Profiles of intercultural sensitivity of healthcare students: a person-centred approach.

Objectives: We aimed to explore healthcare students' intercultural sensitivity profiles and their relationship with empathy to develop effective education methods that promote non-discriminatory patient care. Methods: We conducted a cross-sectional questionnaire study, involving a total of 508 international (n= 100) and local (n= 408) healthcare students in Hungary by convenience sampling. The survey included demographics, the Intercultural Sensitivity Scale, and the Interpersonal Reactivity Index. We applied latent profile analysis to identify distinct sensitivity profiles and used multinomial logistic regression to estimate the predictive power of several background variables on profile group membership. Results: A four-profile solution emerged: "Interculturally average" (n= 241), "Interculturally uncertain" (n= 76), "Interculturally sensitive" (n= 132), and "Interculturally refusing" (n= 54). The model (R2= 0.123; p= 0.001) revealed that psychology major tended to predict "uncertain" group membership (OR= 0.56, p= 0.08) and higher personal distress was a significant predictor of this group (OR=1.11, p= 0.002). Male gender (OR= 3.03, p= 0.001), medicine major (OR= 5.49, p= 0.01), lower perspective-taking (OR= 0.91, p= 0.007) and higher personal distress (OR= 1.09, p= 0.028) were identified as predictors of "refusing" group membership, compared to the "average" group. Conclusions: By exploring the ways students experience intercultural situations, a more personalized medical education can be developed with a special focus on vulnerable subgroups. For the "uncertain" group, the focus should be more on developing confidence, and intercultural experiences, whereas in the "refusing" group on strengthening empathy. In general, it can be useful to create mixed-gender, multidisciplinary, and intercultural learning environments.

Enhancing self-management of patients with inflammatory bowel disease: the role of autonomy support in health goal pursuit.

Background: Inflammatory bowel disease (IBD) is a chronic condition that significantly affects patients' physical, mental, and social health, as well as their overall quality of life. Effective management of the disease demands self-management skills, enabling patients to navigate the daily challenges associated with IBD, such as unpredictable flare-ups, frequent hospitalization, severe symptoms, pain, and physical changes. Objectives: This study examines the motivational aspects of self-management for patients with IBD and focuses on the role of autonomy and directive support from healthcare professionals in enhancing their self-concordance and self-efficacy. Design: From November 2022 to February 2023, a cross-sectional questionnaire study was conducted at the IBD Center of Internal Medicine Clinic in Szeged, Hungary. Methods: A total of 374 adult patients with IBD completed the paper-pencil questionnaire, of whom 241 patients (64.4%) had Crohn's disease, and 133 patients (35.6%) had ulcerative colitis. Results: Based on the findings of the path analysis (χ2 (8) = 18.914, p = 0.01, comparative fit index = 0.935, TLI = 0.837, root mean squared error of approximation = 0.06), autonomy support positively predicted self-concordance (ß = 0.48) and self-efficacy (ß = 0.02), particularly during disease relapse. In addition, self-concordance and self-efficacy predicted more positive (ßs = 0.28 and 0.35) and fewer negative emotional experiences (ßs = -0.09 and -0.20). The model's associations varied between the relapse and remission groups, indicating distinct impacts on different states of the disease. Conclusion: Overall, autonomy support from healthcare professionals has been shown to enhance self-management in patients with IBD, particularly during disease relapse. Meanwhile, self-concordance and self-efficacy act as positive internal factors, thus reducing negative emotional experiences, especially during remission. In sum, this study underscores the need for further exploration of the motivational aspects of self-management and provides insights into developing interventions that promote the health behaviors of patients with IBD.

Self-management of inflammatory bowel disease patients Autonomy support from healthcare professionals has been shown to significantly improve the effectiveness of self-management in patients with inflammatory bowel disease (IBD) (especially during disease relapse), by enhancing their self-concordance and self-efficacy. In this case, the interplay between disease activity, positive and negative emotions, and self-regulatory mechanisms underscores the importance of examining the motivational aspects for developing interventions that promote health behaviors in patients with IBD.

