摘要:

Objectives. This study sought to examine how patients’ mood and quality of life (QoL) change during the early high‐risk period after a diagnosis of heart failure (HF) and to identify factors that may influence change.Design. A within‐subjects, repeated‐measures design was used. Assessments took place within 4 weeks of diagnosis and 6 months later.Methods. One hundred and sixty six patients with HF completed assessments of their mood, QoL, and beliefs about HF and its treatment. Correlation analysis was conducted between the variables and analysis of variance andt‐tests were used to assess differences in categorical variables. To examine which variables predicted mood and QoL, hierarchical multiple regressions were conducted.Results. At follow‐up, patients’ beliefs indicated a realization of the chronicity of their HF, however their beliefs about the consequences of having HF did not change and their satisfaction with their treatment remained high. QoL and anxiety improved significantly over time but there was no significant change in depressed mood. As would be expected, improvement in symptoms was a key factor in improved mood and QoL. Other significant explanatory variables included age, comorbid chronic obstructive pulmonary disease, depressed mood, patients’ beliefs about the consequences of their HF and their concerns about treatment.Conclusions. This study suggests that addressing patients’ mood and beliefs about their illness and its treatment may be additional ways of improving patient QoL in the early perio

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02047.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objectives.  Comorbid anxiety is highly prevalent in Chronic Obstructive Pulmonary Disease (COPD), and it is related to increased morbidity and mortality. It has consistently been found that social comparison has substantial impact on mood. However, despite the strong social component of pulmonary rehabilitation, the effect of social comparison processes on anxiety has not been explored in this context.Design.  Participants were 43 COPD patients enrolled in a 3‐week pulmonary rehabilitation programme. We tested in a longitudinal design the relationship between social comparison and assimilation and contrast at the beginning of rehabilitation and anxious mood at the end of the programme.Methods.  Using moderator analysis, we tested whether perceived similarities and differences to upward and downward social comparison standards influence the relationship between comparison direction at the beginning of the programme and anxious mood at the end of the programme.Results.  The relationship between social comparison at the start of rehabilitation and anxious mood at the end of the programme was dependent on assimilation and contrast to upward and downward standards. Downward assimilation and upward contrast were related to a stronger relationship of upward and downward social comparison and anxious mood.Conclusion.  This study demonstrates the important role of social comparison focus in moderating beneficial effects of pulmonary rehabilitation. Downward assimilation and upward contrast might be important targets in reducing anxiety in pulmonary reh

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02048.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objective. Adherence to behavioural intervention programmes is a necessary condition for beneficial outcomes to be achieved. This study tested whether social cognitive variables and coping plans predict adherence.Design and methods. Adherence was examined in a randomized controlled trial with healthy older women (age range: 70–93 years), who were randomized to a physical (N= 86) or a mental (N= 85) activity intervention. Intentions, self‐efficacies, coping plans, and objectively measured adherence levels were assessed. A moderated mediation analysis evaluated the power of coping plans to translate intention into behaviour, depending on levels of prior adherence.Results. Adherence to the physical activity programme (65%) was significantly lower than adherence to the mental activity programme (84%,p<.001). Intentions (β= .22) weakly predicted adherence in the initiation period of the physical activity programme (6 weeks); pre‐action self‐efficacy predicted adherence in the initiation period of the mental activity programme (β= .35). In both groups, coping plans predicted mid‐period adherence (10 weeks) and long‐term adherence (20 weeks), moderated by prior adherence (allps<.01). Coping plans mediated the relationship between intentions and behaviour only in the exercise condition.Conclusions. Instructing older individuals to generate coping plans facilitated their adherence to physical and mental activity programmes. This effect was larger for participants with lower levels of prior adherence – and may have prevented them from droppi

