摘要:

Objectives.Female cardiac patients' health‐related quality of life (HRQoL) during the first year after an acute cardiac event was compared with age‐weighted Australian population norms. The impact of age, event type and cardiac rehabilitation (CR) programme attendance on recovery was assessed.Methods.The short form 36‐item health survey (SF‐36) was administered to 229 women aged from 36 to 84 years consecutively admitted to 4 hospitals after acute myocardial infarction (AMI) or to undergo coronary artery bypass graft surgery (CABGS). Data were collected at 4 time points over 12 months. SF‐36 subscale scores were compared with age‐weighted norms for Australian women. Mplus was used to analyse growth trajectories for SF‐36 subscales.Results.Patients had impaired HRQoL at baseline (except in general health), with progressive improvement over time. Recovery to normative levels was fastest in the areas of bodily pain and mental health (by 2 months) and slowest in the area of physical functioning, and physical and emotional role limitations (by 12 months). By 4 months, general health scores had surpassed population norms. For all scales, most improvement occurred in the first 2 months, with little subsequent improvement. CABGS patients showed significantly more improvement than AMI patients in several areas, partly due to the poorer functioning of CABGS patients at baseline. Rate of improvement was not influenced by patients' age or frequency of CR attendance.Conclusion.Impairment of HRQoL in female cardiac patients is most pronounced at the time of the event, with most recovery occurring during early convalescence and full recovery in all domains by 12 mont

ISSN:1359-107X    

DOI:10.1348/135910705X90127

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Objectives.Despite the widespread belief that orthodontics improves psychological well‐being and self‐esteem, there is little objective evidence to support this (Kenealyet al., 1989a; Shaw, O'Brien, Richmond,&Brook, 1991). A 20 year follow‐up study compared the dental and psychosocial status of individuals who received, or did not receive, orthodontics as teenagers.Design.A prospective longitudinal cohort design with four studies of the effect of orthodontic treatment. Secondary analysis of outcome data incorporated orthodontic need at baseline and treatment received in a 2 × 2 factorial design.Methods.A multidisciplinary research programme studied a cohort of 1,018, 11–12 year old participants in 1981. Extensive assessment of dental health and psychosocial well‐being was conducted; facial and dental photographs and plaster casts of dentition were obtained and rated for attractiveness and pre‐treatment need. No recommendations about orthodontic treatment were made, and an observational approach was adopted. At the third follow‐up 337 (30–31 year olds) were re‐examined in 2001.Results.Participants with a prior need for orthodontic treatment as children who obtained treatment demonstrated better tooth alignment and satisfaction. However when self‐esteem at baseline was controlled for, orthodontics had little positive impact on psychological health and quality of life in adulthood. Lack of orthodontic treatment where there was a prior need did not lead to psychological difficulties in later life. Dental status alone was a weak predictor of self‐esteem at outcome explaining 8% of the variance. Self‐esteem in adulthood was more strongly predicted (65% of the variance) by psychological variables at outcome: perception of quality of life, life satisfaction, self‐efficacy, depression, social anxiety, emotional health, and by self‐perception of attractiveness.Conclusion.Longitudinal analysis revealed that the observed effect of orthodontic treatment on self esteem at outcome was accounted for by self esteem at baseline. Prior need for treatment assessed in childhood made a small contribution to the prediction of self‐esteem 20 years later in adulthood. Dental status in adulthood, whilst statistically significant, appeared to be of minor importance in a model that included other psychological variables. When prior need for treatment was taken into account there was little objective evidence to support the assumption that orthodontics improves

ISSN:1359-107X    

DOI:10.1348/135910706X96896

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Objectives.In South Africa, a gender power imbalance exists which may prevent women from negotiating safe sexual encounters. In this study we tested which constructs from Protection Motivation Theory (PMT) and the Theory of Planned Behavior (TPB) under these circumstances were most related to condom use intention. We hypothesized that in a situation of gender power imbalance self‐efficacy would be a more salient correlate of intended condom use for females, while for males attitude to condoms and subjective norm would be more important.Design.This study employed a cross‐sectional questionnaire design.Method.Male participants (N= 94) and female participants (N= 101) from Venda, South Africa completed standard, multi‐item, reliable measures of TPB constructs (condom‐related attitude, subjective norm, perceived behavioural control, intention) and PMT constructs (vulnerability, severity, fear, response‐efficacy, self‐efficacy) and reported their past condom use behaviour.Results.Regression analysis indicated that among males attitude to condoms and subjective norm were significantly related to intended condom use. Among females attitude and self‐efficacy were significantly related to intended condom use.Conclusion.The findings indicate that in a situation of gender power imbalance psychosocial correlates of intended condom use differ for males and females. Gender‐specific analysis of determinants of condom use may be more appropriate in a situation of gender

ISSN:1359-107X    

DOI:10.1348/135910706X102104

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Objectives.To measure levels of anxiety, depression and post‐traumatic stress among survivors of a critical illness and to relate these symptoms to general health parameters.Design.A prospective study of patients who had spent a minimum 3 days (median 9 days) in a general intensive care unit (ICU). Of these patients, 51 were interviewed 3 months after discharge and 45 of them were reviewed at 9 months.Methods.General health was assessed by a physical symptom score, the EuroQol ‘thermometer’ and the Short Form 36 (SF‐36) questionnaire. Physical and mental component summary measures (PCS, MCS) were calculated from the SF‐36 data. Psychological health was assessed using both the Hospital Anxiety and Depression Scale and the Impact of Events Scale.Results.At both 3 and 9 months after ICU discharge 24% of patients qualified as a ‘case’ of anxiety, while similar figures were seen for intrusion (24 and 20%). The incidence of depression (35 and 47%) and avoidance (36 and 38%) was higher on each occasion. Four of the eight SF‐36 domains improved with time, as did PCS (from 29.0 to 35.4), but there was no significant difference in physical symptom score, EuroQol value or MCS. Strong correlations were seen between the physical and psychological parameters at each time point.Conclusion.A substantial proportion of patients who survive a critical illness show evidence of anxiety and depression up to 9 months later, and most of them also have symptoms indicative of post‐traumatic stress. Delayed physical recovery may contribute to this psychological morbidity. ICU follow‐up clinics should be able to detect patients suitable for psychol

ISSN:1359-107X    

DOI:10.1348/135910706X94096

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

It is not clear how developmentally appropriate healthcare services for adolescents (11–15) and young adults (16–25) should be provided.Aims.First, to describe and understand the influence of diabetes upon psychosocial development and second, to highlight the implications for healthcare teams.Design.Given the heterogeneity of findings, lack of conceptual clarity and lack of quantitative measures, qualitative semi‐structured interviews were used, to define more clearly the constructs significant to young people.Methods.People aged 16–25 registered with one secondary care diabetes service, across two districts in north‐east England were contacted. Nineteen interviews were conducted and analysed using a Framework Approach.Results.Diabetes can impact upon personal identity and self‐concept. Peer support can buffer from negative effects, especially if young people control the disclosure of their diabetes. In coming to rely more on peers, participants continue to value the safe base of their family, especially at times of change and challenge. A key challenge appears to be coming to terms with risk and mortality.Conclusion.Health care services need to support young people with self‐care but must also understand and respond to the social and personal complexities of growing‐up with a long‐term health condition. Psychologists may have a role in promoting and supporting

ISSN:1359-107X    

DOI:10.1348/135910706X98317

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Objectives.To elicit salient beliefs about walking for an average of 30 minutes per day, with the aims of investigating whether the order of Theory of Planned Behaviour (TPB) belief elicitation questions affects the number and types of beliefs elicited and whether affective and instrumental questions elicit different beliefs.Design.A 3 × 2×2 × 2 mixed factorial design was employed, with order of behavioural, normative and control questions, and affective and instrumental questions as between‐subjects variables, and affective/instrumental and positive/negative questions as within‐subjects variables.Method.Quota sampling with regards to age and gender (N= 180) was employed to obtain a sample that was broadly representative of the adult general population.Results.The order in which behavioural, normative and control beliefs were asked had little impact on the number or type of beliefs elicited. The affective/instrumental attitude distinction was supported. Few differences were apparent between older and younger respondents and between men and women.Conclusion.TPB belief elicitation studies are not biased by order effects. Interventions to promote walking should consider targeting affective beliefs, e.g. stress relief, in addition to beliefs about health, which is the traditional focus of health campaigns. Given the similarities in beliefs across demographic groups, ‘one size fits all’ interventions to promote walking are a

