Caregivers and their relatives disagree about care given, received

ScienceDaily (Aug. 1, 2011) — Caregivers and their relatives who suffer from mild to moderate dementia often have different perceptions regarding the amount and quality of care given and received. A study by researchers at Penn State and the Benjamin Rose Institute on Aging examined a major source of those differences -- caregivers do not understand the things that are important to their relatives with dementia.

"Family caregivers often become the surrogate decision makers of relatives who have dementia, so the two groups need to communicate well and to understand each other," said Steven Zarit, a professor and head of the Department of Human Development and Family Studies at Penn State and the study's leader. "Unfortunately, in our study we found that family caregivers and their relatives often do not understand each other well when it comes to the values they hold about giving and receiving care."

The team interviewed 266 pairs of people, each composed of an individual with mild to moderate dementia and his or her family caregiver. To participate in the study, caregivers had to be the primary family caregiver of the dementia patient and the dementia patient had to be living in his or her own home. The researchers interviewed members of the pairs separately, asking questions related to how much value they place on five core values: autonomy, burden, control, family and safety. For example, one question focused on the level of importance a dementia patient gave to the ability to spend his or her own money in the way he or she wants.

"Our results demonstrate that adult children underestimate the importance that their relatives with dementia placed on all five core values," said Zarit. "For example, the person with dementia might think it is very important to continue to be part of family celebrations, but his or her caregiver might not." The team's results will appear in the August issue of The Gerontologist.

According to Zarit, a major reason for differences in these perceptions is that caregivers come to view people with dementia as unable to make their own decisions about daily life. "That is something that does happen as the disease progresses, but the people in our study remained capable of making decisions for themselves and could express their values in a clear and direct way," said Zarit. "Caregivers who still saw the person with dementia as able to direct his or her daily life were also more in tune with that person's values and beliefs."

This lack of agreement about how care is provided has ominous implications for when the dementia worsens. "As people's cognitive abilities decline," Zarit said, "they can no longer express clearly what they want. Family members have to act as surrogate decision makers, but if they don't understand the dementia patients' preferences about care, they may not be able to make the best choices."

Zarit plans to continue this research by developing and evaluating protocols for improving communication between caregivers and their relatives to ensure that medical and social decisions are made in such a way that reflect dementia patients' actual values.

This work was supported by the Administration on Aging, the Robert Wood Johnson Foundation, the AARP Andrus Foundation, the Retirement Research Foundation, the National Institute of Aging and the National Institute of Mental Health. Other authors on the paper include Allison Reamy and Kyungmin Kim, both graduate students in human development and family studies at Penn State, and Carol Whitlatch of the Benjamin Rose Institute on Aging.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Penn State, via EurekAlert!, a service of AAAS.

Journal Reference:

A. M. Reamy, K. Kim, S. H. Zarit, C. J. Whitlatch. Understanding Discrepancy in Perceptions of Values: Individuals With Mild to Moderate Dementia and Their Family Caregivers. The Gerontologist, 2011; 51 (4): 473 DOI: 10.1093/geront/gnr010

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Quality of life for children with ADHD and their families worsens with greater disease severity

ScienceDaily (July 26, 2011) — The greater the severity of a child's Attention Deficit Hyperactivity Disorder (ADHD) symptoms, the more negative impacts on the child's health-related quality of life from the perspective of the child and the parent, a new study by a Baylor University psychologist has found.

Researchers compared children with ADHD in different types of treatment settings and found that children with ADHD being treated by a general pediatrician have better overall health-related quality of life and family functioning than children with ADHD being treated in a psychiatric clinic.

The study appears online in the Journal of Attention Disorders and is the first study to demonstrate greater negative impact on quality of life and family function in children with ADHD treated at a psychiatric clinic compared to those treated at a general pediatric clinic.

"These findings have potential implications for the health care needs of children with ADHD," said study author Dr. Christine Limbers, assistant professor of psychology and neuroscience at Baylor. ""The finding that overall agreement between children and parent ratings of the child's quality of life was low underscores the importance of evaluating both children's and parents' perspectives regarding quality of life in routine assessment in clinical practice and clinical trials for children with ADHD since their different perspectives potentially provide unique information."

The researchers surveyed nearly 200 families and evaluated health-related quality of life and family functioning, such as physical, emotional, social and family relationships, from both the perspective of children with physician-diagnosed ADHD and their parents. Researchers then compared those results to a sample of healthy children and to children with ADHD being seen in a psychiatric clinic.

The study found children with ADHD being treated at a general pediatric clinic reported fewer problems with quality of life compared to a sample of children with ADHD being treated in a psychiatric clinic. The study also showed that while children with ADHD treated by a general pediatrician have better overall health-related quality of life than children being seen in a psychiatric clinic, they still experience significant impairments in health-related quality of life compared to healthy children, particularly in psychosocial functioning, which encompasses a wide range of behaviors related to social and emotional well being.

