摘要:

Objective. Studies examining the relationship between adverse life events and breast cancer have produced conflicting results. A systematic review of the published studies was therefore carried out. Methods. Electronic databases and bibliographies of review articles were searched for studies in any language. Studies were assessed for methodological quality by two reviewers. Results. Twenty‐nine studies were found. These were of variable quality. Random effects meta‐analysis of the higher quality studies found no significant relationship between breast cancer and either bereavement (summary odds ratio(OR)=0. 9;95% confidence interval (CI) 0. 57 to 1. 45) or other adverse life‐events (summary OR=0. 8; 95% CI 0. 61 to 1. 06). Funnel plots may be suggestive of publication bias, with small studies reporting negative findings less likely to be published. Conclusions. Good quality case‐control studies, and the single large prospective study in this area, do not support the hypothesis of a casual relationship between adverse life events and onset of breast

ISSN:1359-107X    

DOI:10.1348/135910799168434

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY

摘要:

Objectives. Increasing availability of predictive testing highlights the importance of understanding the decision‐making process when people are confronted with the optionto have testing. The present study aimed to demonstrate experimentally the impact of (i) providing relatively positive versus relatively negative information, and (ii) focusing on positive or negative issues, on anticipated decisions regarding genetic testing. Method. Two experimental studies were carried out in order to investigate what influences the anticipated decision, one relating to breast cancer and the other heart disease. In each study, participants were randomly allocated to either the positive, the negative or the control group. There were two consecutive experimental manipulations. Firstly, participants were given further information on detecting and preventing the disease (positive group) and on the limitations of these methods (negative group). The control group received information about the common cold. Secondly, participants were encouraged to focus on positive (positive group) or negative (negative group) issues of predictive testing. The control group focused on statements referring to the common cold. Participants made pre‐experimental and post‐information and post‐focusing ratings including how likely they would be to opt for the test. Results. Both information and the focusing manipulations separately modified the rating of anticipated likelihood of being tested in the expected direction. There was also a significant decrease of rated anxiety in the negative group. Conclusion. It appears that anticipated decisions are strongly influenced not only by the information received by the decision maker, but also by the factors on which the decision maker focuses at the time of the decision. This second result in particular has implications for the way in which pre‐test counselling is carried out; counsellors may believe that they are being non‐directive in their questioning when they are in fact directly and systematically influencing the decision whether or not t

ISSN:1359-107X    

DOI:10.1348/135910799168443

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY

摘要:

Objectives. To investigate the nature of patients' perceptions of the role of the general practitioner in the management of emotional problems in primary care; the association between patient characteristics and perceptions; and the association between perceptions and the recognition of psychiatric morbidity by the GP. Design. Cross‐sectional correlation design. Methods. Patients attending their GPs completed the General Health Questionnaire (N = 1511) and a scale measuring perceptions of the GP's role (the Patient Perceptions Scale (PPS), N = 867). Forty‐three volunteer GPs assessed patients for psychiatric symptomatology. Self‐report and GP assessments of psychiatric status were compared to examine detection of disorder. Results. Principal component analysis of responses to the PPS indicated four dimensions. A multilevel model indicated that some of these PPS dimensions were related to patient age, sex and current levels of psychiatric symptomatology. Furthermore, in one dimension there was significant variation at the GP level (i. e. in the average PPS scores between patients consulting different GPs). The likelihood of a patient with significant psychiatric symptoms being recognized was related to the disorder's severity and to the patient's perception of the degree to which the GP was oriented to the management of emotional problems. There were no other significant associations with the perception questionnaire factors or patient demographic characteristics. Conclusions. The perceived role of the GP in the management of emotional problems varies among patients, reflecting both patient characteristics and the characteristics of their own GP. Perceptions of the orientation of the GP towards emotional issues may influence the likelihood of the recognition of dis

ISSN:1359-107X    

DOI:10.1348/135910799168452

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY

摘要:

Objective. To determine what patients considered important to gain from consultation, the extent to which these expectations were fulfilled and the relationship of this to patient satisfaction and distress. Congruence between patient and doctor expectations was also examined. Design. This was a questionnaire study using a repeated measures (pre‐ and postconsultation) design. Methods. Expectations of clinic attendance were assessed in 29 male clinic attenders. Participants completed questionnaires before and after consultation. Visual analogue scales were used to assess patient expectations of the consultation and the extent to which expectations were fulfilled. Results. Men rated increasing the chance of their partner conceiving as most important, with gaining information also rated highly. Informational expectations were rated more highly than discussing feelings. Following consultation, patients felt they had gained understanding and their expectations of having help with decision making were fulfilled. They rated their satisfaction with the consultation as high and distress during consultation low. Despite the fact that increasing chances of pregnancy was an important expectation, failure to fulfil this expectation did not relate to satisfaction. There was no significant correlation between doctor and patient ratings of distress. Conclusion. It appears that the medical consultation has a role beyond simply finding ways to increase the chance of pregnancy. For these men the benefits of increasing understanding seemed to outweigh the disappointment of not having pregnancy expectations increased as much as they had hoped for. Patients did not appear to be seeking emotional support from the consultatio

ISSN:1359-107X    

DOI:10.1348/135910799168461

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY

摘要:

Objectives. This paper describes two experiments which develop a self‐categorization theory (SCT) (Turner, Hogg, Oakes, Reicher&Wetherell, 1987) approach to the way people make sense of their symptoms. The first experiment builds upon a study by Levine&Reicher (1996) in which it is proposed that symptoms are evaluated, not against pre‐existing illness representations, but by reference to their impact on situationally salient identities. The second experiment extends the SCT perspective on symptom evaluation to argue that the identities that are instrumental in assigning meaning to symptoms are themselves situationally constructed. Design and methods. In the first experiment, 40 female secretaries, defined either in terms of a ‘secretary’ identity or in terms of a ‘gender’ identity, were asked to evaluate a number of scenarios which describe different illnesses or injuries. In the second experiment 40 men from a rugby club were asked to evaluate a number of scenarios relating to illness and injuries. The identity from which scenarios were evaluated was held constant, but the comparison groups (or frame of reference) was manipulated. Results. Overall, the results of the first study provide clear evidence that the significance ascribed to scenarios depends on which identity is salient. The results from the second study provide clear evidence that the significance ascribed by the males to the scenarios was a function of the comparison groups they believed they were being compared to. Conclusions. Taken together, these two experiments provide strong evidence for the viability of an SCT approach to symptom

ISSN:1359-107X    

DOI:10.1348/135910799168470

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY

摘要:

Objectives. In the present study we investigate the relevance of the monitoring‐blunting concept to the realm of health behaviour, and to health promotion and disease detection behaviour in particular. Design. The study is correlational in character, supplemented with some qualitative data. Methods. Sixty participants of varying sex, age and educational level filled out the Threatening Medical Situations Inventory, measuring the monitoring and blunting coping style, and the newly developed Health Promotion‐Detection Questionnaire, intended to measure the tendencies to exhibit health promotion and disease detection behaviours. In addition, they answered a few open questions concerning their health. Results. It emerged that disease detection behaviour is positively related to age, and it is more often carried out for health reasons than health promotion behaviour. The monitoring coping style is significantly, though modestly, related to both health promotion and disease detection. The latter relation still holds when we controlled for age and gender. No relations with blunting were found, except for individual health behaviours. Conclusion. The results of the present study encourage further investigation of the role of coping styles in the performance of different types of health behaviours. Hereby, the further distinction between health strivings of the approach and the avoidance type may prove use

ISSN:1359-107X    

DOI:10.1348/135910799168489

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY

摘要:

Book reviewed in this article:Perceptions of Health and Illness: Current Research and Applications. Edited by Keith J. Petrie&John A. Weinman. AmsterdamCulture and Health. ByMalcolm MacLachlan. Chichester

ISSN:1359-107X    

DOI:10.1348/135910799168498

出版商:Blackwell Publishing Ltd    

年代:1999

数据来源: WILEY