Patients' experience one year after dialysis initiation: a lexicometric analysis

Background Dialysis implies huge changes in patients' lives. Yet, there is a need to better understand patients' experience in the time following dialysis initiation. Objective The objective of this study was to investigate patients' experience of dialysis a year after treatment initiation and the associations between patients' discourse and their anxiety and depression symptoms. Methods Twenty two patients (mean age 63.4; 68% men) took part in a semi-directed interview about their experience with dialysis. Participants completed the Hospital Anxiety and Depression Scale (HADS). Interviews were analyzed using a lexicometric analysis. Results The analysis generated five classes: experience with nephrological care, facing loss and family relationships, family and acceptance, implementation of a new routine and making sense of the end-stage renal disease experience. Patients' felt very passive in their experience with care. They reported the importance of integrating dialysis in their lives and the role of family support when facing treatment initiation. Depressed patients were more likely to describe their nephrological monitoring very factually and to talk about what they lost with dialysis initiation. Conclusion Dialysis initiation is a hard time for patients during which they face many challenges. This first year represents a time of adaptation, in which family seems essential

Construction et validation d’une épreuve de groupe élaborée dans le cadre d’un « assessment center » pour des officiers de marine

Si les études antérieures ont établi la validité prédictive des Assessment Center (A.C.) dans le domaine de l’évaluation du personnel et du recrutement, leur validité de construit n’a pas été démontrée. Dans le cadre d’un travail plus large visant à construire et valider un « Assessment Center » destiné à des officiers de la marine nationale française, nous avons élaboré une épreuve de groupe (discussion sans leader assigné), dont nous présenterons ici la construction et la validation (validité de contenu, de construit et validité prédictive) ; ces validités ont été testées sur un échantillon de 125 officiers de marine. Nous décrirons ici la construction de grilles d’observation « comportementales » et la formation des observateurs. Tout d’abord, des analyses factorielles exploratoires ont été menées sur les données collectées et trois dimensions furent identifiées (prise d’initiatives efficaces, travail en équipe, autoritarisme). Ensuite, des régressions linéaires multiples ont été calculées entre ces trois facteurs et un critère ultérieur de réussite professionnelle. Ces dimensions ont avec le critère un coefficient de régression multiple significatif (R2 = .43). Les mises en situation apportent des informations complémentaires précieuses que les tests psychométriques classiques ne permettent pas de capturer, soit les interactions entre individus et situations professionnelles.If past research has established the predictive validity of Assessment Centers (A.C.) in the field of personnel assessment and recruitment, their construct validity has not been demonstrated. Within the framework of a larger study aiming to construct and validate an Assessment Center for French Navy officers, we elaborated a group situation (leaderless group discussion), whose construction and validation (content, construct and predictive validity) will be presented here. The validities were tested on a sample of 125 navy officers. We describe here the construction of behavioral checklists and the training of the observers. First, exploratory factor analyses were conducted on the data gathered, and three factors were identified (initiative, teamwork, authoritarianism). Then, linear multiple regressions were calculated between these three factors and a criterion of further professional performance. These factors have a significant multiple regression coefficient with the criterion (R2 = .43). The situational tests bring us precious complementary information that classical psychometrical tests cannot capture, e.g. the interactions between individuals and professional situations

Evolution et différences dans l'ajustement des couples au cancer du sein (rôle des facteurs psychosociaux et influence réciproque des deux membres de la dyade)