The researchers said that parental worry and family relationships, such as lack of communication between family members and conflicts between family members, and daily family activities, such as family activities taking more time and effort and difficulty finding time to finish household tasks, are key areas to address in a family intervention.

"The data suggest that from the perspective of parents, child social functioning may have the strongest association with impaired family functioning. Consequently, it does not seem sufficient for interventions to only address social functioning with the child," Limbers said. "Teaching parents strategies for coping with their child's social impairments is also critical"

ADHD is one of the most prevalent chronic disorders in childhood and is characterized by impulsivity, a developmentally inappropriate activity level, low frustration tolerance, poor organization of behavior, distractibility, and an inability to sustain attention and concentration.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Baylor University.

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Risk Taking Depends On Whether Participants Recalled Past Episode Of Good Or Bad Luck And Whether They Washed Their Hands

Main Category: Psychology / Psychiatry
Article Date: 22 Jul 2011 - 4:00 PDT window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend   printer friendly   opinions  

Do people believe good and bad luck can be washed away?

Yes, according to an advanced online publication in the Journal of Experimental Psychology that was co-authored by Rami Zwick, a University of California, Riverside marketing professor in the School of Business Administration.

Zwick, working with Alison Jing Xu of the University of Toronto, and Norbert Schwarz of the University of Michigan, designed two experiments that showed risk taking depends on whether participants recalled a past episode of good or bad luck and whether they washed their hands before engaging in a risky decision making task.

The experimental findings, in the paper "Washing Away Your (Good or Bad) Luck: Physical Cleansing Affects Risk-Taking Behavior," converge with anecdotal reports of superstitious practices, such as an athlete wearing the same unwashed shirt during a winning streak, and show that magical beliefs about luck have behavioral consequences.

Magical beliefs are exhibited, for example, by having confidence in one's ability to predict the outcome of a random event beyond the known probabilities if one can exert irrelevant control on the situation. For example, research has shown people are more confident they will have a winning scratch-off lottery ticket if they pick the ticket instead of being given one by a clerk.

Debriefing conversations with participants suggest that people remain unaware of these influences, as has also been observed in other studies. Although participants are familiar with the underlying metaphors and related superstitious practices, they do not realize that this knowledge is applicable to the experiment and, needless to say, insist that they would never be influenced by such a thing.

In the first experiment outlined in the paper, 59 business students at a North American university were brought in. Half were asked to recall an incident in which they had good luck financially and the other half were asked to recall an incident of bad financial luck.

Next, an ostensibly unrelated product evaluation study served as a cover story. All participants evaluated an antiseptic wipe. Half were told to use the wipe, the other half were told to form and impression of the product without using it. Product evaluation questions followed.

Finally, the participants were given a managerial decision task. Taking the role of a chief executive officer, they had to adopt or reject a product improvement recommendation based on two consequences of action.

Under the first option, if they stayed with the existing product profits would remain at the current level, about $20 million per year.

Under the second option, the product was modified, but profits would depend on acceptance by consumers. Marketing research indicated there was a 75 percent chance of strong acceptance, which would result in an increase in profits to $24 million, but there was a 25 percent chance of weak acceptance, resulting in a drop in profits to $12 million.

The researchers found those who recalled an unlucky incident and cleaned their hands and those that recalled a lucky incident and didn't clean their hands were more likely to select the riskier option.

Of those who recalled an unlucky incident and cleaned their hands, 73 percent selected the riskier option, while only 36 percent who recalled an unlucky incident and didn't clean their hands picked the riskier option.

Of those who recalled a lucky incident, 77 percent who didn't clean their hands picked the riskier option, while only 35 percent who cleaned their hands selected the riskier option.

In the second experiment, students and staff from the Hong Kong University of Science and Technology, where Zwick formerly taught, were given HK $100 (US$1 = HK$7.8) to gamble with. They were told this was "for real" money that they would keep at the end. Indeed, they were paid based on their decisions and luck.

The experimenters showed participants a pink ball and a green ball and placed them in a bag. Participants selected one of the colors as their "winning" color and blindly picked a ball from the bag. If they picked the winning color they won HK$50. If not, they lost HK$50. They repeated the task until they lost their HK$100, won an additional HK$100 or completed four rounds.

Next, an ostensibly unrelated product evaluation study served as a cover story for the hand-washing manipulation. Participants evaluated organic soap. Half were told to wash their hands with the soap. The other half were told not to use the soap.

Finally, participants did a second round of gambling. They received HK$50 and were told they could bet any amount from nothing to HK$50.It was the same game as last time, but with only one round.

Researchers found participants who had good luck in the initial round bet more money in the second round than participants who had bad luck.

However, participants who had bad luck in the first round bet more money in the second round if they washed their hands. The difference was an average of HK$31.15 versus HK$17.47.

In contrast, those who had good luck in the first round bet less money in the second round if they had washed their hands. The difference was an average of HK$28.08 versus HK$37.75.

Source:
Sean Nealon
University of California - Riverside

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