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At least 1,603 records · Page 89Linked to original sources
PubMed2000

A social-ecologic approach to assessing support for disease self-management: the Chronic Illness Resources Survey.

We report on the development and validation of an instrument to assess support and resources for chronic illness management (the Chronic Illness Resources Survey; CIRS). The 64-item full instrument and the 29-item Brief CIRS are based on a social-ecologic model, designed to apply across chronic diseases, and assess support and resources at each of seven levels (e.g., family and friends, physician and health care team, neighborhood/community). A prospective evaluation with 123 patients having heart disease, arthritis, diabetes, and/or COPD revealed that the overall instrument, as well as subscales and the brief instrument, had acceptable internal consistency, moderate to high test-retest reliability, good construct validity, and moderate concurrent and prospective criterion validity. We discuss potential uses of the CIRS for assessment, feedback, tailoring intervention, and evaluation and make recommendations for future research.

Adult↗
PubMed2000

Coping with technological disaster: an application of the conservation of resources model to the Exxon Valdez oil spill.

One hundred twenty-five commercial fishers in Cordova, Alaska, completed a mailed survey regarding current mental health functioning 6 years after the Exxon Valdez oil spill. Economic and social impacts of the oil spill and coping and psychological functioning (modified Coping Strategies Scales, Symptom Checklist 90-R) were measured. Multiple regression was used to test the utility of the Conservation of Resources stress model for explaining observed psychological symptoms. Current symptoms of depression, anxiety, and Posttraumatic Stress Disorder were associated with conditions resource loss and avoidant coping strategies. The Conservation of Resources model provided a framework for explaining psychological impacts of the oil spill. Future research is needed to identify factors related to recovery.

Adaptation, Psychological↗
PubMed1997

Physical and psychosocial resource variables related to long-term survival in older dialysis patients.

The association of baseline characteristics with long-term survival (7 years past baseline interview) was investigated in a prevalent sample of 349 dialysis patients aged 60-87 at baseline. In primary diagnosis, treatment modality, and months on dialysis, the sample was representative of all patients aged 60+ living in the state of Georgia. There were 38 surviving patients at a 7-year follow-up. At their baseline assessment, long-term survivors were significantly younger and less likely to report cardiovascular comorbidity. With age and cardiovascular comorbidity controlled, long-term survivors were more likely at baseline to desire a transplant, and reported needing less time to "recover" from HD treatments. Survivors' physical functioning resources at baseline included less health limitation of activity, lower functional impairment, and more frequent activity/exercise. Psychosocial well-being resources included higher self-esteem, higher sense of mastery, and higher self-rated health status. Ongoing assessment of these resource variables, with targeted interventions, might contribute to improved survival as well as improved functioning and well-being for older patients.

Aged↗
PubMed2000

Youths' access to mental health services: the role of providers' training, resource connectivity, and assessment of need.

This paper posits that providers with training in and knowledge of mental health resources are more likely to recognize youths' mental health problems, and provide youths with services. In 1994 and 1996, we interviewed 792 adolescents who were involved with St. Louis public health, juvenile justice, child welfare. or education service sectors. Two hundred eighty-two youths had received some services, listing 533 providers. We could identify 364 of those providers, and 61% (222) responded concerning service need, service use, and provider knowledge and behavior. Structural equation models demonstrate that provider assessment of youths' mental health problems is the largest and provider knowledge of service resources the second largest determinant of service provision. Youths' self-reported mental health is not positively associated with increased services and is only minimally associated with provider assessment of their problems. Training (both professional and inservice) contributes to higher assessments of youths' problems and greater resource knowledge, which is associated with increased service provision. Providers from the mental health and child welfare sectors have more professional training in mental health and are more likely to receive inservice training. Inservice training should be offered to all who work with youths.

Adolescent↗
PubMed1999

Psychosocial adjustment and mental health two months after coronary artery bypass surgery: a multisystemic analysis of patients' resources.

Resources related to cardiac patients' sense of self, marital quality, and social support were assessed before their first planned bypass surgery to determine their relationship with later psychosocial functioning. Six female and 45 male cardiac patients, 45-70 years old, answered self-report instruments 1 week before and 8-10 weeks after the operation. Regression analyses indicated that only the marital relationship variables made independent contributions to the prediction of functioning. Since self-report measures of resources can be affected by negative affectivity, a second level of analysis predicted change scores while controlling for initial levels of functioning. Marital flexibility and support were found to make an independent contribution to recovery. These results highlight the importance of marital resources in coping with the acute phase following bypass surgery and have implications for prevention and clinical practice.

Adaptation, Psychological↗
PubMed2002

A framework for operational modelling of hospital resources.

