Processing speed and executive functioning in relation to off-topic verbosity among young adults and older adults.

PURPOSE: Off-topic verbosity (OTV) is a tendency towards excessive, off-topic speech and has been linked with age-related deficits in executive functioning, particularly inhibition. However, there are numerous disagreements within the literature on what constitutes OTV, and there is a further lack of investigation into alternative cognitive explanations for the link between inhibition and OTV. The purpose of this study was to investigate the speech characteristics of OTV in young and older adults as well as to examine whether variations in OTV are better explained by diminished executive functioning or processing speed, as measured by the D-KEFS Stroop test. METHODS: Young adults (n = 65; age 18-28) and older adults (n = 85; age 60-98) completed the D-KEFS Color-Word Interference Test and provided verbal samples of autobiographical episodic and procedural speech. These speech samples were rated on three facets of OTV: tangentiality, egocentrism and quantity of speech. RESULTS: Procedural autobiographical speech was found to best measure age cohort variations in OTV, and higher OTV was associated with poorer Stroop test performance in older adults but not in young adults. In fact, young adults only displayed associations between poorer Stroop performance and a reduction in speech quantity. Finally, processing speed deficits were more associated with increased OTV in older adults than executive functioning. CONCLUSION: These results provide support for links between age-related cognitive decline and OTV, but the results suggest that processing speed may be more implicated than executive functioning.

End-of-life treatment preferences and advanced care planning among older adults.

End-of-life treatment preferences (EOLTPs) refer to the amount of medical intervention an individual would wish to receive in a life-threatening scenario. This study aimed to investigate relationships between older adults' EOLTPs and advance care planning (ACP). Using archival data from two interview surveys of community-dwelling older adults (study 1 n = 331, study 2 n = 338; age 60-102), results found that a desire for less end-of-life medical intervention was associated with greater EOL discussion with physicians. This relationship was explained by greater death preparation and younger age. Older adults may use ACP to limit unwanted medical interventions.

Peer observation of teaching: A feasible and effective method of physician faculty development.

Physician faculty learn teaching skills informally while fighting competing professional obligations. One underutilized proven technique to improve teaching skills is peer observation with feedback. We aimed to understand benefits and challenges of a physician faculty development program based on peer observation of teaching and to develop best practice recommendations for future program development. The authors developed a peer observation-based physician faculty development program from 2015 to 2017. Two interviewers conducted and analyzed qualitative interviews with 13 faculty participants and four non-participants using content analysis to identify themes and subthemes in NVivo©. Participant-identified program benefits included conveyed institutional support for teaching, the opportunity for peer observation with direct and timely feedback, the opportunity for community building, and overall program feasibility. Program challenges included competing scheduling demands, variability in feedback quality, and difficulty maintaining engagement for the program duration. Potential areas for improvement included participation incentives, external faculty involvement, assistance with program logistics and administration, and improvement in the consistency of the feedback experience. While peer observation is a valued approach to physician faculty development of teaching skills, competing demands on physicians may still limit program effectiveness. Program sustainability depends on optimizing feedback quality, boosting motivation for participation, and providing administrative support.

Correlates of Disclosure of Virginity Status Among U.S. College Students.

Disclosure of virginity status (DVS) refers to the extent to which an individual reveals that they identify as a virgin or not to different individuals in their lives. The purpose of this study was to investigate how generalized self-disclosure, virginity beliefs, and religiosity, as well as interactions with gender and virginity status, relate to DVS to family, peers, and religious communities. Southern U.S. college students (N = 690) took an online sexuality questionnaire. Generalized self-disclosure did not relate to DVS, suggesting that DVS represents a unique form of self-disclosure. Gender by virginity status interactions suggested that societal double standards of gender and virginity status (i.e., non-virgin women and virgin men being stigmatized for their virginity identifications) may be most relevant to one's decision to disclose to family, and somewhat relevant to one's decision to disclose to religious communities. Individuals high in religiosity overall tended to disclose their virginity status when they identified as a virgin, but not as a non-virgin. Virgins concealed their virginity status from religious communities when they stigmatized their own virginity but disclosed to family and peers when they viewed virginity as a gift. Overall, the results suggest that, although religiosity and virginity beliefs indeed play a role in DVS toward certain targets, one's gender and virginity status appear to be most important. Increased education on the double standard regarding gender and virginity status may help reduce stigma and improve sexual well-being.

