Strong Social Support Networks Research Articles

Social support, distress, stress, anxiety, and depression as predictors of suicidal thoughts among selected university students in Bangladesh.

This study examines the association of perceived social support with suicidal thoughts among a young adult sample of university students and estimates the degree to which perceived stress, distress, anxiety, and depression may explain the association. A cross-sectional survey was conducted from June to September 2022 among 642 students, selected using the probability proportional to size procedure, at a large university in Bangladesh. We used the Multidimensional Scale of Perceived Social Support (MSPSS) to measure support. The Impact of Events Scale-Revised (IES-R), the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorders (GAD-7) scale, and the Patient Health Questionnaire (PHQ-9) were used to assess distress, stress, anxiety, and depression. The association between social support and suicidal thoughts was examined using multivariable logistic regression models. Mediation analyses were carried out using the Karlson, Holm, and Breen (KHB) method. We found that perceived social support was associated with lower odds of suicidal thoughts after controlling for other variables (adjusted odds ratio = 0.94; 95% confidence interval = 0.92-0.96). Mediation analysis showed that, after adjusting for potential confounders, the mediating effects among the total effect of perceived social support on suicidal thoughts were 56.1%, 20.8%, 22.5%, 38.8%, and 50.9% for all mental disorders together and four specific adverse mental health outcomes, i.e., perceived distress, stress, anxiety, and depression, respectively. This study demonstrates that perceived social support reduces the likelihood of suicidal thoughts among university students, and mental disorders have a partial mediating effect on the association. Suicide prevention and mental health promotion efforts among university students should consider encouraging students to build and strengthen a strong social support network.

Resilience after combat: A prospective, longitudinal study of Marines and Navy Corpsmen.

Resilience is common, yet our understanding of key biopsychosocial and environmental correlates is limited. Additionally, perceived resilience is often conflated with absence of psychiatric symptoms. Here we leverage prospective, longitudinal data from 1835 Marines and Navy Corpsmen to examine predictors of perceived resilience 3 months after a combat deployment, while controlling for pre-deployment and concurrent psychiatric symptoms. Marines and Corpsmen did not differ significantly on psychosocial or clinical factors, and 50.4% reported high perceived resilience after deployment. Across groups, the strongest predictors of post-deployment perceived resilience were pre-deployment perceived resilience, positive emotions, and social support. Concurrent depression was the only clinical symptom negatively associated with perceived resilience. Our findings suggest that perceived resilience is a multi-dimensional construct that involves both psychosocial and personality factors, including but not limited to low psychopathology. Notably, establishing strong social support networks and encouraging positive emotions may help promote resilience following deployment.

Women with ovarian cancer's information seeking and avoidance behaviors: an interview study.

Despite the importance of using information for ovarian cancer (OvCa) disease management and decision-making, some women with OvCa do not actively seek out information. The purpose of this study is to investigate factors that influence information seeking behaviors and information avoidance behaviors and information resources among women with OvCa and their caregivers. We conducted in-depth interviews with OvCa patients or caregivers of OvCa (n = 20) and employed deductive and inductive coding methodologies for analysis. Our analysis revealed 5 emerging themes associated with active information seeking behavior, 5 themes of passive information acquisition, and 4 themes of information avoidance behavior. Additionally, we identified participants' preferred information sources for OvCa management, such as health organization or government operated resources and web-based social groups. To enhance information access, strategies should be developed to motivate people with OvCa to seek rather than avoid information. The study emphasizes the significance of promoting patient-provider communication and leveraging strong social support networks for effective information acquisition. Our findings provide valuable implications for clinical practice and policymaking, emphasizing the need to improve access to information for individuals with OvCa. By addressing the identified factors influencing information seeking behaviors, healthcare professionals and policymakers can better support patients and caregivers in their information-seeking journey, ultimately enhancing disease management and decision-making outcomes.

