摘要:

Objective. Analysis of health service statistics reveals that men tend to under‐use primary health care services. Previous research has suggested that men view illness as a form of weakness and have negative views about men who seek medical help. It has also indicated that some men believe that male General Practitioner (GP)s hold similar views, a factor which may influence their own tendency to self‐refer. This study aims to explore male GPs' experiences of their male patients' patterns of self‐referral and to identify factors that may negatively influence doctor–patient relationships.Method. Semi‐structured interviews were carried out with 10 male GPs (ages=35–53). These were audiotaped and subjected to interpretative phenomenological analysis to identify relevant themes.Results. For all participants, managing service demands were seen as a major challenge. Analysis of these GP's accounts suggested that they see men's self‐referral as being primarily influenced by the need to conform to masculine gender roles and a number of ways that men accessed services in a way congruent with this were identified. This study also explored how participants' own adherence to gender roles may itself influence the doctor–patient relationship.Conclusion. This study suggests that, like other men, male GPs may have ambivalent attitudes towards male self‐referral and that this may influence their interactions w

ISSN:1359-107X    

DOI:10.1348/135910709X479113

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objective. This study was designed to examine the extent of medical pluralism among the Chinese in London.Design. Members of the London Chinese community were recruited through Chinese organizations in London and participated in six focus groups.Method. A total of 48 Chinese men and women aged 24–74 years were asked to talk about their health behaviour and health utilization patterns. Transcripts of the focus group discussions underwent thematic analysis to explore and describe the utilization of traditional Chinese medicine (TCM) and Western medicine (WM) of informants and factors that impacted on utilization.Results. Findings focus on participants' evaluation of TCM and WM as two systems of health provision, how informants used these two health systems, and the reasons associated with use of these two systems. Utilization of TCM and WM varied. Concurrent use of TCM and WM was common. The National Health Service was generally perceived as difficult to use, with concerns over the language barrier, and communicating with and being able to trust health providers. The UK TCM trade was perceived as being aimed at the non‐Chinese market and there were issues of trust related to the regulation of UK TCM.Conclusions. Although none of these issues are unique to the Chinese in the UK, previous experience with different approaches to health care, particularly TCM, may make the experience of such barriers more extr

ISSN:1359-107X    

DOI:10.1348/135910709X479195

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives. The study investigates theoretical debates on the contribution of spiritual, religious, and personal beliefs (SRPB) to quality of life (QoL) in health, by examining contrasting models.Design and method. The WHOQOL‐SRPB assesses QoL relating to SRPB where 33 QoL facets are scored in 6 domains, of which SRPB is one. The measure was completed by a heterogeneous sample of 285 sick and well people representing a cross‐section of religious, agnostic, and atheist beliefs in UK, and structured for gender (52% female) and age (mean 47 years).Results. No evidence was found to support the model of spiritual QoL as a concept that overarches every other QoL domain. Confirmatory factor analysis showed that SRPB is an integral concept to overall QoL, with a very good fit (comparative fit index=.99). Spiritual QoL made a significant, relatively independent contribution, similar to the other five domains (β=0.68). Spiritual QoL is most closely associated with the psychological domain, particularly hope and optimism and inner peace; two of the nine SRPB facets. Spiritual QoL, but not most other aspects of QoL, is higher for religious people.Conclusion. The results explain theoretical confusion arising from previous research. Spiritual QoL makes a significant and distinctive contribution to QoL assessment in health and should be assessed routinely in health care populat

ISSN:1359-107X    

DOI:10.1348/135910709X479799

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Purpose. This systematic review aimed to assess the effectiveness of psychoeducational smoking cessation interventions for coronary heart disease (CHD) patients; and to examine behaviour change techniques used in interventions and their suitability to change behavioural determinants.Methods. Multiple bibliographic databases and references of retrieved articles were searched for relevant randomized controlled studies. One reviewer extracted and a second reviewer checked data from included trials. Random effects meta‐analyses were conducted to estimate pooled relative risks for smoking cessation and mortality outcomes. Behaviour change techniques used and their suitability to change behavioural determinants were evaluated using a framework by Michie, Johnston, Francis, Hardeman, and Eccles.Results. A total of 14 studies were included. Psychoeducational interventions statistically significantly increased point prevalent (RR 1.44, 95% CI, 1.20–1.73) and continuous (RR 1.51, 95% CI, 1.18–1.93) smoking cessation, and statistically non‐significantly decreased total mortality (RR 0.73, 95% CI, 0.46–1.15). Included studies used a mixture of theories in intervention planning. Despite superficial differences, interventions appear to deploy similar behaviour change techniques, targeted mainly at motivation and goals, beliefs about capacity, knowledge, and skills.Conclusions. Psychoeducational smoking cessation interventions appear effective for patients with CHD. Although questions remain about what characteristics distinguish an effective intervention, analysis indicates similarities between the behaviour change techniques used in such inte

