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Background Many children do not accumulate sufficient physical activity for good health and development at early childhood education and care (ECEC). This study examined the association between ECEC organizational readiness and implementation fidelity of an ECEC-specific physical activity policy intervention. Methods Play Active aimed to improve the ECEC educator's physical activity practices. We investigated the implementation of Play Active using a Type 1 hybrid study (January 2021–March 2022). Associations between organizational readiness factors and service-level implementation fidelity were examined using linear regressions. Fidelity data were collected from project records, educator surveys and website analytics. Results ECEC services with higher levels of organizational commitment and capacity at pre-implementation reported higher fidelity scores compared to services with lower organizational commitment and capacity (all P s < 0.05). Similarly, services who perceived intervention acceptability and appropriateness at pre-implementation to be high had higher fidelity scores (P  < 0.05). Perceived feasibility and organizational efficacy of Play Active were associated with higher but nonsignificant fidelity scores. Conclusions Results indicate that organizational readiness factors may influence the implementation of ECEC-specific physical activity policy interventions. Therefore, strategies to improve organizational readiness should be developed and tested. These findings warrant confirmation in the ECEC and other settings and with other health behavior interventions. [ABSTRACT FROM AUTHOR]

Through two studies (N = 544 women), the role of types of relational problems (absence vs. presence of intimate partner violence [IPV]) in the use of conflict resolution strategies (exit and loyalty) was analyzed, considering the serial mediating effect of dependency and commitment and the moderating effect of benevolent sexism. The main results showed that higher scores in dependency and commitment predicted less use of exit strategies among women who reported IPV. No significant results were found regarding loyalty strategy and benevolent sexism. Ultimately, implications for women's perceived risk of future violence were discussed. [ABSTRACT FROM AUTHOR]

Positive Psychotherapy is a comprehensive therapy approach that helps couples understand the conflicts they experience in their relationships, discover their inner talents, and communicate more healthily. This approach evaluates the lives of individuals in four dimensions and applies the therapy process step by step by using unique models such as the "Balance Model" and "Five-Step Therapy". The therapy process consists of a five-stage process that guides couples to understand the conflicts in their relationships, discover themselves and find healthier solutions. This process provides couples with a framework for them to better understand themselves and improve their relationship. Marriage is the process of two people by coming together with mutual love, respect and commitment, living together and growing together in line with common goals. Marriage is a form of union in which emotional bonds are established between couples, trust is provided and responsibilities of living together are shared. While Positive Psychotherapy is influenced by a variety of theories and techniques, it provides a broad perspective to couples by offering a holistic approach and supports them in accordance with their unique needs. The purpose of this approach is to help couples have a happier and more satisfying relationship. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursology is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dialetheists believe some sentences are both true and false. Objectors have argued that this makes it unclear how people can disagree with each other because, given the dialetheist's commitments, if I make a claim and you tell me my claim is false, we might both be correct. Graham Priest (2006a) thinks that people disagree by rejecting or denying what is said rather than ascribing falsehood to it. We build on the work of Julien Murzi and Massimiliano Carrara (2015) and show that Priest's approach cannot succeed: given the same dialetheist's commitments you may be correct to reject a claim that I correctly believe. We argue further that any attempt to solve the problem by identifying a new attitude of disagreement will also fail. The culprit, we claim, is the attempt to find a pair of attitudes that satisfy 'exclusivity'—that is, attitudes such that both cannot be simultaneously correct. Instead of identifying disagreement by the kinds of attitudes involved, we propose dialetheists focus on the normative landscape and identify it in part by whether parties have reasons to change their attitudes. We offer our own normative theory of disagreement to help dialetheists with this challenge. [ABSTRACT FROM AUTHOR]

