ISSN:1359-107X    

DOI:10.1111/bjhp.12124

年代:2015

数据来源: WILEY

摘要:

ObjectivesSelf‐affirmation (e.g., by reflecting on important personal values) has been found to promote more open‐minded appraisal of threatening health messages in at‐risk adults. However, it is unclear how self‐affirmation affects adolescents and whether it has differential effects on the impact of these messages amongst those at relatively lower and higher risk. The current study explored moderation by risk.DesignParticipants were randomly assigned to either a self‐affirmation or a control condition before receiving a health message concerning physical activity.MethodsOlder adolescents (N = 125) completed a self‐affirmation or control writing task before reading about the health consequences of not meeting recommendations to be physically active for at least 60 min daily. Most of the sample did not achieve these levels of activity (98%,N = 123). Consequently, the message informed these participants that – unless they changed their behaviour – they would be at higher risk of heart disease. Participants completed measures of responses to the message and behaviour‐specific cognitions (e.g., self‐efficacy) for meeting the recommendations.ResultsFor relatively inactive participants, self‐affirmation was associated with increased persuasion. However, for those who were moderately active (but not meeting recommendations), those in the self‐affirmation condition were less persuaded by the message.ConclusionsWhilst self‐affirmation can increase message acceptance, there are circumstances when the open‐mindedness it induces may decrease persuasion. The evidence provided in this study suggests that caution may be needed when recommendations are challenging and it could be considered reasonable to be sceptical about the need to change behaviour.Statement of contributionWhat is already known on this subject?Self‐affirmation can facilitate open‐mindedness and sensitivity to whether health messages suggest high or low risk on the basis of current behaviour.What does this study add?Demonstrates that self‐affirmation effects can be moderated by the extent of failure to meet recommendations.Shows that self‐affirmation can be associated with less persuasion whe

ISSN:1359-107X    

DOI:10.1111/bjhp.12090

年代:2015

数据来源: WILEY

摘要:

ObjectiveThis study aimed to explore the experience of writing about a traumatic birth experience and sharing it online.MethodTwelve women who had submitted their stories about traumatic birth experiences to theBirthTraumaAssociation for online publication were interviewed about their experiences. Women were interviewed shortly after writing but before posting and again 1 month after the story was posted online. All participants completed both interviews. These were transcribed and analysed using template analysis.ResultsWomen described varied reasons for writing and sharing their stories, including wanting to help themselves and others. The process of writing was described as emotional, however was generally seen as a positive thing. Aspects of writing that were identified as helpful included organizing their experiences into a narrative, and distancing themselves from the experience.ConclusionWriting and posting online about a traumatic birth is experienced positively by women. It may be a useful self‐help intervention and is worthy of systematic evaluation. The mechanisms through which writing is reported to have impacted as described in the interviews link to the mechanisms of change in cognitive‐behavioural approaches to post‐traumatic symptoms.Statement of contributionWhat is already known on this subject?Some women develop post‐traumatic stress disorder‐like symptoms following birth. These can impact on both themselves and their family, yet these women may not seek professional help. Writing about a traumatic event may be a useful approach for reducing post‐traumatic stress symptoms, but the impact of online sharing is unknown.What does this study add?This study demonstrates that women report benefits from writing about their birth experiences.Writing enabled organizing the experience into a narrative and distancing from the trauma, which was helpful.Sharing the story online was an emotional experience for participants, however was generally see

ISSN:1359-107X    

DOI:10.1111/bjhp.12093

年代:2015

数据来源: WILEY

摘要:

ObjectivesThe aim of this paper was to explore how patients experience an initial oncology consultation. This study was part of a larger mixed methods research project designed to address the issue of improving communication and enhancing patient satisfaction with oncology consultations.DesignInterpretive phenomenological analysis was used to interpret the participants' meanings of their experiences in their initial consultation. It is an idiographic approach that focuses in depth on a small set of cases in order to explore how individuals make sense of a similar experience. This retains the complexity and diversity of experiences.MethodsIn the larger study, semi‐structured interviews were carried out with 36 patients as soon as possible after a consultation in oncology to explore their experiences. Five cases were selected for this study on the basis of homogeneity; they had all undergone some prior investigations of their illness, and this was their first consultation in oncology; they all provided rich accounts relating to how they had experienced the consultation.ResultsPatients' experiences of being given their diagnosis differed both between participants and within the same participant. Various defences seemed to be used in order to protect them from fully engaging with the knowledge they were given. Their accounts of what they wished to know in the consultation could be affected by a desire to protect themselves and/or family members from distress and by the practical need to know that may vary over time.ConclusionThe complexity of patients' needs and preferences regarding information means that the doctor's role in communicating that information in a patient‐centred way is difficult. The findings are discussed in relation to open awareness theory as to how the emotional context of the consultation process affects information needs. Doctors need strategies to elicit information from patients about their needs from the consultation. This needs to be done at the start of consultations and throughout investigations and treatment, as needs may change over time.Statement of contributionWhat is already known on this subject?Patients' desire to know information is sometimes tempered with by a desire to avoid distress to themselves.Patients do not always understand or make accurate sense of what they have been told.Receiving a diagnosis of cancer is distressing for patients.What does this study add?Doctors need strategies to elicit information from patients about their needs for each consultation. This needs to be done consistently throughout the patient journey as needs may change over time.Patients control what they do or do not do with information but do not openly share this with the doctor.Our interpretations of the interviews stray beyond the conscious accounts of the consultations and draw on (unconscious) absences that may also be of significance in making sense of overall experience.The complexity of patients' needs and preferences regarding information means that the doctors' role is very difficult.Patients have a right to know but not a duty to know their diagnosis and progno

ISSN:1359-107X    

DOI:10.1111/bjhp.12096

年代:2015

数据来源: WILEY

摘要:

ObjectivesThis study explored whether self‐esteem would moderate the effectiveness of a self‐affirmation manipulation at increasing openness to personally relevant health‐risk information.DesignThe study employed a prospective experimental design.MethodParticipants (N = 328) completed either a self‐affirmation manipulation or a control task, prior to reading information detailing the health‐related consequences of taking insufficient exercise. They then completed a series of measures assessing their cognitions towards exercise and their derogation of the information. Exercise behaviour was assessed at 1‐week follow‐up.ResultsSelf‐esteem moderated the impact of self‐affirmation on the majority of outcomes. For participants with low self‐esteem, the self‐affirmation manipulation resulted in more positive attitudes and intentions towards exercise, together with lower levels of derogation of the health‐risk information. By contrast, there was no effect of the self‐affirmation manipulation on outcomes for participants with high self‐esteem.ConclusionFindings suggest that self‐affirmation manipulations might be of particular benefit for those with low self‐esteem in terms of promoting openness towards health‐risk information. This is promising from a health promotion perspective, as individuals with low self‐esteem often represent those most in need of intervention.Statement of contributionWhat is already known on this subject?Self‐affirmation has been shown to result in more open processing of personally relevant health‐risk information.Individuals low in self‐esteem tend to process such information more defensively than those high in self‐esteem.What does this study add?It explores whether self‐esteem moderates the impact of self‐affirmation on responses to health‐risk information.Findings suggest that individuals with low self‐esteem benefit most from the self‐affirmation manipulation.This has important applied implications, as individuals w

ISSN:1359-107X    

DOI:10.1111/bjhp.12097

年代:2015

数据来源: WILEY

摘要:

ObjectivesThe quality of life (QoL) of children with sickle cell anaemia (SCA) in the United Kingdom has not been examined, and a discrepancy measure based on Gap theory has rarely been used. This study investigated whether (1) child self‐reports of QoL using a discrepancy measure (the Generic Children's QoL Measure;GCQ) are lower than those from healthy children, (2) proxy reports from parents and health care professionals are lower than child self‐reports, and (3) demographic and disease severity indicators are related to QoL.Design and methodsAn interdependent groups, cross‐sectional design was implemented. Seventy‐four children withSCA, their parent, and members of their health care team completed theGCQ. Demographic and disease severity indicators were recorded.GCQdata from healthy children were obtained from theUKData Archive.ResultsContrary to past research, when examining generic discrepancy QoL, children withSCAdid not report a lower QoL than healthy children, and parent‐ and health care professional‐proxy reports were not lower than child self‐reports. Few of the demographic and disease severity indicators were related to QoL.ConclusionsProxy reports may be used to gain a more complete picture of QoL, but should not be a substitute for self‐reports. The explanation for the relatively high levels of QoL reported is not clear, but children withSCAmay have realistic expectations about their ideal‐self, place greater emphasis on aspects other than health in shaping their QoL, and define achievements within the limits of their illness. Future research should focus on psychological factors in explaining QoL.Statement of contributionWhat is already known on this subject?Children with sickle cell disease (SCD) generally have a reduced QoL compared with healthy children, but there appears to be no research measuring QoL in paediatricSCDin the United Kingdom.Proxy QoL reports from parents are often lower than child self‐reports, but there is less research examining proxy reports from health care professionals.Previous research has measured paediatric QoL using measures of current health‐related QoL, but this is not in line with theWHO's definition of QoL as the discrepancy between current state and expectations.What does this study add?Children with Sickle cell anaemia do not have an impaired discrepancy QoL; they may have realistic expectations about their ideal‐self and define achievements within the limits of their illness.Health care professionals are able to gauge aSCAchild's discrepancy QoL better than parents.TheGCQ(a generic discrepancy measure of QoL) takes into account expectations about ideal QoL and does not emphasize health; it may be of use to Psychologists

ISSN:1359-107X    

DOI:10.1111/bjhp.12099

年代:2015

数据来源: WILEY

摘要:

ObjectivesPrototypes (i.e., social images) predict health‐related behaviours and intentions within the context of the Theory of Planned Behaviour (TPB). This study tested the moderating role of temporal stability of drinker prototype perceptions on prototype–intentions and prototype–behaviour relationships, within an augmentedTPB. The study examined abstainer, moderate drinker, heavy drinker, tipsy, and drunk prototypes.Design and MethodsAn online prospective study with 1‐month follow‐up was conducted among 410 young adults (18–25 years old,Mage = 21.0,SD = 2.14, 21.7% male). Assessed were prototype perceptions (favourability and similarity,T1,T2), stability of prototype perceptions,TPBvariables (T1), intentions (T2), and drinking behaviour (T2). Intention analyses were corrected for baseline behaviour; drinking behaviour analyses were corrected for intentions and baseline behaviour.ResultsHierarchical regressions showed that prototype stability moderated the relationships of drunk and abstainer prototype similarity with intentions. Similarity to the abstainer prototype explained intentions to drink sensibly more strongly among individuals with stable perceptions than among those with unstable perceptions. Conversely, intentions were explained stronger among individuals with stable perceptions of dissimilarity to the drunk prototype than among those with unstable perceptions. No moderation effects were found for stability of favourability or for relationships with behaviour.ConclusionsStable prototype similarity perceptions were more predictive of intentions than unstable perceptions. These perceptions were most relevant in enhancing the explanation of young adults' intended drinking behaviour. Specifically, young adults' health intentions seem to be guided by the dissociation from the drunk prototype and association with the abstainer prototype.Statement of contributionWhat is already known on this subject?Prototypes have augmented the Theory of Planned Behaviour in explaining risk behaviour.Temporal stability has been shown to successfully extend theTPBin explaining intentions.Temporal stability ofTPBvariables can moderate the relationships with behaviour and intentions.What does this study add?Stability of prototype perceptions moderates the prototype–intentions relationship.Stability of abstainer and drunk prototype similarity enhances the explanation of (intentional) drinking.Stable prototype perceptions are more explanatory than un

ISSN:1359-107X    

DOI:10.1111/bjhp.12101

年代:2015

数据来源: WILEY

摘要:

ObjectivesDistressing imagery is often used to improve the persuasiveness of mass‐reach health promotion messages, but its effectiveness may be limited because audiences avoid attending to content. Prior self‐affirmation or self‐efficacy inductions have been shown to reduce avoidance and improve audience responsiveness to distressing messages, but these are difficult to introduce into a mass‐reach context. Reasoning that a behavioural recommendation may have a similar effect, we reversed the traditional threat‐behavioural recommendation health promotion message sequence.Design2 × 2 experimental design:Factor 1, high‐ and low‐distress images;Factor 2, threat‐recommendation and recommendation‐threat sequences.MethodsNinety‐one students were exposed to an identical text message accompanied by high‐ or low‐distress imagery presented in threat‐recommendation and recommendation‐threat sequences.ResultsFor the high‐distress message, greater persuasion was observed for the recommendation‐threat than the threat‐recommendation sequence. This was partially mediated by participants’ greater self‐exposure to the threat component of the message, which we attribute to the effect of sequence in reducing attentional avoidance. For the low‐distress message, greater persuasion was observed for the threat‐recommendation sequence, which was not mediated by reading time allocated to the threat.ConclusionsTailoring message sequence to suit the degree of distress that message developers wish to induce provides a tool that could improve persuasive messages. These findings provide a first step in this process and discuss further steps needed to consolidate and expand these findings.Statement of contributionWhat is already known on this subject?Health promotion messages accompanied by distressing imagery might, under some circumstances, persuade individuals to engage in healthier behaviour.Audiences can respond defensively to distressing imagery, but may be less inclined to do so when an easily followed behavioural recommendation is presented before imagery.Current literature is divided on whether presenting a behavioural recommendation before a threat component accompanied by distressing images will improve the persuasiveness of messages.What does this study add?We show that, when a behavioural recommendation precedes a threat containing distressing images, persuasiveness of a threatening message is stronger than a threat‐recommendation sequence.We show that a recommendation‐threat sequence improves persuasiveness of distressing