Relationship satisfaction and self-esteem in patients with breast cancer and healthy women: the role of expected and actual personal projects support from the partner.

BACKGROUND: For breast cancer patients, the partner's support for personal projects can serve as a means of adaptation. We aimed to investigate the associations between the intimate partner's personal project support and women's well-being. METHODS: A sample of 274 Hungarian women (breast cancer patients n = 137, control n = 137) took part in the study. Expected and actually received autonomy-, directive- and emotional project support was assessed by the procedure of Personal Project Assessment. Well-being was measured by the Relationship Assessment Scale and the Rosenberg Self-Esteem Scale. For investigating the associations between project support and well-being in a multivariate way, structural equation modelling was used. RESULTS: Except for autonomy support, participants expected more support than they received. A path model indicated multiple associations between types of project support and relationship satisfaction and self-esteem. The partner's emotional project support was predictive of women's relationship satisfaction and self-esteem, while directive support was predictive of self-esteem only. The associations showed similar patterns in the subgroups of patients with breast cancer and control. CONCLUSIONS: Our results highlight the importance of involving women's subjective perspectives regarding the partner's project support while also have implications for praxis. Teaching women how to communicate their needs to their partner effectively (whether it is the need for autonomy or directive guidance) can help close the gap between expected and received support, which may in turn enhance relationship satisfaction and self-esteem.

[Health goals amongst patients with Crohn's disease.] / Egészséggel kapcsolatos célok Crohn-betegek körében.

INTRODUCTION: Inflammatory bowel diseases, including Crohn's disease, have a significant impact on patients' lifestyle, requiring lifelong attention to health behavior. OBJECTIVE: The aim of our study was to investigate health-related goals, emotions related to health goals, the use of infocommunication tools and their associations. METHOD: 79 patients with Crohn's disease (59.5% female, mean age 40.7 years, SD = 11.89) participated in the study. They answered demographic and health behaviour questions and completed the Personal Health Plans Questionnaire, which assessed their personal health goals, positive and negative emotions about health goal(s), support for personal health goals from their physician, negative and positive effects (barriers/support) of achieving health goals, and digital technology and internet use. RESULTS: 70% of patients had at least 1 health goal. The health goals were classified into four categories: physical activity (43.6%), stress management (25.4%), nutrition (18%) and smoking cessation (7%). 71% of participants experienced at least average levels of positive emotions related to the health goal, but about 50% also experienced negative emotions. 51% of those with a health goal regularly use the internet and apps on smartphones. Infocommunication device use showed a medium-strength correlation with perceived health goal-related barrier/support (ρ = 0.55, p<0.01), support from the person's doctor (ρ = 0.45, p<0.05) and physical activity (ρ = 0.40, p<0.01). DISCUSSION: More than two-thirds of patients had a health goal; most of the goals were related to health behaviours that are also relevant to Crohn's disease, but few had healthy eating and smoking cessation as health goals. Half of those with a health goal regularly use the internet and apps on smartphones. Among health behaviours, physical activity was associated with infocommunication device use. CONCLUSION: It is recommended to investigate patients' health goals and infocommunication device use in the care of patients with Crohn's disease. This would allow the development of specific interventions to improve their health behaviour, which could increase the quality of life and disease prognosis. Orv Hetil. 2023; 164(28): 1102-1110.

Improving disease management of patients with inflammatory bowel disease: the potential role of self-concordant health goals.

Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that significantly impact patients' quality of life. Previous research indicates that patients with IBD have a higher prevalence of anxiety compared to the general population and other chronic diseases. This pilot study aimed to investigate the relationships between goal integration, positive and negative emotions, goal self-efficacy, and trait anxiety as the outcome variable, focusing on patients' self-management strategies. Drawing from the Self-Concordance Model (SCM) of Self-Determination Theory (SDT), the study explored how goal integration is associated with more fulfilling and enjoyable experiences and fewer negative emotions, ultimately improving psychological well-being. Health-related goals were evaluated using the Personal Project Analysis technique, while the State-Trait Anxiety Inventory was utilized to measure general anxiety levels. Among the 141 participants with inflammatory bowel disease, 96 reported having health-related goals. Of these, 66 were female (68.75%), and 30 were male participants (31.25%). Path analysis revealed a moderate negative association between self-concordance (SC) and negative emotions, which, in turn, predicted higher levels of trait anxiety. Furthermore, the alternative model tested indicated that trait anxiety predicted a lower level of self-concordance. Setting well-integrated health goals involves an internal capacity, enabling patients to experience less negative emotions during self-management activities. Anxiety can hinder individuals from accessing their inner needs, resulting in less self-concordant aspirations and more negative emotions. These findings may contribute to developing prevention and intervention programs to enhance IBD patients' adherence to lifestyle changes, ultimately improving their overall well-being.

Flourishing Together: The Longitudinal Effect of Goal Coordination on Goal Progress and Life Satisfaction in Romantic Relationships.

Goal pursuit shapes people' everyday experiences and is deeply embedded within close relationships. Several studies have shown that goal support from romantic partners facilitates goal progress, and individual goal progress contributes to wellbeing. However, few pieces of research have examined the whole process, how efficient goal coordination in a romantic relationship contributes to life satisfaction through goal progress. In these studies, short time frames were used and only one aspect of goal coordination was examined. To generate more complex, long-term understanding we collected data from 148 married or cohabitating Hungarian heterosexual couples (mean age 39.71 ± 10.40 and 38.57 ± 10.00 years for men and women, respectively) in a two-wave longitudinal study with a year-long time window. Both partners individually completed an adapted version of the Personal Project Assessment and evaluated four chosen projects associated with project coordination (emotional support, communication, and cooperation) at baseline, and project attainment (progress, success, satisfaction) in the follow up. Life satisfaction was assessed during both waves. Results from the actor-partner interdependence mediation modeling revealed complete mediation, where project coordination increased project attainment one year later, and consequently associated with higher life satisfaction for both partners. The direct effect between project coordination and life satisfaction remained nonsignificant. This association indicates that for long-term life satisfaction, it is crucial to experience better goal outcomes as the result of the couple's collaborative effort.

Health Psychology Services for People in Disadvantaged Regions of Hungary: Experiences from the Primary Health Care Development Model Program.

BACKGROUND: The importance of community health psychology in providing complex bio-psycho-social care is well documented. We present a mixed-method outcome-monitoring study of health psychology services in the public-health-focused Primary Health Care Development Model Program (2012-2017) in four disadvantaged micro-regions in northeast Hungary. METHODS: Study 1 assessed the availability of the services using a sample of 17,003 respondents. Study 2 applied a follow-up design to measure the mental health outcomes of the health psychology services on a sample of 132 clients. In Study 3, we conducted focus-group interviews to assess clients' lived experiences. RESULTS: More mental health issues and higher education predicted a higher probability of service use. Follow-up showed that individual and group-based psychological interventions resulted in less depression and (marginally) higher well-being. Thematic analysis of the focus-group interviews indicated that participants deemed topics such as psychoeducation, greater acceptance of psychological support, and heightened awareness of individual and community support important. CONCLUSIONS: The results of the monitoring study demonstrate the important role health psychology services can play in primary healthcare in disadvantaged regions in Hungary. Community health psychology can improve well-being, reduce inequality, raise the population's health awareness, and address unmet social needs in disadvantaged regions.

Medical educators' experiences on medically unexplained symptoms and intercultural communication-an expert focus group study.

