The Impact of Social Isolation on Coping Style Utilization

This study explores the different coping styles used depending on the individuals perceived level of social isolation. 151 undergraduate students from the University of Bridgeport were recruited to complete scales used to measure coping styles (Carver, 2013) and Social Isolation (UCLA Loneliness scale; Russell, 1996). Results demonstrated that styles of coping were impacted when comparing high vs. low perceived social isolation. This has ramifications for future studies, which should explore the socio-cognitive mechanisms underlying these changes

The relationship between online gaming and wellbeing among post-secondary students

As the “fastest growing form of entertainment in the world” (Tran, 2019, p. 76), gaming has become a significant part of our society (Groening & Binnewies, 2019). Considering its widespread popularity as a leisure activity amongst adolescents and adults (Entertainment Software Association of Canada, 2020), it is unsurprising that multiple studies have explored its relationship to the player’s wellbeing. Previous research has found mixed findings regarding gaming’s impact on wellbeing. Several findings have identified gaming as a way to relieve stress, relax (Russoniello et al., 2009; Snodgrass et al., 2011; Wack & Tantleff-Dunn, 2009), positively influence aspects of social wellbeing (Gitter et al., 2013; Kowert & Oldmeadow, 2015; Martončik & Lokša, 2016) and is associated with a variety of improvements in psychological and physiological functions (Ryan et al., 2006). Despite these benefits, numerous other findings have associated gaming with negative outcomes such as interfering with a player’s social functioning, wellbeing, and adjustment (Grüsser et al., 2007; Stockdale & Coyne, 2018; Weinstein, 2010). Given these apparent contradictions in previous literature, further exploration needs to be conducted in understanding the relationship of gaming and wellbeing among post-secondary students. To examine this relationship, additional factors that can impact one’s wellbeing should be considered such as the motives for engaging in their leisure pursuits, one’s feelings of connection and support from others in the community, and the breadth of activities one engages in. The purpose of this study was to explore the relationship between gaming and wellbeing among post-secondary students while taking into account the player’s motivation, social connectedness, and overall leisure repertoire. A secondary data analysis was undertaken using data (n = 982) gathered from the Georgian College Student Wellbeing Survey launched in January 2019 conducted by the Canadian Index of Wellbeing (CIW). Multiple factors were considered in exploring the relationship to wellbeing including the students demographic characteristics (age, sex, student status). Students identified the frequency and intensity of their gaming, a measure of their leisure repertoire was calculated, and the degree to which they were socially motivated to participate in their leisure assessed. Three different measures were used to assess social connectedness: (1) number of close friends, (2) feelings of social isolation, and (3) sense of community (i.e., social climate and bonds). Finally, as a measure of their subjective wellbeing, students rated their life satisfaction along an 11-point scale. The findings indicated that neither whether students participated in gaming nor their intensity of gaming were significant factors in explaining wellbeing. Instead, social factors (feelings of social isolation and perceptions of social climate and bonds) and leisure repertoire were particularly significant factors in explaining their wellbeing. Reducing feelings of social isolation emerged as the most important factor in explaining wellbeing irrespective of how intensely or how often students participate in gaming. Ultimately, social context is the most important factor in explaining variations in wellbeing, above and beyond other factors including gaming participation and intensity

The Influence of Stigma on Disclosure Decision-Making in People Affected by Dementia

