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ABSTRACT: BACKGROUND:: Cancer patients with diabetes have higher mortality rates and are more likely to develop infections, and be hospitalized during treatment. Hyperglycemia has been hypothesized as one of the factors associated with this increased risk. Diabetes self-management is one of the essential elements used by patients to maintain glucose levels. OBJECTIVE:: This exploratory study seeks to develop an understanding of the impact cancer treatment can have on overall diabetes self-management and how individual, clinical, and behavioral characteristics may influence or predict the level of diabetes self-management in adults who are undergoing chemotherapy for a solid tumor cancer. METHODS:: This study was conducted at 8 community-based cancer centers in Michigan and Ohio and used a written, self-administered survey at baseline and a phone survey 8 weeks later. RESULTS:: Diabetes self-management significantly decreased (P < .001), and the level of symptom severity significantly increased (P < .001) after patients were on chemotherapy for a minimum of 8 weeks. The level of symptom severity and diabetes self-efficacy were significantly predictive of the performance of diabetes self-management activities. CONCLUSIONS:: Chemotherapy and associated symptoms can have a negative impact on the performance of diabetes self-management activities in adults with both diabetes and cancer, increasing the risk for hyperglycemia and development of complications. IMPLICATIONS FOR PRACTICE:: Oncology nurses need to be aware of the impact cancer treatment can have on the performance of diabetes self-management activities in adults. Future research needs to test interventions that may assist patients with diabetes and cancer in managing both diseases.
Cancer nursing 03/2013; · 1.88 Impact Factor
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ABSTRACT: Cohen's κ (kappa) is typically used as a measure of degree of rater agreement. It is often criticized because it is marginal-dependent. In this article, this characteristic is explained and illustrated in the context of (1) nonuniform marginal probability distributions, (2) odds ratios that remain constant while κ changes in the presence of varying marginal distributions, and (3) percentages of raw agreement that remain constant while κ changes in the presence of varying marginal distributions. The meaning and interpretation of κ are explained with reference to the log-linear main effect model of variable independence. This model is used for the estimation of the expected cell frequencies of agreement tables. It is shown that the interpretation of κ as a measure of degree of agreement is incorrect. The correct interpretation is that κ assesses the degree of agreement beyond that expected based on a statistical model such as the independence or the null model. Based on Goodman's (1991) distinction between marginal-free and marginal-dependent measures, it is shown that κ is marginal-dependent. It shares this characteristic with the well-known χ²-statistic and the correlation coefficient for cross-classifications. In contrast, the odds ratio, the unweighted log-linear interaction, and the percentage of raw agreement are marginal-free. Therefore, the expectation that marginal-dependent κ would reflect the same data characteristics as some of the marginal-free measures is misguided. It is recommended that researchers report both measures of degree of agreement and measures of agreement beyond some expectation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
European Psychologist 10/2012; 13(4):305-315. · 1.31 Impact Factor
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ABSTRACT: In this chapter, person-oriented research strategies in developmental psychopathology are reviewed. After providing the theoretical background to the person-oriented approach, it is our aim to review major types of person-oriented methods that we believe can be useful in research on developmental psychopathology. To make this review more concrete, we also present empirical examples that illustrate some of the methods. Finally, we discuss issues in implementing a person-oriented research strategy and perspectives for future research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
10/2012;
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ABSTRACT: This research discusses the use of Cohen's Κ (kappa), Brennan and Prediger's Κ
n, and the coefficient of raw agreement for the examination of disagreement. Three scenarios are considered. The first involves all disagreement cells in a rater × rater cross-tabulation. The second involves one of the triangles of disagreement cells. The third involves the cells that indicate disagreement by one (ordinal) scale unit. For each of these three scenarios, coefficients of disagreement in the form of Κ equivalents are derived. The behavior of the coefficients of disagreement in the three situations is studied. The first and the third case pose no particular problem. The Κ equivalents and the other coefficients can be interpreted as usual. In the second case, problems arise such that the range of disagreement Κs is restricted because the tables are incomplete. Thus, the standard log-frequency model of rater independence is no longer applicable. When the more general models of quasi-independence are used, negative degrees of freedom can result for smaller tables. Simulation results illustrate the characteristics of the coefficients of disagreement for each of the three scenarios. Empirical data examples are given. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Methodology European Journal of Research Methods for the Behavioral and Social Sciences 10/2012; 1(4):129-142. · 0.33 Impact Factor
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ABSTRACT: To explore whether three factors (physical function, mental health, and social function) of health-related quality of life (HRQOL) are impacted differently in patients with cancer and diabetes when compared to those with cancer who do not have diabetes at the beginning of chemotherapy.
