Background: Pain and neuropsychiatric symptoms are related to a poorer quality of life (QoL). Due to the lack of cure for dementia, QoL becomes more important as an outcome measure or treatment...Show moreBackground: Pain and neuropsychiatric symptoms are related to a poorer quality of life (QoL). Due to the lack of cure for dementia, QoL becomes more important as an outcome measure or treatment goal for residents with dementia. It is fundamental to understand clinically relevant variables such as pain and neuropsychiatric symptoms (NPS) in relation to QoL, because knowledge on mediating effects of NPS on the relationship between pain and QoL might contribute to a practical model which in turn can help identifying factors that can be changed to maximize QoL. Objective: The aim of this study is to explore the relationship between pain and QoL with NPS as a mediator. Methods: Cross-sectional data was collected from 27 residents with dementia in a nursing home in the Netherlands. The participants had dementia and had at least one NPS. The primary health care professionals filled out questionnaires containing the Neuropsychiatric Inventory Questionnaire, Quality of life in Late-Stage Dementia, and demographics. Pain was observed with the Pain Assessment in Impaired Cognition in rest moments and during activities of daily living (adl). A mediational analysis using the PROCESS macro of Hayes is performed to explore the associations via total, direct and indirect effects. Two models were tested, the first model contained pain in rest and the second model contained pain during adl. The models were adjusted for dementia severity and gender. Results: There was no significant indirect effect in either model, meaning no mediating role of neuropsychiatric symptoms in the relationship between pain in rest or during adl and quality of life in nursing home residents with dementia. A significant association was found between NPS and QoL in both models, in which more severe NPS were related to a poorer QoL (model 1: b = .20, p = .01, 95% CI [0.04, 0.36]; model 2: b = .20, p = .01, 95% CI [0.05, 0.36]. Conclusions: This study showed that more severe neuropsychiatric symptoms are associated with lower quality of life. Further longitudinal research is recommended to investigate the direction of the relationship for pain, QoL and NPS and to discover a precise outcome prediction model.Show less
To investigate the effects of maternal borderline personality disorder symptoms (BPS) and prenatal reflective functioning (RF) on the development of children’s behavioural problems. The sample...Show moreTo investigate the effects of maternal borderline personality disorder symptoms (BPS) and prenatal reflective functioning (RF) on the development of children’s behavioural problems. The sample consists of 105 mothers (M = 22.75, SD = 2.21) and their twenty-montholds (M = 17, SD = 0.6, 54.3% boys). During pregnancy, the Borderline personality disorder-checklist (Giesen-Bloo, 2006) was used to assess the presence of BPS and the Pregnancy interview-revised (Slade, Patterson, & Miller, 2007) was used to measure the RF of the mother. Behavioural problems of the child were measured by the Child Behaviour Checklist (Verhulst, Ende, & Koot, 1996) at the age of twenty months. The analyses show that there is no correlation between BPS and RF of the mother, having BPS or not having BPS seems to have no effect on the RF. A low correlation is found between BPS and Problem behaviour of the child. This means that the more BPS the mother shows, the more Problem behaviour the child shows. Having or not having BPS appears to have no effect on the Problem behaviour of the child. There is no correlation between the level of RF and Problem behaviour of the child and showing no difference in upper and lower level of RF on Problem behaviour of the child. Finally, no predictive relation was found between BPS, RF and Problem behaviour of the child, there was no evidence of a moderation effect. On the basis of the results of this research, it can be concluded that mothers with borderline personality symptoms should be informed on how they can respond to the needs of their child, to avoid behavioural problems of the child. If mothers are more responsive to the needs of their child, the chance of developing and maintaining behavioural problems of the child decreases.Show less