The provision of hospital resources, such as beds, operating theatres and nurses, is a matter of considerable public and political concern and has been the subject of widespread debate [1,2,31. The political element of healthcare emphasises the need for objective methods and tools to inform the debate and provide a better foundation for decision-making. There is considerable scope for operational models to be widely used for this purpose. An appreciation of the dynamics governing a hospital system, and the flow of patients through it, point towards the need for sophisticated capacity models reflecting the complexity, uncertainty, variability and limited resources. Working alongside managers and clinicians from participating hospitals, this paper proposes a generic framework for modelling of hospital resources in the light of perceived user-needs and real-life hospital processes. The proposed framework incorporates the need for patient classification techniques to be adopted, which forms a key differentiator between this approach and other attempts to produce practical capacity planning and management tools. Statistically and clinically meaningful patient groupings may then be fed into developed simulation models and individual patients from each group passed through the particular hospital system of concern. The effectiveness of the framework is demonstrated through the development and use of an integrated hospital capacity tool.

Algorithms↗
PubMed2002

Transnational health resources, practices, and perspectives: Brazilian immigrant women's narratives.

This paper examines the representations of transnational health resources, practices, and perspectives in the narratives of Brazilian immigrant women. The results of this qualitative narrative research indicated that in taking care of their health, these Brazilian immigrants often relied on a combination of personal and collective transnational resources. They engaged in a variety of pre-migration and transnational health practices and demonstrated a high degree of personal responsibility for their health, although they frequently delayed or postponed seeking formal health care. In responding to health and illness concerns, these immigrant women moved back and forth across informal and formal health care systems, crossing multiple national, cultural, and health care system borders. Their stories illustrated the transnational nature of personal, cultural, and political perspectives on health and health care and highlighted the layered complexities of immigrant women's health practices and resources.

Journal Article↗
PubMed1998

Life circumstances and personal resources as predictors of the ten-year course of depression.

A 10-year naturalistic study of 313 patients who entered treatment for unipolar depression and a community comparison group of 284 nondepressed adults was conducted. We compared life stressors, social resources, personal resources, and coping among patients who were remitted (N = 76), partially remitted (N = 146), or nonremitted (N = 91). Compared with the controls and the remitted patients, the partially remitted and nonremitted patients consistently experienced more life stressors and fewer social resources, were less easygoing, and relied more on avoidance coping. A less easygoing disposition, fewer close relationships, and more reliance on avoidance coping were associated with higher odds of experiencing a course of partial remission or nonremission. In addition, more depressive symptoms and medical conditions predicted nonremission.

Adaptation, Psychological↗
PubMed1999

Personal resources and the social distribution of depression.

This paper addresses the hypothesis that gender, age, marital status, and SES matter for depression partly because of associated differences in the availability and/or impact of the personal resources of mastery and self-esteem. It is argued that findings indicating that the social distributions of these resources complement those for depression would provide preliminary support for this hypothesis. Based on a large urban community sample (n = 1,390), our findings fail to support the availability hypothesis in relation to marital status, provide only modest support in reference to age and gender, but yield compelling support in relation to socioeconomic status (SES). Indeed, variations in the availability of these resources, especially mastery, provide a largely, if not entirely, adequate explanation for the SES-depressive symptoms relationship and accounts for nearly half of the SES-Major Depressive Disorder relationship. Although the significance of mastery was more pronounced among women and unmarried persons, such differences did not contribute to understanding observed gender or marital status variations in depression.

Adolescent↗
PubMed1997

A linear goal programming model for human resource allocation in a health-care organization.

This paper presents the development of a goal programming (GP) model as an aid to strategic planning and allocation for limited human resources in a health-care organization. The purpose of this study is to assign the personnel to the proper shift hours that enable management to meet the objective of minimizing the total payroll costs while patients are satisfied. A GP model is illustrated using the data provided by a health-care organization in the midwest area. The goals are identified and prioritized. The model result is examined and a sensitivity analysis is performed to improve the model applicability. The GP model application adds insight to the planning functions of resource allocation in the health-care organizations. The proposed model is easily applicable to other human resource planning process.

Algorithms↗
PubMed2003

Resource allocation in health care: health economics and beyond.

As resources in health care are scarce, managers and clinicians must make difficult choices about what to fund and what not to fund. At the level of a regional health authority, limited approaches to aid decision makers in shifting resources across major service portfolios exist. A participatory action research project was conducted in the Calgary Health Region. Throughfive phases of action, including observation of senior management meetings, as well as two sets of one-on-one interviews and two focus groups, an approach to priority setting at the macro level within the health region was developed and implemented. The resulting macro level approach builds on the program budgeting and marginal analysis (PBMA)framework. Using a multi-disciplinary expert panel, about dollar 45M (CAN) was released for the 2002/03 fiscal year and made available for re-allocation to service growth areas and the deficit. Important qualitative themes from the managers and clinicians informed both process development and refinement. The approach developed here not only facilitated re-allocation of resources, but also drew in both clinicians and managers to work together on this challenging task. The approach is pragmatic, transparent and evidence based, and should have application elsewhere.

