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The role of psychological variables in explaining depression in older people with chronic pain
- Authors:
- LOPEZ-LOPEZ Almundena, et al
- Journal article citation:
- Aging and Mental Health, 12(6), November 2008, pp.735-745.
- Publisher:
- Taylor and Francis
Depression is commonly associated with chronic pain, and is also a common condition in the elderly. However research in the area of depression and pain is scarce. The aim of the present work was to analyse how cognitive-behavioural and perceptual variables help to explain the presence or absence of depression in older people with chronic pain caused by osteoarthritis. A total of 104 older adults were evaluated using a protocol that measured depression, perceptual characteristics of pain (intensity, frequency and duration), beliefs about pain, self-efficacy beliefs, coping style, coping strategies and pain behaviours. Using Student's t-tests and discriminant analysis, it was found that psychological variables such as catastrophizing, passive coping, complaint behaviour, avoidance, coping self-statements, ignoring pain sensations and stability and mystery beliefs help to explain depressive symptomatology. The present study confirms the important role of cognitive-behavioural variables in the discrimination between older adults who suffer pain with and without symptoms of depression. Moreover, certain variables that in young adults had been seen to play a non-adaptive role, such as ignoring pain sensations, were seen to have an adaptive function in the elderly. The results also support depression models - such as Abramson's Hopelessness Model - proposing that depression in chronic pain patients, unlike in other groups of depressed people, is characterized by absence of self-blame feelings.
Health services use by older people with disabilities in Spain: do formal and informal care matter?
- Authors:
- ROGERO-GARCIA Jesus, PRIETO-FLORES Maria-Eugenia, ROSENBERG Mark W.
- Journal article citation:
- Ageing and Society, 28(7), October 2008, pp.959-978.
- Publisher:
- Cambridge University Press
As people grow older in late life, their need for help with the activities of daily living increases. Support may be from formal care, informal care or both, and the type has different consequences for care receivers and their social networks. The aim of this paper is to examine the relationship between informal and formal care and the use of health services among older people in Spain. Using a sample of 1,148 respondents aged 65 or more years from the Spanish National Health Survey of 2003, this study analysed the association between the sources of care (formal, informal, both, or no care) and the frequency of three types of health-care utilisation: hospitalisation, emergency services and medical consultations. After controlling for sex, age, level of difficulty in the activities of daily living, self-perceived health status, and social class, it was found that older people with disabilities who received neither informal nor formal care were more likely to consult physicians than those who received informal care, but that there were no significant relationships between the type of care and health-services utilisation. The findings provide new information about the consequences of the different types of care of older people with disabilities, and suggest specifically that informal care substitutes for some tasks usually done by health professionals.
Analysis of the efficacy of a psychotherapeutic program to improve the emotional status of caregivers of elderly dependent relatives
- Authors:
- LOPEZ Javier, CRESPO Maria
- Journal article citation:
- Aging and Mental Health, 12(4), July 2008, pp.451-461.
- Publisher:
- Taylor and Francis
This Spanish study examined the long-term impact of a psychotherapeutic cognitive-behavioural program with two intervention formats (traditional weekly sessions (TWS) and minimal therapist contact (MTC)) in caregivers who suffered from emotional problems due to caring for elderly dependent relatives. The 86 participants, who lived with the older persons at home, were randomized into one of the two intervention formats. The individual treatment program was carried out during an 8-week interval. Measures of anxiety, depression, burden, coping, social support, and self-esteem were analyzed at pre- and post-treatment, and at 1-, 3-, 6-, and 12-month follow-ups. Significant effects were found in the expected direction in most of the measures analyzed. The participants in the intervention reduced significantly their levels of anxiety, depression, and burden, and they improved the levels of problem-focused coping, social support, and self-esteem. The two intervention formats had different evolutions, with better effects in the TWS format, especially at the first post-test measurements, but the differences tended to decrease over time. These data suggest that individual psychotherapeutic interventions with caregivers are efficient to reduce their emotional problems, and that this effect is mediated by improvement both in their appraisal of the situation and in their personal resources.
Self-efficacy and participation in physical and social activity among older adults in Spain and the United States
- Authors:
- PERKINS Jessica M., et al
- Journal article citation:
- Gerontologist, 48(1), February 2008, pp.51-58.
- Publisher:
- Oxford University Press
Bandura's self-efficacy theory was applied to older adult (aged 63–92) participation in physical and social activity in a cross-cultural study. Older adults in Spain (n = 53) and the United States (n = 55) completed questions regarding self-efficacy, outcome expectancy, and participation in physical and social activities. Self-efficacy significantly predicted both physical and social activity in both Spain and the United States. Outcome expectancy did not significantly predict either activity, nor did education, gender, or overall health. Modified and new self-efficacy measures proved reliable in both samples. Implications: This study enhances understanding of how self-efficacy motivates participation in physical activity, as noted in previous studies, as well as provides a new understanding of what motivates participation in social activities. The high reliability of the new measures used in this study provides evidence for further use of these measures in other contexts. It is important to note that this study further supports the use of Bandura's theory of self-efficacy for cross-cultural applications.