Optimism measured pre-operatively is associated with reduced pain intensity and physical symptom reporting after coronary artery bypass graft surgery.

OBJECTIVE: Optimism is thought to be associated with long-term favourable outcomes for patients undergoing coronary artery bypass graft (CABG) surgery. Our objective was to examine the association between optimism and post-operative pain and physical symptoms in CABG patients. METHODS: We assessed optimism pre-operatively in 197 adults undergoing CABG surgery, and then followed them up 6-8 weeks after the procedure to measure affective pain, pain intensity, and physical symptom reporting directly pertaining to CABG surgery. RESULTS: Greater optimism measured pre-operatively was significantly associated with lower pain intensity (β=-0.150, CI=-0.196 to -0.004, p=.042) and fewer physical symptoms following surgery (β=-0.287, CI=-0.537 to -0.036, p=.025), but not with affective pain, after controlling for demographic, clinical and behavioural covariates, including negative affectivity. CONCLUSIONS: Optimism is a modest, yet significant, predictor of pain intensity and physical symptom reporting after CABG surgery. Having positive expectations may promote better recovery

Psychological, surgical, and sociodemographic predictors of pain outcomes after breast cancer surgery: A population-based cohort study

Chronic postsurgical pain (CPSP) is a common postoperative adverse event affecting up to half of women undergoing breast cancer surgery, yet few epidemiological studies have prospectively investigated the role of preoperative, intraoperative, and postoperative risk factors for pain onset and chronicity. We prospectively investigated preoperative sociodemographic and psychological factors, intraoperative clinical factors, and acute postoperative pain in a prospective cohort of 362 women undergoing surgery for primary breast cancer. Intraoperative nerve handling (division or preservation) of the intercostobrachial nerve was recorded. At 4 and 9 months after surgery, incidence of chronic painful symptoms not present preoperatively was 68% and 63%, respectively. Univariate analysis revealed that multiple psychological factors and nerve division was associated with chronic pain at 4 and 9 months. In a multivariate model, independent predictors of CPSP at 4 months included younger age and acute postoperative pain (odds ratio [OR] 1.34, 95% confidence interval [CI] 1.12 to 1.60), whereas preoperative psychological robustness (OR 0.70, 95% CI 0.49 to 0.99), a composite variable comprising high dispositional optimism, high positive affect, and low emotional distress, was protective. At 9 months, younger age, axillary node clearance (OR 2.97, 95% CI 1.09 to 8.06), and severity of acute postoperative pain (OR 1.17, 95% CI 1.00 to 1.37) were predictive of pain persistence. Of those with CPSP, 25% experienced moderate to severe pain and 40% were positive on Douleur Neuropathique 4 and Self-Complete Leeds Assessment of Neuropathic Symptoms and Signs pain scales. Overall, a high proportion of women report painful symptoms, altered sensations, and numbness in the upper body within the first 9 months after resectional breast surgery and cancer treatment.For the Recovery Study Grou

Factors associated with good adherence to self-care behaviours amongst adolescents with food allergy

Background: Our understanding of factors which affect adherence to health sustaining self-care behaviours in adolescents with food allergy is limited. This study used the Health Belief Model to explore the relationship between food allergic adolescents’ health beliefs, demographic, structural and social psychological factors with adherence to self-care behaviours, including allergen avoidance and carrying emergency medication. Methods: A cross-sectional study of 188 13- to 19- olds identified from hospital prescribed auto-injectable epinephrine for food allergy. Data were collected on demographics, structural factors, social psychological factors, health beliefs and current adherence behaviour using a postal questionnaire. Results: Full adherence was reported by 16% of participants. Multivariate analysis indicated that adherence was more likely to be reported if the adolescents belonged to a support group (OR = 2.54, (1.04, 6.20) 95% CI), had an anaphylaxis management plan (OR = 3.22, (1.18, 8.81) 95% CI), perceived their food allergy to be more severe (OR = 1.24, (1.01, 1.52) 95% CI) and perceived fewer barriers to disease management (OR = 0.87, (0.79, 0.96) 95% CI). Conclusions: Membership of a patient support group and having an anaphylaxis management plan were associated with good adherence to self-care behaviours in adolescents with food allergy. Our results suggest that interventions to improve provision and utilisation of management plans, address adolescents’ perceptions of the severity of anaphylaxis and reduce barriers to disease management may facilitate good adherence behaviours than focussing on knowledge-based interventions