Attitude toward death, not religious commitment mediates the relationship between political ideology and attitudes toward life extension.

Previous research has linked political ideology - right-wing authoritarianism and social dominance orientation - with more positive attitudes toward life extension. The purpose of this study was to investigate death attitudes and religious commitment as mediators of the relationship between political ideology and attitudes toward life extension. College students (N = 406) completed an online survey. One death attitude - neutral acceptance - and not religious commitment mediated the relationship between political ideology and attitudes toward life extension. Individuals with more intolerant political ideology may see death as aberrant and thus be more likely to embrace life extension technology.

Correlates of end-of-life treatment preferences among young adults and older adults.

The purpose of this study was to investigate correlates of end-of-life treatment preferences. Young adults (n = 117) and older adults (n = 305) completed an interview survey. Compared to older adults, young adults endorsed a desire for more medical intervention in end-of-life scenarios. After controlling for age cohort and education, a desire for more medical intervention in end-of-life scenarios was associated with higher religiosity, greater death anxiety, and more positive attitudes toward aging but not with physical or mental health. End-of-life treatment preferences may be more closely related to attitudes, beliefs, and practices than health status.

Compassion fatigue, emotional labor, and emotional display among hospice nurses.

The purpose of this study was to investigate relationships between compassion fatigue, emotional labor, and emotional display among hospice nurses (N = 90; 94.4% women). The hospice nurses indicated the emotional labor they utilize is primarily suppressing both positive and negative affect. Compassion fatigue was positively associated with expressing negative emotions, faking negative emotions, negative display rule perceptions, and surface acting, and negatively associated with suppressing negative emotions. Interventions and policies that foster greater authenticity and support emotional regulation may help reduce compassion fatigue among hospice nurses.

Clinging to power, clinging to life: Rightwing authoritarianism, social dominance orientation, and attitudes toward life extension.

The purpose of this study was to investigate the relationship between political ideology and attitudes toward life extension among college students (N = 484). Older age and male gender were associated with more positive attitudes toward life extension, while religious commitment was not. Authoritarian aggression/submission and social dominance orientation were associated with more positive attitudes toward life extension. The results suggest older people, men, and individuals higher in authoritarian traits and social dominance orientation may be more likely to use life-extending biomedical technology.

The development of an individual differences end-of-life treatment preferences scale.

The purpose of this study was to create an individual differences measure of end-of-life treatment preferences (EOLTPs). Young adults (n = 427) and older adults (n = 333) completed a survey. Results found that hope of recovery was an important factor in whether individuals preferred a given medical intervention. A single factor explained the majority of the variance in EOLTPs, and EOLTPs were distinct from more general attitudes about medical care. Older adults preferred less end-of-life medical intervention compared to younger adults. Overall, the results of the study support the use of an individual differences approach to measuring EOLTPs.

Generalized Self-Disclosure Explains Variance in Outness Beyond Internalized Sexual Prejudice Among Young Adults.

Outness, or self-disclosure of sexual orientation, plays a key role in the sexual identity development of LGB individuals and is linked with mental health. Lower outness has been consistently linked with higher internalized sexual prejudice; however, no extant research has explored the relationship between generalized self-disclosure and outness. The purpose of this study was to investigate the incremental validity of general self-disclosure to explain variance in outness beyond what is accounted for by internalized sexual prejudice among young adults (N = 387; 46 lesbians; 78 gay men; 49 bisexual men; 214 bisexual women). Self-disclosure explained additional variance in outness beyond internalized sexual prejudice. While outness is related to internalized sexual prejudice, general personality characteristics such as self-disclosure may also play a role in LGB individuals' disclosure of their sexual orientation. These findings suggest that while internalized sexual prejudice is still the primary driver of lower outness, lower general self-disclosure may also play an important role. Closeted individuals may be weighing the risks and benefits of disclosing their sexual orientation, as they would with any other personal information. For those struggling with self-disclosure of sexual orientation, clinicians should attend to internalized sexual prejudice while also noting an individual's comfort with general self-disclosure.

Choice of and comfort with health care proxy among older adults: Hierarchical compensation and perceived similarity in values.

The purpose of this study was to investigate choice of and comfort with health care proxy among older adults (N = 240). Results indicated that choice of proxy follows a hierarchical compensation model. Perceived similarity regarding end-of-life preferences and political views were not associated with comfort with proxy; however, perceived similarity with regards to religious values was associated with comfort with proxy. Attempts to promote advance care planning and advance directives may benefit from emphasizing individuals' choice and autonomy but also their opportunity to designate a health care proxy who they feel represents their religious values.

The death panel myth among older adults: Political ideology, advance directives, and perceived discrimination on the basis of age.

The "death panel" myth holds that the Affordable Care Act sought to determine which Americans are worthy of medical care. Two interview surveys among older adults (Study 1, N = 210, Study 2, N = 196) investigated differences between those who do and do not believe the death panel myth. Those who believed in the death panel myth had more conservative political ideology, lower perceived need for living wills, and higher perceived discrimination on the basis of age. The death panel myth may stem from partisanship and a belief that society places less value on the lives of older adults.

Death Attitudes, Palliative Care Self-efficacy, and Attitudes Toward Care of the Dying Among Hospice Nurses.

Previous research has linked death attitudes, palliative care self-efficacy, and attitudes toward care of the dying among nursing students and other nursing samples, but not among hospice nurses. The purpose of this study was to investigate these relationships among hospice nurses (N = 90). More positive attitudes toward care of the dying were associated with lower fear of death and death avoidance as well as higher neutral acceptance and escape acceptance, but not with approach acceptance. More positive attitudes toward care of the dying was associated with perceived capability to answer end-of-life concerns, but not with perceived capability to respond to end-of-life symptoms. Clinical interventions seeking to improve attitudes toward care of the dying among hospice nurses may be most effective by targeting death attitudes and improving self-efficacy in the area of discussing end-of-life concerns with patients.

The Role of Empathy in the Relationship Between Social Political Ideology and Sexual Prejudice in Heterosexual College Students in the U.S.

While public acceptance of lesbian, gay, and bisexual (LGB) individuals and same-sex relations has grown over the past few decades, there is still opposition to LGB civil rights in the U.S. Previous literature has found links between political ideology and sexual prejudice, while empathy has been linked to both political ideology and sexual prejudice. However, no study has examined the interrelationships between these three variables. For this study, an online survey was administered to a diverse sample of college students in exchange for course credit, and those who self-identified as heterosexual were retained for analyses (N = 1143; 66.1% female; 45.5% White). Mediation analyses were performed to examine whether two subfacets of empathy (empathic concern and perspective taking) mediated the relationship between political ideology and sexual prejudice. Due to gender differences in sexual prejudice and empathy, gender was included in the model as a moderator. The results of moderated mediation analyses indicated both empathic concern and perspective taking were mediators for women, while perspective taking was the only mediator for men. These results suggest that interventions for sexual prejudice may be more effective when using approaches that promote taking the perspective of LGB individuals. Specifically, interventions that utilize empathy training or direct contact with LGB individuals may result in a decrease in sexual prejudice.

The glass is not half empty: optimism, pessimism, and health among older adults.

OBJECTIVES: Optimism and pessimism are distinct constructs that have demonstrated independent relationships with aspects of health and well-being. The purpose of this study was to investigate whether optimism or pessimism is more closely linked with physical and mental health among older adults. DESIGN: Cross-sectional survey. PARTICIPANTS: Community-dwelling older adults (N = 272) ages 59-95 in the southern United States. MEASUREMENTS: The Life Orientation Test-Revised and the Short Form 8. RESULTS: At the bivariate level, optimism was associated with higher physical health and mental health, while pessimism was associated with lower physical health and mental health. Multiple-regression analyses as well as comparison of correlation coefficients found that pessimism was more closely associated with physical health and mental health than optimism. CONCLUSIONS: These results add to the literature suggesting that, in terms of older adults' health and well-being, avoiding pessimism may be more important than being optimistic.

Attitudes toward euthanasia among hospice nurses: Political ideology or religious commitment?

Attitudes toward euthanasia have been linked with political ideology among hospice nurses; however, a larger body of research has linked attitudes toward euthanasia with religiosity. The purpose of this study was to explore relationships between political ideology, religious commitment, and attitudes toward active and passive euthanasia among hospice nurses. Hospice nurses (N = 90) volunteered to take an online survey. Religious commitment fully mediated the relationship between social political ideology and disapproval of active euthanasia. The results suggest that, among hospice nurses, religious commitment accounts for links between social political ideology and disapproval of active euthanasia.

