Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages?

Background: Many people experience cancer as a chronic disease followed by adaptation to a new reality. Adjustment to cancer is a continuous process that follows the progression of the disease. Aims: We aimed to support the claim that patients in different stages of cancer develop different adjustment patterns, and that the stage of the disease modifies the interrelationships among social support, coping styles, and quality of life. We also hypothesized that greater perceived social support influence more adaptive coping strategies, which mediate the relationship between social support and adjustment, differently in the early and advanced stage of cancer. Methods. One-hundred-two consecutive cancer patients were recruited. Measures. We administered the Social Provision Scale, the Mini-Mental Adjustment to Cancer, the Brief-COPE, and the SF-12 health survey. Results. No differences emerged in adjustment to cancer, coping relate variables and quality of life between stage III and stage IV patients. Subsequent analyses revealed that the stage of the disease moderated the relationships between fatalism and fighting spirit and those between physical health and both avoidance and problem-solving. Regardless of the stage of illness, positive thinking mediated between social support and fighting spirit. Conclusion. Although the average adjustment pattern was the same for early-stage and advanced patients, adjustment processes were different according to cancer stage. The results confirm that social support and disease stage are important for adjustment to cancer. Favouring acceptance, positive reframing, and humour, social support helped patients to be more determined in fighting the disease and contrasted helpless-hopelessness and anxious preoccupation

Towards a community clinical psychology? Insights from a systematic review of peer-reviewed literature

The present systematic review provides a narrative synthesis of the peer-reviewed literature concerning the synergy between community and clinical psychology, with the specific aim of detecting the theoretical, research, and practical basis for the development of a well-integrated community clinical psychology perspective. The authors screened 216 records on the topic, found in major citation databases (PsycArticles, PsycINFO, Scopus, and Web of Science) without time or language restrictions. Six articles addressing the review question were identified and examined through seven conceptual criteria referred to contextual premises, definitions, addressed problems/issues, application areas, reference theoretical models, examined constructs, and required professional competences. The results do not show evidence for a well-integrated community clinical psychological perspective, despite the many synergies between such disciplines on a theoretical and applied level. Community and clinical psychology could thus be further integrated in the future, potentially giving rise to a new and independent field of knowledge to get more comprehensive understanding of the relationship between individuals and social contexts

Il rapporto tra ospedale e territorio nell’attuazione della continuità assistenziale. Il caso del fine vita