Child marriage, a stark disruption of the traditional childhood experience, remains a pressing concern, yet the scientific exploration of this complex issue has been surprisingly overlooked in terms of comprehensive analysis and mapping. This study aimed to bridge this gap by conducting an extensive examination and mapping of child marriage literature within peer-reviewed journals. Employing the powerful Scopus database, the study combed through research articles spanning from 1983 to 2022. Both quantitative and qualitative analyses were applied to uncover research trends and content patterns. The search string led to the retrieval of 964 relevant documents, revealing a nearly equal distribution between medical and social science subject areas. The analysis yielded several crucial findings. Firstly, it became evident that the current volume of research on child marriage, considering the prevalent rates and impact, falls considerably short of being adequate. A notable surge in research output was detected in the most recent five-year span (2018–2022), likely in response to the global commitment to sustainable development goals. Despite countries with high child marriage rates contributing relatively less to the research landscape, specific nations like India, Bangladesh, Ethiopia, and Nigeria left a noticeable imprint. Furthermore, high-income countries, including the US, the UK, Canada, and Australia, demonstrated significant involvement primarily through international research collaborations with scholars in high child marriage rate regions. Equally noteworthy is the revelation that the field of child marriage is a convergence of scholarly efforts from both the social and medical sciences. Notably, the University of California San Diego played a pivotal role in shaping and fostering research in this domain. In conclusion, the urgency of eliminating all detrimental practices against girls necessitates heightened research efforts, deeper collaboration, and a more holistic approach. [ABSTRACT FROM AUTHOR]

Human resource (HR) practices are potent in shaping workplace social relationships, which play a crucial role in employees' well‐being. While the role of formal relationships (i.e., relationships based on prescribed work roles) has received relatively more research attention, little is known about the nexus between HR practices, informal relationships at work and employee well‐being. Drawing on social interdependence theory, we conducted two studies to investigate how high commitment work systems (HCWS) affect employee well‐being through workplace friendship, beyond the effects of formal interpersonal relationships. In Study 1, using time‐lagged data from a sample of 253 full‐time employees, we found that workplace friendship, a type of informal relationship at work, mediated the relationship between HCWS and employee well‐being. In addition, task interdependence strengthened the relationship between HCWS and workplace friendship as well as the indirect effect of HCWS on employee well‐being. In Study 2, we replicated these findings and extended them to multiple forms of well‐being using multilevel data collected at three time points from 310 employees in 61 organizations. Theoretical and practical implications of the findings as well as future research directions are discussed. [ABSTRACT FROM AUTHOR]

In the article "Principled Conscientious Provision: Referral Symmetry and Its Implications for Protecting Secular Conscience," Abram L. Brummett, Tanner Hafen, and Mark C. Navin reject what they call the "referral asymmetry" in U.S. conscientious objection law in medicine, which recognizes rights of conscientiously objecting physicians to withhold referrals for medical interventions but does not (yet) recognize rights of physicians to make referrals for medical interventions to which they are morally committed but to which their health care institutions are morally opposed. This commentary concentrates on a second asymmetry, namely, the relationship of a health care provider's referral or nonreferral to the medical standard of care. The commentary argues that this second asymmetry seems to require action more appropriately recognized as civil disobedience than conscientious provision of referral. [ABSTRACT FROM AUTHOR]

'Are physicians who they ought to be?' This commentary advocates for a critical re‐examination of what is at the core of being a physician via a process of inclusive co‐construction [ABSTRACT FROM AUTHOR]

Drawing on explorations of emergency responses, Bailie and Scott comment on learning through covid, highlighting influences on sense of duty, the concept of volunteering, and the importance of adaptability. [ABSTRACT FROM AUTHOR]

Studies of human resource management (HRM) have produced plentiful results on commitment HRM, but its effects during a crisis have rarely been examined. Incorporating the commitment HRM view and the cognitive phenomenological framework, we examined whether and how commitment HRM practices implemented prior to the COVID-19 mitigate employees' negative cognitive evaluations and attitudes during the pandemic. Moreover, a pandemic is a situation that requires strong government interventions, and we further examined whether employees' trust in the government would play a moderating role in explaining the effects of commitment HRM. With a multilevel framework, we measured commitment HRM via an analysis of big data provided online prior to the pandemic and matched the information to employees' responses collected from a survey after the outbreak of the pandemic. With data from 1010 employees and 52 companies, we found that employees in organizations with a higher utilization of commitment HRM showed less threat appraisals. Moreover, those experiencing fewer threat appraisals showed more commitment to their organizations. In addition, we found that the negative link between a company's commitment HRM and its employees' threat appraisals was pronounced when they had a lower level of trust in the government. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

How do organizational responses to environmental disruptions affect employees' job-related well-being? As the COVID-19 pandemic has led to new ways of working, increased health concerns, and added responsibilities, employees are facing important challenges in doing their work that can affect their job-related well-being. This study aims to understand how different types of work support (i.e., perceived organizational support and supervisor accessibility) in response to environmental disruption interact with personality traits (i.e., core self-evaluations and future focus) to influence changes in employees' affective commitment to their organization and in their job-related well-being. We develop a moderated mediation model and test it on data collected from 295 individuals working in the United Kingdom. We find that work support for the COVID-19 pandemic, both perceived organizational support and supervisor accessibility, is associated with more positive changes in employees' jobrelated well-being and that this effect is mediated by changes in employees' affective commitment to their organization. Furthermore, we find that personality traits moderate the relationships between these two types of support and changes in affective commitment to the organization, with those relationships being more positive for employees with low core self-evaluations and for those with a high future focus. [ABSTRACT FROM AUTHOR]

Employees form commitments to multiple targets, and the coordination of those multiple commitments has become a ubiquitous part of the contemporary workplace. However, commitments are still largely studied in isolation or in one-off combinations, and current commitment theory does not account for the dynamic interrelationships among multiple commitments. To address this deficiency, we propose commitment system theory (CST). We draw upon general systems theory to depict commitment systems as malleable and interconnected structures. We present the defining elements by which commitment systems can be described and studied, develop theory regarding when commitment systems will diverge or converge over time, and discuss how taking a systems perspective resolves discrepant findings in the literature. Specifically, CST advances the commitment literature by offering an alternative perspective to explain how commitments behave as parts of larger systems. Specifically, CST accounts for (a) why and when commitments have synergistic, neutral, or conflicting interrelationships; and (b) the temporal dynamics of those interrelationships as commitments develop, change, and dissipate. CST thus offers a new vocabulary and conceptual toolkit for understanding the evolving structure of commitments to multiple targets. [ABSTRACT FROM AUTHOR]

The topic of green human resource management (HRM) has drawn increasing attention of HRM scholars in the past decade. Recent research has called for more studies to identify the antecedents of green HRM used in organizations and explore the mediating mechanisms through which green HRM is related to performance outcomes. This study represents an effort to address these research needs by examining the joint effects of chief executive officer (CEO) environmental belief and external pollution severity on the use of green HRM and testing the mediating role of employee environmental commitment in the relationship between green HRM and firm performance. Drawing upon data collected from multiple sources (i.e., survey data from chief executive officer (CEOs), chief financial officers (CFOs), HR managers and employees, and archival data from government statistics), we found that CEO's environmental belief is significantly related to the use of green HRM, especially for companies operating in locations with severer pollution. Green HRM in turn has a positive relationship with the firm's environmental and financial performances via employee commitment to the environment. The findings highlight the often‐overlooked role of in the strategic HRM literature pertinent to environmental management and clarify the antecedents and influential mechanisms of green HRM at the firm level of analysis. We also discuss theoretical and practical implications in this study. [ABSTRACT FROM AUTHOR]

Background. Emergency departments suffer from authoritarian and manipulative leadership styles that affect team dynamics, emotional exhaustion, and quality patient care. However, little research specifically explores these toxic leadership effects on conflict management and nurses' organizational commitment. Objectives. This cross-sectional study aimed to assess the correlations between perceived toxic leadership, conflict resolution strategies, and commitment dimensions among emergency nurses while evaluating conflict tendencies as a mediating mechanism. Methods. A cross-sectional design that included multiple regression and mediation analyses was utilized. The sample consisted of 387 emergency nurses from five major Saudi hospitals surveyed using validated scales that measure perceived toxic leadership, conflict styles, and organizational commitment. Results. High prevalence rates for perceived authoritarian (77%), narcissistic (75%), and unpredictable (63%) leadership were reported. Increased toxicity was positively related to dominating and avoiding conflict styles but negatively related to integrating and compromising strategies. Toxic leadership is also associated with lower affective/normative commitment but higher continuance commitment. Conflict management partially mediated the leadership-commitment relationship, which explained 29% of the total effect. Finally, higher experience and education predicted greater perceived toxicity. Conclusions. The significant correlations between destructive leadership, adverse conflict, and reduced commitment in emergency nurses underscore the need for context-specific leadership training. Fostering supportive environments through multifaceted interventions can counteract toxicity impacts, impart constructive communication techniques, improve nurse well-being, and ensure high-quality patient care. As conflict tendencies and nurse characteristics influence susceptibility to detrimental leadership, tailored programs addressing experience levels are vital. [ABSTRACT FROM AUTHOR]

Introduction. The coronavirus disease 2019 (COVID-19) pandemic necessitated the suspension of most educational activities and a shift from face-to-face (FTF) education to virtual education (VE). These changes were associated with new educational experiences for both instructors and students. This study aimed to explore nursing instructors' and students' experiences of VE during the COVID-19 pandemic. Method. This descriptive qualitative study was carried out in 2021. Participants were 21 bachelor's, master's, and Ph.D. nursing students and six nursing instructors purposively selected from the Faculty of Nursing and Midwifery of Tehran University of Medical Sciences, Tehran, Iran. Data were gathered through FTF or online in-depth semistructured interviews and were analyzed through conventional qualitative content analysis as proposed by Graneheim and Lundman (2004). Results. Eight subthemes and three main themes were developed during data analysis. The main themes and subthemes were VE as a double-edged sword (VE as a threat, VE as an opportunity, and necessity to improve VE), weaknesses in clinical education (reduced quality of clinical education and necessity to compensate for students' retarded clinical learning), and reduced reliability of virtual student evaluation (cheating as a problem of virtual evaluation, stresses and tensions of virtual evaluation, and necessity to use new strategies in virtual evaluation). Conclusion. Despite the different shortcomings and challenges of VE during the COVID-19 pandemic, educational experiences gained in this period can be used to improve the quality of nursing VE in future epidemics and pandemics. [ABSTRACT FROM AUTHOR]

Background: Menopause is a stage in a woman's physiology where several chronic illnesses begin to appear, compromising both the quality and quantity of their life. It has been postulated that a decrease in estrogen levels in women may be important for accelerated disc degeneration in postmenopausal women. The overall prevalence of LBP is 52% higher in perimenopausal women with osteoporosis which is considered to be one of the predominant factors for low back pain in women. There are many modalities like Interferential therapy, ultrasound therapy, and transcutaneous electrical nerve stimulation, that treat nonspecific back pain with varying results, some advanced electrotherapy modalities like shockwave, low-level laser therapy, Matrix Rhythm Therapy (MaRhyThe) also proved to be effective in reducing the nonspecific chronic low back pain. Matrix Rhythm Therapy was invented by Dr. Med. Ulrich Randoll (1987–1999) at the University of Erlangen, Germany. Matrix Rhythm Therapy includes a wand with a resonating head that oscillates at the frequency of 8-–12 Hz and is connected to the machine with a connecting cable (U.G Randoll p18 The Principles of Matrix Rhythm Therapy – MaRhyThe 3rd edition 2015). Objective: The main objective of this survey study is to investigate awareness among physiotherapists in the use of Matrix Rhythm Therapy in treating chronic low back pain in post-menopausal women. Methods: For this study, Google Forms were distributed to physiotherapists of diverse area specializations through social media. The survey was carried out between 16th December 2022 to 18th April 2023. Results: Out of 103 responses which is 10% of the total sample size, 69.9% of the physiotherapists were aware of Matrix Rhythm Therapy whereas 30.1% were not aware of the same. Meanwhile, when it comes to treating chronic low back pain in post-menopausal women, only 49.5% of the physiotherapists say that the condition can be treated with Matrix Rhythm Therapy, the rest of the 28.2% are not aware and 11.7% are not sure if the condition can be treated with the same. Conclusion: In conclusion, these findings show that implementing or using Matrix Rhythm Therapy as a physical therapy intervention in treating chronic low back pain is woefully inadequate, despite Physical therapists and clinicians recognizing the need for or usage of matrix rhythm therapy, they also must maintain a consistent interest and commitment to effectively employ Matrix Rhythm Therapy for clinical conditions and active research. [ABSTRACT FROM AUTHOR]

Personal identity and social identification processes can be challenging for adolescents belonging to an ethnic minority, who have to cope with the acculturation task of navigating several (and often conflictual) alternatives put forth by their cultural heritage community and destination society. Because identity and acculturation tasks are embedded in core domains of adolescents' life, this three-wave longitudinal study with ethnic minority adolescents (N = 244, 43.4% male; Mage = 14.9) examined how personal identity processes and social identifications are related to acculturation orientations in the education and friendship domains. Results of traditional cross-lagged models showed that, in the educational domain, adolescents who scored higher on cultural heritage maintenance compared to their peers, scored higher on commitment later on. In the friendship domain, stronger associations were found, such that adolescents who scored higher on cultural heritage maintenance compared to their peers, reported higher commitment and in-depth exploration later on, while those who scored higher on identification with friends reported over time also higher cultural heritage maintenance and destination culture adoption. Random-intercept crossed-lagged models indicated that, when adolescents reported above their own average on reconsideration of educational commitment, they reported increased cultural heritage maintenance later on. Furthermore, consistent associations (at baseline and over time) emerged. Overall, this study points to virtuous alliances between the fulfillment of tasks related to adolescents' identity development and acculturation. [ABSTRACT FROM AUTHOR]

Objective. Examine the distribution of funding for suicide prevention in Australia from 2021-22 to 2026-27. Methods. Government websites were reviewed to locate budget documents related to suicide prevention funding. Information was extracted on the program/service to be funded, and the funder entity, duration, and year allocation. Extracted data was reviewed to identify commonly targeted sub-populations. Results. The majority of suicide prevention-related funding was allocated to aftercare for persons who have attempted suicide, consistent with the effectiveness of these services, followed by programs targeting the general population. Little funding was allocated to other specific sub-populations, such as young people and Aboriginal and Torres Strait Islander peoples. The amount of funding allocated to suicide prevention varied across jurisdictions, which is only partially explained by suicide rates. Conclusions. There is a need for greater investment in care for specific sub-populations who are at higher risk of suicide. This study provides a baseline for comparing future investments in suicide prevention in Australia. [ABSTRACT FROM AUTHOR]

Given the absence of COVID-19 treatments, the best way to control the spread of the virus is to break the chain of infection by increasing public participation in preventive behaviors recommended by health authorities. This study proposes a moderated mediation model of information behaviors (e.g. information seeking and information verification) and trust in government that explores the relationship between risk perception and preventive behaviors regarding COVID-19. Using a survey study in South Korea, we conducted the moderated mediation analysis with latent moderated structural equation modeling (LMS). We found serial mediation effects for risk perception, information behaviors, and preventive behaviors, as people both seek out information and verify that information before adopting preventive behaviors. Additionally, trust in government moderated information behaviors in the relationship between risk perception and preventive behaviors, suggesting that trust in government encourages people to adopt more preventive actions via information seeking and information verification. Further implications are discussed to promote public understanding of the health crisis and public participation in preventive measures. [ABSTRACT FROM AUTHOR]

Research shows differences in gendered caring expectations between mothers and fathers across countries and how they are affected by the development of different family forms and cultural practices. In this study, we explore the meaning that 14 children and youths in long‐term non‐kinship foster care in Spain ascribe to their birth mothers. We found three main perspectives among the participants. Within these perspectives, age, gender and socio‐cultural context seem to be intertwined in how children and youths in foster care perceive their birth mother's role in their lives. The analysis gives insight into the complexity of child–mother relationships and how young people navigate these. In light of these findings, we discuss some practical implications for social workers in child protection services. [ABSTRACT FROM AUTHOR]

Social tensegrity integrates the concepts of tensile architectural structure (tensegrity) and social system. It deepens our understanding of family structures and the influences of internal and external factors. Attachment, internal working model, and level of commitment provide the foundation that creates stability and integrity within social and family systems. Social tensegrity also highlights the influence of various factors both locally and globally on individuals, families, communities, and societies. The societal foundation constructed to promote overall stability also strongly influences commitment of compression members at each system level. Social tensegrity provides an additional means to examine social interaction on each systems level and contributes to a new conceptual foundation for future visual assessment tools and research. [ABSTRACT FROM AUTHOR]

Love is a phenomenon that occurs across the world and affects many aspects of human life, including the choice of, and process of bonding with, a romantic partner. Thus, developing a reliable and valid measure of love experiences is crucial. One of the most popular tools to quantify love is Sternberg's 45-item Triangular Love Scale (TLS-45), which measures three love components: intimacy, passion, and commitment. However, our literature review reveals that most studies (64%) use a broad variety of shortened versions of the TLS-45. Here, aiming to achieve scientific consensus and improve the reliability, comparability, and generalizability of results across studies, we developed a short version of the scale—the TLS-15—comprised of 15 items with 5-point, rather than 9-point, response scales. In Study 1 (N = 7,332), we re-analyzed secondary data from a large-scale multinational study that validated the original TLS-45 to establish whether the scale could be truncated. In Study 2 (N = 307), we provided evidence for the three-factor structure of the TLS-15 and its reliability. Study 3 (N = 413) confirmed convergent validity and test–retest stability of the TLS-15. Study 4 (N = 60,311) presented a large-scale validation across 37 linguistic versions of the TLS-15 on a cross-cultural sample spanning every continent of the globe. The overall results provide support for the reliability, validity, and cross-cultural invariance of the TLS-15, which can be used as a measure of love components—either separately or jointly as a three-factor measure. [ABSTRACT FROM AUTHOR]

