Unforgiveness, depression, and health in later life: the protective factor of forgivingness

Objectives: Feeling unforgiven by others has been linked to poor health outcomes. The current study examined whether feeling unforgiven by others is associated with depression and self-rated health among older adults in the United States. The potential moderating roles of forgiving others and self-forgiveness in the association between unforgiveness and both depression and self-rated health was also assessed along with gender differences. Method: Data were drawn from a sample of 1009 adults in Wave 2 of the Religion, Aging, and Health Survey, a national sample of adults aged over 67. Depression was measured using the eight item short form from the Center for Epidemiologic Studies-Depression (CES-D) scale. Self-rated health was assessed with a one-item indicator. Results: Analyses indicated that higher levels of self-forgiveness ameliorated the relationship between unforgiveness by others and depression for men and women and higher levels of forgiving others attenuated the association between unforgiveness by others and depression for women. Self-forgiveness was protective of depression for women who reported unforgiveness by others and low levels of forgiving others. Regardless of levels of self-forgiveness, men who were most likely to forgive others experienced a significant association between unforgiveness by others and depression. Neither forgiving others nor the self were significant moderators in the association between unforgiveness and self-rated health. Conclusion: Forgiving others and the self may be protective of well-being when women feel unforgiven by others. These findings have implications for forgiveness intervention programs and contribute to literature pertaining to forgiveness and health in later life

Impact of a nurse-led home management training programme in children admitted to hospital with acute asthma: a randomised controlled study

BACKGROUND: Re-admissions to hospital in childhood asthma are common with studies reporting that 25% or more of children will be re-admitted within a year. There is a need for strategies to reduce re-admissions. METHODS: A prospective randomised control study of an asthma home management training programme was performed in children aged two years or over admitted with acute asthma. Two hundred and one children were randomised at admission to either an intervention group (n = 96) which received the teaching programme or a control group (n = 105). A nurse- led teaching programme used the current attack as a model for the management of future attacks and included discussion, written information, subsequent follow up and telephone advice aimed at developing and reinforcing individualised asthma management plans. Parents were also provided with a course of oral steroids and guidance on when to start them. RESULTS: The groups were similar in degree of social deprivation, length of stay, number of previous admissions, acute asthma treatment, and asthma treatment at discharge. Subsequent re-admissions were significantly reduced in the intervention group from 25% to 8% in individual follow up periods that ranged from two to 14 months (chi 2 = 9.63; p = 0.002). This reduction was not accompanied by any increase in subsequent emergency room attendances nor, in the short term, by any increase in urgent community asthma treatment. The intervention group also showed significant reductions in day and night morbidity 3-4 weeks after admission to hospital. CONCLUSIONS: A nurse- led asthma home management training programme administered during a hospital admission can significantly reduce subsequent admissions to hospital for asthma. Acute hospitalisation may be a particularly effective time to deliver home management training.