ISSN:1359-107X    

DOI:10.1348/135910709X480436

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives. This study tested whether (1) chronic fatigue syndrome (CFS) individuals have a bias in the initial orientation of attention to illness‐related information, which is enhanced by rumination. (2) CFS individuals have an illness interpretation bias (IB) in their early automatic processing of ambiguous information. (3) CFS individuals experience a greater degree of mood fluctuation following rumination and distraction inductions.Design. Thirty‐three CFS participants who had received a medical practitioner's diagnosis of CFS were compared to 33 healthy matched controls on an exogenous cueing task and a lexical decision task.Method. All participants underwent either a rumination or distraction induction. They then completed an exogenous cueing task to assess bias to illness and social threat compared with neutral stimuli, as well as a lexical decision task to assess their interpretation of ambiguous words having illness, social threat, or neutral interpretations.Results. Reaction time data revealed that CFS individuals did not have an attentional bias (AB) in the initial orientation of attention to illness‐related material. Nor was there an IB towards illness in CFS individual's automatic response to ambiguous information. However, as hypothesized, CFS individuals showed a greater degree of mood fluctuation following the rumination/distraction induction.Conclusion. Rumination and distraction lead to greater mood volatility in CFS individuals than in controls, but not to attentional nor interpretation biases in the early automatic stages of information processing in CFS indivi

ISSN:1359-107X    

DOI:10.1348/135910709X480346

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Purpose. A new strain of H1N1 influenza, also known as swine flu was confirmed in the UK in May 2009 and has spread to over 100 countries around the world causing the World Health Organization to declare a global flu pandemic. The primary objectives of this review are to identify the key demographic and attitudinal determinants of three types of protective behaviour during a pandemic: preventive, avoidant, and management of illness behaviours, in order to describe conceptual frameworks in which to better understand these behaviours and to inform future communications and interventions in the current outbreak of swine flu and subsequent influenza pandemics.Methods. Web of Science and PubMed databases were searched for references to papers on severe acute respiratory syndrome, avian influenza/flu, H5N1, swine influenza/flu, H1N1, and pandemics. Forward searching of the identified references was also carried out. In addition, references were gleaned from an expert panel of the Behaviour and Communications sub‐group of the UK Scientific Pandemic Influenza Advisory Group. Papers were included if they reported associations between demographic factors, attitudes, and a behavioural measure (reported, intended, or actual behaviour).Results. Twenty‐six papers were identified that met the study inclusion criteria. The studies were of variable quality and most lacked an explicit theoretical framework. Most were cross‐sectional in design and therefore not predictive over time. The research shows that there are demographic differences in behaviour: being older, female and more educated, or non‐White, is associated with a higher chance of adopting the behaviours. There is evidence that greater levels of perceived susceptibility to and perceived severity of the diseases and greater belief in the effectiveness of recommended behaviours to protect against the disease are important predictors of behaviour. There is also evidence that greater levels of state anxiety and greater trust in authorities are associated with behaviour.Conclusions. The findings from this review can be broadly explained by theories of health behaviour. However, theoretically driven prospective studies are required to further clarify the relationship between demographic factors, attitudes, and behaviour. The findings suggest that intervention studies and communication strategies should focus on particular demographic groups and on raising levels of perceived threat of the pandemic disease and belief in the effectiveness of measures designed to protect aga

