摘要:

Cultural assumptions about motherhood create an artificial dichotomy between the normal, happy, mother and the pathological experience of post‐partum depression. However, the evidence suggests that it is more reasonable to see post‐partum depression as one end of a continuum of normal adjustments to motherhood. While some postpartum psychiatric conditions do seem to be hormonally mediated, non‐psychotic postpartum depression is not qualitatively different from other forms of depression, and is best explained by inadequate social support, high workloads, and unrealistic expectations about motherhood. This paper reviews the evidence on post‐partum depression and on the normal experiences of new mothers, showing that new motherhood is a major life‐event which poses extensive adjustment problems for most women. Cultural expectations that family caring is naturally women's work, and that it is easy and stress free, mean that many mothers suffer a combination of work overload and guilt. A change in social expectations, greater involvement by fathers, and more flexible work practices to allow parents to care for their children would contribute greatly to the alleviation of distress in the post‐partum and early mothe

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00527.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

摘要:

Objectives. This paper details the theoretical position that coping function is transactionally defined. It details the psychometric development of an instrument to assess coping function transactionally: Functional Dimensions of Coping (FDC) scale. The FDC scale permits individuals to define for themselves what functions they believe their coping behaviours/styles perform. Four functions are used: approach, avoidance, reappraisal and emotional regulation. It was hypothesized that a four‐factor model would be a better fit to the data than other more parsimonious models (e.g. approach‐avoidance). Validity was assessed in terms of associations with health anxieties (hypochondriasis) and it was hypothesized that those who report health anxieties should perceive their coping behaviours in terms of the avoidance and reappraisal functions.Design. Two retrospective questionnaire studies (Ns = 333, 101) are reported.Methods. Survey questionnaires were distributed to two samples of undergraduate students. The data were analysed using a mixture of LISREL modelling and multiple linear regression analyses.Results. The FDC was shown to: (1) have excellent factorial validity (the four‐factor model was the best fit to the data), (2) have excellent internal psychometric properties, (3) have no significant associations with social desirability and (4) covary in predicted ways with a number of health anxieties.Conclusions. These results indicate that coping function can be assessed usefully in a transactiona

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00528.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

摘要:

This paper describes the development and piloting of the Central Middlesex Hospital Children's Health Diary (CMHCHD) for children and adolescents with sickle cell disease (SCD), and examines the reliability and validity of its key outcome measures. The diary has a semi‐structured format to be completed daily, covering general well‐being, common symptoms, pain events, coping strategies and the impact of any pain/illness events. Key summary measures consisted of total pain and impact scores for the diary‐keeping period. A pilot study was carried out with 25 children with SCD, and 25 matched controls who completed the diary for a four‐week period. Compliance with the procedure was satisfactory and adequate reliability was indicated although fatigue affects were observed during the fourth week of record keeping on some variables. The pain score had satisfactory concurrent validity with higher pain scores associated with more school absence (u= 88.5,p<.03) and greater disruption of daily life (u= 57,p<.01) and demonstrated encouraging construct validity by identifying expected higher rates of limb pain in children with SCD compared with controls (u= 196,p<.02). Parent and child interview ratings of pain frequency were not associated with quality of life measures, and could not discriminate between the clinical and non‐clinical population. Compared with both parent and child interview ratings of pain frequency, the total pain score was a more accurate predictor of the impact of pain in children's everyday life (F(47) = 10.80,p<.001). In conclusion, the CMHCHD shows considerable potential both for research, improving clinical assessment, and for enhancing coping strategies of children and their

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00529.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

摘要:

Objectives. The study examined the impact of beginning a junior house officer post on possible changes in psychological health and propensity to make errors. It was predicted that there would be a significant increase in psychological disturbance and error making following the onset of the post.Design. Questionnaires were administered at two times—prior to and eight weeks after the beginning of a junior house officer post.Methods. Thirty graduates of medicine/junior house officers were recruited from a university medical school in the UK. All participants completed the General Health Questionnaire and the Cognitive Failures Questionnaire at Times 1 and 2, as well as a Medical Errors Questionnaire at Time 2.Results. Significant increases were found in reported levels of anxiety, insomnia and somatic symptoms. There were also significant increases in the number of errors that the respondents reported making in everyday life. These everyday errors were significantly related to the reported frequency of errors made in a medical context.Conclusions. Despite recent revisions to the working hours and conditions of junior doctors in Britain, the respondents in this study were experiencing considerable increases in stressful symptoms and consequent increases in the number of errors they made. These findings suggest that further research and policy development is required to explore means of easing the transition to work for junior doctor

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00530.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

摘要:

The use of psychological interventions within medical contexts is a relatively new field. The adaptation of cognitive therapy for use in this context holds promise. However, at present the lack of a generalized cognitive model of illness behaviour is a restriction to further development. Recently developed social cognitive models of ‘normal’ illness behaviour may also be able to offer some insights into dysfunctional illness behaviour. Self‐regulation theory (Leventhal, Meyer&Nerenz, 1980) and existing cognitive models of chronic pain and health anxiety are reviewed and a new cognitive model of dysfunctional illness behaviour is proposed. A central role is given to the patient's beliefs about their illness, other beliefs, particularly about self, others and the world, and the net interaction of these two sets of beliefs which give the illness its own unique meaning for that individual. These three components are described as theillness belief triad. The model leads to specific suggestions for the clinical assessment and treatment of dysfunctional illness behaviours using cognitive behavioural interven

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00531.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

摘要:

Objectives. The Well‐Being Questionnaire, originally developed in groups with diabetes, is recommended by the World Health Organization for widespread use. This study investigates the validity of the WBQ in patients with rheumatoid arthritis (RA) using structural equation modelling.Design. Two case‐control studies, comprising postal questionnaires are described.Method. Questionnaires completed by RA patients (377) and matched controls (282) were analysed using structural equation modelling.Results. The findings suggest that the full version of the WBQ is not suitable for use in RA populations. A shorter version, measuring positive and negative well‐being fits the data better. Comparisons with matched controls and against the Hospital Anxiety and Depression Scale scores suggest that anxiety is measured well, but that the depression factor does not perform well. Positive well‐being appears to be measured well.Conclusion. Further research is necessary before the WBQ can be utilized in groups

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00532.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

摘要:

Objective. Community‐based health interventions have been shown to be effective in promoting arthritis self‐management amongst people in North America. The aim of this study was to determine the effectiveness of such programmes among older people in the UK.Design. The study was a multiple baseline, pre‐test–post‐test design of 62 older people (>55 years of age) attending Arthritis Self‐Management Programmes (ASMP) delivered in community settings.Method. Data were collected by self‐administered questionnaires at two points in time: prior to the intervention and after the intervention, four months from baseline.Results. The sample comprised 94 per cent women, with a mean age of 69 and mean disease duration of 26 years. Most participants had either osteoarthritis or rheumatoid arthritis. Results showed that after four months, participants demonstrated significant increases in arthritis self‐efficacy (p<.0005), positive affect (p= .042), cognitive symptom management (p<.0005), communication with doctors (p=<.0005), exercise (p<.0005) and relaxation (p<.0005). In addition, significant decreases were found in terms of pain (p= .026), depression (p= .042) and visits to GPs (p= .013).Conclusion. This first evaluation of the ASMP delivered in community settings suggests that this form of health intervention is not only acceptable to older people in the UK, but can offer considerable benefits in terms of arthritis self‐efficacy, increased use of self‐management strategies such as exercise, a reduction in pain and improved psych

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00533.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY

ISSN:1359-107X    

DOI:10.1111/j.2044-8287.1997.tb00534.x

出版商:Blackwell Publishing Ltd    

年代:1997

数据来源: WILEY