‘The bar is different as a woman’: A thematic analysis of career advice given by female police officers

Abstract In an effort to reduce gender disparities in policing and move beyond the current legitimacy crisis faced by the profession, there has been a renewed focus on increasing the recruitment and retention of female police officers. Beyond understanding why current female officers have remained in the field, it is important to understand why some have left the profession altogether. The current study employs deductive and inductive coding of a mixed-methods self-report survey from 154 current and former female officers in the Dallas Police Department (DPD). We sought to examine the advice that current and former female police officers would give to other women who might want to enter or promote within policing. Responses highlighted challenges related to the impact on family life, navigating the male-dominated culture, maintaining one’s sense of identity and integrity, and creating strong social support networks. Implications for the DPD and other agencies are discussed.

Coming of age in a pandemic era: The interdependence of life spheres through the lens of social integration of care leavers in Quebec during the COVID‐19 pandemic

AbstractThis paper explores how the COVID‐19 pandemic affected care leavers in Quebec, a social group already facing obstacles to social integration. Semi‐structured qualitative interviews were conducted with 48 participants and analysed through Castel's zones of vulnerability model. Results suggest that youth who entered the pandemic with more vulnerabilities were more affected by it in all dimensions of their lives. However, results also suggest that the presence of a strong social support network protects even the most vulnerable ones from being overly afflicted, highlighting the importance of interventions that reinforce care leaver's social support network during times of crisis.

29 Associations Between Social Support and Cognitive Performance Among Persons with MS

Objective:Social support is an emerging protective factor against cognitive decline. However, the relationship between social support and cognitive functioning in the multiple sclerosis (MS) population is not well understood. The present study aimed to investigate the associations between different aspects of social support and cognitive performance among persons with MS.Participants and Methods:A volunteer sample of 63 persons with MS (% female = 88.9, mean age = 48.16) completed measures assessing perceived levels of social support measured by the Medical Outcomes Study Support Social Survey 5-item short form (MSSS-5), and social network (social network diversity and total size of social network) measured by the Social Network Index (SNI). Cognitive functioning was assessed by a brief virtual examiner-administered neuropsychological test battery (using a teleconferencing platform), including the Rey Auditory Verbal Learning Test, Controlled Oral Word Association Test, animal naming, and the Symbol Digit Modalities Test. Participants also completed brief, self-paced, virtual cognitive tests through the testmybrain.org platform, which consisted of digit span and the Trail-Making Test. A principal component analysis (PCA) was carried out to reduce the number of neuropsychological outcomes into fewer dimensions. Multiple linear regressions were conducted to examine the associations between social support measures and cognitive performance. Regression models were adjusted by the levels of depressive symptoms (operationalized by the Chicago Multiscale Depression Inventory or the Hospital Anxiety and Depression Scale) and premorbid functioning (measured by the Test of Premorbid Functioning).Results:A PCA reduced neuropsychological outcomes into 3 components representing cognitive domains of 1) processing speed/executive functioning, 2) verbal memory, and 3) verbal fluency / simple attention. In the unadjusted models, both perceived social support (i.e., to what extent one receives assistance from their social network) as well as total size of social network (i.e., total number of people one regularly talks to) were significant predictors of the processing speed/executive functioning component score of moderate strength, where F(1, 59) = 11.93, p = .001, β = 0.41 and F(1, 59) = 11.57, p = .001, β = 0.41, respectively. These associations were maintained after adjusting for depressive symptoms and level of premorbid functioning (F(4, 55) = 3.31, p = .003 and F(4, 55) = 3.31, p = .006, respectively). On the other hand, social network diversity (i.e., number of different types of close social relationships one has) was not a significant predictor of the processing speed/executive functioning component score (p > 0.05). None of the social support measures were significantly associated with the verbal memory and verbal fluency/simple attention component scores.Conclusions:Greater social support (specifically, perceived levels of assistance and total size of social network) is associated with better performance on processing speed/executive functioning measures among persons with MS, independent of effects from depressive symptoms and premorbid functioning. Maintaining a strong social support network may be an important factor in optimizing cognitive health in MS.

Associations between Social Support and Cognitive Performance among Persons with MS.