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02049.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Purpose. The view of the patient is central to their care. Focus group methodology has been used in health psychology to capture patient views on health and illness. However, the process of conducting focus group research with patient groups has received scarce attention. The purpose of this paper was to highlight lessons learned from the conduct of focus groups in psychological research with chronic pain samples.Methods. Lessons were taken from three structured focus groups containing participants recruited from General Practice. Each group contained five, four, and six chronic pain sufferers from upper, middle and lower socioeconomic areas, respectively.Results. Nine lessons were learned about the conduct of focus group research in general, and also with chronic pain sufferers in particular. The lessons relate to (1) translating study interest into group attendance, (2) ensuring the environment maximizes the opportunity to learn from participants, (3) understanding participant motivations for attendance as well as (4) what participants take from the group, (5) ensuring adequate question specificity, accommodating the needs of particular groups in (6) moderation style and (7) discussion time scales, (8) considering the function of conflict in the group and (9) paying due attention to simultaneous dialogue. Recommendations for addressing the lessons are made.Conclusion. Patient groups have specific requirements and the conduct of focus groups should be driven by these needs to maximize inclusion and quality contributions in the group. Time, resources, and flexibility are needed to ensure the successful transition of these groups into focus group r

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02050.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objectives. This study investigated the relationships between job characteristics and coping in predicting levels of anxiety and depression in nurses. The study was based on current theories of occupational stress, and predictors included job demands, social support, decision authority and skill discretion control, effort, over‐commitment, rewards, and ways of coping. It was predicted that job demands, extrinsic effort, over‐commitment, and negative coping behaviours would be positively associated with depression and anxiety, and social support, rewards, decision authority, skill discretion control, and positive coping would be negatively associated with depression and anxiety.Methods. Participants were 870 nurses, who responded to a bulk mail sent randomly to 4,000 nurses from the south of England.Results. The results showed that job demands, extrinsic effort, and over‐commitment were associated with higher levels of anxiety and depression. Social support, rewards, and skill discretion were negatively associated with mental health problems. Few interactions were found between the variables. Coping behaviours significantly added to the explanation of variance in anxiety and depression outcomes, over and above the use of demand–control–support, and effort–reward factors alone.Conclusion. The results from the study demonstrated the importance of coping factors in work‐stress research, in accordance with the multi‐factorial premise of transactional stress models. It is argued that multi‐factor research is needed to help develop effective org

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02051.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objectives. Impulse control behaviours (ICBs) have been a recent focus of research in people with Parkinson's disease (PD). However, the current literature is largely limited to a biomedical understanding and gaps remain in our understanding of the perceived cause of these behaviours and how people themselves experience them. Consequently, this study sought to investigate how people with PD perceive the cause and controllability of their ICB.Design. The study utilized qualitative methodology involving semi‐structured interviews. Interpretative phenomenological analysis (IPA) allowed an in‐depth exploration of the subjective experience of ICBs.Methods. Ten people with idiopathic PD and current or recent history of ICBs were recruited from an existing research participant pool.Results. The themes that arose from the participants’ accounts were ‘Conflicting views on causality’, ‘Impulse control behaviours as a coping strategy’, and ‘The relationship between causal attribution and perceived controllability’.Conclusion. Participants’ beliefs about the cause of ICBs varied from externalized cause (medication) to internalized (coping with the impact of PD). These causal attributions were fundamental to the perceived controllability of the behaviours and psychological benefits. Further research is warranted to explore a psychosocial viewpoint of this feature of PD and to provide appropriate and effective

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02052.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objectives. The present study explored factors that underpin increased internalization (i.e., perceived autonomy) in motivation towards exercise over a 1‐year period in adolescent girls.Design. A mixed methods prospective study.Methods. A total of 107 girls (mean age = 13.28 years) reported their exercise behaviour, exercise goals, and a multidimensional measure of motivation towards exercise on two occasions, 1 year apart. Ten girls reporting increased autonomous motivation were then interviewed.Results. Two themes were extracted; growing up and seeking challenge. Most participants reported being more interested in exercising for their health as a result of growing up, through having greater understanding of the health‐behaviour link and willingness to act now for future health gain. However, their motivation appeared to be only partially internalized, as health was still viewed primarily as a value promoted by respected others (parents, teachers, media). Furthermore, as many girls conflated being healthy with being thin, health for appearance‐related weight control was experienced as an extrinsic (controlling) goal. The second theme was more suggestive of autonomous motivation; girls reported valuing exercise for the opportunity it provides to set and achieve personally meaningful challenges, facilitating a sense of competence and achievement.Conclusions. The findings may have a useful application in suggesting how exercise settings could be manipulated to increase enjoyment and participation during adolescence. In particular, the findings suggest that means of increasing the salience of the rewarding nature of setting and reaching personal challenges in an exercise setting a

