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Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care.

We measured staff members' satisfaction with their work before and after increased information technology (IT) support in dementia care. Comparisons were also performed of perceived life satisfaction and sense of coherence. Data were collected before, and 6 and 12 months after implementation of the first part of an IT support project. Instruments used were the Satisfaction with Work Questionnaires, the Life Satisfaction Questionnaire (LSQ) and the Sense of Coherence (SOC) scale. The study was performed in a residential home for persons with dementia. The participants were 33 staff members. The IT technology included general and individualized passage alarms, sensor-activated night-time illumination, fall detectors and Internet communication. Results showed that staff members' job satisfaction and perceived quality of care improved in comparison with the control group. Personal development, workload, expectations and demands, internal motivation and documentation, as well as the total scores for "psychosocial aspects of job satisfaction" and "quality of care aspects", increased in the experimental group. There were significant interaction effects for the factors family relation, close friend relation (LSQ), the total SOC scale and the meaningfulness subscale. The study showed that IT support in dementia care increased staff members' satisfaction with their work in several ways.

Adult↗

Feasibility of thalassaemia control by extended family screening in Indian context.

Thalassaemia is one of the most common genetic disorders in India. Its control is possible by screening of general population for carrier status and by antenatal diagnosis in couples at risk of having a child with thalassaemia. This study explored the feasibility of screening the extended family to detect carriers to prevent birth of thalassaemic children and identified the barriers to its acceptance. One hundred parents with thalassaemic child on a regular hypertransfusion programme were interviewed using a pre-designed questionnaire. The results showed that 96% of them were more willing to share information on their thalassaemic children with relatives and friends. Relatives of 62 parents accepted the risk of being a carrier, and 14 families got themselves tested for it so far. Another 34 families could not get themselves tested due to non-availability of screening facilities in the nearby town, high cost of the test, and lack of sufficient motivation. It is concluded that, by and large, parents have no reservations in sharing information on their affected children with their relatives, but the communication needs to be improved for all families to accept the risk of having a thalassaemic child. There is also a need to make the screening more readily available and to motivate high-risk groups through awareness-raising programmes.

Adult↗

Daily stress and recurrence of genital herpes simplex.

It is widely believed that emotional stress triggers recurrences of both oral and genital herpes simplex virus. On a daily basis, we studied 64 subjects prospectively for 1 to 3 months; all subjects had at least one culture-proved recurrence of genital herpes simplex virus type 2 before or during the study. All subjects filled out a questionnaire that measured psychological/emotional stress in six areas: physical health, relations with friends, relations with family, relations with sex partner(s), financial, and vocation/education. These questionnaires were mailed back to us daily. Data were analyzed by General Linear Models analysis of variance to compare stress reported on each of the 6 days before a recurrence with that on days during or after a recurrence, as well as days not temporally related to recurrence. Under these conditions, in which retrospective bias was minimized, there was no significant increase in psychological/emotional stress on any day in any area preceding a recurrence of genital herpes simplex virus.

Adult↗

High touch in high tech: the presence of relatives and friends during resuscitative efforts.

Hospital emergency departments traditionally have policies that require relatives and friends to wait out the resuscitative attempt of their loved ones in a counseling room. In recent years, this widespread practice has been questioned. In some hospitals, family members and friends are given the option to attend the resuscitative effort. Based on in depth interviews, three different resuscitation perspectives to which health care providers subscribe have been identified. According to the advocates of the survival framework, the only goal that a resuscitation should achieve is to save a human life. In the bifurcated perspectives, a resuscitation has two separate goals: saving lives and taking care of family members. Health care providers who subscribe to the holistic framework are still concerned with survival of the patient, but significant others become participants in the resuscitation process.

Attitude of Health Personnel↗

Health Risks Associated with Visiting Friends and Relatives in Developing Countries.

