摘要:

Chronic bronchitis (a form of chronic obstructive pulmonary disease or COPD) is a common cause of morbidity and mortality resulting in around 5% of deaths in the UK. Over recent years, there has been an increased emphasis on patient‐based evaluation of health and social care, which has led to a rapid growth in quality of life measures and an increase in measuring quality of life for COPD patients. However, less attention has been paid to patients' perceptions and experiences of everyday life, specifically their active engagement in the psychological, emotional and social aspects of adjustment and adaptation to living with chronic bronchitis. This study employs a series of four focus groups (N= 20) to identify key experiences of living with chronic bronchitis. The results, obtained through using both thematic and conceptual qualitative analysis, within a broadly symbolic interactionist framework, describe the subjective and sometimes contradictory ways in which the disease leads to psychological distress, dependency on medication, and disruption to social and family relationships, and has a negative impact on self‐esteem. The study further argues for greater awareness of qualitative approaches to the broad view of quality of life as complementary to quality of life assessme

ISSN:1359-107X    

DOI:10.1348/135910703322370842

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY

摘要:

Objective: Emotional expression is an important means of coping with stressful experiences such as cancer. Social barriers to expression may have adverse effects. Research has suggested that men are less likely to express their emotions and have different patterns of social support compared to women. We examined whether male cancer patients have a lower tendency to express emotions, are less likely to perceive social barriers to expression, and are differentially affected by social barriers from different support sources as compared to women.Design: Questionnaires were administered to 41 women and 41 men using a cross‐sectional study design.Method: Patients diagnosed with gynaecological or prostate cancer within the past 5 years completed questionnaires on moods, intrusive thoughts, social constraints and emotional expressivity.Results: There was a trend towards greater emotional expressivity in women as compared to men, but no significant gender differences in perceptions of social constraints from spouse/partner or others. Multiple regression analyses revealed that men experienced significantly greater distress in association with social constraints from their spouse/partner than did women.Conclusion: Men may be more vulnerable to social barriers to expression than previously assumed. Gender differences in emotional expressivity may be less important than the social context in which expression takes plac

ISSN:1359-107X    

DOI:10.1348/135910703322370851

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY

摘要:

Objectives: The main aims of the present study were to explore the illness representations of individuals with multiple sclerosis (MS) and investigate the relationship of these beliefs to outcome. Based on Leventhalet al.'sself‐regulation model, the commonly accepted generic five‐component structure of illness representations including identity, time‐line, consequences, cause, and cure/controllability was used.Design: A cross‐sectional, correlational design was employed for the study. Interrelationships among the illness representation components and the relationships between the components and outcome were explored using Pearson'sr. To determine the contribution of the illness representation components to the explained variance in outcome, a series of stepwise multiple regression analyses was used.Method: A total of 99 participants took part in the study. A series of measures were completed to assess (1) illness representations and (2) five specific areas of outcome.Results: Participants' illness representations of MS were consistent with the medical nature and understanding of this illness indicating that they held the perceptions of a strong illness identity, chronic time‐line, no particular cause and no cure. Beliefs in the serious consequences of MS and limited control were also reported. Some important interrelationships among the illness representation components were demonstrated where a strong illness identity, chronic time‐line view and perception of low control were related to more serious consequences. Overall, evidence was provided to suggest that illness representations contribute to outcome. The consequences component was associated with, and contributed to, the explained variance for each of the five outcome areas, indicating that the perception that MS has many negative effects on an individual's life was associated with greater levels of difficulty in all of the outcome areas. In addition, for each of the outcome variables, different combinations of illness representation components explained their variance. For example, higher levels of depression were associated with perceptions of a stronger illness identity, more serious consequences, acute time‐line, and low control.Conclusion: Overall support is provided for the application of the five‐component structure of illness representations to MS and the likely contribution of such beliefs to outcome. The concept of illness representations therefore provides a useful framework for understanding the psychosocial effects

ISSN:1359-107X    

DOI:10.1348/135910703322370860

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY

摘要:

Objectives: Taylor's theory of cognitive adaptation proposes that adjustment depends on the ability to sustain and modify illusions (i.e. unrealistic optimism, exaggerated perceptions of control, and self‐aggrandizement) that buffer against threats but also against possible future setbacks. Because the question of whether cancer patients show these illusions has received little attention, the present study compared patients' perceptions of optimism, control, and self‐esteem at different stages of the cancer process with that of healthy references. The effects of these perceptions on psychological distress were also assessed.Design: The present study has a longitudinal design. Including a group of healthy references enabled us to draw more firm conclusions about the effect of cancer upon cognitive perceptions. Methods: The participants were 67 cancer patients and 50 healthy references. Patients filled out questionnaires prior to their first radiotherapy (T1), at 2 weeks (T2), and at 3 months (T3) after completing radiotherapy. Healthy references were assessed at similar intervals.Results: T tests revealed that patients experienced significantly higher levels of optimism and self‐esteem than the healthy reference group. Concerning control, no group differences were found. Importantly, regression analyses showed that lower levels of optimism and control at T1 were predictive of feelings of anxiety at T3. Lower perceived control also predicted depressive symptoms.Conclusion: Results support the theory of cognitive adaptation in that patients are indeed able to respond to cancer with high levels of optimism and self‐esteem and that lower levels of optimism and control are predictive of psychological d

