ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00561.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The literature on communication, compliance, and patient satisfaction is selectively reviewed. As in earlier reviews, it is concluded that dissatisfaction with communication remains widespread, as does lack of compliance with medical advice. Related factors include poor transmission of information from patient to doctor, low understandability of communications addressed to the patient, and low levels of recall of information by patients. There does not appear to be any evidence that provision of additional information leads to adverse reactions by patients. Theoretical approaches to communication and compliance are described, and it is concluded that these should be used to direct future research.

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00562.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Previous studies indicate that patients' worries may not be communicated very effectively to hospital staff. The current study examines whether other patients know more about surgical patients' worries than the nursing staff on the ward. For each patient, the patient, a nurse and a colleague‐patient completed a checklist to describe the patients' worries. The results showed that the other patients were more accurate than the nurses both in terms of overall accuracy and, more tentatively, using signal detection theory estimates of sensitivity. As in a previous study, the nurses overestimated the number of worries; the overestimation did not appear to be related to the content of the items nor was it due to patients' underreporting of problems. Relationships between patients, both on the surgical ward and in self‐help groups, are discus

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00563.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

This study investigated the relationship between women's expectations of control during labour and the experience of childbirth. The women's expectations about their personal ability and about the ability of the staff to exercise control over, labour were examined. It was predicted that women who attended childbirth preparation classes would be less anxious about, and anticipate more control over, labour than non‐attenders. Among the attenders, perceived personal control was expected to be related to self‐reports of a more satisfying and less painful birth, while among the non‐attenders beneficial effects were expected to be associated with greater perceived staff control. It was found that class attendance was associated with enhanced perception of personal and staff control but not with decreased anxiety. Class attendance and perceptions of personal and staff control predicted less painful (but not more satisfying) labour. A multiple regression analysis indicated that in the sample as a whole, perception of staff control was the single best predictor of reported discomfort. As expected, this was not equally true of attenders and non‐attenders. Perceived staff control was a better predictor of reported discomfort in non‐attenders while among class attenders perceptions of personal control were closely associated with the later reported experience of d

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00564.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Sixty hysterectomy patients were randomly assigned to one of three types of psychological preparation prior to surgery, while an additional 10 patients declined psychological help. Twenty patients received information about the surgical procedure and its effects, another 20 were instructed in a cognitive coping technique, and the remainder were given general information about the ward. Interventions were shown to have different effects on a number of pre‐ and post‐surgical measures; notably on knowledge about hysterectomy, analgesic usage, reported days of pain after discharge, and belief in the usefulness of intervention methods. Whereas information about surgery enhanced knowledge and usefulness ratings, cognitive coping appeared to have most effect on indices of recovery. Patients declining preparation responded badly immediately after surgery, but made a satisfactory recovery after discharge. Cognitive coping methods seem to be an effective way of managing specific worries about the operation, and it is suggested that this underlies differences in patterns of recovery following surg

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00565.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

The literature on direct behavioural interventions to reduce two coronary risk factors, Type A behaviour and essential hypertension, is reviewed. It is concluded that there is preliminary evidence that the alteration of Type A behaviour is possible and that such alteration is associated with a reduction in the risk of recurrence of myocardial infarction. It is also concluded that reductions in blood pressure can be achieved using behavioural techniques and that such reductions persist for at least 12 months. The exact components of an effective treatment package for essential hypertension are not yet fully established but it is suggested that live relaxation training and stress management techniques are an important part of effective therapy. The positive therapeutic effects obtained in the behavioural treatment of essential hypertension are unlikely to be due to either non‐specific effects of therapy or to altered compliance with pharmacological treatment. Reductions in blood pressure of the order obtained in the relaxation and stress management studies could be expected to lead to significant gains in health, including reductions in cardiovascular morbidity, if they are sustained for long period

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00566.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

