Social Adjustment Of Patients Research Articles

Resilience and work and social adjustment in patients of end-stage renal disease undergoing hemodialysis

Introduction: End-stage renal disease (ESRD) is a typical chronic, irreversible, and life-threatening illness. Hemodialysis is one of the most common treatments for renal patients. People who face chronic renal illness suffer a devastating impact on the social and psychological state. Therefore, the purpose of this study was to assess the levels of resilience and work and social adjustment in these patients.Materials and Methods: The present study was a cross-sectional study on 60 ESRD patients undergoing hemodialysis. Patients were selected using the purposive sampling method. The data gathering tools in this study included demographic information form, the Connor-Davidson Resilience Scale and the work and social adjustment scale. The data were analyzed using descriptive statistics (percentage, mean, and standard deviation) as well as Chi-square test in SPSS version 20.Results: In 60 patients, 90% had low resilience. The significant difference was found between the resilience scores and gender, marital status, and income. In 60 patients, all 100% had their work and social adjustment significantly impaired.Conclusion: People with ESRD undergoing hemodialysis were significantly found to have low resilience. Many who had low resilience were males, in the age group of 40–60 years and the majority had co-morbidities and all the patients had significantly impaired work and social adjustment.

The effectiveness of acceptance and commitment therapy on sociooccupational compatibility and acceptance of symptoms in patients with painful Diabetic Neuropathy: A single-blind randomized clinical trial

Introduction: Neuropathic pain is a common complication of diabetic patients. In these people, the pain reduces the work and social adjustment. Aim: The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy on chronic pain acceptance and the work and social adjustment in patients with painful diabetic neuropathy. Method: This study was a quasi-experimental study in which patients were randomly divided into intervention and control groups. Participants were all patients with a diagnosis of diabetic neuropathy referred to the neurology department of Farabi Hospital in Kermanshah in 2019. Instruments included Chronic Pain Acceptance Questionnaire (CPAQ) and the Work and Social Adjustment Scale (WSAS). The results of three phases of pre-test, post-test and follow-up were evaluated. Data were analyzed by descriptive statistics, the repeated measures ANOVA, and chisquare tests using SPSS version 22. Results: The results demonstrate that in the post-test and follow-up phases, acceptance and commitment therapy could improve pain acceptance and the work and social adjustment in the intervention group as compared to controls. In the acceptance variable, the test results within the group showed that the effect of time (P=0.003, F=6.48) and the interactive effect of time and group (P=0.001, F=12.49) were significant. Also in the variables of work and social adjustment, the effect of time (P=0.046, F=3.21) and the interactive effect of time and group (P=0.028, F=3.74) were reported (p>0.001). Conclusion: Acceptance and commitment therapy can be used as a psychological intervention along with drug therapy to improve the work and social adjustment and acceptance symptoms in patients with painful diabetic neuropathy (PDN).

The effects of resilience training on self-efficacy, empowerment, and social adjustment of renal transplant patients

Context: Chronic kidney disease refers to one of the chronic diseases highly affecting the quality of life (QoL) of patients.Aim: The present study investigated the effectiveness of resilience training on self-efficacy, empowerment, and social adjustment of renal transplant patients. Setting and Design: This study was a quasi-experimental interventional pre-test-post-test research with control group conducted at Shahid Modarres Hospital in 2020.Materials and Methods: From all kidney transplant patients admitted to Shahid Modarres Hospital and Shohada Tajrish Hospital who underwent kidney transplant surgery in 1398, 30 people were selected and randomly divided into two experimental groups (15 kidney transplant patients in Shahid Modarres Hospital in Tehran) and Witnesses (15 kidney transplant patients were admitted to Shohada Tajrish Hospital in Tehran). The experimental group participated in 12 sessions of 45 minutes in the resilience training program. Both groups completed the Scherer and Maddox (1982) self-efficacy questionnaires, the Spritzer (1995) psychological empowerment questionnaire, and the Wissman and Pickel (1974) social adjustment questionnaires before and after the intervention.Statistical Analysis Used: Data were analyzed using Kolmogorov–Smirnov test, t-test, and paired t-test using SPSS software version 18. Results: Resilience training was effective on self-efficacy, social adjustment, as well as the empowerment of renal transplant patients. Conclusion: The findings showed that resilience training in renal transplant patients enhances self-efficacy, empowerment, and social adjustment, thus promoting their physical, general, and psychological health. Also, it seems that the designing andresilience training can facilitate the process of empowerment, accompanied by increasing self-efficacy and social adjustment of patients.

Seizure control and anxiety: Which factor plays a major role in social adjustment in patients with Juvenile Myoclonic Epilepsy?

PurposeThis study aimed to determine the presence of anxiety disorder and severity of anxiety symptoms in an extensive series of consecutive patients with JME and its association with epilepsy-related factors. In addition, we evaluated the impact of anxiety and clinical variables on social adjustment. MethodsWe prospectively evaluated 112 (56.2 % females, mean age 27.2 years) patients with an electroclinical diagnosis of JME and 61 (52.4 % females, mean age 29.3 years) healthy controls. Anxiety symptoms were assessed by the State and Trait Anxiety Inventory (STAI). Social functioning was addressed with Self-Report Social Adjustment Scale (SAS). The patient group was also evaluated with a psychiatric interview. ResultsPatients with JME presented more severe anxiety symptoms and worse social adjustment compared with controls. The presence of anxiety disorder and the severity of anxiety symptoms was associated with frequent seizures - generalized tonic-clonic seizures (p = 0.008) and drug-resistant epilepsy (p = 0.021). Regarding social adjustment, the severity of anxiety symptoms was associated with lower economic adjustment (p = 0.039), while the presence of anxiety disorder impacted family relationships (p 0.025). The presence of hard-to-control myoclonic seizure was associated with lower scores on work (p = 0.019), leisure activities (p = 0.008), family relationship (p = 0.022) and overall social adjustment (p = 0.038). ConclusionPatients with JME have severe anxiety symptoms and worse social adjustment. Anxiety disorder and symptoms were associated with frequent seizures and drug-resistant epilepsy. Epilepsy-related factors and anxiety impaired distinct aspects of social functioning.

Increasing outcome measure completion in adult patients with a traumatic brain injury: Ideas from the research literature and evaluation of service change

The use of Patient Reported Outcome Measures (PROMs) is increasingly important in clinical practice. Within the Department of Clinical Neuropsychology at Salford Royal Hospital they are used routinely to collect information on the overall physical, psychological and social adjustment of patients with a traumatic brain injury (TBI). In an attempt to increase PROMs completion rates, we implemented two major changes, reducing the number of PROMs completed and changing the collection method. We critically evaluated the influence that these changes have had on PROMs completion rates and discussed the potential barriers in PROMs completion rates in TBI patients, together with reflections for future improvements of the PROMs used and their administration methods.

Clinical-Dynamic Features of Affective Disorders Comorbid with Alcohol Dependence

Comorbidity of affective disorders (AD) and alcohol dependence (AlD) worsens prognosis and efficiency of therapy, exacerbates non-compliance in patients, and lowers their level of social adjustment. To study the influence of AlD on clinical-dynamic characteristics of AD, two groups of patients were examined and compared. The study group included 32 patients with AD and comorbid AlD. The comparison group included 31 AD patients without comorbid addictive pathology. The patients of compared groups did not have statistical differences (p > 0.05) according to sex, age, and AD. The Clinical Global Impression scale (CGI), Hamilton Depression Rating Scale (HDRS-17), Hamilton Anxiety Rating Scale (HARS), and Social Adaptation Self-evaluation Scale (SASS) were used. Compared to the group without comorbidity, the group of patients with comorbid AD and AlD had more frequent suicide attempts in their medical history, a high level of anxiety according to HARS, severe disorders according to CGI-S, and difficult and impaired social adaptation according to SASS; patients with recurrent depressive disorder (RDD) and bipolar disorder (BD) also experienced a larger number of affective episodes per year. AlD comorbid with AD affects clinical-dynamic indicators and levels of social adjustment in patients.

The Effect of Short-Term Solution Focused Therapy on Distress Tolerance and Social Adjustment of Patients with MS in Sari

The present study aimed to investigate the effect of short-term solution focused therapy on distress tolerance and social adjustment of patients with MS (Multiple Sclerosis) in Sari. The sample of this study consisted of all MS patients in Sari who were members of MS society of Mazandaran province including 480 patients. Accordingly, two groups of 13 subjects, each including 10 women and 3 men, were randomly assigned into experimental group and control group. Using pretest and posttest, the effect of short-term solution focused therapy on the experimental group was investigated. For data collection, Distress Tolerance Scale (DTS) and Social Adjustment Scale (SAS) were used. Data were processed using analysis of covariance and the results confirmed research hypotheses. This means that short-term solution focused therapy increased distress tolerance and social adjustment of patients with MS.

