摘要:

Purpose.  To provide a critical review of methods used to assess human wound healing in psychological research and related disciplines, in order to guide future research into psychological influences on wound healing.Methods.  Acute wound models (skin blister, tape stripping, skin biopsy, oral palate biopsy, expanded polytetrafluoroethylene tubing), surgical wound healing assessment methods (wound drains, wound scoring), and chronic wound assessment techniques (surface area, volumetric measurements, wound composition, and assessment tools/scoring systems) are summarized, including merits, limitations, and recommendations.Results.  Several dermal and mucosal tissue acute wound models have been established to assess the effects of psychological stress on the inflammatory, proliferative, and repair phases of wound healing in humans, including material‐based models developed to evaluate factors influencing post‐surgical recovery. There is a paucity of research published on psychological factors influencing chronic wound healing. There are many assessment techniques available to study the progression of chronic wound healing but many difficulties inherent to long‐term clinical studies.Conclusions.  Researchers need to consider several design‐related issues when conducting studies into the effects of psychological stress on wound healing, including the study aims, type of wound, tissue type, setting, sample characteristics and accessibility, costs, timeframe, and facilities available. Researchers should consider combining multiple wound assessment methods to increase the reliability and validity of results and to further understand mechanisms that link stress an

ISSN:1359-107X    

DOI:10.1348/135910710X524633

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objective. The study evaluated the effects of a pros enhancing intervention on intention to uptake cervical cancer screening. It was hypothesized that the pros enhancement session (compared to an education session) would affect intentions of preintentional women, whereas it was expected to have negligible effects among women in intentional and actional stages of the health action process approach (HAPA). Thus, we tested the HAPA using stage‐matched and stage‐mismatched interventions. Further, a change in decisional balance was assumed to mediate the relationship between the group assignment and intention, with age acting as the moderator.Design and methods. Respondents (1,436 women, aged 18–60) were randomly assigned to either the intervention or control condition and filled out questionnaires before and directly after the manipulation (in one web‐based session).Results. Direct effects of the group assignment were observed only among preintentional women. Across the stages, however, change in decisional balance mediated the effects of the group assignment on the intention to uptake screening. Further, among participants in the preintentional stage, this mediation became significant only for women aged 35 or older.Conclusions. Although direct effects are in line with stage assumptions of the HAPA, meditational analysis among pre‐ and post‐intentional women indicated that similar processes accounted for post‐manipulation intention. Future research testing stage models should account for the mediating processes, which explain the effect

ISSN:1359-107X    

DOI:10.1348/135910710X499416

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objectives.  Biopsychosocial models suggest altered attention to pain plays a role in the aetiology of irritable bowel syndrome (IBS). We investigated whether attention to pain words differed in IBS participants relative to healthy controls, and whether attentional indices predicted self‐reported health and illness behaviour.Design.  A between‐subjects design was used to enable investigation of differences between an IBS participant group and a healthy participant group.Methods.  Twenty IBS participants and 33 healthy controls completed a modified version of a task commonly used to investigate attentional processes, the exogenous cueing task. Attentional bias, engagement, and disengagement indices were calculated from reaction time data to assess attention to pain and social threat words. Questionnaires were used to investigate self‐reported health and illness behaviour.Results.  Relative to controls, IBS participants were more biased towards pain than neutral words, showing faster engagement with pain words than controls. Measures of attention to pain words were associated with increased reporting somatic symptoms and sick leave taking.Conclusions.  These results support atypical attention to pain in IBS and suggest these attentional biases are associated with increased pain report and illness behaviour. A vicious circle maintenance model of IBS, in which attentional biases exacerbate symptom perception and illness behaviour, increasing focus on pain, is a potential explanation of

ISSN:1359-107X    

DOI:10.1348/135910710X505887

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objective.  To explore the value of demographics, clinical parameters, and treatment beliefs in predicting attendance at follow‐up visits in a lipid clinic.Design.  Prospective cohort study.Methods.  A total of 104 consecutive patients, who attended the Meir Medical Center lipid clinic for the first time, were followed for an average of 14 months. During the first visit, demographic and clinical parameters were obtained and a treatment beliefs and a self‐rated health questionnaire were completed. Those who kept all scheduled follow‐up visits were categorized as attendees and those who were lost to follow up as non‐attendees. The two groups were compared on demographic and clinical parameters, as well as on treatment and health beliefs.Results.  Lipid target level achievement was higher in attendees (p<.001). However, only 49 patients (47%) attended the scheduled clinic visits. None of the demographic or clinical parameters significantly predicted attendance. Both groups scored high on perceived risk‐to‐health of uncontrolled lipid levels and on perceived effectiveness and benefits of treatment. Non‐attendees reported significantly more perceived barriers and treatment misconceptions/disbeliefs, and lower self‐rated health.Conclusions.  Beliefs concerning lipid‐lowering treatment should be identified so that they may be effectively addressed in order to improve patient attendance at follow

