Relocation Stress Research Articles

Development and psychometric evaluation of the Relocation Stress Syndrome Scale-Short Form for patients transferred from adult intensive care units to general wards

ObjectiveThis study aimed to develop the Relocation Stress Syndrome Scale-Short Form as an assessment tool for relocation stress experienced by intensive care unit patients after transfer to general wards. MethodsThis study included 535 intensive care unit patients at two tertiary care hospitals in South Korea from May to December 2018. Data were collected through face-to-face interview, using a structured questionnaire. Study 1 was conducted to estimate the factorial structure, and reliability of the scale. Study 2 was conducted to confirm the factorial structure of the scale. Main outcomesStudy 1 found that the new instrument had a good reliability (α = 0.92) and validity. In study 2, confirmatory factor analysis supported a three-factor structure and the scale continued to demonstrate good psychometric properties. The criterion validity showed that a low level of relocation stress syndrome was associated with higher satisfaction with the transfer process (r = −0.58, p < .001) and good general health status (r = −0.51, p < .001). ConclusionThe 10-item Relocation Stress Syndrome Scale was developed with appropriate validity and reliability. This scale can be used to assess relocation stress of patients in transition periods. This new scale requires cross-cultural validation.

REASONS FOR RELOCATING TO ASSISTED LIVING: THE PUSH, THE PULL, AND DECISIONAL CONTROL

Using the push-pull framework, this study describes reasons for relocation and self-reported decisional control in the move to assisted living (AL). A sample of 202 residents of 21 ALs responded to a semi-structured questionnaire regarding their relocation. Participants most commonly relocated from a private local residence (n = 80, 40%), hospital/rehab facility (n = 27, 13%), or private long-distance residence (n = 24, 12%). The most frequently reported pull reasons to relocate to an AL were: “security and safety” (n = 46), “closer to family or friends” (n = 43), and “appearance of the facility” (n = 40). The most frequently reported push reasons to relocate from a previous residence were: “health problems” (n = 94), “others planned the move” (n = 87), and “fear of an accident” (n = 53). On average, participants who moved from other ALs reported the most decisional control in the move (M = 3.94, SD = 1.47), while participants from hospitals/rehab facilities reported the lowest control (M = 2.48, SD = 1.42). On average, participants who relocated from other ALs reported the most pull factors (M = 2.67, SD = 1.15), while participants from independent living communities reported the most push factors (M = 2.53, SD = 1.46). Results suggest that current residents commonly cite safety as both a push and pull reason for relocating to their AL. In addition, reasons for relocation and decisional control varied based on previous residence, which may be useful for identifying AL residents at risk for relocation stress.

Correlation analysis between relocation stress, family function and coping strategy in parents of children transferred from Intensive Care Unit

Objective To investigate and analyze the relationship between relocation stress, family function and strategy in parents of children transferred from Intensive Care Unit (ICU) . Methods Using the method of cross-sectional study, the parents of children transferred from ICU to general ward in Children's Hospital Affiliated to Zhengzhou University from October 2018 to March 2019 were selected as the subjects of study by convenience sampling. General Information Questionnaire, Family Relocation Stress Scale (FRSS) , Feetham Family Functioning Survey (FFFS) , and the Coping Health Inventory for Parents (CHIP) were used to evaluate the relocation stress level and analyze the relationship between scores of FRSS, FFFS, and CHIP. A total of 200 questionnaires were distributed and 179 valid ones were retrieved, yielding an effective recovery rate of 89.5%. Results The total score of FRSS of the 179 ICU-transferred children's parents was (34.52±8.46) , which was in a high level of stress; the total average score of FFFS was (1.27±1.14) ; the total score of coping style use was (144.57±13.57) in CHIP, and the total score of coping style effect was (78.20±14.83) ; correlation analysis showed that each dimension and total score of FFFS was negatively correlated with the level of relocation stress of parents (P<0.05) , and positively correlated with the frequency and role of styles (P<0.05) . Conclusions The relocation stress of ICU-transferred children's parents is serious. Family function and style are closely related to the level of relocation stress. Medical staff should pay attention to the adaptation of families in the process of transfer, encourage parents to adopt more positive ways to cope with diseases and improve the overall health of children and families. Key words: Intensive Care Unit Ward; Parent; Transfer; Relocation stress; Family function; Coping method