Social support is a protective factor against cognitive decline in the general population. However, the relationship between social support and cognitive functioning among persons with multiple sclerosis (MS) is not well understood. The present study aimed to investigate the associations between different aspects of social support and cognitive performance among persons with MS. A volunteer sample of 60 persons with MS completed the Medical Outcomes Study Support Social Survey 5-item short form (MSSS-5) and the Social Network Index (SNI). Cognitive functioning was assessed through a virtually-administered neuropsychological battery. Multiple linear regressions were conducted to examine the associations between social support measures and cognitive performance. In models adjusting for level of premorbid functioning, both perceived social support (i.e., to what extent one receives assistance from their social network; p=.002) and total size of social network (i.e., total number of people one regularly talks to; p=.002) were significant predictors of processing speed/executive functioning with moderate effect sizes. However, when we accounted for employment status in a post hoc analysis, the association between social network size and processing speed/executive functioning became statistically insignificant, while the relationship between perceived social support and processing speed/executive functioning remained significant (p = .002). Greater perceived social support is associated with better performance on processing speed/executive functioning measures among persons with MS, independent of effects from premorbid functioning and employment status. Maintaining a strong social support network may be an important factor in optimizing cognitive health in MS.

Perfiles de resiliencia asociados al engagement académico y al apoyo social en estudiantes universitarios

Adjustment of first-year students to university environments, as well as their academic success, is not exclusively related to their academic aptitude; instead, this adjustment is associated with psychological characteristics, personal and even social resources that help students cope with stressors and new circumstances. A comprehensive assessment of the students’ adjustment to university environment must transcend preoccupation on academic performance, and instead explore associations among psychological, academic, and social elements that promote adaptation during the initial years of higher education (Marenco-Escuderos et al., 2021). In this line of research, the objective of this work was to inquire how internal characteristics of students (psychological and academic) interplay with external elements in their support systems to promote adaptation in a higher education environment. Associations were explored among resilience, academic engagement, and social support as determining elements in the adjustment to the demands of the university context. The sample consisted of 371 undergraduate students (60 % female), of low socioeconomic status, enrolled in public universities in the Caribbean region of Colombia. Firstly, the resilience of university students was explored, as the ability to respond to obstacles with a positive view of the world, of others, and of one’s own abilities to cope with stressors (Saavedra-Guajardo et al., 2019). Second, the level of engagement that drives young students to concentrate their energies on academic activities was reviewed; and third, the role of peers, and friends as the close-support system that facilitates the overcoming of personal and academic difficulties was investigated (Fernández-Martínez et al., 2017). Based on a statistical cluster analysis, by the agglomerative hierarchical method, individuals were classified according to their similarities in the expression of 12 dimensions of resilience (SV-RES scale), and subsequently compared in terms of engagement (UWES-S scale), and personal support networks (UNICET software). The results showed four student profiles: (1) the largest group consisting of students with low-resilience, high engagement and strong support networks; (2) a resilient group with low levels of engagement and support networks with little intimacy; (3) a resilient group with high characteristics of autonomy, intermediate levels of engagement, and support networks with weak structure; and (4) a very resilient group, high engagement, and wide and strong social support networks. The results point out the fact that the greatest proportion of students who start college show profiles of low resilience, however, high levels of motivation for studies and social resources such as peer support networks are the conditions that mostly allow for coping with adversity in the first years of college. These results could point to cultural aspects specific to the Caribbean region, where social networks are of great importance for daily functioning (Marenco-Escuderos et al., 2021). Regarding the association among the studied variables, it is important to note that only the last profile gathered all elements of high resilience, high engagement, and strong support networks that allow for confirming the association among these constructs. The other three profiles represent cases in which the resilience traits are independent of the students' levels of engagement and the composition of their personal support networks. This study is valuable as it provides a differentiating picture of the relationship of resilience with other psychological and social constructs, and in that it allows to better understand resilience in association with other elements that mediate its interpretation. Important gender differences among the profiles are additionally discussed. https://doi.org/10.16888/interd.2023.40.2.14

Alignment of Doctors' Understanding of Treatment Burden Priorities and Chronic Heart Failure Patients' Experiences: A Nominal Group Technique Consultation.

