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Biomedical subjects

R H Moos

Publications and source records attributed to R H Moos.

At least 127 records · Page 7Linked to original sources
PubMed1990

Determinants of interpersonal support and self-direction in group residential facilities.

This study examined the determinants of residents' and staff's judgments of interpersonal support and self-direction in group residential facilities for older people. The Multiphasic Environmental Assessment Procedure (MEAP) was used to assess social climate dimensions and their determinants in a national sample of 244 facilities. Residents saw more interpersonal support and self-direction in facilities with more physical resources (comfort and staff facilities) and policies providing more autonomy. A similar pattern was found for staff's perceptions of self-direction. Residents and staff also viewed facilities as providing more interpersonal support and self-direction when residents were more socially competent. Larger facility size was associated with residents' assessments of more conflict, and a higher staff-resident ratio was related to residents' judgments of having less independence and influence. These findings may help to improve residential facilities by suggesting factors that can be targeted in interventions to improve the social climate.

Activities of Daily Living↗
PubMed1990

Depressed outpatients' life contexts, amount of treatment, and treatment outcome.

This paper examines the influence of life context factors and the amount of treatment on treatment outcome after 1 year among 265 unipolar depressed outpatients. Preintake medical conditions, family conflict, and lack of family support predicted poorer treatment outcome. Moreover, patients' family conflict and confidant support at intake interacted with the amount of treatment to influence outcome. Patients who had a close confidant and less family conflict showed better outcome with brief therapy; patients who lacked a confidant and had more family conflict experienced better outcome with longer treatment. Posttreatment stressors and lack of social resources were associated with poorer treatment outcome. The findings imply that treatment can provide temporary support to compensate for a lack of social resources. More intensive treatment may be needed for patients who experience more family conflict and who have a poor relationship or no relationship with a confidant.

Depression↗
PubMed1990

Conceptual and empirical approaches to developing family-based assessment procedures: resolving the case of the Family Environment Scale.

This article focuses on the reliability and validity of the Family Environment Scale (FES). The FES subscales generally show adequate internal consistency reliability and stability over time when applied in samples that are diverse; the items also have good content and face validity. An extensive body of research supports the construct, concurrent, and predictive validity of the FES. More generally, reliability and validity are a joint function of scale items and response formats and of the characteristics and diversity of specific samples. To contribute to further advances in family assessment, researchers need to use both conceptual and psychometric criteria rather than rely too heavily on the pursuit of internal consistency reliability and factor analytic approaches to scale construction and validation.

Adult↗
PubMed1989

Life stressors, social resources, coping, and the 4-year course of unipolar depression.

Little is known about the effects of psychosocial factors on the long-term course of unipolar depression. This article examines the 4-year stability and change in life stressors, social resources, and coping, and their effect on the course of treated unipolar depression among 352 men and women. Depressed patients were assessed at treatment intake and at 1-year and 4-year follow-ups. Over the 4 years, patients improved in symptom outcomes, the quality of social resources, and coping responses; there were some declines in life stressors. Life stressors, social resources, and coping were related to patient functioning concurrently, after controlling for demographics, initial treatment, and initial dysfunction severity. Preintake medical conditions and family conflict consistently predicted poorer long-term outcomes. The findings imply that medical conditions and family conflict are important risk factors that predict poorer long-term outcome of depression.

Adaptation, Psychological↗
PubMed1989

Preferences of older adults and experts for policies and services in group living facilities.

The Policy and Program Information Form-Ideal Form (POLIF-I) was developed to assess preferences of older adults for the policies and services of group living facilities. Compared with older community residents (n = 205), congregate apartment residents (n = 229) prefer facilities that have higher behavioral standards, deemphasize supportive services and formal avenues for resident influence, and emphasize privacy. In contrast to older respondents, experts (n = 44) prefer settings with lower behavioral standards, more supportive services, more resident input, and more privacy. Sociodemographic characteristics (marital status, occupation, education, age, gender) and functional ability are weakly associated with the policy and service preferences of older respondents. The POLIF-I has several applications, including examination of the congruence between residents' preferences and the actual policies and services of group living facilities.

Activities of Daily Living↗
PubMed1989

Personal and environmental determinants of activity involvement among elderly residents of congregate facilities.

This study examined the personal and environmental factors related to the activity involvement of older people living in congregate residential settings. A sample of 1,428 residents in 42 such settings provided information about their activities, functioning, and background. Measures of facility features were also available. These data show that individuals are more likely to participate in facility-organized activities in settings where overall resident participation is greater, the average functioning of residents is lower, staffing is higher, and the program more structured. Participation in facility activities is not related to personal characteristics. In contrast, involvement in resident-initiated activities, both in the facility and in the community, is related to personal characteristics (being functionally intact, female, and better educated) and to facility features (larger size, lower staffing, greater autonomy and cohesiveness). The impact of some features varies depending on the functional capacity of the individual resident.

Aged↗
PubMed1989

Ownership and quality of care in residential facilities for the elderly.

