While expressed emotion has long been considered a valid predictor of a poor clinical outcome in individuals with mental and physical conditions, the present study marks the empirical investigation to assess specific communication patterns between family members and individuals with chronic gastrointestinal disorders. Following a rich tradition of studying illness narratives and a narrative approach to healing chronic illnesses, the present study examined illness narratives in a group of 40 mid-life adults with chronic gastrointestinal disorders. Two reliable, independent experts unfamiliar with the participants' research objectives and diagnostic status coded all narratives (ICC = 0.77). Self-narratives describing the illness and its impact on the family life were analyzed for a set of narrative elements, including agency, communion fulfilment, and narrative coherence. In addition, the study applies measures to assess expressed emotion, criticism towards family and perceived criticism towards individuals with a condition. The correlation analysis results indicate an association between agency and criticism (0.33) and perceived criticism (0.33). The main issue emerging from the multiple regression analysis findings is that agency of the narrative, criticism towards family and duration of disease taken together contribute to perceived criticism of the family towards the individual with a condition. However, a family’s criticism towards the individual with a condition is the only independent significant predictor of perceived criticism. One of the more significant findings from this study is that substantial autonomy from significant others and empowerment of individuals with a condition could worsen the family environment and have an unfavourable clinical outcome. More practical information on service users' autonomy and its impact on disease self-management would help us establish a greater accuracy.
The study aims to expand the understanding of perceived relatives’ expressed emotion (EE) according to four subscales: lack of support, irritability, criticism and emotional over-involvement towards service users with chronic gastrointestinal diseases. Considering the aim of the study there is a key research question: Are there any differences in the service users’ subjective experience of EE (perceived EE) and its subscales (lack of support, irritability, criticism and emotional over-involvement) according to demographic characteristics, namely gender, marital status and professional status? The study sample includes 118 service users who were undergoing inpatient treatment in the gastroenterology and proctology departments of the "Volyn Regional Clinical Hospital". The study applies methods of theoretical analysis and the Level of Perceived EE (pLEE) Scale. The results of the study indicate that there are no significant differences in pLEE according to professional status. Employed persons have the same indicies of perceived lack of support, irritability, criticism and emotional over-involvement with unemployed service users. Married individuals with chronic gastrointestinal diseases have lower indices of emotional over-involvement and higher indices of perceived lack of support nad iratbility compared to single service users at the level p<0.01. Women experience higher lack of support compared to men at the level p<0.05. The study has an important practical implication, namely developing a psychoeducational program for relatives and healthcare staff of service users with chronic gastrointestinal diseases. It will lead to enhancing the illness-related quality of life in service users.
Introduction: Arterial hypertension (AH) coexists with such conditions as obesity, insulin resistance/hyperinsulinemia and dyslipidemia, that is, interrelated metabolic disorders that characterize the metabolic syndrome (MS). The aim of the study was to establish relationships between components of MS and chronotype, level of daytime sleepiness, and dispositional optimism in patients with AH. Methods: The study included 42 patients diagnosed with stage 2 essential AH. To study the chronotype, we used the validated questionnaire “Composite Scale of Morningness” and scales from official available sources. Dispositional optimism (LOT-R) was assessed using a questionnaire adapted from O.A. Sychova. Epworth scale was used to assess the severity day sleepiness. Laboratory parameters were determined using commercially available kits. Results: The main components of the MS are found in more than half of the patients with AH, of which 61.90% have abdominal obesity, 42.86% have hypertriacylglycerolemia, 26.19% have hyperglycemia, and 66.67% have a decrease in HDL-C levels. Patients with AH with diagnosed components of MS have an evening chronotype, daytime sleepiness, and low optimism is diagnosed to the same extent as patients without MS. At the same time, evening (53.85%) and intermediate (38.46%) chronotypes are found in patients with abdominal obesity, and the frequency of daytime sleepiness registration, and a low level of optimism does not depend on the presence of abdominal obesity; patients with dyslipidemia are characterized by low optimism, evening and intermediate chronotypes, and severe daytime sleepiness; and a glucose level ≥5.6 mmol/l is registered in most patients with an evening chronotype. Conclusion: The research conducted showed significant relationships between abdominal obesity, dyslipidemia, hyperglycemia and evening chronotype, daytime sleepiness, and low optimism in patients with AH.
Large gaps of data still exist within the Ukrainian context utilizing Expresses Emotion as a warm, hostile, critical or emotional over-involving behaviour towards individual with a mental or physical condition. The aim of the current article was to suggest translation and cross-cultural adaptation of level of expressed emotion (LEE) as it is perceived by service users. This study applies the LEE which includes four factors: perceived lack of emotional support (pLES: 19 items), perceived intrusiveness (pIN: seven items), perceived irritation (pIR: seven items), and perceived criticism (pC: five items). All items are rated according to frequency and intensity on a four-point Likert scale 1 to 4 (1: untrue; 2: somewhat untrue; 3: somewhat true; 4: true). The total score of the 38 items is entitled perceived expressed emotion (pEE). LEE has strong psychometric properties in adolescents and adults. The translation LEE followed WHO guidelines (2020) and comprises some stages, namely a forward translation from English to Ukrainian, a back translation, expert panel validation, pretesting and cognitive face-to-face interviews with 10 clinical psychologists. The Ukrainian translation version of LEE meets requirements of LEE original version. However, some items were transformed according to semantic, grammatical or stylistic norms of the Ukrainian language. The Ukrainian version of LEE is the first psychometric tool to assess expressed emotion in a Ukrainian healthcare setting.
Objectives. The article aims to reveal language-based markers of stressful experiences in healthcare workers in terms of their cognitions and emotions. The following research questions were formulated for the current study: (1) Are risk and protective factors for psychological stress in healthcare staff, working with patients with COVID-19 aligned with anxiety, depression and resilience? (2) Are there any language-based indicators for emotional distress in healthcare staff, working with patients with COVID-19? (3) What are the key cognitions, emotions, and behavioral patterns are expressed in healthcare workers’ staff language? (4) What are words-associations in the Ukrainian Associative Dictionary aligned with language-based indicators of professional ethics in healthcare staff? Materials and Methods. The study applies Beck’s Depression Inventory (BDI-II), Beck’s Anxiety Inventory (BAI), the Brief Resilient Coping Scale (BRCS), the Psychological Stress Scale (PSM-25), and the Linguistic Inquiry and Word Count (LIWC 2015). Results. Results show that healthcare staff demonstrates a low level of psychological stress, depression and anxiety, and a medium level of resilience. The results of multiple linear regression indicate that the only significant negative predictor of stress is resilience. The psycholinguistic analysis of healthcare staff's narrative on their professional experience treating COVID-19 patients shows the key meaningful categories, namely social contacts, cognitive processes, and time. Social contacts are primarily represented by the category family. The word-associations from the Ukrainian Associative Dictionary indicate that feeling of guilt related to professional ethics in healthcare staff is more expressed in men compared with women. Conclusion. The insights gained from this study may be of assistance to developing effective interventions for healthcare staff during a pandemic, primarily focusing on protective factors and weakening feelings of guilt to prevent moral injury. The study also raises some issues of the clinical psycholinguistic approach to examining emotional distress. This approach would be a fruitful area for further work.
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