The impact of relocation stress on cognitively impaired and cognitively unimpaired long-term care residents

Objectives: The current aims were to explore the effects of relocation stress on depression and anxiety in long-term care residents and to investigate the moderating effect of cognitive status.Methods: The study used existing data from nursing home and congregate apartment residents. Self-reported measures of relocation stress, cognitive status, depression, and anxiety were examined. Exploratory analyses examined group differences in depression and anxiety within the full sample (n = 568) and the sample of first-year residents (n = 347). Main analyses were conducted in a subsample of 107 first-year residents who completed the measure of relocation stress.Results: Residents who had moved in the past year reported more anxiety but not depression than longer-term residents. Relocation stress significantly predicted depression but not anxiety in the subsample of first-year residents. There was no significant effect of cognitive status or the interaction of cognitive status and relocation stress on depression and anxiety.Conclusion: Findings suggest that cognitively impaired older adults are no more vulnerable to the negative effects of relocation stress than cognitively unimpaired older adults. Relocation stress should be regarded as a risk factor for depression in long-term care residents, regardless of cognitive status, in the first year after relocation.

The influence of social comparison orientation and family function on relocation stress in families of patients transferred from ICU

Objective To explore the relocation stress in families of patients transferred from ICU, and the influence of social comparison orientation and family function on it. Methods There were 168 participants recruited from Critical Medical Department of the First Affiliated Hospital of Xi′an Jiaotong University by convenience sampling method between June 2017 and February 2018. The ICU patients′ Family Relocation Stress Scale, Chinese version of the Iowa-Netherland Social Comparison Orientation Measure and Family Adaptation and Cohesion Evaluation Scale Ⅱ were used. Results The score of relocation stress and social comparison orientation were 58.47±7.66 and 37.83±9.11. The score of family real cohesion was 65.85±7.83, which was higher than norms (t=-2.067, P<0.05). The score of dissatisfaction of adaptation was 9.22±4.41, which was higher than norms (t=-3.093, P<0.05). The results of regression analysis showed that the time of patient staying in ICU, education level, religion, social comparison orientation, family real cohesion and dissatisfaction of adaptation could influence relocation stress. Conclusion Health professionals should pay attention to the relocation stress in families, provide emotional support and effective information support, guide family members to correctly understand the patients′ condition and prognosis, respect their religious beliefs, give full play to their family functions, help them adapt to the role changes quickly and reduce the level of relocation stress. Key words: Families of patients transferred from ICU; Relocation stress; Social comparison orientation; Family cohesion; Family adaptation

The effect of the intervention program for relocation on relocation stress in family members of cancer patients transferred from ICU

The effect of the intervention program for relocation on relocation stress in family members of cancer patients transferred from ICU

‘It was Hard but it is Satisfying’: The Lived Experience of Older Adults Moving to a Residential Home (Griya Werdha) in Surabaya

Relocation stress could occur in relocated older adults. The signs and symptoms often manifest as non-specific complaints. This study aimed to elicit the lived experience of relocated older adults in a residential home in Surabaya. Individual interviews were conducted following consent being given, in addition to MMSE, GDS and Family APGAR score tests. Seven residents aged between 60 to 80 years old voluntarily participated in this study. A phenomenological approach was used to develop the narrative findings following verbatim transcription and the work by Colaizzi (1976). Five themes emerged from the study: moving was a hard decision, feeling lonely in the first months, trying to accept changes and the feeling of being health-supported. These themes reflected that moving to a residential home was hard despite the voluntary decision. Eventually, they adapt by virtue of support from the other residents, their visiting families and the health staff. Their final stories reflected satisfaction focused on their well-maintained daily and health needs. Keywords: Relocation stress, older adults, residential home, experience

The Benefits of Continuous Leisure Participation in Relocation Adjustment Among Residents of Long-Term Care Facilities.