BACKGROUND: Medically unexplained symptoms (MUS) are highly prevalent and remain challenging in healthcare and medical education, along with the increase in the importance of intercultural issues regarding MUS. However, less is known about the challenges of professionally addressing patients with MUS in the interprofessional and intercultural contexts. Thus, the present study aims to provide the first exploration of the experiences of medical specialists regarding treating MUS in intercultural contexts and inputs for training development on the intercultural aspects of MUS. METHODS: Three focus groups (total n = 13) consisting of medical specialists from a Hungarian university who were teaching at the medical faculty in intercultural settings and also worked for the university health services were interviewed. The topics covered the participants' personal experiences on addressing MUS and the challenges of intercultural communication and the intercultural educational context. Thematic analysis was used to yield a qualitative account of the interviews as guided by the research questions. RESULTS: Representing the different aspects of medical specialists, the study identified three main themes in the experiences of medical specialists, namely, 1) the need to adapt to the personal world of patients and search for common frames to understand MUS, 2) the need to discover methods for adapting to cultural differences and 3) the need to enhance the interprofessional coordination of knowledge and practices. CONCLUSIONS: The results are in line with the distinct conclusions of previous studies. Moreover, an integrated educational program on the intercultural aspects of MUS may address the main themes separately and, subsequently, support their integration. Therefore, the study discusses the manner in which an integrated educational program on the intercultural aspects of MUS may address the needs recognized in these aspects.

[Social anxiety and the use of environmental self-regulation strategies].

INTRODUCTION: The prevention of social anxiety alone and in the prevention of comorbid diseases is key. In the present research, we examine subclinical-level social anxiety from a previously understudied perspective, in its asso ciation with environmental self-regulatory strategies. We use the theory of favorite places to describe environmental self-regulatory processes. The aim of the research is to determine how subclinical level social anxiety is related to the environmental self-regulatory processes taking place in favorite places. METHODS: In the study, we conducted an online questionnaire survey of 483 adults who were clinically healthy - 329 women (68.11%) and 154 men (31.88%). Respondents' social anxiety was assessed with the Fear of Negative Evaluation Questionnaire (BFNE-S), while environmental self-regulatory strategies were assessed with the Favorite Places Questionnaire. RESULTS: The extent of social anxiety was correlated with visiting favorite places in positive and negative emotional states, as well as the level of recovering and distressing experiences in the favorite place. Within the subsample characterized by elevated social anxiety, the pattern that visiting a favorite place helps a person regain his or her emotional balance primarily through the regulation of negative experiences was more characteristic. However, we found no correlation between the type of favorite place (e.g., place of residence, natural place) and the person's level of social anxiety. CONCLUSION: The research highlights that individuals with subclinical-level social anxiety are particularly active in using environmental self-regulatory processes to achieve their emotional balance. In prevention and clinical practice, it is worthwhile to monitor environmental self-regulatory processes and support for related needs, with particular emphasis on place use patterns.

Cooperation and conflict in romantic partners' personal projects: the role of life domains.

Personal projects represent a person's pursuits in different life domains. The present study examines the orientations of adults' personal projects and how these orientations are embedded in the dynamics of romantic relationships. Cross-sectional data from 249 married or cohabitating Hungarian heterosexual couples were collected (mean age 42 ± 10.76 and 39.64 ± 10.21 years for male and female partners, respectively). An adapted version of the Personal Project Assessment procedure was completed by both partners individually. Four of their chosen projects were evaluated based on perceived cooperation and conflict regarding these projects and other predefined aspects. First, after applying a person-oriented approach, four meaningful content domains emerged from the thematically coded data using cluster analysis: (1) Practical, (2) Work-Life Balance, (3) Relationships, and (4) Learning and Growth orientations. For both genders, people with Learning and Growth orientation were younger than those with Practical orientation, and among women, the Work-Life Balance orientation group was older. Second, we linked the content domains to relationship experiences on the dyadic level. Both partners with Learning and Growth orientation goals perceived less cooperation. Female partners whose spouses had Work-Life Balance or Learning and Growth orientation goals perceived less conflict regarding their own goals. Overall, Learning and Growth-oriented goals can be considered more distant from the dynamics of romantic relationships because they involve fewer joint experiences and less cooperation and conflict.

Assessing meaningful work among Hungarian employees: testing psychometric properties of work and meaning inventory in employee subgroups.