The quality of care older people receive in a residential facility is related to its ownership. Nonprofit facilities (N = 44) provided a more comfortable physical environment, more cohesive relationships, and more resident control than proprietary settings (N = 44) matched for size and resident functioning. Veterans facilities (N = 44) offered more services and a more diverse staff, but their policies permitted less resident autonomy and their social climates were less cohesive than community facilities of comparable size and resident functioning.

Aged↗
PubMed1988

Positive perimenstrual changes: toward a new perspective on the menstrual cycle.

Although many women report negative symptoms, the perimenstrual phase also is associated with enhanced mood and performance among some women. However, research on perimenstrual concomitants reflects a sterotypic negative bias that does not encompass the complexity of the phenomena. This paper tries to redress that balance by documenting the prevalence of positive perimenstrual changes. Overall, about 5-15% of women experience increased excitement, energy, and well-being in the perimenstrual phase. Many women also report increased activity, heightened sexuality, and improved performance on certain types of tasks during the perimenstrual phase. Future research should examine why some women report positive perimenstrual changes, the extent to which individual variations in hormone levels can account for differences in women's perimenstrual experience, and how much women differ in their responsiveness to changing hormone levels. The influence of menstrual-related beliefs and expectations on the changes a woman reports also needs to be clarified.

Affect↗
PubMed1988

Life stressors and social resources: an integrated assessment approach.

The Life Stressors and Social Resources Inventory (LISRES) is described. The inventory provides an integrated assessment of an individual's life context. It taps both relatively stable and new aspects of life stressors and social resources in eight domains: physical health, home/neighborhood, financial, work, spouse/partner, children, extended family, and friends. The indices were developed on data obtained at two points in time from groups of depressed patients, alcoholic patients, arthritic patients, and healthy adults. The indices are internally consistent, moderately intercorrelated, and relatively stable over time. In addition, they are predictably related to changes in respondents' functioning. Although more developmental work is needed, the LISRES has some potential clinical and research applications and may be helpful in examining the process of stress and coping.

Adaptation, Psychological↗
PubMed1988

[Coping: concepts and measuring procedures].

Major types of coping responses are described and the problems with the measurement of coping behavior are discussed. The Coping Response Inventory is introduced. Family and work resources provide a social context for coping: An integrating framework is described. First results of the association between coping responses and the process of remission and relapse in depression and alcohol abuse are presented.

Adaptation, Psychological↗
PubMed1987

Psychosocial risk and resistance factors among children with chronic illness, healthy siblings, and healthy controls.

Psychosocial risk and resistance factors within the domains of parental functioning, family stressors, and family resources were examined as predictors of psychological adjustment and physical problems in juvenile rheumatic disease patients (N = 93), their healthy siblings (N = 72), and demographically matched healthy controls (N = 93). Family socioeconomic status and background variables showed few consistent relationships with child functioning. However, a constellation of risk and resistance factors tended to show comparable associations with functioning for patients, siblings, and controls. Higher parental depression and medical symptoms and more family stressors, sibling problems, and burden of illness on the family predicted more problems among the patients. These relationships held when disease duration and severity were controlled. For the siblings, increased parental and patient dysfunction, more family stressors, and less family cohesion and expressiveness were associated with more problems. Although the associations were not as strong, mothers' depression and lack of family cohesion and expressiveness also were related to more adjustment problems among the control children. These findings imply that there may be a general association between certain risk and resistance factors and childhood adaptation.

Child↗
PubMed1987

Social support and coping: a longitudinal analysis.

This paper examined the interrelation between social support and coping in a longitudinal study of 380 clinically depressed individuals. A two-wave, two-variable panel analysis revealed that connections between support and coping varied by gender and across the specific sources of support and modes of coping examined. In the family context, increases in support were related to increases in problem-solving coping among women and to a decline in emotional discharge coping among men. In the work context, increases in social support were related to a greater reliance on affective regulation among women and to more information/support seeking among men. Overall, the results suggest that specific aspects of support and coping processes jointly mediate the link between stress and adjustment among depressed individuals.

Adaptation, Psychological↗
PubMed1987

Personal and contextual determinants of coping strategies.

This study examined personal and contextual predictors of active and avoidance coping strategies in a community sample of over 400 adults and in a sample of over 400 persons entering psychiatric treatment for unipolar depression. Sociodemographic factors of education and income (except for active-cognitive coping), personality dispositions of self-confidence and an easy-going manner, and contextual factors of negative life events and family support each made a significant incremental contribution to predicting active and avoidance coping. Among both healthy adults and patients, active and avoidance coping were positively associated with negative life events. Individuals who had more personal and environmental resources were more likely to rely on active coping and less likely to use avoidance coping. Moreover, for both groups, most of the predictors continued to show significant relations with active and avoidance coping strategies even after the stable component in coping was controlled in a longitudinal design. A comprehensive framework to understand the determinants of coping can be of practical value in suggesting points for therapeutic interventions aimed at fostering more adaptive coping efforts.

Adaptation, Psychological↗