Introduction : Les premiers mois qui suivent un diagnostic de cancer du sein représentent un temps critique pour les patientes et leur partenaire. Les objectifs de cette étude sont de décrire l évolution de variables psychosociales et d examiner les effets individuels et dyadiques de ces variables sur l ajustement des couples. Méthode : 83 patientes atteintes d un cancer et 76 couples touchés par cette maladie ont été rencontrés au début, au milieu et à la fin du traitement, puis 1, 3 et 6 mois après la fin du traitement. Ils ont complété des mesures de contrôle émotionnel, de détresse psychologique, de qualité de vie, d ajustement dyadique, de soutien social et de coping face à la maladie. Résultats: Les résultats montrent que les sujets rapportent des niveaux élevés d anxiété, avec un court déclin pour les patientes durant le traitement. Le soutien social, l esprit combatif et les préoccupations diminuent avec le temps.En utilisant l Actor and Partner Interdependence Model, nos résultats révèlent que la détresse psychologique, le contrôle émotionnel, le soutien social négatif et les stratégies de coping émotionnelles ont des effets acteurs et partenaires négatifs sur l ajustement des patientes et des conjoints, et que l ajustement dyadique et le soutien social ont des effets acteurs et partenaires positifs sur ce même ajustement. De plus, la détresse psychologique des patientes, le soutien social négatif et les stratégies de coping émotionnelles jouent un rôle positif et significatif sur l ajustement des partenaires. Le soutien social a des effets acteurs et partenaires sur le choix des stratégies de coping. Conclusion : Ces résultats montrent l importance de combiner les approches transactionnelle individuelle et systémique. Les résultats suggèrent également que les couples pourraient bénéficier d interventions qui augmentent le soutien social et les compétences de communication et qui aident à gérer la détresse psychologique.Introduction: The first months following breast cancer diagnosis is a critical period for patients and their partners. The objectives of the study were to describe the course of psychosocial variables and to examine the individual and dyadic effects of these variables on the adjustment of couples.Method: 83 breast cancer patients and 76 couples dealing with breast cancer were interviewed at the biginning, half way through, at the end of the treatment, and 1, 3 and 6 months after treatment completion. They completed measures of emotional control, psychological distress, quality of life, dyadic adjustment, social support and coping.Results: Results showed that subjects endured high levels of anxiety, with a short decline for women during treatment. Social support, fighting spirit and anxious preoccupations decreased over time.Using the Actor and Partner Interdependence Model, results revealed that psychological distress, emotional control, negative social support and emotional coping strategies had similar negative actor and partner effects on respective adjustment, and that dyadic adjustment and social support had similar positive actor and partner effects on patients and partners adjustment. Patient s psychological distress, negative social support and emotional coping strategies play significant and positive roles in partner s adjustment. Social support had actor and partner effects on choices of coping strategies.Conclusion: These findings show the importance of combining individual transactional and systemic approaches. Results also suggest that couples may benefit from interventions that enhance social support and communications skills and manage psychological distress.BORDEAUX2-Bib. électronique (335229905) / SudocSudocFranceF

Le stress professionnel et le burnout chez les chirurgiens-dentistes (rôle de certaines caractéristiques personnelles et contextuelles dans l'ajustement au stress professionnel)

