Adherence to social distancing during the Covid-19 pandemic in Italy: The role of autonomous motivation and defiance.

To maintain social distancing in the long term, in the current COVID-19 scenario, people's motivation must be strong and of high quality. Many governments adopted measures enforcing social distancing. Enforcement, however, can produce feelings of defiance and backfiring effects. The present work aims at investigating the relationship between autonomous motivation and intentions to maintain social distancing, through adherence to recommendations and feelings of defiance. A sample of 502 Italian residents, from different parts of Italy, completed an online survey assessing their present behavior, levels of autonomous motivation and feelings of defiance, as well as intentions to observe social distancing in the short and long term. Results support the hypotheses that autonomous motivation is related to stronger intentions to maintain social distancing, particularly in the long term, and that feelings of defiance mediate this relationship. These results underline importance of promoting understanding and internalizing reasons for social distancing, beyond norms.

A Cluster Analysis of the Acceptance of a Contact Tracing App-The Identification of Profiles for the Italian Immuni Contact Tracing App.

Digital contact tracing apps have been introduced by governments as a strategy to limit the spread of the COVID-19 pandemic. Digital contact tracking is an alternative to traditional contact tracing performed by human tracers who have to reconstruct each contact an infected person had in the recent past by means of interviews. The Italian government proposed the Immuni digital contact tracking app as a solution. Immuni uses Bluetooth technology to anonymously register all close contacts a person had: if she tests positive for COVID-19 then all registered contacts are notified. The main aim of the paper is to propose a cluster analysis of some factors concerning the possible acceptance of the Immuni app to build behaviour profiles that explain and predict the possible behaviours of the respondents. The factors considered referred to three different pillars: the technological pillar, investigated by considering factors from the technology acceptance models family; the health pillar, where variables of the health belief model were used; and the sociopolitical pillar, where some values of the respondents were considered as possible barriers to or facilitators of the acceptance of this technology. As a result of the cluster analysis, three behavioural profiles were built: the ProApp profile, the Hesitant profile, and the AntiApp profile. The first is the profile grouping the respondents who intend to use the contact tracing app; the second is more about people who are favourable of the use of the app, but some issues such as privacy reduce the strength of their intention; the last profile is about people who are less favourable to use the app. We are confident that the behaviour profiles found would be useful to build more tailored communication campaigns to help promote the use of the app by managing factors that could either be facilitators or barriers.

Stability and change of lifestyle profiles in cardiovascular patients after their first acute coronary event.

BACKGROUND: Acute coronary syndrome (ACS) is a major cause of morbidity and mortality. Lifestyle and health behavior changes play an important role in the primary and secondary prevention of ACS recurrence. Changes in unhealthy lifestyles after an acute coronary event have been analyzed by considering separate behaviors individually, even though research on the healthy population has demonstrated that unhealthy behaviors tend to co-occur. PURPOSE: The aim of this study was to identify lifestyle profiles of ACS patients and to explore their pathways of change for one year after their first coronary event by adopting a typological approach. METHODS: Two hundred and twenty-three patients (84% male; mean age = 57.14) completed self-report measures of health-related behaviors at the beginning of cardiac rehabilitation, and six months and twelve months after. At each wave depression, anxiety and heart rate were also evaluated. Cluster analysis was performed to identify lifestyle profiles and to analyze their change over time. Differences in psychological factors and heart rate among clusters were assessed. RESULTS: Patients' diet, physical activity, and smoking behavior greatly improved six months after their first coronary event. No further improvements were detected after one year. At each wave specific lifestyle profiles were identified, ranging from more maladaptive to healthier clusters. Patients with multiple unhealthy behaviors experience greater difficulties in maintaining a healthier lifestyle over time. Moreover, the results demonstrated the association between lifestyle profiles at twelve months after the acute coronary event and depression measured six months earlier. Finally, the most maladaptive lifestyle profile had many members with elevated heart rate at twelve months after the cardiac rehabilitation. CONCLUSIONS: Current findings may have a strong practical impact in the development and implementation of personalized secondary prevention programs targeting lifestyles of ACS patients.

Occupational Resilience Assets Questionnaire (ORA-Q): a multilevel measure.

OBJECTIVES: The main aim of the present study is to present the Occupational Resilience Assets Questionnaire (ORA-Q), a questionnaire developed in three different levels (organizational, occupational, and personal) for assessing resilience resources at work. The purpose of the ORA-Q is to improve and facilitate research on resilience processes in the workplaces. Further the stress-buffering valence of the considered dimensions have been tested, too. METHODS: The development of the questionnaire is based on a survey of a sample of 1,518 Italian employees aged 18-55 years. Altogether 45 questions were tested with exploratory factor analysis, internal consistency and criterion validity. RESULTS: All the scales have good reliability. Principal component analysis enable to identify the hypothesized factors. Logistic regression analysis confirm the role of all resilience assets as buffer against stress conditions. CONCLUSION: The Occupational Resilience Assets Questionnaire is a valid and reliable tool for international research and workplace surveys. The questionnaire seems to be comprehensive and to include the most relevant resilience resources according to several important theories on this topic. Differently from many tools for the assessment and improvement of the psychosocial work environment, the ORA-Q is useful as resilience measure in the workplace. Its three-level structure facilitates surveillance, benchmarking and evaluation of interventions.

A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators.

Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed.

A longitudinal study on the information needs and preferences of patients after an acute coronary syndrome.

BACKGROUND: Research has shown that the provision of pertinent health information to patients with cardiovascular disease is associated with better adherence to medical prescriptions, behavioral changes, and enhanced perception of control over the disease. Yet there is no clear knowledge on how to improve information pertinence. Identifying and meeting the information needs of patients and their preferences for sources of information is pivotal to developing patient-led services. This prospective, observational study was aimed at exploring the information needs and perceived relevance of different information sources for patients during the twenty-four months following an acute coronary syndrome. METHODS: Two hundred and seventeen newly diagnosed patients with acute coronary syndrome were enrolled in the study. The patients were primarily men (83.41 %) with a mean age of 57.28 years (range 35-75; SD = 7.98). Patients' needs for information and the perceived relevance of information sources were evaluated between 2 and 8 weeks after hospitalization (baseline) and during three follow-ups at 6, 12 and 24 months after baseline. Repeated measures ANOVA, Bonferroni post hoc tests and Cochran's Q Test were performed to test differences in variables of interest over time. RESULTS: Results showed a reduction in information needs, but this decrease was significant only for topics related to daily activities, behavioral habits, risk and complication. At baseline, the primary sources of information were specialists and general practitioners, followed by family members and information leaflets given by physicians. Relevance of other sources changed differently over time. CONCLUSION: The present longitudinal study is an original contribution to the investigation of changes in information needs and preferences for sources of information among patients who are diagnosed with acute coronary syndrome. One of the main results of this study is that information on self-disease management is perceived as a minor theme for patients even two years after the event. Knowledge on how patients' information needs and perceived relevance of information sources change over time could enhance the quality of chronic disease management, leading health-care systems to move toward more patient-tailored care.

Post-traumatic growth enhances social identification in liver transplant patients: A longitudinal study.

OBJECTIVE: The main aim of this paper is to investigate the prediction that greater subjective identification with relevant groups and social categories (i.e. 'family' and 'transplantees') can be an outcome of post-traumatic growth (PTG). To date there are no studies that have explored these relationships. METHODS: A longitudinal study was conducted with a group of 100 liver transplant patients from the outpatient populations of the participating centre. Data were collected by means of a self-report questionnaire, which was completed at two different time points (T1 and T2) that were 24months apart. PTG was assessed using the Post-Traumatic Growth Inventory, while both transplantee and family identification were assessed using group identification scales. A path model was tested, using a structural equation model (SEM) approach, to examine the reciprocal effects among family identification, transplantee identification, and PTG over time. RESULTS: As predicted, we found that greater PTG T1 predicted both greater family identification T2 and marginally greater transplantee identification T2. However, the two identification variables did not predict PTG over time. CONCLUSIONS: The results show that family identification and transplantee identification may be outcomes of the PTG process, confirming the importance of adopting a thriving multidimensional model of adjustment to medical illness, whereby people facing adverse life events, such as transplantation, may flourish rather than deteriorate psychologically.

From Adjustment to Thriving: Exploring Well-Being in Young Adult Survivors of Childhood Cancer and Their Siblings.

PURPOSE: Few studies have addressed the adaptive mental health status of young adult (YA) survivors of childhood cancer (SCCs) and the siblings (SIBs) of the same families. This article explores the existence of different psychological well-being (PWB) profiles and verifies their relationship with life satisfaction, resilience, and mental adjustment among Italian YA survivors of childhood leukemia or lymphoma and their own SIBs. METHODS: YA SCCs (n = 35) who had been off primary treatment for at least 5 years and their SIBs (n = 47) completed anonymous self-report questionnaires for PWB, life satisfaction, resilience, and mental adjustment. The survivors at the time of the survey had an average age of 27 years (SD 3.37) and they were an average age of 12 years (SD 1.93) at diagnosis. Their own SIBs had an average age of 29 years (SD ±5.25). RESULTS: No significant differences were found between SCCs and their SIBs in all considered dimensions. Only 12% of the sample showed evidence of clinically significant mental health disorders, 51% manifested medium levels of resilience, and 49% fit a functional PWB profile. By means of cluster analysis, three PWB statuses could be derived: self-devaluing (25.5%), fatalist (25.5%), and eudaimonic (49%). Each of these PWB statuses exhibited a significant distinct profile in terms of life satisfaction, resilience, and mental adjustment. CONCLUSIONS: There is a need to establish psychosocial services that offer follow-up examinations aimed to not only prevent mental disorders but also to promote PWB.