Community health workers are members of two groups whose short- and long-term health has been uniquely shaped by the COVID-19 pandemic: health workers and the oft-marginalized populations that they serve. Yet, their wellbeing, particularly of those serving resettled refugees, before and during the pandemic has been largely overlooked. Drawing from a holistic conceptualization of wellness, this study examined the effects of the COVID-19 pandemic on a group of cultural health navigators (CHNs), who serve resettled refugees. We conducted semi-structured individual interviews with CHNs at a southwestern U.S. hospital system between July and August 2020, a critical time in the pandemic. Our analysis produced four themes that encapsulate the effects of the pandemic on CHN wellbeing: (1) "You fear for your life": Chronic risk of COVID-19 exposure takes a toll on physical, emotional, and environmental wellbeing; (2) "It is stressful because it is completely new": Uncertainty diminishes occupational, financial, and emotional wellbeing; (3) "If you don't have the heart to help, you cannot do this job": CHNs remain committed while facing challenges to their occupational wellbeing on multiple fronts; and (4) "Now, you cannot release your stress": Loss of and shifts in outlets integral to social and spiritual wellbeing. The findings deepen empirical understanding of how the pandemic affected the holistic wellbeing of CHNs, as they continued to serve their communities in a time of crisis. We discuss the implications for addressing the multidimensionality of community health worker wellbeing in research, policy, and practice. [ABSTRACT FROM AUTHOR]

The article announces winners of the 2023 Pathway Nurse of the Year Award which includes Holly Weaver, and Rebekah Mitchell.

The article provides information on the key differences between interviewing for a faculty versus clinical specialist position based on personal experience and available literature. Topics discussed include way many institutions conducts screening interviews, how interviews for clinical specialist positions may be conducted, and differences between faculty interviews and clinical specialist interviews.

Psychiatric nurses are at a higher risk for exposure to violence and aggression, leading to potential burnout, moral injury, post-traumatic stress, and turnover. There is little evidence of a preferred strategy to support nurses and decrease the impact of traumatic experiences on psychiatric nurses. The aim of this integrative review was to explore potential strategies to decrease the impact of traumatic experiences among nurses in psychiatric settings. Following a systematic search of PsycINFO/Ovid, CINAHL, and MEDLINE/Pubmed, Joanna Briggs Institute quality appraisal tools were used to analyze quality of the articles. Thirteen articles met the inclusion/exclusion criteria for this study. Data were analyzed and synthesized into three key themes and seven sub-themes. Three themes were noted to be common to the included texts. 1. Interpersonal Supports (Formal Support, Peer/Supervisor Support, and Informal Family/Social Support). 2. Organizational Supports (Perception of Job Safety/Satisfaction, Promoting Personal Resilience, Supporting Team Resilience, and Organizational Commitment to Resilience). 3. Protection of Personal Resources. Many common suggestions for decreasing the impact of exposure to violence and trauma were noted across the thirteen articles, however, there is little evidence of a preferred strategy, how strategies are developed and employed or the efficacy of any particular strategy. Further investigation is needed to identify and evaluate supportive interventions, their feasibility and efficacy. [ABSTRACT FROM AUTHOR]

Objectives In a longitudinal design, this study investigates the role of the quality of relationships in the well-being of caregivers for a family member with advanced cancer, specifically, the quality of relations among family members and the caregiver's commitment to caregiving. Following the stress process model, good quality of relations and caregiver's high commitment should be resources mitigating caregiver burden, even though overinvestment in the caregiver role may lead to the opposite outcome. Methods Data were drawn from a longitudinal study of 336 caregivers of advanced cancer patients in an urban community, who were interviewed shortly after patient diagnosis and again 3 months later. Caregiver burden is measured by 4 subscales (17 items) of the Caregiver Reaction Assessment. We used a random-effect model to investigate the association between caregiver burden and the 2 focused contributing factors—caregiver commitment and family relationship quality—when other covariates were controlled. A fixed-effect model then examines the association between the changes in caregiver burden and related time-varying factors, including caregiver commitment, when family relationship quality was used as a moderator. Results Both the random and fixed-effect models consistently show that a cancer caregiver's positive commitment to the patient reduces caregiver burden, and family relationship quality provides an overall moderating influence that reduces the felt burden. Discussion The quality of relations between the caregiver and patient and with others in the family network is critical in understanding caregiver burden in advanced cancer and should be viewed as part of long-term family dynamics. [ABSTRACT FROM AUTHOR]