic rigor required in future investigations. In particular, studies are needed that employ prospective designs and that deliberately measure or control for the extraneous prognostic variables that may affect adjustment. Future investigations need to incorporate adequate precision in measurement so that measures of the psychosocial variables are objective, reliable, and valid.

The impact of breast cancer on the family

T O DATE, primary emphasis in research on the psychosocial aspects of breast cancer has been on the individual patient's response to the illness and its medical management. 1-3 Early work by clinicians was typified by seminal case studies, 4-7 but no studies systematically documented the impact of cancer on the family. Thus, although there has been a proliferation of authoritative literature on women's psychosocial adjustment to breast cancer, comparatively little attention has focused on the family's immediate and long-term adaptation to the illness. The tradition of examining the impact of cancer or life-threatening illness on the individual continues but fails to include the broader context of family-level impact and coping; 89 despite the growing awareness of the importance of the social support network in which the diagnosed member belongs ~°-19 and despite the recognition that it is the family, and not the isolated patient, that experiences the illness~ j'2°-z3 The family is often treated as a bystander rather than an influencing, organizing, and creative agent. Only recently have clinicians turned their attention toward systematic documentation of the family's functional status during an episode of illness. 24-27 This article has three purposes: to review selected concepts that characterize the impact of breast cancer on the family; to highlight selected preliminary research results from a longitudinal study of the impact of breast cancer on the family; and to draw implications for clinical practice for nurses working with women who have breast cancer and their families.

The interpretation of women's experience: A critical appraisal of the literature on breast cancer

In the last few decades there has been a proliferation of authoritative literature on women's psychosocial adjustment to Breast Cancer and its treatment. This literature is ostensibly concerned with understanding women's experiences in order to recommend effective intervention programmes. The aim of this appraisal is to make explicit some implicit assumptions embodied in that literature, which severely inhibit comprehensive investigation of women's needs. While these assumptions remain implicit, any recommended intervention will necessarily be fragmentary, focusing on only a few features of the experience in only a proportion of the women. In order to illustrate this, the paper will focus on the literature's management of women's reactions to breast loss as treatment for the disease.