Multidimensional emotion regulation strategies among hospice nurses.

The purpose of this study was to investigate relationships between four emotion regulation strategies (intrinsic affect-improving, intrinsic affect-worsening, extrinsic affect-improving, and extrinsic affect-worsening) and compassion fatigue, job satisfaction, and life satisfaction among 90 hospice nurses who completed an online survey. Intrinsic affect-improving was associated with higher life satisfaction. Intrinsic affect-worsening was associated with higher compassion fatigue and lower life satisfaction. Extrinsic affect-worsening was associated with lower job satisfaction. Overall, these findings support a multidimensional approach to understanding emotion regulation among hospice nurses.

Satisfaction With Work-Family Balance Mediates the Relationship Between Workplace Social Support and Depression Among Hospice Nurses.

PURPOSE: The purpose of this study was to investigate the relationship between social support (from personal and workplace sources) and psychological distress (depression, anxiety, and stress symptoms), as well as to examine the mediating role of satisfaction with work-family balance among hospice nurses. DESIGN AND METHOD: A cross-sectional study design was utilized with a sample of 90 hospice nurses from the southern United States. Participants completed online surveys, including (a) the Depression, Anxiety, and Stress Scale (DASS-21), (b) loosely adapted items from the Affectivity, Burnout, and Absenteeism Scales, and (c) Satisfaction with Work-Family Balance Scale. FINDINGS: Workplace social support, not personal social support, was associated with lower psychological distress, and satisfaction with work-family balance mediated the relationship between workplace social support and depression symptoms, a component of psychological distress. CONCLUSIONS: Hospice nurses' social support in the workplace and their satisfaction with the balance between their work and family lives play a role in supporting their mental health. CLINICAL RELEVANCE: Hospice nurses may benefit from programs fostering the creation of workplace-based interpersonal relationships.

Meaning in life and self-esteem help hospice nurses withstand prolonged exposure to death.

AIM: The purpose of this study was to investigate relationships between the presence of and search for meaning in life and self-esteem, psychological distress, burnout and affect among hospice nurses. BACKGROUND: The nature of hospice nursing may prompt existential concerns. METHOD: Hospice nurses (N = 90) completed an online survey. RESULTS: The presence of meaning in life was associated with lower psychological distress, burnout and negative affect, and higher levels of positive affect, whereas the search for meaning in life was only associated with higher negative affect. Self-esteem mediated the relationship between the presence of meaning in life and psychological distress, burnout and negative affect. CONCLUSION: The presence of meaning in life promotes self-esteem, which then buffers against negative outcomes. IMPLICATION FOR NURSING MANAGEMENT: Although managers cannot directly instil meaning in life in hospice nurses, they may be able to help nurses to find or maintain meaning by promoting policies that allow them to participate in meaningful personal, cultural or religious activities. Additionally, managers of hospice nurses could connect them with resources (e.g. mentors, counsellors or chaplains) to cope with the existential demands of providing end-of-life care.

Economic and Social Political Ideology and Homophobia: The Mediating Role of Binding and Individualizing Moral Foundations.

Previous research has linked conservative political ideology with homophobia. Political ideology has also been linked to differences in moral decision-making, with research suggesting that conservatives and liberals may use different values in their moral decision-making processes. Moral foundations theory is a model of moral decision-making that proposes that individuals emphasize different domains in moral decision-making. Conservatives tend to emphasize binding foundations, while liberals tend to emphasize individualizing foundations. Utilizing large, ethnically diverse college samples, the purpose of these two cross-sectional studies (Study 1 N = 492; Study 2 N = 861) was to explore whether moral foundations mediate the relationship between political ideology and homophobia. These studies explored economic and social political ideology separately and utilized a two-factor model of moral foundations theory (individualizing and binding foundations). Results of both studies found that conservative economic and social political ideology was positively associated with homophobia. Study 1 found that both conservative economic and social political ideology had an indirect effect on homophobia through binding foundations. Study 2 found that both economic and social political ideology had an indirect effect on homophobia through both binding and individualizing foundations. Overall, the results were consistent with the notion that moral foundations may explain the relationship between political ideology and homophobia.