BACKGROUND: The construct of meaningful work (MW) has become the subject of various studies. Workers who experience MW have higher career and organizational commitment, report fewer days absent, and are characterized by a higher level of well-being. The aim of this study is to test a measure of MW, the Work and Meaning Inventory by Steger et al. This measure was created on theoretical background, and it constructs MW from three dimensions: psychological meaning, meaning-making, and greater good motivation. METHODS: The analysis was conducted in a Hungarian sample (N = 2,498), using confirmatory factor analysis (CFA), and multiple-group CFA. RESULTS: The three-dimensional model of the WAMI was confirmed in the analysis. In our study, the measure proved to be reliable, even in the test-retest analysis. Moreover, the discriminant and convergent validity of the WAMI was tested, with various relevant constructs: the presence and the search for life meaning, life satisfaction, and job satisfaction. Also a multiple-group CFA was conducted with the three-factor model, confirming measurement invariance regarding sex and working position. CONCLUSIONS: In line with the original version of the WAMI, the three-dimensional model was confirmed, with good psychometric properties in the Hungarian working context.

Finding a Secure Place in the Home during the First COVID-19 Lockdown: A Pattern-Oriented Analysis.

In challenging times, home is frequently the primary basis of environmental self-regulation processes, individual and relational coping, and well-being. This study aimed to identify multiple types of security experiences at home during the first lockdown period of the COVID-19 pandemic. We used data from 757 Hungarian adults who completed the online, modified form of the Emotional Map of the Home Interview method in 2020 after the outbreak of the COVID-19 pandemic. Participants imagined their homes, chose the place of security in their homes and rated their personal experiences (i.e., experiences of agency, communion, self-recovery, and distress) related to these places. Latent profile analysis of personal experiences revealed four types of relational-environmental self-regulation in secure places: "security in active self-recovery," "security in detachment," "security in doing and feeling good enough," and "security in stress and compensation." Profile membership was predicted by age, gender, and indices of psychological support and well-being. Results suggest that finding psychological security in the home is a multifaceted phenomenon that may be partly affected by the perception of the broader social-ecological context. Identifying subpopulations vulnerable to the challenges of the pandemic may help researchers and practitioners provide better support in times of local and global crises.

Striving for autonomy in everyday diabetes self-management-qualitative exploration via grounded theory approach.

OBJECTIVES: The rapid worldwide increase in the incidence of diabetes significantly influences the lives of individuals, families and communities. Diabetes self-management requires personal autonomy and the presence of a supportive social environment. These attributes can considerably ameliorate the outcomes of the chronic condition. However, little is known about individual variations in overcoming the illness-related challenges and in the achievement of autonomy in daily activities. This paper seeks to bridge this knowledge gap. DESIGN: This qualitative study used the grounded theory approach. Semi-structured interviews were conducted, and the data collection and data analysis probed participant experiences of autonomy through the self-management of their daily socio-physical environments. SETTING: Participants were recruited from the outpatient ward of a university clinic in Hungary. PARTICIPANTS: The study was conducted with 26 adult patients with type 2 diabetes mellitus (15 females and 11 males aged between 26 and 80 years; M=62.6 years; SD=13.1). The inclusion criteria were: T2D diagnosis at least 1 year before the beginning of the study; prescribed insulin injection therapy; aged over 18 years; native Hungarian speaker and not diagnosed with dementia or any form of cognitive impairment. RESULTS: The study established three principal aspects of the active construction of personal autonomy in diabetes self-management: coping strategies vis-à-vis threats posed by the symptoms and the treatment of the disease; autonomous ways of creating protective space and time and relationship processes that support everyday experiences of self-directedness. CONCLUSIONS: The results of this study confirm the validity of the self-determination theory in diabetes self-management. They also imply that pathways towards constructing everyday experiences of self-directedness in participants lead through self-acceptance, supporting family relationships and a doctor-patient relationship characterised by partnership. The tentative empirical model of pathways towards patients' experience of self-directedness can serve as a framework for future research, patient-centred clinical practice, and education.

Epidemiology and organisation of care in medically unexplained symptoms: A systematic review with a focus on cultural diversity and migrants.