Disease Severity and Social Adjustment of Patients with Obsessive Compulsive Disorder from West Bengal

Obsessive-Compulsive disorder (OCD) is a neuropsychiatric disorder prevalent in population worldwide. In the present study we investigated OCD patients from the state of West Bengal, India. Patients were evaluated for social adjustment using Rosenzweig PF test and severity of OCD using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). It was found that patients from urban areas had poor social adjustment compared to those from semirural areas. Rural population fared well in adjustment in spite of disease.

Frontal lobe function and social adjustment in patients with schizophrenia: near-infrared spectroscopy.

The study evaluated relationships between frontal lobe function in patients with schizophrenia and both their social adjustment and medication, using 22-channel near-infrared spectroscopy (NIRS). One hundred ninety-nine stable patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision schizophrenia, whose medication had not been changed within the preceding 3 months and who were able to visit our clinics for NIRS, were the study subjects. As a comparator, 144 healthy volunteers who underwent a physical examination and the Mini-International Neuropsychiatric Interview also received NIRS. The main outcomes evaluated were frontal lobe oxyhemoglobin concentration (OxHb) measured by NIRS, current medication, social adjustment, and scores on the Brief Psychiatric Rating Scale. The OxHb in schizophrenic patients (0.878 ± 1.1801 mM mm; n = 199) was significantly lower than that in the healthy volunteers (2.085 ± 1.7480 mM mm: n = 100) (p < 0.001). NIRS-measured OxHb values reflected disease severity and degree of social adjustment in schizophrenic patients. Patients with higher OxHb values were socially better adjusted than those with lower OxHb values. Patients treated with atypical antipsychotic monotherapy showed lower treatment resistance and better social adjustment than those treated with combination therapy.

Impulsivity and seizure frequency, but not cognitive deficits, impact social adjustment in patients with juvenile myoclonic epilepsy

Despite growing evidence on the occurrence of poor psychosocial adjustment, to the moment there is no formal assessment of social adjustment (SA) using a validated instrument developed and standardized for this purpose in patients with juvenile myoclonic epilepsy (JME). We aimed to: (1) verify social adjustment in patients with JME with an objective scale and; (2) identify whether clinical variables, impulsiveness, and neuropsychological profile are associated with worse social adjustment. We prospectively evaluated 42 patients with an unequivocal diagnosis of JME and 42 controls. The inclusion criteria for patients and controls included age range from 16 to 40 years and an estimated intelligence quotient (IQ) ranging from 85 to 110. One trained neuropsychologist administered the scales and tests in a standard sequence. Social Adjustment was evaluated by The Self-Report Social Adjustment Scale (Weissman & Bothwell, 1976), a 42-item scale, measuring performance in seven major areas: work; social and leisure activities; relationship with extended family; marital role as a spouse; parental role; membership in the family unit; and economic adequacy. Impulsivity was assessed by using the Temperament and Character Inventory (Cloninger, 2000). Patients with JME and control subjects were evaluated with a comprehensive battery of neuropsychological tests evaluating executive and memory functions. We evaluated the age at onset; time from onset to seizure control with antiepileptic drugs (duration of epilepsy); seizure control; frequency of myoclonic seizures; frequency of generalized tonic-clonic GTC seizures; frequency of absence seizures; family history of epilepsy; family history of psychiatric disorders; and personal history of psychiatric disorders. The score on Global Social Adjustment was worse than controls (p = 0.001), especially on the factors: Work (p = 0.032); Extended Family (p = 0.005). Higher Novelty Seeking (NS) scores were significantly correlated with worse on Global (p = 0.002); Work (p = 0.001) and Leisure (p = 0.003). There was no correlation between cognitive performance and Social Adjustment Scale (SAS) factors. Higher seizure frequency--myoclonic (p = 0.005) and GTC (p = 0.035)--were correlated with higher scores on factor Work of SAS. Our findings suggest that patients with JME have worse social adjustment in two relevant aspects of their lives--work and familiar relationship. In this series of patients with JME, higher seizure frequency and impulsive traits, but not cognitive performance, were correlated with worse social adjustment.