To identify and rank areas of treatment burden in chronic heart failure (CHF), including solutions, that should be discussed during the clinical encounter from a patient, and doctors' perspective. Patients with CHF and clinicians managing heart failure were invited. Nominal group technique sessions held either face to face or online in 2021-2022, with individual identification of priorities and voting on ranking. Four patient groups (N=22) and one doctor group (N=5) were held. For patients with heart failure, in descending order of priority Doctor-patient communication, Inefficiencies of the healthcare system, Healthcare access issues, Cost implications of treatment, Psychosocial impacts on patients and their families, and Impact of treatment work were the most important treatment burdens. Priorities independently identified by the doctors aligned with the patients' but ranking differed. Patient solutions ranged from involvement of nurses or pharmacists to enhance understanding of discharge planning, through to linkage between health information systems, and maintaining strong family or social support networks. Doctors' solutions covered timing medicines with activities of daily living, patient education on the importance of compliance, medication reviews to overcome clinical inertia, and routine clinical audits. The top treatment burden priorities for CHF patients were related to interaction with clinicians and health system inefficiencies, whereas doctors were generally aware of patients' treatment burden but tended to focus on the complexity of the direct treatment work. Addressing the priority issues identified here can commence with clinicians becoming aware of the issues that matter to patients and proactively discussing feasible immediate and longer-term solutions during clinical encounters.

The Roles of Minority Stress and Thwarted Belongingness in Suicidal Ideation among Cisgender and Transgender/Nonbinary LGBTQ+ Individuals

Rates of suicidal ideation (SI), attempts, and death by suicide are consistently elevated among persons from sexual and gender minority groups relative to the general population. Experiences of minority stress and thwarted belongingness may contribute to elevated risk, and be most pernicious among persons with multiple marginalized identities. Aim The present study sought to examine the relation between gender identity (cisgender vs. transgender and nonbinary individuals [TNB]) and recent SI among a convenience sample of lesbian, gay, bisexual, questioning, and queer adults. Methods Participants (N = 807) completed an online survey with measures of minority stress, SI, and thwarted belongingness. Results We tested a mediation model in which TNB identity was indirectly associated with SI via minority stress (β = 1.94, SE = 0.30, Bootstrap 95% CI = [1.39, 2.58]). We also investigated thwarted belongingness as a moderator between minority stress and SI, and found evidence of a two-way interaction (β = 0.01, SE = 0.001, p < .001). The conditional indirect effect of gender identity on SI through minority stress was higher for individuals with higher levels of thwarted belongingness (β = 0.07, SE = 0.02, Bootstrap 95% CI = [0.04, 0.11]). Conclusion Gender identity was indirectly associated with SI through minority stress and elevations in minority stress were associated with more frequent SI. The minority stress and SI association was strongest for participants reporting higher thwarted belongingness. Building and maintaining strong social support networks may be especially important for persons with intersecting gender and sexual minority identities who face minority stress. HIGHLIGHTS TNB gender identity was indirectly associated with SI via minority stress Thwarted belongingness moderated the relation between minority stress and SI The minority stress SI relation was strongest at higher thwarted belongingness

Resilience Profiles Associated with Social Support and Engagement for Overcoming Academic Obstacles in Undergraduate Education

The main objective of this work was to explore the configuration of those elements that allow students to better adapt to university environments and persist even in the presence of difficulties. The sample consisted of 371 undergraduate students (60% female), of low socioeconomic level, enrolled in public universities in the Caribbean region of Colombia. The methodological approach was based on a cluster analysis, in which, using the hierarchical agglomerative method, groups were extracted according to their similar characteristics of resilience in 12 dimensions assessed by the SV-RES scale and subsequent analyses of variance reported how each style was associated with engagement, and with a particular constitution of personal support networks, assessed respectively with the UWES-S scale, and from a square matrix of reticular data on the social networks of each participant. The results showed four profiles of students, characterized by: a) low resilience, high engagement, and strong support networks; b) resilience with low engagement, and dispersed support networks; c) resilience with high autonomy, intermediate levels of engagement, and weak support networks; and d) resilience, high engagement, and strong social support networks.