La continuità assistenziale è un principio fondamentale nelle cure primarie. Essa risponde all’obiettivo di creare una integrazione e una collaborazione tra le varie strutture e servizi di assistenza sanitaria. A livello organizzativo rappresenta l’erogazione di servizi inseriti all’interno di un piano gestionale condiviso che dovrebbe sostanziarsi nella capacità di avviare e mantenere attivo un modello di lavoro in rete. Implementare un lavoro di rete tra ospedale e territorio implica un cambiamento culturale radicale che sembra essere perseguito con molta difficoltà nella realtà italiana. La difficoltà di questa sfida è più evidente nella gestione del fine vita, specialmente per il personale medico. A questo proposito il nostro studio si pone le seguenti domande di ricerca: Come i medici si rappresentano la continuità tra ospedale e strutture del territorio deputate alla gestione di pazienti terminali? quali sono le connotazioni culturali prevalenti della struttura ospedaliera e dell’hospice? Come viene trattata la questione del fine vita? L’obiettivo principale della ricerca è stato quello di esplorare i modelli culturali che organizzano le rappresentazioni che i medici hanno della continuità della cura nel fine vita. A questo proposito sono stati intervistati, attraverso un’intervista semi-strutturata, 10 medici (4 appartenenti all’UOC di Oncologia medica dell’ospedale, 4 appartenenti all’UOC di Medicina d’urgenza dell’ospedale e 2 appartenenti all’hospice), operanti nel territorio di un capoluogo di provincia umbro. I testi delle interviste sono stati interamente trascritti e analizzati attraverso l'Analisi Fenomenologica Interpretativa (IPA). Complessivamente i dati emersi evidenziano una offerta dei servizi al paziente terminale non inserita in una rete condivisa, una cultura della continuità assistenziale ancora debole ma fortemente differente nei due contesti di riferimento. Il processo di handover appare una pratica sostanzialmente formale e adempitiva, non basata su una comunicazione efficace e costruita sulle esigenze di paziente e familiare, quanto piuttosto agita in tempi strettissimi e quando il fine vita è imminente. Viene, infine, discussa la funzione della professione di psicologo, evidenziando la necessità di una sua collocazione all'interno del team di assistenza, non solo con compiti di assistenza agli utenti, ma anche di facilitazione dei processi di lavoro e di costruzione dell’handoverContinuity of care is a fundamental principle in primary care. It responds to the integration and collaboration principle between different health-care services. At the organizational level, continuity of care is the provision of services included in a management plan that uses a shared model of network work. Implementing the network between hospital and territory implies a radical cultural change, which shows many difficulties to be achieved in Italian reality. The complexity of this challenge is most evident in the management of end of life, especially for physicians. In this regard, in our study we posed the following research questions: As physicians represent the continuity between hospital and territory in the management of terminal patients? What are the cultural characteristics of the Hospital and Hospice? How it is treated the issue of the end of life? So, main objective of the research was to investigate the cultural models that organize the representations of physicians regarding continuity of care in the end of life. Through semi-structured interview, were interviewed 10 physicians (4 UOC of Medical Oncology Hospital, 4 of the 'Division of Emergency Medicine Hospital and 2 of hospice), operating in Umbria territory. The texts of the interviews were fully transcribed and analyzed through the Interpretative Phenomenological Analysis (IPA). Overall, the findings highlight a offer of services to the terminal patient not included in a shared network and a culture of continuity of care still weak but strongly different in the two contexts. The handover process appears to be a formal practice, not built on the patient and family’s needs, and acted when the end of life is imminent. The function of the psychological profession is discussed, highlighting the need for its placement within the care team, not only with tasks of assistance to users but even on the facilitation of the working group processes and handover construction

Body mass index, personality traits, and body image in Italian pre-adolescents: An opportunity for overweight prevention

We investigated the relationship between body mass index (BMI) and personality traits, socioeconomic status (SES), and body image (BI) at the beginning of preadolescence. Data were collected from 238 Italian children aged 10?11 years using self-report scales. Information about SES was derived from parental education and professional status. BI was the variable the most strongly associated with BMI. Controlling for BI, SES, and gender, Agreeableness was inversely associated with BMI, whilst Extroversion was related to BMI in girls only. Gender did not moderate the associations between BI and BMI at this age. The relationship of certain personality traits with BMI is likely to emerge during preadolescence. Early interventions to reduce overweight and obesity could consider the interplay of Agreeableness and Extroversion with gender, BI, and SES

Psychologists in italian hospital settings: an exploratory analysis of hospital physicians: representations and demands of psychological Intervention