ISSN:1359-107X    

DOI:10.1348/135910710X510232

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objective.  Advances in web‐based animation technologies provide new opportunities to develop graphic health communications for dissemination throughout communities. We developed imagery and text contents of brief, computer‐based programmes about heart disease risk, with both imagery and text contents guided by the common‐sense model (CSM) of self‐regulation. The imagery depicts a three‐dimensional, beating heart tailored to user‐specific information.Design.  A 2×2×4 factorial design was used to manipulate concrete imagery (imagery vs. no imagery) and conceptual information (text vs. no text) about heart disease risk in prevention‐oriented programmes and assess changes in representations and behavioural motivations from baseline to 2 days, 2 weeks, and 4 weeks post‐intervention.Methods.  Sedentary young adults (N= 80) were randomized to view one of four programmes: imagery plus text, imagery only, text only, or control. Participants completed measures of risk representations, worry, and physical activity and healthy diet intentions and behaviours at baseline, 2 days post‐intervention (except behaviours), and 2 weeks (intentions and behaviours only) and 4 weeks later.Results.  The imagery contents increased representational beliefs and mental imagery relating to heart disease, worry, and intentions at post‐intervention. Increases in sense of coherence (understanding of heart disease) and worry were sustained after 1 month. The imagery contents also increased healthy diet efforts after 2 weeks. The text contents increased beliefs about causal factors, mental images of clogged arteries, and worry at post‐intervention, and increased physical activity 2 weeks later and sense of coherence 1 month later.Conclusion.  The CSM‐based programmes induced short‐term changes in risk representations and behaviour motivation. The combination of CSM‐based text and imagery appears to be most effective in instilling risk representat

ISSN:1359-107X    

DOI:10.1348/135910710X511709

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objective.  Risk perceptions play a pivotal role in health behaviour theories. Accurate measurement is essential in order to investigate the explanatory value and effectiveness of interventions influencing these beliefs. This study investigated the reliability and predictive validity of different risk perception operationalizations related to skin cancer and sunscreen use in order to explain the inconsistent findings in literature regarding the relationship between risk perceptions and (cancer related) behaviours.Design and methods.  Two on‐line surveys were conducted. Study 1 (N= 175) was conducted among university students to investigate the test–retest reliability of different operationalizations of perceived likelihood and perceived severity and to assess their correlations with sunscreen use. Study 2 (N= 418) was a prospective study among Dutch adults and assessed longitudinal correlations between the different operationalizations and sunscreen use.Results.  Internal consistency (alpha) ranged between .13 and .90 for likelihood measures and between .37 and .88 for severity measures. Test–retest correlations (r/ICC) ranged between .51 and .82 for the likelihood measures and between .58 and .75 for the severity measures. Conditional likelihood estimates, particularly when phrased affectively (feeling at risk), and comparative severity questions were the strongest correlates of behaviour.Conclusion.  Conditional likelihood and comparative severity might be better predictors of health behaviour than commonly used operationalizations of risk perception. These measures may be relevant for use in the development and evaluation of intervention programmes, and should be acknowledged by health behaviour theories. Suggestions for future research

ISSN:1359-107X    

DOI:10.1348/135910710X514120

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objectives The aim of the study was to test the relations between constructs from the self‐determination theory (autonomous and controlled motivation), the theory of planned behaviour (attitudes, self‐efficacy, and intentions), and behaviour change within a theoretically integrated model. Additionally, the aim was to test if these relations vary by behaviour (physical activity or dietary behaviour) or intervention intensity (frequency).Design. It was a randomized controlled trial with a ‘usual care’ condition (medical screening only) and an intervention condition (medical screening+access to a website and coaching). Participants in the latter condition could freely determine their own intervention intensity.Methods. Participants (N= 287) completed measures of the theoretical constructs and behaviour at baseline and after the first intervention year (N= 236). Partial least squares path modelling was used.Results. Changes in autonomous motivation positively predicted changes in self‐efficacy and intentions towards a healthy diet. Changes in controlled motivation positively predicted changes in attitudes towards physical activity, changes in self‐efficacy, and changes in behavioural intentions. The intervention intensity moderated the effect of self‐efficacy on intentions towards physical activity and the relationship between attitude and physical activity. Changes in physical activity were positively predicted by changes in intentions whereas desired changes in fat intake were negatively predicted by the intervention intensity.Conclusions Important relations within the theoretically integrated model were confirmed but others were not. Moderation effects were found for behaviour and