Abstract 10078: Facilitators and Barriers to Chronic Care Among Patients with Heart Failure in Rural Haiti: A Qualitative Study

Introduction: Heart failure (HF) is a leading cause of hospitalizations in rural Haiti. However, few patients hospitalized for HF return for outpatient care. The factors that contribute to chronic HF care access are poorly understood. Objective: To investigate the facilitators and barriers to accessing care for chronic HF from the patients’ perspectives. Methods: We conducted three group interviews and one individual interview with thirteen patients with HF. We recruited patients after discharge from a non-governmental organization-supported academic hospital in rural Haiti. We employed thematic analysis using emergent coding and categorized themes using the socioecological model. Results: Facilitators of chronic care included participants’ knowledge about the importance of HF treatment and engagement with health systems to manage symptoms. Strong social support networks helped participants access clinic visits. Participants reported low cost of care at this subsidized hospital, good medication accessibility, and trust in the healthcare system. Participants expressed the strong spiritual belief that the healthcare system is an extension of God’s influence. Barriers to chronic care included participants' misconceptions about adherence to medications and the need to take HF medications with food. Lack of social support prevented clinic access, and non-healthcare costs associated with clinic visits were prohibitive. Participants expressed low satisfaction regarding the clinic experience. Another barrier to healthcare was the belief that heart disease caused by supernatural spirits is incurable. Conclusions: We identified several facilitators and barriers to chronic HF care with implications for HF management in rural Haiti. Future interventions to improve chronic HF care should address misconceptions and foster patient support systems for visit and medication adherence. Leveraging local spiritual beliefs may promote care engagement.

A Qualitative Study: The Journey to Self-Acceptance of Sexual Identity among Young, Black MSM in the South

HIV disparities among Young, Black men who have sex with men (YBMSM) persist despite concerted efforts to increase uptake of prevention tools like HIV pre-exposure prophylaxis (PrEP). We conducted in-depth interviews with 25 YBMSM (aged 18-29 years old) to understand factors contributing to PrEP access in Birmingham, Alabama. We identified that one major barrier to PrEP uptake was intersectional stigma related to their multiple identities and contributed to lack of feeling able to accept their sexual identities. Facilitators of validation and acceptance of sexual identity were strong social support networks, which participants reported consisted of, not only other gay and bisexual Black men, but also Black women, an unexplored social support group among YBMSM networks. However, participants felt that internal, perceived and experienced homophobia were exacerbated in Southern, Black communities due to perceived values surrounding masculinity, which were reinforced by religious doctrine. Looking forward, public health officials will need to add additional resources to support interventions that have meso-level impact to effectively change social norms as a critical determinant of individual-level prevention practices within this at-risk group and their social networks.

A Qualitative Assessment of Factors That Children, Parents, and Clinicians Prioritize in the Setting of Elective Anesthesia and Surgery.

Assessing the postoperative recovery of pediatric patients is challenging as there is no validated comprehensive patient-centered recovery assessment tool for this population. A qualitative investigative approach with in-depth stakeholder interviews can provide insight into the recovery process and inform the development of a comprehensive patient-centered postoperative assessment tool for children. We conducted open-ended, semistructured interviews with children 6-12 years old undergoing elective surgery (n = 35), their parents (n = 37), and clinicians (n = 23) who commonly care for this population (nurses, anesthesiologists, and surgeons). A codebook was developed and analyzed using NVivo 12 Plus. The codebook was iteratively developed using a qualitative content analysis approach with modifications made throughout to refine codes. We report the results of this thematic analysis of patient, parent, and clinician transcripts. Postoperative recovery priorities/concerns overlapped and also diverged across the 3 groups. Topics prioritized by children included mobility and self-care, as well as access to a strong social support network following surgery. The majority of children reported feeling anxious about the surgery and separating from their parents, as well as sadness about their inability to participate in activities while recovering. Although children highly valued familial support during recovery, there was variable awareness of the impact of surgery on family members and support network. In contrast, parents focused on the importance of clear and open communication among themselves and the health care team and being equipped with appropriate knowledge and resources on discharge. The immediate repercussions of the child's surgery, such as pain, confusion, and nausea, appeared to be a primary focus of both parents and clinicians when describing recovery. Clinicians had a comprehensive awareness of the possible psychological impacts of surgery in children, while parents reported varying degrees of awareness or concern regarding longer-term or more latent impacts of surgery and anesthesia (eg, anxiety and depression). Prior experience with pediatric surgery emerged as a distinguishing characteristic for parents and clinicians as parents without prior experience expressed less understanding of or comfort with managing a child's recovery following surgery. A patient-centered qualitative investigative approach yielded insights regarding the importance of various aspects of recovery in pediatric patients, their parents, and members of the health care team. Specifically, this investigation highlighted the importance of clear communication providing anticipatory guidance for families presenting for elective surgery in an effort to optimize patient recovery. This information will be used in the development of a patient-centered recovery assessment tool.