Background Disclosure decision-making refers to the way in which people affected by dementia choose to conceal or reveal their diagnostic status to others. Dementia is a stigmatised condition; the presence of stigma may generate reluctance to disclose a dementia diagnosis for fear of the consequences. Aims The aim of this thesis is to understand the influence of stigma on disclosure decision-making in dementia, to (1) establish the motivations for diagnostic secrecy and the barriers to disclosure in dementia, utilising literature on stigma, stigma reduction and decision-making; (2) test measures of stigma with people affected by dementia; (3) develop and test an intervention to support disclosure decision-making for people affected by dementia. Methods Robust methodology was employed to gather an initial understanding of the influence of stigma on disclosure decision-making through one conceptual and one systematic review, followed by adaptation and statistical analysis of psychometric instruments quantifying stigma in people affected by dementia. Intervention development and evaluation was conducted using Medical Research Council guidelines to create the first support group focussed on disclosure decision-making in dementia. Public and patient involvement was used throughout, ranging from the adaptation of psychometric instruments to intervention production being informed by coproduction principles. Results Stigma exacerbates the existing complexities in the nature of decision-making in dementia. Stigma measures for people living with dementia (N = 40) and carers (N = 70) were acceptable and suitable with adequate psychometric properties with some exceptions. Intervention development procedures resulted in a novel, 3-session, group based, dyadic (pairs of people living with dementia and their carers) approach heavily endorsed by stakeholders. Preliminary evaluation of the “who to tell, how and when?” intervention (N = 14; 7 dyads) is presented along with recommendations for further iterations. Conclusion Stigma negatively influences disclosure decision-making in dementia. Outputs of this thesis, with further testing, can help change this

Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives"

The "Age-Friendly Cities & Communities: States of the Art and Future Perspectives" publication presents contemporary, innovative, and insightful narratives, debates, and frameworks based on an international collection of papers from scholars spanning the fields of gerontology, social sciences, architecture, computer science, and gerontechnology. This extensive collection of papers aims to move the narrative and debates forward in this interdisciplinary field of age-friendly cities and communities

The Importance of Responsiveness: Improving Health-Related Outcomes Among Ostomates

More than 750,000 individuals in the United States live with an ostomy appliance, and additional 130,000 patients undergo ostomy surgery each year (United Ostomy Association of America, 2018). Although a life-saving procedure, patients confront significant physical (e.g., bowel routine and activity levels) and emotional (e.g., poor body image and depression) challenges that impede the adjustment process. When faced with health-related threats, the transactional action model of stress and coping argues that patients use strategies, such as seeking support, to effectively cope. However, because of perceptions of felt and enacted stigma and health-related uncertainty, some patients conceal ostomy-related issues and limit access to social support. Thus, patients struggle to effectively transition and adapt to life with an ostomy appliance. While the transactional model accounts for patients’ self-disclosure practices, little theoretical development has been offered to explain the importance of others’ responsiveness in shaping health-related quality of life. The purpose of this study is to better understand the ways self-disclosure about one’s ostomy to others, and the perception of responsiveness to the disclosure affect ostomy patients’ perceptions of social support, coping, and health-related quality of life. Specifically, this study proposes a theoretical model that incorporates perceived partner responsiveness within the transactional model of stress and coping framework. Survey data was collected from 375 ostomy patients. Path analysis was conducted to test the hypothesized model. Although the proposed model did not demonstrate adequate fit, analyses identified several direct and indirect factors influencing ostomy patients’ health-related quality of life. Most importantly, findings revealed that ostomates’ self-disclosure and health-related quality of life is mediated by perceived partner responsiveness. This study suggests that for patients perceived reactions that are responsive are paramount in improving health-related quality of life. To account for this relationship, this study this study proposes the disclosure-responsiveness theor

Health communication management: the interface between culture and scientific communication in the management of Ebola in Liberia