One hundred and seven obese patients with essential hypertension from eight general practices received one of the following psychological group therapy procedures: (1) modification of nutritional patterns; (2) modification of nutritional patterns plus self‐monitoring of blood pressure and training in social competence; (3) modification of nutritional patterns plus Jacobson's relaxation training; (4) information about the causes and consequences of high blood pressure. An approximately equal number of patients served as a waiting‐control group. All patients had received pharmacological treatment for at least a year. Each procedure was administered by a psychologist with groups of up to 15 patients in 12 weekly sessions. The blood pressure values measured before and after intervention showed a clear reduction; this fall is greatest when the initial values were high. Even when the magnitude of the initial values was statistically controlled there was a distinctly greater reduction in blood pressure in the treatment groups than in the waiting‐control group. No differential effect between the various therapy procedures could be demonstrated, however. The changes in general health behaviour of the treatment groups was statistically confirmed. In addition, there was a distinct reduction in body weight. Medication compliance also improved in the treatment groups. Since group procedures were accepted both by the doctors and the patients involved, they should be included to a great extent in the basic care of hypertensive patients in the f

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00567.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

This study was designed to examine the links between psychological characteristics and mild essential hypertension. Hypertensives were identified through mass screening of industrial populations. Sixteen men under the age of 56 whose blood pressure remained above 145/90 (145/95 for the 45 − 55 age group) on three separate occasions were compared with 13 age‐matched normotensives from the same population. Participants completed a series of personality questionnaires, and carried out concurrent mood ratings and blood pressure self‐monitoring four times daily for 14 days. Subjects remained unaware of their diagnostic status until the procedure was completed. No differences between groups were found on measures of trait anxiety, total hostility or direction of hostility. State anxiety and Type A (coronary‐prone) scores were significantly higher in normotensives than in hypertensives. Analysis of mood and self‐monitored blood pressure revealed consistent correlations between negative mood and higher pressure in both groups. Comparison of correlations between blood pressure, tension and anger with the correlations of pressure with a control mood scale permitted spurious associations based on expectancies or reporting biases to be distinguished from genuine effects. Only the correlation between tension and systolic pressure in the hypertensive group exceeded the correlation with the control mood scale. Self‐monitored pressure also correlated with pressure levels recorded in the laboratory. These results suggest that examination of blood pressure variations and psychological factors on a longitudinal basis may be valuable, particularly in the development of self‐management procedures for essential

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00568.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

This review outlines a behavioural view of chronic pain, in which pain behaviours are considered as operants. This view is supported by experiments in which pain behaviour is shown to be under the influence of environmental factors. The number of exercises performed by pain patients working to tolerance tend to be in multiples of five, rather than following a chance distribution. The exercise deficit seen in pain patients under conditions where exercises are counted does not occur when feedback is removed, and under these circumstances pain patients do not differ from normals. Other studies show that tolerance can be increased by verbal reinforcement, and that pain ratings are influenced by the presence or absence of a patient's spouse. Implications of these findings for the maintenance or reduction of chronic pain are discussed.

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00569.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

Studies of the effectiveness of operant, relaxation, cognitive, and multimodal behavioural approaches to the treatment of chronic benign pain other than headache were evaluated. In general, the quality of the studies was poor, and most investigations lacked appropriate and adequate control conditions, outcome measures, and/or follow‐ups. While outcome reports for all four behavioural treatments have been mainly positive, few data were found which conclusively demonstrate that any of the approaches are effective or that they are the treatment of choice. The data do, however, imply that behavioural approaches may help patients lead more normal and productive lives. Specifically, the literature suggests that: (1) the operant method leads to increased activity levels and decreased pain and drug intake, (2) the relaxation approach results in decreased EMG levels and some pain reductions, (3) the cognitive techniques are speculative at this time, and (4) the multimodal method regularly produces a variety of improvements, but the diversity of the treatments makes general statements about utility impossible. It is concluded that behavioural treatments for pain are warranted in the clinic and that research dealing with effectiveness and subsequently with component analyses of treatments is badly neede

ISSN:0144-6657    

DOI:10.1111/j.2044-8260.1982.tb00570.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY