摘要:

Objectives.Women reaching menopause must make a controversial decision about whether to use hormone therapy (HT). The theory of planned behaviour (TPB) was the organizing framework. The objectives were to determine if (1) influence of different TPB constructs varied with stage of menopause and HT use, (2) women with diabetes were influenced in significantly different ways from women without, (3) the overall perceived behavioural control (PBC) and self‐efficacy (SE) have independent effects on intention, and (4) physician influence was mediated by subjective norm (SN).Design.Cross‐sectional survey of women from a managed care organization.Methods.Multiple regression analysis was used to analyse 765 responses (230 from women with diabetes) and separately four main subgroups: (1) early menopause stage and never used HT, (2) late menopause stage and never used HT, (3) late menopause stage and previously used HT, and (4) late menopause stage currently using HT.Results.For the entire sample, the model explains 68% of variance in intention, where SE, physicians' influence, self‐identification with menopause as a natural part of ageing, self‐identification as someone who wants to delay menopause, HT status, menopause status, and diabetes were added to the TPB. For the entire sample, SE added 2% to the explained variance and the physician determinant added 7%.Conclusions.An augmented TPB is useful for understanding women's HT use decisions. The theory explains more variance in intention before a behaviour is enacted than after, and decision structure changes over time. PBC and SE have independent effects on in

ISSN:1359-107X    

DOI:10.1348/135910709X457946

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives.This study investigated the relationship between participants' expected levels of pain intensity before a colonoscopy, pain intensity experienced while they were undergoing this medical procedure (real‐time pain), and their retrospective evaluation of this experience.Design.Correlational design. Regression analyses were performed and mediational models were tested.Methods.Ninety patients who were about to undergo a colonoscopy were asked to report the pain intensity on a scale ranging from 0 (no pain) to 10 (extreme pain). They reported the expected intensity of pain before the examination, their real‐time intensity of pain every 60 s during the colonoscopy, and their global retrospective evaluation of the pain experienced when the procedure was over.Results.Results confirmed that, regardless of participants' gender, the variability of the real‐time pain distribution was a significant predictor of the accuracy of recall (i.e. the discrepancy between recalled pain and mean real‐time pain). Moreover, participants' pain expectations preceding the examination were a significant predictor of the accuracy of recall. It was further demonstrated that the effect of patients' expectations on the discrepancy was mediated by the real‐time pain variability.Conclusions.The results of the present study provide useful indications about what the target of interventions aimed at reducing the bias in pain recall

ISSN:1359-107X    

DOI:10.1348/135910709X458305

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Purpose.Increasing self‐efficacy is an effective method to increase physical activity. Despite this, the evidence concerning the most effective techniques to increase self‐efficacy in physical activity interventions has not been systematically reviewed. The aim of the present research is to systematically gather, and meta‐analyse, intervention studies which aimed to increase self‐efficacy for physical activity; to estimate the association between intervention techniques used, and change in self‐efficacy achieved.Methods.A systematic database search was conducted for papers reporting lifestyle or recreational physical activity interventions. Published intervention studies explicitly targeting self‐efficacy in order to change physical activity behaviour in ‘healthy’ adults were eligible for inclusion.Results.The search strategy identified 27 unique physical activity intervention studies, with a total of 5,501 participants. A significant, yet small, relationship between the interventions and changes in self‐efficacy was found (meand=0.16,p<.001). Owing to significant heterogeneity, moderator analyses were conducted, examining the association of changes in self‐efficacy with whether or not specific intervention techniques were used. Interventions that included feedback on past or others' performance produced the highest levels of self‐efficacy found in this review. Vicarious experience was also associated with higher levels of self‐efficacy. Persuasion, graded mastery, and barrier identification were associated with lower levels of self‐efficacy.Conclusions.This meta‐analysis forms an evidence base for which psychological techniques are most effective in increasing self‐efficacy for physical activity. The results are presented in terms of recommendations for those developing interventions and d

ISSN:1359-107X    

DOI:10.1348/135910709X461752

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives.Differences in breast cancer screening rates have been linked to many factors including race, access to healthcare, and breast cancer knowledge and beliefs; less frequently studied has been the role of characteristic styles of coping. In this study, we examined ethnicity and the role of coping with a possible breast cancer diagnosis in the context of whether or not women obtained clinical breast examinations (CBE).Design.To measure coping, a stressor, in the form of a vignette asking participants to imagine they had just received a breast diagnosis upon a doctor's visit, was used.Method.Three hundred and eight women from seven ethnic subpopulations (and from three racial groups) in the USA were interviewed regarding frequency of breast screening, as well as how they would likely cope with a diagnosis of breast cancer.Results.CBE rates were similar across groups and were differentially predicted by the different coping styles. Analysing the results using typical racial categories (rather than distinct ethnic groupings) obscured these results. Furthermore, avoidance predicted CBE and mammogram rates differently, specifically, predicting mammogram rates differentially for each group, with no relation to CBE rates.Conclusion.Recognition of the roles of problem solving, social support, and avoidance in coping with a possible breast cancer diagnosis may guide the development and provision of interventions that are more sensitive to the characteristics of specific groups of women. Examinations of psychological variables in preventive health behaviours must begin to analyse diversity by paying attention to ethnic specificity, rather than race, as well as to the underlying nature of the screening task.

ISSN:1359-107X    

DOI:10.1348/135910709X463723

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives.To examine whether any response shift in quality of life (QoL) assessment over the course of a cardiac rehabilitation (CR) programme could be explained by changes in individuals' internal standards (recalibration), values (reprioritization), and/or conceptualization of QoL and the extent to which any response shift could be explained by health locus of control, optimism, and coping strategy.Design.Longitudinal survey design.Methods.The schedule for evaluation of individual QoL‐direct weighting (SEIQoL‐DW) was administered at the beginning and end of a CR programme. At the end of the programme, the SEIQoL‐DW then‐test was also administered to measure response shift. A total of 57 participants completed these measures and other measures to assess health locus of control, optimism, and coping.Results.Response shift effects were observed in this population mainly due to recalibration. When response shift was incorporated into the analysis of QoL a larger treatment effect was observed. Active coping as a mechanism in the response shift model was found to have a significant positive correlation with response shift.Conclusion.This study showed that response shift occurs during CR. The occurrence of response shift in QoL ratings over time for this population could have implications for the estimation of the effectiveness of the inter

ISSN:1359-107X    

DOI:10.1348/135910709X464443

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objective.Personality factors moderate self‐efficacy enhancing effects of some illness self‐management interventions, but their influence on self‐rated health is unclear. This study examined whether high neuroticism and low conscientiousness, extraversion, and agreeableness (the distressed personality profile) moderated the effects of the homing in on health (HIOH) illness self‐management intervention on mental and physical health status.Design.Analysis of data from 384 subjects completing a randomized controlled trial of HIOH.Methods.Regression analyses examined effects of NEO‐five factor inventory scores on SF‐36 mental component summary (MCS‐36) and physical component summary (PCS‐36) scores (baseline; 2, 4, and 6 weeks; 6 months; 1 year), adjusting for age, gender, and study group.Results.Baseline MCS‐36 scores were worse in those with the distressed personality profile relative to others: high neuroticism (13.3 points worse, 95% confidence interval (CI)=11.0, 15.7) and low conscientiousness (6.6 points worse, 95% CI=4.1, 9.2), extraversion (10.1 points worse, 95% CI=7.7, 12.5) and agreeableness (4.2 points worse, 95% CI=1.6, 6.8). Intervention subjects had better MCS‐36 scores at 4 and 6 weeks, and benefits were confined to participants with low conscientiousness (4 weeks – 3.7 points better, 95% CI=0.2, 71; 6 weeks – 5.0 points better, 95% CI=1.57, 8.4). There were no intervention or personality effects on PCS‐36 scores.Conclusions.Chronically ill self‐management intervention recipients with the distressed personality profile had worse self‐rated mental health, and conscientiousness moderated the short‐term effects of the intervention on self‐rated mental health. Measuring personality may help identify individuals more likely to benefit f

ISSN:1359-107X    

DOI:10.1348/135910709X464353

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives.Self‐reported health has a well established relationship to later mortality, although the reasons are not entirely understood. This study examined the association of a similar self‐reported measure of fitness with mortality and compared it to that of self‐reported health.Design.The study had a prospective cohort design with multiple sampling points.Methods.Participants were 858 men and women from Glasgow and the surrounding area of Scotland, aged 59 when self‐reported health and fitness data were first collected in 1991/92. They were re‐interviewed at age 64 and 69 and mortality was tracked for 16.5 years in total. Hazard ratios for all cause mortality were estimated for those that reported poor health or poor fitness relative to others their age, taking into account a range of covariates, some of which were also time varying.Results.In both unadjusted and covariate adjusted models, self‐reported fitness was at least as good a predictor of mortality as self‐reported health. In a mutually adjusted model, both again emerged as significant predictors. Poor subjective health with poor subjective fitness appeared to be a particularly lethal combination.Conclusion.Both self‐reported health and self‐reported fitness were independent predictors of mortality. Where the objective assessment of aerobic fitness is not feasible, a simple measure of subjective fitness could prove a u