ISSN:1359-107X    

DOI:10.1348/135910703322370879

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY

摘要:

Purpose: Delays in seeking help for symptoms have been found to be associated with poorer outcome in breast‐cancer patients. This study explores symptom perceptions and health beliefs as predictors of intentions to seek medical help in a general female population. The utility of the self‐regulation model of illness cognition and the theory of planned behaviour were examined in predicting help‐seeking intentions for potential symptoms of breast cancer in a general population sample.Methods: A general population sample of 546 women completed a postal questionnaire comprising items examining components of the self‐regulation model and the theory of planned behaviour. Help‐seeking intention was determined by asking participants to rate the likelihood of visiting their GP for a range of breast symptoms.Results: Hierarchical multiple regression analysis revealed that the cognitive component of the self‐regulation model accounted for approximately 22% of the variance in help‐seeking intention. Identity (β = 0.45,p<.001) emerged as a significant predictor of intention to seek help. Inclusion of the components of the theory of planned behaviour accounted for an additional 7% of the variance; the significant predictors were attitude to help‐seeking (β = 0.19,p<.001) and perceived behavioural control (β = 0.12,p<.01).Conclusions: Intention to seek medical help for a potential breast‐cancer symptom may be mediated, partly, by cognitive representations of the identity and consequences of breast cancer and by attitudes towards help‐seeking and perceived behavioural control. Although less than one‐third of the variance was accounted for, these results have important implications for future research (in terms of identifying which variables should be examined) and for the development of a model of help‐seeking behaviour in women w

ISSN:1359-107X    

DOI:10.1348/135910703322370888

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY

摘要:

Objective: To determine whether diabetic children with psychological adjustment problems have greater difficulties in specific areas of disease adaptation than their welladjusted diabetic peers by comparing their diabetes‐related adjustments in the family, school and peer environments.Method: Mothers of 47 school‐age preadolescent children with diabetes completed a standardized assessment of general psychological functioning. Children with psychological adjustment problems were then compared with children who did not exhibit problems along the following dimensions: their demographic and medical profiles, maternal diabetes knowledge, associations between general psychological functioning and diabetes control, and the quality of their diabetes adjustment.Results: No differences were found between children with psychological adjustment problems and their better‐adjusted peers along any of the demographic or health status variables tested or in maternal diabetes knowledge. However, children with adjustment problems were more likely to receive visits from the hospital's home‐care team and to be absent from school. Also, for children with psychological difficulty, indices of diabetes control and general psychological functioning were related, and the nature of this relation differed across the school and family environments. In addition, poorer psychological adjustment was associated with diabetes‐specific problems in both mother and child. These included individual adjustment problems such as feeling different, relationship difficulties with family and peers, and difficulties with the treatment protocol, in particular, with the dietary regime.Conclusion: These findings are considered in relation to (1) the importance of multi‐method techniques in research which concerns adjustment to diabetes, in particular the need to use both psychological and disease‐specific instruments, and (2) clinical evaluations and interventions for children with diabetes and t

ISSN:1359-107X    

DOI:10.1348/135910703322370897

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY

摘要:

Purpose: Religion is frequently ignored within the clinical domain. Yet when examined, empirical evidence indicates that specific aspects of religiosity are correlated with mental health. The established associations between religious dimensions and mental health could be mediated by cognitive‐behavioural mechanisms. This paper proposes a preliminary conceptual framework in which two types of cognitive and behavioural mechanisms are described, (1) generic mental models that provide a basis for guiding appraisals of life events and (2) self‐regulation of thinking processes (metacognitive control).Method: A critical analysis of extant literature was employed to examine support for each of the mechanisms.Discussion: Evidence supports the idea that a religious framework can serve as a generic mental model that influences appraisals and affects well‐being. The benefits derived depend on the salience of the framework, level of certainty with which attributions can be accepted, and the content of the information. Evidence for the self‐regulation mechanism is weaker. Although consistent with this supposition, it requires further empirical evaluation.Conclusion: The relationships between religious variables and mental health may depend on cognitive‐behavioural mechanisms. Developments in this area might encourage clinicians to consider further the ways in which religious variables might be utilized and assessed in therapy. However, there is a need for further efforts to incorporate religious and spiritual factors in the clini

ISSN:1359-107X    

DOI:10.1348/135910703322370905

出版商:Blackwell Publishing Ltd    

年代:2003

数据来源: WILEY