Alberta↗
PubMed2004

Revictimization and interpersonal resource loss predicts PTSD among women in substance-use treatment.

Child physical abuse (CPA) and child sexual abuse (CSA) were hypothesized to be associated with revictimization and interpersonal resource loss in adulthood. These adulthood experiences were, in turn, hypothesized to increase risk for current posttraumatic stress disorder (PTSD). High-risk women were recruited from an innercity drug and alcohol treatment center (N = 105). Interpersonal resource losses, partner-produced physical assault, adulthood rape, CPA, and CSA had direct effects on PTSD. CPA and CSA also had indirect effects on PTSD through rape, which, in turn, predicted PTSD. Results suggest that the traumatic origins of current PTSD among substance-using women are multifaceted and support the importance of considering interpersonal coping resources in evaluating and treating female substance users.

Adult↗
PubMed2003

Does extra staff change clinical practice? A prospective study of the impact of extra resources in mental health teams.

OBJECTIVE: To compare patterns of clinical activity amongst existing staff in two inner-city community mental health teams before and after their enhancement with extra resources using a new activity schedule containing 11 comprehensive and mutually exclusive practice categories. METHOD: Patterns of clinical activity amongst existing members of two inner-London community mental health teams were compared before and after the addition of extra resources. RESULTS: The amount of time spent in face-to-face contact with patients and carers showed no meaningful change following team enhancement. Patterns of clinical activity amongst team members remained relatively static. CONCLUSION: Adding resources to community mental teams without considering how to target the time released amongst existing staff may reduce their capacity to work more innovatively.

Adolescent↗
PubMed1991

Life stressors, personal and social resources, and depression: a 4-year structural model.

By extending earlier stress-resistance research with a 1-year time lag, findings with 254 adults show that adaptive personality characteristics and positive family support operate prospectively over 4 years in predicting reduced depression, even when prior depression is controlled. By strengthening knowledge about the determinants and mediational role of coping, the results demonstrate in a 2-group LISREL analysis that the pattern of predictive relations differs under high and low stressors. Under high stressors, personal and social resources relate to future psychological health indirectly, through more adaptive coping strategies. Under low stressors, these resources relate directly to psychological health. The results support the idea that such resources play a causal role in maintaining psychological health, and they suggest the potential for a general, adaptively oriented framework applicable to adjustment under both high and low stressors.

Adaptation, Psychological↗
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↗
PubMed2002

The mediating roles of perceived social support and resources in the self-efficacy-suicide attempts relation among African American abused women.

The authors examined whether self-efficacy among African American abused women decreased their risk of suicide attempts through the mediating influences of perceived social support from friends, perceived social support from family, and perceived effectiveness for obtaining material resources. The sample consisted of 100 women who presented to a hospital following a suicide attempt and 100 women who presented to the same hospital for nonemergency medical problems. Results revealed that the association between self-efficacy and suicide attempt status was partially accounted for by the mediating roles of perceived social support from friends and family, and perceived effectiveness at obtaining resources. Findings suggest that interventions to increase abused women's self-efficacy should focus on increasing their capacity to obtain social and material resources.

Adolescent↗
PubMed1984

Coping, stress, and social resources among adults with unipolar depression.

We used a stress and coping paradigm to guide the development of indices of coping responses and to explore the roles of stress, social resources, and coping among 424 men and women entering treatment for depression. We also used an expanded concept of multiple domains of life stress to develop several indices of ongoing life strains. Although most prior studies have focused on acute life events, we found that chronic strains were somewhat more strongly and consistently related to the severity of dysfunction. The coping indices generally showed acceptable conceptual and psychometric characteristics and only moderate relationships to respondents' sociodemographic characteristics or to the severity of the stressful event for which coping was sampled. Coping responses directed toward problem solving and affective regulation were associated with less severe dysfunction, whereas emotional-discharge responses, more frequently used by women, were linked to greater dysfunction. Stressors, social resources, and coping were additively predictive of patient's functioning, but coping and social resources did not have stress-attenuation or buffering effects.

Adaptation, Psychological↗
PubMed1980

Processing resource demands of failure detection in dynamic systems.

The information-processing channels, proprioceptive versus visual, that are used to detect changes in the response of dynamic systems are investigated using a loading-task methodology. Conditions are compared in which subjects either control the dynamic system (MA mode) or monitor an autopilot controlling the same system (AU mode). Failure detection in these two modes of participation is evaluated when subjects perform the task alone and concurrently with either a tracking loading task or a mental arithmetic-memory loading task. The former task disrupted MA detection but not AU detection, whereas the converse results were obtained with the mental-arithmetic task. The results, interpreted within the framework of a structure-specific resource theory of human attention, suggest that AU detection relies exclusively on processing resources associated with perceptual/central-processing stages. MA detection in contrast relies on separate-processing resources residing in a response-related reservoir.

Automobile Driving↗