Trial of CBT for impulse control behaviors affecting Parkinson patients and their caregivers

To test the effects of a novel cognitive-behavioral therapy (CBT)-based intervention delivered by a nurse therapist to patients with Parkinson disease (PD) with clinically significant impulse control behaviors (ICB). This was a randomized controlled trial comparing up to 12 sessions of a CBT-based intervention compared to a waiting list control condition with standard medical care (SMC). A total of 27 patients were randomized to the intervention and 17 to the waiting list. Patients with a Mini-Mental State Examination score of <24 were excluded. The coprimary outcomes were overall symptom severity and neuropsychiatric disturbances in the patients and carer burden and distress after 6 months. Secondary outcome measures included depression and anxiety, marital satisfaction, and work and social adjustment in patients plus general psychiatric morbidity and marital satisfaction in carers. There was a significant improvement in global symptom severity in the CBT intervention group vs controls, from a mean score consistent with moderate to one of mild illness-related symptoms (χ(2) = 16.46, p < 0.001). Neuropsychiatric disturbances also improved significantly (p = 0.03), as did levels of anxiety and depression and adjustment. Measures of carer burden and distress showed changes in the desired direction in the intervention group but did not change significantly. General psychiatric morbidity did improve significantly in the carers of patients given CBT. This CBT-based intervention is the first to show efficacy in ICB related to PD in terms of patient outcomes. The hoped-for alleviation of carer burden was not observed. The study demonstrates the feasibility and potential benefit of a psychosocial treatment approach for these disturbances at least in the short term, and encourages further larger-scale clinical trials. The study provides Class IV evidence that CBT plus SMC is more effective than SMC alone in reducing the severity of ICB in PD, based upon Clinical Global Impression assessment (χ(2) = 16.46, p < 0.001): baseline to 6-month follow-up, reduction in symptom severity CBT group, 4.0-2.5; SMC alone group, 3.7-3.5.

Clinical correlates of social adjustment in patients with obsessive-compulsive disorder

BackgroundPatients with obsessive-compulsive disorder (OCD) frequently show poor social adjustment, which has been associated with OCD severity. Little is known about the effects that age at symptom onset, specific OCD symptoms, and psychiatric comorbidities have on social adjustment. The objective of this study was to investigate the clinical correlates of social functioning in OCD patients. MethodsCross-sectional study involving 815 adults with a primary DSM-IV diagnosis of OCD participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were assessed with the Social Adjustment Scale, the Medical Outcomes Study 36-item Short-Form Health Survey, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Clinical correlates of social adjustment were assessed with generalized linear models with gamma distribution. ResultsPoor overall social functioning was associated with greater OCD severity (p = 0.02); hoarding symptoms (p = 0.004); sexual/religious obsessions (p = 0.005); current major depressive disorder (p = 0.004); current post-traumatic stress disorder (p = 0.002); and current eating disorders (p = 0.02). Poor social adjustment was also associated with impaired quality of life. ConclusionsPatients with OCD have poor social functioning in domains related to personal relationships and professional performance. Hoarding symptoms and sexual/religious obsessions seem to have the strongest negative effects on social functioning. Early age at OCD symptom onset seems to be associated with professional and academic underachievement and impairment within the family unit, whereas current psychiatric comorbidity worsen overall social functioning. In comparison with quality of life, social adjustment measures seem to provide a more comprehensive overview of the OCD-related burden.

Work and social adjustment in patients with anorexia nervosa

Objective and methodsThe Work and Social Adjustment Scale (WSAS) assesses patients' perceptions of impairment in everyday functioning and has been reported as a simple and reliable self-report measure in different psychiatric disorders. This study compared WSAS data from an anorexia nervosa (AN) patient group with that from healthy controls (HCs) and published data from other patient groups. A total of 160 female participants (AN, 77; HC, 83) completed the WSAS as well as measures of eating disorder symptom severity and brief assessments of anxiety and depression. ResultsWork and Social Adjustment Scale scores for the AN group were found to be in the severely impaired range, whereas the scores for those within the HC group indicated very little, or no impairment. Total WSAS scores in the AN group were significantly correlated with severity of clinical symptoms, and eating disorder–specific symptoms were the best predictor of social and occupational functional impairment. The greatest impairment in the AN group was reported in the realm of social leisure. ConclusionsConsistent with reports in other clinical populations, it is suggested that the WSAS could be an extremely useful and meaningful measure to assess social and occupational functioning in people with eating disorders, in addition to eating disorder–specific assessments.