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02053.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objectives. A focus on individualistic coping strategies such as positivity and fighting spirit has done little to inform the development of interventions for people affected by cancer. The aim of this study was to conduct an inquiry, which focused on the ‘lived experience’ and the social context within which communication about cancer occurs.Design. A semi‐structured interview schedule was used. These interviews were complemented by the Mini‐International Neuropsychiatric Interview (M.I.N.I., Sheehanet al., 1998).Methods. Twenty participants with mixed diagnoses (13 female and seven male), ranging in age from 44 to 73 (Mean = 58.35,SD= 8.20) were interviewed. Consistent with Glaser's (1992) constant comparative method, research data were open coded, selectively coded, and then theoretically coded so that initial codes were collapsed into models and compared against existing literature for completeness.Results. Fifty percent of participants met criteria for an Axis 1 diagnosis. Three models emerged from the research interview; the first provides a description of the way in which patients evaluate the quality of care they receive across the cancer pathway. Other models refer to the cancer‐coping process in which participants describe successful and unsuccessful attempts at coping via communication and whereby coping with cancer is characterized by a series of losses accompanied by increased distress.Conclusions. A research focus on the social environment in which cancer is experienced provides considerable insight into the cancer‐coping process. As such, interventions focused on understanding the social context in which patients experience cancer, and attempt to cope, may facilitate improved adjustment for those directly, and potentially indirectly, affected by cancer. Further research is required to develop interventions to address the uniq

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02054.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objectives.Repeated action can lead to the formation of habits and identification as ‘the kind of person’ that performs the behaviour. This has led to the suggestion that identity‐relevance is a facet of habit. This study explores conceptual overlap between habit and identity, and examines where the two constructs fit into an extended Theory of Planned Behaviour (TPB) model of binge‐drinking among university students.Design.Prospective, questionnaire‐based correlational design.Methods.A total of 167 UK university students completed baseline measures of past behaviour, self‐identity, the Self‐Report Habit Index (SRHI), and TPB constructs. One week later, 128 participants completed a follow‐up behaviour measure.Results.Factor analyses of the SRHI and four identity items revealed two correlated but distinct factors, relating to habit and identity, respectively. Hierarchical regression analyses of intention and behaviour showed that identity contributed over and above TPB constructs to the prediction of intention, whereas habit predicted behaviour directly, and interacted with intentions in predicting behaviour. Habits unexpectedly strengthened the intention–behaviour relation, such that strong intenders were more likely to binge‐drink where they also had strong habits.Conclusions.Identity and habit are conceptually discrete and impact differently on binge‐drinking. Findings have implications for habit theory and measurement. Recommendations for student alcohol consumption reduction in

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02056.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY

摘要:

Objective.Global pandemic H1N1 was atypical of influenza in that it was associated with high symptom severity among young adults. Higher education institutions were therefore understandably concerned about the potential for high infection rates among students. This study examined intention to uptake H1N1 vaccine between November and December 2009, when the virus was classified by the World Health Organization (WHO) as being in the pandemic phase.Design.A cross‐sectional survey design was employed.Method.Two hundred university students completed a questionnaire battery comprised of health, belief/attitudes, and behavioural intention measures.Results.Findings suggested that non‐intention to vaccinate is associated with a strong disbelief in its efficacy, in negative attitudes towards vaccinations, and in lack of perceived threat, which is underscored by a disinterest in others’ opinions, including authoritative bodies. Findings also suggested that there is resistance to the idea of vaccinations being mandatory.Conclusions.Vaccination intent is in some way linked to a range of attitudes and beliefs. The implication for health practitioners is that behaviour intent may be open to influence where psycho‐education can create pro‐vaccine attitudes an

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.2011.02057.x

出版商:Blackwell Publishing Ltd    

年代:2012

数据来源: WILEY