Browsing School, Graduate by Subject "Well-being"
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African American youth and their fathers: Exploring the relationship between perceived nurturance and psychological well-beingMany researchers suggest that mothers and fathers influence children's outcomes through nurturant personal and social characteristics (Lamb & Tamis-LeMonda, 2004), and that father nurturance is universally associated with positive child outcomes (Rohner, 1986; Rohner & Khaleque, 2005). However, empirical evidence related to father nurturance is sparse (Rohner & Veneziano, 2001), particularly among African Americans. Given recent agreement regarding the salience of cultural variation within fatherhood (Lamb & Tamis-LeMonda, 2004), and the limited empirical literature base, the first objective of this dissertation is to identify factors that are predictive of father nurturance. The second objective is to investigate whether youths' perceptions of father nurturance during childhood and adolescence (birth to 18) predict their current level of psychological well-being. Data were collected from 264, 18-25 year old African American college students. Participants completed a self-administered survey consisting of demographic questions and four scales: The Parental Acceptance/Rejection Questionnaire (Rohner & Khaleque, 2005), the Nurturant Fathering Scale (Finley & Schwartz, 2004), The Personality Assessment Questionnaire (Rohner & Khaleque, 2005), and the Sources of Social Support Scale (Friedman, Koeske, Silvestre, Korr, & Sites, 2006). Overall, those who interacted more frequently and over longer periods of time (from birth to 18) with their identified father have higher perceptions of father nurturance. The high percentage of variance accounted for lends partial support to the notion that father nurturance and father involvement are separate, yet interrelated constructs (Schwartz & Finley, 2005b; Williams & Finley, 1997). Those whose mothers and identified fathers were married or cohabitating have lower levels of psychological well-being, and those who perceived greater levels of mother nurturance have higher levels of psychological well-being. The inverse relationship between youths' parents' marital status and youth psychological well-being may speak to the interplay between youths' mothers and fathers and raises a number of questions regarding the specific nature of the marital and cohabitating relationships. Finally, the lack of significance of father nurturance raises questions about potential cultural variations in the definition of the concept itself and the potential need to incorporate additional roles of the father into this definition.
Availability of social support resources and survival strategies among African American grandmother caregiversWhile the literature has explored the positive relationship between social supports, coping and mental health well-being, there has been minimal exploration of this relationship among African American grandmother caregivers. The purpose of this qualitative field study was to describe available resources (social supports and coping) used by grandmother caregivers and to explore how their use of social supports and coping related to caregiver well being. This study was guided by a Womanist Perspective to explore social supports, coping and caregiver well-being. The aim was not to compare African American grandmother caregivers to the dominant group but to gain an understanding of African American grandmother caregivers from their own cultural framework, which encompassed issues related to racism, sexism and classism. Data were collected through 14 semi-structured interviews gathered from seven participants. The constant comparative method was employed to build working hypotheses that became the 'grounded theory.' Findings revealed that grandmother caregivers experienced significant losses in their informal social support network, which were experienced as a drain or depletion on their informal social support resources. These losses represented social conditions (e.g. drug abuse, incarceration and poverty) which affected the type and degree of support remaining in their informal social support networks. Despite the depletion in resources, grandmother caregivers had at least one person they could rely upon in times of need. Grandmother caregivers' coping strategies were primarily influenced by the availability of supportive resources remaining in their informal and formal social support structures. In the context of their social support structures, grandmother caregivers employed the necessary adaptive strategies to meet their caregiving role expectations. Implications of these findings are significant for direct practice (micro and macro), research and social policy. Direct micro practice suggests that a strengths-based, case-management approach, which includes culturally competent clinical tools and is built upon an interdisciplinary and empowerment approach, is essential to providing services to African American grandmother caregivers. On the macro level, social workers need to politically advocate with regards to the impact of social and economic conditions on African Americans' traditions of relying upon their extended kin.
The relationship between stress appraisal, coping behavior, and subjective well-being in Chinese elderly with a diagnosis of congestive heart failureThe purpose of this study was to examine the relationships between stress appraisal, coping behavior, and subjective well-being. The theoretical framework for the investigation was based on a process theory of stress and coping developed by Lazarus and Folkman (1984). A descriptive correlational research design was used to examine the relationships among the variables. Convenience sampling was used to select the subjects from three hospitals in Northern Taiwan. A convenience sample of 133 Chinese elderly aged 60 and over had a diagnosis of Congestive Heart Failure. Subjects were interviewed with structured questionnaires. Stress appraisal was measured by the Appraisal Scale. Coping was measured by the revised Ways of Coping Checklist. Subjective well-being was measured by the Philadelphia Geriatric Center Morale Scale. Descriptive statistics were reported for several demographic variables. Several multiple regressions were performed to determine the significance of the independent variables. Those Chinese elderly patients who perceived Congestive Heart Failure as a challenge, used more problem-focused coping and less emotional-focused coping. When Congestive Heart Failure is viewed as a threat or harm, they used more emotional-focused coping. There were no significant relationships between benefit appraisal and coping behaviors. The seven significant predictors of subjective well-being were identified as higher income, less threat and harm appraisals, less avoidance coping behavior, and higher health perception. Demographics (age, gender, education and income), severity of illness, and comorbidity variables together explained a significant amount of the variance (11%) in subjective well-being, but only income was an individually significant predictor. Stress appraisal, coping behaviors, physical functioning, and health perception contributed an additional statistically significant amount variance (46%) of subjective well-being after controlling for demographic variables, severity of illness, and comorbidity. Additional findings indicated that men had significantly higher physical functioning and subjective well-being than women. In addition, men used more problem-focused coping. Findings provide more information for health care providers to recognize the variables that influence subjective well-being, identify patients at greater risk for lower subjective well-being, and assist patients to achieve the highest subjective well-being possible within the constraints of their heart disease.
The Use of Text Messaging to Improve Adherence and Functioning in Psychiatric PatientsBackground: Failure to attend psychiatric appointments can lead to poor medication adherence, relapse into crisis and/or re-hospitalization, or dropping out of treatment altogether. Changes are called for in the way clinicians and their practices can use technology to level the playing field in terms of health disparities, remove barriers to communication, decrease stigma, and assist in building self-efficacy and confidence in the treatment system. Purpose: To explore whether text messaging can improve adherence and function in the adult psychiatric outpatient population. Methods and Results: A literature review demonstrated that psychiatry, as a discipline, has not fully embraced all that technology has to offer despite a limited number of studies showing phone interventions improved health outcomes. A pilot randomized texting intervention of 89 adult psychiatric patients was conducted at a non-profit outpatient mental health clinic in a large urban Mid-Atlantic metropolitan area. The intent to treat group (n=47) received text message appointment reminders in addition to regular reminder calls from the clinic's Front Desk, while the treatment as usual group (n=42) received the reminder phone calls only. Implications: Though the main outcomes of appointment and medication adherence in response to the text reminder intervention of this study did not achieve significance, the results were still generally in line with the literature, which demonstrates support for the use of text messaging technology in this way. This would suggest there is value in using text appointment reminders in practice for psychiatry/mental health. Because appointment adherence is a problem that plagues every type of healthcare practice, those that avail themselves of technology that provides text reminder capability will likely benefit in terms of improved appointment adherence. Regular attendance at appointments improves the patient-provider relationship which plays an important role in patients' medication adherence and overall stability and good health. This cannot help but cascade into improved well-being.