Secondary analysis using baseline data from two randomized, controlled trials.
Two comprehensive cancer centers, one community cancer oncology program, and six hospital-affiliated community oncology centers.
661 patients aged 21 years or older with a solid tumor cancer or lymphoma undergoing cancer treatment.
Baseline data from both randomized, controlled trials were used. The SF-36® was used to measure physical function, mental health, and social function. Analysis included descriptive statistics and a general linear model.
Presence or absence of diabetes and physical function, social function, and mental health.
Patients with cancer and diabetes had significantly lower levels of physical function (p < 0.001) when compared to those who had cancer without diabetes. The interaction of diabetes and age was found to be significantly predictive of mental health (p < 0.05).
The presence of diabetes negatively impacts physical function and mental health in patients undergoing chemotherapy.
Nurses should be aware of diabetes' effect on HRQOL in patients with cancer. In addition, nurses may need to intervene earlier for patients with diabetes and cancer to maintain or improve their quality of life.
Oncology Nursing Forum 09/2012; 39(5):449-57. · 1.91 Impact Factor
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ABSTRACT: This research examines children’s beliefs about moral behavior in the virtual world and the real world. Participants were
515 children, average age 12years old. One-third were African American and two-thirds were Caucasian American. Children completed
surveys mailed to their homes which included questions about the acceptability of morally questionable virtual behaviors.
Findings indicated: (1) gender and race differences in the acceptability of morally questionable behaviors in the virtual
world; (2) moral behavior and moral attitudes in the real world predicted the acceptability of morally questionable behaviors
in the virtual world; and (3) the frequency of IT use predicted the acceptability of morally questionable behaviors in the
virtual world. Implications for children’s IT education are discussed.
Sex Roles 04/2012; 60(11):859-869. · 1.47 Impact Factor
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ABSTRACT: Using a diathesis–stress model, this study examined the development of depressive and anxiety symptoms in women who experience
stressors of domestic violence (DV) and/or negative life events (NLEs) over the course of three years. Family history of affective
mental health problems represented the diathesis. Using a person-oriented approach, 182 women were grouped into 6 risk profiles
based on varying levels of DV and NLEs. Results showed that family history of psychopathology increased vulnerability to mental
health disorders; however, the best predictor of symptoms was the presence of either stressor at any time. A quadratic relationship
between the risk pattern and mental health symptoms indicated that fluctuations in depression were related to the pattern
of stress experienced. Results support the diathesis–stress model for occurrence of depressive but not anxiety symptoms in
women with DV and/or NLEs.
Journal of Family Violence 04/2012; 23(8):661-670. · 1.17 Impact Factor
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Computers in Human Behavior. 01/2012; 28:370-376.
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ABSTRACT: Using a person-centered approach, we examined the relations between goal selection, various indicators of parenting, and positive development among 510 Grades 9 to 11 participants (68% female) in the 4-H Study of Positive Youth Development (PYD), a longitudinal study involving U.S. adolescents. Goal selection was operationalized by the "Selection" (S) subscale of the Selection, Optimization, and Compensation intentional self-regulation measure. Using Configural Frequency Analysis, we assessed the association between Selection, parenting (warmth, monitoring, and school involvement), and PYD. Results indicated that, while having the combination of consistently high Selection and above-median levels of the parenting variables was the most common path to PYD, having consistently low levels of Selection across grades was also related to positive development at Grade 11, regardless of parenting factors. We interpret these findings based in relation to the PYD and the identity development literatures and discuss implications for applied programs.
Journal of Adolescence 12/2011; 34(6):1137-49. · 2.05 Impact Factor
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ABSTRACT: Two theoretical perspectives have been proposed to describe, explain, and intervene in adolescent development - prevention science and positive youth development (PYD). An integrative model bridging these two perspectives posits that it is important to assess the extent to which the same, similar, or complementary mechanisms may be responsible for preventing problem behavior and promoting PYD. Therefore, using data from the 4-H Study of PYD, the present study examines the role of assets in the family, school, and neighborhood in differentiating trajectories of goal-optimization and delinquency in a sample of 626 youth (50.9% female) from Grades 5 to 11. The results indicated that collective activity in the family best predicted membership for the five goal-optimization trajectories while school-based assets differentiated the four delinquency trajectories that were identified. The findings suggest that multidimensional approaches may be most effective to promote PYD and prevent problem behaviors.
Journal of Adolescence 12/2011; 34(6):1151-65. · 2.05 Impact Factor
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ABSTRACT: This study assessed 1574 Grades 5 to 11 youth (63.6% female) from the 4-H Study of Positive Youth Development (PYD), a longitudinal study involving U.S. adolescents, to assess if patterns of intentional self regulation (ISR) existed; whether these trajectories differed in relation to several Grade 5 parenting characteristics; and whether ISR trajectories were linked to positive and negative developmental outcomes at Grade 11. Growth mixture modeling identified a four-group solution of ISR trajectories: Steady Decline, Elevated, Late Onset, and Pronounced Decline. Most adolescents reported an incremental decrease in ISR from Grades 5 to 11 (Steady Decline). Lower levels of parental warmth, monitoring, and school involvement at Grade 5 predicted Late-Onset ISR development while Pronounced Decline adolescents reported lower levels of PYD and Contribution at Grade 11. We discuss the finding that youth at initially similar levels of ISR diverged over adolescence, while youth at initially disparate levels converged.
Journal of Adolescence 12/2011; 34(6):1193-206. · 2.05 Impact Factor
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ABSTRACT: We introduce this special issue on the individual and contextual bases of adolescent thriving by describing the relational developmental systems theory-based, positive youth development (PYD) perspective that frames much of contemporary research about health and positive development across the adolescent period and that, more specifically, frames the 4-H Study of PYD, the data set from which the empirical work in this special issue is drawn. All articles point to the combined role of characteristics of the person and ecological assets in the family, school, or community settings of youth to promote the development of PYD. We discuss how these articles provide evidence about the empirical usefulness of the PYD perspective and discuss how research testing the PYD model has new and important implications for both adolescent development research and for the application of developmental science.
Journal of Adolescence 11/2011; 34(6):1107-14. · 2.05 Impact Factor
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ABSTRACT: The current paper provides external validation of the bifactor model of ADHD by examining associations between ADHD latent factor/profile scores and external validation indices. 548 children (321 boys; 302 with ADHD), 6 to 18 years old, recruited from the community participated in a comprehensive diagnostic procedure. Mothers completed the Child Behavior Checklist, Early Adolescent Temperament Questionnaire, and California Q-Sort. Children completed the Stop and Trail-Making Task. Specific inattention was associated with depression/withdrawal, slower cognitive task performance, introversion, agreeableness, and high reactive control; specific hyperactivity-impulsivity was associated with rule-breaking/aggressive behavior, social problems, errors during set-shifting, extraversion, disagreeableness, and low reactive control. It is concluded that the bifactor model provides better explanation of heterogeneity within ADHD than DSM-IV ADHD symptom counts or subtypes.
Journal of Abnormal Child Psychology 07/2011; 39(8):1111-23. · 3.09 Impact Factor
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ABSTRACT: Persons with chronic illness commonly report fatigue. Measurement of perceived self-efficacy for fatigue self-management (PSEFSM) is essential if fatigue is to be monitored and enhanced to improve physical functional status.
The objective of the study was to describe the development and testing of the PSEFSM instrument.
The PSEFSM instrument was incorporated into 2 randomized controlled trials for secondary analysis (N=298): 63 persons with lung cancer and 235 persons with other cancer diagnoses undergoing a course of chemotherapy.
: Evidence for construct validity and generalizability was supported through hypotheses testing of the mediation pathway from fatigue to physical functional status through PSEFSM, with results indicating support for partial mediation. Structural modeling indicated a good model fit that further supported the construct validity of the PSEFSM instrument.
The instrument provides a reliable and valid measure of PSEFSM that could be used in research to facilitate the development of interventions to increase perceived self-efficacy to achieve optimal symptom self-management.
The PSEFSM instrument is brief and easy to complete, which results in a low response burden for persons who are already fatigued, providing for regular use in transdisciplinary research and practice settings. This is important because the use of this instrument can impact how we partner with our patients to better understand how to manage this troublesome symptom, fatigue.
Cancer nursing 04/2011; 34(3):167-75. · 1.88 Impact Factor
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ABSTRACT: In this research we examined the effects of Internet use and videogame playing on children’s academic performance. Gender, race, and income were also considered. Participants were 482 youth, average age 12 years old. One-third were African American and two-thirds were Caucasian American. All measures were completed twice, first in Year 1 and then one year later, Year 2. Results indicated that greater Internet use was associated with better reading skills, but only for youth initially low in reading skills. Videogame playing was associated with better visual-spatial skill but also with lower GPAs. Gender, race and income influenced Internet use, videogame playing and academic performance but not the relationships between using these technologies and academic performance. Implications of the results for increasing the benefits of technology use are discussed.
Computers in Human Behavior 01/2011; 27(1):228-239. · 2.29 Impact Factor
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Computers in Human Behavior. 01/2011; 27:599-604.
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ABSTRACT: We hypothesized that trajectories of domestic violence (DV), maternal depression, and household income (from pregnancy to age 4) would be differentially associated with instability and stability of attachment, as measured by the Strange Situation at ages 1 and 4. Participants were 150 women and children. Women were first assessed during pregnancy and then yearly when the children were 1 to 4 years old. Overall, attachment was unstable for 56% of the sample from age 1 to age 4. Trajectories of DV and income both predicted attachment patterns. Positive outcomes (secure-secure and insecure-secure) were related to initially low levels of DV that stayed constant or became lower as well as initially high or low levels of income that increased over time.
Journal of Clinical Child & Adolescent Psychology 01/2011; 40(3):398-410. · 1.92 Impact Factor
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ABSTRACT: The study of positive youth development (PYD) rests on the integration of sound developmental theory with rigorous developmental methods, To illustrate this link, we focused on the Selection (S), Optimization (O), and Compensation (C; SOC) model of intentional self regulation, a key individual-level component of the individual context relations involved in the PYD process, and assessed the dimensional structure of the SOC questionnaire, which includes indices of Elective Selection, Loss-Based Selection, Optimization, and Compensation. Using cross-sectional and longitudinal data from Grades 10 and 11 of the 4-H Study of PYD, we estimated three models through bifactor data analysis, a procedure that allows indicators to load both on their specific latent variables and on a superordinate factor that comprises the construct under study. The first model estimated was a standard bifactor model, computed separately for the 10th and 11 graders. In both samples, the same model described the hypothesized structure well. The second model, proposed for the first time in this chapter, compared multiple groups in their bifactor structure. Results indicated only minimal gender differences in SOC structure in Grade 10. The third model, also proposed for the first time in this chapter, involved an autoregression-type model for longitudinal data, and used data from the 609 participants present in both grades. Results suggested that the SOC bifactor structure was temporally stable.
Advances in child development and behavior 01/2011; 41:349-75. · 0.95 Impact Factor
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ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) frequently co-occur. Comorbidity of these 2 childhood disruptive behavior domains has not been satisfactorily explained at either a structural or etiological level. The current study evaluated a bifactor model, which allows for a "g" factor in addition to distinct component factors, in relation to other models to improve understanding of the structural relationship between ADHD and ODD. Participants were 548 children (321 boys, 227 girls) between the ages of 6 years and 18 years who participated in a comprehensive diagnostic assessment incorporating parent and teacher ratings of symptoms. Of these 548 children, 153 children were diagnosed with ADHD (without ODD), 114 children were diagnosed with ADHD + ODD, 26 children were diagnosed with ODD (without ADHD), and 239 children were classified as non-ADHD/ODD comparison children (including subthreshold cases). ADHD symptoms were assessed via parent report on a diagnostic interview and via parent and teacher report on the ADHD Rating Scale. ODD symptoms were assessed via teacher report. A bifactor model of disruptive behavior, comprising a "g" factor and the specific factors of ADHD and ODD, exhibited best fit, compared to 1-factor, 2-factor, 3-factor, and 2nd-order factor models of disruptive behaviors. It is concluded that a bifactor model of childhood disruptive behaviors is superior to existing models and may help explain common patterns of comorbidity between ADHD and ODD.
Psychological Assessment 12/2010; 22(4):816-26. · 2.99 Impact Factor
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ABSTRACT: Intentional self regulation describes how people make choices, plan actions to reach their goals, and regulate the execution of their actions, making processes of intentional self regulation central to healthy human functioning. Prior research has confirmed the presence of three processes of intentional self regulation-elective selection (ES), optimization (O), and compensation (C)-in middle adolescence (Grades 8 through 10) and concurrent and predictive relationships with measures of Positive Youth Development (PYD). A fourth process, loss-based selection (LBS), should also develop by the end of middle adolescence. The present study used data from the 4-H Study of PYD to confirm the presence of a four-scale structure of intentional self regulation (ES, O, C, and LBS) in a sample of 2,357 racially diverse Grade 10 youth (63% female) and examine its covariation with indicators of positive and problematic development. Results supported the identification of a four-part structure of intentional self regulation, and scores covaried positively with indicators of PYD and negatively with substance use, delinquency, and depressive symptoms. Implications of the findings for the understanding of self-regulatory actions in adolescence and for future research are discussed.
Journal of Youth and Adolescence 07/2010; 39(7):764-82. · 2.72 Impact Factor