BACKGROUND: Since the pathophysiology of medically unexplained symptoms (MUS) remains unclear, healthcare providers often struggle with these patients, especially with a different ethnic and/or cultural background. These challenges are insufficiently addressed in their training and in the organisation of care. AIM: To improve healthcare provider-patient interaction focused on MUS patients in general and in ethnic minorities and refugees in particular through a systematic review of syndromal definitions and epidemiology and organisation of care of MUS patients. METHODS: Screening of PubMed, Web of Science, Cinahl and Cochrane Library on the keywords 'Medical unexplained (physical) symptoms (MUPS)', 'Somatoform disorder', 'Functional syndrome', 'Diversity', 'Migrants', 'Ethnicity', 'Care models', 'Medical education', 'Communication skills', 'Health literacy'. RESULTS: Different case definitions result in markedly different epidemiological estimates for MUS patients. Nevertheless, they are prevalent in a wide range of healthcare settings. Literature offers evidence of the effectiveness of structural frameworks in approaching MUS patients. Organisation of MUS care needs to transcend different levels of care: specialist tertiary and secondary care and primary care involving different qualifications of caregivers need to be aligned. CONCLUSION: The systematic review identified significant gaps and shortcomings in organisation of care. These need to be addressed in order to improve outcomes.

Preferred ways of giving birth in non-pregnant and pregnant nulliparous women: the role of control beliefs.

PURPOSE: To explore the association between delivery-specific, health-related control beliefs and preferred ways of delivery in nulliparous Hungarian women. Moreover, since data about the delivery-specific control beliefs and delivery-related preferences of non-pregnant nulliparous women are lacking, the present study also seeks to provide descriptive information in this regard. METHODS: A total of 984 Hungarian nulliparous women (26.45 ± 5.42 years; 660/77.2% non-pregnant and 224/22.8% pregnant) were included in the present study. The online assessment included measures of delivery-specific (internal-, healthcare professional-, and chance-related) health control beliefs, fears of childbirth, self-esteem, as well as preferences regarding delivery setting (i.e. spontaneous vaginal birth in hospital, planned cesarean birth and home birth). RESULTS: Healthcare professional-related control beliefs were associated with a stronger preference for spontaneous vaginal birth in hospital (OR = 1.87, 95% CI: 1.56-2.23) and planned cesarean birth (OR = 1.96, 95% CI: 1.60-2.40), alongside a weaker preference for home birth (OR = 0.31, 95% CI: 0.25-0.39). In contrast, internal delivery-specific control beliefs predicted a weaker preference for planned cesarean (OR = 0.66, 95% CI: 0.55-0.78) and a stronger preference for home birth (OR = 1.63, 95% CI: 1.33-2.00). A general preference index for medicalized ways of delivery was negatively associated with internal - and positively with healthcare professional - and chance-related control beliefs (ßs = -.173, .074 and .445, respectively). CONCLUSIONS: Delivery-related control beliefs are important psychological characteristics in the prediction of preferences for ways of delivery. Understanding delivery-specific control beliefs may be an important component of supporting women to give birth in a mentally and physically healthy way.

Cardiovascular disease risk perception in a Hungarian community sample: psychometric evaluation of the ABCD Risk Perception Questionnaire.

OBJECTIVES: Reliable and valid assessment of subjective risk perception is a crucial part of cardiovascular disease (CVD) prevention and rehabilitation. Since the recently developed Attitudes and Beliefs about Cardiovascular Disease (ABCD) Risk Questionnaire complies with these requirements, the aim of the present study was to investigate the psychometric properties of the Hungarian version of the measure. DESIGN AND SETTING: Community-based cross-sectional observational study PARTICIPANTS: In sum, 410 (M=49.53 years, SD=8.09) Hungarian adults (inclusion criteria: aged 35 and above, not under treatment with a psychiatric disorder) were included in the present study (female: n=277, 67.6%; college or university-level education: n=247, 60.2%). METHODS: We translated the ABCD Risk Questionnaire into Hungarian and checked its psychometric properties and validity indices. PRIMARY OUTCOME MEASURES: Internal consistency, explorative and confirmative factorial validity. Associations with sociodemographic and health-related characteristics, as well as with measures of mental health (depressive symptoms, perceived stress and well-being). RESULTS: Exploratory and confirmatory factor analyses supported a three-factor solution, corresponding to the original subscales of Risk Perception, Perceived Benefits and Healthy Eating Intentions, with a moderate correlation between the latent constructs. The respondents' level of knowledge on CVD risk factors was largely independent of their subjective risk perception. The results also provided evidence on the weak-to-medium associations between mental health indices and CVD-related perceptions. Based on the results, a shortened scale version was also suggested. CONCLUSION: This study confirms the factorial structure, internal consistency and validity of the Hungarian version of the ABCD Risk Questionnaire in a non-English-speaking community sample. The ABCD Risk Perception Questionnaire is a parsimonious and psychometrically adequate measure to assess CVD-related attitudes and knowledge in the general population. Further research is needed in socioeconomically more diverse and in clinical samples, as well as in longitudinal intervention studies.

[Attachment style, relationship and sexual satisfaction: comparing breast cancer patients and healthy women]. / Kötodési stílus, kapcsolati és szexuális elégedettség: emlorákos és egészséges nok összehasonlító vizsgálata.

Introduction: Many studies have investigated attachment styles in adults diagnosed with breast cancer: previous results indicate the importance of considering the associations between attachment style and relationship functioning in order to support better quality of life and optimal healing process in patients. Aim and method: In this study we intend to assess the attachment style (anxiety and avoidance) of Hungarian women diagnosed with breast cancer (n = 135) and to compare it with a group of women not diagnosed with cancer (n = 137). We examined attachment style in relation to self-rated health as well as relational and sexual satisfaction. Results: In the diagnosed group, we found higher level of avoidant attachment as well as poorer self-rated health, and lower relationship and sexual satisfaction. Both higher avoidance and anxiety predicted lower relationship satisfaction, while sexual satisfaction was predicted by having a breast cancer diagnosis and better self-rated health. Conclusion: Our results indicate that the attachment pattern of women diagnosed with cancer can play a role in their relationships and sexual satisfaction, along with their subjective health status. Monitoring and supporting physical, mental and relational characteristics may contribute to the attainment of better quality of life. Orv Hetil. 2020; 161(13): 510-518.

[Correlation of social support and healthy lifestyle]. / A társas támogatás és az egészséges életmód összefüggései.

Introduction: Cardiovascular disease is the leading cause of death accounting for 4 million deaths per year in Europe. Psychosocial factors explain at least 25-40% of the disease's prevalence beyond the well-known lifestyle factors. Isolation in adulthood is one of the main sources of chronic stress that raises the incidence of the disease. The low level of social support and social isolation are increasing the risk of depression and high blood pressure hence the incidence of cardiovascular diseases. Aim: Our aim was to observe the correlation between social isolation and health behaviour. Furthermore, we have adapted the earlier validated Multidimensional Social Support Scale to the domain of health. Method: The data from 507 persons were collected online in 2018. Multidimensional Social Support Scale adapted to health, self-rated health, subjective means, short version of Beck Depression, shortened version of WHO Wellbeing, and Perceived Stress Scales were recorded. Results: Factor analysis verified the scale construction of the original 3-subscale structure (Cronbach alpha values = 0.945, 0.950 and 0.905). According to the regression models, social support received from friends we have observed to have moderately positive correlation with intensive exercises (B = 0.205, beta = 0.096, p = 0.093). Logistic regression model revealed that health-connected social support does not correlate with smoking, only education variable was related with it strongly, statistically significantly (B = -1.284, OR = 0.277, p<0.001). Conclusion: Multidimensional Social Support Scale has satisfactory stability and consistency to measure health-related social support. Social support showed correlation with the measures of mental health (depression, stress-level, wellbeing), and moderate association with intense exercises. Orv Hetil. 2020; 161(4): 129-138.