The research questioned the efficacy of standard biomedical information sharing and communication processes in ensuring rapid and reliable behavioural changes in the control of epidemics, especially in high-context cultures. Information processing arousals and behaviour change motivations are subject to the level of interactions in the extrinsic and intrinsic elements of an information. Following, epidemic control can only be successful if relevant elements of a system’s values, norms, beliefs and practices for information processing are superimposed on scientific communication to create shared meanings. An empirical research approach in grounded theory underscore the data collection of this research with the data analogy utilising the MAXQDA Analytics Pro software. Ebola behavioural changes were identified to be enabled by the functional properties of community mobilisation as a structure and process for meaning making and behavioural motivation. A contextual health communication model dubbed the ecological collegial communication model has been modelled for epidemiological control as the output of the research. Specific to the methodology, a systematic qualitative and data analysis process in grounded theory was adopted for conducting the research and the dissertation writing. Commencing the process was the identification and analysis of the problem from the perspectives of the challenges to the Ebola communication management. This was comprehensively identified from the fundamentals of the process of communication to the communication itself and was assessed from the motivational factors underlying the behaviours within which the rationality of the behaviours could be understood for their inflexibility to change or their insensitivity to the Ebola messages. The mediations of the behavioural motivators in the cognitive processes to information processing were considered for their intrinsic and extrinsic values to arouse information processing and persuade change. To explore the interface between communication and culture in cognitive processes of information processing and decision making, literatures on behavioural theories, including anthropological theories from which the processes and determinants of behavioural enactment are predicted were reviewed in chapters two to four. Intention (also used interchangeably in this dissertation as motivation) was unanimously construed as proximal in determining behaviours in the literatures. However, intention was also construed to have linkages with other factors in the determination of behaviours.:Dedication ii Declaration iii Acknowledgements iv Table of contents v List of figures vi List of photos vii List of matrices vii List of tables vii List of appendices viii Abbreviations ix 1 Communication and culture of the 2014/2015 West Africa Ebola outbreak 1 1.1 Introduction 1 1.2 Conceptualisation of the research problem – the key factors of the Ebola outbreak 4 1.2.1 Structural violence 7 1.2.2 Communication deficiency 10 1.2.3 Cultural models (values and practices 20 1.2.3a Death and funerals 21 1.2.3b Caregiving 26 1.2.3c Reliance on traditional healers 31 1.3 Research objectives 37 1.4 Definitions 38 1.5 Questions formulation and research questions 42 1.6 Justification 52 1.7 Conclusion 58 2 Theoretical frameworks consistent with the 2014/2015 Ebola outbreak health communication approaches – A discourse 59 2.1 Introduction 59 2.2 Psychological/behaviour science models 60 2.2.1 Health belief model 61 2.2.2 Protection motivation theory 64 2.2.3 Theory of planned behavior /reasoned action 71 2.2.4 Social cognitive theory / social learning theory 76 2.3 Summary 79 3 Information processing/communication theories 81 3.1Introduction 81 3.2 Elaboration likelihood model 81 3.3 Activation model 86 3.4 Narrative theory and entertainment education 88 3.5 Summary 95 4 Ecological theories / framework 97 4.1 Introduction 97 4.2 The PEN-3 Model 98 4.2.1 Health education (cultural identity)100 4.2.2 Cultural appropriateness of health behavior (cultural empowerment) 101 4.3 Bioecological theory 103 4.4 Developmental process of Bronfenbrenner’s model in the framework of the 2014/2015 Ebola outbreak 108 4.5 Theoretical framework of this dissertation 119 5 Research process and methodologies 125 5.1 Introduction 125 5.2 Justification of the research methodology 128 5.3 Overview of Monteserrado County 134 5.4 Techniques/procedures 137 5.4.1 Archival materials/documents 138 5.4.2 Ethnographic/observations 139 5.4.3 Key informants/in-depth interviews 142 5.4.4 Focus group discussions 143 5.5 Data analysis 146 5.5.1 Codes 147 5.5.2 Qualitative analysis employed in the research 152 5.6 Role of the researcher 153 5.6.1 Origins of the project 153 5.6.2 The discourse - philosophical worldview 156 5.6.3 Concluding thoughts 157 6 Data analysis: cultural practices, health and communication in the Liberian context 160 6.1 Introduction 160 6.2 Ethnicity and religion 162 6.3 Social organization 171 6.4 Aspects of death and burial practices 179 6.5 Concept of health and health care 186 6.6 Communication and information sharing approach in Liberia 193 6.6.1Traditional communication and the town crier in Liberia 195 6.6.2 Contribution of Crusaders for Peace 201 6.6.3 Development of overarching Ebola communication messages 206 6.7 Conclusion 210 7 Data analysis: Socio-cultural patterns in Ebola perceptions, content of messages and behavioural outcomes 212 7.1 Introduction 212 7.2 Parent codes – summative description and discussions 214 7.3 Understanding the socio-cultural patterns in Ebola knowledge and behaviours: Perceptions of Ebola transmissions 226 7.4 Content and nature of Ebola messages in perceptions and behaviours 237 7.5 Conclusion 276 8 Data analysis: Understanding the motivators of Ebola behaviours – an analytical interrelationships model perspective 278 8.1 Introduction 278 8.2 Patterns of Ebola behaviours 279 8.3 Conclusion 317 9 Decoding: the interface between culture and communication in the Ebola communication management 319 9.1 Introduction 319 9.2 Contextual elements of effective communication – the interface 321 9.3 Cognitive heuristics to “…protect yourself…” 336 9.4 Processes of moderations of “protect yourself” in cognitions 339 9.5 Conclusion 343 10 Theoretical and conceptual inferences from empirical data and framework for a culturally appropriate communication 344 10.1 Introduction 344 10.2 Research questions 344 10.3 Epidemic control: The cultural model framework to persuasive communication for epidemic management 359 10.3.1 The composite conceptual analytical elements of the model 364 10.3.1a Model definition and assumptions 365 10.3.1b The ECCM – the interactive elements of a system 367 10.3.1c Pattern of communication in the ECCM 371 10.3.2 Summary 374 10.4 Processes of how to apply the ECCM 375 10.5 Limitations of the model 382 10.6 Conclusion 383 11 Conclusions and recommendations 385 11.1 Introduction 385 11.2 Key conclusions 385 11.3 Implications 387 11.3.1 Policy framework implications 387 11.3.2 Theoretical implications 390 11.4 Further research 393 11.4.1 Approach to communication 393 11.4.2 Cultural dynamics 396 11.4.3 Health perceptions 398 11.4.4 Ebola orphans and victims 398 11. 5 Research limitations 399 References 40

Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis

Background: To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people. Objectives: The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives. Data sources: Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants. Review methods: Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness. Results: The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal levels increase risk of loneliness, and undermine access to, and the impact of, interventions. Racism operates in various ways throughout the system to increase risk of loneliness. Limitations: There was a lack of high-quality quantitative studies, and there were no studies with longer-term follow-up. UK evidence was very limited. Studies addressing upstream determinants operating at the community and societal levels did not link through to individual outcome measures. Some elements of the search approach may mean that relevant literature was overlooked. Conclusions: Theory regarding the causes of loneliness, and functioning of interventions, among migrant and ethnic minority populations was usefully developed. Evidence of positive impact on loneliness was strongest for shared-identity social support groups. Quantitative evidence was inadequate. The UK evidence base was extremely limited. Future work: UK research in this area is desperately needed. Co-production of interventional approaches with migrant and ethnic minority people and evaluation of existing community-based initiatives are priorities

Views from the “dustbin”: a phenomenological examination of the experiences of a borderline personality disorder diagnosis as a parent

Literature highlights negative attitudes among different health and social care professionals towards individuals diagnosed with borderline personality disorder (BPD). Negative attitudes and inconsistent interactions are implicated in poor outcomes, including: increased stigma, self-stigmatisation, disengagement from treatment, and malignant alienation, often contributing to increased incidence of symptomatology, self-harm, and suicidal ideations and behaviours. To date, efforts to understand the extent to which these attitudes are internalised by service users, from the perspective of service users, are marked by their paucity. Coupling this with research highlighting poor outcomes among the children of individuals diagnosed BPD, along with a noted child protection risk among this group, the present research aims to increase understanding from the perspective of BPD-diagnosed parents themselves. The empirical chapters of this thesis see a phenomenological approach; through an IPA interview study and a phenomenologically driven series of focus groups, to examine diagnosis, experiences of care and treatment, and parenting. Findings highlight experiences of negative attitudes and interactions with service providers exacerbating stigma and self-stigma, lack of understanding of the diagnosis and how it relates to the individual specifically representing a barrier to engagement and therefore treatment. Little specific information is provided about the parenting challenges and capacities representing a significant aspect of the experience of participants. These findings are discussed in relation to previous research, demonstrating inconsistency and iatrogenic interactions during the period of diagnosis and treatment, identifying further impact on parents and parenting. The process and utility of diagnosis is also examined with a proposed diagnostic trajectory model applied to this participant group