Assessment of psychosocial adjustment in patients with temporal lobe epilepsy using a standard measure

Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL. We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL. Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL. These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.

Psychological aspects of glycemic control in young patients with type 1 diabetes

Aim. To elucidate the relationship between glycemic control (assessed by the level of HbA1c) and psychological status of the patients. Materials and methods. The study included 115 patients with type 1 diabetes aged 13-27 years. The following tests were used to assess the psychological statusof the patients status (emotional state, social relations, attitude toward disease): State-trait-anxiety Inventory (Spielberger C.D., Hanin Y.L), Center for EpidemiologicStudies Depression Scale (CES-D), Social ajustment scale by A.K. Osnizkiy based on Q-Sort Adjustment Scale developed by R. Dymond andC.R. Rogers (1954), Lusher colour test , Colour attitudes test, A.M. Etkind original technique, method for the assessment of attitude toward disease developedin V.M. Bekhterev Research Psychoneurologic Institute, Sankt-Peterburg. The patients were allocated to 3 groups differing in terms of 33.3% percentile ofHbA1c levels. Results. Patients with good glycemic control (mean HbA1c level 7.4%) show the lowest level of social adaptation and emotional well-being. The reason for thisphenomenon is the excessive focus of patient on the disease and narrow scope of interests, which suggest psychological dependence on diabetes. Patients withpoor glycemic control (mean HbA1c level 13.1%) also experience emotional discomfort due to increased anxiety. Despite the fact they exhibit a higher degreeof social adaptation than the patients of the above group, the main concern is the low level of communicative autonomy and the feeling of being unable to copewith the disease. Such personal characteristics also create a psychological dependence on diabetes, although of a different type than in the first group of patients.Patients with average glycemic control (mean HbA1c level 9.5%) in the sample have the most favorable psychological state in comparison with the other twogroups. Their emotional state and social adaptation are significantly better than in the other two groups. These patients tend to psychological autonomy and independenceand maintain multifaceted life motivation in terms of diabetes. They perceive the disease as a given, some life condition that allows to maintaina positive psychological state, high daily activity, not to feel overwhelmed with diabetes and at the same time pay attention to diabetes self-management evennot quite sufficient.Conclusions. Glycemic control and psychological status in young adults does not coincide with each other, although there is a close relationship among them.Attitude toward the disease is the most important mediator of this relationship. Professional psychological help and educational interventions designed to developskills of the practical management of diabetes may contribute to improvement of metabolic control, psychological well-being and social adjustment of patients.

Neurosurgery in Parkinson disease

To prospectively evaluate the impact of subthalamic nucleus (STN) stimulation on social adjustment in patients with Parkinson disease (PD). Before and 18 to 24 months after bilateral STN stimulation, the authors assessed 29 patients with PD for motor disability, cognition (Mattis dementia rating scale, frontal score), psychiatric morbidity (Mini-5.0.0, MADRS, BAS), quality of life (PDQ-39), social adjustment (Social Adjustment Scale), and psychological status using unstructured in-depth interviews. Despite marked improvement in parkinsonian motor disability, the absence of significant changes in cognitive status, and improvement of activities of daily living and quality of life by the end of the study, social adjustment did not improve. Several kinds of problems with social adjustment were observed, affecting the patients' perception of themselves and their body, marital situation, and professional life. Marital conflicts occurred in 17/24 couples. Only 9 out of 16 patients who had a professional activity before the operation went back to work after surgery. After STN stimulation, patients experienced difficulties in their relations with themselves, their spouses, their families, and their socio-professional environment. The authors suggest a multidisciplinary psychosocial preparation and follow-up to help patients and their entourage cope with the sudden changes in their existence following successful neurosurgery.

Clinical observation of acupuncture, Tuina and acupoint injection on cervicogenic headache

Objective: To investigate the clinical effect of acupuncture therapy and Tuina therapy in treating cervicogenic headache.Method: Forty inpatients, were divided into acupuncture and Tuina group (experiment group,n=20), and Tuina and acupoint injection group (controlled group,n=20) with random number table. Patients in the experimental group were firstly needled Fengchi (GB 20, major acupoint), Taiyang (Ex-HN 5), Baihui (GV 20), Shuaigu (GB 8), and Jiaji (Ex-B 2) around the affected cervical vertebrae, and applied Tuina treatment. Patients in the controlled group were treated with Tuina treatment, and then injection in Fengchi (GB 20) with 500 μg of Methycobal. Before and after treatment, all patients in both groups were evaluated with Evaluation Scale for Cervicogenic Headache.Result: After treatment, score of each item of patients in both two groups were enhanced (P<0.01), and compared with patients in the controlled group, patients in the experimental group had higher scores of headache(13.1±3.02 vs 10.8±2.36,P<0.01), daily life and working (3.3±0.66 vs 2.6±0.79,P <0.01), mental state and social adjustment (3.1±0.75,P<0.05), and total points (24.6±4.36 vs 20.3±2.53,P<0.01).Conclusion: Acupuncture combining with Tuina had better effects than acupoint with Tuina, and could effectively relieve pain, and enhance quality of life and ability of social adjustment in patients with cervicogenic headache.

Perception of quality of life and social adjustment of patients with recurrent depression

Depression is the most commonly present psychiatric entity in clinical practice, accompanied by significant impairment of both social and professional functioning. In addition, depression frequently develops as complication of other psychiatric disorders and various somatic diseases. To investigate subjective perception of quality of life and social adjustment, severity of depressive symptoms as well as level of correlation of severity of depressive symptoms and quality of life and social adjustment of patients with recurrent depression in comparison to the group of patients with diabetes and healthy subjects. The study included 45 subjects of both sexes, ranging from 18 to 60 years of age, divided in three groups of 15 subjects each. The experimental group comprised the patients diagnosed with recurrent depression in remission (DSM-IV), one control group was consisted of patients diagnosed with Type 2 Diabetes mellitus and another one comprised healthy subjects. The instruments of assessment were: The Beck Depression Inventory-BDI, The Social Adaptation Self -evaluation scale -SASS, The Psychological General Well-Being Scale-WBQ. RESULTS Significant difference of both BDI and WBQ scales was found between the experimental and the control group of healthy subjects (ANOVA, Mann Whitney; p < 0.01), as well as between two control groups (p < or = 0.02). The level of inverse correlation of mean score values of BDI and SASS scales was significant in the control group of patients with diabetes while such levels of BDI and WBQ scales (Spearman correlation coefficient, p < 0.01) were found in all groups of our study. In the group of patients with recurrent depression, significant decline of quality of life and significantly higher severity of depressive symptoms were present in comparison to the group of healthy subjects as well as significant level of inverse correlation of severity of depressive symptoms and quality of life.

Self-Efficacy and Social Adjustment of Patients With Mood Disorder

BACKGROUND. Social adjustment is often a problem for patients with both bipolar disorder and major depression, particularly after hospital discharge, often contributing to relapse. Bandura (1982) described self-efficacy as addressing the interaction of cognitive, behavioral, and social characteristics that influence health behavior. OBJECTIVE . This study examined the relationship between self-efficacy and social adjustment after hospitalization for patients with a mood disorder. STUDY DESIGN . A descriptive, correlational study with predictive components was conducted. RESULTS . Self-efficacy explained 17% of the variance in social adjustment at the time of discharge and 49% of the variance 2 months posthospitalization in patients with mood disorder. CONCLUSIONS . Self-efficacy influenced social adjustment, particularly after hospital discharge, in this sample of 45 patients treated for mood disorder. Self-efficacy is important for individual’s integration in social networks and role functioning and contributes to community adjustment for those with mood disorder.

Psychological stress as a predictor of psychological adjustment and health status in patients with rheumatoid arthritis

This study examined the extent to which perceived stress, social support, coping and clinical disease indicators predict physical, psychological and social adjustment in patients with rheumatoid arthritis (RA). Participants were 59 women recruited at an outpatient clinic at University College Hospital, Galway. A range of psychological measures was administered and disease status was assessed by physician ratings of joint involvement and blood assays of inflammatory indices. Findings from correlational and hierarchical regression analyses revealed a number of statistically significant relationships ( p < .01). Perceived stress was a better predictor than disease severity of positive and negative emotionality. Coping explained variability on positive and negative affect. Social support was linked to level of social activity. Results demonstrated that disease status predicted illness related functioning but did not predict emotional or social adjustment. Results suggest that a cognitive behavioural intervention to facilitate patient adjustment could usefully include management of stress and its appraisal, the fostering of adaptive coping strategies and utilization of social support resources. It is concluded that improving patient adjustment to rheumatoid arthritis has implications for medical care seeking.