Changes in Dietary Behavior among Coronary and Hypertensive Patients: A Longitudinal Investigation Using the Health Action Process Approach.

BACKGROUND: Cardiovascular diseases (CVDs) are a major cause of worldwide morbidity and mortality. Nutrition plays an important role in the primary, secondary, and tertiary prevention of CVDs. The present longitudinal study used the Health Action Process Approach (HAPA) to investigate changes in dietary behavior in coronary patients (CPs) affected by acute coronary syndrome and hypertensive patients (HPs) affected by essential arterial hypertension. METHODS: CPs (N = 250) and HPs (N = 246) completed a questionnaire during three measurement points (baseline, 6-month follow-up, and 12-month follow-up). Statistical analyses included a repeated measures ANOVA and a multi-sample structural equation model. RESULTS: HPs showed no changes in dietary behavior, whereas CPs improved their nutrition at 6 months and then maintained the healthier diet. The multi-sample analysis indicated equivalence of the HAPA model for both patient populations. CONCLUSIONS: These findings provide further evidence for the generalisability of the HAPA model, shedding light on dietary behavior among CVD patients and particularly on hypertensive patients which has received little attention. Moreover, the equivalence of the model suggests that the process of change is almost identical for individuals who are at high risk for a coronary event (i.e. HPs) and individuals who have already had the event (i.e. CPs).

Social support and adherence to treatment in hypertensive patients: a meta-analysis.

BACKGROUND: It is important to examine factors associated with patient adherence to hypertension control strategies. PURPOSE: A meta-analysis was conducted to examine whether social support was related to adherence to healthy lifestyle and treatment medication in hypertensive patients. METHODS: Journal articles were searched in medical (CINAHL, MEDLINE), psychological (PsycINFO, PsycARTICLES), and educational (ERIC) electronic databases; in reference lists of selected papers; and in the reference list of a previous review. RESULTS: Findings of a set of meta-analyses indicated that (a) structural social support was not significantly related to overall adherence, (b) functional social support was significantly and positively related to overall adherence, (c) these findings were further confirmed in meta-analyses conducted on specific types of adherence, and (d) most results were characterized by heterogeneity across studies that was partially explained by moderator analyses. CONCLUSIONS: Functional social support, but not structural social support, was associated with adherence in hypertensive patients.

Seeking and experiencing meaning: exploring the role of meaning in promoting mental adjustment and eudaimonic well-being in cancer patients.

OBJECTIVE: The present study is the result of theory-driven research investigating the role of the search for and presence of meaning in enhancing both mental adjustment and eudaimonic well-being in cancer patients. METHOD: A cross-sectional study involved 266 cancer patients currently in the treatment and management phase of their illness. Data were collected by a written questionnaire. The search for meaning was assessed with the Seeking of Noetic Goals Test, and the presence of meaning was assessed using the Purpose in Life Test. Mental adjustment to a cancer diagnosis was assessed by two subscales of the Italian version of the Mini-Mental Adjustment to Cancer Scale, and eudaimonic well-being was assessed with the Psychological Well-Being Scale. Correlation and mediation analyses based on five thousand bootstrapping samples were performed. RESULTS: The mediation analyses showed that the presence of meaning totally or partially mediated the effect of the search for meaning on both mental adjustment and eudaimonic well-being. Further correlation analyses showed a high negative correlation between eudaimonic well-being and hopelessness. SIGNIFICANCE OF RESULTS: Our results appear relevant from both the theoretical and clinical points of view. They support a deeper understanding of the combined contribution of the search for and presence of meaning in promoting well-being in cancer patients. Simultaneously, they are consistent with suggestions from recent studies on the clinical psychology of posttraumatic growth and emphasize the relevance of eudaimonic well-being as a protective factor for hopelessness.

Correlates of identity configurations: three studies with adolescent and emerging adult cohorts.

Adolescence and emerging adulthood are two core developmental periods in which individuals can develop a meaningful identity across domains. However, there is a lack of studies exploring correlates of different identity configurations. The purpose of this article was to fill this gap in examining correlates of configurations characterized by identity stability or instability in both ideological and relational domains or identity stability in one domain and instability in the other domain. Three studies were presented. In the first study, we investigated links between identity configurations and internalizing problem behaviors in early and middle adolescents (N=1,891; M (age) =14; 55% female); in the second study, we focused on associations between identity configurations and identity functions in late adolescents and early emerging adults (N=1,085; M (age) =19; 63% female); in the third study, we investigated relationships between identity configurations, sense of coherence, and basic psychological need satisfaction in emerging adults (N=489; M (age) =21; 71% female). Overall, findings highlighted that participants experiencing a condition of identity stability in both domains reported a better profile than their peers displaying a condition of instability in both realms. Further, individuals with identity stability only in one domain reported intermediate scores and the effect provided by each domain varied according to the correlate examined and the age group taken into account. Implications of these findings are discussed.