The rising population of older adults is transforming Taiwan society. Although many long-term care facilities now operate for older adults, the transition from the home environment to long-term facilities may cause multiple issues, including relocation stress syndrome, for new residents. Autonomy is a critical element of the human experience. Leisure, as an expression of autonomy, has been shown to enhance self-image and promote feelings of competence and mastery. The aim of this study was to assess the relationship between participation in leisure activities and adjustment to residential care using the continuity theory. One hundred sixty-three qualified individuals from 11 long-term care institutions were recruited and completed the questionnaire. The sampling criteria for the study were age (55+ years), appropriate cognitive skills, and residency (less than 5 years). Interviews conducted by trained interviewers were used to collect data. Measured outcomes included leisure participation; physical, psychological, and social adjustments; and background information. Cluster analysis, descriptive analysis, multivariate analysis of variance, and least significant difference test were used in analysis. Type of admission (voluntary/mandated) and type of leisure participation significantly affected the level of relocation adjustment success. Four leisure behavior categories were identified, including reduced participation, expanded participation, active participation, and continuing participation. The participants in the active and continuing participation categories had significantly higher psychological adjustment than their peers in the reduced participation category. Moreover, the continuing participation category had a significantly better level of social adjustment than their expanded participation category peers. Continuous and active participation categories had a beneficial outcome in relocation adjustment. The findings support that, in general, residents of long-term care facilities who participate continuously in leisure activities adjust better psychologically and socially to their new life in these facilities than individuals in the other participation categories. As continuity of participation in leisure activities is important for successful aging, institutions should facilitate the continuing leisure behavior of new residents.

Attachment and relocation stress in families of patients transferred from ICU: mediating effects of experiential avoidance

Objective To explore the relationship between attachment, experiential avoidance and relocation stress in families of patients transferred from the Intensive Care Unit (ICU) . Methods Totally 272 families of patients transferred from the ICU of the First Affiliated Hospital of Xi'an Jiaotong University were selected by convenient sampling between May and September 2017. Their attachment, relocation stress and experiential avoidance were investigated with the Experiences in Close Relationships Questionnaire-Revised, Relocation Stress Scale for the Families of Patients Transferred From ICU and Acceptance and Action Questionnaire-2nd Edition. Amos 17.0 was used to test the mediating effects. Results Totally 272 questionnaires were distributed, and 256 valid questionnaires were collected, with a valid collection rate of 94.1%. The total relocation stress score was (59.84±7.53) ; the attachment anxiety score was (3.51±0.92) ; the attachment avoidance score was (3.12±0.87) ; and the experiential avoidance score was (16.61±6.24) . There was a correlation between relocation stress, attachment avoidance and experiential avoidance (P<0.05) . Experiential avoidance had mediating effect between attachment avoidance and relocation stress, and the mediating accounted for 41.4% of the total effect. Conclusions Medical workers shall pay attention to the psychological health of the families of patients transferred from ICU, encourage them to pour out their real feelings, help them take positive countermeasures, improve their physical and mental health, and provide sound social support for the patients. Key words: Intensive Care Units; Families; Relocation stress; Attachment; Experiential avoidance

Feasibility of Implementation of a Parenting Intervention with Karen Refugees Resettled from Burma.

Parents and children exposed to war and relocation have high rates of negative relational and mental health outcomes. This study tested the feasibility of implementing an adapted evidence-based parenting intervention for contexts of trauma and relocation stress. Eleven Karen refugee caregivers from Burma participated in the intervention. Participants and a focal child completed ethnographic interviews as well as structured assessments at baseline and follow-up. Caregivers reported changes in their teaching, directions, emotional regulation, discipline, and child compliance. Children reported changes in these areas and in positive parent involvement. Caregivers reported higher mental health distress immediately after the intervention, potentially due to increased awareness. Researchers made personalized referrals for counseling services as needed. Children reported a decrease in mental health symptoms.

Development of family relocation stress scale during patient transferred from intensive care units

Objective To develop an instrument for measuring family relocation stress scale during patient transferred from ICU. And to provide evidence for ICU health care personnel to assess and deal with the family member′s relocation stress. Methods A draft scale was developed based on the result of related scale abroad, literature review and semi-structured interviews. Delphi method and Classical test theory were used in item selection. Results The degree of experts′ authority in two rounds′ consultation were 0.83. The Kendall′s coordination coefficients of importance were 0.36, 0.36 (P <0.05) in dimension and 0.35, 0.37 (P < 0.05) in item. Five items were deleted by the statistical analysis with pilot investigation. 6 dimensions (transfer anxiety, environmental changes, disease severity, nursing model changes, the safety of transfer, self-efficacy of care ability) and 20 items consisted the scale. The Cronbach α coefficient was 0.882. Exploratory factor analysis extracted 6 items, accumulated variance contribution rate was 72.226%. Confirmative factor analysis showed χ2/df=1.677, comparative fit index=0.936, Tucker-Lewis index=0.921, root mean square error of approximation=0.061. Conclusions The scale is based on abundant theoretical evidence and reasonable design, with satisfactory reliability and validity. It can be used as the evaluation tool for family relocation stress during patient transferred from ICU. Key words: Intensive care unit; Patients′ families; Transfer; Relocation stress; Assessment scale