An increasingly large proportion of immigrants to developed countries is arriving from less developed countries in Africa, Asia, and Latin America. When these immigrants return to their country of origin to visit friends and relatives, they are at high risk of acquiring tropical infections, compared with other travelers. Immigrants who return to their country of origin to visit friends and relatives (VFRs) are more likely to travel to rural areas for long periods of time, to consume contaminated food and beverages, and to have more prolonged, intimate contact with local populations. As a group, they are less likely to seek pretravel advice or take antimalarial chemoprophylaxis. This article discusses the increased risk of tuberculosis, malaria, food- and waterborne illnesses, hepatitis A, and HIV and other sexually transmitted infections in VFRs.

Journal Article↗

The advice-giving role of female friends and relatives during pregnancy.

Disparities in prenatal smoking rates indicate the need for new smoking cessation intervention strategies tailored to low-income pregnant women. Information about natural patterns of advice-giving during pregnancy would facilitate this goal. This study examines the advice-giving role of close female friends and relatives ('confidantes') during pregnancy, and assesses the utility of including them in an intervention. A questionnaire was administered verbally to 225 low-income pregnant women to assess: (1) the prevalence and characteristics of confidantes, (2) the persuasiveness of confidante advice in general and with respect to smoking, specifically, and (3) the permissiveness of confidante smoking advice. Comparisons were made with doctors and partners. Most women (91.4%) identified a confidante, the majority of whom were their own mothers. Doctors were rated most persuasive in their general prenatal advice, followed by confidantes and partners (all differences, P < 0.05). A similar pattern was observed among prenatal smokers in relation to advice given about prenatal smoking. As compared to doctors, confidante advice was significantly more permissive of smoking during pregnancy. While women value their doctors' advice during pregnancy, close female friends and relatives also have an important and unique role. Educational efforts may be effective when directed at these advice-givers.

Adult↗

Health disparities among travelers visiting friends and relatives abroad.

For an estimated 10 million trips abroad by U.S. residents in 2002, "visiting friends and relatives" (VFR) was a purpose for travel. Made up largely of foreign-born U.S. residents and their children, this population shows disparities in the number of reported cases of many preventable travel-related illnesses compared with people who travel for other purposes, such as tourism. High-risk illnesses in VFR travelers include childhood vaccine-preventable illnesses, hepatitis A and B, tuberculosis, malaria, and typhoid fever. Gaps in the prevalence of disease and access to care both between countries and within the United States uniquely influence disease risk in this population of travelers. We describe this population, a framework for understanding travel-related health disparities, and recommendations for improving the effective delivery of preventive travel-related care to VFR travelers. In addition to transnational efforts to control and eradicate disease, preventing illness in U.S. resident VFR travelers requires focused efforts to remove barriers to their care. In the United States, barriers exist at the systems level (for example, low insurance coverage), patient level (for example, misperception of disease risk), and provider level (for example, inadequate knowledge of travel medicine).

Communicable Disease Control↗

Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network.

Travelers returning to their country of origin to visit friends and relatives (VFRs) have increased risk of travel-related health problems. We examined GeoSentinel data to compare travel characteristics and illnesses acquired by 3 groups of travelers to low-income countries: VFRs who had originally been immigrants (immigrant VFRs), VFRs who had not originally been immigrants (traveler VFRs), and tourist travelers. Immigrant VFRs were predominantly male, had a higher mean age, and disproportionately required treatment as inpatients. Only 16% of immigrant VFRs sought pretravel medical advice. Proportionately more immigrant VFRs visited sub-Saharan Africa and traveled for >30 days, whereas tourist travelers more often traveled to Asia. Systemic febrile illnesses (including malaria), nondiarrheal intestinal parasitic infections, respiratory syndromes, tuberculosis, and sexually transmitted diseases were more commonly diagnosed among immigrant VFRs, whereas acute diarrhea was comparatively less frequent. Immigrant VFRs and traveler VFRs had different demographic characteristics and types of travel-related illnesses. A greater proportion of immigrant VFRs presented with serious, potentially preventable travel-related illnesses than did tourist travelers.