Perception of family sense of coherence during parental transition: A qualitative study.

This study described the perspectives and interplay of factors affecting the family sense of coherence of Chinese couples during the perinatal period. We adopted a grounded theory approach and conducted semi-structured interviews with 36 Chinese couples during pregnancy and at 2-3 months postpartum. Four major themes emerged involving meaningfulness, comprehensibility, and manageability of new parenthood and factors affecting the family sense of coherence. The strong sense of family unity and harmony embedded in the Confucian philosophy and the collective coping, in particular the strong social support network, seemed to contribute to couple's experience of new parenthood as meaningful, comprehensible, and manageable.

The role of stigma in the acceptance and disclosure of HIV among recently diagnosed men who have sex with men in Australia: A qualitative study.

BackgroundOur primary study aimed to explore the experiences of men who have sex with men (MSM) recently diagnosed with HIV and their partner notification practices. Themes relating to acceptance, and disclosure of, their HIV status strongly emerged during analysis in our larger study and are reported separately here.MethodFifteen MSM participated in semi-structured interviews by phone or face to face about their experience of a recent HIV diagnosis. In this paper we report on how they received and accepted the diagnosis, who they disclosed their diagnosis to and what is needed to improve support for MSM recently diagnosed with HIV.ResultsMSM’s reactions to their HIV diagnosis ranged from shock, devastation and anger to a calm acceptance and feeling HIV would not have a significant impact on their lives. MSM who reported strong social support networks, or knew others with HIV, seemed better able to cope with and accept their diagnosis than those with fewer support networks. Due to prevailing stigma around HIV, most MSM were very selective about who they disclosed their status to, often only telling partners perceived to be at risk but no, or only few, close friends. Regardless of how well men accepted their diagnosis, most did not disclose their status to family members for fear of rejection or causing distress due to ideologies based on outdated information about HIV.ConclusionThe prevailing stigma around HIV can have a significant impact on MSM’s acceptance of, and willingness to disclose their HIV serostatus to others, and consequently the levels of professional and social support they receive. HIV-related stigma needs to be addressed through community campaigns which better educate the wider population about the current state of HIV prognosis and treatment.

Parents’ experiences with pediatric chronic pain

ABSTRACT Introduction Pediatric chronic pain affects 15%–39% of children. Chronic pain can have significant negative effects on a child’s physical functioning, psychological and cognitive functioning, quality of life, and social functioning. Parents of children with chronic pain have reported being affected by their child’s condition. There have been few studies exploring the experiences of parents of children with chronic pain through a qualitative descriptive lens. Methods Thirteen parents from a pediatric chronic pain clinic participated in semistructured interviews. Concurrent data collection and analysis occurred to allow for follow-up of ideas that emerged during analysis. Three phases of analysis occurred: coding, categorizing, and developing themes. Results Three themes were developed: (1) Parents’ emotional journey; (2) chronic pain affects the entire family; and (3) social support is critical. Parents described emotions caused by the arduous process of obtaining a chronic pain diagnosis, followed by difficulties finding strategies to help their child manage the pain. Family life was affected because special accommodations often had to be made. Families were affected financially, incurring costs due to time off of work or additional therapies. Finally, parents stressed the importance of a strong social support network to provide assistance and flexibility for the changing needs of their child. Discussion This research identified a better understanding of the impact of pediatric chronic pain on parents. These findings can be used to provide and promote more effective treatments and education to improve the psychological, physical, and social well-being of children with pediatric chronic pain and their families.

