Perceived Stress. As discussed above, theories of self-efficacy and stress suggest that perceived stress may be dynamically associated with PSE. Research has demonstrated cross-sectional associations between PSE and perceived stress, but these findings are limited in that they have relied on single measurements and leave unanswered essential questions of the extent of this association in the moment and over time. In line with this, a review of stress and PSE called for the need for future research to examine this association in a way that allows for a more nuanced and specific understanding of how perceived stress may be associated with PSE (Crnic & Xxxx, 2017). The current study heeds this call and builds on cross-sectional findings by examining perceived stress and PSE in the moment and over time and in ecologically valid settings.
Perceived Stress. Four questions from the Perceived Stress Scale (PSS) (Xxxxx et al., 1983) were used for the survey in a Likert scale format with four questions asking individuals about the frequency of daily stressful experiences. Questions included how often within the past month they felt unable to control important things in life, their ability to manage personal problems, whether they felt life was going as planned, and how often they felt like their difficulties could not be overcome. Response options for participants included “never”, “almost never”, “sometimes”, “fairly often”, and “often” (1 = never to 5 = very often) (Xxxxx et al., 1983). Items 1 and 4 were re-coded so 1 = 0 (never) and 5 = 4 (very often). Items 2 and 3 were reverse scored so 1=4 (very often) and 5=0 (never). This was done as these items focus on individuals’ ability and confidence to work through their day-to-day lives, where reporting low occurrences of confidence is associated with higher stress. were then summed for a total score to represent this outocome. Scores can range 0 – 16 (Xxxxx et al., 1983). Similar tertial methodology as demonstrated by (Xxxxx et al., 1983) was used to create high, medium, and low perceived stress categories, which included 0-2=low, 3- 5=medium, 6-8=high). Once the scale was determined, the variable was dichotomized into a categorical binary variable so that there were two categories: high acculturative stress and medium/low acculturative stress. These were created by combining scores from the high category into one category (greater than or equal to 6) and combining medium and low into one category (less than or equal to 5). Socio-Demographic Variables Socio-demographic variables were also re-coded so that new binary, categorical variables were created for analysis between independent and dependent variables. Re-coding processes followed similar methodology as previous variables, however, no reverse scoring was performed. Age was re-coded into three main groups: 18-29, 30-49, and 50+ to account for primary stages of life. Ethnicity was re-coded based off of the top three ethnicities represented which included ‘Indian’, ‘Bengali’, and ‘Pakistani+Other SA Groups. Due to minimal representation among the other South Asian ethnicities such as Nepali and Bhutanese, they were combined with the Pakistani category to create ‘Pakistani+All’ so that all participants could be included into analysis. Employment status was divided into ‘Employed’ (full-time + part-time) and ‘U...
Perceived Stress. Hypothesis 1: Live-in caregivers, compound caregiving, lack of family cohesion, duration of caregiving, patient condition, education, low self-efficacy, low Alzheimer’s disease knowledge, and poor coping efforts will be identified as factors that are associated with elevated IL-6 levels and perceived stress scores in caregivers at baseline. Bivariate analyses were conducted to examine the associations between independent variables and dependent variables. A Xxxxxxx correlation was conducted for AD knowledge, family cohesion, depression, Xxxxxx ADL and IADL, self-efficacy, anxiety, ways of coping, burden, with the outcome variables, perceived stress, and IL-6. Additionally, Xxxxxxx correlations were performed to examine the relationship between demographic variables such as age, caregiving duration, co-residence, and the outcome variables perceived stress and IL-6. Results suggest that there is a statistically significant positive association between depression and perceived stress (p<0.001); family cohesion (FAD) communication and perceived stress (p<0.001); family cohesion (FAD) problem solving and perceived stress (p=<0.001); family cohesion (FAD) global family functioning and perceived stress (p<0.001); anxiety and perceived stress (p<0.001); and burden and perceived stress (p<0.001). There was a statistically significant negative association between self-efficacy and perceived stress (p<0.001) and ways of coping and perceived stress (p=0.02). A Xxxxxxxx-Rho correlation was conducted to examine the association between gender, education, ethnicity, marital status, caregiver/care-recipient relationship, family help, co-residence with patient, compound caregiving, with the outcome variables, perceived stress and IL-6. There were statistically significant positive association between the following: gender and perceived stress (p=0.002); family help and perceived stress (p<0.001); and co-residence and perceived stress (p=0.029). However, there was a statistically significant negative association between the caregiver/care-recipient relationship and perceived stress (p=0.006). One-Way ANOVAs were also conducted in order to determine whether there were any statistically significant differences between the categories within the following demographic variables: gender, education, ethnicity, marital status, caregiver/care- recipient relationship, family help, co-residence with patient, compound caregiving, and the outcome variables, perceived stress and IL-6. A s...
Perceived Stress. In contrast to major life events, which are regarded as acute incidents, perceived stress and daily stressors are understood as indicators of chronic stress. Because maternal chronic stress has been widely suggested as having an adverse impact on babies’ health, prenatal maternal perceived stress has been mostly studied for its association with birth outcomes (Xxxx et al., 2011; Xxxxxxxxxxx, 2009). For instance, a rigorous study of 1399 Russian women tested the impact of mothers’ substance use, living situation, and perceived stress on the birth weight of newborns, controlling for factors such as maternal education, age, occupation, marital status, and parity (Grjibovski, Bygren, Svartbo, & Magnus, 2004). The results indicate that perceived stress, independent of drinking, smoking, crowdedness of living conditions, and family support, is a predictor of infants’ birth weight. In another study with a sample of 78 mother-neonate dyads, perceived stress, associated with corticotrophin-releasing hormone, accounted for up to 27% of the variance in gestational age (Ruiz, Fullerton, Xxxxx, & Xxxxxxxxxxx, 2001). The same research team also found that increases in perceived stress over the course of pregnancy was associated with higher risk for early delivery (Ruiz, Fullerton, Xxxxx, & Xxxxxx, 2002). Similar findings were also reported by Gennaro, Shults, and Xxxxx (2008) who studied 57 African American women. They discovered that the participants with early delivery had experienced higher perceived stress during pregnancy than their counterparts with full term delivery. However, another research group, which also recruited African American participants, failed to identify an association between perceived stress and gestational age, or between perceived stress and adjusted birth weight, after controlling for potential confounding variables such as maternal age and weight gain (Dominguez, Schetter, Mancuso, Rini, & Xxxxx, 2005). Instead, they found stressful life events to be strongly related to the duration of pregnancy. Similarly, a recent study on 1602 Canadian women also failed to support a connection between perceived stress and birth outcomes, whereas body mass index, smoking, obstetric history, and maternal health were identified as risk factors for adverse pregnancy outcomes (St-Laurent, De Wals, Moutquin, Xxxxxxxxxx, & Xxxxxxx X, 2008). Given the inconclusiveness in current maternal stress literature, meta- analyses of existing studies, replication of simila...
Perceived Stress. The Perceived Stress Questionnaire is a widely used and validated tool that was developed for clinical psychosomatic research in 1993 to assess stress levels in individuals with chronic disease (Xxxxxxxxxx et al., 1993). The Perceived Stress Questionnaire was later reevaluated in larger adult populations and was revised and streamlined, retaining high reliability and validity (Fliege et al., 2005). Twenty-one statements are included on the revised questionnaire, including both negative and positive stress aspects. Respondents are asked to report the frequency of these aspects over the last year or two: (1) almost never, (2) sometimes,
Perceived Stress. The mean perceived stress index score on a scale of 0-1 among participants was 0.36, with higher scores indicating higher perceived levels of stress. Table 2 describes these results in detail. Men had a mean index score of 0.35 while women had a mean score of 0.39; this difference was not significant. Those with annual income below $100,000 had a mean stress score of 0.38 while participants with annual income $100,000 or more had a mean stress score of
Perceived Stress. The outcome variable of stress was measured was through the
Perceived Stress. The overall mean perceived stress index score of 0.36 on a scale of 0-1 indicates a low to moderate average stress level among participants. The original DPP study reported a perceived stress index score of 0.3 among participants (Xxxxxxxxx et al., 2002). The lack of significant differences by sex, education, income, and BMI suggests that stress may not be a psychosocial factor of primary concern in our population. This population primarily consisted of well- educated and moderate to high-income participants. Experiences of stress may have been lower in this cohort compared to less-educated and lower-income populations who may face more magnified stressors related to socioeconomic factors. It is also possible that this instrument was not the most effective tool for measuring stress within this population. However, literature suggests that stress is viewed as a psychosocial contributor to the development of diabetes and a barrier to a healthy lifestyle among South Asians (Tirodkar, Baker, Makoul, et al., 2011; Xxxxx et al., 2020). Further research in this area is warranted.