Adolescent↗

"Because you know there's an end to it": caring for a relative or friend with advanced breast cancer.

OBJECTIVE: The aim of this paper is to delineate the particular nature of the end-of-life care experience from the perspective of family members and friends. Ideas drawn from feminist analyses of caring and the sociology of death and dying are used to illuminate study respondents' accounts. METHODS: Qualitative study with people who cared for a family member or friend who died of breast cancer. Two interviews were conducted with each of 12 study participants, and one carer responded by letter to a series of questions drawn from the interview guide. Accounts were analyzed with reference to grounded theory methods. RESULTS: The analysis presented here suggests that anticipating the death of an ill relative or friend generates imperatives to care, imperatives that are both "felt" and linked to wider social structures and processes. The value assigned to closeness with the ill person can be seen to reflect cultural injunctions toward a "good death," and to shape informal carers' perceptions of their labor. Also discussed in this paper are the complex negotiations undertaken by relatives and friends, for the life and death of someone with advanced cancer. SIGNIFICANCE OF RESULTS: This paper offers insight into the social processes of caregiving, revealing how care may be shaped in particular ways by an awareness of approaching death.

Adult↗

[Self-evaluation maintenance processes in time sequential changes of relations between friend choice and school performance].

The purpose is to elucidate the sequential change in relations between students' friend choice and their school performance in terms of self-evaluation maintenance model. One hundred and thirty-five elementary school children and one hundred and twenty junior high school students were used as subjects of this survey. On the two questionnaires, each student was asked how he rated his own school performance, that of his friend, and that of his distant classmate, on both the high and low relevant subjects. According to the result of the survey, most students changed the combinations of each factor (relevance, closeness, school performance) in order to maintain their desirable self-evaluation. A time sequential analysis showed that students' self-evaluation maintenance processes were not so much based on their own ratings of school performance as on actual grades. It also showed that self-evaluation maintenance and personality traits were related to each other: As for elementary school children, their personality traits were related to the ratings of their own school performance and of their friends' school performance.

Achievement↗

Accompany the sick: a unique practice in Chinese hospitals by patients' relatives and friends.

There is a practice commonly found in many Chinese hospitals called 'accompany the sick' (pei ban). It means that many patients' relatives or friends 'live' with patients in the hospital. Such practice can benefit patients in that the visitors are providing psychological support and carrying out some bedside nursing care to the patients. However, it also creates many problems to nurses and hospitals such as overcrowding, an over-demand of hospital resources, and maintaining quality care. There is no study of such practice. In order to gain better understanding of 'accompany the sick', its impact on nursing practice and nursing professional development, identifying the contributing factors of such practice is needed. This is an ethnographic case study of a public hospital in western China. The study has discovered a number of factors that contribute to the practice, such as the Chinese concept of duty of care, the geographic and economic situation, and the unique culture of nursing practice. This is a pilot study and the result of this study will contribute to further study in nurses' work in China.

China↗

An investigation into the response of subjects to a plaque control programme as influenced by friends and relatives.

The aim of the present study was to assess the response of patients to a course of instruction in plaque control as influenced by friends and relatives. The subjects in the study were 41 patients who had been referred to a dental hospital for treatment. There was a major reduction in plaque and gingivitis levels in the subjects at both the 10th and 14th weeks of the study. There was a greater proportional reduction in gingivitis levels in those subjects who had a higher number of reported discussions with their friends. The effect of discussions with members of the family was less clear. Lower values for gingivitis levels at 10 weeks were associated with a higher number of discussions with parents. However the levels of gingivitis tended to be adversely affected by discussions between the subjects and their spouses. The importance of recognising the influence of family and friendship networks needs to be understood when preventive programmes are designed, especially where high levels of self-care are sought as outcomes. Further work is in progress on a group of office workers being treated in a dental practice environment. This will allow the type of advice being obtained from the various contacts to be investigated in more detail.

Adult↗

Physical disease among 21 suicide cases: interviews of relatives and friends.

In an earlier study made in Uppsala, it was found that in 17% of suicide cases there was a correlation between the suicidal act and serious physical disease. To obtain a deeper knowledge of this, an interview study among relatives and/or friends of 21 patients who had committed suicide was performed. Variables studied were: demographic data, somatic diagnoses, psychiatric diagnoses, contact with the medical sector, earlier suicidal signals, and the correlation between the suicidal act and the physical disease. The provision of inadequate medical treatment was sought. The persons who had committed suicide were allocated to one of three groups according to the degree of correlation between suicidal act and physical disease. "Very strong" correlation was found for five persons, "rather strong" for nine persons, and "weak" for five persons. We found that physical disease was seldom decisive for the suicidal act. Medical treatment was experienced as inadequate in nine cases. Since there is reason to believe that physical disease is an important complicating risk factor for suicide, it is important to be aware of anxiety in patients and their relatives, give plenty of time for information, show empathy and give the care-providers a sense of security to avoid suffering and reduce suicidal acts.

Adult↗

The grief experiences and needs of bereaved relatives and friends of older people dying through suicide: a descriptive and case-control study.

BACKGROUND: Little is known about grief experiences of individuals bereaved through suicide of older people. Legal procedures may be one source of distress. Studies have suggested that guilt feelings, and a sense of rejection, shame or stigma, are probably more frequent in relatives bereaved through suicide than in those bereaved through other modes of death. METHODS: We examined (a) problems experienced during legal procedures after death and (b) grief experiences, in 85 relatives and friends bereaved through the suicide of person 60 years old or over. In a case-control study the bereavement reactions in a subgroup of 46 people were compared with those of a control group bereaved by the natural death of an older person. Interviews, carried out 6-21 months after the deaths, included a semi-structured assessment of problems following the death, the Grief Experience Questionnaire (GEQ) and the Montgomery and Asberg Depression Rating Scale (MADRS). RESULTS: Thirty-six (42.4%) of those bereaved through suicide reported problems in their dealings with the coroner's office, and 33 (38.8%) described distress caused by media reporting of the inquest. Depression scores were similar in the group of individuals bereaved through suicide and those bereaved through natural causes. The former scored higher on subscales of the GEQ measuring stigmatisation, shame, sense of rejection and "unique reactions" compared with those bereaved through natural death. LIMITATIONS: The participation rate of potential subjects was somewhat low, especially in the control group. Proportions of different kinships to the deceased differed in the study and control groups. CONCLUSIONS: Problems in the media reporting of coroners' inquests and in inquest procedures are a frequent source of distress for bereaved relatives. The common themes of stigma, shame, and sense of rejection in bereavement after suicide suggest that these areas should be specifically addressed in the counselling of relatives bereaved in this way.

Adult↗

United States epidemiology of hepatitis A: influenced by immigrants visiting friends and relatives in Mexico?

Among the industrialized nations, the United States annually receives the greatest number of immigrants as permanent residents. Immigrants from Mexico have represented the largest segment of the foreign-born population in recent decades, and continued growth of Mexican immigration is predicted for the decades ahead. The changing demographics of this population, including the emergence of new immigrant growth centers, will influence the future epidemiology of hepatitis A virus transmission in the United States. Travel home to the place of origin to visit friends and relatives (VFR) by both newly arrived and established Mexican immigrants constitutes a new group of travelers that now include intergenerational family units. Asymptomatic pediatric travelers-who acquire hepatitis A abroad and are infectious on return to American communities-contribute to the silent transmission of hepatitis A to playmates, caretakers, and contacts in households, daycare facilities, and elementary schools. Considering the expanded geographic distribution of Mexican immigrant settlement, the predicted increased diversity of pediatric populations in the United States over time, and the continued growth of VFR travel, a universal pediatric vaccine recommendation for hepatitis A immunization can help to prevent hepatitis A transmission in this country in the future.

Emigration and Immigration↗

Shared targets for aggression by early adolescent friends.

Similarity in early adolescent friends' general aggressiveness is well known, but questions remain regarding the degree to which friends aggress against the same victims. The authors examined this by administering the newly created Dyadic Aggression and Victimization Inventory to 417 sixth- through eighth-grade boys and girls (53%). Friends were found to share more targets for aggression than nonfriends, even after general levels of aggression were controlled (all ps < .05). Moreover, greater sharing of targets with friends relative to nonfriends was more pronounced among aggressive youths than nonaggressive youths, especially among aggressive youths' best friends relative to their other friends. Generally, these findings were similar across boys and girls as well as among older and younger youths. Implications of these findings and directions for future research are discussed.

Adolescent↗

Measurement of quality of life in women with breast cancer. Development of a Life Satisfaction Questionnaire (LSQ-32) and a comparison with the EORTC QLQ-C30.

The purpose was to develop and validate a new instrument suitable for measuring perceived quality of life in women with breast cancer. The instrument is to be used within conventional cancer therapy as well as in complementary care, and is called the LSQ-32 (Life Satisfaction Questionnaire). The subjects were 362 women with breast cancer in all cancer stages. Cronbach's alpha reliability coefficient of the LSQ was 0.89. The construct validity was estimated by a principal component analysis. Six orthogonal factors were identified: (1) 'Quality of family relation', (2) 'Physical symptoms', (3) 'Socioeconomic situation', (4) 'Quality of daily activities', (5) 'Sickness impact' and (6) 'Quality of close friend relation'. The criterion-related validity was estimated by comparing the LSQ-32 and the EORTC QLQ-C30. The scales/items of the EORTC QLQ-C30 were represented in the LSQ-32, but the factors 'Quality of family relation' and 'Quality of close friend relation' were not found in the EORTC QLQ-C30. It was concluded that the LSQ-32 as well as the EORTC QLQ-C30 are valuable tools in the measurement of quality of life in women with breast cancer. The LSQ-32, however, also contains an existential factor.

Adult↗

Survey into health problems of elderly people: multivariate analysis of concordance between self-report and proxy information.

BACKGROUND: In many cases probands are unable to give information about their own history. Our objective was to compare information given by elderly people on their past and current health and family history of illness with similar information given by a relative, friend or carer. MATERIAL: In three urban and two rural areas of England and Wales a sub-sample, weighted by age and cognitive status, was drawn from random population samples of people aged >/=65, not permanently living in hospital, and interviewed between 1991 and 1994, plus for each of these a relative, friend or carer. METHODS: The relation between the reports of probands and informants on cognitive function, lifetime illnesses, current health problems, and family history of illness was analysed using multiple regression of agreement, measured using Cohen's kappa, and logistic regression of bias and of proportion of 'not known' responses. Potential explanatory variables used were: centre, proband cognitive function, proband sex, informant sex, proband age, difference in age (generation), relationship, frequency of contact, period known, modality of informant interview. RESULTS: Overall agreement per interview measured by kappa between informant and proband was lower for older probands, probands who were cognitively impaired, and those who saw one another less often; each effect adjusted for all the others using multiple regression. Informants tended to over-report relative to probands if the proband was cognitively impaired, male, they themselves were female, of a younger generation, and co-resident; each effect adjusted for all the others using logistic regression. Interviews were more likely to be missing at least one item if the informant was not the spouse, had known the proband for less time, and was not co-resident; each effect adjusted for all the others using logistic regression. CONCLUSION: There is reasonable accord between probands and informants which is enhanced by close contact, long period of knowledge, and a female informant. Degree of kinship is not critical. Informant interviews may be conducted by telephone rather than face-to-face without serious loss of quality.

Age Factors↗