Introduction : L Odontologie est considérée comme une profession stressante, fréquemment associée à des problèmes de santé, tant d ordre physique que psychique. L objectif de cette étude est d élucider le rôle de certains facteurs psychosociaux chez les Chirurgiens Dentistes Français et Brésiliens.Méthode : Nous avons mené une étude longitudinale auprès de 322 Chirurgiens-Dentistes (161 Français et 161 Brésiliens) au premier temps et au deuxième temps sur une cohorte de 179 (94 Français et 85 Brésiliens). Des mesures relatives à certaines caractéristiques socio-démographiques, psychosociales et transactionnelles ont été ont été administrées aux Chirurgiens-Dentistes. Les critères retenus étaient le burnout, la dépression, les troubles musculo-squelettiques et les troubles du sommeil évaluées à T2 ainsi que des stratégies de coping. Nous avons construit une échelle de stress spécifique à notre population. L analyse factorielle a permis d obtenir 1 facteur. Dans une perspective prédictive, des analyses en équation structurales nous ont permis, pour chacun le burnout et la dépression, de tester l adéquation d un modèle théorique aux données observées.Résultats : L influence des scores obtenus sur le burnout, les troubles musculo-squelettiques et les troubles du sommeil) est confirmée par des analyses typologiques identifiant trois profils des dentistes : les dentistes en bonne santé, moins accomplis et en mauvaise santé. Les profils des dentistes Français et Brésiliens sont similaires. Les profils des dentistes moins accomplis et en mauvaise santé liés à certains facteurs psychosociaux, semblent particulièrement à risque de développer une mauvaise santé. Nous avons mis en évidence plusieurs modèles intégratifs témoignant d effets directs et indirects des antécédents sur les critères, médiatisés par certaines variables transactionnelles. Les variables ratio effort/récompense et le coping de réévaluation du problème ont des effets médiateurs sur : le perfectionnisme et l épuisement émotionnel, la solitude et l épuisement émotionnel, le sentiment de solitude et la dépression. Le perfectionnisme prédit la dépression, cet effet passe par le ratio effort/récompense. Conclusion : Ces résultats montrent l intérêt d appliquer le modèle transactionnel à la santé des Chirurgiens-Dentistes et suggèrent des pistes de réflexion concernant les perspectives appliquées que ce soit en terme de prévention ou de prise en charge.Introduction: The Dentistry is considered a stressful profession, being frequently associated with health problems, physical as much mental. The objective of this study is to elucidate the role of psychosomatic factors that affect French and Brazilian dentists.Method: Was made a longitudinal study in 322 dentists (161 French and 161 Brazilians), at a first turn, and 179 dentists at a second turn (when 94 was French and 85 was Brazilians). Measures related to certain socio demographic characteristics (psychosomatic and transactional) were administered for the dentists. The study s criterions at the second turn were: burnout, depression, muscle-skeleton s disturbances and sleep disturbances and copping strategies. We construct a specific stress scale for our sample. The factorial analysis resulted in only one factor. Through a perspective predictive, analysis of structural equations allowed to burnout and to depression to test a theoretical model across the observed data.Results: The score analysis obtained from burnout, depression, muscle-skeleton s disturbances and sleep disturbance, allowed to identify, by cluster analysis, three dentists profiles: with good health ; with minor personal accomplishment ; with health at risk . The French and Brazilian dentist profiles were similar. The psychosomatic factors that influence the adhesion to a one of these profiles are different between the two groups (French and Brazilians). At France, above all, are the context variables and from stress processes (imbalance of effort and reward, specific stress of dentists and copping strategies) that are risk factors to the health. At Brazil, this is the dispositional variables (age, perfectionism and over commitment). We tested an integrator model which showed direct and indirect effects on criterions of our study, mediated by some transactional variables. The variables imbalance between effort and reward and copping, in the revaluation of the problem, has mediation s effects between perfectionism and emotional exhaustion, between the solitude and emotional exhaustion, between the solitude and depression and between perfectionism and depression.Conclusions: These results showed the interest of application of the transactional model to the health of the surgeons dentists in two different cultures and suggests ways to a reflection about the applied perspectives, in terms of prevention as much as care.BORDEAUX2-Bib. électronique (335229905) / SudocSudocFranceF

Psychometric Properties of the French Adaptation of the Multidimensional Body Self Relations Questionnaire–Appearance Scales

International audienceThe present study investigated the psychometric properties of the French adaptation of the Multidimensional Body Self Relations Questionnaire–Appearance Scales, a widely used instrument in body image research. The questionnaire is composed of five subscales: Appearance Orientation, Appearance Evaluation, Overweight Preoccupation, Self-classified Weight, and the Body Areas Satisfaction Scale. Exploratory factor analyses were conducted on a sample of 765 subjects for the first two subscales. As expected, the analyses yielded two factors: Appearance Orientation and Appearance Evaluation. Internal consistencies ranged between .66 and .88 and test-retest reliabilities ranged between .78 and .85 for the five subscales. Appearance evaluation and the Body Areas Satisfaction Scale showed good convergent validity with the Body Image Questionnaire. Validity was supported by comparing scores for sex, for groups according to body mass index (underweight, normal weight, overweight, and obese), and by exploring the influence of social desirability

Changes in Mothering Ideology After Childbirth and Maternal Mental Health in French Women

