Significant Improvement In Psychological Well-being Research Articles

Attributional Style, Efficacy, and the Enhancement of Well-Being Among Housebound Older People

This study examines the effects of an intervention that involves the compilation of a book of wartime experiences on a group of housebound older people who live in the community with the support of social services. Using the theoretical framework of the Hopelessness Theory of Depression (Abramson, Metalsky, & Alloy, 1989), we examine the impact of attributional style (Abramson et al., 1989) and efficacy (Bandura, 1977; Houston, 1995) on changes in psychological well-being following the intervention. Prior to the intervention, participants completed a newly constructed Extended Attributional Style Scale for the Elderly and the General Health Questionnaire (Goldberg & Hillier, 1979). Following the intervention there was a significant improvement in psychological well-being across the sample-those with depressogenic styles and low efficacy and those with high efficacy and nondepressogenic styles reported most improvement. The findings indicate that a relatively small-scale intervention can have a significant impact on the well-being of older people living alone in the community.

Intensive rehabilitation of emotionally distressed patients after coronary by-pass grafting.

To evaluate whether the status of emotionally distressed post coronary by-pass surgery patients can be improved by a comprehensive, in-patient rehabilitation programme. Cross-sectional. Rehabilitation hospital. One hundred and fifty-two post coronary by-pass surgery patients referred to an intensive rehabilitation programme. The study group was divided into two subgroups, according to the level of emotional distress. Forty-three (30%) out of 142 patients who completed the Nottingham Health Profile were considered to be distressed. The comprehensive 4-week inpatient rehabilitation programme consisted of daily physical exercise, lectures about coronary disease and risk factors, psychological support and nutrition counselling. Physical fitness, blood lipids and quality of life questionnaires. The two-way analysis of variance showed that emotionally distressed patients achieved equally good results as those obtained by nondistressed patients in performance regarding the maximal exercise stress test, maximum rate pressure product achieved, or the level of resting heart rate. Significant improvement in psychological well-being as assessed by a seven-point rating scale was observed in both groups. Both groups of patients were also equally successful in weight reduction and lowering of total cholesterol and triglycerides. Of all the patients who were employed at admission, twice the number of patients in the distressed group were in receipt of a permanent disability pension and half the number of patients was employed, compared to the initially nondistressed group, at 1-year follow-up. Distressed patients were very successful in improving their functional status and reducing risk factors when offered an intensive rehabilitation programme but they were much less successful in returning to work. Secondly, patients who were emotionally distressed after surgery did not differ in regard to disease status or physical capacity from nondistressed patients. They did, however, experience more angina pectoris both in daily life and when exposed to a maximal exercise stress test. Finally, the presence of emotional distress was easily detected by any measure of psychological status.

Gender difference in the response of growth hormone (GH)-deficient adults to GH therapy

While individual hypopituitary patients undoubtedly benefit from growth hormone (GH) therapy, there is considerable variability in the response to treatment. Given the expense, possible lack of benefit, and potential risks associated with long-term therapy, we sought to identify characteristics potentially associated with a favorable response to GH replacement. Twelve GH-deficient adults (seven men and five women aged 35.4 ± 2.5 years, mean ± SEM) participated in a 12-month open study of GH replacement (0.125 IU/kg/wk for 4 weeks and 0.25 IU/kg/wk thereafter) designed to examine the impact of GH on body composition, lipid profile, and psychological well-being. Using bioelectrical impedance analysis (BIA), there was a reduction in body fat (BF) and an increase in lean body mass (LBM) and total body water (TBW) ( P < .05) following 12 months of GH treatment. In addition, there was a significant improvement in psychological well-being as indicated by a decrease in the Nottingham Health Profile (NHP) score ( P < .05) and a decrease in both total cholesterol ( P = .005) and low-density lipoprotein (LDL) cholesterol ( P < .03). GH therapy was associated with an increase in fasting plasma glucose ( P = .008) and hemoglobin A 1c (HbA 1c ( P = .06). When analyzed by gender, the beneficial effect of GH was greater in men versus women for the increment in insulin-like growth factor-1 ([IGF-1] 375 ± 59 v 148 ± 73 μg/L, mean ± SEM), increase in LBM (6.8 ± 2.5 v −0.06 ± 1.6 kg), reduction in BF (5.6 ± 1.6 v 1.0 ± 1.9 kg), and increase in TBW (5.0 ± 1.6 v 0.14 ± 1.29 L) ( P < .05). HbA 1c increased significantly in women ( P < .05). The beneficial effect of GH tended to be greatest in those with the most significant abnormality in baseline values ( P < .05). The duration of hypopituitarism showed an indirect correlation with the change in total cholesterol ( P < .005). Baseline IGF-1 levels correlated directly with changes in TBW ( P < .05). These data indicate that men with GH deficiency appear more responsive to GH therapy than women with respect to the increase in IGF-1 levels and improvement in body composition. In general, patients with the most significant abnormality in baseline values, the highest IGF-1 levels, and the shortest duration of hypopituitarism respond best. With long-term GH therapy, careful monitoring of glucose tolerance is indicated.

The psychological impact of hip arthroplasty.

The impact of total hip arthroplasty on psychological functioning was examined in 51 patients; 25 females and 26 males with a mean age of 65 years (range 42-81 years). Assessments of psychological well-being and distress were made with the Mental Health Inventory. Life satisfaction, self-rated health, and pain ratings were also obtained. Assessments were made prior to surgery, immediately after surgery, and at a 2 month follow-up. The operation produced significant improvements in psychological well-being (P < 0.001), psychological distress (P < 0.001), life satisfaction (P < 0.01), self-rated health (P < 0.001), and pain (P < 0.001). It is concluded that the changes in medical and functional status following hip arthroplasty documented in previous research are accompanied by substantial improvements in psychological state, and that the inclusion of psychological factors in hip arthroplasty research will provide a more comprehensive assessment of outcome.