ISSN:1359-107X    

DOI:10.1348/135910710X485826

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objective. The present study attempts to develop and pilot the feasibility and efficacy of a novel intervention using affective messages as a strategy to increase physical activity (PA) levels in adolescents.Design. An exploratory pilot randomized control trial was used to compare behaviour change over 2 weeks. A modified form of the International Physical Activity Questionnaire was used to assess PA behaviour. A total of 120 adolescents (16–19 years) from 4 sixth forms in West Yorkshire completed the field‐based study.Method. Participants were randomly assigned to one of three experimental conditions, or the control condition (N=28). Participants in experimental conditions received 1 short messaging service (SMS) text message per day over the 2 weeks, which included manipulations of either affective beliefs (enjoyable/unenjoyable;N=31), instrumental beliefs (beneficial/harmful;N=30), or a combination of these (N=31). Control participants received one SMS text message per week. Outcomes were measured at baseline and at the end of the 2 week intervention.Results. PA levels increased by the equivalent of 31.5 minutes of moderate (four metabolic equivalent) activity per week during the study. Main effects of condition (p=.049), and current physical activity level (p=.002) were identified, along with a significant interaction between condition and current activity level (p=.006). However, when the sample was split at baseline into active and inactive participants, a main effect of condition remained for inactive participants only (p=.001).Post hocanalysis revealed that inactive participants who received messages targeting affective beliefs increased their activity levels significantly more than the instrumental (p=.012), combined (p=.002), and control groups (p=.018).Conclusion. Strategies based on affective associations may be more effective for increasing PA levels in inactive individu

ISSN:1359-107X    

DOI:10.1348/135910710X486889

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives. Socially isolated individuals report more cardiac symptoms, suffer increased cardiovascular morbidity and mortality, and experience higher levels of stress and anxiety than those with more effective support resources. However, the complex interactions of psychosocial factors implicated in the disease process remain to be fully elucidated. We sought to explore these relationships, with the addition of a novel psychosocial variable, anger rumination, which could be associated with increased cardiovascular risk.Design. We examined the association of psychological stress, social support, and anger rumination, with surgical anxiety, self‐reported cardiac symptoms, and angiographically documented coronary artery disease, using a correlationalex post factodesign.Methods. One hundred and one patients scheduled for elective coronary angiography completed questionnaires during the week prior to angiography. Disease severity was objectively assessed using the Gensini scoring system.Results. Self‐reported cardiac symptom severity was significantly correlated with higher perceived stress, less social support, and higher anger rumination, but none of the psychosocial variables predicted Gensini score. Social support partially mediated the relationship between anger rumination and surgical anxiety. Perceived stress mediated the relationship between anger rumination and cardiac symptoms.Conclusions. For patients awaiting angiography, stress, and lack of social support are important predictors of self‐reported cardiac symptoms, irrespective of actual disease severity. Intervention could focus on reducing perceived stress by encouraging reappraisal and a support seeking, rather than a ruminative, anger coping

ISSN:1359-107X    

DOI:10.1348/135910710X491360

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives. Social support for physical activity is reliably associated with regular physical activity, however the social cognitive processes, particularly post‐intentional processes, that can explain this link have not been well characterized. In this study, we examined the extent to which the relationship between social support for physical activity and subsequent physical activity can be accounted for by planning processes.Design and method. The design was prospective observational and the sample consisted of 903 university students. Participants completed standard theory of planned behaviour, planning, and physical activity measures at 2 time points, approximately 7 weeks apart. A gender stratified multiple mediation model was conducted to test the study hypotheses.Results. A significant interaction between social support and gender was observed. This indicated that lower levels of social support for physical activity were associated with lower levels of physical activity at Time 2, for women only. In multiple mediation analysis, this was partly explained by the indirect effects of social support through perceived behavioural control and coping planning.Conclusion. These findings highlight the importance of interpersonal processes in understanding the post‐intentional social cognitive determinants of regular physical activity. It is likely that planning processes relating to physical activity are often influenced by those in the ongoing immediate social environment who support this behaviour. Future development of theory and interventions should take account of the socially interactive nature of planning proces

ISSN:1359-107X    

DOI:10.1348/135910710X490406

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives. The present research explored the role that culture plays in smokers' description of their risk perceptions and experiences as targets of moralization.Methods. We conducted in‐depth qualitative interviews with 15 smokers each from Denmark (a smoking‐lenient culture) and the USA (a smoking‐prohibitive culture).Results. Smokers said they were well aware of the risks of smoking yet minimized the risks of active and passive smoking; Danes were particularly likely to minimize these risks. Smokers also described many experiences as targets of moralization and accepted some elements of moralized attitudes although overall Danes more strongly rejected moralized opinions. Smokers described adjusting to moralization by changing when and where but not how much they smoked.Conclusion. It is important to consider cultural influences on moralization and risk perception of sm

ISSN:1359-107X    

DOI:10.1348/135910710X490415

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY