摘要:

Objective: Irritable bowel syndrome has no observable symptom markers and there is little that the medical profession can do to help sufferers. Psychotherapy, antidepressants and drugs aimed at the most problematic symptoms have been shown to have limited efficacy. Inan attempt to help understand the illness better, and to suggest alternative forms of intervention, the study tested whether outcome might be influenced by patients' representation of their illness and by their coping strategies.Method: All members of the IBS Network (an independent charitable support network based in the UK) were invited to participate via their quarterly newsletter, and 209 completed questionnaires were returned. Participants completed the Illness Perception Questionnaire (IPQ), the COPE, and the Hospital Anxiety and Depression Scale (HADS), and rated their quality of life and their satisfaction with their health.Results: The reporting of serious consequences was associated with lower quality of life and lower satisfaction with health, and with higher scores for anxiety and depression (p<.001). Weaker control beliefs were related to lower quality of life, lower satisfaction with health, and higher depression scores (p<.01). Lower illness scores were associated with more satisfaction with health (p.05). Psychological causal attribution of IBS was positively correlated with anxiety (p<.001) and depression (p<.01). Path analyses based on multiple linear regression demonstrated that (1) the reporting of serious consequences was a strong independent predictor of outcome; (2) coping mediated the link between representation and outcome; and (3) when predicting depression, coping strategies predicted coping independently of representation dimensions.Conclusions: The findings indicate that the illness representations of IBS sufferers can have significant implications for outcome. Therapeutic interventions based on illness representations may prove useful for treatment.

ISSN:1359-107X    

DOI:10.1348/135910702320645372

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

摘要:

Objectives: To develop a questionnaire to assess the responses of transplant recipients to the receipt of an organ, including their self‐care behaviour.Design: Following a literature review, open‐ended interviews and a focus group, a transplant questionnaire was developed. Two studies (Study 1:N= 231, Study 2:N= 105) were conducted to evaluate its psychometric properties.Methods: A pool of 51 items was derived from themes identified in published studies and from interviews and a focus group discussion with renal transplant recipients. These were constructed into a questionnaire and were then administered to two renal transplant out‐patients populations. Item responses of study sample 1 were subjected to principal components analysis (PCA) using varimax rotation to examine the structure of responses. In order to investigate the stability of the factor structure found in Study 1, item responses of the second sample were subjected to confirmatory factor analysis (CFA) using structural equation modelling.Results: PCA indicated six factors that accounted for 64.2% of the variance. With extraneous items omitted, the final questionnaire derived from Study 1 has 24 items clustered around five conceptual coherent factors: worry about transplant (22.1%), guilt regarding donor (11.9%), disclosure (9.58%), medication adherence (8.73%), and responsibility (6.63%). CFA on the final 24‐item version of the TxEQ revealed that the resulting model was a good fit for the Study 2 data (RMSEA = 0.08,pclose = .005).Conclusions: The TxEQ has potential application as a measure in the area of transplantation research. CFA demonstrated that the factor structure of the TxEQ is consistent across different renal transplant out‐patients populations. Further research is currently in progress to assess other groups of transplant recipients and to examine its relationship to other

ISSN:1359-107X    

DOI:10.1348/135910702320645381

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

摘要:

Objectives: To determine the role of optimistic beliefs in adaptation processes of three chronic diseases different in controllability by self‐care. It was expected that optimism towards the future would relate to adaptation independently of the controllability of disease. Optimism regarding one's coping ability should be beneficial in controllable diseases. Unrealistic optimism was expected to be beneficial in uncontrollable disease.Design: The cross‐sectional design involved 104 patients with type 1 diabetes, 95 patients with rheumatoid arthritis and 98 patients with multiple sclerosis, recruited via their physician at the out‐patient department of five hospitals.Method: Confirmatory Factor Analysis (LISREL) was employed to confirm a three‐dimensional approach of optimism: outcome expectancies, efficacy expectancies and unrealistic thinking. Multi‐sample analysis by path modelling was used to examine whether the relationship of the three optimistic beliefs with coping (CISS‐21), depression and anxiety (HADS), and physical functioning (SF‐36) differs with the controllability based on the self‐care options of chronic disease.Results: These show that when chronic disease must be controlled by self‐care, physical health depends more strongly on positive efficacy expectancies. In contrast, when self‐care options for controlling chronic disease are limited, physical health depends more strongly on positive unrealistic thinking and relates negatively to positive efficacy expectancies. The impact of the three optimistic beliefs on mental health is independent of the controllability by self‐care.Conclusion: Optimistic beliefs are differently beneficial for physical health dependent on the controllability of chronic disease. Unrealistic beliefs are helpful when patients are confronted with moderately to largely uncontrollable disease where self‐care options are limited, in contrast to positive efficacy expectancies that are helpful when patients deal with largely controllable disease wher

ISSN:1359-107X    

DOI:10.1348/135910702320645390

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

摘要:

Objective: To examine the relation between illness cognitions and two measures of adherence in patients with hypercholesterolaemia, a disease marked by chronically high cholesterol.Design: Cross‐sectional. Based on the self‐regulation model (Leventhal, Diefenbach,&Leventhal, 1992), patients' illness cognitions were predicted to be related to cholesterol control and medication adherence. Patients with illness cognitions consonant with an experts' mental model of hypercholesterolaemia were expected to show better control and adherence.Method: Hypercholesterolaemic patients (N= 169) were recruited at a university‐based general medicine clinic. Patients completed a survey that assessed beliefs about hypercholesterolaemia and medication‐taking behaviour. Cholesterol levels were obtained from patients' medical charts.Results: Low‐density lipoprotein (LDL) cholesterol control was related to believing that hypercholesterolaemia is a stable, asymptomatic disease with severe coronary consequences, and self‐report of medication adherence was related to believing that the disease has severe coronary consequences (ps<.05). LDL cholesterol differences between groups low and high in various illness beliefs ranged between 0.04 and 0.24 mmol/l (2 and 9 mg/dl) which translated to between 1% and 18% lower LDL cholesterol levels.Conclusion: The present study shows several relations that have not been previously demonstrated between better LDL cholesterol control and illness cognition, cognitions that were similar to an expert or physician's mental model of hypercholesterolaemia. The magnitude of differences in patient cholesterol levels was small but may be clinicall

ISSN:1359-107X    

DOI:10.1348/135910702320645408

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

摘要:

Objectives: To describe the illness perceptions and coping mechanisms of patients with Huntington's disease (HD), and to assess their role in the well‐being of these individuals.Design: A single group, cross‐sectional study.Methods: In 77 individuals with a clinically confirmed diagnosis of HD, illness perceptions, coping mechanisms, motor and cognitive performance, and well‐being were assessed by means of questionnaire‐guided interviews, and subjected to correlational analyses,t‐tests and two‐stage regression analyses.Results: HD patients' illness perceptions were characterized by a strong illness identity, combined with beliefs about a long duration of HD, perceived negative consequences for their daily lives, and little hope for cure or improvement of their symptoms. In turn, the coping strategies that HD patients reported adopting to deal with their disease were comparable with those adopted by reference individuals dealing with everyday life stressful situations.Where the well‐being of HD patients is concerned, compared with Dutch community sample, HD patients scored significantly lower on measures of physical well‐being and general health. Both illness perceptions and coping mechanisms were significant predictors of patients' well‐being.Conclusions: More systematic research within a health psychology framework is justified in order to assess the role of illness perceptions and coping mechanisms in the well‐b

ISSN:1359-107X    

DOI:10.1348/135910702320645417

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

摘要:

Objectives: To explore the structure of causal beliefs about heart attack, using network analysis, in particular to determine whether there is a consensual representation and, if so, which putative causes of heart attacks were perceived as being proximal or distal causes and which were perceived to mediate the effects of other causes.Methods: A total of 107 adult respondents completed questionnaires, indicating the extent to which they perceived each of eight agents as causes of a heart attack, as well as whether they perceived that each of these eight causal agents, in turn, causally affects each of the other seven causal agents.Results: A consensual representation was produced, indicating how these eight agents were perceived as causally relating to each other, and to heart attack. Three key features were evident. First, the type of work a person does was perceived to be a distal cause of heart attack, operating mainly through stress and high blood pressure. Second, the causal impact of stress on heart attack was not seen as mediated by behaviour, but mediated via blood pressure. Third, the causal impact of genes on heart attack was perceived as unmediated by behaviour or physiological processes.Conclusions: The general public appears to share a reasonably complex view of how different agents lead to heart attack. This complexity would not be elicited by standard methods, suggesting that the network analysis method may be usefully employed as either a process or an outcome measure in health‐promotion researc

ISSN:1359-107X    

DOI:10.1348/135910702320645426

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

摘要:

Objectives: This study examined a possible explanation for the frequently reported finding that female caregivers perceive more psychological distress than do male caregivers. Our ‘identity‐relevant stress’ hypothesis asserts that feelings of incompetence with respect to caregiving are more strongly associated with psychological distress in women than in men. Women who feel competent with respect to caregiving may report levels of distress as low as that of male caregivers.Design: This study has a cross‐sectional design.Methods: Psychological distress (CES‐D) was measured in 32 female and 36 male partners of patients suffering from various types of cancer. Furthermore, partners' perceptions of caregiving performance and patients' perceptions of partners' supportive and unsupportive behaviour were assessed.Results: Only among female partners were self‐efficacy and personal accomplishment regarding caregiving found to be positively linked to distress. Also, in contrast to male partners, female partners reported more distress when they acted less supportively.Conclusion: The difference in psychological distress between female and male caregivers seems to be carried by a subgroup of partners who feel that they are not doing a very good job at

ISSN:1359-107X    

DOI:10.1348/135910702320645435

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY

ISSN:1359-107X    

DOI:10.1348/135910702320645444

出版商:Blackwell Publishing Ltd    

年代:2002

数据来源: WILEY