Osteoarthritis: Patient Expectations about Future Pain, Stiffness and Function

Objectives The aim of the present study was to examine the difference between osteoarthritis patients’ self-reported assessments of current pain, stiffness and physical function and their expectations of these symptoms in one and five years’ time, and to determine the significant predictors of positive expectations. Methods Eighty patients completed ratings of baseline assessments and one- and five-year expectations of pain, stiffness and physical function using the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Measures of illness perceptions, coping styles, health values, satisfaction, quality of life, optimism, self-esteem and moods were also collected at baseline. Agreement between patients’ current assessment and expectations were calculated using intra-class correlations (ICCs). Paired-sample t-tests were conducted to look at differences between assessments. Univariate logistic regressions were then performed to identify the variables significantly associated with positive expectations of pain, stiffness and function. Significant variables (p < 0.05) were entered into a forward stepwise multivariate logistic regression to identify unique independent predictors of positive expectations for each of the WOMAC subscales. Results Differences were found between current assessments and expectations, with the majority of patients being positive about future symptoms. There were some differences between the predictors for one- and five-year expectations, with current assessments of health status only affecting five-year expectations. Conclusions It is necessary to investigate further the variables that may contribute to positive expectations in osteoarthritis patients in order to manage the condition more effectively

Self-regulation of unattainable goals in suicide attempters: the relationship between goal disengagement, goal reengagement and suicidal ideation

There is growing interest in models of adaptive self-regulation. Recent research suggests that goal disengagement and goal reengagement (i.e., goal adjustment) are implicated in the self-regulation of emotion. This study extends the self-regulation research to investigate the utility of goal adjustment in understanding suicidal risk. To this end, two hundred adults hospitalised following a suicidal episode completed a range of clinical and psychological measures in hospital and were followed up approximately 2.5 months after discharge (Time 2). Hierarchical regression analyses showed that goal reengagement predicted suicidal ideation at Time 2. In addition, the lack of goal reengagement was especially pernicious when reported concomitantly with high disengagement. These predictive effects were independent of baseline mood, attempt status and suicidal intent. The theoretical and clinical implications are discussed

An interpretative phenomenological analysis of stress and coping in first year undergraduates

In the UK, changes to the higher education system have increased the range of stressors experienced by students above those traditionally associated with the transition to university. Despite this, there is little qualitative research examining how students experience and cope with the adjustment to university. The experience of the transition was investigated in depth amongst 10 first year UK undergraduates. Purposive sampling resulted in a group with demographics similar to national statistics on UK undergraduates. Semi-structured interviews were used beginning with a content specific vignette to develop rapport. Interpretative phenomenological analysis was utilised to analyse the transcripts and quality checks were implemented to increase the validity of the analysis. Five main themes were identified: all the change, with subthemes of independent living, homesickness, differences between post-compulsory education and university; expectations of university; academic focus with subthemes of self-discipline, motivation, learning from experience; support network with subthemes of establishing a support network, support for coping with problems; and difficulties with subthemes of difficulties experienced with housemates, finances and employment, and academic difficulties. Students used a range of coping strategies. By identifying the role of positive psychological strengths such as optimism, hope, self-efficacy and self-control in coping with stress and facilitating positive adaptation, the study locates positive psychological strengths within a transactional understanding of stress and provides depth and relevance to their role in facilitating adjustment. Such qualitative research is rare in the positive psychology and stress literature. Suggestions for easing the transition are made

Optimistic Disclosure Tone and Conservative Debt Policy

We examine the relationship between managerial optimism and debt conservatism (i.e. the low-leverage puzzle). Our analysis demonstrates that optimistic tone, our time-varying optimism measure, significantly decreases leverage. This evidence supports the proposition that optimistic managers who consider external financing as unduly costly use debt conservatively. This reduced reliance on external financing can be explained by our further evidence that optimistic tone significantly increases cash holdings and decreases dividend payment. The negative tone-leverage relation is stronger in the presence of high insider purchase of own stocks which confirms that optimistic tone reflects managerial optimism. This study suggests that managerial optimism can help explain the low-leverage puzzle

Optimism scale: Evidence of psychometric validity in two countries and correlations with personality

Optimism can be defined as the hope that something good is going to happen in the future. It is a relevant construct in the study of happiness, and is associated with a range of variables, including subjective well-being, reduced risk of suicidal ideation, quality of social relationships, and a healthier lifestyle. However, current measures of optimism were criticized regarding their structure and reliability. To address these limitations, Pedrosa et al. (2015) proposed a new scale of dispositional optimism that was originally published in Spanish. In the present research, we aimed to provide further psychometric evidence of the 9-item Optimism Scale in the United Kingdom (N = 325) and Brazil (N = 421). Exploratory and confirmatory factor analyses in both countries were consistent with the original findings, supporting the unifactorial structure. Item Response Theory revealed good discrimination, level of difficulty, and informativeness of the items. Further, we found good reliability estimates of the scale, full factorial invariance across participants' gender and partial invariance across countries, and positive correlations with all Big-5 personality traits. In sum, our findings suggest that the dispositional Optimism Scale is a psychometrically adequate measure that can be used cross-culturally