Hbhe600 2008 07 Stress-coping-1

8/14/2019 Hbhe600 2008 07 Stress-coping-1

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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH

Next week: Ken Resnicow


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Motivation x self-efficacy quadrants

Can and

wants to

Cant but

wants to

Can but

doesnt

want to

Cant and

doesnt

want toS

elf

-ef

fi

cacy

Motivation

Motivation Self-efficacy


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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTHUNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH

Both motivation and self-efficacy are

influenced by stress and ones ability

to cope with stress.


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Association between stress, coping, and motivation:

weight

Stress

CopingMo

tiv

at

ion

UPS T1 Succeed data (n=19533)


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Stress

CopingMo

tiv

at

ion



physical activity


7/38UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH

Stress

CopingMo

tiv

at

ion



cigarette smoking



Stress / coping questions (S. Cohen)



How often have you dealt successfully with irritating life hassles?

How often have you been able to control irritations in your life?

How often have you felt nervous or stressed?

How often have you found that you could not cope with all the

things you have to do?

How often have your felt that things were going your way?

How often have you felt that you were on top of things?

How often have you felt difficulties were piling up so high that

you could not overcome them?

Stress / coping questions

(S. Cohen) (continued)



Coping efforts

Problem management

Emotional regulation



Dispositional coping style

Generalized ways of behaving that can affect apersons emotional or functional reaction to a stressor;relatively stable across time and situations.

Optimism Information seeking

Monitoring

Blunting



Social support

Social Support - aid and assistance exchanged through social

relationships and interpersonal transactions

Emotional Support: Expressions of empathy, love, trust, caring

Instrumental Support: Tangible aid and service Informational Support: Advice, suggestions, and information

Appraisal Support: Information that is useful for self-evaluation



Low levels of social integration (social isolation) aremost deleterious to health; while social integration

above a certain threshold does not produce additional

benefit.

Evidence for a link between social networks and socialsupport and the incidence of a particular disease is not

strong.

Emotional support has been consistently associated

with coping with, recovering from, and survivingserious illness.

Research findings



Research findings

Social relationships have been found to influence thefollowing health behaviors:

Compliance with medical regimens

Help-seeking behavior

Smoking

Weight loss



Small social networks with strong ties are good forhealth enhancements.

Large social networks with weak ties are good for

facilitating social outreach and the exchange of

informational support.

Gender differences have been found in type of support

provided.

Research findings



Interventions

Enhancing existing social network linkages

Developing new social network ties

Using indigenous natural helpers Enhancing networks through community problem-solving

Social Support/Network Strategies


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LINKING CELLS TO SOCIETY:

Neighborhoods- physical environment- social environment

Individual

Characteristics

Health Care System- access- quality- prevention

Health Behaviors- tobacco- diet- exercise

Cumulative

Physiological

Dysregulation*

Outcome

Source: Centers for Population Health and Health Disparities (CPHHD) 2007

*metabolic, endocrine,

cardiovasular, inflammatory

dysregulated systems


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SOCIAL CAPITAL:

Source: Lochner KA, Kawachi I, Brennan RT, and Buka SL. (2003) Social capital andneighborhood mortality rates in Chicago. Social Science & Medicine. 56(38):1797-805.

Reciprocity (people around here are willing to help their neighbors)

Trust (people in this neighborhood can be trusted)

Civic participation (voluntary associations, religious orgs, business gps, etc)


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COLLECTIVE EFFICACY:

Source: Cohen DA, Finch BK, Bower A, and Sastry N. (2006). Collective efficacy and obesity:The potential influence of social factors on health. Social Science & Medicine. 62(3):769-78.

Close-knit neighborhood

Adults that kids look up to

People willing to help neighbors

Neighbors dont get along

Adults watch out that kids are safe

People in neighborhood dont share same values

Neighbors will do something if a kid hangs out

Would do something if kid does graffiti

Would scold kid if showing disrespect


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Employer settings:

stressful environments vs stress management

W b G id


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Web Guide -Monitoring Symptoms

Interactive Web Component

Track severity of symptoms

before and after using stress

reduction technique

Print to keep results

Reset and track as often aswanted


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Treatment condition

Percent of work time missed due to stress over the past 7 days at 6-month follow-up by

HealthMedia Relax versus control conditions, stratified by % worked missed at baseline

assessment (n=82; t=2.12; p


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Caregivers:

Who Are They?


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Caregiver Defined

Anyone who provides assistance to someone else who isin some degree incapacitated and needs help.

Informal caregiver and family caregiver are terms that

refer to unpaid individuals such as family members, life-partners, friends, and neighbors who provide care.

Family Caregiver Alliance

www.caregiver.org


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Weekly Hours of Informal Caregiving for Dementia

4.6

13.1

22.0

46.1

05

10

15

20

25

30

35

40

4550

Normal Mild Moderate Severe

Hou

rs

Source: Langa et al, JGIM, 2001.


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Source: Hickenbottom et al, Neurology, 2002.

6.1

8.6

18.6

0

5

10

15

20

Normal Mild Severe

Hou

rs

Weekly Hours of Informal Caregiving for Stroke


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Source: Langa et al, J of Gerontology, 2002.

Weekly Hours of Informal Caregiving for Diabetes

6.6

8.5

10.6

0

5

10

15

Normal Oral Meds Insulin

Hou

rs


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l l fl


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Culture & Family Influence

We were raised in our culture to take care of

each other.

Its like when I was growing up, my mother cared

for others. She would send me to deliver foodto a sick neighbor so I learned it from my

mother. Ive been like this all my life.

C i E l t St t


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Caregiver Employment Status

Employment Status % of All Caregivers

Full-time 51.8%

Not Employed 19.7%

Retired 15.9%

Part-time 12.3%

F li R d b P l C i f Th i P


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Feelings Reported by People Caring for Their Parent

Feeling % Reporting

Loving 96%

Appreciated 90%

Proud 84%

Worried 53%

Frustrated 37%

Sad or Depressed 28%

Overwhelmed 22%

Participants could choose all that apply


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Multicultural differences: 88% of Black caregivers use prayer to cope with stress Blacks & Whites are more likely than Hispanics & Asians to talk with friends/relatives Asians are less likely to seek help from a professional counselor Hispanics are more likely than whites to use the word stressful in describing their caregiving

experiences

Caregiver coping mechanisms


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Self-identification

Benefits exist to helping a caregiver formallyacknowledge their role

94% become more proactive in seeking resources &skills for their care recipient

83% have increased confidence speaking tohealthcare professionals about their loved onescare

92% like the idea of caregivers being considered a

special group in society

Hbhe600 2008 07 Stress-coping-1

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