The social process of involuntary separation and the search for connection.

Placing a loved one in care does not relieve informal caregivers' physical and emotional stresses. This study identified the unique psycho-social-spiritual processes of involuntary separation among spouses following long-term care admission. Participants were 17 spouse-caregivers (12 women and 5 men) with a mean age of 84 years who had been involuntarily separated for an average of 20 months. The basic psycho-social-spiritual process of spouse-caregiver involuntary separation was connecting in disconnection, which had three distinct stages: (1) Initial coping, (2) Adjusting to the new situation, and (3) Moving forward. Movement through the three stages was influenced by individuals' capacity and willingness to reach out for connection and by the abilities of others to extend accurate empathy and practical help. The implications of this study highlight spouse-caregivers' needs for connection and support not only during the crisis of separation, but in the months and years that follow.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Impact of a critical care clinical information system on interruption rates during intensive care nurse and physician documentation tasks.

Computerized documentation methods in Intensive Care Units (ICUs) may assist Health Care Providers (HCP) with their documentation workload, but evaluating impacts remains problematic. A Critical Care clinical Information System (CCIS) is an electronic charting tool designed for ICUs that may fit seamlessly into HCP work. Observers followed ICU nurses and physicians in two ICUs in Edmonton, Canada, in which a CCIS had recently been introduced. Observers recorded amounts of time HCPs spent on documentation related tasks, interruptions encountered by HCPs, and contextual information in field notes. Interruption rates varied depending on the charting medium used, with physicians being interrupted less frequently when performing documentation tasks using the CCIS, than when performing documentation tasks using other methods. In contrast, nurses were interrupted more frequently when charting using the CCIS than when using other methods. Interruption rates coupled with qualitative observations suggest that physicians utilize strategies to avoid interruptions if interfaces for entering textual notes are not well adapted to interruption-rich environments such as ICUs. Potential improvements are discussed such that systems like the CCIS may better integrate into ICU work.

Elimination communication contributes to a reduction in unexplained infant crying.

The Normal Crying Curve refers to infants' unexplained crying from birth to a peak at about 6-8 weeks, and self-resolving by three months. However, it is known that infants signal their need to eliminate (micturate/defecate) through a variety of cues, including fussing and crying. Elimination Communication (EC) refers to a caregiver's nurturant response to infant cues, while also using timing, to gently and non-coercively cradle the infant in a supported, secure squatting position to eliminate. Such practices have been reported in ethnographic observations of hunter-gatherer care of infants, who cry less than minority world (Western) infants. We hypothesize that the current minority world practice of delayed toilet training and lack of caregiver response to elimination cues results in excessive, unexplained infant crying as infants eliminate in the constraints of diapers and in non-beneficial postures. As a corollary, we hypothesize that EC will reduce unexplained infant crying in the early months, perhaps even planating the Normal Crying Curve. To evaluate our hypothesis, we designed a pilot study to collect empirical data from mothers who practiced EC with their infants, tracking crying and fussing at Weeks 4, 6, 8 and 12 primarily utilizing a 24-hour Baby's Daily Diary. We computed baseline measures, compared our crying data with those from the literature, assessed our data for internal crying peaks, and used hierarchical multi-level modeling to evaluate cross-level interactions. We found that infants in our pilot study cried on average 50.3% less (p < 0.05), and up to 70.9% less in Week 6, compared to literature studies. Moreover, when we evaluated our data to seek out a significant crying peak across weeks, no such crying duration difference was found. Using hierarchical generalized linear modeling, we found that greater daily crying episodes predicted greater daily elimination opportunities. Shorter crying episodes predicted a greater number of daily elimination opportunities compared to longer crying episodes, especially among low baseline crying infants. Our results suggest that crying prompts caregivers to offer elimination opportunities, but when the crying continues, caregivers may try other behavioral responses, such as feeding. Additionally, our results suggest that with the practice of EC, unexplained infant crying may be significantly reduced and warrant future research with an expanded sample. If the practice of EC indeed planates the Normal Crying Curve, then such results will have a significant impact on our understanding of unexplained infant crying.

'I drew the parts of my body in proportion to how much PCOS ruined them': Experiences of polycystic ovary syndrome through drawings.

Polycystic ovary syndrome is a chronic endocrine disorder associated with persistent physical symptoms and psychological and lifestyle repercussions. Eighty-nine participants (83 females, 6 non-binary) aged 19-43 years described their experiences of polycystic ovary syndrome through drawings and personal accounts. Four descriptive themes were identified: awareness of visible and invisible symptoms, misshapen self and body, limitations and barriers and resignation. Taken together, participants described a condition with all-encompassing effects: much more than symptom management alone. Findings support the use of drawings as an appropriate method with this population and suggest continuing need for supports for individuals with polycystic ovary syndrome.

Caregiving Spouses and the Experience of Involuntary Separation.

BACKGROUND AND OBJECTIVES: We explored the meaning of the experience of involuntary separation, as defined formally by the Canadian government and informally by our participants, in formerly caregiving spouses whose partners had been admitted to long-term care. Our goal was to explore their lifeworld experience of separation, including factors influencing well-being as spouses shifted from at-home caregiving to involuntary separation. RESEARCH DESIGN AND METHODS: Guided, semi-scripted personal interviews were conducted with 10 individuals who had become involuntarily separated up to 4 years prior to the interview. A psychological-phenomenological analysis of participant narratives was conducted following procedures set out by Giorgi (2009). RESULTS: Themes included access and continued involvement with spouse post-admission; seeking connections with family, friends, and spiritual resources; adaptability in the face of change and loss; and the immediate and long-term emotional impact of involuntary separation. Regular involvement with spouses, resources and connections with others, and adaptability contributed to well-being, but the experience was nonetheless described as an "emotional bomb." DISCUSSION AND IMPLICATIONS: Participants experienced involuntary separation as an overwhelming burden marked by ongoing losses, from connections with spouses and social supports to shifts in identity and financial security. Greater understanding of the unique needs and experiences of involuntarily separated spouses may help individuals cope in practical ways with their shifting situation and highlights the value of meaning-focused support.

Drinking to enhance and to cope: a daily process study of motive specificity.

OBJECTIVE: Daily process studies of internal drinking motives have not examined motive specificity, i.e., whether theoretically plausible trait and situational antecedents differ in their ability to predict the extent to which alcohol consumption on any given day is motivated by coping or enhancement. METHOD: University students (N=81) completed trait measures of coping and enhancement-motivated drinking (trait CM and EM), sensation seeking, and conscientiousness, and then completed a 14-day online diary assessing daily completion of tasks, daily alcohol use, and (on days when alcohol was consumed) the extent to which drinking was motivated by coping or enhancement (daily CM and EM). RESULTS: Hierarchical linear models revealed unique situational and trait antecedents of daily CM and EM. In the daily EM drinking model, main effects of daily positive affect (b=0.11, p<0.05), trait EM (b=2.88, p<0.01), and trait sensation seeking (b=0.36, p<0.01) were qualified by cross-level interactions between daily task accomplishment and trait conscientiousness (b=0.03, p<0.01), and daily task accomplishment and trait sensation seeking (b=0.03, p<0.01). In the daily CM drinking model, main effects of daily positive affect (b=-0.08, p<0.05), daily negative affect (b=0.13, p<0.05), and trait CM (b=4.40, p<0.01), were qualified by cross-level interactions between trait CM and daily positive affect (b=-0.12, p<0.05), trait CM and daily negative affect (b=0.18, p<0.01), and trait conscientiousness and daily task accomplishment (b=0.01, p<0.01). CONCLUSION: Our results replicated and extended Cooper et al.'s (1995) findings on the differential roles of sensation seeking and negative affect in CM and EM drinking at the daily level, and call into question the view that drinking motives should be solely conceptualized as individual difference variables. Theoretical and applied implications of the findings are discussed.

Dating, sex, and substance use as correlates of adolescents' subjective experience of age.

This study examined in a random community-based sample of 664 12-19-year-olds, the relation of subjective experience of age (SEA) with chronological age, dating experience, sexual activity, and substance use. The results revealed a positive linear relation between SEA and chronological age: individuals who were chronologically older felt subjectively older than their actual age. Several possible sources of interindividual differences in SEA were identified. Adolescents who were dating an older partner felt older compared to other dating adolescents. Sexually experienced adolescents felt older than their non-experienced counterparts. Smoking (in boys), higher alcohol use, and higher drug use were also related to an older SEA. These results suggest an increasing discrepancy between SEA and chronological age across the teen years as young people experience the normative changes associated with adolescence. Dating, sexual, and substance use activities may figure importantly in the way that adolescents experience their age.