The prevailing dominant discourse about motherhood in western societies reflects a set of interconnected beliefs referred to as intensive mothering ideology. Little is known about how intensive mothering ideology changes after childbirth, and the associations between intensive mothering ideology and maternal mental health. The current study aims to explore how intensive mothering ideology may evolve after childbirth in both primiparous and multiparous women, and whether any observed changes in this ideology impact maternal mental health. French women (n = 144) completed a set of study measures during late pregnancy and then again at two months and four months postpartum, which assessed intensive mothering ideology, postpartum depression, and maternal burnout symptoms. As expected, the results indicated that intensive mothering ideology increases after childbirth. However, changes in ideology were not stronger in primiparous women compared to multiparous women. Of note, multiparous women reported stronger challenge and sacrifice beliefs. Finally, linear mixed models showed that changes in intensive mothering ideology were associated with maternal mental health in contradictory ways, while controlling for parity and unemployment. Mainly, growth in sacrificial beliefs seems to be detrimental to maternal mental health. These findings have implications for the well-being of mothers after childbirth and call for challenging the self-sacrifice beliefs that underpin intensive mothering ideology in order to promote self-care

The Maslach Burnout Inventory – Human Services Survey (MBI-HSS): factor structure, wording effect and psychometric qualities of known problematic items

International audienc

Matern Child Health J

Introduction According to many studies, anxiety in the perinatal period is widespread and has many detrimental effects. Thus, screening measures should not be limited to assessing depression symptoms. The widely used Edinburgh Postnatal Depression Scale (EPDS) might assess depression but also anxiety symptoms. This study explores whether an anxiety dimension (EPDS-3A) was found and valid in French women during pregnancy and the postpartum period. Methods French women were followed-up at late pregnancy and 2 and 4 months postpartum (N = 144, 138 and 129). They completed the EPDS and the Hospital Anxiety and Depression Scale (HADS-A). Exploratory factor analyses were performed. Then to test its validity, the EPDS-3A was correlated with anxiety (HADS-A) and depression (EPDS-D) scores. Finally, prevalence estimates were computed according to recommended cut off. Results The anxiety dimension assessed through the EPDS-3A was observed during the postpartum period but not during pregnancy. A two-factor structure (depression and anxiety) increases the variance explained at 2 and 4 months postpartum (respectively 6 and 12%). The EPDS-3A shows good internal consistency (≥ .70) and was more strongly associated with anxiety scores (HADS-A) (.48–.57) than with depression scores (EPDS-D) (.30–.39). Nearly 28% of mothers had scores that exceeded the EPDS-3A cut off (≥ 4) but not the full EPDS cut off (≥ 13 or more). Discussion The EPDS contains an anxiety component (EPDS-3A) that can be found in French women during the postnatal period but not during pregnancy. It shows signs of internal consistency and validity. The EPDS-3A could be considered when screening for postpartum anxiety

Workplace bullying: is there a difference by enterprise size?

OBJECTIVE: While relationships between working conditions, bullying and health issues have been proven, most studies have investigated these relationships in large enterprises (> 250 employees). Indeed, only a few studies have analyzed this issue in small firms, despite the fact that the latter differ from the former at multiple levels. Therefore, our objective was twofold: to assess whether the size of a firm had an impact on the frequency of workplace bullying and to identify whether the effects of bullying on workers' health differed according to the size of the company. METHOD: Data from the 2010 SUMER French periodical cross-sectional survey were analyzed (N = 31,420 for the present study). Bullying at work was measured based on nine possible hostile attitudes derived from the French version of the Leymann Inventory of Psychological Terror. Two other questions measured colleague-to-colleague verbal violence and sexual or physical assaults. Anxious or depressive episodes were measured using the Hospital Anxiety and Depression scale (HAD). Other health issues were: perceived health status, sickness absence (at least one absence lasting more than eight days), and work injuries. RESULTS: Our findings show that bullying at work was less frequent in micro enterprises (< 10 employees). Anxiety/depression, perceived health status, sickness absence (at least one lasting more than eight days) were significantly associated with workplace bullying, but the effects of bullying were significantly higher in micro enterprises (statistical interaction). CONCLUSION: This study highlights how a firm's size influences workplace bullying and, in particular, the prevalence and consequences of bullying in micro enterprises. The implication and guidelines for practice are discussed