ISSN:1359-107X    

DOI:10.1348/135910709X466180

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives.The classification of health behaviours may provide a useful framework for understanding their characteristics and therefore the ways in which they are similar and different. However, to date, little research has attempted to identify these characteristics and explore the dimensions along which behaviours differ. This paper uses an inductive approach to explore this issue.Design and methods.In Study 1, 25 repertory grid interviews and 3 focus groups encompassing lay public and health professionals identified 25 ways of describing health behaviours. These were refined into 11 key characteristics. In Study 2, 180 members of the general public rated 20 health behaviours on each of these characteristics.Results.Principal components analysis indicated behaviours were perceived along three key dimensions: ‘easy immediate pay‐offs’ versus ‘effortful long‐term pay‐offs’; ‘private unproblematic’ versus ‘public and problematic’; and ‘important routines’ versus ‘unimportant one‐offs’. Risk behaviours were clearly differentiated being perceived as ‘easy immediate pay‐offs’ and ‘public–problematic’. In contrast with other approach behaviours such as diet or self‐examination, physical activity behaviours were perceived as ‘effortful long‐term pay‐offs’.Conclusions.This research provides an useful starting point in the development of a framework that allows us to better understand differences and similarities between health behaviours. These dimensions may be important to consider wh

ISSN:1359-107X    

DOI:10.1348/135910709X466487

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objective.In the US population, the prevalence of fibromyalgia is about 3.4% in women. For those who are affected, fibromyalgia is associated with significant limitations relating to quality of life, activity, and participation. Furthermore, fibromyalgia leads to serious socio‐economic costs. The objective of the present paper is to describe the cognitive illness representations of women with fibromyalgia and to analyse their relationship to rehabilitation outcomes.Methods.The outcome was measured using the SF‐36 and fibromyalgia impact questionnaire. The illness perceptions were assessed using the Illness Perception Questionnaire – revised. The prediction of outcome was done using hierarchical multiple regression analyses.Results.N=245 patients are included in the sample. The patients attribute a multitude of symptoms to fibromyalgia and name numerous triggering factors. Illness representations are correlated with the illness impact at the beginning of rehabilitation and predict the outcome after the end of rehabilitation.Conclusion.The fact that illness representations turn out to be predictors of outcome, even when the baseline health status is statistically controlled, highlights the relevance of the illness representations of patients with fibromyalgia. Therefore, effective and efficient methods should be developed for integrating patient's illness beliefs into the management of the illness as early as pos

ISSN:1359-107X    

DOI:10.1348/135910709X466315

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY

摘要:

Objectives.Irritable bowel syndrome (IBS) presents in the absence of identifiable organic pathology. Clinical and research literature has suggested that both childhood abuse and anger are linked to functional gastrointestinal conditions including IBS. The present study tested the predictions that IBS patients, when compared to patients with an organic bowel disease (Crohn's disease), have higher levels of trait and suppressed anger, and that these mediate the link between abuse and IBS.Design.The study was a cross‐sectional multivariate comparison between groups of patients with IBS and Crohn's disease.Method.Levels of self‐reported trait and suppressed anger and recalled childhood abuse in patients with IBS (N=75) or Crohn's disease (N=76) were compared, using self‐report questionnaires and controlling for other psychological characteristics (anxiety, depression, and dissociation).Results.Trait and suppressed anger were greater in IBS patients, and differences in trait anger remained significant after controlling for other psychological variables. Childhood sexual abuse was more prevalent in IBS than Crohn's disease patients but was unrelated to trait anger.Conclusions.Higher levels of anger characterize IBS patients when compared to an organic bowel disease group, but do not explain the link between childhood abuse an

ISSN:1359-107X    

DOI:10.1348/135910709X466496

出版商:Blackwell Publishing Ltd    

年代:2010

数据来源: WILEY