摘要:

ObjectiveThe aims of this study were twofold: to determine in what way people with a non‐fatal chronic illness experience positive change after the onset of their illness, and to determine whether comparing with other people with Ménière's disease influenced perceiving this change.DesignUsing a longitudinal method, questionnaires were administered at baseline and at ten‐month follow‐up.MethodAt both time points 301 people with Ménière's disease completed the Posttraumatic Growth Inventory and at baseline they also completed questionnaires measuring, demographic variables, disease severity, psychological variables (self‐esteem, perceived control, and optimism), and social comparison variables.ResultsPeople with Ménière's disease in this study perceived positive change. Greater positive change was perceived on the domain of ‘appreciation of life,’ followed by ‘relating to others,’ ‘personal strength,’ ‘new possibilities,’ and ‘spiritual change’. In addition, more change was perceived at follow‐up than at baseline. Social comparison was associated with perceiving change at both time points.ConclusionsPeople with Ménière's disease do perceive positive change. Perceiving change is an on‐going process for people with Ménière's disease, as they perceived more change over time. Social comparison was related to the perception of change, in particular, to the

ISSN:1359-107X    

DOI:10.1348/135910708X383598

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

BackgroundMany theories of behaviour are potentially relevant to predictive and intervention studies but most studies investigate a narrow range of theories. Michieet al.(2005) agreed 12 ‘theoretical domains’ from 33 theories that explain behaviour change. They developed a ‘Theoretical Domains Interview’ (TDI) for identifying relevant domains for specific clinical behaviours, but the framework has not been used for selecting theories for predictive studies. It was used here to investigate clinicians' transfusion behaviour in intensive care units (ICU). Evidence suggests that red blood cells transfusion could be reduced for some patients without reducing quality of care.Objectives(1) To identify the domains relevant to transfusion practice in ICUs and neonatal intensive care units (NICUs), using the TDI. (2) To use the identified domains to select appropriate theories for a study predicting transfusion behaviour.MethodsAn adapted TDI about managing a patient with borderline haemoglobin by watching and waiting instead of transfusing red blood cells was used to conduct semi‐structured, one‐to‐one interviews with 18 intensive care consultants and neonatologists across the UK.ResultsRelevant theoretical domains were:knowledge,beliefs about capabilities,beliefs about consequences,social influences, behavioural regulation. Further analysis at the construct level resulted in selection of seven theoretical approaches relevant to this context: Knowledge‐Attitude‐Behaviour Model, Theory of Planned Behaviour, Social Cognitive Theory, Operant Learning Theory, Control Theory, Normative Model of Work Team Effectiveness and Action Planning Approaches.ConclusionsThis study illustrated, the use of the TDI to identify relevant domains in a complex area of inpatient care. This approach is potentially valuable for selecting theories relevant to predictive studies and resulted in greater breadth of potential explanations than would be achieved if a single theoretical model

ISSN:1359-107X    

DOI:10.1348/135910708X397025

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

Organ donation is the only available treatment for end‐stage failure of organs such as liver, lung, and heart and therefore increasing the number of organ donors is a priority for most countries. One measure that could be taken by a country to increase the number of organ transplants is to introduce the opt‐out system of organ donation. Public opinion is divided on this issue and policy makers need to tread with caution before introducing legislation. This paper proposes that understanding the social representations the public has of organ donation is important in taking the right policy decisions. We propose here that an in‐depth study of the views held by people on the issue is essential in this regard and that this can best be done by investigating the metaphors people use to describe organ donation, interpreted within the theory of social representation. In this study, the social representations of organ donation were investigated through five focus groups with 57 participants living in Malta. Analysis of the transcriptions of these focus groups yielded pertinent issues related to organ donation. Moreover, metaphors of organ donations and how these were related to social representations of the body and attitudes towards the opt‐out system are discussed. It is being suggested that these findings could be of relevance to the present discussion on the opt‐out system in the UK and in other

ISSN:1359-107X    

DOI:10.1348/135910708X397160

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectivesLung recipients undergo a complex psychological process, including organ integration and processing of attitudes towards the organ donor.DesignSeventy‐six lung recipients were asked to participate in a cross‐sectional questionnaire study on the psychological processing of lung transplants.MethodsThe questionnaire consisted of statements describing aspects of organ integration and the patient's relationship with the donor. Furthermore, chronic stress/psychological distress (Screening Scale of the Trier Inventory; Symptom Checklist SCL‐K‐9) and the emotional effects of transplantation/immunosuppression (Transplant Effects Questionnaire; Medication Experience Scale for Immunosuppressants) were assessed.ResultsIn general, lung recipients perceive the transplant as part of themselves (97.4%) and not as a foreign object (90%). One‐third of patients still have frequent thoughts about the donor, whilst the majority (80.3%) do not believe that they have adopted the donor's characteristic traits. Factor analysis reveals the two‐dimensional structure of the questionnaire items ‘organ integration’ (factor 1) and ‘relationship to the donor’ (factor 2). Poor organ integration predicts low adherence, low disclosure and high feelings of guilt, whilst a close donor relationship predicts chronic stress and psychological distress.ConclusionsPoor organ integration and a close relationship to the donor should be borne in mind in psychosocial treatment regarding the patient's adherence behaviour and psy

ISSN:1359-107X    

DOI:10.1348/135910708X399447

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectivesTheory and research suggest that the intention to smoke is the main determinant of smoking initiation and emphasizes the role of cognitive and social factors on the prediction of the intention to smoke. However, extended models such as the I‐Change and results from published studies reveal inconsistencies regarding the impact of social influence on the intention to smoke. Possible explanations for this may be the definition and measurement of the constructs that have been used.Design and methodsThe current study was designed with two main goals: (i) to test a measurement model for social influence, combining different types of social influence (subjective norms, perceived behaviour, and direct pressure) with various referents of influence (parents, siblings, peers, and teachers); (ii) to investigate the impact of social influence on adolescent intention to smoke, controlling for smoking behaviour. LISREL was used to test these models. The sample includes 3,064 Portuguese adolescents, with a mean age of 13.5 years, at the beginning of the seventh school grade.ResultsThe hypothesized measurement model of social influence was supported by results and explained 29% of the variance of the intention to smoke. A more extended model, including attitude and self‐efficacy, explained 55% of the variance of the intention to smoke. Perceived behaviour of peers, parental norms, and perceived behaviour of parents were the social influence factors with impact on adolescent intention to smoke.ConclusionsResults suggest that different referents exert their influence through distinct types of social influence and recommend further work on the definition and measurement of social influe

ISSN:1359-107X    

DOI:10.1348/135910709X421341

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectivesTo determine the influence of trait anxiety on patient reports of health‐related quality of life (HRQoL) and post‐traumatic stress symptoms (PTSS) in a sample of rectal cancer survivors.DesignEighty patients who had been diagnosed with rectal cancer were assessed at two points in time in a longitudinal study.MethodsAt Time 1, soon after initial treatment, participants completed the State‐Trait Anxiety Inventory and the Temperament and Character Inventory Harm Avoidance scale, which were combined into a composite measure of trait anxiety. At Time 2, 2–5 years following Time 1, participants were assessed for HRQoL using the Functional Assessment of Cancer Therapy‐Colorectal scale (FACT‐C) and for PTSS using the Impact of Event Scale‐Revised (IES‐R).ResultsHRQoL and PTSS were generally favourable on average, although many of the patients reported faring poorly. Higher levels of trait anxiety were predictive of poorer scores on all of the FACT‐C and the IES‐R total and subscale measures. More severe faecal incontinence was associated with poorer scores on the FACT Emotional well‐being subscale, the FACT‐Colorectal Cancer Scale, and all of the IES‐R scales. Males were more likely than females to have poorer scores on the FACT Social well‐being subscale, and those patients who were further out from active treatment had more favourable scores on the FACT‐Colorectal Cancer Scale. The presence of a colostomy did not impact HRQoL or PTSS.ConclusionTrait anxiety had a significant influence on HRQoL and PTSS several years following diagnosis a

ISSN:1359-107X    

DOI:10.1348/135910708X400462

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectivesObesity has been shown to be negatively related to physical health‐related quality of life (HQOL) much more strongly than mental HQOL. This is remarkable given findings on obesity‐related social stigmata and associations with depression. Considering obesity as a stressor, this study tests for a moderating role of social support for obesity/HQOL associations among women and men.DesignData come fromN=2,732 participants aged 35–74 years in a 2004–2005 general population survey in the Augsburg region, Germany.MethodsBody weight and height were assessed by anthropometric measurements (classified by body mass index using WHO standards), social support by the Social Support Questionnaire 14‐item Short‐Form (F‐SozU‐K14) and HQOL by the 12‐item Short‐Form Health Survey (SF‐12). In multiple regression and general linear models, age, education, family status, health insurance, and place of residence were adjusted for.ResultsAmong both genders, obesity was associated with reduced physical but not mental HQOL. Among men reporting strong social support, physical HQOL was impaired neither in the moderately nor the severely obese group (compared with normal weight), while it was given less social support. Among women, poor physical HQOL was associated with obesity regardless of social support.ConclusionsIn this adult population sample, no association was found for obesity with mental HQOL. In contrast, a negative association with physical HQOL exists for all subgroups except men with strong social support, indicating that social support buffers obesity‐related impairments in physical HQOL in men but not in women. This suggests that obese women and men with strong social support represent distinct populations, with possible implic

ISSN:1359-107X    

DOI:10.1348/135910708X401867

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectivesA predominantly quantitative approach to the psychological study of chronic low back pain (CLBP) has shown that enduring negative emotional responses and passive coping strategies contribute towards disability. The main objective of this study was to extend existing knowledge by providing a detailed and contextualized understanding of the meaning of CLBP for participants with long‐standing experiences of chronic pain.DesignThis is a qualitative, semi‐structured interview study. The data were analysed using interpretative phenomenological analysis (IPA). This is the first of three sets of individual interviews comprising a longitudinal study of the same participants over 3 years.MethodsTen patients with CLBP were interviewed prior to their attendance at a medically staffed chronic pain clinic. The sample comprised seven females and three males. Ages ranged between 39 and 66 years. All had experienced CLBP for at least 4 years.ConclusionsThe participants' experiences are represented by three main themes: ‘maintaining integrity’, ‘the crucial nature of the pain’ and ‘managing the pain’ that highlight participants' understanding of their pain within a biomedical framework. The findings are discussed with reference to the role of illness beliefs in the man

ISSN:1359-107X    

DOI:10.1348/135910709X402612

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectiveDyspnea is defined as anuncomfortableawareness of the need to breathe. Verbal report of dyspnea can be a valuable source of diagnostic information. However, little is known about the cognitive representation of respiratory sensations and about their affective evaluation in individuals not suffering from respiratory disease. Such knowledge would be important in evaluating the comparability of respiratory sensation report between healthy controls and patient groups.MethodFive hundred and eighty‐two healthy individuals rated 20 descriptors of respiratory sensation with regard to frequency, valence, and situational incidence. Ratings were analysed on the level of subgroups of items found with cluster analysis and Multidimensional Scaling (MDS).ResultsNot all respiratory sensations commonly subsumed under dyspnea are perceived to be uncomfortable by healthy individuals. Two higher‐order clusters were found, interpreted as (1)compensation of dyspneaand (2)breathing deficiencies. Breathing deficiencies were unknown by approximately 50% of participants and rated to be less frequent and more uncomfortable than compensation of dyspnea. Furthermore, three dimensions of respiratory sensations were found using MDS interpreted as (1) fit between need for air and actual breathing, (2) effort, and (3) attempt of voluntary control.ConclusionThe extent to which respiratory sensation ratings can be compared between patients and healthy individuals is limited. Latent dimensions of dyspnea might be less affected by differences in interpretation and evaluation of language descriptors of dyspnea and could help to assess comparability of sensation report between groups with different experiential background regarding breathlessn

ISSN:1359-107X    

DOI:10.1348/135910709X412800

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY

摘要:

ObjectiveWe applied Antonovsky's salutogenic model to healthy ageing. Basically, salutogenic theory states that generalized resistance resources build‐up the sense of coherence which in turn determines an individual's health level. Specifically, we explored the status of the sense of coherence as a mediator variable.Design and MethodWe conducted a cross‐sectional questionnaire study with 387 volunteering elders (73.4% women and 22.2% nursing home residents) at the mean age of 74 (SD=7.58) years. We assessed 19 bio‐psychosocial resources, the sense of coherence, and three subjective health measures – psychological health, symptom reporting, and physical health. As nursing home residents were generally inferior, our study controlled for dependent living.ResultsResources, sense of coherence, and subjective health were significantly inter‐related. A regression showed that optimism, self‐esteem, low depressive mood, self‐efficacy, and social support predicted the sense of coherence significantly. Predicting psychological health and symptom reporting, the sense of coherence remained significant when resources were added in the final step of the regression. This pattern was not found for physical health. Mediator analyses using Preacher and Hayes' paradigm showed that every eligible resource influenced both psychological health and symptom reporting, but not physical health, indirectly via the sense of coherence.ConclusionThe sense of coherence is largely shaped by individual difference variables. As a mediator variable, it strongly accounts for the relation between resources and psychogenic aspects of health, whereas its relative significance for physical health is not corroborated. Our findings emphasize the importance of resource‐oriented health

ISSN:1359-107X    

DOI:10.1348/135910709X413124

出版商:Blackwell Publishing Ltd    

年代:2009

数据来源: WILEY