Coping strategies among colorectal cancer patients undergoing surgery and the role of the surgeon in mitigating distress: A qualitative study

BackgroundDistress is common among cancer patients and leads to worse postoperative outcomes. Surgeons are often the first physicians to have in-depth conversations with patients about a new colorectal cancer diagnosis; therefore, it is important that these surgeons understand how patients cope with the distress of a diagnosis and how they can help patients manage this distress. MethodsPatients with colorectal cancer were recruited from an outpatient surgery clinic. Purposive sampling was used to recruit patients if they were either planning to undergo surgery or had undergone surgery within six months. In-depth, open-ended, individual qualitative interviews were performed. Grounded theory was used to develop themes regarding patients’ coping strategies and beliefs regarding the role of the surgeon in helping them cope. ResultsPatients described their own internal coping strategies using problem-focused, emotion-focused, and meaning-focused techniques. Patients also reported the importance of their social support network for coping. Patients believed surgeons and their teams should help patients manage the emotional components of their cancer diagnosis and surgical experience, especially if patients were experiencing high levels of distress or had inadequate coping skills. They did not believe surgeons themselves should be primarily responsible for helping them cope. ConclusionIn order for surgeons to guide diagnosis and initial management of distress in colorectal cancer patients undergoing surgery, they should screen patients for distress, identify and strengthen patients’ own coping strategies, facilitate a strong social support network, and provide patients with the option to obtain further support from the surgeon's office.

The Role of Perceived Stress in Families of Patients with Hemophilia in Prediction of Cognitive Failures and Mental Health of Patients with Hemophilia

Background: Haemophilia (hemophilia) is a chronic and inherited genetic disorder that can cause physical and mental problems, as well as harm the individual and social life of families. The present paper aimed to survey the role of perceived stress in families of patients with hemophilia and its role in the prediction of cognitive failures and mental health in patients with hemophilia. Methods: The present paper was a descriptive - correlational study. The population of the study comprised 370 patients with hemophilia and one of their companions in 2017. Using convenience sampling, 188 patients were chosen by the use of Morgan’s formula. Data were gathered using cognitive failures, mental health, and perceived stress questionnaires. The data were analyzed in SPSS - 16 using Pearson correlation and Stepwise Regression. Results: The results showed a significant positive correlation between cognitive failure of patients with hemophilia and negative perception of stress in families of patients with hemophilia (r = 0.195, P = 0.05). There was also a significant negative correlation between the mental health of patients with hemophilia and negative perception of stress in the families (r = 1.060, P < 0.05). Regarding the results of the regression analysis, negative perception of stress predicted 3.8% of changes in cognitive failure and 2.6% of changes in the mental health of patients with hemophilia. Conclusions: The findings showed that negative perception of stress in patients with hemophilia and their families could predict cognitive failure and mental health of these patients. Therefore, it is necessary to provide more access to strong social support networks and provide parents and patients with essential information about hemophilia, in addition to current hemophilia treatments.

Assessing the relationships among spiritual social support, stress, and anxiety: Does extraversion also play a role in the coping process?

Research indicates that people with strong social support networks tend to cope more effectively with stressful life events. This study aims to contribute to this literature in three ways. First, we assess spiritual social support that was received in religious institutions. Spiritual support is assistance that is provided with the explicit purpose of increasing the religious beliefs and behaviors of the recipient. Second, an effort was made to see if potential stress-moderating effects of spiritual support are more likely to arise among extraverts than among introverts. Third the data come from a recent nationwide survey (N = 1657). Statistical tests were performed to see if there is a three-way interaction between stress, spiritual support, and extraversion on anxiety. The findings indicate that strong spiritual support moderates the relationship between stress and anxiety, but only among highly extraverted study participants. In contrast, spiritual support tends to exacerbate the relationship between stress and anxiety among study participants with very low extraversion scores (i.e., introverts). The theoretical implications of these findings are discussed.