ISSN:1359-107X    

DOI:10.1348/135910710X519305

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objective.  The objective was to test, in a trial cohort of sedentary adults at risk of Type 2 diabetes, whether theory of planned behaviour (TPB) cognitions about becoming more physically active predicted objective and self‐reported activity levels and change.Design.  Participants of a randomized controlled trial underwent measurement at baseline, 6 and 12 months.Methods.  Participants (N= 365, 30–50 years) were recruited via their parent or family history registers at 20 general practices in the UK. Energy expenditure was measured objectively at baseline and 1 year. Participants completed questionnaires assessing physical activity and beliefs about becoming more physically active over the next year at baseline, 6 and 12 months.Results.  Between baseline and 12 months, objective energy expenditure in the cohort increased by an average of 20 minutes of brisk walking per day. Based on the 252 participants who provided complete data, affective attitude and perceived behavioural control consistently predicted intention, but intention and perceived behavioural control failed to predict physical activity levels or change (p‐values>.05).Conclusions.  Failure of the theory to predict behaviour and behaviour change may be due to inapplicability of the theory to this at‐risk population or to trial participation and intensive measurement facilitating behaviour change without affecting measured cognitions, or lack of correspondence between cognitive and behavioural measures. A wide range of potential personal and environmental mediators should be considered when designing physical activity interventions among at‐risk groups. High‐quality experimental tests of the theory are needed

ISSN:1359-107X    

DOI:10.1348/135910710X523481

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objectives.  Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non‐adherence is unclear. We investigated the relationship between five‐factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non‐adherence among older participants during a six‐year randomized placebo‐controlled trial (RCT).Design.  Observational cohort data from 771 subjects aged ≥72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT ofGinkgo bilobafor prevention of dementia.Methods.  Random effects logistic regression analyses examined effects of NEO Five‐Factor Inventory scores on medication non‐adherence, determined via pill counts every 6 months (median follow‐up 6.1 years) and defined as taking<80% of prescribed pills. Analyses adjusted for covariates linked with non‐adherence in prior studies.Results.  Each 5 year increment in participant age was associated with a 6.7% greater probability of non‐adherence (95% confidence interval, CI [2.4, 11.0]). Neuroticism was the only personality factor associated with non‐adherence: a 1SDincrease was associated with a 3.8% increase in the probability of non‐adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non‐adherence: a 1SDdecrease in mental status exam score was associated with a 3.0% increase in the probability of non‐adherence (95% CI [0.2, 5.9]).Conclusions.  Neuroticism was associated with medication non‐adherence over 6 years of follow‐up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older

ISSN:1359-107X    

DOI:10.1348/135910710X524219

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY

摘要:

Objective.  This study examined the impact of future friends and the contribution of different social influence and selection processes in predicting adolescents' smoking behaviour by extending the theory of planned behaviour (TPB). We investigated the impact of previous smoking, direct pressure from friends, descriptive norms of present and future friends, smoking‐based selection of future friends, and distinguished between reciprocal and desired friends.Design.  A longitudinal design with three measurements was used.Methods.  The sample consisted of 1,475 Dutch high school students (mean age = 12.7 years) that participated as a control group in the European Smoking prevention Framework Approach study at three measurements.Results.  Structural equation modelling revealed that adolescent smoking was influenced by intention, previous smoking, descriptive norms of parents and siblings, and that desired as well as reciprocal friends were selected based on similar smoking behaviour. Future friends indirectly influenced adolescent smoking through intention, as did attitude, subjective norms of parents and siblings, previous smoking, and descriptive norms of reciprocal friends and siblings.Conclusions.  The present results suggest that descriptive norms and selection of friends need to be considered as major factors explaining smoking behaviour among adolescents besides the TPB components. These insights contribute to the further refinement of smoking prevention

ISSN:1359-107X    

DOI:10.1348/135910710X531608

出版商:Blackwell Publishing Ltd    

年代:2011

数据来源: WILEY