ISSN:1359-107X    

DOI:10.1111/bjhp.12103

年代:2015

数据来源: WILEY

摘要:

ObjectivesAlthough non‐invasive ventilation (NIV) can benefit survival and quality of life, it is rejected by a substantial proportion of people with motor neurone disease (MND). The aim of this study was to understand why someMNDpatients decline or withdraw fromNIV.MethodNine patients withMND(male = 7, mean age = 67 years) participated in this study. These patients, from a cohort of 35 patients who were offeredNIVtreatment to support respiratory muscle weakness, did not participate inNIVtreatment when it was clinically appropriate. Semi‐structured interviews and interpretative phenomenological analysis (IPA) were employed to explore these patient's experience ofMNDand their thoughts and understanding ofNIVtreatment.ResultsUsingIPA, four themes were identified: preservation of the self, negative perceptions ofNIV, negative experience with health care services, and not needingNIV. Further analysis identified the fundamental issue to be the maintenance of perceived self, which was interpreted to consist of the sense of autonomy, dignity, and quality of life.ConclusionsThe findings indicate psychological reasons for disengagement withNIV. The threat to the self, the sense of loss of control, and negative views ofNIVresulting from anxiety were more important to these patients than prolonging life in its current form. These findings suggest the importance of understanding the psychological dimension involved in decision‐making regarding uptake ofNIVand a need for sensitive holistic evaluation ifNIVis declined.Statement of contributionWhat is already known on this subject?Non‐invasive ventilation is widely used as an effective symptomatic therapy inMND, yet about a third of patients decline the treatment.Psychological disturbance generated byNIVuse leads to negative experiences of the treatment.Decision‐making about treatment potentials is complex and unique to each individual affected by perceived impact of disease.What does this study add?A decision concerningNIVuptake was influenced by perceived impact on individuals' sense of self.Sense of self was influenced by the maintenance of autonomy, dignity, and quality of life.Individuals' sense of self was identified to have been challenged by the disease,NIV, and their experience of healt

ISSN:1359-107X    

DOI:10.1111/bjhp.12104

年代:2015

数据来源: WILEY

摘要:

ObjectivesThe current study sought to explore the indirect association of spousal overprotection on patient dietary adherence through the mechanism of diabetes distress and whether the link between overprotection and diabetes distress was moderated by spouse active engagement.MethodParticipants were 117 married couples in which one member had been diagnosed with type 2 diabetes and were recruited from a patient registry at a Midwestern (USA) medical centre. Data were gathered from spouses and patients through a self‐report survey instrument. The research questions were answered with structural equation modelling using the latent moderated structural equations (LMS) approach and dyadic data analytic procedures.ResultsOverprotection was associated with reduced dietary adherence indirectly via increased diabetes distress only at low levels of active engagement. The proposed model also proved superior when compared to two plausible alternatives.ConclusionsThese findings highlight the importance of understanding the nuanced associations among the different ways spouses cope with illness to achieve better diabetes outcomes and the mechanisms responsible for linking coping and dietary adherence.Statement of contributionWhat is already known on this subject?Spousal coping behaviour can influence dietary adherence among patients diagnosed with type 2 diabetes, positively and negatively.Spouses simultaneously engage in different ways of coping with partner illness, but little is known about the interactive nature of coping styles or possible mechanisms that might link coping with illness outcomes.What does this study add?Spousal overprotection is only associated with reduced patient dietary adherence when spouses are also engaging in low levels of active engagement.Diabetes distress is an important mechanism linking spousal coping with patient dietary adherenc

ISSN:1359-107X    

DOI:10.1111/bjhp.12105

年代:2015

数据来源: WILEY