Stress and Dyadic Coping in Personal Projects of Couples - A Pattern-Oriented Analysis.

Relational accounts of goal striving have barely considered dyadic coping as an element of the process, nor has dyadic coping research utilized the unique advantages of the goal construct (e.g., in form of personal project assessment) so far. Therefore, the primary aim of the present study was to explore stress and dyadic coping experiences associated with the personal projects of partners in a close relationship. Moreover, we approached data analysis in a pattern-oriented way, instead of using variable-centered linear models. We used cross-sectional data from 270 married and cohabiting Hungarian heterosexual couples (mean age 40.1 ± 11.2 and 37.8 ± 10.9 years for male and female partners, respectively). Partners individually completed an adapted version of the Personal Project Assessment procedure. First, they named an important but stressful personal project. Respondents appraised their experiences with the chosen personal project along several predefined aspects. These included: (1) stress experiences; (2) dyadic coping, using the adapted Dyadic Coping Inventory; (3) positive emotions; and (4) sense of community. The Relationship Assessment Scale was also assessed. Cluster analysis of both partners' stress experiences, positive and negative dyadic coping strategies in their own personal projects revealed six relationship-level clusters. Cluster solutions represented typical variations of the stress and dyadic coping patterns of the couples, and could be arranged in a three- (lower, medium, and higher stress) by-two (positively vs. negatively balanced dyadic coping pattern) array. Further analyses indicated the general trend that couples with lower (vs. higher) stress together with more positively (vs. negatively) balanced dyadic coping may have experienced better functioning in projects (more positive emotions and higher sense of community) and higher relationship satisfaction. Results confirm that the partners' pursuit of their personal projects is embedded in their relationship, and their functioning in these projects may partly depend on dyadic coping with the stress that arises during the accomplishment of the project. By using a pattern-oriented approach to dyadic data, we were able to distill stress and coping patterns that capture the specific types of couples' relationships and indicate the non-linear and multidimensional nature of stress and dyadic coping processes.

Strategies of Dyadic Coping and Self-Regulation in the Family Homes of Chronically Ill Persons: A Qualitative Research Study Using the Emotional Map of the Home Interview Method.

Environmental and emotional self-regulation skills play a critical role in promoting well-being of individuals and in encouraging healthy relationships. However, occurrence of chronic illness in one family member complicates routine dyadic coping processes for the couple. Additionally, according to environmental psychologists, self-regulation processes are influenced by individuals' perceptions of their socio-physical environments, and during times of chronic illness, the family home is frequently the primary site of dyadic coping. To date, few researchers have investigated the complex relationship among dyadic coping, the family home, and self-regulation processes in the context of chronic illness. The purpose of this paper is to report the results of qualitative research conducted to explore these relationships by analyzing participants' emotionally significant experiences within the family home. We purposively sampled and conducted in depth semi-structured interviews with 23 adults representing 10 families with one chronically ill adult family member. Representative illnesses included epilepsy (4) and chronic back pain (6). We used the Emotional Map of the Home Interview method (EMHI), an elicitation process in which participants are initially asked to place predefined positive and negative experiences on drawn diagrams of their homes. We analyzed the data through grounded theory coding methods, including open, axial and selective coding. Results of data analysis suggest that the family home operated as a critical socio-physical environment and had a profound impact on environmental and emotional self-regulation as well as on dyadic coping when one partner experienced chronic illness. Key selective codes derived from the data that reflect the variation and nuance within this impact included: "stress communication through the home space," "coping by spatial separation" and "coping by joint striving for at-homeness." These results reveal formerly hidden aspects of dyadic coping with chronic illness: the role of environmental cues, represented by the family home in this study, in perceptions of stress; the coordinated use of spatial-environmental contexts to engage the appropriate self-regulatory strategies for coping with illness-related stress. These findings demonstrate the utility of EMHI as an assessment tool and provide meaningful theoretical and practical information about dyadic coping among couples living with chronic disease.