Aunque la Organización Mundial de la Salud ha evidenciado la importancia de adoptar modelos integrados de asistencia basados en el enfoque bio-psico-social, en los servicios de salud, como los hospitales, existe todavía mucha resistencia para su implementación. Se presenta un estudio exploratorio cualitativo dirigido a comprender las representaciones y las demandas de los médicos hospitalarios con respecto a la intervención psicológica en los contextos hospitalarios italianos. Conforme a este objetivo se desarrolló un guión de entrevista semi-estructurada y se entrevistaron 15 médicos italianos divididos por género, edad y especialidad médica. Fueron investigados las representaciones de la enfermedad, el acercamiento a los pacientes y los modelos de intervención, la experiencia de colaboración con psicólogos, las representaciones de dónde, cuándo y cómo los psicólogos podrían ser útiles en el contexto hos pitalario, las visiones generales del hospital y de su futuro, los puntos de fuerza y de debilidad de su trabajo, las estrategias utilizadas para superar las dificultades diarias y las estrategias propuestas pa ra mejorar el sistema hospitalario. El análisis de contenido de las entrevistas ha revelado que la intervención psicológica está representada predominantemente como una intervención a nivel individual dirigida a contener el distrés emocional en relación con la enfermedad. Además se ha evidenciado la falta de consideración de la competencia psicológica como útil para promocionar el funcionamiento organizativo de los servicios hospitalarios. Estos resultados pueden apoyar la investigación futura en esta área y son utilizados pa - ra discutir las oportunidades de un diálogo constructivo entre ciencias médica y psicológica en los contextos hospitalarios.ABSTRACT: During the years, the World Health Organiza - tion has been emphasising the importance of promoting integrated models of care consistent with a bio-psycho-social approach to health-illness. Nonetheless, healthcare services still show much resistance to the implementation of such models and the use of multidisciplinary teams. As a con - sequence, and despite the efforts made over the years by psychologists, the role and specificity of psychological competence in healthcare settings continues to remain unclear. This is particularly true as regards hospital settings. Based on these considerations, this article presents an exploratory qualitative study aimed at understanding hospital physicians’ representations of, and demands for, psychological intervention in Italian hospital set - tings. The main argument on which the study was based is that the integration of psychological competence into hospital settings very much depends on other professionals’ representation of the psychological profession, as well as on the emotional symbolization of their work context and professional practice. A key role is played by physicians, whose representations of the psychol - ogical intervention in hospital settings have been under studied at the international level, and almost not studied with regard to the Italian context. The purpose of this study was to respond to this gap in the literature. In this regard, a semi-structured interview script was developed and used to inter - view 15 Italian hospital physicians varying in gender, age, and medical speciality. Participants were selected by convenience and interviews were carried out individually in the hospital settings. Representations of disease; approach to patients and models of intervention; experiences of collab - oration with psychologists; representations of where, when and how psychologists could be use - ful in the hospital context; overall visions of one’s hospital and its future; strengths and weaknesses of one’s own work; strategies used to overcome every day difficulties and strategies advocated to improve the hospital were focus of analysis. The interviews, administered by two researchers, were audio-recorded and transcribed. Then a content analysis was developed by three analysts that cod - ed the units of the text (sequences) according to the ca tegories and subcategories identified. The cate - gories were: (a) perspective on medical inter vention; (b) problems and weak nesses; (c) strengths; (d) current and future strategies; (e) psychosocial component of disease, and (f) relation ship between Medicine and Psychology. Transcripts were ana - lyzed independently by the analysts, and the interrater agreement was 83%. Results revealed a widespread view that psychol ogical science is of limited relevance in the hospital context. The difficulty in perceiving psychologists as a medical resource appeared to be largely related to phys - icians’ endorsement of a bio-medical ap proach, as well as to their lack of opportunities for formal and/or informal collaboration with psy chologists. Psychologists were thought of primarily as diag - nosticians or therapists, and psychological interven tion was mainly characterized as an individuallevel intervention whose main objective is to support the patient and manage his / her emotional response to the disease (and the response of his / her family). Despite physicians felt the hospital system plagued by problems, especially at the structural and functional levels, they did not envisage psychological competence as useful for fostering hospital organisational functioning. On the contrary, they advocated a top-down change in the hospital system, delegating responsibility for change to hospital management or policy makers. As a consequence, an urgent demand for Psychol - ogy remains unexpressed. Although based on a small sample, the present study provides useful insights which may prompt further research in this area. Furthermore, it provides information about the demand for psychological intervention in the hospital context which can be used to develop strategies to promote multidisciplinary care and integrated mind-body interventions. Results sug gest the necessity to rethink professional roles and to promote a constructive dialogue between medical and psychological science in Italian hospital set - tings.info:eu-repo/semantics/publishedVersio

Psychological, emotional and social impairments are associated with adherence and healthcare spending in type 2 diabetic patients: an observational study