ISSN:1359-107X    

DOI:10.1348/135910706X100458

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Objectives.This study investigated the novel use of written emotional disclosure procedures for motivating health behavior change, specifically engagement in breast self examination (BSE) among college‐aged women. Writing instructions were tailored to a precontemplative stage of change in accordance with the transtheoretical model proposed by Prochaska and DiClemente (1983) to test the hypothesis that stagematched writing strategy would facilitate greater contemplation than a stage‐mismatched writing strategy and a control condition.Design and methods.Precontemplative women (N= 55) were randomly assigned to one of three groups: (a) a stage‐matched consciousness‐raising writing exercise; (b) a stage‐mismatched BSE action‐oriented exercise; or (c) a control condition, and measured on contemplation, preparation, and action, as well as performance of BSEs.Results.Analyses indicated that both the consciousness‐raising writing exercise and the BSE action‐oriented exercise increased participants' level of contemplation when compared to the control condition. Women assigned to the BSE action‐oriented exercise endorsed more statements indicative of an action stage of change and exhibited a trend for greater performance of BSE compared to the other two conditions.Conclusion.The application of writing exercises and the relevance of stage‐matching is discussed in the context of the st

ISSN:1359-107X    

DOI:10.1348/135910706X93637

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Objectives.To determine which variables from a pool of potential predictors predict General Health Questionnaire ‘caseness’ in pre‐registration nursing students.Design.Cross‐sectional survey, utilizing self‐report measures of sources of stress, stress (psychological distress) and coping, together with pertinent demographic measures such as sex, ethnicity, educational programme and nursing specialty being pursued, and age, social class and highest qualifications on entry to the programme.Methods.Questionnaire packs were distributed to all pre‐registration nursing students (N= 1,362) in a large English university. Completed packs were coded, entered into statistical software and subjected to a series of logistic regression analyses.Results.Of the questionnaire packs 1,005 (74%) were returned, of which up to 973 were available for the regression analyses undertaken. Four logistic regression models were considered and, on the principle of parsimony, a single model was chosen for discussion. This model suggested that the key predictors of caseness in the population studied were self‐report of pressure, whether or not respondents had children (specifically, whether these children were pre‐school or school‐age), scores on a ‘personal problems’ scale and the type of coping employed. The overall caseness rate among the population was around one‐third.Conclusion.Since self‐report and personal, rather than academic, concerns predict stress, personal teachers need to play a key role in supporting students through ‘active listening’, especially when students self‐report high levels of stress and where personal/social problems are evident. The work‐life balance of students, especially those with child‐care responsibilities, should be a central tenet in curriculum design in nurse education (and, indeed, the education of other professional and occupational groups). There may be some benefit in offering stress management (coping skills) training to nursing students and, in

ISSN:1359-107X    

DOI:10.1348/135910706X98524

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY

摘要:

Purpose.The domestic dog is one of the most commonly owned, and widely utilized, animals in today's society. This paper provides an overview of research that has explored the relationship between the domestic dog and human well‐being.Methods.The article initially concentrates on the value of dogs for physical health in humans, exploring the evidence that this species can prevent us from becoming ill, facilitate our recovery from ill‐health, and even serve as an early warning system for certain types of underlying ailment including cancer, oncoming seizures and hypoglycaemia. The paper then examines the relationship between dogs and psychological health in humans, exploring the ability of this species to aid the disabled and serve as a therapist to those in institutional settings such as hospitals, residential homes and prisons. Weaknesses in the existing research in this area are highlighted throughout the article.Conclusion.Taken together, the studies reviewed suggest that dogs can have prophylactic and therapeutic value for peo

ISSN:1359-107X    

DOI:10.1348/135910706X103284

出版商:Blackwell Publishing Ltd    

年代:2007

数据来源: WILEY