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Biomedical subjects

R A Pruchno

Publications and source records attributed to R A Pruchno.

At least 19 recordsLinked to original sources
PubMed2000

The effect of long-term care environments on health outcomes.

This study contrasts rates of mortality and of relocation to higher levels of care as well as trajectories of cognitive status, functional ability, depression, and subjective health of residents of an assisted living facility with those of a nursing home. Data were collected from medical records and face-to-face interviews with 158 residents at baseline and 4, 8, and 12 months later. All participants lived on a single long-term care campus. Logistic regression revealed that facility was not a significant predictor of mortality or relocations due to declining health. A repeated measures analysis of variance found that outcomes for people living in the two facilities did not change at different rates. These consistent findings suggest that although the assisted living and nursing home environments claim to have different philosophies of care, health outcome patterns for people living in the two environments were similar.

Activities of Daily Living↗
PubMed1999

Behavior sequences of long-term care residents and their social partners.

OBJECTIVES: This study examines similarities and differences in social interactions of residents of an assisted living facility and those of a nursing home. Given increasingly popular alternative models of long-term care such as assisted living, the study seeks to identify how these long-term care settings differentially promote dependence and independence among their residents. METHODS: Data were collected during 256 observations of 64 residents and their social partners at meal times in public areas. Sequences of antecedent and response behaviors relating to independence and dependence in the two different long-term care settings were examined. RESULTS: Social partners responded consistently to behavior of long-term care residents, and the behavior of residents was consistently affected by that of their social partners. These sequential interactions were not affected by setting. DISCUSSION: Differences in the nursing home and assisted living facilities' stated philosophies of care were not manifested in the interactions of their staff and residents.

Activities of Daily Living↗
PubMed1999

Children-in-law in caregiving families.

Data were collected from 252 coresident caregiving daughters and daughters-in-law and their husbands. We hypothesized that biological children would give more care than children-in-law and that children-in-law would have very different caregiving experiences and resultant appraisals than biological children. Contrary to our hypotheses, we found that the experiences are very similar for biological children and children-in-law in caregiving families. We suggested that the important factor is not the relationship to the elder that has the impact--it is the quality of the relationship with the elder that is consistently significant.

Adult↗
PubMed1999

Effects of formal and familial residential plans for adults with mental retardation on their aging mothers.

Data regarding future residential plans were collected from 141 mothers of adult children with mental retardation. Results demonstrate that greater caregiving burden was associated with more extensive planning for residence within the formal service system and less planning for residence with a family member. More frequent service use also predicted greater planning for future residence within the formal system. Planning for residence with a family member and higher functional ability on the part of the child significantly decreased the sense of worry mothers had about the child's future whereas plans for the child to reside within the formal system had no association with worry about the future.

Activities of Daily Living↗
PubMed1998

Recruiting research participants: a comparison of the costs and effectiveness of five recruitment strategies.

Among the major costs associated with conducting survey research are the time and money spent recruiting a large and racially representative sample. Contrasted here are the costs of different recruitment strategies (agencies, support groups, snowballs, media, mass mailings) in terms of project time, supplies (e.g., postage, support materials), and staff time as they bear on the costs of recruiting 841 older mothers of offspring with lifelong disabilities. Results indicate that the costs of recruitment vary by method and race. Whereas agencies, support groups, and snowball recruitment were low- to moderate-cost strategies, they were less effective for recruiting African Americans than were media and demographic sampling unit strategies. These analyses suggest that with appropriate planning, funding, and implementation, nonprobability sampling methods can be used successfully to recruit a large and diverse sample. Suggestions for improving the implementation of future recruitment campaigns are also offered.

Adult↗
PubMed1997

Coping strategies of people living in multigenerational households: effects on well-being.

Analyses examined whether information about the coping strategies used by family members adds to an understanding about the psychological well-being of individuals. Data from 140 women and their husbands and children who were living in multigenerational households that included a disabled older relative indicated that for the women and children, the best predictors of depression, positive affect, and mastery were their own coping strategies; the coping strategies used by other family members did not add significantly to the predictive equation. For husbands, however, depression was predicted by both their own coping strategies and the coping strategies of their wives. Husbands' positive affect was predicted only by the coping strategies of their wives and children, and their mastery was predicted by their own coping strategies and those of their wives and children.

Adaptation, Psychological↗
PubMed1997

Understanding the well-being of care receivers.

A model in which the contributions made by older care receivers to their family members predicted personal control and ultimately psychological well-being of older people living in multigenerational households was proposed and tested. Data from 129 people over the age of 60 reveals that physical health predicts the extent to which elders contribute to the family, with those in poorer health giving less help to family members than those in better health. Elder contributions to the family increased the sense of control experienced by the older person. Although personal control increased the overall sense of psychological well-being experienced by the older care receivers, there was no direct relationship between the elder's contributions to the family and their psychological well-being.

Adaptation, Psychological↗
PubMed1997

Typologies of caregiving families: family congruence and individual well-being.

Data from 252 female primary caregivers, their husbands, and children living in multigenerational households were used to create family typologies based on the extent of similarity among reports of elder behaviors. Analysis of variance indicates that families characterized by high agreement and those characterized by low agreement were significantly different from one another on a number of dimensions. When the relationship between caregiver-reported stressors and mental health was examined as a function of family typology, results indicate that for high agreement families there were significant correlations between the caregiver's report of the elder's behaviors and her burden; satisfaction with caregiving; relationships with her husband, child, and elder; and depression. Similar relationships characterize data reported by husbands and children in high agreement families. For families characterized by low agreement, the majority of these relationships were not significant.

Adaptation, Psychological↗
PubMed1996

Mental health of aging women with children who are chronically disabled: examination of a two-factor model.

Data were collected from 838 women over age 50 who have either a child with a developmental disability or a child with schizophrenia. Lawton et al.'s (1991) parallel channel hypothesis, which suggests that positive and negative aspects of mental health have differential predictors, was tested. Results indicate that positive caregiving appraisals were predicted by quality of the mother-child relationship, while negative caregiving appraisals were predicted by the amount of help mother provided to her child, mother's health, child's behaviors, and positive appraisals. Positive well-being was predicted by mother's health, positive appraisals, and negative appraisals, while negative well-being was predicted by mother's health, child's behaviors, and negative appraisals. Hence, the data support the usefulness of the hypothesized model.

Adolescent↗
PubMed1995

Mental health of coresident family caregivers: examination of a two-factor model.

Data were collected from 140 caregivers of elderly relatives, their husbands, and coresident children. Lawton et al.'s (1991) parallel channel hypothesis, which suggests that positive and negative aspects of mental health have differential predictors, was tested. Data from caregivers, their husbands, and children support the hypothesized model, with greater interdependence of psychological process being associated with greater role centrality.

Adolescent↗
PubMed1995

Competence of long-term care residents to participate in decisions about their medical care: a brief, objective assessment.

Data from 50 residents of a long-term care facility were used to examine the extent to which performance on a brief, objective inventory could predict a clinical psychologist's evaluation of competence to participate in decisions about medical care. Results indicate that the competence to participate in medical decisions of two-thirds of the residents could be accurately assessed using scores on a mental status instrument and two vignette-based measures of medical decision-making. These procedures could enable nursing home staff to objectively assess the competence of residents to participate in important decisions about their medical care.

Aged↗
PubMed1994

Attachment among adult children and their institutionalized parents.

Structural equation analysis using data from 424 adult children with parents living in long-term care facilities indicated that the attachment experienced by adult children for their institutionalized parents was predicted from child's report of parent's mood and child's sense of guilt regarding his/her parent. Parent's mood was predicted by parent's health, and child's sense of guilt was predicted by the amount of help provided to the parent by the adult child. Results are interpreted in the context of theories of attachment.

Adult↗
PubMed1990

Mental and physical health of caregiving spouses: development of a causal model.

This study modeled the causal relationship between physical health and depression among a sample of 315 people providing home care for a spouse who had been diagnosed as having Alzheimer's disease. In addition to significant stability paths and correlations among variables at any one point in time, significant lagged paths were found in which depression (1) predicted physical health (2), depression (2) predicted physical health (3), and depression (1) predicted burden (2). Contrasting the overall model for husband and wife caregivers over a 6-month period indicated that the model was significant for wives but not for husbands.

Aged↗
PubMed1990

Predictors of institutionalization among Alzheimer disease victims with caregiving spouses.

A theoretical model predicting "desire to institutionalize" and actual institutionalization was developed and tested on a sample of 220 persons caring for a demented spouse. Significant predictors of "desire to institutionalize" include age and education of caregiver, spouse's forgetful behaviors, ADL tasks done by the caregiver, medications taken by the caregiver, services used, and quality of relationship with spouse. Predictors of actual institutionalization are desire to institutionalize, length of time spent as a caregiver, religion, uplifts, and forgetful behaviors of the impaired spouse.

Aged↗
PubMed1990

Mental health of sons and daughters of the institutionalized aged.

Predictors of depression in a study of 331 adult children whose parents resided in nursing homes were respondent's poor health, time pressures, viewing the parent as demanding, and lack of involvement with IADL tasks. Emotional effects specific to parent's situation were predicted by poor health, negative perceptions of nursing home staff, upsetting visits, time pressures, and being female and young. Predictors of depression and emotional effects between sons and daughters are compared.

Adult↗
PubMed1990

The effects of help patterns on the mental health of spouse caregivers.

Investigated were the patterns of task assistance and social support received by 315 people who were the primary caregivers to spouses suffering from Alzheimer's Disease. Despite the fact that spouse caregivers themselves are old and frail, they continue to provide the bulk of care required by their impaired partner. When help is forthcoming from any source, it is minimal. Contrary to the hypothesis that back-up sources of support or confidants should buffer the primary caregiver from negative mental health effects, there was no relationship between existence of either task support or social support and mental health.

Aged↗
PubMed1989

Mental health of caregiving spouses: coping as mediator, moderator, or main effect?

Coping strategies used by 315 persons providing care to a spouse diagnosed with Alzheimer's disease were characterized as either emotion-focused (wishfulness, acceptance, intrapsychic) or problem-focused (instrumental). Models in which coping strategies were postulated as having mediator, moderator, and independent main effects were tested using multiple indexes of mental health. Wishfulness and intrapsychic strategies mediated the relationship between degree of stress and CES-D, Anxiety, and Depression. Wishfulness had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; intrapsychic strategies had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; and instrumental strategies had a direct effect on Positive Affect. Hierarchical regression analyses indicated that stressors and coping strategies explained between 12% and 40% of the variance on mental health indexes.

Adaptation, Psychological↗