A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress management and make meaningful contribution to the relief of family relocation stress, promote patient recovery and enhance the well-being of patients and family caregivers.

Clinical validity of a relocation stress scale for the families of patients transferred from intensive care units.

This study was conducted to develop a family relocation stress scale by modifying the Son's Relocation Stress Syndrome Scale, to examine its clinical validity and reliability and to confirm its suitability for measuring family relocation stress. The transfer of ICU patients to general wards is a significant anxiety-producing event for family members. However, no relocation stress scale has been developed specifically for families. A nonexperimental, correlation design was adopted. The study subjects were 95 family members of 95 ICU patients at a university hospital located in Incheon, South Korea. Face and construct validities of the devised family relocation stress scale were examined. Construct validity was examined using factor analysis and by using a nomological validity test. Reliability was also examined. Face and content validity of the scale were verified by confirming that its items adequately measured family relocation stress. Factor analysis yielded four components, and the total variance explained by these four components was 63·0%, which is acceptable. Nomological validity was well supported by significant relationships between relocation stress and degree of preparation for relocation, patient self-care ability, family burden and satisfaction with the relocation process. The devised scale was also found to have good reliability. The family relocation stress scale devised in this study was found to have good validity and reliability, and thus, is believed to offer a means of assessing family relocation stress. The findings of this study provide a reliable and valid assessment tool when nurses prepare families for patient transfer from an ICU to a ward setting, and may also provide useful information to those developing an intervention programme for family relocation stress management.

Exploring relocation stress and diabetes control in the elderly residents of long-term care facilities

Stress and glycemic control have a significant and positive relationship. However, elderly diabetic patients who are relocated involuntarily to an institution often exhibit poor control of blood sugar. Few studies have addressed the relationship between relocation stress and diabetes control. This study explores the relationship between relocation stress and glycemic control in seniors with diabetes in nursing homes. This study used a cross-sectional descriptive correlation design with a convenience sampling method to recruit 88 elderly diabetes patients who had relocated to a nursing home within the past 1 year. The structural questionnaires used in this study adopted a personal and disease characteristics datasheet and the modified Chinese-version Relocation Appraisal Scale (RAS). SPSS (Window 18.0 version) was used for statistical analyses. Those participants with diabetes who relocated involuntary, had low functional independence, lived with their family prior to admission, had poor health, or were diagnosed with depression faced a significantly higher risk of poor diabetes control. The significant predictors for diabetes control were: low functional independence and relocation stress, which accounted for 45.7% of the total variance for diabetes control. The result of this study may be referenced to help reduce relocation stress and help improve glycemic control in recently institutionalized seniors with diabetes.

Effectiveness of Critical Care Discharge Information in Supporting Early Recovery From Critical Illness

Providing patients with information can alleviate or reduce relocation stress, but how best to provide information to patients being discharged from critical care units is unclear. This narrative critical review describes (1) the current evidence base on the use of discharge information for adult critical care patients and (2) the extent of involvement of service users in the design and evaluation of such information. Seven publications reported data from 121 patients, 252 relatives, and 33 nurses. Overall evidence was of low quality but use of individualized information was associated with beneficial physical effects for patients and increased knowledge and satisfaction for their relatives. Findings highlight the significant gaps in our knowledge and understanding. The consequences of such findings for the future development of information that meets service users' needs are discussed. Results should inform the design of future studies on this topic.