OBJECTIVE: The aim of the present study was to assess the association among anxiety, depression, stress, social support and emotional abilities with adherence and healthcare spending in type 2 diabetic patients. PATIENTS AND METHODS: Sixty-four patients were enrolled and completed: Interpersonal Processes of Care (IPC), 20-item Toronto Alexithymia Scale (TAS-20), Rapid Stress Assessment Scale (RSAS), Morisky Medication Adherence Scale (MMAS-4), International Physical Activity Questionnaire (IPAQ)-Short Form and a socio-anamnestic questionnaire regarding also the healthcare spending. RESULTS: Mathematical linear regressions models were performed showing the predictive effects of: anxiety and social support scores (RSAS) on adherence levels (respectively p =. 019; p =. 016); adherence levels on anxiolytic use (p =.04); aggressiveness scores (RSAS) on the number of general check-ups (p =.031); TAS-20 and physician-patient communication (IPC) on the number of hospitalization days (respectively p=.001; p=.008); physician patient decision making (IPC) scores on physical activity (IPAQ) levels (p=.025); physical activity (IPAQ) on the number of medical examinations (p=.039). CONCLUSIONS: An association among psychosocial impairment, adherence and health- care spending was found. Future studies should investigate the effect of a brief psychological intervention in increasing adherence levels and reducing the healthcare spending in this clinical population

Empowering Students, Teachers, Non-teaching Staff and Parents in a ‘Troubled High School’ through Strategies of CP Multidimensional Interventions

In this paper, we outline some of the main principles underlying the intervention strategies that have been used in a project aimed at empowering students, staff, teachers and parents. This project reduced dropout, truancy, failure and bullying rates in a very disadvantaged Italian region. (Peer Reviewed

Empowering Students, Teachers, Non-teaching Staff and Parents in a ‘Troubled High School’ through Strategies of CP Multidimensional Interventions

In this paper, we outline some of the main principles underlying the intervention strategies that have been used in a project aimed at empowering students, staff, teachers and parents. This project reduced dropout, truancy, failure and bullying rates in a very disadvantaged Italian region. (Peer Reviewed

“Yes, but somebody has to help them, somehow:” Looking at the italian detention field through the eyes of professional nonstate actors

Although migration-related detention has proliferated around the world, little is known about life inside these sites of confinement for illegalized non-citizens. Building on 34 months of fieldwork, this article examines the lived experiences of center staff and external civil-society actors engaged within Rome’s detention center. We discuss the emotional, ethical, and political challenges faced by these professional actors in their everyday work and their relationship with detainees. Our aim is to shed light on psychosocial life in detention and the intersections between humanitarian and security logics in this setting. In doing so, we problematize the idea that “humanizing detention” can be a solution for change.Fundação para a Ciência e Tecnologiainfo:eu-repo/semantics/publishedVersio

The Structure of the Emotional Processing Scale (EPS-25): An Exploratory Structural Equation Modeling Analysis Using Medical and Community Samples

The Emotional Processing Scale (EPS) assesses emotional processing in terms of suppression, signs of unprocessed emotion, controllability of emotions, avoidance of emotional triggers, and impoverished emotional experience. Previous confirmatory factor analyses (CFA) yielded insufficient fit and questioned the EPS factors' discriminant validity. The present study aimed to test unidimensional, five-factor, and bifactor models using exploratory structural equation modeling (ESEM) and CFA. We administered the scale to 350 Italian participants in good health and 346 gastrointestinal patients referred for endoscopy because of mild-to-severe gastrointestinal symptoms. ESEM models outperformed corresponding CFA models. The bifactor ESEM model was a good fit in single group analyses and achieved metric and scalar invariance in multigroup analyses. The inspection of latent mean differences revealed a consistent trend for patients to avoid emotional triggers and have less general emotional processing difficulties. The study clarified the EPS factor structure and supported its use to assess the emotional processing of medical patients and community participants