Destructive managerial leadership and psychological well-being among employees in Swedish, Polish, and Italian hotels.

OBJECTIVE: The aim of this cross-sectional exploratory study was to investigate destructive managerial leadership in the hotel industry in Sweden, Poland, and Italy in relation to psychological well-being among employees. METHODS AND PARTICIPANTS: 554 questionnaires were collected from employees in all occupational groups within hotels. The Copenhagen Psychosocial Questionnaire (COPSOQ) measured working conditions, particularly iso-strain or high work demands combined with low control and poor social support, and psychological well-being, defined in terms of mental health, vitality, and behavioural stress. Items adapted from the Global Leadership and Organisational Behaviour Effectiveness (GLOBE) research program questionnaire measured autocratic, malevolent, and self-centred leadership styles. Differences in ratings between countries were estimated, as well as the relationship between destructive managerial leadership on an organisation level and employee psychological well-being on an individual level. The relationship between destructive leadership and psychological well-being among employees was adjusted for employees' reported iso-strain. RESULTS: Autocratic and malevolent leadership were at the organisation level related to low vitality among employees and self-centred leadership was significantly associated with poormental health, low vitality, and high behavioural stress. Autocratic and malevolent leadership were more strongly related to iso-strain than was self-centred leadership. Variations in leadership practice between countries were seen in autocratic and malevolent leadership. CONCLUSION: This exploratory study suggests a significant association between destructive managerial leadership on the organisation level and poor psychological well-being among employees on an individual level. Interventions to decrease iso-strain and enhance psychological well-being among employees could be directed at an organisation level.

The combined contribution of social support and coping strategies in predicting post-traumatic growth: a longitudinal study on cancer patients.

OBJECTIVES: The aim of this study is to investigate the role of social support and coping strategies in enhancing post-traumatic growth (PTG) in cancer patients. The study focused on both avoidance and approaching coping and on four distinct types of social support: (a) perceived availability, (b) actual received, (c) satisfaction with received support, and (d) the competence of caregiver to satisfy the patient's basic psychological needs of autonomy, competence, and relatedness. METHODS: A longitudinal study was conducted with a group of 41 cancer patients currently in the treatment and management phase of their illness. Data were collected by means of a written questionnaire, at two time points (T1 and T2) that were 6 months apart. Social support was assessed using the Interpersonal Support Evaluation List and the Need Satisfaction in Relationship Scale. Coping strategies were assessed using the Brief COPE questionnaire. Social support and coping strategies were assessed only at T1. PTG was assessed using the Post-Traumatic Growth Inventory at T1 and T2. Correlation and regression analyses were used to examine the association between social support and coping strategies with short-term reports of post-traumatic growth. RESULTS: Regression analyses showed that autonomy-supportive caregivers and a problem-focused strategy of coping significantly predicted greater PTG at T2. CONCLUSIONS: This study contributes to a deeper understanding of the type of social support that may specifically aid cancer patients in experiencing PTG. Furthermore, findings confirm the important role of problem-focused coping strategies in growing psychologically.

[Training and information interventions aimed at stress control in the health care sector: potentialities and limits]. / Interventi di informazione e formazione per il controllo dello stress in ambito sanitario: punti di forza e limiti.

Training programs for health care workers aimed at controlling job-related stress (person-directed, person-work interface and organizational interventions) demonstrate only short-term effect in reducing stress levels. Medium-long-term results could be achieved only through well-articulated programs, which involve health administration managers and nursing staff in a solid and enduring prevention-centered approach. Informative interventions conducted in hospital for preventing job-related stress have a particularly good response rate among nurses and other members of medical support and technical staff. Physicians don't seem to respond to these interventions since they have more decision-making autonomy and develop reward mechanisms; for these reasons, they feel to have less need for training/support interventions. Finally, our results confirm the need for a more-active stress management policy in hospitals and other health care institutions.

In-group identification mediates the effects of subjective in-group status on mental health.

We present two studies exploring the effects of the relative standing of one's in-group in the social hierarchy, which we conceptualize as 'subjective in-group status', on mental health and well-being. Study 1 focuses on the subjective status of a professional in-group (prison guards) while Study 2 concerns the subjective status of the family in-group. Results show that higher subjective in-group status predicts better mental health (e.g., less depression) and greater well-being (e.g., higher satisfaction with life). Also, results demonstrate that the effects of subjective in-group status on mental health are mediated by the extent to which one subjectively identifies with the in-group.