Parameters of haematology, clinical chemistry and lipid metabolism in the common marmoset and alterations under stress conditions

Common marmosets are suitable non-human primate models for many human diseases. Standard values for blood parameters are required to evaluate physiological and pathological situations. Two studies were conducted: study I to determine standard values and study II to examine these under changed housing conditions. In study I, all parameters for clinical chemistry were similar in range for both genders with these specifics: male marmosets had significantly higher total and LDL cholesterol levels than females, whereas the mean corpuscular volume and the mean corpuscular haemoglobin were significantly lower than in females. In study II, glucose, lymphocytes and salivary cortisol were significantly lower, and faecal cortisol was increased during the change of housing conditions. In conclusion, standard values for haematology and clinical chemistry for the common marmoset were determined. Further on, parameters that are influenced by relocation stress and its importance for experimental results are described.

Mapping of b-values, earthquake relocation, and Coulomb stress changes during 1992–2007 in the Murindó seismic zone, Colombia

Seismicity in the Murindo seismic zone, Colombia (6° to 8° and − 75.5° to − 78.0°) during 1992–2007 included the occurrence of the MW 6.6 foreshock on October 17, and MW 7.1 mainshock on October 18, 1992, and aftershocks, which caused severe damage throughout the region. We modeled this seismic sequence by means of Coulomb stress changes imparted by slip along two semi-vertical fault planes with left-lateral motion and subdivided slip. Seismicity thereafter (1993–2007) was characterized by earthquakes magnitude in the range 0.7−6.1 for which a magnitude of completeness MC = 2.7 was determined. b-values are relatively high to the south of the study region and relatively low to the north and northwest. The relocation of epicenters indicates that recent seismicity may be occurring on a fault that is yet to be mapped under the Atrato river valley. We conclude that the 1992 seismic sequence was a case of a major earthquake facilitated by the stress changes imparted during a strong rupture the previous day and that the aftershocks and background seismicity in the region can be explained by static Coulomb stress changes up to 50.1 bar. Our results have implications for hazard in Colombia and serve as basis to foster future investigations.

Developing user centred critical care discharge information to support early critical illness rehabilitation using the Medical Research Council's complex interventions framework

This paper reports on an intervention designed during an ongoing two phase project aimed at improving early critical illness rehabilitation. It focuses specifically on the justification for a newly developed critical care discharge information pack: 'User Centred Critical Care Discharge Information Pack' (UCCDIP). The intervention is described in detail and the chosen research methods are discussed. Discharge from critical care to a ward is a difficult time for patients and relatives. Research suggests that effective information has the potential to reduce relocation stress and optimise recovery. Using the Medical Research Council framework for the development and evaluation of complex interventions, a phase I focus group study and collaboration with service users/carers informed the development of a new critical care discharge information pack, currently being evaluated in a phase II Randomised Controlled Trial. UCCDIP acknowledges the patients' need to understand what they have been through and the progress they have made. It provides for the different information needs of patients and relatives, recognising their physical and psychological vulnerability. Through its use of reflection and participation, UCCDIP has the potential to optimise support of adult patients and their families during early critical illness rehabilitation.

Pre-migration adaptation of highly skilled self-initiated foreign employees: the case of an EU agency

This study analyzes pre-migration adaptation among highly skilled self-initiated foreign employees (SFEs) of the EU Chemicals Agency in Finland (N = 95). Organizational, expatriate and acculturation perspectives were integrated to develop a model of factors predicting SFEs' psychological, socio-psychological and work adaptation in the pre-migration stage. Previous international work experience, perceived organizational prestige, satisfaction with the time, information and assistance to prepare for the relocation and quality of contact with Finns during recruitment positively predicted SFEs' pre-migration adaptation. European identification, self-esteem and relocation stress acted as mediators. The study emphasized the importance of a multidimensional approach to SFE adaptation prior to relocation.

Preparedness, Ideology, and Subsequent Distress: Examining a Case of Forced Relocation

The current study investigated the relationships between levels and modes of preparedness for relocation, ideology, and subsequent posttraumatic stress disorder (PTSD). A sample of 269 relocated residents from Gush Katif completed questionnaires examining their previous life stressors, preparation prior to their relocation, level of ideology, and current level of PTSD. Contrary to expectations, the findings showed a negative correlation between instrumental preparedness and PTSD, which suppressed the positive association between ideology and PTSD. These findings suggest that some modes of preparedness may lead to better psychological readjustment, while others may be irrelevant or even harmful when they contradict one's ideology. Further research on the unique and combined role of preparedness and ideology in coping with stressful events is needed.