Perceived Stress. The study’s original hypothesis of identifying variables associated with higher levels of perceived stress and IL-6 within the caregiving situation found statistically significant associations between gender, family help, co-residence, caregiver/care- recipient relationship, and perceived stress. These results also suggest that females may have higher levels of perceived stress. Additionally, family cohesion (communication, problem solving, global family functioning), self-efficacy, ways of coping, anxiety, burden, and depression were all significantly associated with perceived stress. Based on the results from the correlations, the data illustrate that live in caregivers, family help, gender, burden, ways of coping, anxiety, family cohesion, and depression are all positively associated with perceived stress. Additionally, self-efficacy and the caregiver/care recipient relationship are negatively associated with perceived stress. The second hypothesis was also tested to examine the impact of self-efficacy, Alzheimer’s disease knowledge, and ways of coping on perceived stress and IL-6. The analyses indicated that there was a statistically significant association between gender, a little family help, self-efficacy, ways of coping, and perceived stress. The analysis of the second hypothesis proved the importance of self-efficacy on perceived stress levels, in addition to ways of coping. Alzheimer’s disease knowledge did not have a significant effect on perceived stress scores. Another sequential multiple linear regression was performed to analyze other psychosocial scales not included in the original hypothesis. Results indicate that “some” family help, “a little” family help, burden, ways of coping, anxiety, FAD global family functioning and perceived stress were all significantly associated.
Perceived Stress. Theories of self-efficacy and stress suggest that the perception or subjective experience of stress, rather than more objective measures of stress exposures (such as stressful life events checklists), influences one’s sense of efficacy. As such, the current study focused on subjective reaction states of stress (Xxxxxxxx & Monroe, 2016), or perceived stress. A review of stress and PSE emphasized that while there is strong theoretical rationale for expecting an association between stress and PSE, direct evidence of this association is somewhat limited (Crnic & Xxxx, 2017). In first time mothers of infants, PSE has been found to be significantly, negatively associated with perceived stress (Ngai et al., 2010; Xxxxx & Xxxxxxxx, 1998). However, these studies of PSE and perceived stress are limited in that they measured stress over the previous year (Ngai et al., 2010) and month (Xxxxx & Xxxxxxxx, 1998). This approach, particularly of assessing stress over the past year, is especially problematic for mothers of infants, as it may encompass events prior to the babies’ birth. The current study builds on these findings on perceived stress by examining cross-sectional associations between PSE and stress in the past week, as well as dynamically (see below), by examining perceived stress and PSE in the moment and over time. PSE and Social Support. Bandura (1989) theorized that social support processes such as social persuasion and verbal encouragement contribute to one’s self-efficacy. This theory has considerable empirical support. Social support has been found to be significantly associated with PSE across diverse samples (Gao et al., 2014; Xxxx et al., 2000; Suzuki et al., 2009), including among first time mothers of infants (Haslam et al., 2006; Xxxxx‐Xxxxxx et al., 2012). PSE has also been found to mediate the association between maternal social support and postnatal depression (Xxxxxxx & Xxxxxxxx, 1986; Haslam et al., 2006). However, findings in mothers of infants have come from studies of very young infants (i.e., four to six weeks; Haslam et al., 2006; Xxxxx-Xxxxxx et al., 2011). This is a concerning limitation because PSE beliefs are theorized to be influenced by social processes regardless of the child’s age. Thus, it is essential to build on the literature that examined PSE and social support in mothers of very young infants in order to test whether the association holds true through later infancy. PSE and Mothers’ Sleep Quality. Mothers of infants report s...
